    [Senate Hearing 112-80, Part 6]
    [From the U.S. Government Publishing Office]

                                                      S. Hrg. 112-80, Pt. 6

    DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
                   2012 AND THE FUTURE YEARS DEFENSE PROGRAM

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

                                    HEARINGS

                                   before the

                          COMMITTEE ON ARMED SERVICES
                              UNITED STATES SENATE

                          ONE HUNDRED TWELFTH CONGRESS

                                 FIRST SESSION

                                       ON

                                    S. 1253

         TO AUTHORIZE APPROPRIATIONS FOR FISCAL YEAR 2012 FOR MILITARY
    ACTIVITIES OF THE DEPARTMENT OF DEFENSE AND FOR MILITARY CONSTRUCTION,
    TO PRESCRIBE MILITARY PERSONNEL STRENGTHS FOR FISCAL YEAR 2012, AND FOR
                                 OTHER PURPOSES

                                   ----------

                                     PART 6

                                   PERSONNEL

                                   ----------

                           APRIL 13; MAY 4, 11, 2011

             Printed for the use of the Committee on Armed Services

    DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
          2012 AND THE FUTURE YEARS DEFENSE PROGRAM--Part 6  PERSONNEL

                                                       S. Hrg. 112-80 Pt. 6

    DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
                   2012 AND THE FUTURE YEARS DEFENSE PROGRAM

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

                                    HEARINGS

                                   before the

                          COMMITTEE ON ARMED SERVICES
                              UNITED STATES SENATE

                          ONE HUNDRED TWELFTH CONGRESS

                                 FIRST SESSION

                                       ON

                                    S. 1253

         TO AUTHORIZE APPROPRIATIONS FOR FISCAL YEAR 2012 FOR MILITARY
    ACTIVITIES OF THE DEPARTMENT OF DEFENSE AND FOR MILITARY CONSTRUCTION,
    TO PRESCRIBE MILITARY PERSONNEL STRENGTHS FOR FISCAL YEAR 2012, AND FOR
                                 OTHER PURPOSES

                                   __________

                                     PART 6

                                   PERSONNEL

                                   __________

                           APRIL 13; MAY 4, 11, 2011

                                   __________

             Printed for the use of the Committee on Armed Services

            Available via the World Wide Web: http://www.fdsys.gov/

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                           COMMITTEE ON ARMED SERVICES

                         CARL LEVIN, Michigan, Chairman

    JOSEPH I. LIEBERMAN, Connecticut     JOHN McCAIN, Arizona
    JACK REED, Rhode Island              JAMES M. INHOFE, Oklahoma
    DANIEL K. AKAKA, Hawaii              JEFF SESSIONS, Alabama
    E. BENJAMIN NELSON, Nebraska         SAXBY CHAMBLISS, Georgia
    JIM WEBB, Virginia                   ROGER F. WICKER, Mississippi
    CLAIRE McCASKILL, Missouri           SCOTT P. BROWN, Massachusetts
    MARK UDALL, Colorado                 ROB PORTMAN, Ohio
    KAY R. HAGAN, North Carolina         KELLY AYOTTE, New Hampshire
    MARK BEGICH, Alaska                  SUSAN M. COLLINS, Maine
    JOE MANCHIN III, West Virginia       LINDSEY GRAHAM, South Carolina
    JEANNE SHAHEEN, New Hampshire        JOHN CORNYN, Texas
    KIRSTEN E. GILLIBRAND, New York      DAVID VITTER, Louisiana
    RICHARD BLUMENTHAL, Connecticut

                       Richard D. DeBobes, Staff Director

                   David M. Morriss, Minority Staff Director

                                     ______

                           Subcommittee on Personnel

                          JIM WEBB, Virginia, Chairman

    JOSEPH I. LIEBERMAN, Connecticut     LINDSEY GRAHAM, South Carolina
    DANIEL K. AKAKA, Hawaii              SAXBY CHAMBLISS, Georgia
    CLAIRE McCASKILL, Missouri           SCOTT P. BROWN, Massachusetts
    KAY R. HAGAN, North Carolina         KELLY AYOTTE, New Hampshire
    MARK BEGICH, Alaska                  SUSAN M. COLLINS, Maine
    RICHARD BLUMENTHAL, Connecticut      DAVID VITTER, Louisiana

                                      (ii)

                                C O N T E N T S

                                  ----------

                        CHRONOLOGICAL LIST OF WITNESSES
            Active, Guard, Reserve, and Civilian Personnel Programs
                                 april 13, 2011

                                                                       Page

    Nelson, Hon. Bill, U.S. Senator from the State of Florida........     3
    Chandler, SGM Raymond F., III, Sergeant Major of the Army, USA...     6
    Kent, Sgt. Maj. Carlton W., Sergeant Major of the Marine Corps,
      USMC...........................................................    10
    West, MCPON Rick D., Master Chief Petty Officer of the Navy, USN.    25
    Roy, CMSAF James A., Chief Master Sergeant of the Air Force, USAF    33
    Barnes, Master Chief Joseph L., USN (Ret.).......................    68
    Strobridge, Col. Steven P., USAF (Ret.), Director of Government
      Relations, Military Officers Association of America............    76
    Moakler, Kathleen B., Government Relations Director, National
      Military Family Association....................................   106
    Puzon, CAPT Ike, USN (Ret.)......................................   132
    Roth-Douquet, Kathy, Chairman, Blue Star Families................   146

     Continuation of Testimony on the Active, Guard, Reserve, and Civilian
                               Personnel Programs
                                  may 4, 2011

    Stanley, Hon. Clifford L. Under Secretary of Defense for
      Personnel and Readiness........................................   189
    Hale, Hon. Robert F., Under Secretary of Defense, Comptroller,
      and Chief Financial Officer....................................   225
    McCarthy, Hon. Dennis M., Assistant Secretary of Defense for
      Reserve Affairs................................................   232
    Woodson, Hon. Jonathan, M.D., Assistant Secretary of Defense for
      Health Affairs, Director of TRICARE Management Activity........   248

     Continuation of Testimony on the Active, Guard, Reserve, and Civilian
                               Personnel Programs
                                  may 11, 2011

    Lamont, Hon. Thomas R., Assistant Secretary of the Army for
      Manpower and Reserve Affairs...................................   308
    Bostick, LTG Thomas P., USA, Deputy Chief of Staff G-1, U.S. Army   320
    Garcia, Hon. Juan M., III, Assistant Secretary of the Navy for
      Manpower and Reserve Affairs...................................   321
    Ferguson, VADM Mark E., III, USN, Chief of Naval Personnel, U.S.
      Navy...........................................................   345
    Milstead, Lt. Gen. Robert E., Jr., USMC, Deputy Commandant for
      Manpower and Reserve Affairs, U.S. Marine Corps................   346

                                     (iii)

    Ginsberg, Hon. Daniel B., Assistant Secretary of the Air Force
      for Manpower and Reserve Affairs...............................   347
    Jones, Lt. Gen. Darrell D., USAF, Deputy Chief of Staff for
      Manpower, Personnel, and Services, U.S. Air Force..............   355

    DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
                   2012 AND THE FUTURE YEARS DEFENSE PROGRAM

                                  ----------

                           WEDNESDAY, APRIL 13, 2011

                                   U.S. Senate,
                             Subcommittee on Personnel,
                                   Committee on Armed Services,
                                                        Washington, DC.

            ACTIVE, GUARD, RESERVE, AND CIVILIAN PERSONNEL PROGRAMS

        The subcommittee met, pursuant to notice, at 1:34 p.m. in
    room SR-222, Russell Senate Office Building, Senator Jim Webb
    (chairman of the subcommittee) presiding.
        Committee members present: Senators Webb, Blumenthal, and
    Ayotte.
        Majority staff members present: Jonathan D. Clark, counsel;
    Gabriella E. Fahrer, counsel; and Gerald J. Leeling, counsel.
        Minority staff members present: Diana G. Tabler,
    professional staff member; and Richard F. Walsh, minority
    counsel.
        Staff assistants present: Jennifer R. Knowles and Christine
    G. Lang.
        Committee members' assistants present: Juliet Beyler and
    Gordon Peterson, assistants to Senator Webb; Lindsay Kavanaugh,
    assistant to Senator Begich; Jeremy Bratt, assistant to Senator
    Blumenthal; Charles Prosch, assistant to Senator Brown; and
    Brad Bowman, assistant to Senator Ayotte.

            OPENING STATEMENT OF SENATOR JIM WEBB, CHAIRMAN

        Senator Webb. The subcommittee will come to order.
        I would like to begin by saying we are awaiting the arrival
    of Senator Nelson, who is scheduled to be the first witness,
    but we're going to go ahead and proceed. If he has not arrived
    by the time I finish with my opening statement, if he arrives
    while you're testifying, then we will interrupt the testimony
    and take his statement.
        The subcommittee meets today to receive testimony on the
    Active, Guard, Reserve, and civilian personnel programs in
    review of the National Defense Authorization Request for Fiscal
    Year 2012 and the Future Years Defense Program.
        Today, we hear from the senior enlisted advisor of each
    military Service, as well as representatives from
    servicemember-oriented beneficiary groups.
        The Committee on Armed Services is an authorizing committee
    with the responsibility to examine and oversee all Department
    of Defense (DOD) programs and budgets. The Subcommittee on
    Personnel is responsible for oversight of all personnel
    programs, to include military personnel policy, pay, and
    benefits for Active Duty, Reserve, and retired military
    personnel and their families, military healthcare, and civilian
    personnel policy for DOD civilian employees.
        I am delighted to be serving with Senator Graham, as the
    ranking member, of this subcommittee. I don't believe he's
    going to be able to make the hearing today. But, for the
    record, and again, I'd point out that his experiences as a
    member of this subcommittee and as an Air Force Reserve officer
    adds a valuable perspective to our considerations. I've really
    enjoyed working with Senator Graham during my first year as
    chair of this subcommittee, and I know we're going to have that
    same cooperation again.
        I'd like to also welcome Senators Blumenthal and Ayotte to
    the subcommittee. I think it's the first time we've met this
    year. We have a really great group of people here on these
    issues. I think we're very bipartisan in looking to the well-
    being of our men and women in uniform.
        In the event that the past few weeks and months have not
    made it obvious, Congress is taking a very careful look at
    budgets and spending levels; and DOD is not immune. Secretary
    Gates has embarked on an ambitious effort to realize
    efficiencies and save taxpayer dollars within the Department.
    As Joint Chiefs Chairman Admiral Mullen has said, the national
    debt may be our biggest national security threat as we move
    forward.
        In this spirit during our hearings this year on this
    subcommittee, I intend to take a closer look at department
    programs, the justifications, what they cost, and whether they
    are achieving their stated goals. To ensure that DOD obtains
    the greatest return on investment for every dollar it spends,
    Congress must do its part to make sure that funded programs are
    effective and efficient. Those that are not should be
    eliminated, and those that are should be sustained properly or
    perhaps even expanded, if necessary. This approach is fully in
    keeping with our roles as stewards of the public trust and
    taxpayer dollars. It's also a practice that was in place in the
    1980s, when I was Assistant Secretary of Defense and Secretary
    of the Navy.
        Our witnesses today do not have responsibility for
    developing the Department's budget. What they do have,
    collectively, is more than 120 years of military service among
    them, an acute sense of the challenges that our soldiers,
    sailors, airmen, marines, and their families face as we enter,
    now, the 10th year of sustained combat operations. I will look
    to each of our witnesses today, as the senior enlisted advisors
    of their Services, to give their frank advice regarding the
    health of the enlisted force, what programs and activities
    work, and which of them might need to be eliminated, expanded,
    or changed to ensure that we are properly attending to the
    well-being of our enlisted servicemembers and their families.
        In reading past testimony, it's clear that all of these
    senior advisors rightly focus on quality of life in military
    families. Our military families, while by and large handling
    the stress of frequent and lengthy deployments, continue to
    face serious challenges.
        Having served in combat as a marine in Vietnam, I know what
    it's like to be deployed. Having grown up in a military family,
    I know what it's like to have a parent deployed. As a father
    and father-in-law of enlisted infantry marines, I also know
    what it's like to have a child deployed, although I don't think
    either of those marines would appreciate the fact that I just
    called them a ``child.'' [Laughter.]
        Senator Webb. I am acutely mindful of our special
    obligation to see to the needs of servicemembers and their
    families and I take that responsibility very seriously.
        In this regard, I have, in the past, declined to support
    the administration's proposed fee increase for military
    healthcare for certain military retirees. I think most of you
    know that. I start from the presumption that lifetime
    healthcare for career military personnel is part of a moral
    contract between our government and those who step forward to
    serve. In my view, they have earned this benefit through their
    years of service, and it would be wrong to change that benefit
    after they've held up their end of a moral contract. I'll keep
    an open mind about discussion on this and other initiatives to
    improve the efficiency and effectiveness of our military
    healthcare benefits. I'm interested in what our witnesses today
    might have to say about these and other proposals.
        Finally, I'd like to acknowledge the work done by the First
    Lady, Michele Obama, and Dr. Jill Biden in support of military
    families. Yesterday, they launched Joining Forces, a program
    that seeks to bring together the private and public sectors to
    ensure that military families have the support they need. I
    know that Blue Star Families and the National Military Family
    Association (NMFA), represented on the second panel, have
    worked with the White House on this promising effort, and I
    look forward to hearing more about it.
        Before introducing our witnesses, I would like to welcome
    Senator Bill Nelson to the hearing and back to the Armed
    Services Committee, on which he spent many years. He has asked
    to appear before us to deliver a statement, relative to a piece
    of legislation that he has introduced--I believe he has
    introduced it every year over the past decade--to repeal the
    offset of the Survivor Benefit Plan (SBP) Annuity by Dependency
    and Indemnity Compensation (DIC).
        Senator Nelson, welcome. We appreciate your presence today.

     STATEMENT OF HON. BILL NELSON, U.S. SENATOR FROM THE STATE OF
                                FLORIDA

        Senator Nelson. Mr. Chairman, thank you for your long
    service to the country and for your continued service. Even
    though you've announced your retirement from the Senate, that
    service that has been, as we say in the south, ``in your
    bones,'' will continue, and we appreciate it very much.
        I want to come and speak about this legislation, that you
    accurately noted that we have filed every year, about the
    inequity in the treatment of military survivors.
        There's a longstanding problem in our military survivor
    benefit system. The requirement for a dollar-for-dollar
    reduction in the SBP annuity by the amount--and offset by the
    amount of the Dependency and Indemnity Compensation received by
    the Department of Veterans Affairs--it's that inequity that I
    want to address and that I have addressed each year that I have
    been here. Over the years, we have chipped away at it, but the
    basic inequity is still there.
        Obviously, we are in a tough fiscal environment, and
    obviously, there are many worthy pieces of legislation to be
    funded. I realize that, in this environment, we are going to
    have to find an offset. What has typically happened, we always
    pass this in the Senate and it goes to the conference. Because
    of the cost of this legislation, it's dropped in the conference
    or it is whittled away at in a minor way.
        Interestingly, the cost is dropping. As the survivors
    increasingly diminish in number, the cost of this, actuarially
    projected, is dropping.
        But, nevertheless, I am here to say to your subcommittee,
    Mr. Chairman, that I am committed to finding an offset.
        I don't want to tell you what the offset ought to be,
    because what I learned from last week's experience is that you
    can be very creative in finding offsets and new sources of
    revenue, as we found in the negotiations that went on between
    the President and the Majority Leader and the Speaker of the
    House last week.
        This benefit plan is an optional program for military
    retirees, offered by DOD. The military retirees pay a premium
    out of their retirement pay to ensure that their survivors will
    have income, upon their death. It's reasonably priced
    insurance. But, from the public marketplace, that's not
    necessarily available, reasonably priced, usually because there
    are service-connected disabilities and health issues. So, SBP
    is a way for retirees to provide income insurance for their
    survivors, their family, and it pays them 55 percent of their
    retired pay. SBP is also paid to survivors when a servicemember
    dies on Active Duty. So, it's an insurance program.
        On the flipside, DIC is a survivor benefit administered by
    the Department of Veterans Affairs (VA). When military service
    caused the servicemember's death, either due to service-
    connected disability or illness or Active-Duty death, survivors
    are entitled to monthly compensation of just over $1,100 a
    month from the VA.
        Of the 270,000 survivors receiving SBP, about 54,000 of
    them are subject to the offset. According to the Defense
    actuary, for 31,000 survivors, SBP is completely offset by DIC;
    meaning that the survivor receives no SBP and must live on that
    $1,100, alone. Retirees bought into the Survivors Benefit Plan
    in good faith, they paid good money. These military families
    planned for the future, and the government offsets it.
        There are other complications to the existing offset,
    including a court decision, in 2009. It requires surviving
    widows to remarry after age 57 in order to eliminate the
    offset. I can't figure that one out, and obviously, this
    shouldn't be tolerated.
        Mr. Chairman, I had a little bit of experience in
    insurance, before I came to the Senate, as the elected
    insurance commissioner of Florida. This offset is troubling
    when somebody buys an insurance policy and there's another
    government program over here, called Disability Indemnity. I
    know of no purchased annuity that would deny payment based on
    the receipt of a different payment.
        You are not only a student of history, Mr. Chairman, you
    are a historian and you are a great writer. You certainly
    recall those immortal words of President Lincoln, in his second
    inaugural address, in which he said, ``Finish the work we are
    in to bind up the Nation's wounds, to care for him who shall
    have borne the battle, and for his widow and his orphan.'' That
    encapsulates what I am trying to say here, and have been trying
    to say for over a decade. To honor these servicemembers, the
    government should take care of the veterans, their widows, and
    their orphans.
        Since 2005, the Senate has supported this almost every
    year. Then we go, in the provision being offset when we get
    into conference.
        We made some steps in the right direction. I hope that we
    can find mandatory spending offsets to pay for this
    legislation, which is always the reason that is given to ax it.
        The Congressional Budget Office informs me that it will
    cost roughly $6.6 billion to completely eliminate the offset
    over 10 years. When I started out on this, a decade ago, the
    cost was upwards of $12- and $15 billion for a 10-year period.
    I would ask you all, in this subcommittee, to consider that as
    we put the legislation together for the authorization bill.
        I would just conclude, Mr. Chairman, by saying that, as the
    President, in his second inaugural address, in the midst of the
    Civil War, said, ``To take care of him, his orphan, and his
    widow is a cost of war,'' one of the costs of war is not only
    what we buy in the way of equipment and salaries, but a cost of
    war is taking care of our veterans and their survivors.
        I humbly submit this to the committee for your
    consideration.
        Senator Webb. It's very compelling testimony. I thank the
    Senator very much.
        Senator Nelson. By the way, Mr. Chairman, there are several
    members of this subcommittee that are cosponsors of the
    legislation.
        Senator Webb. Just as a matter of historical record, my
    father paid into SBP from 1969 to 1997 in order to be able to
    have my mother have an annuity when he passed away. When he
    passed away, there was another problem in this program that
    you're aware of, where they offset out of her Social Security
    when she started receiving the SBP annuity in 1997.
        So, this is a program that's had kind of a complicated
    history, and we'll certainly take a strong consideration of
    your legislation, as has been done in the past. We thank you
    very much for your testimony today.
        Senator Nelson. Thank you very much.
        Senator Webb. I'd like to now welcome the first panel of
    witnesses for this hearing: Sergeant Major of the Army, Raymond
    Chandler III; Master Chief Petty Officer of the Navy, Rick B.
    West; Sergeant Major of the Marine Corps, Carlton W. Kent; and
    Chief Master Sergeant of the Air Force, James Roy.
        We welcome all of you, look forward to hearing your frank
    and candid testimony, which I have no doubt we will be
    receiving.
        I'll have to get advice from counsel, is there a protocol
    done by Services? I'm a little partial to the Marine Corps.
    [Laughter.]
        Okay. We're going to start with the Army and move over to
    the Air Force.
        Sergeant Major Chandler, welcome.

    STATEMENT OF SGM RAYMOND F. CHANDLER III, SERGEANT MAJOR OF THE
                               ARMY, USA

        Sergeant Major Chandler. Good afternoon.
        Senator Webb. I would ask that you summarize your
    statements in 5 minutes, and your full statements will be
    entered into the record as if read.
        Sergeant Major Chandler. Thank you, Mr. Chairman.
        Chairman Webb, members of this committee, thank you for
    your invitation to testify today on our Army's quality of life.
    I truly appreciate this committee's commitment to our 1.1
    million soldiers, their families, and our Department of the
    Army civilians.
        I'm still relatively new to this job, but after being
    around the Army for almost 30 years, I have seen first-hand the
    important decisions this committee makes on behalf of our
    military every day.
        I pledge to always be a point of contact, should you ever
    have any questions or comments about our soldiers, equipment,
    training, or quality-of-life programs.
        Our top priorities will be to continue to maintain our
    combat edge while reconstituting our force and building
    resilience in our soldiers and families. During the last
    several years, we have made significant progress in restoring
    balance to our four imperatives: sustain, prepare, reset, and
    transform.
        Increasing the dwell time between deployments is the single
    most important component of restoring balance. Most of our
    Active Duty soldiers deploying in October 2011 have the
    expectation that, after 1 year of deployment, they will be able
    to spend 2 years at home. Most of our Army National Guard and
    Army Reserve soldiers will be home for 4 years before possibly
    deploying again.
        I truly appreciate all the work Congress has done for our
    soldiers in the areas of behavioral health, wounded warrior
    care, and TRICARE. With your help, we have provided our
    soldiers, families, and civilians the best possible care,
    support, and services.
        Our focus continues to be improving access to, and
    predictability for, our services. We continue to enhance
    support for our wounded, families of our fallen, victims of
    sexual assault, and those with behavioral health issues.
        Our soldiers have also begun chain-teaching to prepare for
    the repeal of Don't Ask, Don't Tell. We are currently
    conducting chain-teaching classes, with a completion date of
    mid- to late August.
        One of the main reasons our soldiers are so successful
    around the world is our diversity. The Army offers
    opportunities to men and women of all backgrounds to be an
    integral part of our All-Volunteer Force. In this time of
    globalization, our Army needs diverse leaders in order to
    successfully interact with different cultural groups.
        The women of our Army continue to serve this Nation with
    honor and distinction. The Army has reviewed our assignment
    policies and regulations to ensure they are relevant and meet
    the needs of current conditions and emerging requirements. This
    ensures all soldiers, regardless of gender, are offered the
    opportunity to reach their highest potential.
        Financial responsibility is everyone's business. We must
    serve as good stewards of the financial resources we receive
    from our Nation. As part of our efficiencies review, we are
    currently looking at removing redundant programs while
    streamlining those that serve a vital purpose. I welcome your
    ideas on this process.
        In closing, I want to stress the amazing work done every
    day by our Army team. As Sergeant Major of the Army, the best
    part of my job is visiting our soldiers, families, and
    civilians across the world. The professionalism, dedication,
    and sacrifice they display every day is the reason our Army,
    your Army, is the envy of every other in the world.
        I appreciate this opportunity to speak before you today to
    tell the Army's story. I welcome your questions at this time.
        Thank you, and Army Strong.
        [The prepared statement of Sergeant Major Chandler
    follows:]
             Prepared Statement by SGM Raymond F. Chandler III, USA
                                  introduction
        Chairman Webb, Senator Graham, and members of this subcommittee,
    thank you for your invitation to testify today on our Army's quality of
    life. I truly appreciate this committee's commitment to the 1.1 million
    soldiers, their families, and the Department of Army civilians. I am
    still relatively new in this job, but after being around the Army for
    almost 30 years, I have seen first-hand the important decisions this
    committee makes on behalf of our military every day.
        This subcommittee has a tremendous responsibility, ensuring we have
    the correct end strength and policies in place for our soldiers today
    and in the foreseeable future. I pledge to always be a point of contact
    should you ever have any questions or comments about our soldiers,
    training, or quality of life programs.
        The Army recognizes that it is our responsibility to serve as good
    stewards of the financial resources we receive from our Nation. As part
    of our efficiencies review, we are currently looking at removing
    redundant or underperforming programs while streamlining those that
    serve a vital purpose and we welcome your ideas on this process.
        The Army continues to prevail against insurgents around the world
    while protecting our country and the rights of our citizens. We have
    completed combat operations in Iraq by transitioning to Operation New
    Dawn, continuing to provide much needed support to the people and
    government of Iraq. We have also surged soldiers into Afghanistan to
    support a new strategic direction. We have reshaped our Army to better
    align ourselves for the challenges of tomorrow. We have accomplished
    much over the last year, but there is still much to do.
        Our top priorities will be to continue to maintain our combat edge
    while reconstituting our force and building resilience in our soldiers
    and families. During the last several years, we have made significant
    progress in restoring balance through our four imperatives: sustain,
    prepare, reset, and transform.
        Increasing the dwell time between deployments is the single most
    important component of restoring balance. A recent study said that
    soldiers require at least 2 to 3 years to fully recover mentally and
    physically from the stresses of a 1-year deployment. As we continue to
    draw down our forces in Iraq, we have been able to continually increase
    our dwell time. Soldiers deploying in October 2011 have the expectation
    that after 1 year of deployment they will be home for 2 years in the
    Active component. After October, our Army National Guard (ARNG) and
    U.S. Army Reserve (USAR)soldiers can expect to see 1 year deployed and
    4 years at home.
        In order to meet the demands of today's strategic environment, we
    had to responsibly grow the Army, which we accomplished ahead of
    schedule in 2009. But even with this growth, we were not able to meet
    the high demands during this era of persistent conflict. As a result,
    Congress and the Secretary of Defense approved an additional 22,000,
    with the last 7,000 added during 2010. The Army's goal is to return to
    our approved active strength of 547,400 by the end of fiscal year 2013.
    It is imperative that as we begin to draw down, we do not sacrifice our
    combat experience and unit cohesion by cutting large numbers of
    soldiers. The Army is in the planning phase of this deliberate process.
        I truly appreciate all the work Congress has done for our soldiers
    in the areas of Behavioral Health, Wounded Warrior Care and TRICARE.
    With your help, we have provided our soldiers, families, and civilians
    the best possible care, support and services. Our focus continues to be
    improving access to and predictability of services. We continue to
    enhance support for our wounded, Families of our Fallen, victims of
    sexual assault and those with mental health issues.
        The Army continues to provide top care for our wounded warriors and
    their families through 29 Warrior Transition Units (WTU) across the
    United States and Europe. Currently, WTUs provide healing,
    rehabilitation, and reintegration to more than 10,000 wounded, ill, or
    injured soldiers, up about 11.5 percent from last year. In addition to
    the WTUs, nine Community Based Warrior Transition Units allow
    recuperating soldiers to utilize health care facilities in their home
    communities, while working at local U.S. Army armories and Reserve
    centers. To better support the housing of our wounded warriors, the
    Army has completed 6 Warrior Transition Complexes with 18 currently
    under construction.
        Through the U.S. Army Wounded Warrior Program (AW2), the most
    severely wounded, ill, and injured soldiers receive personalized
    support, regardless of location or length of care. More than just
    medical care, AW2 advocates assist warriors and their families with
    career and education opportunities, benefit information, and local
    resources. There are more than 8,000 soldiers enrolled in the program,
    up 24 percent from last year.
        Our Army Medical Command continues to meet the increased behavioral
    health demand of our soldiers and families. Even with the influx of
    behavioral health providers, the Army has seen a range of operational-
    related stress reactions including post-traumatic stress disorder,
    depression, anxiety, alcohol and substance abuse, family and
    relationship problems, increased risk taking behavior, compassion
    fatigue and suicide behaviors.
        Our soldiers receive top-notch behavioral health care, but access
    to this care is impacted by shortages of behavioral health
    professionals. Since 2005, the number of behavioral health visits has
    doubled, from 900,000 to more than 1.8 million. We continue to maximize
    the use of authorities that Congress has provided us to attract both
    military and civilian behavioral health providers to the Army. We have
    had some success hiring behavioral health professionals, increasing our
    staff by 65 percent, but we are still about 400 professionals short of
    our goal. Between fiscal year 2012-2017, we aim to hire 1,000
    additional behavioral health care providers.
        Finally, the Army has lacked a standardized resiliency promotion
    program, which is a key component of psychological health. Through
    three key plans, the Comprehensive Soldier Fitness, the Army's Campaign
    Plan for Health Promotion, Risk Reduction and Suicide Prevention, and
    Warrior and Community resiliency training, the Army is closer than ever
    to standardizing resiliency for soldiers from all three components.
        Overall, the Army has implemented over 45 initiatives to fix or
    change access to care, resiliency, quality of care and surveillance. We
    have shifted our focus to providing care and support for those serving
    in Operation Enduring Freedom and have expanded our telebehavioral
    health and automated behavioral health clinics. We are working hard to
    increase our behavioral health care providers for all components by
    approximately 1,000 across all components between 2012 and 2017.
        TRICARE is the health care program for active duty servicemembers,
    ARNG, USAR, retirees, family members, survivors, and certain former
    spouses worldwide. This program is a network of military and civilian
    health care professionals working together to foster, protect, sustain,
    and restore health for those entrusted to their care. Over the last
    year, TRICARE has introduced several new programs to provide care to
    those soldiers and families who need it most.
        The TRICARE Reserve Select (TRS) program continues to be a huge
    success for our ARNG and USAR soldiers and families. TRS gives these
    citizen-soldiers and their families access to an affordable benefit
    while serving in part-time status. TRS offers a health care plan
    similar to the TRICARE Standard and TRICARE Extra programs with a
    monthly premium. These rates did rise a little for fiscal year 2011.
    Single soldier rates increased from $49.62 to $53.16 and the family
    rate from $197.65 to $197.76. In addition to the TRS program, eligible
    ARNG and USAR soldiers and families can begin receiving TRICARE
    benefits up to 180 days before activating for a contingency operation.
    Under the Transitional Assistance Management Program, soldiers from all
    three components can receive an extra 180 days of TRICARE health
    benefits after separating from the Army.
        The TRICARE Retired Reserve (TRR) is a premium-based, worldwide
    health plan that provides care for USAR and USARNG soldiers and their
    families who have retired but are not yet eligible for TRICARE for Life
    coverage. TRR offers comprehensive health coverage from any TRICARE-
    authorized provider. Costs for TRR Member-Only coverage is $408.01 and
    TRR member and family coverage runs $1,020.05.
        TRICARE plans to roll out its new Young Adult Program this spring
    to extend parent's health care benefits to their children up to the age
    of 26. This program is for young adults who do not have access to
    employer-sponsored health care coverage. TRICARE is still working out
    the details for the Young Adult program including eligibility, coverage
    criteria, costs, etc.
        We are in our final year of our 5-year effort to improve work and
    training facilities for our soldiers and civilians, as well as new or
    improved housing, medical, and child care facilities for our families.
    Under the base realignment and closure program, we have disposed of
    more than 24,000 acres and closed 3 Active installations and 5 U.S.
    Army Reserve Centers. We are on track to complete BRAC in fiscal year
    2011.
        The Army's Child, Youth, and School Services program supports the
    readiness and well-being of Army families by reducing the conflict
    between on-the-job military missions and parental responsibilities.
    Generally, Army families are younger than the average American family
    and more geographically dispersed from extended families in their
    hometown and communities.
        The Army has added 128 child development centers and 24 youth
    centers since fiscal year 2008. Last year, we were able to meet and
    maintain the DOD standard of 80 percent of the child care demand and 35
    percent of the youth program demand.
        The modernization of Army Family Housing and Soldier Barracks is
    critical to maintaining our All-Volunteer Force. The Army continues to
    make huge strides for both, expanding housing services and creating a
    secure and affordable environment for all of our soldiers and families.
        As part of the fiscal year 2012 budget, the Army has asked for
    $681.8 million for Army family housing. With this funding, the Army
    hopes to eliminate all inadequate family housing worldwide by replacing
    inadequate homes, improving existing homes and leasing where
    appropriate. This funding will be used to construct 128 new homes,
    renovate 276 homes, and operate and maintain the government-owned
    homes.
        We are on schedule to finish our barracks modernization plan for
    the 35 percent of our single soldiers by the end of fiscal year 2013.
    The Army is planning to fund 14 projects to construct 3,880 spaces at 9
    garrison locations for fiscal year 2012.
        The Army continues to fix and build all Army Initial Entry and
    Advanced Individual Training Barracks by 2015. Many of our outdated
    training barracks range in age from 40 to 100 years old. By the end of
    fiscal year 2011, the Army will only have funded 55.2 percent of the
    required spaces. During fiscal year 2012, we are planning to fund 3
    military construction projects and 14 OMA funded modernization
    projects. We also plan to allocate funding to eliminate inadequate
    training barracks by fiscal year 2015 and complete new barracks by
    fiscal year 2017. We ask for your continued support to help us complete
    this important program.
        One of the main reasons our soldiers are so successful around the
    world is our diversity. The Army offers opportunities to men and women
    of all backgrounds to be an integral part of our All-Volunteer Force.
    In this time of globalization, our Army needs diverse leaders in order
    to successfully interact with different cultural groups from across the
    world.
        Women in the Army continue to serve this Nation with honor and
    distinction in the roles, positions, units, and specialties in which we
    allow them to serve. Since 2002, more than 100 women have been killed
    in combat due to enemy contact and more than 14,000 are currently
    serving in Iraq and Afghanistan. It is no secret that women are an
    integral part of our force. They are on the front line, engaging the
    enemy, and making a difference.
        The Army has reviewed our assignment policies and regulations to
    ensure they are relevant and meet the needs of current conditions and
    emerging requirements. This ensures all soldiers, regardless of gender,
    are afforded the opportunity to reach their highest potential.
        Our soldiers have also begun chain-teaching to prepare for the
    repeal of ``Don't Ask, Don't Tell.''The Secretary of Defense has said
    that certification and the repeal must be accomplished across the
    entire Department at the same time. He added that this should be done
    consistent with the standards of military readiness, military
    effectiveness, unit cohesion, and recruiting and retention.
        For the Army, the guiding principles for implementation are:
    leadership matters most; minimize management; communicate and educate;
    and implement consistent with Army Core values. These principles have
    been instituted in our training and education efforts. The training and
    education has been implemented in three tiers beginning last month with
    Tier 1. We are currently conducting chain teaching classes with our
    Tier 2 and Tier 3 soldiers. Our goal is to have all three tiers
    complete by mid to late August.
        In closing, I want to stress the amazing work being done every day
    by our Army Team. As the Sergeant Major of the Army, the best part of
    my job is visiting our soldiers, families, and civilians across the
    world. The professionalism, dedication and sacrifice they display every
    day is the reason our Army is the envy of every other in the world. Our
    soldiers are the best trained, best manned, best equipped, and best led
    force in our history. I appreciate this opportunity to speak before you
    today to tell the Army story. I welcome your questions at this time.
    Thank you and Army Strong.

        Senator Webb. Thank you, Sergeant Major.
        Sergeant Major Kent.
        I should have pointed out earlier that I believe this would
    be Sergeant Major Kent's final appearance before this
    subcommittee before his retirement.
        Sergeant Major Kent. Yes, sir.
        Senator Webb. I'd like to add my own personal appreciation
    for all your years of service, Sergeant Major, and for the
    terrific job that you have done in your position as Sergeant
    Major of the Marine Corps.
        Sergeant Major Kent. Thank you, sir.
        Senator Webb. Welcome.

     STATEMENT OF SGT. MAJ. CARLTON W. KENT, SERGEANT MAJOR OF THE
                           MARINE CORPS, USMC

        Sergeant Major Kent. Thank you, sir.
        Thank you, Chairman Webb, members, for the opportunity to
    testify for the last time as a United States marine on Active
    Duty on the important issues that directly impact the quality
    of life of our marines and families.
        I am leaving the active ranks, but ``once a marine, always
    a marine.'' So, these will continue to be important issues to
    all marines who have served.
        First of all, I'd like to report that your marines are
    honored to serve this great Nation and happy to be doing what
    marines do best, fighting and winning our Nation's battles.
    They are truly living up to the great warfighting legacy of our
    Corps that was founded in 1775. Your marines, including their
    spouses and family members who support them, remain our most
    valuable asset and our number one priority.
        As our Commandant, General James F. Amos, has said, ``We
    will keep faith with marines, sailors, and our families.'' I'm
    proud to report to you that we're keeping the faith with all
    marines, sailors, and their families. We invest in the marines,
    sailors, and our family, to include housing, Bachelor Enlisted
    Quarters (BEQs), wounded warriors, ill and injured, and also
    families of our fallen warriors.
        Both the Commandant and I receive feedback from our marines
    and their families as we travel the globe and look them eye-to-
    eye. They notice and they appreciate the much-needed
    improvements in quality of life, but they also have no problem
    looking us in the eye and telling us we have additional work to
    do. As we move forward, we will continue to keep the faith with
    marines, sailors, and families by assessing the effect of our
    support services and demonstrating, through our direct actions
    that we are committed to improving them.
        We are grateful for the support of the Senate and the
    American people who continue to provide for the men and women
    who proudly wear our uniform. We're also grateful for the
    increased attention placed on support for our families. It is
    true that, while we recruit marines, we retain families. Their
    readiness is directly linked to the readiness of our Corps.
        Again, thank you very much for this opportunity to testify
    for my last time. I am available for questions.
        [The prepared statement of Sergeant Major Kent follows:]
               Prepared Statement by SgtMaj Carlton W. Kent, USMC
                                  introduction
        Chairman Webb, Senator Graham, and distinguished members of the
    subcommittee, as I finish my last tour of duty, I want to thank you for
    this final opportunity to report to you on the state of your Marine
    Corps and our families' personal and family readiness.
        Throughout the last 10 years of war, our marines and their families
    have faced many challenges and made great sacrifices. Their endurance
    has been bolstered by your generous and sustained support which has
    enabled our continued success, on the battlefield and at home, and
    ensured our ability to maintain a high state of personal and family
    readiness. As we continue to serve this great Nation, we are grateful
    to you and the American people and thank you for your unwavering
    support.
        As our Commandant, General James F. Amos, has said, our marines and
    their families are our greatest and most valuable assets and caring for
    their welfare will be one of our top priorities. My testimony today
    will outline the progress we have made as well as the actions we are
    taking to fulfill that mandate.
                               your marine corps
        Today, through your ongoing support and that of the American
    people, your Marine Corps is a cohesive, total force of 202,100 Active
    Duty marines; 39,600 Selected Reserve marines; and 25,000 civilian
    marines. At any given time, approximately 30,000 marines are forward
    deployed in ongoing global operations in support of our Nation's
    defense. Your Marine Corps is also the youngest, most junior, and least
    married of the four military Services.

             Sixty-five percent of marines are 25 or younger;
             Twenty-one percent of marines are not old enough to
            legally consume alcohol;
             Forty percent of marines are lance corporal or below
            (other Services are between 20 to 24 percent);
             Forty-nine percent of marines are married (next
            closest is Navy at 54 percent); and
             Has 1 officer per 8.3 marines (next closest is Navy
            with 1 officer per 5.1 sailors).

        In addition, the Marine Corps has approximately the same number of
    active duty personnel as family members. There are 207,194 family
    members: 90,566 spouses, 116,335 children, and 293 parents. This close
    relationship, 49:51, is unique among the military Services. The active
    duty to family member ratios of the Army, Navy, and Air Force are all
    approximately 40 percent servicemembers to 60 percent family members.
                              personnel readiness
        For our deployed and next-to-deploy forces, personnel readiness is
    extremely high. We continue to source our best-trained and most ready
    marines and sailors to meet geographic combatant commander requirements
    in Afghanistan and around the globe. The Marine Corps is prepared to
    sustain this for as long as the Nation requires.
                            operation iraqi freedom
        This past year, we completed our mission in Iraq, effecting the
    retrograde of more than 25,000 marines; 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. At present, approximately 100 marines remain in
    Iraq serving in individual augment, transition team and other
    miscellaneous billets.
                           operation enduring freedom
        In Afghanistan, the mission has expanded. Over the past year, we
    increased our force strength in Afghanistan from 10,600 in December
    2009, to 20,700 in December 2010. We will continue to provide forces in
    Afghanistan capable of full-spectrum, counterinsurgency operations
    while balancing our capabilities to perform what the Nation will likely
    ask of us in the future.
                                  end strength
        Current authorized end strength is 202,100 marines in the Active
    component and 39,600 marines in the Selected Reserve. During fiscal
    year 2012, the Marine Corps will concentrate on sustaining and shaping
    the Active Force. Our success can be attributed to four factors:
    quality recruiting, exceptional retention, reduced personnel attrition,
    and a great young generation of Americans who want to serve their
    country during wartime. Also, key to sustaining the force is an
    effective Enlistment Bonus and Selective Reenlistment Bonus programs
    which allow us to access and retain quality marines to sustain the
    Active Force. The Marine Corps Reserve is a full partner of the Marine
    Corps' Total Force. The Marine Corps Reserve continues to provide
    critical support for overseas contingency operations and noncontingency
    combatant commander requirements. At home, Marine Forces Reserve
    maintains marines and assets prepositioned throughout the country who
    are ready to assist with not only national defense missions, but also
    civil-military missions such as providing disaster relief.
                                   dwell time
        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-to-2 dwell
    time. 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. We are actively working to recruit, promote, and
    retain the right number of marines in the right occupational
    specialties to promote resiliency of our Total Force and reduce the
    stress on our families.
               keeping faith with marines, sailors, and families
        Just as our marines are required to be in a constant state of
    readiness, so must our families. Our Nation has been at war for a
    decade, placing unprecedented burdens on marines, sailors, their
    families, wounded warriors, and the dependents 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 know that in order to develop, maintain, and sustain
    their personal and family readiness and resiliency, we must provide
    innovative programs and services that are timely and relevant. We will
    do this by focusing on several key areas during this fiscal year.
        In his 2010 Planning Guidance, our 35th Commandant directed us to
    ``look across the entire institution and identify areas that need
    improvement and effect positive change.'' Specifically, he asked us to
    evaluate all of our family readiness programs, to determine which
    require enhancement and/or expansion and which can be streamlined to
    reduce redundancy. This is not just about efficiencies; it is also
    about effectiveness. As part of that mandate, we have been directed to
    continue our behavioral health program integration; institutionalize
    resiliency training; and reorganize our Transition Assistance
    Management Program. My testimony today will outline the progress we
    have made and the actions we are taking in these and other critical
    areas.
                                family readiness
        In 2010, the Marine Corps increased baseline funding for family
    support programs by $110 million to ensure an appropriate wartime
    footing. Programs benefitting from this measure include: 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. As we continue the process of providing marines
    and their families with the most effective and relevant services, we
    are assessing all of our family support programs, identifying gaps and
    overlapping or duplicative efforts, and looking for opportunities to
    develop partnership programs and share resources with other agencies.
    Some of our notable accomplishments include the following:

             Established over 400 full-time civilian Family
            Readiness Officers to facilitate family contact and provide
            critical information and referral services to support the
            resiliency needs of marines and their families.
             Developed an inventory of Deployed Support and Life
            Skills Education and Training courses that address the
            challenges of military life, as well as personal and family
            life.
             Transformed the Exceptional Family Member Program to
            ensure that enrolled family members are provided a continuum of
            care, while providing the sponsor opportunity for a successful
            career.
             Established school liaisons who form strong
            partnerships with schools and other supporting agencies to
            improve access and availability to quality education.
             Implemented program and infrastructure enhancements at
            remote and isolated commands, including investments in child
            care, single marine programming, fitness and recreation
            centers, and recreational equipment to support deployed
            marines.
             Increased Marine Corps child care capability from 64
            percent to 73 percent with projection to meet 80 percent of
            potential need by fiscal year 2012.
                          deployed and warrior support
        Deployed support is one of the most important services we provide.
    Our Exchange; Recreation and Fitness; and Communication services not
    only boost and maintain morale but also help to reduce mission-related
    stress.

             Exchange. Ongoing missions in Afghanistan include the
            operation of two Direct Operation Exchanges at Camps
            Leatherneck and Dwyer, and one Tactical Field Exchange at Camp
            Delaram II.
             Recreation and Fitness. We assist in providing sports,
            recreational, and fitness equipment to units throughout Helmand
            Province with the joint support of USFOR-AJI. This
            transportable equipment includes sports/recreation cooler kits
            filled with sports gear and board games, electronic game kits,
            Theater-in-a-Box kits, and functional fitness equipment for use
            in austere environments. Reading materials, both electronic and
            paperback, are also distributed.
             Communication. Morale satellite services are available
            to forward operating bases, combat outposts, and other austere
            locations. We have delivered 13 satellite communications
            systems to units in Afghanistan. Each system has 2 phones that
            provide 6,000 free minutes per month and 5 laptops that allow
            internet browsing, social networking and chat/video
            capabilities to deployed marines.
                              family care programs
    Exceptional Family Member Program
        The most tender of our families, those enrolled in the Marine Corps
    Exceptional Family Member Program (EFMP), have strongly endorsed the
    improvements made to their level of support and our focus on providing
    a continuum of care. Year after year since our program expansion, we
    have gained the trust of our families. This is demonstrated in our
    increasing enrollments and reduction in issues experienced by families
    relocating to new duty stations. I am proud to state that the
    Department of Defense (DOD) and the other Services recognize our EFMP
    as a premier, full-service program based on the quality and efficiency
    of program operations.
        Our EFMP sponsors will always be an advocate for their special
    needs family member, but when they need legal help, our EFMP attorneys
    are ready to assist families with obtaining benefits and services under
    Federal and State education and disability laws, special needs trusts,
    landlord-tenant issues and other legal areas.
        In 2001, EFMP had only 4,500 enrolled family members. This number
    has grown to over 9,850 today. In the past year, we have taken multiple
    actions to transform the program, including:

             Utilizing Family Case Workers, at ratio of 1 FCW: 225
            sponsors, to support families during relocation, deployments,
            and life events and assist families with gaining access to
            medical, educational, and financial support services.
             Establishing installation-level Training Education
            Outreach specialists to provide training and support for
            families and the programs that support them.
             Utilizing a Continuation on Location policy that
            ensures the assignment and relocation process is sensitive to
            EFMP family needs and meets statutory stabilization
            requirements.

        In addition, the Marine Corps continues to underwrite the cost of
    up to 40 hours of short-term respite care per month for EFMP enrolled
    families. To date, we have provided more than 450,000 hours of respite
    care. Since the cost is underwritten by the Marine Corps, families are
    able to use their TRICARE Extended Care Health Option benefit for
    needed therapies and equipment. Nevertheless, challenges remain, such
    as:

             the lack of portability of services for adults with
            autism;
             the inability of military families to gain access to
            Medicaid; and
             national economic impacts and subsequent State budget
            cuts, particularly at local and State levels, which impede
            school districts' abilities to provide special education
            services and impact access and availability to critical
            services.

        To address some of the State access issues, we have partnered with
    the National Council on Disabilities to study this problem. Results are
    under review.
    Children, Youth, and Teen Programs
        Whether parents are working, experiencing family emergencies, or
    needing respite from single parent responsibilities connected to
    deployments, child care services remain a high priority quality of life
    requirement. In 2010, we provided 13,431 child care spaces and met 73
    percent of potential need requirements. Within these totals, we are
    caring for approximately 2,500 special needs children.
        The Marine Corps, with your support, is executing an aggressive
    Military Construction program and is opening six Child Development
    Centers in fiscal year 2011 and five more in fiscal year 2012.
    Nevertheless, as you might expect, the demand for quality child care
    on- and off-installation continues to grow and outweighs the
    availability of resources. To address this growing demand and help
    further define requirements, we have contracted for the development of
    a Child Development Program and Facility Master Plan. Using market
    assessments and analysis tools, the plan will evaluate on- and off-base
    access, unmet need, and will provide prioritized recommendations for
    meeting the need across the Marine Corps. We anticipate results this
    summer.
        In 2011, we will work with Marine Forces Reserve and Marine Corps
    Recruiting Command to identify opportunities to enhance availability of
    child care for Marines and their families serving on independent duty
    and at locations that are separated from military bases and stations.
    In addition, we are partnering with Boys & Girls Clubs of America for
    developmental youth programs, and working to identify ways to better
    support our youth and teens affected by a parent's deployment. We have
    reviewed the results of the National Military Family Association and
    RAND Study related to impacts on youth from deployments and are
    considering ways to address this situation.
    School Liaison Program
        To help school-age children of marines flourish in new school
    environments, our School Liaison Program partners with Local Education
    Agencies (LEAs) to raise the educational capacity and standard of our
    military children. Supporting more than 80 school districts surrounding
    major Marine Corps installations, our school liaisons provide LEAs with
    information on Marine Corps families' needs and access to beneficial
    training and counseling services to support teachers and students.
    Marine parents have the comfort of talking with and being supported by
    a local education expert who provides meaningful insight and support to
    new transfers and those with questions on local education policies. In
    addition, school liaisons provide Marine parents with connections to
    online curricular resources that are linked to State standards,
    permanent change of station checklists to assist parents with pre-
    relocation planning and registration in the receiving school districts,
    on-line tutoring and other resources.
                     personal and professional development
        Throughout the Nation, veterans aged 18-24 have experienced
    traditionally higher unemployment rates than their non-veteran
    counterparts. Our Commandant is focused on this problem and has
    directed the Marine Corps to conduct a thorough ``bottom up''
    assessment of our Transition Assistance Management Program to
    revolutionize the process, embrace best practices, and ensure we are
    providing the right educational and career assistance to marines
    leaving the Corps. 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. These teams identified issues, stakeholders and a
    conceptual framework for improved services and ways in which we will
    integrate Marine Corps Community Services transition assets. Key
    stakeholders involved in this process include servicemember recruiters,
    commanders, unit transition coordinators, and most importantly--our
    marines and their family members.
        With our predominately first-term force, we are committed to
    reaching our marines at designated touch points, helping them develop
    roadmaps that support their Marine careers, and better equipping them
    to reintegrate back into civilian life upon leaving active duty
    service. 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.
        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.
    In addition, we will adapt our current job fairs to support increased
    networking opportunities that will allow marines to meet mentors and
    employers and find meaningful employment.
        Marines have also 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 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. We are initiating actions and integrating
    existing capabilities that will most directly improve the quality of
    support provided to marines 6 months prior to separation as well as the
    support provided to marines who have been separated at least 6 months.

             Establishing formal processes to initiate periodic
            lifecycle contact to offer education, career, and financial
            advice/counseling to marines and their families.
             Creating an Individual Development Plan for each
            marine, with execution and delivery of required transition
            services.
             Improving the current Active-to-Reserve transition
            process to better educate marines on Reserve opportunities to
            retain the best talent. An enhanced, streamlined transition
            process will increase the number of valuable, trained marines
            who consciously choose to affiliate with the Reserves.

        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. We believe this effort will result in an
    innovative program that addresses the Commandant's concerns, assists
    our families with their education and career goals, and meets the needs
    of our marines as they progress through their military life cycle,
    whether a single enlistment or a lifetime of military service, and
    transition to a successful post-military career.
                         behavioral health integration
        Since September 11, behavioral health needs have become
    increasingly complex with individuals often requiring assistance in a
    number of areas at one time. Marines with three or more deployments
    have been identified as particularly at risk. As a result of risk
    factors, our Combat Operational Stress Control (COSC) Program is
    currently developing a policy that will direct commanders to conduct
    face-to-face interviews with marines who have had three or more
    deployments. These commanders' interviews will identify marines at some
    level of elevated risk; allow commanders to engage their marines (pre-
    and-post-deployment); and provide an opportunity for intervention
    (medical and non-medical).
        As directed by the Commandant, we continue to move forward with the
    integration of our prevention and intervention programs--Family
    Advocacy, COSC, Suicide Prevention, Sexual Assault Prevention and
    Response, and Substance Abuse--initiated in 2009. We have established a
    new Behavioral Health Branch at our headquarters for Marine and Family
    Programs, Manpower & Reserve Affairs which will assess common
    behavioral health trends, risk factors, training needs, and protective
    factors to ensure maximum use of resources and to enhance existing
    prevention capabilities. We are also more fully utilizing the Institute
    of Medicine's ``Behavioral Health Prevention Intervention Spectrum'',
    which establishes common definitions, to focus our prevention efforts
    on marines and families.
        Through collaboration of services, we will deliver effective,
    evidence-based practices and behavioral health programs that are
    seamlessly woven into the larger support network of Marine Corps
    command structures, health and human services, and are in concert with
    building resilience and strengthening marines and their families.
    Sexual Assault Prevention and Response
        Marine Corps leadership has initiated aggressive actions to elevate
    and highlight the importance of the Sexual Assault Prevention and
    Response (SAPR) Program and institutionalize a zero-tolerance policy.
    SAPR is focused on several key initiatives:

             Prevention: Commanders are accountable for creating a
            climate of respect in which sexual assault will not be
            tolerated and building trust within their units that enables
            victims of sexual assault to report the crime. Bystander
            intervention training has been identified as an evidence-based
            best practice for engaging marines in their role in sexual
            assault prevention. New video-based bystander intervention
            training is in development with a completion date of April
            2011.
             Risk Reduction: Alcohol has a tremendous impact on the
            prevalence of sexual assault. Research on best practices for
            addressing risk reduction, consent, and raising awareness
            within the Marine Corps is forthcoming in 2011.
             Victim Advocacy: During 2010, SAPR Program Managers
            were hired at 18 installations to heighten sexual assault
            prevention efforts by serving as master trainers and reporting
            coordinators. A 24/7 helpline was established across all
            installations to provide victims with emotional support,
            information on reporting options, and critical resources.
             Offender Accountability: The Trial Counsel Assistance
            Program (TCAP) and a Joint Mobile Training Team were
            implemented in 2010 to provide training for 40 Marine Corps
            investigators and prosecutors on best practices in handling sex
            crimes. Following-up on the success of the Case Review Project
            in 2009, the Judge Advocate Division Military Law Branch is
            reviewing closed cases of sexual assault to develop lessons
            learned. This information will be disseminated in the form of
            training techniques for investigators and prosecutors.
    Suicide Prevention
        During calendar year 2010, we saw a nearly 30 percent decrease in
    the number of suicides within our Total Force (52 in calendar year
    2009; 37 in calendar year 2010). 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:

             Evocative Peer-led Training Program: ``Never Leave a
            Marine Behind'' suicide prevention program for noncommissioned
            officers and Junior Marines. We are expanding this training to
            include staff noncommissioned 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 work in
            the area of building and maintain resiliency across the Corps.
             Unit-Level Prevention Officer Training: Working with
            the American Association of Suicidology to develop effective
            training programs for these officers.

        We believe our training and other prevention efforts will help our
    marines and their family members maintain readiness and win their
    personal battles.
    Combat and Operational Stress Control--Resiliency Training
        Stress issues affect all marines and families regardless of
    deployment. Assisting marines who show signs of stress and preventing
    combat and operational stress is one of our highest leadership
    priorities. 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 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,
    spiritual and physical fitness will best instill in our marines the
    resiliency to endure the stressors of combat and enhance their ability
    to perform effectively across the range of military operations.
        Our COSC program's goal is to help Commanders and Marine leaders
    maintain their warfighting capabilities and, with assistance from
    medical personnel, reduce the impact of negative stress reactions. By
    providing tools and resources to assist Marines with coping with the
    challenges of combat and the rigor of life as a marine, our COSC
    program implements activities focusing on force preservation and
    readiness and the long-term health and well-being of our marines and
    their families. COSC, with other behavioral health initiatives,
    aggressively combats these problems by strengthening marines,
    mitigating stress, identifying those who are at risk, and providing
    treatment when necessary, with the goal of re-integrating marines back
    into the force.
        Our Operational Stress Control and Readiness Program (OSCAR) embeds
    mental health professionals in operational units and provides training
    that helps the OSCAR team identify and mitigate negative stress
    reactions. The OSCAR team is comprised of 3 different groups: Providers
    (mental health professionals), Extenders (other medical and religious
    personnel), and Mentors (selected unit marines) who are trained to
    quickly intervene when marines show signs of stress reactions
    Currently, over 1,700 marines are trained as mentors.
        In fiscal year 2011, COSC will sustain and improve the OSCAR
    training by conducting a RAND evaluation, working with units who
    utilized OSCAR training while in combat environments and providing
    refresher training to OSCAR trainers. Extenders began receiving formal
    OSCAR training at Field Medical Schools in January 2011, which also
    supports institutionalizing OSCAR enhancing resiliency training.
        Our COSC program continues to show positive results as indicated by
    outside evaluations and assessments. The Joint Mental Health Advisory
    Team-7 reports that marines surveyed in Afghanistan in July 2010 show
    increased exposure to heavy combat. Marines also indicate increased
    protective factors including unit resilience, small-unit cohesion,
    perceived readiness, and improved climate in asking for help. This
    assessment also shows increased training effectiveness in managing
    combat/deployment stress and significant reduction in stigma associated
    with seeking behavioral health treatment.
                     post-traumatic stress and brain injury
        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 servicemembers 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.
                            wounded warrior regiment
        I am pleased to report on the progress of the Marine Corps' Wounded
    Warrior Regiment (WWR) and the determined spirit of our Nation's
    wounded warriors and their families. The WWR stood up in April 2007 and
    was built on a compressed timetable--it was essentially built in
    progress. Early efforts involved the identification of immediate
    requirements and the design and sourcing of a scalable organization
    that could expand or contract as needed. The initial focus was on a
    Marine's and his or her family's immediate needs, construction
    projects, basic administrative support, the stand-up of the Sergeant
    Merlin German Wounded Warrior Call Center, and the establishment of the
    Marine Corps' Recovery Coordination Program. When the WWR was
    established, long recovery times were not expected and long-term
    recovery support requirements were not anticipated. Since then, the WWR
    has continually assessed changing requirements, its organizational
    structure, and resourcing needs. We are now adjusting our structure
    based upon confirmed requirements, sound assumptions, and findings in
    warrior care that will allow for the enduring care of wounded, ill, and
    injured (WII) marines and their families.
        In his 2010 Planning Guidance, General Amos stated his commitment
    to ``enhance the capabilities of the WWR to provide added care and
    support to our wounded, ill, and injured.'' Moreover, he affirmed the
    need to sustain the Regiment for the long term given the wounds of the
    war and the fact that the WWR also provides care for our young Marines
    who are not combat wounded, but are injured in training or other
    accidents, suffer from diseases, and other tragedies.
        The WWR will continue to meet the Commandant's intent by refining
    our support capabilities and growing our care model to ensure we work
    toward healing the ``whole'' marine. Through synchronization of our
    programs and resources and external programs, the WWR is striving to
    help each WII marine focus on their abilities to heal medically while
    strengthening their mind, body, spirit, and family. The WWR works to
    ensure marines' medical treatments are harmonized with non-medical
    needs to optimize their recovery through their continuous engagement in
    productive activities.
        These activities include pursuing and reaching goals in areas that
    will improve readiness for return to duty or reintegration to
    communities, such as education, employment, physical fitness, and
    building strong families. For WII marines who are unable to continue
    their service, the Marine Corps has a moral obligation to them, their
    families, and this country to help them live productive and fulfilling
    lives and be good citizens.
    WWR Programs and Services
        The non-medical care needs of our WII marines and their families
    can be extensive, and vary in type and intensity throughout the
    recovery process. The WWR assists active duty, Reserve, retired, and
    veteran WII marines and their families with their non-medical care
    needs through all phases of care from recovery to rehabilitation and to
    community reintegration. Each phase brings new challenges for the
    marine, their family, and the support staff. The complexity of their
    care does not allow for isolated decisionmaking and it requires a
    heightened level of coordination between medical and non-medical care
    providers. There is no ``one-size-fits-all'' approach to care. The WWR
    has a cross-section of services and resources to ensure WII marines and
    families are provided for.
    Sergeant Merlin Gennan Wounded Warrior Call Center
        Our call center extends support to marines and families through
    advocacy, resource identification and referral, information
    distribution, and care coordination. Located at the call center are
    clinical services staff who provide immediate assistance and referral
    for marines with psychological health issues and/or traumatic brain
    injury. Outreach is an important aspect of the Regiment's non-medical
    care delivery and management. The call center also conducts outreach
    calls to offer assistance on a wide variety of issues, such as service
    disability ratings, awards, employment, financial assistance,
    education, and benevolent organizations.
    Administrative Support
        The WWR stresses at all levels that WII care is a relationship, not
    just an administrative process. With this in mind, the WWR provides WII
    marines and their families with one-on-one education on available
    benefits and compensation.

             WWR staff strives to proactively track the progress of
            paperwork and keep marines and families informed on the status
            of claims, reimbursements, and any changes in benefits.
             A family member's funded travel to the bedside of
            their wounded marine is of particular concern to the WWR. The
            USMC issues Invitation Travel Orders (ITOs) that can authorize
            up to three individuals designated by a very seriously or
            seriously WII marine to travel to the medical facility
            providing care.
             When on ITOs, travel to and from the hospital, hotel
            costs, meals, and incidental expenses are reimbursed by the
            government.
             Additionally, for WII marines who require extended,
            outpatient care, the USMC may authorize Non Medical Attendant
            (NMAs) Orders. One person is typically authorized NMA travel
            entitlements similar to ITOs which provide per diem and lodging
            costs.
             The WWR works to ensure that these types of
            entitlements are tracked and monitored so that reimbursements
            or compensation are provided in a timely manner.
    Family Support
        The care needs of families of WII marines are of particular concern
    to the WWR and the Marine Corps.

             The WWR strives to proactively identify and solve the
            often unique family support needs of our WII marines, their
            families, and caregivers.
             Families of WII marines have a heightened requirement
            for communication, information, and referral services to help
            them navigate through the various phases of recovery.
             The WWR has family support staff in place at all
            locations to address immediate needs, provide a one-on-one
            orientation to the many resources available to support them,
            and to serve as subject matter experts on family support
            requirements for regimental staff.
    Medical Cell
        WWR headquarters has a Medical Section that advises the commanding
    officer regarding medical issues and emerging technologies/treatments
    impacting WII marines.

             The section includes: a Regimental Surgeon, a Mental
            Health Advisor, a Nurse Case Manager, a Psychological Health
            Program Coordinator, a Traumatic Brain Injury Program
            Coordinator, and Licensed Clinical Consultants.
             Together, this team works with public and private
            medical providers to ensure the best care for WII marines,
            particularly in the areas of post-traumatic stress and
            traumatic brain injury.
    Recovery Care Coordinators
        As WII marines transition through the phases of recovery, it is
    important that they have a consistent contact in place to help them
    navigate the system. The WWR has Recovery Care Coordinators who are
    assigned to WII marines to help them and their families develop
    Comprehensive Transition Plans to define and meet their individual
    goals for recovery, rehabilitation, and reintegration.
    Warrior Athlete Reconditioning Program
        Under this program, (which is mandatory for all marines joined to
    the WWR, but tailored to accommodate their medical limitations),
    marines engage in both physical and cognitive activities outside the
    traditional therapy setting. Activities are individualized to the WII
    marine's needs, and encompass over 18 areas--from aquatic training to
    yoga. Supporting WII marines in individual or team settings, the
    program greatly improves overall physical and mental fitness and helps
    to improve their self-esteem.
    Transition Support
        Many WII marines will not return to duty and will pursue careers in
    their communities. The WWR recognizes its commitment and moral
    obligation to marines who are unable to continue their service to help
    them live productive and fulfilling lives and understands the
    challenges associated with reintegration and obtaining a rewarding
    career. To enhance community reintegration, the WWR's Transition
    Support Cell, manned by marines and representatives from the
    Departments of Labor and Veterans Affairs, proactively reaches out to
    identify employers and job training programs that help WII marines
    obtain positions in which they are most likely to succeed and enjoy
    promising and fulfilling careers.
    District Injured Support Cells
        District Injured Support Cells, consisting primarily of mobilized
    Reserve marines, are located throughout the country to conduct face-to-
    face visits and telephone outreach to WII marines and their families
    within their assigned region. They maintain oversight of the welfare
    and quality of life of all WII Reserve marines, Active Duty marines
    convalescing at home, and all OEF/OIF WII marine veterans.
    Reserve Support
        The WWR makes a special effort to ensure that WII Reserve marines
    do not fall through the cracks. The majority of the WWR's staff
    consists of Reserve marines with a high level of subject matter
    expertise that allows for heightened advocacy with regard to Reserve-
    specific issues. Our staff is dedicated to supporting WII reservist
    needs. The WWR's Reserve Medical Entitlements Determination Section
    maintains oversight of all cases of reservists who require medical care
    beyond their contract period for service-connected ailments. The
    Regiment also has Reserve specific Recovery Care Coordinators who
    provide the one-on-one support and resource identification needed to
    support reservists who are often times residing in remote and isolated
    locations away from base and station support.
    Integrated Disability Evaluation System (IDES) Support
        The WWR has Regional Limited Duty Coordinators to help marines
    processing through the IDES and Wounded Warrior Attorneys, to advise
    and support WII marines through this process. The WWR also published a
    pocket guide (via the web and hard copy) to help marines and families
    understand the Disability Evaluation System.
    Enduring Commitment to Wounded, Ill, and Injured Marines
        The Marine Corps is committed to the long-term care of its wounded
    warriors and their families. As warrior care evolves and innovates, the
    WWR will continue to adjust to ensure we are providing the best support
    possible. The WWR will continue to assess its current programs and
    support structure to evolve to meet the long-term recovery requirements
    of our WII marines and their families.

             The USMC is proud to report that the results of our
            assessments thus far are positive.
             The assessments have substantiated that the creation
            of the WWR has had a positive impact on the support offered WII
            marines and families.
             Additionally, our assessments have shown positive
            satisfaction levels in important areas, such as our Recovery
            Care Coordination Program (executed by the WWR's Recovery Care
            Coordinators) and our family support staff.

        Your WII marines are highly motivated, focused on their abilities,
    and remain in the fight. The Marine Corps is grateful for the
    exceptional support that you have provided to them and the families who
    support them.
                              casualty assistance
        The Marine Corps Casualty Assistance Program is committed to
    ensuring that families of our fallen marines are always treated with
    the utmost compassion, dignity, and honor. Our Casualty Assistance
    Program actively seeks opportunities to improve survivor assistance and
    has a demonstrated record of taking quick, effective action as needed.
        The Headquarters Casualty Section is a 24-hour-per-day operation
    manned by Marines trained in casualty reporting, notification, and
    casualty assistance procedures. Next-of-kin (NOK) are notified in-
    person by a marine in uniform--Casualty Assistance Calls Officer
    (CACO)--and a chaplain whenever possible. Notifications are typically
    completed within 4 hours of receipt of the casualty report. Marine
    CACOs are there for the NOK--to assist with burial arrangements,
    applications for benefits and entitlements, contact with benevolent and
    philanthropic organizations, and obtaining reports of investigation.
    Within days of the incident, families are connected to representatives
    from the Tragedy Assistance Program for Survivors (TAPS), a nationally
    recognized provider of comfort and care to those who have suffered the
    loss of a military loved one and are experts at ``taking care of the
    heart''. TAPS services are no cost and available 24/7. Approximately 60
    days following the death, we reach out to the NOK to help resolve any
    residual issues and let them know we are available to them for as long
    as they need us.
                                 infrastructure
        The Marine Corps continues to strive for a prolonged commitment to
    facilities and infrastructure that supports operations and quality of
    life for our marines and their families.

             The fiscal year 2012 budget request includes $4.6
            billion (military construction, family housing construction and
            operations, sustainment, base operating support, and
            restoration and modernization) which continues our efforts to
            operate, maintain, and improve our infrastructure. This funding
            provides critical Military Construction and Facilities support
            for our Active and Reserve Forces.
             For many years, we have funded only our most critical
            facility needs. As a result, our installations were in a poor
            position to properly house and operate with the additional
            forces required to meet our planned end strength increase.
             In fiscal year 2007-2010, the Marine Corps 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 up-to-date
            utility infrastructure systems.
             Your generous assistance in the past has provided
            critical support that allows us to improve our installations.
            However, it is critical that Congress provide necessary
            legislative language in order to allow us to proceed with
            approximately $2.9 billion of military construction and family
            housing efforts in fiscal year 2011 to support the operational
            and quality of life needs of our marines.
             Plans for fiscal year 2011 include construction of
            5,000 new barracks spaces, improvements to existing family
            housing units, critical aviation facilities to support next
            generation aircraft, improvement of Professional Military
            Education, replacement of outdated and inadequate facilities,
            other quality of life facilities, and correction of safety and
            encroachment issues.
             The USMC has four major funding areas where
            recapitalization and modernization initiatives in
            infrastructure and facilities are programmed: Bachelor and
            Family Housing; Facility Sustainment, Restoration and
            Modernization; Military Construction; and Military
            Construction, Navy Reserve.
    Bachelor Housing
        Bachelor enlisted housing is the Commandant's top Military
    Construction priority. The Marine Corps currently maintains over
    100,000 bachelor enlisted housing spaces worldwide.

             In fiscal year 2012, the Marine Corps is requesting
            $58 million to support this program and we are working towards
            constructing approximately 800 new barracks spaces.
             This investment, along with nearly 25,000 new spaces
            programmed since fiscal year 2008, will provide much needed
            support to have all single marines adequately housed.
             Barracks are a critical element in supporting our
            warfighters. The Bachelor-Enlisted-Quarters initiative focuses
            on our enlisted troops and their quality of life within our
            barracks.
             The USMC is the youngest, most junior, and least
            married of the four military Services. Providing appropriate
            and comfortable living spaces that positively impact the morale
            and development of these young men and women makes sense.
             We are also committed to funding whole room barracks
            furnishings on a 7-year replacement cycle and prioritizing
            barracks repair projects to preempt a backlog of repairs.
             The Marine Corps' goal is to provide a 2+0 room
            standard that allows two junior enlisted marines (E1-E3) to
            share a room and bath. We believe that assigning two junior
            marines to a room is the correct balance between the privacy
            desired by the marines and the Marine Corps' goals of providing
            companionship, camaraderie, and unit cohesion.
             This balance provides the atmosphere we believe is
            necessary to motivate, train, and develop marines, while
            fostering unit integrity. Noncommissioned officers (E4 and E5)
            are provided a private room with bath in a 2+0 room.
             With your continued support, the Marine Corps is on
            track to obtain our goal to achieve the 2+0 standard for all of
            our marines by 2014.
    Family Housing
        Marine Corps families are an integral component of readiness. We
    must always remember that marines and their families serve out of a
    sense of duty and loyalty to our country and, as they do so, face the
    difficulties of the military lifestyle--frequent relocations often far
    from extended family and frequent deployments that separate families
    for months at a time. We have a responsibility to provide adequate
    family housing to our families.

             We continue to increase both the quantity and quality
            of our family housing inventory through public private ventures
            (PPVs) and military construction where necessary.
             In addition to PPV initiatives for family housing,
            continued support for full funding of the Basic Allowance for
            Housing (BAH) allows more families to access quality,
            affordable housing in the local community. This is important
            since more than two-thirds of servicemembers do not live on a
            military installation.
             However, many families continue to prefer to live in
            military or PPV housing for a number of reasons, including
            economics, safety, schools, and community support. PPVs,
            combined with traditional military construction, will continue
            to build and improve the homes necessary to supplement local
            community housing.
             We have over 24,000 owned, leased, or PPV family
            housing units worldwide.
             Thanks to your support over the last year, we were
            able to award projects for additional privatized housing at
            Marine Corps Base Camp Lejeune, NC; Marine Corps Air Ground
            Combat Center Twentynine Palms, CA; and at Marine Corps Base,
            HI. We were also able to continue progress on our series of
            planned renovations to our housing in Iwakuni, Japan.
             In 2001, the Marine Corps had nearly 17,700 inadequate
            housing units, with the majority of those units requiring
            significant revitalization or replacement.
             Based on contracts in place by the end of fiscal year
            2007, the USMC has met DOD's goal to eliminate inadequate
            housing by 2007 and will complete the build-out by 2014.
             The funding provided by Congress in fiscal year 2010
            provided almost $128 million for public private venture (PPV)
            seed money, operations, maintenance, sustainment and
            restoration for family housing. This request included $79
            million for PPV seed money, $15 million for traditional
            military construction, and $34 million for family housing
            operations.
             Your support for this request allowed us to continue
            to address the requirement for additional family housing
            resulting from Grow the Force increases and sustaining and
            modernizing our remaining government-owned housing.
             This PPV seed money will permit construction of
            approximately 230 new units and a DOD Dependent school addition
            at Marine Corps Base Camp Lejeune, NC.
             Our PPV program continues to allow the Marine Corps to
            leverage private sector funds. In addition to government
            financing, the private sector contributed development capital
            for PPV projects in fiscal year 2010. We are using traditional
            military construction to sustain and restore mid-rise units for
            marines at Marine Corps Air Station Iwakuni, Japan and restore
            the National Historic Landmark Home of the Commandants on the
            Marine Barracks in Washington, DC.
             Our fiscal year 2012 family housing budget request of
            $53 million includes $26 million for improvements to 76 homes
            at MCAS Iwakuni, Japan and for the operations, maintenance, and
            leasing of 1,100 units located worldwide.
    Public Private Ventures
        We have privatized over 97 percent of our worldwide inventories to
    date and continue to see success from our PPV projects across Marine
    Corps installations in Arizona, California, Georgia, Hawaii,
    Massachusetts, Missouri, New York, North and South Carolina, and
    Virginia. PPVs have not only improved the homes in which our families
    live, they are also providing community support facilities such as
    community centers, playgrounds, and greenscapes that help create
    neighborhoods and a sense of community for our marines and their
    families. Resident satisfaction with both the quality of their home and
    the service provided continues to increase every year. With almost our
    entire domestic inventory privatized, we will continue to build on our
    prior successes and use PPVs to help us address most of our remaining
    housing requirement.
    Facility Sustainment, Restoration, and Modernization
        Facility sustainment funding is critical to keeping our buildings
    ready to support the mission and provide an acceptable quality of life.
    In the past, our infrastructure could not be replaced at an appropriate
    rate, causing portions of it to deteriorate. As a consequence, the
    Marine Corps has had to use an increasing percentage of its facility
    sustainment funds to bind together old, inadequate buildings throughout
    the course of their service life, rather than maintaining newer, more
    economical structures resulting in significant numbers of facility
    sustainment projects being deferred due to a lack of funds. This
    directly impacted the living and working conditions in barracks, mess
    halls, and other facilities, in highly visible and negative ways. In
    addition, we suffered a ``quiet crisis'' with respect to less obvious
    repairs to steam plants, airfields, sewer lines, and roads. These
    requirements are no longer being ignored.

             A few years ago, the Office of the Secretary of
            Defense (OSD) developed a model to determine the amount of
            funding we need to sustain our facilities. This model continues
            to be refined and strengthened.
             Since inception of the model, and because of the
            funding standards put in place by OSD, we have done very well
            in programming and execution of sustainment.
             In fact, in fiscal years 2006, 2007, and 2008 our
            sustainment rate is over 100 percent. In 2009 and out, however,
            OSD set our programmed sustainment rate at 90 percent of the
            model.
             This equates to $592 million in fiscal year 2012. This
            level allows for a slow degradation of our facilities and
            allows the remaining 10 percent to move to meet more urgent
            operational needs elsewhere.
             This, along with low Operation and Maintenance (O&M)
            recapitalization funding in fiscal year 2012 of $49 million,
            over the next few years will take us back to where we were
            prior to the implementation of the sustainment model.
             However, since we now have metrics and tools that will
            alert us to the coming degradation, corrections can be made
            accordingly in future budgets.
    Military Construction
        For the fourth year in a row, the fiscal year 2010 funding provided
    by Congress represented a significant increase from historical funding
    levels. In 2010, over $2.7 billion in funding will provide facilities
    that address longstanding requirements at our bases and stations and
    support the increased end strength across the Marine Corps. It is
    always a pleasure to visit our installations and hear young marines
    talk about the work they perform in these new facilities.

             Our fiscal year 2012 budget request of $1.4 billion
            continues to support our marines. Funds are being requested to
            support Bachelor Enlisted Quarters, Joint Strike Fighter and
            MV-22 support facilities, quality of life improvements, such as
            a child development center and fitness facility at Twentynine
            Palms, utilities and infrastructure improvements, and training
            and professional military education facility improvements.
             Additionally, the fiscal year 2012 budget request
            includes funding to support the relocation of marines to Guam.
             Our Military Construction program is a key to success
            in achieving and sustaining our new force structure and
            maintaining the readiness of our marines.
    Marine Corps Exclusive, Military Construction, Navy Reserve
        The Marine Forces Reserve is an integral and vital portion of our
    Marine Corps total force. Marine Forces Reserve is comprised of almost
    39,600 Select Marine Corps Reserve personnel at approximately 183
    sites, dispersed throughout 48 States, Washington DC, and Puerto Rico.
    The Military Construction, Navy Reserve program for exclusive Marine
    Corps construction must effectively allocate limited funding to address
    at least $140 million in deferred construction projects. As these
    numbers suggest, maintenance of adequate Marine Corps Reserve
    facilities presents a considerable challenge:

             Over 57 percent of the Reserve centers our marines
            train in are more than 30 years old and of these, 44 percent
            are more than 50 years old.
             The equipment our marines use today is bigger,
            heavier, wider, and longer, creating support requirements that
            these antiquated facilities cannot meet.
             The electrical demand on our facilities because of
            modem equipment has increased significantly.
             Appropriately constructed or modified maintenance
            facilities, as well as adequate electrical power and other
            support infrastructure upgrades, are necessary to maintain
            combat readiness.
             We still continue to use facilities built to
            accommodate manual typewriters, M151 jeeps, and M-48 tanks.

        To help us address these challenges, the fiscal year 2012 budget
    request includes $8 million for Military Construction, Navy and Marine
    Corps Reserves. This program addresses pressing requirements and will
    provide a new Reserve Training Center and a vehicle maintenance
    facility in Memphis, TN. Additionally, we and the Navy are working
    together with the Army to fund a joint Reserve complex in Indianapolis,
    IN.
                                   conclusion
        Whether serving in combat or in garrison, marines are guided by
    honor, courage and commitment. These core values have been the compass
    for every marine's service throughout our rich history. Leadership,
    hard training, and a willingness to sacrifice have forged our Corps
    into one of the most capable fighting forces the world has ever known.
    Our Marine Corps has remained true to these values for 235 years. As we
    continue to transition and align our programs and services to meet
    current and future challenges, we will continue to be fiscally
    responsible and frugal with taxpayers' dollars. As always, we are
    grateful for your sustained support.
                                     ______

               Executive Summary by SgtMaj Carlton W. Kent, USMC
        Chairman Webb, Senator Graham, and distinguished members of the
    subcommittee, as I finish my last tour of duty, I want to thank you for
    the support you and the American people have given the men and women
    who proudly serve and wear our uniform, especially over the last 10
    years of war. Although I am leaving the active duty ranks, once a
    Marine, always a Marine. The quality of life issues we discuss today
    will continue to be important to all marines and their families.
        I am pleased to report that your marines are honored to serve this
    great Nation and are happy to be doing things that marines do best,
    fighting and winning our Nation's battles. They are truly living up to
    the great warfighting legacy that marines have built since 1775. Your
    marines, including their spouses and family members who support them,
    continue to remain a valuable asset and our number one priority.
        Throughout the last 10 years of war, our marines and their families
    have faced many challenges and made great sacrifices. Their endurance
    has been bolstered by your generous and sustained support which has
    enabled our continued success, on the battlefield and at home, and
    ensured our ability to maintain a high state of personal and family
    readiness. It is true, that while we recruit marines, we retain
    families, and their readiness is directly linked to the readiness of
    our Corps. As we continue to serve this great Nation, we are grateful
    to you for the increased attention placed on the support of our
    families.
        As our Commandant, General James F. Amos has said, ``We will keep
    faith with our marines, our sailors, and their families.'' I am proud
    to report to you that we are keeping faith by providing the kinds of
    programs and services that are critical to their quality of life and
    overall well-being. 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 in 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 heroes, we will support and protect their surviving spouses and
    dependents. As both the Commandant and I travel the globe to visit our
    marines and their families, they provide us valuable feedback and let
    us know that they notice and appreciate the much improved quality of
    life programs, such as transitioning our single marine and family
    readiness programs from a peacetime model to a wartime footing;
    expanding support to our wounded, ill, and injured marines; and
    investing in our infrastructure such as housing and bachelor enlisted
    quarters. However, our families also have no problem telling us that we
    have additional work to do. We know that in order to develop, maintain,
    and sustain their personal and family readiness and resiliency, we must
    provide innovative programs and services that are timely and relevant.
    We will do this by focusing on several key areas during this fiscal
    year.
        In his 2010 Planning Guidance, our 35th Commandant directed us to:
    ``Review and Improve Family Readiness--Evaluate all Marine Corps Family
    Team Building Programs and make recommendations on optimum span of
    control, where we require further assistance to our families, and where
    we should streamline to erase redundancy.'' To respond to the
    Commandant's concerns, we have developed a deliberate process and are
    taking the following actions:

        1.  Launching a web-based Program Prioritization Tool that will be
    sent, via email, to Active and Reserve Unit Commanders and Sergeants
    Major to ask them to prioritize our Marine Corps Family Programs based
    on the value to marines and their families.
        2.  Initiating Operational Planning Teams to review the structure
    of the Unit, Personal and Family Readiness and Marine Corps Family Team
    Building Programs to redefine staffing requirements.
        3.  Conducting focus groups with unit commanders, associated
    sergeants major, and respective spouses to obtain their insights on the
    effectiveness of Marine Corps Family programs; identify unmet needs of
    marines and families; and acquire recommendations to fix identified
    deficiencies.

        Based on the feedback we receive, we will develop recommendations
    for funding current and future programs. This is not just about
    efficiencies; it is also about effectiveness. As part of that mandate,
    we have been directed to continue our behavioral health program
    integration; institutionalize resiliency training; and reorganize our
    Transition Assistance Management Program.
        As we move forward, we will continue to keep faith with our marines
    and families by assessing the effectiveness of our support services,
    transitioning and aligning our programs to meet their current and
    future challenges, and demonstrating, through our direct actions, that
    we are committed to improving them. As always, we will continue to be
    fiscally responsible with taxpayers' dollars. My testimony today will
    outline the progress we have made and the actions we are taking in
    these and other critical areas. Thank you.

        Senator Webb. Thank you, Sergeant Major.
        Master Chief Petty Officer of the Navy, Rick West.
        Welcome, Master Chief.

    STATEMENT OF MCPON RICK D. WEST, MASTER CHIEF PETTY OFFICER OF
                             THE NAVY, USN

        Master Chief Petty Officer West. Thank you very much, sir.
        Mr. Chairman, distinguished members of the subcommittee, I
    appreciate the opportunity to appear before you to discuss the
    health of our Navy's enlisted force.
        Your steadfast support of our men and women in uniform has
    had a tremendous impact on their quality of life and quality of
    work. Both are vital to operational readiness and mission
    effectiveness.
        As I speak today, approximately 60 percent of our ships are
    underway, with 40 percent being on deployment worldwide. Other
    than our global presence, traditional maritime operations, and
    developing partnership capacity through worldwide engagement, a
    snapshot across our global Navy would look like the following:
        More than 14,000 sailors are on the ground and more than
    14,000 sailors at sea in Central Command, supporting operations
    in Iraq and Afghanistan.
        Our Navy is executing counterpiracy missions off the coast
    of Africa.
        As part of our global reach, we are at the forefront of
    providing humanitarian assistance and disaster relief support
    to the victims of natural disasters, wherever they occur.
        Our Navy, America's Navy, has no boundaries. We are a
    global force for good.
        In my travels this past year, I have enjoyed the visits
    I've had with the sailors who defend America every day. In
    these visits, I have taken a special note of the quality of
    life and the many programs that support our sailors and their
    families. Current operational demands and high operational
    tempo have placed added stress on the force. Our many personnel
    and family readiness programs remain one of our Navy's highest
    priorities.
        One area that has a recent significant impact on the
    quality of life for our families that I feel a need to
    highlight is the Continuing Resolution (CR) for 2011. Under the
    CR, physical constraints, considerable delays, and permanent
    change-of-station orders occurred, resulting in more than
    20,000 sets of orders being deferred. For those transfers that
    we were able to execute, we have reduced transfer times to 2
    months or less. While relief is on the way, lingering effects
    of the CR will continue to place emotional and economic strain
    on our sailors and their families as they attempt to sell
    homes, seek follow-on employment for family members, enroll
    children in schools and complete necessary screening and
    training requirements prior to transfer.
        Though leadership has been resourceful in mitigating the
    impact, the CR has also affected our ability to execute
    contract for phased new construction and facility sustainment
    in our barracks while, at the same time, forcing us to curtail
    contracts for base operating support and delay necessary
    civilian hiring.
        Despite these challenges, our leadership remains focused on
    providing support to our sailors and their families to foster
    resiliency as well as family readiness.
        Our Navy team will accomplish any mission or task we ask
    them. They do this, knowing their families will be well
    supported and cared for when we go over the horizon into harm's
    way.
        In closing, on behalf of our sailors and their families
    serving throughout the world, thank you for your continued
    support of our great Navy and the programs that support the
    quality of life of all personnel. I look forward to your
    questions, sir.
        Hooyah Navy.
        [The prepared statement of Master Chief Petty Officer West
    follows:]
                 Prepared Statement by MCPON Rick D. West, USN
                                  introduction
        Chairman Webb, Ranking Member Graham, and distinguished members of
    the Personnel Subcommittee of the Senate Committee on Armed Services,
    thank you for the opportunity to testify before you. As the Enlisted
    representative of the Navy, I am honored and privileged to speak before
    you on behalf of more than 430,000 Active and Reserve sailors who make
    the finest Total Force in the history of our great Navy.
        Last year, I visited many commands around the world and most
    recently I traveled with our Chief of Naval Operations (CNO) to
    Afghanistan, Iraq, Kuwait, Bahrain, and Landstuhl, during which I was
    impressed by the quality of sailors serving with such great enthusiasm
    and devotion. I am constantly amazed and truly awed by the daily
    sacrifices and outstanding capabilities and resiliency of our sailors
    who serve with distinction on ships, squadrons, submarines and on land.
    No matter where they are in the world or what they do for our great
    Navy, everything they do is very important and it all plays part in our
    Navy's Maritime Strategy. Our sailors are the best we have ever seen as
    a Navy; they are performing their missions well and I am very proud of
    what they do everyday.
    Sailors in Action
        America's Navy is a global force for good on station around the
    world, around the clock building partnerships through maritime security
    cooperation and spanning the core capabilities of our Maritime Strategy
    of forward presence, deterrence, power projection, sea control,
    maritime security, and humanitarian assistance, and disaster response.
    Our Navy's responsibilities have increased because the challenges our
    country faces are so unpredictable and diverse. We need to be ready to
    confront these challenges, and we are.
        In addition to our traditional maritime mission, below, on or above
    our world's oceans, we are boots-on-ground alongside our brothers and
    sisters in the Army and Marine Corps in places like Iraq and
    Afghanistan. In fact today, we have the second largest force operating
    in that Area of Responsibility (AOR).
        The Navy's contribution in support of Overseas Contingency
    Operations (OCO) has been a vital component of our national effort to
    secure a safer world. At any given time, there are more than 15,000
    sailors in the Individual Augmentee (IA) pipeline worldwide, either
    with orders, in training, or deployed, filling almost 11,000 IA
    requirements. The Navy has almost 25,000 Active and Reserve sailors on
    the ground and at sea in the U.S. Central Command (CENTCOM) AOR
    supporting Navy, Joint Force, and combatant commander requirements in
    support of OCO.
        Using skills traditional to the Navy, our sailors continue to fill
    combat support and combat service support missions. These missions
    include medical support, Joint Task Force and headquarters staff, base
    operating support, detainee operations, engineering, intelligence and
    surveillance, embedded training teams and provincial reconstruction
    teams.
        To date, there have been more than 90,000 IAs in support of OCO
    with more than two-thirds of these sailors mobilized from the Navy
    Reserve. Most IAs are concentrated in the CENTCOM region, which
    includes Iraq, Afghanistan, Kuwait, and Bahrain. But there are also IAs
    serving in other regions to include, but not limited to, Germany,
    Philippines, Cuba, Horn of Africa, and Japan. I assure you that your
    sailors are ready to take on any challenge necessary to protect our
    great nation by providing a constant, well-trained forward presence
    throughout the world.
        With more than 40 percent of our ships deployed daily, America's
    Navy is making the world a better place. Our Navy has conducted counter
    piracy operations in the Indian Ocean and deployed ships to provide
    proactive humanitarian assistance with global partners in missions such
    as Pacific Partnership and Continuing Promise 2010 in the Caribbean.
    Our sailors perform remarkable and selfless feats every day out of
    devout patriotism and commitment to helping others. Last year, our
    sailors responded compassionately while providing humanitarian
    assistance and disaster relief following the earthquake in Haiti and
    flood in Pakistan, and today they are providing assistance in strength
    to the people of Japan after the devastating earthquake and tsunami.
    With all the events and coverage by our Navy worldwide we 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. Our Nation's Navy
    has a global presence and are the first responders when the Nation and
    the world calls.
                              personnel readiness
        We have been very successful in our recruiting and retention
    efforts over the past 3 years. However, we are encountering challenges
    in recruiting health professionals, nuclear operators and special
    warfare operators in both the Active and Reserve components. To meet
    increased demands for these skills, we maintained bonus levels for
    nuclear officers and health professionals and continue to offer
    enlisted accession bonuses to special warfare/special operations and
    other critical ratings.
        In fiscal year 2010, Navy recruiting achieved all enlisted goals,
    including nuclear field, Naval Special Warfare/Special Operations and
    all OCO ratings, as well as total female and women in nontraditional
    ratings. We continue to exceed Department of Defense (DOD) quality
    standards in all recruit categories. For new contract quality in fiscal
    year 2010 we achieved 97.4 percent High School Diploma Graduates (HSDG)
    and 83 percent scored 50 or higher on their ASVAB (Test Score Category
    I-IIIA). We expect this trend to continue into fiscal year 2011.
        America's Navy has transitioned from a posture of reducing end
    strength to one of shaping the force. Our force shaping efforts remain
    focused on maintaining a balanced force in terms of seniority,
    experience and skills, while staying within our congressionally
    authorized end strength limits. We are projected 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 are training and retaining superb sailors who are dedicated to
    serving our Nation. In particular, we remain focused on retaining
    sailors with critical skills in high demand in civilian sector and
    specialties that continue to experience high operation tempo in support
    of OCO. Key to sustaining the force are effective Enlistment and
    Selective Reenlistment Bonus programs which allow us to access and
    retain quality sailors to sustain the Active Force.
        We are finding ways to provide flexible service options and levels
    of participation to maximize each individual sailor's ability to serve
    in the Navy over the course of a lifetime.
        Our Perform-to-Serve program which includes a Selected Reserve
    option, gives us the opportunity to retain our fully-qualified sailors
    within the Reserve component before they separate from active duty. We
    recently incorporated a Fleet Rating Identification Engine (Fleet RIDE)
    application with our Perform-To-Serve initiative. This tool provides a
    comprehensive assessment of sailors' qualifications for alternate Navy
    enlisted ratings so we can transition them to an undermanned technical
    specialty. It further facilitates the Reserve affiliation process by
    providing each Active component sailor with information about Reserve
    opportunities and the ability to apply for a Reserve component quota.
        The Continuum of Service concept looks to develop programs that
    provide sailors with flexible career options within Navy's Total Force
    construct. Our goal for the continuum of service initiative is to
    achieve a seamless transition between the active and Reserve
    components, and civilian work force, to meet mission requirements and
    encourage a lifetime of service. Since the establishment of the Career
    Transition Office (CTO) in May 2009, average transition time has
    decreased from more than 30 days to 4 days. Transition from Active Duty
    to Reserve creates a ``Recruit Once, Retain for Life'' culture. We view
    a sailor's career similar to driving down a highway. Sailors need the
    ability to make ``lane changes'' to meet life-work needs, and the CTO
    is there to make the ``lane change'' as seamless as possible.
        Existing transition assistance programs to facilitate sailors'
    relocation to the civilian sector are robust but would benefit from
    expansion. In the last 5 years, more than 300,000 sailors have
    separated from Navy service while our end strength dropped by
    approximately 35,000 personnel. Although we expect this rate to plateau
    as we satisfy end strength requirements and shape our force, properly
    preparing our sailors for this transition will remain critical so that
    they are able to plan for and become equally productive citizens of
    society.
                               navy reserve force
        Since 1915, Navy reservists have played an integral part in service
    to our Nation. From World War I to World War II, through Operation
    Desert Shield and Operation Desert Storm, to September 11, and to
    Overseas Contingency Operations (OCO), Navy reservists have continually
    stepped up, supported and defended our Nation against enemies, foreign
    and domestic. Since September 11, our Navy Reserve has filled more than
    63,000 mobilization requirements. As of October 2010, more than 7,000
    reservists were mobilized to support of OCO. Our Navy Reserve makes up
    slightly more than 50 percent of the IA force, with slightly less than
    50 percent being Active component sailors. Our Navy Reserve warriors
    continually prove they are more than capable of meeting any challenge
    and conducting any mission, anytime, anywhere.
        As I travel the world to meet and talk with sailors, I could not be
    more proud of the day-to-day efforts and tenacity of our sailors. I'm
    amazed at the integration that has taken shape over the years between
    our Active and Navy Reserve. We are one Force working side-by-side in
    all corners of the world; a Total Force integrated and executing the
    Navy's mission wherever and whenever called.
        Even though we have always had an operational Navy Reserve, since
    the terrorist attacks on September 11 we have relied heavily on our
    Strategic Reserve Force in order to meet various Naval and joint
    military missions. Our Sailor's Creed begins with ``I am a United
    States Sailor'' and that is exactly what I see when I travel throughout
    our Navy; Active and Reserve sailors from all walks of life working
    side-by-side as one team, one family and one Navy.
        We ensure that billets are filled and missions are manned properly,
    but our Navy families are top priority, and we remain committed to
    balancing mission requirements with family needs.
                          sailor and family readiness
        As our Navy evolves and we continue to have the most advanced
    equipment, technology, weapons systems and platforms, one thing remains
    the same: The engine that truly drives our Navy and the reason we are
    the best is our people.
        I greatly enjoy every opportunity I get to travel around the world
    to meet and talk with sailors and their families. When I see our hard-
    working, high-spirited and amazingly capable sailors, it makes me very
    proud and humbled. Now, that I am toward the end of my career, I am
    entering a new career field, that of being a Navy family member. My
    oldest son, Zach, is a Navy Diver and my wife Bobbi and I know what it
    is like to watch our son deploy in harm's way, waiting, wondering and
    praying that everything will be alright and he will return home safely.
    I also know what it feels like to be the spouse at home watching your
    loved one deploy. I experienced this first-hand this past year when my
    wife was deployed to Afghanistan with the Naval Criminal Investigative
    Service. As we all know, we certainly could not do our jobs and
    probably would not be where we are today without the love and support
    from our families and spouses.
        I could not be more proud of our Navy families for their remarkably
    selfless dedication and steadfast support of our sailors. Our families
    have sacrificed so much as they have supported their sailors and our
    great Navy. We are the greatest Navy in the world and a big part of
    that is our sailors being ready and able to focus on the mission and
    their individual jobs because they have the confidence that our Navy is
    taking care of their families.
        Deployments are an integral part of Navy life. We have been
    deploying our forces since we formed our great Navy during times of
    both peace and conflict, but it is important not to underestimate or
    take for granted the incredible strain that a long deployment imposes
    on our sailors and their families. Multiple deployments, frequent
    relocations and the stresses associated with being part of a military
    family all impact the overall readiness of the unit, the readiness of
    the individual sailor, and the readiness of their family.
        Keeping our Navy families informed about resources available to
    them to mitigate the strain of deployment and provide support is
    instrumental to their peace of mind while waiting for their sailors to
    return from year-long assignments in the Middle East or 6-month
    deployments safeguarding our seas. Through resources such as `Navy for
    Moms,' `Navy Dads,' Military OneSource, Navy.mil and various other web
    sites, our sailors and their families are more informed today about the
    resources available to them than they have ever been in the history of
    our Navy. Another success in communication has been the use of smart
    phone applications such as `Navy Life' and `Navy IA' as well as social
    media web sites such as Facebook and Twitter to connect with sailors
    and families. Both CNO and I are committed to using social media
    because it is a great opportunity to remain connected with our sailors
    Navy-wide and a great tool in our outreach efforts for getting
    information out in a timely manner to our entire Navy family, which
    includes Active and Reserve sailors, families, retirees, and Department
    of the Navy civilians.
        Morale, Welfare, and Recreation (MWR) programs are also
    instrumental in our commitment to addressing Sailor and Family
    Readiness. The Navy has embraced a ``Culture of Fitness'' through
    incorporation of programs such as the Navy Operational Fitness and
    Fueling Series and Family Fitness Opportunities. We facilitate these
    and other initiatives through access to modern facilities and evolving
    approaches to holistic health. Sailors are required to meet physical
    fitness and body composition standards that necessitate a regimented
    approach regardless of environment, climate or other limitations.
    Ashore, our sailors and families also rely on MWR to strike a balance
    between the demands of military service and the importance of off-duty
    pursuits with loved ones.
                               continuum of care
        Health care is one of our top recruiting and retention tools for
    our sailors, and I continuously hear just how important access to
    health care is for them and their family members. Navy Medicine
    continues to focus on developing an economic and quality-centric
    strategy for the delivery of top-quality health care to our
    beneficiaries, and the recruitment and retention of providers in
    critical specialties allowing the fulfillment of the wartime mission,
    while sustaining the benefit here at home.
        Operational tempo of the force remains at very high levels. To
    ensure the behavioral health needs of our sailors is met, we are
    seeking ways to refine existing programs, as well as exploring new
    opportunities to address future demands. In particular, our Navy's
    Operational Stress Control Program, Navy Reserve Psychological Health
    Outreach Program, Warrior Transition Program, Returning Warrior
    Workshop, Navy Safe Harbor, and our Medical Home Port Program are
    critical elements of our comprehensive continuum of care and we must
    continue to support the expansion of these programs as the need
    requires.
        The Navy's Safe Harbor Program is the Navy's lead organization for
    providing the highest quality non-medical care to all seriously
    wounded, ill, and injured sailors, coastguardsmen, and their families.
    Using a holistic approach, Navy Safe Harbor offers a lifetime of
    individually tailored assistance designed to optimize the success of a
    sailor's or coastguardsmen's recovery, rehabilitation and reintegration
    activities. Since January 2008, Safe Harbor has grown from 9 personnel
    supporting 145 sailors and families at 6 locations to serving a case
    load of more than 1,200 wounded, ill, or injured servicemembers at 16
    locations. Safe Harbor's goal is to return sailors and coastguardsmen
    to duty and when not possible, work collaboratively with Federal and
    nongovernmental agencies, including the Department of Veteran Affairs
    and State and local organizations, to ensure their successful
    reintegration back into their communities.
        Through our Fleet and Family Support Centers we offer a number of
    personnel and family support programs to reduce life stressors
    including, but not limited to physical readiness, life skills
    education, financial management, health promotion, and religious
    ministries. Furthermore, our family readiness programs promote healthy
    and resilient families, focusing on areas such as the prevention of
    suicide and domestic violence, and providing developmental child care
    and youth programs and services. We make every effort to reach
    servicemembers and families no matter how remote their location through
    webinars, monthly electronic newsletters and deployment preparedness
    handbooks.
        The Bureau of Medicine and Surgery implemented Medical Home Port
    (MHP) throughout Navy Medicine in 2010 as a new model of healthcare
    delivery in primary care. Care delivered in the MHP model includes, but
    is not limited to, readiness, prevention, wellness, behavioral health,
    and disease management. This model enables sailors to be treated in the
    settings in which they feel most comfortable and reduces the stigma
    associated with the care they receive. MHP increases access to care,
    improves clinical quality and patient outcomes, enhances patient
    satisfaction, promotes a healthier and fit force, and reduces
    healthcare utilization, resulting in a reduction in overall healthcare
    costs.
        Combat casualty care is provided by Navy medical personnel assigned
    to and serving with Marine Corps units, in Expeditionary Medical
    Facilities, aboard casualty receiving/treatment ships and hospital
    ships, and in military and Department of Veteran Affairs hospitals.
    Recent advances in force protection, battlefield medicine, combat and
    operation stress control, medical evacuation, and family support
    programs have led to improved survival rates, healthier family
    functioning and enhanced operational effectiveness.
        The Navy continues to provide support to sailors and their families
    through a variety of programs that increase medical and non-medical
    assistance to wounded, ill, and injured servicemembers utilizing a
    comprehensive approach designed to optimize their recovery,
    rehabilitation and reintegration. Navy Case Management is the link that
    connects resources and services which allow injured servicemembers to
    reach their optimum goals in healthcare. Case Management provides the
    critical support servicemembers need during this challenging time in
    their lives. Case Management will continue to be at the forefront of
    providing optimal care to our servicemembers with war-related injuries.
    Navy Medicine has 192 Medical Case Managers providing service to our
    wounded, ill, and injured sailors in Military Treatment Facilities and
    ambulatory care clinics.
                     suicide and sexual assault prevention
        We continue our suicide prevention efforts through a multi-faceted
    system of communication, training and command support designed to
    foster resilience and promote psychological health among sailors. In
    calendar year 2010, the Navy had 38 sailor suicides compared to 46 in
    2009.
        The Navy continues to develop and enhance programs designed to
    mitigate suicide risk factors and improve the resilience of the force.
    These programs focus on substance abuse prevention, financial
    management, positive family relationships, physical readiness, and
    family support with the goal of reducing individual stress. We continue
    to work toward a greater understanding of the issues surrounding
    suicide to ensure that our policies, training programs, interventions,
    and communication efforts are meeting their intended objectives.
        More and more shipmates, leaders, and family members are noting
    signs of concern and are reaching out to get sailors the help they
    need. We recognize that long before thoughts of suicide occur, we have
    opportunities to build resilience, intervene early when risk factors
    are present, and create the connections that help sustain us in times
    of challenge. Most of these efforts fall within our broader family
    readiness and health promotion activities.
        The Navy has expanded the surveillance and analysis system for Navy
    active and Reserve suicide deaths and attempts; supported command
    prevention and stress control programs with printed resource and
    interactive training materials; provided training world-wide to suicide
    prevention coordinators and first responders; and provided Navy
    representation in DOD, VA, and other cooperative efforts.
        For most sailors, suicide prevention is more than just a training
    topic. About half have personally known someone in their lives who was
    lost to suicide. Sailors and leaders genuinely care and have shown it
    in the way they have engaged vigorously in focus groups, put forth
    tremendous creativity in developing suicide prevention posters and
    materials, and enthusiastically embraced new hands-on training
    materials. Their caring shows in the dozens of times each month someone
    assists a struggling shipmate to get some help. This past year, we
    implemented programs such as the Coalition of Sailors Against
    Destructive Decisions (CSADD) which is gaining momentum with our
    younger sailors.
        CSADD's mission is to provide military members of all branches with
    the best prevention and intervention tools possible to deal with the
    issues of drinking, reckless driving, and other destructive decisions
    while maintaining good order and discipline, to assist sailors in
    making life decisions that will maintain positive lifestyles in keeping
    with the Navy's core values, to guide sailors away from making poor and
    destructive decisions by providing them with positive and dynamic
    training and to show sailors how to make quick positive decisions and
    put their training to use in moments of high stress and peer pressure.
        The Navy has a `zero' tolerance policy for sexual assault; it is a
    criminal act. The majority of sexual assaults are servicemember-on-
    servicemember and it is incomprehensible that a sailor would commit
    such a horrible crime against another shipmate. It undermines teamwork,
    morale, unit cohesion, and operational readiness.
        At the close of calendar year 2010, reports of sexual assault
    increased from 2009. This increase could be attributed to victims'
    increased willingness to report the crime. This demonstrates that our
    education and prevention efforts are showing progress, but we
    acknowledge sexual assaults are still occurring in our Navy. The
    highest risk group for victims over the past several years remains E-1
    to E-4, ages 20 to 24, with most incidents occurring during the
    weekends. In most sexual assault incidents, alcohol was a major factor
    impairing the judgment of offenders, victims, and bystanders.
        In order to remove sexual assault from our Navy, we are ensuring
    commands have a strong partnership with Sexual Assault Response
    Coordinators (SARCs) and a robust Sexual Assault Prevention and
    Response (SAPR) Program which fosters an environment where `shipmates
    help shipmates' by not allowing destructive behavior to occur.
        The SAPR program, established in 2004, promotes training, builds
    awareness and provides advocacy and supportive services for victims of
    sexual assault. It is a victim-focused program that focuses on response
    and offender accountability. The SAPR program is conducting a
    comprehensive review of training curriculum for those entering the
    Service ranks and attending professional military schools. The Navy
    embraces bystander intervention as the core of our strategy to protect
    sailors from sexual assault. Bystander intervention is key to
    preventing sexual assaults before they occur. Our goals include
    reducing the incidents of sexual assault, improving support for victims
    of sexual assault, and building prevention based upon insights from
    data-driven critical assessments. We will continue to revise and
    improve the SAPR program to create an environment free of sexual
    assault for all Navy personnel.
                                   child care
        In today's military, many of our sailors have working spouses or
    have the responsibility of being single parents who depend heavily on
    our military child and youth system of care, which includes Child
    Development Centers (CDC), to provide quality child care. Due to
    frequent relocations and the length of deployments, many of our sailors
    do not have the option, like civilian families, to rely on family
    members and friends to assist with taking care of their children when
    they are away.
        An important facet that stands out in the quality of our child care
    programs is the continuity of service from location to location as we
    operate a standardized worldwide program. Sailors and their children
    can count on the same quality of care whether they are stationed in
    Chinhae, Korea, or San Diego, CA. Additionally, our programs are among
    the most affordable. Commercial programs charge parent fees based on
    the age of the child while our programs base fees on total family
    income. This model is critical to the economic viability of our
    families. Children under the age of three are the most costly to care
    for due to the lower child-to-staff ratios, and typically our most
    junior enlisted families have children in this age group.
        This fiscal year, we will complete an expansion of approximately
    7,000 new child care spaces meeting the Office of the Secretary of
    Defense guidance to provide 80 percent of potential need for child care
    spaces (54,000 total spaces for children ages infant to 12th grade,
    including 19,000 CDC spaces). With the construction of these spaces, we
    will reduce the waiting time for child care to 3 months or less Navy-
    wide with first priority given to single parents.
        Our continuing expansion initiatives are not only meeting the needs
    of our families living on or near our installations, but also those
    living and working throughout the United States, including Reserve
    members. Our contract programs ``Military Child Care in Your
    Neighborhood'' and ``Mission Youth Outreach'' provide subsidized child
    and youth services from commercial programs that meet community quality
    standards. We continue to work with communities, assisting them with
    raising the quality of their standards.
               homeport ashore, bachelor and navy family housing
        Thanks to the support of Congress, through military construction
    and housing privatization, we have made significant strides in
    improving the living conditions of our sailors and their families. Our
    Homeport Ashore program continues to provide adequate off-ship quarters
    to junior sailors who are not entitled to a Basic Allowance for Housing
    and would normally live aboard ships. This effort marks the most
    dramatic quality of life improvement initiative for our single sailors
    that I have seen over the course of my career.
        Still, one of my biggest quality of life concerns is that we have
    approximately 5,400 single sailors, E-1 to E-4 with less than 4 years
    of service living aboard ship while in their homeport. The Navy has
    made considerable progress toward achieving the Homeport Ashore goal
    through military construction, privatization, and intensified use of
    existing barracks capacity (based on an interim assignment policy
    standard 55 square feet of space per person). Moving our single sailors
    off ships remains a priority and requires us to assign two or more
    sailors per room. Although housing these sailors does not meet the DOD
    requirement of 90 square feet per person, our sailors are very thankful
    for this initiative and know that we will continue to work to meet this
    requirement.
        Our Bachelor Housing provides permanent party personnel, students,
    and mobilized Sailors with suitable, affordable, and safe environments
    in community, privatized, or Navy-owned housing. It supports
    unaccompanied permanent party personnel, students, and mobilized units
    worldwide. The fiscal year 2012 Bachelor Housing program is focused on
    completing Homeport Ashore by 2016 and eliminating substandard Bachelor
    Housing conditions. With respect to addressing the condition, the Navy
    has increased its investment in the restoration and modernization of
    bachelor housing across the Future Years Defense Program to bring 90
    percent of the inventory to Q1/Q2 (or adequate) standards by 2022.
        In fiscal year 2011, the Navy would begin this initiative through
    the renovation of barracks in Milton, FL; Atsugi, Japan; Ventura,
    Lemoore, and San Diego, CA; Whidbey Island and Bremerton, WA; and Pearl
    Harbor, HI.
        The Navy owns approximately 10,000 family housing units worldwide.
    Based on revised Office of the Secretary of Defense criteria directing
    the use of Q-ratings, the Navy has identified approximately 3,700 Navy-
    owned homes as inadequate. The revised definition is based on the
    physical condition of the home as a function of its replacement value.
    The previous inadequate definition was identified as a building in need
    of more than $50,000 of repairs. We have privatized approximately
    40,000 homes in the CONUS and Hawaii inventory. The privatization of
    the remaining 870 homes in the northwest is scheduled for the end of
    2013. The privatization of the remaining 226 homes in the southwest is
    under review. When the Public Private Venture (PPV) transition is
    complete, the Navy will own less than 100 homes in CONUS and Hawaii,
    but will retain ownership and management of all foreign assets.
        Thanks to the support of this committee and Members of Congress, we
    have improved the housing available to our sailors through PPV. Sailors
    cite the PPV initiative as one of the most effective quality of life
    improvements in recent years.
        Quality of life does affect retention and recruiting. PPV and
    Homeport Ashore are examples of initiatives that have had a direct
    impact on the retention, morale and the quality of life of our men and
    women. They are shining examples of our covenant with sailors to
    recognize their service through tangible improvements to their welfare,
    and represent ideal opportunities for expanded utilization.
                                   conclusion
        America's Navy is very much a global force for good on station
    around the world and around the clock, deterring aggression, keeping
    the sea lanes open for free trade, projecting power and maritime
    security, and delivering humanitarian assistance and disaster response
    where needed. Sailors are the key element in our Navy's future force.
        Our Navy family members share our sacrifices while providing
    support. They have courage, strength and deep devotion to our country.
    Our Navy families endure the challenges of multiple deployments and
    moves, spend holidays and life milestones apart, juggle everyday tasks
    while a spouse, parent, son, or daughter is in harm's way, and honor
    the service of their loved ones and memories of those lost.
        We must continue to ask hard questions and make hard decisions that
    will enable us to provide a quality of life commensurate to the
    sacrifices our sailors and their families make. The Continuing
    Resolution (CR) for 2011 has affected us in several areas including
    various military construction projects that have been delayed and may
    not be executed. But most of all, it has had a negative effect on our
    ability to properly support quality of life for sailors and their
    families.
        Due to the way resources are phased and allocated under the CR, the
    Navy does not have sufficient manpower funding to allow for normal lead
    times for sailors to receive Permanent Change of Station (PCS) orders
    as funds must be allotted to cover pay and benefits. Average lead times
    have been reduced from 4 to 6 months to approximately 2 months or less.
    This places great emotional and economic stress on sailors and their
    families. In today's economy, there is a great possibility that if they
    own a house, they will not be able to sell it or have enough time for
    the spouse to be able to find a job in the new location. Our Navy
    families affected by these constraints are often forced to live apart.
    The impact of Navy's PCS funding level is being felt across the force,
    and will continue until funding is resolved.
        On behalf of our sailors who sacrifice daily and their families who
    faithfully support them, I want to extend my sincere appreciation for
    your unwavering support for our U.S. Navy. Thank you.

        Senator Webb. Thank you, Master Chief.
        Chief Master Sergeant of the Air Force, James Roy, welcome.

     STATEMENT OF CMSAF JAMES A. ROY, CHIEF MASTER SERGEANT OF THE
                            AIR FORCE, USAF

        Chief Master Sergeant Roy. Chairman Webb, members of the
    subcommittee, thank you for the opportunity to tell you about
    America's Air Force and our families.
        It's an honor and a distinct privilege to join my fellow
    senior enlisted advisors here today to represent one of the
    finest air forces in the world and, of course, those young men
    and women that make up our U.S. Air Force.
        There are more than 702,000 who make up the total force
    team: Active Duty, Guard, Reserve, and civilians. Two members
    of the total force team join me today: Chief Master Sergeant
    Denise Jalinski-Hall, a senior enlisted leader for the National
    Guard Bureau, and Chief Master Sergeant Chris Muncey, the
    command Chief Master Sergeant for the Air National Guard.
        We appreciate the unwavering support of the members here
    and from the entire Senate, which is a vital part of our
    success. We are greatly appreciative of your efforts, actions,
    and legislation that have led to the expansion of
    servicemembers' and veterans' pay and benefits. We also
    appreciate the visits by the Senators to our servicemembers in
    the field and to the wounded warriors in healthcare facilities.
        To represent all the Air Force wounded warriors, I am
    joined here today by Technical Sergeant Chris Frost, an
    explosives ordinance disposal technician who lost both legs
    below the knee when his vehicle struck a 700-pound improvised
    explosive device in Iraq in 2008. The blast killed one soldier
    and injured two others in his vehicle. Sergeant Frost has since
    returned to duty, mentored other wounded warriors and cycled
    3,500 miles across America. Sergeant Frost inspires all of us.
    It is an absolute pleasure serving with him, and I salute his
    resiliency.
        Senator Webb. Sergeant, where are you? Thanks for what
    you've been doing, and we are really proud of how you've come
    back from your wounds. You bounced right out of that chair.
    That's very impressive.
        Chief Master Sergeant Roy. Our airmen are on our front
    lines in a variety of theaters of operation, including
    America's recent missions over Libya and on the ground for
    humanitarian missions in Operation Tomodachi. They are also
    providing airmanship skills to combatant commanders around the
    world, and they are constantly deployed, leaving behind
    families and friends.
        We must ensure our airmen and their families are safe,
    healthy, and resilient. Building resiliency among airmen and
    their families is a key focus area. Our warriors have been in
    Iraq and Afghanistan for nearly 10 years, and in the Middle
    East for over 20 years.
        We are deliberately increasing the focus on building
    stronger, resilient families because of our continued high
    operational tempo at home and abroad, as well as the unique
    role of airmen, such as remotely piloted aircraft operators,
    who affect the battlespace each and every day. Resilient airmen
    are better equipped to withstand, recover, and continue to grow
    in the face of stressors and the changing demands, while
    continuously getting the job done.
        It is my distinct honor to be with you here today and tell
    you about America's Air Force and what we do on a daily basis.
        Thank you again. I look forward to any questions.
        [The prepared statement of Chief Master Sergeant Roy
    follows:]
                 Prepared Statement by CMSAF James A. Roy, USAF
                                  introduction
        Chairman Webb, Senator Graham, members of the subcommittee, thank
    you for this opportunity to share with you information important to
    America's airmen, their families, and our U.S. Air Force. It is an
    honor and distinct privilege for me to join my fellow Service Senior
    Enlisted Advisors and represent our Nation's finest men and women.
        This fiscal year, we have a programmed Total Force end strength of
    702,367 which includes 332,200 active duty, 192,267 civilians, 71,200
    Reserve, and 106,700 Air National Guard personnel. In the fiscal year
    2012 budget, we have requested a Total Force end strength that will
    decrease to 693,099. While active duty end strength will only increase
    by 600 airmen to 332,800, our civilian end strength will decrease by
    just over 10,000 to 182,199 civilians. We will also increase the
    Reserve end strength by 200 to 71,400 while the Air National Guard
    remains unchanged at 106,700.
                                force management
        Fiscal constraints and 16-year record high retention rates compel
    the Air Force to develop voluntary and involuntary programs to manage
    our end strength levels. We must operate within our budget and we are
    committed to meeting our end strength. To do so, we have made tough
    decisions that will impact airmen across the 30-year continuum of
    service. For new airmen who fail to complete their initial skills
    training, we established a Limited Initial Skills Training process that
    considers these airmen for either retention or separation based on the
    needs of the Air Force. We encourage voluntary separations and
    retirements for more seasoned airmen by offering both limited active
    duty service commitment waivers and time-in-grade waivers. They may
    also voluntarily apply to complete their service commitment in the Air
    Reserve component through our Palace CHASE Program or continue service
    in the Army through the Blue-to-Green Program.
        In an effort to manage the enlisted force within authorized end
    strength, we are continuing the Date of Separation (DOS) Rollback
    Program. This initiative separates airmen early who have already chosen
    to transition from the Air Force. It also provides an avenue to
    accelerate the removal of airmen who possess negative quality force
    indicators.
        Our force management strategy is not a quick fix, but a tailored,
    multi-year effect designed to manage the force along a 30-year
    continuum of service.
                                   accessions
        We must protect accessions while taking care of our people as the
    impact of under-accessing airmen is felt for the next 20 years. As
    previously mentioned, our force management efforts include reducing
    accessions. Although below desired sustainment levels, reductions are
    manageable within the short- and long-term health of the force. For
    fiscal year 2011, this included 2,135 enlisted accession reductions and
    439 officer reductions. In fiscal year 2012, our reductions are deeper.
    Enlisted accession reductions are set at 2,407 while officer reductions
    are set at 639.
               recruiting, retention, bonuses, and incentive pays
        America deserves the very best Air Force in the world, and it takes
    recruiting, developing, and retaining the highest quality airmen to
    maintain that status. To do so, our fiscal year 2012 budget request
    includes $30.5 billion in military personnel funding, to include a 1.6
    percent pay increase. Although our recruiting quality and retention
    levels are at the highest in 16 years, we are obligating $630 million
    for bonuses to recruit the right skill sets and retain experienced
    airmen for today's fight and the emerging missions of tomorrow. Without
    these funds we will handicap our commanders in their ability to
    efficiently and effectively carry out the full range of missions
    America demands of its Air Force.
        Air Force recruiting continues to need high quality recruits, even
    during periods of high retention. Higher quality recruits increase the
    probability of success during their initial training. Basic Military
    Training attrition went from a high of 10.7 percent in fiscal year 2007
    down to 6.8 percent in fiscal year 2010 due to higher caliber recruits.
    Additionally, as a Service, we need a continuing flow of high quality
    recruits to fill entry-level positions as current airmen progress into
    advanced positions and eventually separate or retire. Continued support
    for maintaining high quality now will allow the Air Force to compete
    for the best and brightest along a broad spectrum, especially when
    unemployment improves and current retention returns to normal levels.
        The Air National Guard (ANG) is focusing its recruiting efforts on
    precision recruiting to existing vacancies. The ANG is currently
    projecting to be at or near its authorized end strength of 106,700 at
    the end of fiscal year 2011.
        The Air Force Reserve uses its bonus program to meet the demand for
    critical skills deemed vital to Air Force Reserve mission. Its bonus
    program has been pivotal to recruiting and retaining the right people
    to meet combatant commander requirements. Development of these skills
    usually requires long training courses. Members with these skills are
    normally in high demand within the private sector. With continued
    funding, the Reserve will be able to offer the appropriate combination
    of bonuses for enlistment, reenlistment, affiliation and health
    professionals. Current indications illustrate the bonus program is
    positively benefitting recruiting and retention.
        The Air Force has a relatively small budget for recruiting special
    skills into the Service. On the enlisted side, these skills range from
    ground and airborne cryptologic language analyst; combat control;
    tactical air control party; survival, evasion, resistance, and escape;
    pararescue; special operations weather; and explosive ordnance
    disposal.
        A 16-year high in active duty enlisted retention has necessitated
    moderate reductions in accessions and additional force management
    actions including rollbacks of Dates of Separation (DOS), separations
    for initial skills training failures, waivers for active duty service
    commitments, time-in-grade requirements and enlistment contracts which
    will continue through fiscal year 2012. Without these actions in fiscal
    year 2010, our overall retention would have exceeded the goal by more
    than 4 percent. The Air Force finished fiscal year 2010 at 100 percent
    of its retention goal in Zone A, 17 months through 6 years of service
    (YOS), exceeded the goal in Zone B, 6 YOS through 10 YOS at 109
    percent, and was under its retention goal in Zone C, 10 YOS through 14
    YOS at 93 percent. Based on current economic forecasting, the Air Force
    is expected to experience consistent retention rates over the next few
    years.
        Selective Reenlistment Bonuses (SRB) are our most effective,
    responsive and measurable tool for targeted retention. The fiscal year
    2012 budget for new SRB contracts does change from fiscal year 2011's
    budget of $145.9 million as we expect to offer SRBs to fewer than 90
    enlisted specialties in fiscal year 2012.
        The Air Force uses Cumulative Continuation Rates (CCR) to track
    retention by AFSC and by reenlistment zones. The CCR shows the expected
    rate an airman is likely to remain in the Service from year-to-year or
    zone-to-zone. SRBs are also an effective tool for addressing targeted
    retention by AFSC and by zone. In fiscal year 2009, SRB costs were
    $227.6 million of the total Air Force budget of which $70.4 million
    were comprised of anniversary payments, $156 million in new bonuses,
    and $1.2 million in accelerated payments. Conversely, in fiscal year
    2010 funding for new bonuses fell from $156 million to $141 million and
    fell even further in fiscal year 2011 and is now down to $129.9
    million. Currently, 89 AFSCs are receiving SRBs in fiscal year 2011.
        Our Service will continue to experience high retention through
    fiscal year 2012 and likely into fiscal year 2013. However, we must
    still overcome several skill imbalances as a result of previous actions
    to reduce end strength by deliberately under-accessing in fiscal year
    2005 and building larger AFSCs for new and emerging mission sets.
    Additionally, the Air Force will continue using CSRBs and SRBs to
    manage retention and address shortfalls in critical skills and levels
    of skill in various AFSCs while also implementing force management
    tools to target losses in overage skill sets as we appropriately shape
    the force.
                                   diversity
        In a Nation where only 25 percent of our youth are eligible to
    serve in an All-Volunteer Military, it is necessary to maintain a
    diverse Air Force to overcome today's increasingly complex challenges.
        In the fall of 2010, we published strategic guidance to include a
    diversity policy directive and Diversity Roadmap, which provides
    priorities, goals and specific actions for implementation of diversity
    initiatives. Formalizing the Diversity Roadmap into an Air Force
    Instruction will provide the Total Force its final piece of strategic
    guidance. Woven into the instruction will be vetted recommendations of
    the Military Leadership Diversity Commission. We anticipate completion
    of the instruction by the end of September 2011.
        We furthered the institutionalization of diversity by holding the
    inaugural Diversity Senior Working Group in October 2010. Showcasing
    senior leader commitment, the Chairman of the Joint Chiefs, Secretary
    and Chief of Staff of the Air Force, in addition to 60 senior leaders
    from the major commands and the Pentagon participated. Participants
    were challenged to promote diversity within their sphere of influence.
    For example, leaders can make diversity a personal commitment by
    participating in two outreach events per year, adding a diversity
    message in speeches, identifying key positions and implementing hiring
    practices with a diversity lens, analyzing mentoring programs and
    determining how to resource diversity within the major commands and
    wings.
                             human capital strategy
        Deliberately developing airmen is a key focus area. Our airmen must
    have the right mix of skills so the Air Force can continue providing
    combat-ready, expeditionary forces to combatant commanders now and in
    the future.
        The Air Force is focused on providing the right expeditionary
    combat skills needed for our airmen to fly, fight, and win. It is
    critical that our airmen have the experience, education, and training
    to think with a global perspective and operate in an expeditionary
    environment.
        Airmen must be specifically trained, educated, and experienced
    through professional development initiatives designed to create the
    capabilities and capture current and future mission demands. We
    implemented several new initiatives to enhance the development of our
    airmen focusing on their experience, education and training to ensure
    they are prepared to fill current and future leadership positions.
    Central to our efforts is the shift to assigning the most ``qualified''
    airman versus the most ``eligible'' airman for our key billets.
        Our new approach to managing enlisted talent gives us the
    capability to evaluate Senior Noncommissioned Officers (SNCOs) and
    select the right airmen for critical jobs, while also ensuring they are
    vectored in the proper career sequence and that we are preparing them
    for future leadership roles. This new approach, coupled with our new
    special experience identifier tracking codes, give our assignment teams
    the tools to identify airmen with the requisite training and experience
    for key positions.
        We start by focusing our attention on the Air Force's No. 1
    priority--Nuclear Enterprise. Our 2W2 (Nuclear Weapons Maintenance) and
    21M (Munitions, Missile Maintenance) career fields have developed
    prioritization lists to ensure we assign the most qualified airmen to
    positions by order of importance within the Nuclear Enterprise.
                 continue to strengthen the nuclear enterprise
        The Air Force continues to strengthen the nuclear enterprise,
    placing increased focus on ensuring the nuclear deterrence mission is
    executed with precision and reliability every single day. Secretary of
    the Air Force Michael B. Donley, Air Force Chief of Staff General
    Norton A. Schwartz, and I have all visited the nuclear missile fields.
    We had the opportunity to speak with the amazing airmen who provide the
    same round-the-clock nuclear deterrence as their predecessors have for
    over 50 years. These airmen are working diligently to achieve the
    standard of perfection the nuclear mission demands and the American
    public expects.
        I'm happy to report that Air Force Global Strike Command reached
    Full Operational Capable status in September 2010. This change provides
    the needed oversight and advocacy of the Air Force's Intercontinental
    Ballistic Missile (ICBM) and nuclear-capable bomber forces.
        The demand of the nuclear mission requires discipline and
    compliance with the highest standards. It is imperative that airmen at
    every level are focused on upholding our core values of Integrity
    First, Service Before Self and Excellence in All We Do.
                    airmen in the joint and coalition fight
        More than 94,400 Total Force airmen are currently forward stationed
    or deployed worldwide supporting combatant commanders. Another 133,000
    provide daily strategic mobility, space and missile capabilities,
    command and control, and intelligence, surveillance, and reconnaissance
    to joint warfighters. In all, 42 percent of the Total Force directly
    supports combatant commander requirements every day.
        Almost 29,000 airmen are deployed to the U.S. Central Command area
    of operations, with more than 3,700 filling joint expeditionary
    taskings. Airmen are on the frontlines with their fellow soldiers,
    sailors, and marines in roles such as detainee operations, convoy
    employment and protection, explosive ordnance disposal, police training
    teams, military transition teams, civil engineering, security,
    communications, fuels, medical services, logistics, intelligence, and
    base operating support. They are part of the joint team, serving in
    whatever capacity needed by the combatant commander. Together with our
    sister services, we are training and augmenting both Iraqi and Afghan
    security forces, rebuilding critical infrastructure, and providing
    medical services to these war-torn countries.
        Our remotely piloted aircraft (RPA) platforms continue to increase
    the support to joint and coalition warfighters on the ground. Airmen
    are finding, tracking, and attacking our enemies using Air Force
    Predators, Reapers and Global Hawk RPA aircraft. Our Predator
    operations alone have increased from 12 combat air patrols in 2007 to
    48 today to support combatant commanders and warfighters. By growing
    the number of RPA operators and increasing the number of combat air
    patrols to 58 by the end of fiscal year 2012, we are protecting joint
    and coalition interests around the globe from bases within the United
    States.
                                  deployments
        As of 1 March 2011, we have more than 38,000 deployed personnel,
    approximately 5,000 of which are fulfilling Joint Expeditionary
    Taskings working with our sister Services. In order to meet the growing
    demands of combatant commanders, Air Force 179-day tours increased from
    12 percent of all deployments in calendar year 2004 to 60 percent
    today. In October 2010, the Chief of Staff of the Air Force established
    the Air Force's baseline deployment tour length to be 179-days,
    normalizing this for all airmen by October 2012. Still, approximately
    1,800 of our deployment requirements, or 7 percent of all deployments,
    call for airmen to be deployed for 365 days.
        Continuing to fill both the deployed and home-station mission
    continues to take its toll on our units. The end-result of the new 179-
    day deployment standard will keep airmen on typical deployments for an
    additional 60 days but will also provide them and their families more
    time at home between deployments. Additionally, the longer standard
    deployment will reduce the amount of pre-deployment training required
    over a career.
        In total, more than 216,000 Total Force airmen support daily
    combatant commander operations.
                          airman and family resilience
        Building resiliency among airmen and their families is another key
    focus area. Our warriors have been in Iraq and Afghanistan for nearly
    10 years and in the Middle East for over 20 years. Continued high
    operations tempo at home and abroad stress to us the need to
    deliberately increase the focus on building strong, resilient families.
    Resilient airmen are better equipped to withstand, recover and/or grow
    in the face of stressors and changing demands, and continuously get the
    job done. Many of our programs are designed to continue to build
    resilient airmen and families.
        We are committed to strengthening the resilience of our airmen and
    their families. Our goal is to improve leadership commitment toward
    building resilient airmen who have the ability to withstand, recover,
    and grow in the face of stressors and changing demands--regardless of
    time, challenge, or location.
                       exceptional family member program
        The Exceptional Family Member Program (EFMP) is how we assist
    airmen and their families who have special needs, balancing mission
    requirements with family care responsibilities. We continue to focus
    attention this year on supporting our 17,000 airmen with exceptional
    family members.
        Two facets of EFMP are assignments, managed through the Air Force
    Personnel Center and Special Needs Identification and Assignment
    Coordination, administered by the Air Force Medical Service. We
    recently added a third element, EFMP-Family Support, which provides
    information and referral services available in the base and local
    community.
        These airmen and their families require more comprehensive support
    beyond the identification and assignment process. To address this gap,
    we have designated a staff member from the Airman and Family Readiness
    Center at each installation to provide information, referral and
    assistance to families with special needs. We have hired additional
    staff at 35 installations with 175 or more special needs families to
    provide targeted focus on family member support. Additionally, to
    improve on the coordination of care for high-risk families, the Air
    Force will add 36 active duty social work billets beginning in fiscal
    year 2012. Furthermore, we have increased our communication and
    marketing efforts at our Airman and Family Readiness Centers and
    Medical Treatment Facilities to ensure airmen and families are aware of
    the enhanced resources available to them.
                                quality of life
        We thank Congress for its steadfast funding for quality of life
    initiatives. We look forward to continued support to enable us to
    retain skilled airmen and develop them into the leaders we need for the
    future.
        The quality of life airmen and their families receive is an
    overwhelming factor in how long they will serve. During the Year of the
    Air Force Family (YoAFF), we focused on four main pillars: health and
    wellness; airmen and family support; education, development and
    employment; and airmen and family housing. Among the many initiatives
    resulting from the YoAFF, we implemented the Family Health Initiative
    at 32 Medical Treatment Facilities, convened a Single Airman Summit in
    April 2010, provided each installation funding to support spouse
    employment programs, and developed the Building Thriving Housing
    Communities Strategy.
        Whether working on the installation or deployed fighting the
    Nation's wars, our airmen deserve buildings and facilities of a high
    standard commensurate with the outstanding service they provide their
    country. Since 2000, and with the very generous support of Congress,
    the Air Force funded many military construction projects for child
    development centers, youth centers and fitness centers. While this
    represents a significant investment by the Air Force, many requirements
    remain.
        Our fitness centers continue to be an important on-base facility
    where airmen and their families gather to participate in numerous
    activities that help to improve their overall heath and build strong,
    resilient families. The Air Force has funded dozens of fitness center
    projects over the last 10 years. These projects have included add-ons
    to existing centers and replacing old and undersized facilities. With
    your continued funding support, we hope to construct and expand our
    facilities to meet the needs of our airmen and their families.
        Last year, we transformed the way the Air Force delivers food
    service. We focused on a campus-style food service for airmen and their
    families while improving efficiency and providing significant savings.
    Our food transformation initiative addresses changing lifestyles, needs
    and preferences while improving program and facility standards. This
    initiative offers a variety of healthy options while keeping our
    warfighting capabilities at the forefront. The transformation was
    implemented at six bases, where operating hours increased while costs
    decreased an estimated 27 percent. Since the initiative began, the
    customer count is up 22 percent and satisfaction has increased 8
    percent.
                       wounded warrior and survivor care
        We remain fully committed to caring for our brave airmen who are
    wounded in battle, who contract serious illnesses or are injured while
    defending the Nation's freedoms. We also recognize the importance of
    family to the healing process and continue to embrace the families of
    our brave men and women in uniform. The Air Force continues to provide
    non-medical case management, support, and assistance through the Air
    Force Survivor Assistance Program, the Recovery Care Program, and the
    Air Force Wounded Warrior Program--and will do so for as long as needed
    in partnership with our medical community. With your support, our
    Warrior and Survivor Care programs continue to prosper. As of March 31,
    2011, we have 1,008 Air Force members enrolled in the Air Force Wounded
    Warrior Program. In keeping pace with our growing Wounded Warrior
    population, the Air Force has hired 33 Recovery Care Coordinators to
    support 31 locations across the Air Force. We have also increased our
    Air Force Wounded Warrior Program consultants from 12 to 21 positions.
        Our Family Liaison Officers, Recovery Care Coordinators, Air Force
    Wounded Warrior Program consultants, and Community Readiness
    Consultants provide immediate and direct care for our airmen and their
    families through recovery, rehabilitation and reintegration. Our
    partnerships with the Department of Defense and the Veteran Affairs are
    improving opportunities for our airmen to continue as active duty
    airmen or as civilians within the Air Force and Department of Defense.
    These partnerships support education and employment opportunities
    geared toward successful reintegration within the civilian communities.
        Once again, we will celebrate the achievements of our Wounded
    Warriors during the 2011 Warrior Games scheduled for May 17-21, 2011 at
    the Olympic Training Center and U.S. Air Force Academy in Colorado
    Springs, CO. The Warrior Games provide a focal point for our recovering
    airmen to incorporate athletics back into their day-to-day lives by
    preparing them mentally and physically to get back to their military
    service.
                post-traumatic stress and traumatic brain injury
        The Air Force has engaged an aggressive and proactive approach to
    track airmen who may have post-traumatic stress (PTS) symptoms or a
    traumatic brain injury (TBI). Airmen learn about PTS, TBI, and other
    deployment-related health issues through education programs both before
    and after they deploy.
        In addition to training, airmen are also screened for TBI before
    and after deployment. Airmen receive a computerized assessment that
    measures cognitive abilities including reaction time and memory. The
    member is reassessed in theater if they sustain a head injury. Scores
    are compared with baseline in order to aid with return-to-duty
    determinations, in conjunction with a clinical assessment.
        Airmen who receive help for deployment-related stress also have the
    option to receive treatment through primary care channels as the Air
    Force increases the mental health presence within the primary care
    setting. At this time, 57 percent of Air Force medical treatment
    facilities have integrated behavioral health services into primary care
    clinics. This program enables airmen to feel more comfortable seeking
    behavioral health assistance.
        Airmen with common symptoms including sleep, energy, mood, or
    concentration difficulties simply see their primary care manager, just
    as they would for any other treatment. The primary care manager then
    refers the servicemember to the behavioral health consultant who can
    provide screening, education and focused intervention in the primary
    care clinic. This process helps to normalize minor behavioral health
    treatment alongside other, more routine care. The goal is to reduce the
    stigma behind seeing a provider for stress, helping airmen feel less
    isolated and more willing to ask for help.
                               key spouse program
        The Key Spouse Program is an effective way to communicate with
    family members and is akin to the Navy Ombudsman Program and the Army
    Family Readiness Group. We aim to bridge the gap between the military
    spouse and the military chain of command to help build a greater sense
    of community within units, especially where families are separated or
    deployed.
        Currently, 97 percent of units have trained key spouses, and we
    have more than 4,121 trained volunteers. We hope increased emphasis and
    continued standardization will make this program become even more
    helpful.
                               spouse employment
        Spouse employment in the military is a constant challenge for our
    military families. Overall, 48 percent of Air Force spouses seek
    employment with each military move. For our junior airmen, the added
    income is often a large part of the quality of life their family
    enjoys. Military spouses report that their work income constitutes
    about 48 percent of total family income.
        We appreciate your support and the administration's effort to
    strengthen our military families by removing barriers that currently
    prevent military spouses from maintaining a career or employment
    because of relocation.
        This support helps ensure our family members have access to careers
    and are not adversely affected when our service calls upon us to
    relocate.
                           unemployment compensation
        When States support unemployment compensation, this also allows
    spouses to take reasonable time to find suitable employment at the new
    location as well as resources necessary to obtain any new licensing or
    credential requirements. Currently, 38 States plus the District of
    Columbia provide unemployment compensation to spouses who leave because
    of a military move, nearly triple the number since 2004. We remain
    hopeful the remaining States, despite the current challenging fiscal
    environment, can provide similar compensation benefits to improve the
    employment outlook of military spouses.
        One of the greatest challenges facing our Nation right now is
    unemployment and underemployment, and we remain especially concerned
    about the challenges facing those in the Guard and Reserve or those
    leaving active military service as they look for work.
        Although the national unemployment rate was 8.9 percent in February
    2011, the unemployment rate for the younger segments of the workforce,
    which includes those veterans who joined the military after September
    11, 2001, remains elevated. As a result, we are committed to assisting
    our separating members in making a successful transition to employment
    in the civilian workforce and in encouraging their continuing education
    through the use of the post-9/11 GI Bill.
                                   child care
        Child care continues to be an important quality of life factor for
    our airmen and their families. Quality child care facilities are a key
    component in assuring airmen that their family is being cared for while
    they defend our country. With your continued support, we are striving
    to eliminate our shortfall in child development center spaces by the
    end of fiscal year 2012. While we have addressed the facilities and
    personnel needed, we are still trying to fund supplies and equipment.
        Our child care programs also include reservists and Air National
    Guardsmen by providing child care during scheduled drill weekends and a
    child care subsidy when activated. While we face funding challenges in
    meeting every child care requirement, we are striving to provide
    quality child care options to all our airmen.
                        education for military children
        Military life, frequent moves and extended separation during
    deployments present a host of challenges for our families. Nearly half
    of all servicemembers are married and have children. Consequently,
    military families often weigh assignment decisions based on the quality
    of education from the local school systems for their children.
        Thirty-five States have passed legislation to establish an
    Interstate Compact On Educational Opportunity For Military Children to
    address educational solutions at the State, local, and school district
    levels. These compact States are working to solve issues dealing with
    class placement, records transfer, graduation requirements,
    immunizations, exit testing and allowing late entry to extra-curricular
    activities and sports teams. Another eight States (Montana, Wyoming,
    Nebraska, Maryland, Vermont, Pennsylvania, New York, and West Virginia)
    have proposed their respective bills, and the final six States and the
    District of Columbia (Oregon, Arkansas, Wisconsin, Georgia, New
    Hampshire, Maine, and the District of Columbiar) have indicated this
    issue is a ``priority.'' The Interstate Compact ensures children in
    military families are not penalized in school for their families'
    service to the Nation.
        We are making great strides in support for Air Force-connected
    students attending public, private, DOD Dependent Schools, home and
    virtual schools. Currently 84 Air Force bases have civilian school
    liaison officer positions. In addition, staff in the Airman and Family
    Readiness Centers provide school liaison support to leadership and
    families. Major commands and installations continue to work creative
    initiatives such as providing webcasts of graduations so parents can
    share these occasions while deployed. Additionally, a senior military
    officer or DOD civilian has been designated at each installation to
    advocate with local and State school administration and school boards
    for the interest of Air Force families.
                         airmen education opportunities
        The U.S. Air Force enlisted force is highly educated. Since April
    25, 1977, more than 303,500 airmen have earned a fully accredited
    associate degree, corresponding to their career field, through the
    Community College of the Air Force (CCAF). In fact, about 153,000 of
    our enlisted airmen have at least 12 college credits; of that more than
    51,500 have associates degrees, almost 18,000 have bachelor's degrees
    or higher and 18 have earned their doctorate degrees.
        The General Education Mobile program is making education more
    accessible for our airmen. This program offers general education
    courses required for a CCAF degree through distance learning courses.
    This program is intended to attract those students who are struggling
    to get their general education credits filled because of numerous
    reasons, primarily the Air Force's high operations tempo. There are 26
    participating schools offering 511 courses of which over 700 airmen are
    enrolled.
        Our Associate-to-Baccalaureate Cooperative program is helping CCAF
    graduates apply credits toward a bachelor's degree at military-friendly
    schools. This program has grown to 44 civilian higher-education
    institutions and offers 219 bachelor's degree programs. These
    institutions take an airman's CCAF credits and apply them toward a
    bachelor's degree. More than 17,000 airmen are participating in the
    program, and since its inception in June 2007, 464 bachelor's degrees
    have been awarded.
        We've also had an overwhelming number of airmen who have
    transferred their G.I. Bill benefits to their dependents. This benefit
    helps families, and it also helps the Air Force retain our airmen
    through the associated service commitment. We continue to recruit and
    retain airmen who value educational opportunities for themselves and
    their families.
        CCAF also offers a Professional Manager Certification, a credential
    award that formally recognizes an individual's advanced level of
    education and experience in leadership and management, as well as
    professional accomplishments. The program provides a structured
    professional development track that supplements Enlisted Professional
    Military Education and the Career Field Education and Training Plan.
                    sexual assault, prevention and response
        Sexual Assault Prevention and Response remains a top priority as we
    work toward providing safe environments for our airmen and families to
    work and live. We are focused on instilling a prevention-based program
    so these sexual offenses cannot and do not occur.
        As part of our approach, consistent top-down messaging is critical.
    These messages continue to emphasize Air Force Core Values and the need
    for active wingmen watching out for one another. Likewise, we have
    spent the last year building community empowerment through bystander
    intervention education. We provide training that ensures airmen
    understand when to act if they observe behaviors or actions that may
    lead to sexual assault. An additional prevention effort includes the
    development of a risk reduction guide which will be provided to senior
    commanders by fall of this year to assist them in providing safe
    environments.
        As a Service, from our most senior leaders to our newest airmen, we
    remain committed to a zero-tolerance standard of sexual assault.
                                   conclusion
        Our airmen are doing incredible work, ranging from providing
    humanitarian aid to the Japan earthquake and tsunami victims for
    Operation Tomodachi to supporting recent NATO operations in Libya and
    daily U.S. Central Command missions in Iraq and Afghanistan. More than
    two-thirds of airmen entered the Air Force after September 11, 2001,
    which means the majority of our force has been at war their entire
    careers. They deploy longer than ever before and some need a second
    hand to count the number of combat tours they have been on. Despite
    this pace, our airmen have shown amazing resiliency.
        Finally, this is a team effort and the contributions of Air Force
    families continue to be amazing. Our families are the ones who deal
    with an empty seat at the dinner table when our warfighting mission
    takes us away. They stand tall when extraordinary challenges attempt to
    knock them down. They keep the faith and their support is critical to
    airmen fulfilling their mission requirements.
        Thank you again for your continued support of our brave airmen and
    their supportive families.

        Senator Webb. I thank all of you for your testimony. As I
    said, your full statements will be entered into the record as
    if read.
        Let me make a comment and ask one question, then I know
    Senator Blumenthal has another meeting he has to go to, and I'd
    like to give Senator Blumenthal an opportunity to jump in,
    here.
        First, let me say, Sergeant Major Chandler, how comforting
    it was to hear you talk about dwell time the way that you did.
    When I got here to the Senate, in 2007, the dwell time was
    0.75. When I was called, by the Chief of Staff of the Army,
    when he told me that they were going to 15 month deployments
    and 12 months at home, I could not believe what I was hearing,
    as someone who's been around the military my entire life and as
    someone who also worked on veterans programs in the House, as a
    young committee counsel, after I finished law school, when I
    left the Marine Corps. The downstream emotional price that a
    lot of people have to pay for those types of deployments were
    predictable.
        I introduced legislation that would have required a minimum
    one-to-one dwell time. Some people thought it was political at
    the time. I said, basically, this is just a safety net. This is
    something that Congress, as the stewards of the people who go
    into the military, should be able to put into law. We had a big
    debate up here. You may have seen something about it, because
    people were saying that Congress wanted to get in the way of
    the Commander in Chief's prerogative. But, there are many
    different situations like this in history, where Congress has
    weighed in, and we lost. We got 56 votes twice, but we did get
    60 to break the filibuster on this.
        But, I think we successfully caused people to really start
    thinking seriously about the need to put a safety net under our
    people. You step forward, you say you're going to serve your
    country, and you're at the mercy of your leadership, quite
    frankly.
        The fact that we have gotten this thing to a point where
    we're back to historical standards of two-to-one, really
    gratifies me to hear you say that.
        I would like to ask a question to all of you to give me
    your thoughts on, and then I'm going to yield to Senator
    Blumenthal.
        One of the areas that I was not hearing very much about
    when I first came to the Armed Services Committee this time was
    our responsibility for non-career military members. We had lots
    of testimony about, you recruit the individual, retain the
    family, the retention issues, we got a career--we have an all
    volunteer system. It took me a year of asking questions before
    I got the data on this, but there are a lot of people who think
    that, because we have an All-Volunteer Force, we have an all
    career force. We don't.
        The numbers that I got back after asking the questions
    were: 75 percent of the Army, 70 percent of the Marine Corps,
    and about half of the Navy and the Air Force were leaving the
    military on or before the end of their first enlistment. Which
    is healthy for the country; we're a citizen soldiery. But,
    those people weren't getting the right kind of focus up here,
    in terms of what happens when ones leave. I introduced the GI
    Bill to try to give a first-class readjustment opportunity for
    the people who were leaving at the end of their first
    enlistment; come in, serve your country, go home.
        But, I'm curious as to what other kind of transitional
    programs you're working on, Service-by-Service, to make sure
    that these people who step forward, they're not going to be
    career military--but, the people who step forward have the
    assistance they need to get back into their civilian
    environment.
        Sergeant Major Chandler. Senator, from the Army's
    perspective, we have the Army Career and Alumni Program, which
    you may be familiar with. That program helps to transition
    soldiers out of the Service as they continue to look for other
    opportunities in life. That program provides some resume-
    building experience, some job interview experience. It
    introduces them to some different Web sites that are out there,
    whether you want to continue service in the government or if
    you're going into the private sector.
        General Chiarelli, the Vice Chief of Staff of the Army,
    directed the Army to take a comprehensive review of that
    program to ensure that we are, in fact, meeting the needs of
    transitioning soldiers. Not to say that we have a problem, but,
    can we do better than we already are? That's our Army program,
    sir.
        Senator Webb. Thank you.
        Sergeant Major?
        Sergeant Major Kent. Sir. First of all, thank you for the
    GI Bill, because we get a lot of positive feedback from the
    marines that have transitioned out, and it is working, sir. So,
    truly, thank you for that.
        Our Commandant has tasked manpower to figure out how we can
    have a one-stop shop, as far as marine transitioning. Sometimes
    we can wait until the last few months and we'll send these
    marines through a week of transitioning class, which don't mean
    anything really, sir. They sit there and we lecture them,
    instead of having a one-stop shop. We want to do it early, like
    a year out. So, the Commandant said, ``This is what I want. I
    want a one-stop shop where a marine can come to do this
    transition course, and you can say, ``Door number one, would
    you like to go to college? Door number two, what type of job?
    Door number two, if you like that job, this is where we would
    transition you to that job.''
        So, he is revamping the whole transition program right now,
    sir. It will work because the Commandant says it will work. So,
    everybody's getting on board. [Laughter.]
        Senator Webb. Master Chief?
        Master Chief Petty Officer West. Sir, from the Navy
    perspective, as well, I would like to say thank you very much
    for that GI Bill. It is very well received, not only in the
    fleet, but with many of the family members that are able to
    take advantage of that.
        Sir, also we have taken a look at many of our transition
    programs--in particular, the Transition Assistance Program
    (TAP), those type of programs for our sailors that are exiting
    the Navy. Also, with that said, sir, our Fleet and Family
    Support Centers have geared--similar to the--some of the same
    things you've heard from my counterparts, to my right,
    regarding the resumes and those type things. It's something we
    keep an eye on. We have to continue to keep that at the
    forefront, especially as all of the Services start about some
    of the downsizing that we are going to be doing. The Navy, sir,
    we've downsized, now, for the past approximately 5 to 6 years.
    So, we had to have that at the front.
        That's where we are, sir. I take a good hard look at that.
    Matter of fact, my EA had just went through the transition
    piece, as well, and he was very pleased with the process that
    we have.
        Chief Master Sergeant Roy. Again, Senator, I want to, just
    like my peers, say how important the Post-9/11 GI Bill was; and
    that transferability piece to it, as well, certainly has helped
    both our airmen and their families.
        One of the other items of note on the same theme is that of
    education. One of the things that the U.S. Air Force has is a
    Community College of the Air Force. As you said, we will retain
    about 55 percent of first-term airmen. Which means that others
    will transition out of the Air Force. I believe the educational
    aspect and the push that we put behind education, really helps
    these airmen in their transition, because there's an awful lot
    of them that transition out of the Air Force with at least an
    associate degree and then go on to bachelors and others.
        Like others, we have an Airmen Family Readiness Center--
    it's mandatory for our airmen to go to TAPs. Just like other
    programs, resume-building, interviewing, along with other
    areas, leads to different jobs, if you will. So, it really
    helps. It's kind of an area of resources that our airmen and
    their families can continue to use. It's one that I believe has
    paid us very well.
        Master Chief Petty Officer West. Sir, can I have a re-
    attack?
        Senator Webb. Yes, sure.
        Master Chief Petty Officer West. Sir, just one thing I
    would like to highlight, it wasn't brought up. Our Safe Harbor
    Program--and I know many of the Wounded Warrior Programs are
    geared and have put a big emphasis on this transition piece, as
    well, for our folks. In particular, we partner with the Coast
    Guard, as far as the Safe Harbor. We receive a lot of good
    feedback from that, sir.
        Senator Webb. Well, thank you for those observations.
        You know that there are two great reasons for doing this.
    One is, stewardship lasts a lifetime, when people step forward
    and serve. The other is there's no better recruiter than a
    veteran who goes back to his or her home community, and is
    proud of what they did.
        Senator Blumenthal.
        Senator Blumenthal. Thank you, Mr. Chairman.
        I would like to join in, as Senator Nelson did, thanking
    you for your service here and in the U.S. Marine Corps, and
    also for your role on the GI Bill that's been mentioned.
        I want to thank the leaders of our enlisted men and women
    who are here today, for your service and for the extraordinary
    sacrifice and service of the enlisted men and women around the
    globe who serve in our U.S. military. I don't need to tell
    anyone in this room, but I think the Nation needs reminding
    that never in our history have so few borne so much of the
    burden of war for so long. I think that's reflected in the
    numbers that you've given us about dwell time, about the men
    and women who have given so much so that we would be free and
    safe and strong. So, thank you for your service, and thank you
    for your testimony here today.
        I want to say a particular thank you to Sergeant Major
    Kent, and, regretfully, on the occasion of your last testimony
    as an Active Duty Marine. But, I am hopeful that we'll see you
    here in these halls in the future.
        Sergeant Major Kent. Yes, sir, thank you.
        Senator Blumenthal. Because, as you say, ``once a marine,
    always a marine.'' We will really welcome your advice and
    counsel as we go forward on this committee and in the U.S.
    Congress.
        I want to drill down a little bit on the excellent question
    that the Chairman asked, and talk about this transition; in
    particular, an area of injury that I think is extraordinarily
    important, often undiagnosed or misdiagnosed: traumatic brain
    injury (TBI) and post-traumatic stress disorder (PTSD) and
    mental health problems that may be even less visible. I know
    that the statistics are that as much as 30 percent of all TBI
    or PTSD may be completely missed or undiagnosed. If you could
    tell us, because I know you care so much about the people who
    serve with you, perhaps what is being done to improve the
    diagnosis and treatment, and what you would recommend we do, if
    you have those kinds of recommendations for us today.
        Sergeant Major Chandler. Well, Senator, I'll start off.
        I'll tell you, first of all, I sit before you as a person
    who has participated in the Army's Behavioral Health Program.
    For the last 2 years, I personally have been treated by
    counselors, because of some behavioral health issues related to
    my deployment. What you have done, by providing us the support,
    has made a difference in the Army.
        My job as a senior leader of the Army is to continue to
    talk about it and reduce the stigma of coming forward and
    saying, ``I need some help.'' It's made me a better man, a
    better husband, a better father, and, at the end of the day, a
    better soldier.
        Within our force, we have soldiers, over 100,000, who have
    been diagnosed with some TBI, and over 40,000 that have been
    diagnosed with some PTSD. We know, based off of studies that
    we've commissioned, that a soldier, in the first 6 years of his
    career, will experience a lifetime of stress. We don't
    completely know what that means. But, we do know that we have
    to do a better job in diagnosis and treatment.
        It first starts with saying and being observant, as a
    leader and as your fellow soldier or battle buddy, that
    something may not be right with Johnny or Jill. Then, as a
    leader, what do you do about it? You act.
        Now, for all of us, we are action-oriented people. So by
    saying something about it and then getting that soldier to help
    will make a difference for the Army.
        Sergeant Major Kent. I'm on the same lines, sir. But, I'd
    just like to add, no marine ever wants to get pulled out of
    combat. They can get hit and they'll say, ``Nothing's wrong
    with me,'' although the possibility that they were knocked out.
    So, leadership is engaging, now, telling marines, ``Hey, it's
    okay. We're going to take you out of the fight for about 24
    hours, and we're just going to observe you. If you're okay,
    we're going to put you back in the fight.'' But, we have to let
    them know that we have to take care of them, also. So, if
    they're hit and they're knocked out, it's our job, as leaders,
    to pull them out of the fight, sir. We're doing a lot better in
    that.
        The Sergeant Major touched on it, sir. The stigma is where
    we need to really push that down and say, ``It's okay to come
    forward. We just need to get you fixed and get you in the
    fight.'' I mean, any one of us up here that have been to
    combat, we can have the same issues, sir. So, we need to tell
    marines, ``Hey, even we can have issues, as senior leaders.'' I
    think, as long as we tell them that, it will be okay.
        Master Chief Petty Officer West. Sir, thank you very much
    for the question and opportunity to comment on that.
        I just got back recently from a trip with our Chief of
    Naval Operations to Afghanistan. I have to tell you, you've
    been at this a long time and from where we started to where we
    are now, we have made absolutely huge gains. If I were to ask
    anything of this panel it would be, we have to keep that
    momentum. It's something that we haven't figured out yet,
    completely, what we need to figure out, but we're getting there
    every single day.
        Not only have I walked it back, I went from the ``Role-3''
    hospitals. What Sergeant Major Kent talks about, about taking
    them offline; that is one of the things that we've been able to
    do, out with our young corpsmen out in the field, and marines,
    soldiers, and airmen. But, I walked it back through Landstuhl
    and then over here to Bethesda. Some of the new facilities that
    we've opened up, for example the TBI Clinics are absolutely
    what we need to continue to do. We owe that to our men and
    women that are out there.
        We are aggressive in our training. Like everyone up here,
    it's something that leadership not only has to take on, but
    those young folks, as well. Those who are standing beside those
    young sailors, who are out there, they need to be able to
    recognize the signs and the symptoms of some of these things so
    they can say, ``Hey, it's time out. It's okay.'' As leaders
    come forward, and the more we talk about it the more it really
    pushes out to those young sailors or those young people out
    there, that are doing their country's work, that it's okay to
    come forward. That is a huge step.
        In my eyes, I think that, again, sir, we're making headway.
    Are we where we need to be? No, sir. But, we sure do need you
    in that area.
        Chief Master Sergeant Roy. I'd just like to add just a few
    other things. A couple of other things that I believe we're all
    doing is pre- and post-assessments on all of our service men
    and women, before they go and then after they come back.
    Another thing you did, through the National Defense
    Authorization Act (NDAA) last year, was to bump up our mental
    health technicians and our doctors within our forces. The Air
    Force, the Army, and the Navy, we've bumped that up. That has
    helped tremendously.
        Though, there's a national shortage of that skill-set, and
    we need to continue. We all have similar problems trying to
    recruit those individuals with that skill-set, so it's a
    challenge for us.
        The other thing I would just add to that is, as we talked
    about stigma, a couple of other things that it has helped us do
    through the last NDAA is this idea of placing the mental health
    doctors within the family practices, so it's not a separate
    ward, it's within the family practice. That has helped us
    tremendously.
        Then one other thing that we have done, internally to the
    Air Force, just like we've done with chaplains for years, is
    placing a chaplain representative within each individual unit.
    We've done similar to that with our mental health technicians
    and our doctors inside our units so that it's easy for a
    servicemember to access that particular skill, if you will,
    when needed; so that they don't have to go to the clinic.
        Senator Blumenthal. I want to thank each of the Services
    for the great work you're doing on these issues and, Sergeant
    Major Chandler, your frankness and candor in talking about your
    own situation, because I think it takes a kind of courage that
    will lead others to avoid the stigma, and eventually ease it or
    remove it, which I think, as each of you have said, is
    absolutely critical to addressing this problem effectively.
        I apologize that I have another hearing that I have to
    attend. I'm a little bit late getting to it. But, in terms of
    continuing the momentum, as you put it, anything that I can do,
    and that I can ask my colleagues to do, and any other
    observations, I would be really honored to continue on this
    work. I'm honored to be here today with you. I'm going to try
    to get back after the next hearing. But, again, I really very
    much thank you for this excellent testimony today.
        Thank you, Senator.
        Senator Webb. Thank you, Senator Blumenthal.
        Thank all of you for the service that you're giving and for
    the candid nature of your responses to this committee. It's
    very, very valuable for people up here to hear the perspectives
    that you have, and particularly the journeys that all of you
    have had, literally, from the bottom up inside our military
    system. So, we appreciate very much you coming and testifying
    today.
        Sergeant Major Kent, best of luck to you as you step
    forward toward retirement.
        Sergeant Major Kent. Thank you, sir.
        Senator Webb. Thank you.
        Our second panel, we have members of The Military Coalition
    (TMC), a consortium of nationally prominent uniformed service
    and veteran's organizations: Retired Master Chief Joseph
    Barnes, the National Executive Director of the Fleet Reserve
    Association (FRA); Ms. Kathleen Moakler, the Government
    Relations Director for the NMFA; Retired Colonel Steven P.
    Strobridge, the Director of Government Relations for the
    Military Officers Association of America (MOAA); Retired
    Captain Ike Puzon, the Director of Government Affairs and
    Legislation of the Association of the U.S. Navy; and Ms. Kathy
    Roth-Douquet, the Chairman of Blue Star Families.
        We'd like to welcome all of you.
        Before our panel begins its testimony, at this time,
    without objection, I will enter into the record the witness
    statement of Senator Graham, who, unfortunately, can't be here
    today. We have also received statements for the record from the
    Reserve Officers Association, the Gold Star Wives of America,
    and the National Guard Association of the United States.
    Without objection, they will be included in the record, as
    well.
        [The prepared statement of Senator Graham follows:]
                  Prepared Statement by Senator Lindsey Graham
        Thank you, Senator Webb. I join you in welcoming Senator Ayotte and
    Senator Blumenthal to the subcommittee. I look forward to working with
    you in the 112th Congress and continuing the bipartisan approach that
    this subcommittee has always employed on behalf of the men and women of
    the Armed Forces. It's all about the men and women in uniform and their
    families, and it's a privilege to serve with you on this subcommittee.
        To the Senior Enlisted Advisors on the first panel, welcome, and
    thank you for your service in these key leadership positions. Sergeant
    Major Kent, I understand your relief has been named and you are nearing
    the end of your active-duty service. All the best to you and your
    family as you approach retirement.
        The threat of a government shutdown last week and the effect it
    would have had on military personnel was very unfortunate, but it's a
    reflection of the difficult financial situation we are in right now as
    a Nation.
        I hope we will be able this week to wrap up funding the government
    for the rest of fiscal year 2011 , and get on with legislation for
    fiscal year 2012. It's pretty clear, however, that we have some
    difficult issues to work through. I'm all for efficiencies when it
    comes to saving taxpayer dollars and reducing the cost of government--
    including the Department of Defense (DOD).
        For example, according to the Congressional Budget Office, medical
    care will consume nearly 16.5 percent of DOD's topline by the year 2028
    based on recent trends. What that tells me is that unless we take steps
    now to control the rate of growth, medical care costs will nearly
    double as a percentage of the DOD top line in less than 20 years, and
    that is not sustainable.
        While we have troops deployed in harm's way, however, it has to be
    our priority to make sure that military personnel and their families
    get the support they need--including their pay on time.
        I think we are all in agreement with respect to the goal of keeping
    the National Guard and the Reserves as an Operational Reserve in the
    future. Even before September 11, we were relying heavily on the
    dedicated service of national guardsmen and reservists, but 10 years of
    combat operations and the continuing need for strong Homeland Defense
    have demonstrated both the essential capabilities or the Reserve
    components and the imperative to provide the services, programs,
    equipment, and training opportunities they require. I endorse the
    Department's attention to enhancing the continuum of service--and I
    look forward to hearing your ideas about how to make the best use of
    our Reserve and Guard forces.
        Again, I thank all our witnesses for their ideas and
    recommendations, and I look forward to their testimony.

        [The information referred to follows:]
     Prepared Statement by the Reserve Officers Association of the United
                    States and Reserve Enlisted Association
                                  introduction
        On behalf of our members, the Reserve Officers Association (ROA)
    and the Reserve Enlisted Association (REA) thank the committee for the
    opportunity to submit testimony on military personnel issues. ROA and
    REA applaud the ongoing efforts by Congress to address readiness,
    recruiting and retention issues.
        The amount of dollars being authorized to the Department of Defense
    (DOD) has peaked. Included in the Budget release is a statement that
    the president has moved $73 billion from the Overseas Contingency
    Operations (OCO) to the base budget (pg. 61). While the budget at $553
    billion appears as a gross increase of $22 billion above fiscal year
    2010, this shift from OCO to the base budget is a de facto cut of $51
    billion with spending on certain items being trimmed down below the
    fiscal year 2010 base budget.
        The Hon. Christine Fox, DOD Director of Cost Assessment and Program
    Evaluation Office briefed that to sustain the current force structure
    and need modernization requires a two to three percent real growth in
    the Defense budget. Secretary of Defense Robert Gates department-wide
    review was intended to provide a series of assessment initiatives to
    improve efficiency and reduce costs.
        Unfortunately, a lot of the needs and requirements of serving
    members and their families were not included in these studies. Too
    often, personnel costs are viewed as competing for resources for other
    DOD programs.
        The ROA and the REA will be doing a separate paper on additional
    efficiencies.
                               executive summary
        The Reserve Officers Association Calendar Year 2011 Legislative
    Priorities are:

             Recapitalize the Total force to include fully funding
            equipment and training for the National Guard and Reserves.
             Assure that the Reserve and National Guard continue in
            a key national defense role, both at home and abroad.
             Provide adequate resources and authorities to support
            the current recruiting and retention requirements of the
            Reserves and National Guard.
             Support warriors, families, and survivors

        Issues supported by the Reserve Officers and Reserve Enlisted
    Associations are to:
    Changes to retention policies:
             Permit service beyond the current Reserve Officers
            Personnel Management Act (ROPMA) limitations.
             Support incentives for affiliation, reenlistment,
            retention and continuation in the Reserve component.
             Advocate against cuts in Reserve component; support
            Reserve commissioning programs
             Reauthorize yellow ribbon program to support
            demobilized Guard and Reserve members.
    Health Care:
        See end of Executive Summary
    Pay and Compensation:
             Reimburse a Reserve component member for expenses
            incurred in connection with round-trip travel in excess of 50
            miles to an inactive training location, including mileage
            traveled, lodging and subsistence.
             Obtain professional pay for Reserve component medical
            professionals, consistent with the Active component.
             Eliminate the 1/30th rule for Aviation Career
            Incentive Pay, Career Enlisted Flyers Incentive Pay, Diving
            Special Duty Pay, and Hazardous Duty Incentive Pay.
             Simplify the Reserve duty order system without
            compromising drill compensation.
             Reauthorize the Reserve Income Replacement Program for
            mobilized Reserve components that expired in 2010.
    Education:
             Include Title 14 Coast Guard Reserve duty in
            eligibility for the Post-9/11 GI Bill.
             Exempt earned benefit from GI Bill from being
            considered income in need based aid calculations.
             Develop a standard nation-wide payment system for
            private schools.
             Re-examine qualification basis for yellow ribbon
            program, rather than first come first serve.
             Increase MGIB-Selected Reserve (MGIB-SR) to 47 percent
            of MGIB-Active.
             Include 4-year reenlistment contracts to qualify for
            MGIB-SR.
    Employee Support:
             Permit delays or exemptions while mobilized of
            regularly scheduled mandatory continuing education and
            licensing/certification/promotion exams.
             Continue to support a law center dedicated to USERRA/
            SCRA problems of deployed Active and Reserve servicemembers.
    Mobilization:
             Oversee service sections' policies to reimburse
            mobilized reservists on Temporary Duty Orders orders with
            lengths over 179 days.
             Provide differential pay for deployed Federal
            employees permanently.
    Spouse Support:
             Expand eligibility of surviving spouses to receive
            Survivor Benefit Plan-Dependency Indemnity Clause payments with
            no offset.
             Provide employment protection and provide family leave
            for spouses and family care-givers of mobilized Guard and
            Reserve for a period of time prior to or following the
            deployment of the military member.
    Deferred Benefits and Retirement:
             Extend current early retirement legislation
            retroactively to September 11, 2001.
             Promote improved legislation on reducing the Reserve
            component retirement age.
             Permit mobilized retirees to earn additional
            retirement points with less than 2 years of activated service,
            and codify retirement credit for serving members over age 60.
             Modify U.S. Code that requires repayment of separation
            bonuses if an individual receives a Uniformed Service
            retirement annuity.
             Change U.S. Code to eliminate the fiscal year barrier
            toward full credit toward early retirement.
             Continue to protect and sustain existing retirement
            benefits for currently retired.
    Voting:
             Ensure that every deployed servicemember has an
            opportunity to vote by:

                     Working with the Federal Voting Assistance
                    Program.
                     Supporting electronic voting.

             Ensure that every military absentee ballot is counted.
    Health Care:
        ROA and REA positions include that:
        TRICARE Prime:
             The proposed $30 increase for individuals and $60 for
            families is a modest proposal.
             If indexed, adjustments to the enrollment fee should
            be population based rather than industry-based.
             It is important to independently verify the current
            total cost of DOD health care benefits. Such an audit will
            permit Congress to validate proposals based on cost-sharing
            percentages.
             Annual increases should not be tied to the market-
            driven Federal Employee Health Benefits Plan or a commercial
            plan.
        On Pharmacy Co-payments:
             ROA and REA believe higher retail pharmacy co-payment
            should not apply on initial prescriptions, but on maintenance
            refills only.
             ROA and REA support DOD efforts to enhance the mail-
            order prescription benefit.
        Sole Community Hospitals:
             Fee adjustments must be approached with caution
            because of inconvenience to beneficiaries.
        U.S. Family Health Plan--Medicare coverage:
             ROA and REA support continuation of the Medicare
            coverage as part of the U.S. Family Health Plan.
             To maintain the program, a mandatory Part ``B''
            payment might be considered.
        Reserve Health Care Initiatives:
             Improve continuity of health care for all drilling
            reservists and their families by:

                     GR members should qualify for Transitional
                    Assistance Management Program (TAMP) coverage when
                    separated from Active Duty.
                     Having Government Accountability Office (GAO)
                    Audit the assumptions used for TRICARE Retired Reserve
                    (TRR) premiums.
                     Creating a self plus one premium for TRR.
                     Providing Continuing Health Benefit Plan to
                    traditional Drilling reservists who are beneficiaries
                    of TRICARE Reserve Select (TRS) but are separated from
                    the Selected Reserve to provide Consolidated Omnibus
                    Budget Reconciliation Act (COBRA) protections.
                     Permitting active members in the Individual
                    Ready Reserve (IRR) to buy-into TRS.
                     Allowing demobilized retirees and reservists
                    involuntarily returning to IRR to qualify for
                    subsidized TRS coverage.
                     Providing TRS coverage to mobilization ready
                    IRR members; levels of subsidy would vary for different
                    levels of readiness.
                     Improving post deployment medical and mental
                    health evaluations and access to care for returning
                    Reserve component members.
                     Providing an option for reservists where DOD
                    pays a stipend to employers.

             Extend military coverage for restorative dental care
            following deployment to 90 days.
             Permit beneficiaries of Federal Employee Health
            Benefit plan the option of subscribing to TRS.
                              readiness discussion
    Operational versus strategic missions for the Reserve component
        The Reserve Forces are no longer a part-time strategic force but
    are an integral contributor to our Nation's operational ability to
    defend our soil, assist other countries in maintaining global peace,
    and fight in OCO.
        National security demands both a strategic and an Operational
    Reserve. The Operational Reserve requires a more significant investment
    of training and equipment resources, and places greater demands on its
    personnel as compared to the Strategic Reserve. Those serving in
    Operational Reserve units must be fully aware of the commitment
    required to maintain the expected level of readiness. A similar
    awareness and commitment is necessary for those responsible for
    providing resources to the Operational Reserve.
        Planners also must recognize that few individuals can remain in the
    Operational Reserve for an entire career. There will be times when
    family, education, civilian career, and the other demands competing for
    their time and talents take priority. Such an approach requires the
    ability to move freely and without penalty between the operational and
    strategic elements of the Reserve component as a continuum of service.
        Each Service has its own force generation models and the Services
    organize, train, and equip their Reserve components to a prescribed
    level of readiness prior to mobilization to limit post-mobilization
    training and to maximize operational deployment time. ROA and REA urge
    Congress to continue to support and fund each Service's authority to
    manage the readiness of its own Reserve Forces as one model does not
    fit all.
        In an era of constrained budgets, a capable and sustainable Reserve
    and National Guard is a cost-effective element of national security.
    Junior Officer and Enlisted Drain
        As an initial obligated period draws to the end, many junior
    officers and enlisted choose to leave, creating a critical shortage of
    experienced young people in the leadership conduit.
        Yet, as the Services face pending end strength reduction, they
    approach this challenge with an inverse solution, by riffing out junior
    people, as the Air Force and Marine Corps are doing. Cutting the most
    junior people does not provide the same amount of savings in that it
    creates an older top heavy organization and does not make room for the
    newest generation of combat veterans. These cuts also reduce a fresh
    prospective brought by younger members.
        Another DOD solution to reduce the end strength is to slow down the
    input into the system. Both ROA and REA are concerned that Reserve
    Officers' Training Corps (ROTC) scholarships and commissioning are
    being reduced. Last year, the Chief of Naval Operations announced a 30
    percent reduction in Navy ROTC scholarships. The U.S. Air Force will be
    screening this year's sophomore class, only allowing 60 percent of the
    class to advance as juniors; next year only 45 percent will be allowed
    to advance.
    End Strength and Preparedness
        Part of the President's budget includes planned reductions for both
    the Army and Marine Corps, by 27,000 and 15,000, respectively. It
    should be remembered that individuals cannot be brought quickly on to
    active duty on a temporary basis, but it is an accumulation of
    experience and training that is acquired over years that becomes an
    asset for the military. Reducing the force will also foreshorten dwell
    time.
        Before cuts to the U.S. Army and U.S. Marine Corps are made, ROA
    and REA hope that Congress requests a report from Services and DOD on
    the effect in the short and long term. These cuts need to be carefully
    evaluated to ensure that it is not based on budgetary concerns, but on
    capability.
        Without external threats, the U.S. Army has traditionally reduced
    the size of its Armed Forces. Since the 1990s, the Pentagon has
    recommended proportional cuts be taken in the Reserve component when
    taken in the Active Force. This reasoning fails in many ways. It
    results in a hollowing out of the force and preparedness, undermines
    morale, and undercuts retention. National security is put at risk.
        Yet, it has been the Reserve component that has provided the
    temporary surge to fill-in the active duty numbers. The end strengths
    included in the President's budget appear to maintain current numbers.
    As end strengths are cut, ROA and REA support transferring both
    manpower and equipment into the National Guard and Reserve to provide
    operational flexibility in the future.
        ROA and REA are concerned that the ongoing cuts to the Navy's
    Reserve will continue and this is a trend that needs to be reversed.
    The reported end strength of the Navy Reserve is just above 64,000
    members. A new manpower study needs to be done and published by the
    Navy Reserve to calculate the actual manning level requirements: this
    study should be driven by readiness and not budgetary requirements. In
    the President's budget, the Navy Reserve will face another 2,900 cut.
                              proposed legislation
    Retirement
        Fixing early retirement--the concept whereby reservists and
    guardsmen can subtract time from age 60 when they would otherwise begin
    drawing their Reserve retirement--has been at the front of ROA's and
    REA's advocacy agenda for a number of years.
        The National Defense Authorization Act for Fiscal Year 2008
    established an early retirement reduction of 90 days for every
    consecutive 90 day period of active duty. However, the one major flaw
    in the law neglects the operational reservists who mobilized prior to
    that date.
        Newly acquired data supports backdating early retirement to 2001.
    Those who served prior to 2008, when the law was established, faced
    higher risks and took more casualties. Between 2001 and the date the
    law took effect, 82 percent (926 deaths) of National Guard and Reserve
    deaths had already occurred. Unfortunately, Congress overlooked this
    early sacrifice by not yet correcting the early retirement statute to
    include those who served between 2001 and 2008.

        1.  ROA and REA endorse a corrective measure to Section
    12731(t)(2)(A) of title 10, U.S.C. Over 600,000 members were unfairly
    excluded. We realize the expense of this corrective measure scored by
    CBO is $1.3 billion over 10 years, but hope that offset dollars can be
    found or the correction can be phased-in.
        2.  ROA and REA don't view this congressional solution as the final
    retirement plan. The Commission on the National Guard and Reserve
    recommends that Congress should amend laws to place the active and
    Reserve components into the same retirement system. Secretary of
    Defense Robert Gates refers to the Tenth Quadrennial Review of Military
    Compensation's comprehensive review of the military retirement systems
    for suggested reform. The latter report suggests a retirement pay equal
    to 2.5 percent of basic pay multiplied by the number of years of
    service.
            ROA and REA agree that a retirement plan, at least for the
    Reserve component, should be based on accruement of active and inactive
    duty. Early retirement should not be based on the type of service, but
    on the aggregation of duty. It shouldn't matter if a member's
    contributions were paid or non-paid; inactive duty, active duty for
    training, special works or for mobilization. Under a continuum of
    service, this approach would provide both the Active or Reserve
    component members with an element of personal control to determine when
    they retire and will encourage increased frequency of service beyond 20
    years within the Reserve.
        3.  Despite efforts by Congress, it appears that DOD will not be
    altering how it credits days toward early retirement that overlap the
    beginning of the new fiscal year. ROA and REA endorse no-cost
    legislation introduced by Sen. Mark Pryor (D-Ark.), S.491, to correct
    existing Section 12731(f)(2)(A) of title 10, U.S.C.
        4.  With an ongoing need for mid-grade officers Congress should
    reexamine the DOPMA and ROPMA laws to:

          a.  Permit 0-3s without prior enlisted service to be able to
    retire at 20 years of service. Many of badly needed skills that the
    Services would like to retain, yet must be discharged if passed over
    for promotion to often.
          b.  Allow 0-4 officers who, after a break in service from active
    duty, return to the Reserve component to retire. After being encouraged
    to return a number of officers find they are not eligible for non-
    regular retirement. When reaching 20 years of commissioned service they
    find they may have only 15 good Federal years.
    Education
        1.  Montgomery ``GI'' Bill-Selected Reserve (MGIB-SR): To assist in
    recruiting efforts for the Marine Corps Reserve and the other uniformed
    services, ROA and REA urge Congress to reduce the obligation period to
    qualify for MGID-SR (section 1606) from 6 years in the Selected Reserve
    to 4 years in the Selected Reserve plus 4 years in the IRR, thereby
    remaining a mobilization asset for 8 years.
        2.  Extending MGIB-SR eligibility beyond Selected Reserve Status:
    Because of funding constraints, no Reserve component member will be
    guaranteed a full career without some period in a non-pay status.
    Whether attached to a volunteer unit or as an individual mobilization
    augmentee (IMA), this status represents periods of drilling without
    pay. MGIB-SR eligibility should extend for 10 years beyond separation
    or transfer from a paid billet.
    Leadership
        ROA and REA urges Congress to change sections 5143 and 5144 of U.S.
    Code Title 10 to only permit appointments from the Navy or Marine
    Corps' Reserve component.
        Both the Army and Air Force Reserve Chiefs may only be selected
    from general officers from that component's reserve, yet the Navy and
    the Marine Corps can select its Reserve leadership from either Active
    or Reserve flag officers. The Reserve Chief of a Service's Reserve
    needs to have an understanding of both the citizen warriors who are
    reporting to him or her, and the system through which they report.
    Draft legislation can be found at www.roa.orgldraftleg.
    Military Voting
        ROA and REA thank Congress for the improvements made to absentee
    voting in the National Defense Authorization Act for Fiscal Year 10.
    Military personnel, overseas citizens, and their families residing
    outside their election districts deserve every reasonable opportunity
    to participate in the electoral process. Yet, studies by Congressional
    Research Service show that 25 percent of military member and family
    votes were not counted in the 2008 election. During the 2010 elections
    there were at least a dozen States that had one or more counties that
    failed to comply with the MOVE Act.
        ROA and REA urge Congress to direct the Government Accountability
    Office to report further on the effectiveness of absentee voting
    assistance to Military and Overseas Citizens for the 2010 General
    Election and determine how Federal Voting Assistance Program's efforts
    to facilitate absentee voting by military personnel and overseas
    citizens differed between the 2008 and 2010 national elections.
        ROA and REA hope that Congress encourages the Secretary of Defense,
    in conjunction with States and local jurisdictions, to gather and
    publish national data about the 2010 election by voting jurisdiction on
    disqualified military and overseas absentee ballots and reasons for
    disqualification.
                             health care discussion
    Military Health Care--a shaky foundation
        The global war on terror is a protracted engagement that will not
    end with the withdrawal of troops from Iraq and Afghanistan and will
    continue, as will military response to crisis spots such a Libya. Yet,
    there are members on both sides of the aisle that are saying if cuts
    are made then Defense should not be exempt. Lawmakers are talking
    openly about TRlCARE fees not having been increased since 1995.
        For a number of years, the Pentagon has spoken out about the rising
    costs of health care and the need for reform. This can be noted by
    statements illustrating that military health costs have increased such
    as ``DOD medical costs have shot up from $19 billion in fiscal year
    2001 to $52.5 billion in fiscal year 2012,'' as made by Deputy
    Secretary of Defense William J. Lynn III at a Senate Budget hearing
    last month.
        Health care costs now consume 9 percent of the DOD budget. Yet
    comparisons of health care costs are distorted by beginning with a
    peacetime starting point followed by a decade of war. Many in the
    Pentagon are attributing the increases in military health care to its
    retirees, especially those working second careers.
        Unfortunately, many retirees are blaming much of this additional
    health care costs on National Guard and Reserve members for being
    included under TRlCARE.
        The Pentagon's public campaign for health care reform has undercut
    its credence by serving members, retirees, and beneficiary associations
    in what has been said, what has been budgeted, and what still might be
    planned.
                                health care cost
        The Reserve Officers Association and the Reserve Enlisted
    Association are disappointed in how the DOD Health Affairs has in the
    past attempted to address such an emotionally laden issue unilaterally.
    While this year, the Pentagon has made efforts to meet with beneficiary
    associations, these gatherings have been more briefings rather than
    discussions to seek solutions. ROA and REA applaud the efforts by
    Congress to address the issue of increasing DOD health care costs and
    its interest to initiate dialogue and work with both the Pentagon and
    the beneficiary associations to find the best solution. The time has
    come to examine the cost of TRICARE and the level of beneficiary
    contribution.
        It is important to sustain the DOD health care as a deferred
    benefit for our serving Active and Reserve component members and their
    families. While retired, these beneficiaries have accepted risks and
    made sacrifices in their earlier military careers that have not been
    asked of the remaining 99 percent of the Nation's population. TRICARE
    fulfills an ongoing promise by the government for continued health care
    to those who have served or are serving.
        ROA and REA are committed to our membership to sustain this health
    care benefit. We fear that Congress will be unable to continue
    prohibitions on health care fees. DOD, Congress, and the beneficiary
    associations need to work together to find a fair and equitable
    solution that protects our beneficiaries and ensures the financial
    viability of the military health care system for the future. Some
    associations seek to continue a freeze on premium fees permanently;
    others are joining ROA and REA by admitting that some increases are
    necessary.
        Conversely, DOD and this Nation cannot afford to carry the full
    burden of health care costs. The operational Active and Reserve Force
    and their families deserve the best, both while serving and into
    retirement. To preserve the top health care program in the Nation as a
    DOD benefit, ROA and REA are open to discussions on cost-sharing.
        Beneficiary medical expense totals have not yet been provided by
    DOD. Congress should ask the Pentagon for a financial breakdown. An
    independent audit by GAO or another agency would allow Congress an
    opportunity to validate proposals based on financial benchmark.
        ROA and REA agree that the proposed $30 increase for individuals
    and $60 for families is a modest proposal, and can accept this as a
    first step.
        Of concern is a proposal to index future increases. Having some
    formula in place seems appropriate, following a similar approach to
    what was taken by Congress to calculate cost-of-living allowances for
    social security and military retirement pay. But the challenge is, what
    index to select?
        ROA and REA agree with other beneficiary associations that it
    should not be a Medicare Index, because a Medicare-based index
    penalizes those retirees under age 65 who don't suffer from the same
    ailments as retirees in the older age group. ROA also found that
    contracted commercial indexes tend to maximize health care growth,
    likely justifying the higher premium increases associated with
    commercial health insurance and should not be used. Comparisons between
    commercial and military health care plans are not justified. ROA is
    continuing to explore indices, but the challenge is that even
    government matrixes are based on an industry and not actual beneficiary
    health care costs.
        ROA and REA share the concern that any process used should be a
    fair and equitable approach where retiree's won't be overburdened.
    Should an index be agreed upon, it should be codified.
                               health care reform
        The beneficiary associations were invited to the Pentagon for a
    meeting with Dr. Clifford L. Stanley, Under Secretary of Defense for
    Personnel and Readiness, about the health reform proposals. At this
    meeting, it was stated that the fiscal year 2012 proposal was enough to
    cover what was needed in the fiscal year 12 budget, and if more was
    needed the next year, DOD would submit additional proposals. During the
    first week of March, the Pentagon also announced that John Baldacci,
    former Governor of Maine, has been hired into in a newly created
    position to recommend to Dr. Stanley ``necessary reforms for the
    military health care system.''
        Statements like these combined with the DOD public relations health
    care costs campaign makes both retirees and beneficiary associations
    nervous.
        In anticipation of less modest proposals in the future ROA and REA
    include the following:
    TRICARE:
             Catastrophic Cap of $3,000 should not be changed, nor
            indexed.
    TRICARE Standard:
             ROA and REA do not endorse an annual enrollment fee
            for either DOD or VA beneficiaries.
             Should DOD suggest increasing deductible levels, the
            total cost of Standard needs to be evaluated, because . . .
             Standard has large co-payments of 25 percent after the
            deductible, and the cost of TRlCARE standard automatically
            adjust to changes in medical costs.
             For individuals or families relying on Standard for
            medical treatment, it is a more expensive health plan than
            TRlCARE Prime.
    TRICARE Reserve Select
             DOD should stop viewing TRS as a health insurance, but
            as a health program.
    TRICARE Retired Reserve (TRR)
             Premiums are too high, and for TRR to be viable,
            premiums need to be reduced.
    TRICARE for Life (TFL)
             No enrollment or separate premium should be
            introduced. Retirees over 65 are already paying more than
            younger retirees.
                         reserve component health care
        The Pentagon views TRlCARE as a health care plan, and Reserve
    TRICARE as a health care insurance. Because words create paradigms,
    Reserve health care is treated by DOD entirely different than active
    duty health care. The differences are easily noted: Active duty members
    enroll in a benefit with deductibles and co-payments; Guard and Reserve
    members ``purchase'' a premium based health plan. The following are
    suggested improvements.
    1. ROA and REA hold concerns over premium rates for TRICARE for gray
            area retirees.
        Because DOD treated Reserve gray area retirees as a separate health
    care risk group, health care premiums proved higher than expected.
    Because of the expense, enrollment is low. It is likely just being used
    by those with health care problems, who can't afford health care from
    other sources. If the program is not changed it will have a similar
    success to mobilization insurance.
        ROA and REA hope that the committee will request a Government
    Accountability Office review of the process that determined the
    published premium levels.
    2. Seamless Transition.
        Servicemembers should not have to navigate through bureaucracy to
    receive care or benefits. Every time a Reserve component member
    transitions into a new category of health care, he or she is required
    to reenroll in the new program. Even those who are beneficiaries of TRS
    need to do an administrative transition between TRS, TRlCARE once
    mobilized, into TAMP and back onto TRS. And once retired, there is
    additional transition into TRlCARE Retired Reserve, and the latter
    TRICARE retiree health care. Add to this the additional health care
    provided by the Department of Veteran Affairs, and there are gaps in
    health care as a Reserve component or family member moves between
    programs.
    3. Access to TAMP.
        It has come to ROA's attention that some Guard and Reserve members
    who have returned from deployment may not be provided TAMP coverage. In
    a number of cases, individuals who were placed in a wounded warrior
    company, after being found fit, were told that they would not qualify
    for transitional health care upon discharge because TAMP coverage was
    started upon the day they returned to the United States and they had
    been in the wounded warrior program for over 180 days.
        ROA and REA feel that TAMP should only begin upon separation from
    Active duty.
    4. Sustaining Reserve Health Care.
        Continued Health Care Benefit Plan continues to be shown as only
    allowing members of the Selected Reserve who have had a tour of active
    duty within the previous 18 months by DOD. This is denying COBRA
    protections for TRS beneficiaries who haven't been activated, and
    doesn't support the Secretary of Defense's directive to mobilize
    National Guard and Reserve members 1 year out of 6, which would be a
    dwell time of 60 months. There is little cost as the beneficiary pays a
    premium of 102 percent of TRlCARE cost.
        As even discharged active servicemembers have the benefit of the
    Continuing Health Care Benefit Plan, those Guard and Reserve members
    who have signed up for TRlCARE Reserve Select need to have protections
    when they leave the Selected Reserve.
        ROA and REA encourage Congress to work with the Pentagon to open up
    Reserve component member access to the Continued Health Care Benefit
    Plan to any TRS beneficiary separating from the Selected Reserve under
    conditions that are not punitive in nature.
    5. Employer health care option.
        DOD pays a stipend to employers of deployed Guard and Reserve
    members to continue employer health care during deployment. G-R family
    members are eligible for TRlCARE if the members' orders to Active Duty
    are for more than 30 days; but some families would prefer to preserve
    the continuity of their own health insurance. Being dropped from
    private sector coverage adversely affects family morale and military
    readiness and discourages some from reenlisting. Many G-R families live
    in locations where it is difficult or impossible to find providers who
    will accept new TRlCARE patients. This stipend would be equal to DOD's
    contribution to Active Duty TRlCARE.
        ROA and REA continue to support an option for individual reservists
    where DOD pays a stipend to employers.
    6. Dental Readiness.
        Currently, dental readiness has one of the largest impacts on
    mobilization. The action by Congress in the NDAA for Fiscal Year 2010
    was a good step forward, but still more needs to be done.
        The Services require a minimum of Class 2 (where treatment is
    needed, however no dental emergency is likely within 6 months) for
    deployment. Current policy relies on voluntary dental care by the Guard
    or Reserve member. Once alerted, dental treatment can be done by the
    military, but often there isn't adequate time for proper restorative
    remedy. Reserve and Guard Dentists could support reducing costs.
        ROA and REA continues to suggest that the services are responsible
    to restore a demobilized Guard or Reserve member to a Class 2 status to
    ensure the member maintains deployment eligibility.
        Because there are inadequate dental assets at Military Treatment
    Facilities for active members, active families, and reservists, ROA and
    REA further recommend that dental restoration be included as part of
    the 6 month TAMP period following demobilization. DOD should cover full
    costs for restoration, but it could be tied into the TRICARE Dental
    program for cost and quality assurance.
    7. Utilization of TRS.
        ROA and REA support efforts by the Pentagon to encourage enrollment
    in TRS. We share a concern that the numbers being published by the
    Pentagon understate the actual level of participation by Guard and
    Reserve members who are eligible. A survey should be taken of TRICARE
    contractors to compare their participation measures with those of DOD.
    8. IRR Access to TRS.
        Not everyone who drills is eligible for TRS. All Services offer
    drilling for points without pay. These members are in the IRR. The Navy
    has Voluntary Training Units. The Air Force and Army have non-paid IMA.
    The Army also has a group within the IRR body that has agreed to
    mobilization during their first 2 years.
        The Army, the Marine Corps, and the Navy have mobilized reservists
    out of the IRR. Under current law, unless these RC members are given an
    opportunity to join the Selected Reserve, they are not eligible to
    purchase TRS following their return.
        ROA and REA feel that IRR members should be eligible for TRS. They
    could qualify if they sign an agreement of continued service and
    complete a satisfactory year of training and satisfy physical
    standards. A satisfactory year could be defined either by points or by
    training requirements, as defined by each Reserve Chief.
        ROA and REA recommend legislation to allow IRR buy-in to TRS.
                                   conclusion
        ROA and REA reiterate our profound gratitude for the progress
    achieved by this committee by providing parity on pay and compensation
    between the Active and Reserve components, with the subcommittee also
    understanding the difference in service between the two components.
        ROA and REA look forward to working with the personnel subcommittee
    where we can present solutions to these and other issues, and offers
    our support in anyway.
                                     ______

           Prepared Statement by the Gold Star Wives of America, Inc.
        Chairman Webb, Ranking Member Graham, and members of this
    committee, I am pleased to submit testimony on behalf of Gold Star
    Wives on legislative issues pertinent to our Nation's military widows
    and widowers. My name is Vivianne Wersel, Chair of the Gold Star Wives'
    Government Relations Committee. I am the widow of Lt. Col. Richard
    Wersel, Jr., USMC, who died suddenly on February 4, 2005, 1 week after
    returning from his second tour of duty in Iraq.
        Gold Star Wives of America, Incorporated (GSW), founded in 1945, is
    a congressionally chartered organization of widows and widowers of
    military members who died while serving on active duty or as a result
    of a service-connected disability. GSW is an all-volunteer organization
    encompassing approximately 10,000 members.
        Our primary mission is to support gold star wives after the death
    of their loved one and a place to connect with other widows. We also
    provide information about military survivor benefits and assist widows
    experiencing difficulties accessing their benefits. We strive to raise
    the awareness of Congress, the public, the military community and Gold
    Star Wives to the many inequities existing in our survivor programs and
    benefits. Many of our members volunteer in Department of Veterans
    Affairs (VA) hospitals and clinics and also visit servicemembers
    hospitalized at Department of Defense (DOD) medical treatment
    facilities.
        GSW's current members are widows and widowers of military members
    who served during World War II, the Korean War, the Vietnam War, the
    Gulf War, the conflicts in both Iraq and Afghanistan, and every period
    in between. For this written testimony, we will refer to all of members
    as widows.
        I am honored to submit testimony for the record today, but am very
    saddened my testimony will show no changes since last year. None of our
    issues passed the last congressional session. GSW's most important
    legislative issues that pertain to this committee are as follows:
       i. elimination of the dependency and indemnity compensation (dic)
                   offset to the survivor benefit plan (sbp)
        GSW strongly supports the complete elimination of the SBP/DIC
    offset. We are grateful for the support of many Members of Congress,
    including most of you here, as this issue has been brought before
    Congress for 11 years. We are also grateful to Senator Bill Nelson his
    sponsorship of S. 260 to remove the SBP/DIC offset. We respectfully
    request Congress eliminate the SBP/DIC offset immediately.
    Two Survivor Programs
        Congress created two programs for survivors of our military
    members. In 1956, Dependency and Indemnity Compensation (DIC) was
    established by the Servicemen's and Veteran's Survivor Benefit Act. The
    purpose of DIC is an indemnity payable to survivors when a military
    member dies as a result of a service-connected cause.
        In 1972, Congress created the Survivor Benefit Plan (SBP). The
    purpose of SBP is to insure that a portion of the military member's
    retirement will be provided to the widow after the military member's
    death.
        Two different plans, two very different purposes, one paid by
    retiree premiums or an active duty military member's life and the other
    paid by the Department of Veterans Affairs.
    GSW Membership and SBP/DIC OFFSET
        GSW encompasses approximately 10,000 DIC recipients. Some of our
    members are eligible for and receive SBP. For those surviving spouses
    who receive SBP, either their retired military servicemember chose to
    purchase SBP at their retirement or their military member died while on
    active duty.
        When a widow is eligible for both SBP and DIC, the widow becomes
    subject to the ``widow's tax''--a dollar-for-dollar reduction in the
    SBP by the amount of DIC received. Military members who died on active
    duty did not pay premiums. (Prior to September 11, a servicemember who
    died on active duty had to be retirement eligible for his survivor to
    receive SBP without payment of premiums.) Their widows became eligible
    for SBP on the date of their active duty death. Retired military
    members chose to purchase SBP and pay premiums with hard-earned
    retirement. Until 2005 and the implementation of concurrent receipt,
    some disabled retirees received no retirement pay with which to pay
    premiums. Many were forced to pay from disability compensation. The
    offset, never mentioned to the military member, only becomes visible to
    their widow once the military member has died. Including GSW members,
    approximately 54,000 surviving spouses are eligible for both SBP and
    DIC.
        Widows who are impacted by the offset are quite often shocked to
    learn they are subject to an offset. Completely unaware of the offset
    and how it would affect them financially forces them to make many hard
    adjustments in their day-to-day lives to accommodate the offset's
    effects.
    Band-Aid Fixes
        Congress has chosen not to eliminate the offset for eleven years
    for the small group of widows impacted by the offset. Instead, Congress
    further divided and subdivided this small group with Band-Aid fixes for
    the offset. Three of the Band-Aid fixes, also called options, create
    even more confusion about benefits and who is eligible and often do
    little to eliminate the financial distress initially. Even reporting
    these options and their consequences to congressional members is
    difficult as they do not understand the impact, ramifications and end-
    result these options caused. The options are below.
        First, the reassignment of a spouse's SBP to her children. In 2003,
    a new law passed, P.L. 108-136, authorizing active duty widows to
    assign the SBP annuity to their children, if any, permanently
    forfeiting any right the widow had to SBP. This reassignment allows
    full receipt of SBP by the child(ren) without offset until they reach
    the age of majority, when the benefit terminates. The widow is forced
    to make this decision very soon after notification of her spouse's
    death and her decision then becomes irrevocable. Complications from
    this new law often require that the widow be granted guardianship of
    her own child(ren) by a court of law. A widow whose husband died in
    retirement is not eligible for this option.
        Second, remarriage. In August 2009, the U.S. Court of Appeals in
    the matter of Sharp, et.al. v. The United States, 82 Fed. Cl. 222
    (2008), ruled that DIC payments may not be deducted from SBP annuities
    if a person entitled to both benefits has remarried after age 57. It
    does not make sense to have two separate standards in the law, one that
    allows payment of full SBP and DIC for widows who remarry after age 57
    and another forcing a dollar-for-dollar offset between the SBP and DIC
    for all others. GSW is concerned that the Federal Government now
    requires a remarriage in order for an annuity to be paid in full.
        Third, Special Survivor Indemnity Allowance (SSIA). The NDAA for
    Fiscal Year 2008 established a Special Survivor Indemnity Allowance for
    widows who are the beneficiary of the SBP annuity and their SBP annuity
    is partially or fully offset by the DIC. The SSIA also applies to the
    widows of members who died on active duty whose SBP annuity is
    partially or fully offset by their DIC. SSIA began at $50 per month and
    increases each fiscal year until 2017, when the SSIA terminates.
        A GSW member inquired recently whether the SBP/DIC offset would be
    removed within her lifetime. She is quite elderly and she stated that
    the odds of her remarrying are not favorable. She knows there are band-
    aid fixes, but stated she was from the old culture and married once for
    a lifetime. For her, the thought of dating or remarrying at the age of
    94 is completely out of the question. The only response we could give
    her is to have faith and hope Congress will eliminate this offset soon.
    Veterans Disability Benefits Commission and Concurrent Receipt
        The Veterans Disability Benefits Commission (VDBC), created by
    Congress in 2004 to review the benefits provided to the disabled and
    their surviving spouses, recommended the elimination of the DIC offset
    to SBP as one of their top priorities for Congress--and they referred
    to this issue as ``survivor concurrent receipt.'' Six years ago,
    concurrent receipt was applied to military members who are 100 percent
    disabled, enabling them to receive both VA compensation and military
    retirement pay in full. Logically, this should have applied to the
    surviving spouse at the same time--death should have been included in
    the 100 percent disabled category for survivor concurrent receipt as
    well.
        GSW understands that Congress does not permit the private sector or
    other Federal benefit programs to reduce or terminate retired annuities
    because the survivor is also eligible for DIC. So it begs to question,
    how can the full receipt of SBP and DIC be considered double dipping
    when in 2004 it was determined by Congress that the 100 percent
    disabled would receive their full retirement and disability
    compensation payments? Survivor compensation is provided to widows
    based on the military member who is rated at 100 percent disabled.
    There is no greater disability than death.
    SBP/DIC Offset Conclusion
        Senator Bill Nelson stated simply for the record before the Senate
    Armed Services Committee Subcommittee on Personnel Hearing on March 10,
    2010, ``To truly honor our servicemembers, we all agree that the U.S.
    Government must take care of our veterans, their widows and orphans. In
    keeping with that moral principle, we must repeal the unjust offset
    that denies widows and orphans the annuity their deceased loved ones
    have earned on active duty or purchased for them. . . . Our efforts
    have been important steps in the right direction, but they are not
    enough. We must meet our obligation to the widow and orphan with this
    same sense of honor as was the service their loved one had rendered. We
    must completely eliminate the SBP/DIC offset.''
        GSW is heartened by all the support and legislation introduced to
    fix the ``widow's tax'' over the past 11 years; however, we are
    perplexed that none of it has led to the necessary change--the complete
    elimination of the SBP/DIC offset. Even the Veterans Disability
    Benefits Commission, chartered by Congress, recommended the elimination
    of the offset in its top six priorities for Congress. Military widows
    have done all that is asked of them over the years and have worked
    tirelessly to educate the government, the public and military
    communities and new members to our own membership. They followed all
    the advice provided by Congress to get the word out to the public,
    garner support within Congress and have had numerous champions sponsor
    legislation to end this offset but to no avail. Our champions retire,
    widows die, and the offset still remains. We watch as other programs
    are easily funded that do not impact the quality of life for their
    recipients. We wait and wait. It is time to do the right thing,
    eliminate the DIC offset to the SBP this session.
        Gold Star Wives would like to thank Senator Bill Nelson for
    introducing S. 260 and the 30 plus cosponsors supporting this effort to
    eliminate the SBP/DIC Offset.
                                 ii. education
        GSW is greatly encouraged by the Gunnery Sergeant John David Fry
    Scholarship Program and request this program be included in the Yellow
    Ribbon Education Program. The Yellow Ribbon Education Program does not
    currently apply to children of the fallen, yet it would help ensure
    these children have a brighter future. We believe this was an oversight
    when the Fry Scholarship was created with the intention of matching
    education benefits to mirror the New GI Bill.
          iii. tricare dental plan for children of active duty fallen
        GSW is thankful for this needed piece of legislation for active
    duty children to continue to receive dental care but we are perplexed
    and concerned at the length of time which has passed without
    implementation. Time is of the essence for many of these children who
    are at an age when dental is pertinent for their optimal well-being.
    Eighteen months is more than sufficient and should have been
    implemented but has not.
                                iv. other issues
    Caregiver/Family Support Services
        While the TMC supports caregiver services, the surviving spouses
    who provided care for their husbands 8 or more years have this
    ``caregiver'' allowance incorrectly included in the DIC check and
    therefore additionally offset from their SBP.
    TRICARE Premiums
        Approximately 33,000 Surviving Spouses of Active Duty and Service
    Connected deaths receive NO RETIRED SBP due to the offset with which to
    pay any TRICARE Premiums.
                         v. recognizing gold star wives
        Gold Star Wives thanks Senator Burr, NC, for sponsoring legislation
    for a Gold Star Wives Day in April 5, 2011 and 2012. The recognition of
    widows' service to our Nation was truly appreciated. These same widows
    and widowers served beside their military member silently, determined
    and unwavering despite hazardous duty, multiple deployments, numerous
    family moves, serving as both parents to their children, and through
    the loss of longevity in their own chosen careers. Many widows and
    widowers were full-time caregivers for their military members. Often
    back-breaking work and enduring financial hardships, these caregivers
    saved the government untold hundreds of thousands of dollars in nursing
    and hospital care, usually to the detriment of their own health. It is
    a shame these same selfless widows and widowers rarely receive
    accolades or honorable mentions in speeches or written statements made
    by our political or military leaders. We ask that you include survivors
    in your speeches, written statements and honorable mentions today and
    into the future.
        This testimony began with one of GSW's most critical issues--the
    elimination of the SBP/DIC offset. Included are several other priority
    issues for GSW that are not unfamiliar to Congress. We request your
    support in caring for our widows and widowers as they look to GSW as
    their support and their voice in Congress. We are the vanguards for
    changing the inequities in military survivor benefits, educating the
    public and military communities, as well as, educating Congress on the
    needs of our members.
        Our husbands would be appalled at the lack of action taken by
    Congress to care for their widows and children. They would be shocked
    to learn their wives and children had to walk the halls of Congress and
    beg for the benefits they had worked so hard for on the battlefield. No
    other group of widows and children are forced to be paraded for all to
    see. These families should be heralded as heroes themselves for
    surviving the life of a military family. I believe that you who serve
    on this committee feel similarly. Let us work to make this statement
    one of action and not just rhetoric.
        I appreciate the opportunity to submit testimony for the record.
    Thank you.
                                     ______

    Prepared Statement by Peter J. Duffy of the National Guard Association
                              of the United States
        Chairman Jim Webb, Ranking Member Lindsey Graham, and members of
    the subcommittee: Thank you for the opportunity to present written
    testimony on behalf of the National Guard Association of the United
    States to address critical personnel issues facing members of the
    National Guard and their families. This brief submission will provide
    factual background, analysis, and corrective recommendations for the
    committee to consider.
                        the unique citizen servicemember
        The National Guard is unique among components of the Department of
    Defense (DOD) in that it has the dual State and Federal mission. While
    serving operationally overseas on Title 10 active duty status, National
    Guard units are under the command and control of the President.
    However, upon release from active duty, members of the National Guard
    return to the far reaches of their states under the command and control
    of their governors where as a special branch of the Selected Reserves
    they train not just for their Federal missions but for their potential
    state active duty missions such as protecting the border and airspace,
    fire fighting, flood control, and providing assistance to civil
    authorities in a variety of possible disaster scenarios.
        Activation numbers for the National Guard as of April 5, 2011 are
    as follows:

            Guardsmen Currently Activated in Support of Operations Noble
            Eagle/Enduring Freedom/New Dawn (as of April 5):
              ARNG: 43,288
              ANG: 5,637

            Total Guardsmen Activated in Support of Operations Noble Eagle/
            Enduring Freedom/New Dawn (Since September 11)
              ARNG: 342,446
              ANG: 87,103

        While serving in their States, members are scattered geographically
    with their families as they hold jobs, own businesses, pursue academic
    programs and participate actively in their civilian communities.
    Against this backdrop, members of the National Guard remain ready to
    uproot from their families and civilian lives to serve their governor
    domestically or their President in distance parts of the globe as duty
    calls and to return to the same communities when their missions are
    accomplished.
        Military service in the National Guard is uniquely community based.
    The culture of the National Guard remains little understood outside of
    its own circles. When DOD testifies before Congress stating its
    programmatic needs, it will likely recognize the indispensable role of
    the National Guard as a vital operational force in the current wars but
    it will say little and seek less to address the benefit disparities,
    training challenges and unmet medical readiness issues that exist for
    National Guard members and their families at the State level before,
    during and after deployment. The National Guard Association of the
    United States asks this subcommittee to please understand that the
    personnel issues of the National Guard are different from those of the
    Active Forces, and in some cases radically so. We ask that they be
    given a fresh look with the best interests of the National Guard
    members and their families in mind, in reviewing the recommendations
    set forth below.
                 support for individual medical readiness needs
        According to The Task Force on the Future of Military Health Care,
    ``Today's Operational Tempo raises the importance of all responsible
    parties doing their part to ensure the Individual Medical Readiness
    (IMR) requirements are satisfied to facilitate maximum deployability of
    our forces.''
        DOD requires all members of the National Guard to be medically
    ready as a condition for deployment. IMR must address the medical and
    dental needs of those members deploying for the first time as well as
    those subject to redeployment whose mental health care needs arising
    from prior service in OIF and OEF have become paramount. However, using
    the National Guard as an operational force requires more accessible
    health care particularly mental health care for members and their
    families pre and post deployment in order to maintain the necessary
    medical readiness required by deployment cycles. It cannot be a simple
    post deployment send off by the active military of ``Good job. See you
    in 3 years.''
        DOD must do more to bring the National Guard to a constant state of
    medical readiness to better support the short notice deployments that
    occur regularly within the National Guard. For example, the Air
    National Guard must maintain constant dental and medical readiness
    because of the short notices they receive for deployments, which
    sometimes can be as little as 72 hours. Short notice deployments also
    occur regularly with cross leveled members who, with as little as 2 or
    3 weeks notice, must fill in for members from other deploying units who
    for various reasons become disqualified for deployment. Members in the
    pool of Individual Mobilization Augmentees whose files are kept at the
    Human Resources Command in St. Louis can also be assigned to fill
    positions in deploying units on short notice without the benefit of the
    premobilization preparations taking place in the deploying unit.
        The Army National Guard currently has the highest suicide rate in
    the military yet there remains no authority in Title 10 to authorize
    the Service Secretaries to provide mental health care for our members
    during dwell time to maintain readiness. In fact, outside of the
    deployment windows which extend from the issuance of an alert order to
    the close of the 6 month Transitional Assistance Management Program
    (TAMP) period following deployment, there is no authority for the
    Service Secretaries to provide any care beyond fixing dental readiness
    issues identified in annual screenings.
        Commanders currently lack the tools during dwell periods to fix
    medical and behavioral readiness issues identified during annual
    screenings identifies. The government pays good money to identify
    treatable medical and behavioral readiness conditions but no money to
    fix them during dwell time. This heightens the risks that members with
    untreated conditions that otherwise could have been fixed will be
    deployed only to be released from active duty at the mobilization
    stations because of the untreated condition. This in turn sets into
    motion the difficult cross leveling process with the unit losing key
    personnel at the worst time and a surrogate stepping in on very short
    notice at great hardship to the member and the member's family. This
    problem is solvable but Congress must act by giving the Service
    Secretaries discretionary authority to correct treatable medical and
    behavioral readiness deficiencies discovered during dwell time
    screenings. Members with conditions that cannot be corrected can be
    separated or reassigned in a more timely manner outside of deployment
    windows. This would allow for a more medically and dentally ready
    deployable force even before the issuance of alert notices. This in
    turn would help to limit the time diverted for treatment during the
    training intensive alert periods.
    Recommendation:
        The National Guard Association of the United States recommends that
    the National Guard Bureau, DOD, and the Congress of the United States
    support authorization and appropriations for programs that will:

             Amend 10 U.S.C. 1074 a(f)(l) to authorize Service
            Secretaries provide the treatment needed to correct treatable
            readiness deficiencies identified during dwell time screenings.
     post-deployment health assessments and medical screenings at the home
                                    station
        It is imperative post deployment that our members while still on
    active duty deployment orders be examined confidentially at the home
    station by a qualified health care provider in order to address the
    under reporting of physical and mental health conditions that is
    occurring on the self-administered Post-Deployment Health Assessment
    (PDHA). The PDHA is currently being completed by a homeward bound
    member in theater or at the demobilization site often several States
    away from home.
        When the PDHA is completed, it is accompanied with the instruction
    that the self-assessing member maybe medically held on active duty at
    the demobilization site if he or she reports a medical condition
    requiring that action. To avoid the risk of being held at the
    demobilization site after a long deployment, members are simply not
    fully reporting their physical and behavioral injuries. This
    underreporting not only delays treatment but can prejudice later claims
    with the VA for service connected disabilities arising from conditions
    not previously reported on the PDHA.
        What is needed forthwith is a free and confidential reporting of
    physical and mental health conditions at the home station by all
    members, stigma free, to a health care provider trained to elicit that
    information and to screen for those conditions without the fear of
    being medically held far from home. If medically holding the member is
    advisable, it should be done as close to home as possible.
        The irony in the current PDHA under reporting phenomenon is that a
    medical hold is usually in the best interest of the member and his or
    her family as it allows pay and benefits to continue during treatment
    for a condition that may well render the member unemployable once
    discharged. The medical hold should not cynically be administered as a
    threat to discourage reporting of injuries when, if properly
    administered in a friendly environment, it offers substantial benefits
    to the members and his or her family.
        The PDHA needs to be completed by returning members at home in the
    presence of a trained health care professional who can screen, observe,
    and ask with the skill necessary to elicit medical issues either
    unknown to the self-reporting member or unreported for fear of being
    retained at far removed demobilization site. Insurance companies in
    performing their due diligence before the issuance of an insurance
    policy do not allow individuals to self-assess their health. Neither
    should the military. If geographical separation from families is
    causing under reporting and non reporting of physical and psychological
    combat injuries on the PDHA, then moving this process to the home
    station would likely produce a better yield at a critical time when
    this information needs to be captured in order for prompt and effective
    treatment to be administered. If necessary and appropriate, the
    examining health care provider in coordination with the National Guard
    J-1 and State's Surgeon General can cause the member to be retained on
    active duty locally for further treatment and evaluation.
        This is especially critical in screening for behavioral conditions.
    At all stages of post-traumatic stress disorder (PTSD) and depression,
    treatment is time sensitive but this is particularly so after onset as
    the illness could persist for a lifetime if not promptly and adequately
    treated and could render the member permanently disabled. The effects
    of this permanent disability on the member's entire family can be
    devastating. It is absolutely imperative that members returning from
    deployment be screened with full confidentiality at the home station
    while still on active duty by trained and qualified mental health care
    providers from VA staff and/or qualified health care providers from the
    civilian community that could include primary care physicians,
    physician assistants and nurse practitioners who have training in
    assessing psychological health presentations. Prompt diagnosis and
    treatment will help to mitigate the lasting effects of mental illness.
        Please see the copy of a November 5, 2008, electronic message to
    NGAUS from Dr. Dana Headapohl set forth in the Appendix which strongly
    recommends a surveillance program for our members before they are
    released from active duty. Dr. Headapohl opines the obvious in stating
    that inadequate medical screening of our members before they are
    released from active duty is ``unacceptable to a group that has been
    asked to sacrifice for our country.'' (emphasis added)
    Recommendation:
        The National Guard Association of the United States recommends that
    Congress support authorization and appropriations for programs that
    will:

             Require the PDHA for National Guard members to be
            administered at the home station before releasing members from
            active duty
             Mandate medical and behavioral screening of all
            National Guard members returning from deployment by health care
            professionals at the home station before releasing the members
            from active duty.
      embed mental health care providers in armories and reserve centers
                                  during drill
        National Guard and Reserve suicides nearly doubled from 80 deaths
    in 2009 to 145 deaths in 2010. This highest suicide rate in the
    military underscores the need to provide the National Guard and Reserve
    with convenient access to mental health care providers in a command
    supported local setting.
        Using the National Guard and Reserve as an operational force in the
    current war requires a funded mental health readiness care program
    during dwell time in order to maintain an important component of
    medical readiness required by deployment cycles.
        As our members reintegrate into their civilian communities or
    prepare for future deployments, many show no signs of physical injury
    but suffer from the psychological effects of traumatic stress requiring
    treatment. These psychological effects may range in severity from
    behavioral readjustment concerns to PTSD with some conditions not
    manifesting themselves until months or even years after returning from
    deployment. Early referral and treatment of behavioral and PTSD issues
    are essential for positive outcomes.
        DOD must provide better access for all National Guard and Reserve
    members during duty hours to seek the assistance of mental health care
    professionals in a convenient stigma free environment. Increased access
    would more thoroughly and expeditiously identify members in need of
    treatment.
        Embedding mental health care providers in armories and Reserve
    training centers during drill would enable on site self referrals or
    mandatory unit wide referrals which would mitigate the perceived stigma
    associated with National Guard members individually seeking mental
    health counseling. This would also eliminate the need for our members
    to take medical leave and drive potentially great distances to seek
    similar services during the work week. As states with piloted programs
    attest, the embedded mental health care provider program works.
        Tri-West with its own funds has instituted a pilot program in
    California that supports 27 mental health care providers as embedded
    screeners with 40 California National Guard units to provide support
    and referral assistance during drill weekends and family readiness
    events. These providers can earn the trust of soldiers and build
    relationships through regular contact in a familiar environment. For
    those National Guard and Reserve members and their families who may not
    have access to the support and resources more commonly found in active
    duty military communities, this outreach is particularly important. The
    pilot program offers soldiers a greater access to the type of care they
    are most comfortable seeking.
        S. 325, The Embedded Mental Health Providers for Reserves Act of
    2011 introduced by Senators Patty Murray and Claire McCaskill, now
    before the 112th Congress would require the Service Secretaries to
    provide to any and all members of the Reserve components performing
    inactive-duty unit training access to mental health assessments and
    treatment with a licensed mental health professional who would be
    available for referrals during duty hours on the premises of the
    principal duty location of the member's unit.
        The Congressional Budget Office has preliminarily estimated the 5
    year outlay for S. 325 to be $109 million. Secretary Gates has
    requested $677 million in the President's fiscal year 2012 budget for
    treatment of PTSD and TBI. A fair allocation of this sum and future
    requests should more than cover the cost of S. 325. In light of the
    recent GAO castigation of the waste and lack of direction in the
    Defense Center of Excellence, the embed program offers a bargain in
    caring for the mental health needs of deserving members of the
    military. Congress needs to require DOD to fairly share mental health
    appropriations with the National Guard and Reserve who can apply those
    funds efficiently with an embedded provider program.
        Our young men and women deserve appropriate and timely mental
    health care assessments and care as they attempt to reintegrate into
    civilian life and maintain medical readiness for future deployments.
    Recommendation:
        Support the passage of S. 325.
    equitably amend the 2008 national defense authorization act in reducing
    the age for members of the reserve components to collect retirement pay
        Having transitioned to an operational force, the National Guard of
    the United States is spending more time on active duty as it shares
    responsibility for the current wars.
        More than 60 years ago, the Congress of the United States
    established the age limit for receipt of retired pay by Reserve
    component members. That law, most recently amended in the 2008 National
    Defense Authorization Act (NDAA), states that a retired Reserve
    component member can begin to draw military retired pay upon reaching
    60 years of age regardless of number of years served. A National Guard
    member who enlists after high school at age 18 and retires after 20
    years of service at age 48 must wait 22 years before drawing a
    retirement check.
                                 retroactivity
        Led by the efforts of Senator Saxby Chambliss, the NDAA for Fiscal
    Year 2008 reduced the 60 year eligibility age for retired members of
    the Ready Reserve to collect retirement pay 3 months for each aggregate
    of 90 days per fiscal year of active duty performed in Title 10 status
    in support of a contingency operation or in Title 32 status in
    responding to a national emergency. Unfortunately, these historic
    provisions applied only to service after January 28, 2008, the date of
    enactment of the 2008 NDAA. Making these changes fully retroactive to
    September 11 is the number one benefit issue in the Guard and Reserve.
        Since September 11, 2001 members of the Reserve component have
    continued to serve as an ``operational'' force with their active
    counterparts in Iraq, Afghanistan, and other dangerous locations around
    the globe. If active duty service of the Reserve components in wartime
    and national emergencies after January 28, 2008 is now recognized in
    reducing the age to collect military retirement pay, it is inequitable
    to not credit retroactively all otherwise qualifying service performed
    after September 11, 2001. Those members currently deployed who fought
    in OIF/OEF before January 28, 2008 know painfully that their earlier
    service is not truly respected. Our members who so bravely risked their
    lives in service to our country deserve that respect.
        The Congressional Budget Office last year estimated the cost of a
    bill to provide retroactivity be 1.353 billion over 10 years. NGAUS
    understands that Reserve retirement is considered mandatory spending
    which would require passage of a retroactivity bill to have an offset
    commensurate with its estimated cost.
        In the event the Senate fields a bill this session that would
    establish the subject retroactivity, NGAUS urges Congress to please
    search for an offset to fund this necessary legislation, or in the
    event a War Supplemental Bill should be introduced this session, to
    fund such a bill as an emergency spending measure.
       eliminating the fiscal year requirement for 90 days of qualifying
                                    service
        The NDAA for Fiscal Year 2008 requires the aforementioned 90 days
    of qualifying service to occur within a single fiscal year thereby
    unfairly not crediting otherwise qualifying service spread over 2
    fiscal years.
        For example, if one served 90 days in OIF from September 1, 2008
    through November 29, 2008, that service would not be credited in
    reducing the retirement eligibility age. However, if the person served
    90 days in OIF from October 1, 2008 through December 29, 2008, that
    service would be fully credited. This distinction unfairly penalizes
    those who serve bravely with orders spanning 2 fiscal years.
        NGAUS urges Congress to correct this inequity by fully crediting
    each aggregate of 90 days of qualifying service irrespective of the
    fiscal year in which it is served.
    Recommendation:
        The National Guard Association of the United States recommends that
    the Congress of the United States support legislation to make the
    Reserve retirement law changes in the NDAA for Fiscal Year 2008
    retroactive to September 11 and to eliminate the fiscal year
    requirement for the 90 days of qualifying service to reduce the
    eligibility age.
        space available travel priority on parity with the active force
        A popular misconception on the Hill holds that Space Available
    (Space A) aircraft travel is governed exclusively by DOD Joint Travel
    Regulations (JTR). Although the JTRs establish the priority categories,
    Congress does intervene with statutory corrections from time to time to
    redirect the Secretary of Defense to reestablish equitable travel
    priorities. Attached to this written testimony is a copy of 110 U.S.C.
    Section 2641b which did just that relative to travel to receive
    specialty care.
        Another statutory change in Space Priorities is in order to bring
    members of the National Guard and Reserve and their dependents on level
    Space A priority with the Active Forces and their dependents. DOD would
    still establish priority categories in the JTR but whatever priority
    category assigned to the Active Forces on leave and their dependents
    would by law apply to the National Guard and Reserve members and their
    dependents.
        The National Guard has established itself as an indispensable
    operational force in defending our country in a most cost effective
    manner. Serving shoulder to shoulder with the Active component
    worldwide, members of the National Guard as citizen soldiers remain
    ready to uproot from their families and civilian lives to serve their
    governor domestically or their President in distant parts of the globe
    as duty calls and to return to the same communities when their missions
    are accomplished.
        In recognition of this service, Congress has worked hard since
    September 11, 2010 to establish Federal legislation to close the
    benefit gap that exists for our deserving members and their families.
    Expanding space-available travel for our members and gray area retirees
    would be a significant step in that direction. It appears that the
    bills would also be budget neutral.
        S. 542 introduced by Senator Mark Begich would provide space-
    available travel on defense department aircraft for members of the
    Reserve components on the same basis as active members of the Armed
    Forces; retired members of the Reserve component eligible to receive
    retirement pay but for age on the same basis as retired members of the
    Armed Forces entitled to receive retirement pay; widows of retired
    members entitled or eligible to receive retirement pay; and the
    accompanying dependents of these members, retired members or widows.
    This legislation is likely budget neutral.
    Recommendation:
        Please support the passage of S. 542.
                 extend tamp coverage with tricare prime remote
        Post-deployment care for members under the TAMP and their families
    must be for a period equal to the period of deployment but not less
    than 6 months. The TAMP program allows members to obtain at government
    expense up to 6 months of TRICARE coverage that is similar, but not
    identical, to the TRICARE Prime coverage they had been receiving on
    active duty.
        Effective TAMP coverage is a medical readiness issue for the
    overwhelming majority of our returning members who are subject to
    redeployment and must maintain their medical and dental readiness.
    Unfortunately, many are slipping through the cracks post deployment
    with undiagnosed medical conditions, particularly behavioral
    conditions, which may not be reported by the returning members when
    they self-assess their medical condition on the PDHA administered at
    the demobilization site. Unreported conditions cannot be treated. As
    these conditions become known over time, a reasonable period is needed
    for proper treatment. The current 6 month TAMP period is proving to be
    inadequate either because of other demands on the returning members'
    time or the late disclosure of a service connected injury.
        The coverage available under TAMP does not include access to the
    provider network under TRICARE Prime Remote, the rural active duty
    coverage available to family beneficiaries while the military sponsor
    is deployed. This breaks provider continuity for rural beneficiaries
    switching to TAMP post deployment who had been treating under the
    TRICARE Prime Remote program while the military sponsor was deployed.
    This requires many of our rural families who had been using TRICARE
    Prime Remote during the deployment to search for a new provider and
    hopefully find one. The TAMP program needs adjusting to expand its
    provider network and to specifically allow rural beneficiaries to have
    access to the same TRICARE Prime Remote providers they had been using.
    Recommendation:
        It is the recommendation of the National Guard Association of the
    United States that the Congress of the United States support funding
    and authority for:

             Extending post-deployment TAMP coverage for a period
            equal to the period of deployment but not less than 6 months.
             To include access to the TRICARE Prime Remote provider
            network as part of the TAMP coverage benefit.
             To expand the TRICARE provider network.
                                   conclusion
        In conclusion, we at NGAUS hope that we have both reinforced and
    amplified this subcommittee's understanding of personnel needs of the
    National Guard. Thank you again for the opportunity to submit testimony
    to this subcommittee and for all that you do for our Nation's
    servicemembers.

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Webb. Having just gone through this on the last
    hearing, I think we'll start from your right, and my left, and
    move this way. If you could summarize your statements in 5
    minutes, the full statements will be entered into the record as
    read.
        Mr. Barnes welcome.

         STATEMENT OF MASTER CHIEF JOSEPH L. BARNES, USN (RET.)

        Mr. Barnes. Thank you, Mr. Chairman.
        Members of the subcommittee, thank you for the opportunity
    to appear before you today.
        My name is Joe Barnes, and I have the privilege of serving
    as FRA's national executive director and also as cochair of
    TMC. I'll be addressing several priority personnel issues. My
    colleagues will do likewise in the areas of family and survivor
    issues, healthcare, and Guard and Reserve issues.
        Military service is unlike any other career or occupation.
    Associated with this is ensuring adequate pay and benefits for
    Active and Reserve personnel, and their families and survivors,
    and fulfilling commitments to provide healthcare and other
    benefits for career personnel after retirement.
        Thanks to the strong support from this distinguished
    subcommittee, there have been significant pay and benefits
    improvements enacted since 2000.
        The Coalition appreciates the exemption of military
    personnel from the Federal pay freeze and strongly supports the
    administration's proposed 1.6 percent 2012 Active Duty pay
    adjustment, which is based on the employment cost index data
    used in preparing the budget request.
        Pay is a major concern for military personnel. If approved,
    this would be the second smallest pay increase in nearly 50
    years, behind the 1.4 percent pay increase this year.
        Adequate end strengths are essential to maintaining
    readiness, prosecuting war efforts, and supporting other
    operations throughout the world, including the recent Libya
    operations and disaster relief in Japan. End-strength levels
    are also related to sufficient dwell time between deployments,
    and debilitating stress on repeatedly deployed servicemembers
    and their families. An article in this week's Navy Times cites
    stresses on Navy personnel and references longer deployments,
    shorter dwell times, and a 15 percent increase in underway days
    over the past decade, with 10 percent fewer ships.
        There are other troubling indicators of the impact of
    stress on personnel and their families after 10 years of war
    and other demanding operational requirements. These include
    increased drug usage, alarming suicide rates, and divorces.
        The Coalition strongly supports the military resale system
    to ensure access to commissaries and exchanges for all
    beneficiaries and provide important support for Morale,
    Welfare, and Recreation (MWR) programs. The pending
    implementation of the Tax Increase Prevention and
    Reconciliation Act will require a 3-percent withholding on
    payments to vendors, and likely result in higher costs being
    passed on to beneficiaries, and reduced MWR program support.
    Accordingly, TMC urges an exemption to the law for the military
    resale system.
        The Coalition supports legislation sponsored by Senator
    Mark Begich that would authorize shipment of a second private-
    owned vehicle to Alaska, Hawaii, and Guam, and increase certain
    permanent change-of-station mileage reimbursement rates.
        Finally, the Coalition supports authorization of full
    concurrent receipt of military retired pay and disability
    compensation for all disabled retirees. This includes phasing
    out the disability offset for all Chapter 61 retirees, as
    previously endorsed by the President and this subcommittee. We
    also urge support for Senator Reid's legislation on this issue.
        Thank you again for the opportunity to present our views on
    these issues.
        [The prepared statement of Chief Barnes follows:]
              Prepared Statement by The Fleet Reserve Association
                         the fleet reserve association
        The Fleet Reserve Association (FRA) is a leading advocate on
    Capitol Hill for enlisted active duty, Reserve, 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. 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 presented awards totaling nearly
    $120,000 to deserving students last year.
        The Association is also a founding member of The Military Coalition
    (TMC), a 33-member consortium of military and veteran's organizations.
    FRA hosts most TMC meetings and members of its staff serve in a number
    of TMC leadership roles.
        FRA's motto is: ``Loyalty, Protection, and Service.''
                 certification of non-receipt of federal funds
        Pursuant to the requirements of House Rule XI, the Fleet Reserve
    Association has not received any Federal grant or contract during the
    current fiscal year or either of the 2 previous fiscal years.
                                    overview
        The Fleet Reserve Association (FRA) is an active participant and
    leading organization in TMC and strongly supports the extensive
    recommendations addressed in the TMC testimony prepared for this
    hearing. The intent of this statement is to address issues of
    particular importance to FRA's membership and the Sea Services enlisted
    communities.
                                  introduction
        Mr. Chairman, the FRA salutes you, members of the subcommittee, and
    your staff for the strong and unwavering support of programs essential
    to Active Duty, Reserve component, and retired members of the uniformed
    services, their families, and survivors. The subcommittee's work has
    greatly enhanced care and support for our wounded warriors, improved
    military pay, eliminated out-of-pocket housing expenses, improved
    health care, and enhanced other personnel, retirement and survivor
    programs. This support is critical in maintaining readiness and is
    invaluable to our Armed Forces engaged throughout the world fighting
    the global War on Terror, supporting the NATO effort in Libya,
    assisting Japan with recovery efforts, sustaining other operational
    requirements and fulfilling commitments to those who've served in the
    past.
        A huge budget deficit, the reduction of troops in Iraq and a
    planned drawdown in Afghanistan increases pressure to slash the defense
    budget. But as the increased hostility on the Korean peninsula last
    November and the recent political instability in the Middle East shows,
    there are many potential conflicts around the world that requires the
    military to be prepared not only in terms of new weapons systems but
    also with adequate personnel strength that is well trained and not
    stressed from continued deployments.
                                    tricare
        Ensuring adequate funding the Military Health System (MHS) and VA
    health care is FRA's top legislative priority and important to every
    segment of our membership, Auxiliary and widows. Our members appreciate
    Chairman Webb's comments that the TRICARE fee increase proposal
    ``violates a moral contract that the government has with those who
    served in the military.'' The importance of health care is reflected in
    responses to the Association's 2011 online survey completed in
    February, which revealed that over 90 percent of all Active Duty,
    Reserve, retired, and veteran respondents cited health care access as a
    critically important quality-of-life benefit associated with their
    military service.
        Higher health care costs are not unique to the military, and FRA
    appreciates the subcommittee's opposition to past proposals to
    drastically increase TRICARE fees and pharmacy co-pays. Our membership
    believes there are management efficiencies and cost saving initiatives
    that can significantly offset higher costs--something first referenced
    in FRA's 2006 testimony on these issues before this distinguished
    subcommittee. An example is the expanded use of the more economical
    pharmacy home delivery option for prescriptions, which saved the
    department over $30 million in 2010.
        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.
        Identifying a permanent solution to pending cuts in Medicare
    physician reimbursement rates is integral to ensuring access to care
    for all beneficiaries seeking care outside the MHS or under TRICARE for
    Life. Congress has repeatedly punted on this matter and the latest
    extension preventing cumulative reimbursement rate cuts now totaling
    29.5 percent expires on December 31, 2011. The Association supports a
    further 2-year extension included in the administration's 2012 budget,
    however, a permanent fix is sorely needed.
                           health care fees proposal
        Regarding the administration's 2012 health care fees proposal, the
    Association believes first and foremost that military service is unlike
    any other civilian career or occupation. Associated with this reality
    and maintaining readiness, are commitments to provide health care and
    other benefits for career personnel after their service careers. As
    stated in the Senate testimony referenced above, ``Providing and
    funding health care benefits for all beneficiaries is part of the cost
    of defending our Nation.'' It's also important to remember that only
    about 1 percent of the population is currently serving in the uniformed
    services to defend our freedoms and prosecute the continuing war
    efforts.
        The Department of Defense's lax management of health care fees
    since TRICARE was established in 1995 led to drastic fee hike proposals
    from 2006 to 2008 including a TRICARE Standard enrollment fee which
    would not enhance access to care for beneficiaries in that program.
        Bipartisan legislation was subsequently introduced in successive
    Congresses that would shift oversight responsibilities from DOD to
    Congress (H.R. 1092 sponsored by Reps. Walter Jones and Dan Boren was
    recently introduced in the 112th Congress), and a Senate bill in the
    110th Congress (S.604 sponsored by Senators Lautenberg and Hagel). If
    enacted, the Senate bill would have prohibited health care fee
    adjustments from exceeding the annual Consumer Price Index (CPI), which
    determines military retired pay adjustments and other Federal benefits
    pegged to inflation. FRA supports (supported) these and related bills
    in the current and previous Congresses.
        Compared to past proposals, the 2012 TRICARE fee changes are more
    reasonable--however, the 2012 adjustments characterized by DOD as
    ``modest'' are only part of the plan and the Association is very
    concerned about the yet-to-determined annual adjustment index for
    TRICARE Prime fees in 2013 and beyond.
        FRA supports other aspects of the proposal including the
    elimination of co-pays for generic drugs dispensed via TRICARE's Home
    Delivery pharmacy program to encourage expanded use of this program--
    and survivors and medically retired personnel are not impacted by the
    proposal. There are also no active duty fee increases, no changes to
    TRICARE Standard--and something especially important to Medicare
    eligible retirees--no additional TRICARE for Life fees.
                             health care inflation
        The Bureau of Labor Statistics' Consumer Price Index (CPI) is the
    basis for annual retired pay adjustments and absent a baseline
    statutory measure for determining health care costs, this index is
    integral to examining proposals to adjust TRICARE Prime enrollment and
    other health care related fees.
        DOD cites a 6.2 percent assumption with regard to adjustments for
    2013 and beyond while acknowledging a number of health care inflation
    indexes. FRA's research found that 1-year Standard & Poor's (S&P)
    Healthcare Economic Indices through November 2010 ranged from 2.71
    percent (S&P Healthcare Hospital Medicare Index) to 6.27 percent (S&P
    Healthcare Economic Composite Index), to 9.04 percent (S&P Healthcare
    Economic Commercial Index). A January 20, 2011 press release on this
    data states that ``Average per capita cost of healthcare services
    covered by commercial insurance and Medicare programs rose 6.27
    (percent),'' which is perhaps the benchmark DOD actuaries used in
    conjunction with projected multi-year savings associated with annual
    health care fee adjustments for military retirees.
                  usfhp and community hospitals reimbursements
        The plan also would require new Uniformed Services Family Health
    Plan (USFHP) beneficiaries to enroll in Medicare Part B and shift to
    Medicare as primary provider at age 65--a change that would impact
    future enrollees to this highly regarded program which serves
    approximately 115,000 beneficiaries in 6 areas throughout the United
    States.
        Although the FRA does not have expertise on the proposed adoption
    of Medicare payment rules at over 400 Sole Community Hospitals over 4
    years, we understand that perhaps 20 of the facilities are near
    military bases and request consideration and/or analysis of the impact
    of these changes with regard to ensuring future access to care for
    TRICARE beneficiaries at these hospitals.
         continued attention to improved service and cost efficiencies
        FRA continues its strong advocacy regarding the need to improve
    service, streamline operations and further identify and implement cost
    saving measures within DOD, all of which are essential to maintaining
    readiness and fulfilling commitments made to all beneficiaries. 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.
                              wounded warrior care
        FRA appreciates the extraordinary efforts by this subcommittee to
    help our wounded warriors. Last year this subcommittee 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).
    Unfortunately, this program of which the Veterans' Affairs Committees
    have jurisdiction has yet to be implemented.
        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.
    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.
        FRA supports additional changes detailed in the full TMC statement
    which include establishing a permanent independent office for the DOD/
    VA Interagency program with expanded authority to include oversight of
    all components of achieving a true seamless transition; authorizing
    active duty TRICARE benefits, regardless of accessibility of VA care,
    for 3 years after medical retirement to help ease transition from DOD
    to VA; and extending and making permanent the charter of the ``Special
    Oversight Committee'' to ensure improved and enduring coordination with
    DOD and VA initiatives to help wounded warriors.
                                      des
        In response to the Dole/Shalala Commission Report a pilot program
    was created (NDAA for 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. The program, now called the Integrated Disability
    Evaluation System (IDES) recently became permanent and is being
    implemented at military medical facilities. This is a common-sense
    approach that FRA believes will reduce bureaucratic red-tape and help
    streamline the process throughout the entire disability rating system.
    Despite jurisdictional concerns, the Association urges the subcommittee
    to provide oversight as the IDES is implemented. According to a recent
    GAO report the new system takes 10 months to traverse as compared to
    the current system that on average takes about 18 months.
        Achieving an effective delivery system between DOD and VA to
    guarantee seamless transition and quality services for wounded
    personnel, particularly those suffering from Post Traumatic Stress
    (PTS) and Traumatic Brain Injuries (TBI) is very important to our
    membership. DOD should also make every effort to de-stigmatize mental
    health conditions that should include outreach, counseling, and mental
    health assessment for all servicemembers returning from the combat
    zone.
                                 suicide rates
        FRA is deeply concerned about military suicide rates. Active duty
    suicides have been reduced or at least leveled off, but suicides for
    non-active duty Reserve component are increasing.
        For example, the Marine Corps ended calendar year 2010 with
    suicides at a 3-year low. The Service reported 37 confirmed or
    suspected suicides in 2010 as compared to 52 in 2009, and 173 marines
    attempted suicide in 2010, which is 9 more than the previous year. The
    Navy reports a decline from 46 per 100,000 personnel in 2009 to 38 in
    2010. Despite this, attempted suicides have increased since 2006.
        Intervention has been helpful for active duty personnel but
    suicides for the Reserve component (RC) not on active duty are
    increasing. Regarding these, (all Services and Guard), 145 suicides
    were reported for 2010 which reflects a significant increase from 80
    suicides the previous year. A March 30, 2011 Fox News segment indicated
    that Guard and Reserve suicides are increasing and that 85 percent of
    those committing suicide in the Guard and Reserve had jobs. A common
    theme also appears to be marriage problems (see USFSPA section below
    for related information.) FRA supports legislation (H.R. 208) sponsored
    by Rep. Thomas Rooney that authorizes reimbursement for mental health
    counseling under TRICARE.
                                 defense budget
        FRA supports a defense budget of at least 5 percent of GDP that
    will adequately 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 adequate in maintaining readiness and associated support for
    both people programs and weapon systems.
                                active duty pay
        FRA appreciates that the military has been excluded from the pay
    freeze for Federal employees announced by President Obama on November
    29, 2010 and 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 compelling 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. The enacted fiscal year
    2011 1.4 percent pay increase and proposed fiscal year 2012 adjustment
    are equal the ECI, are the smallest pay increases in recent memory, and
    do not further reduce the pay gap.
        The Association recommends that this distinguished subcommittee
    authorize 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 military end strengths are 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 we're still engaged
    in war in Iraq and Afghanistan. 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.
                               concurrent receipt
        FRA's recent survey indicates that nearly 70 percent of military
    retirees cite concurrent receipt as ``very important.'' The Association
    supports Senate Majority Leader, Harry Reid's ``Retired Pay Restoration
    Act'' (S. 344) and Rep. Sanford Bishop's ``Disabled Veterans Tax
    Termination Act'' (H.R. 333). Both proposals would authorize
    comprehensive concurrent receipt reform, and Rep. Gus Bilirakis'
    ``Retired Pay Restoration Act'' (H.R. 303) would authorize current
    receipt for retirees receiving CRDP with a disability rating of 50
    percent or less.
        The Association is disappointed that the administration failed to
    address concurrent receipt reform in its budget request as it has for
    the last 2 years, but strongly supports House Personnel Subcommittee
    Chairman Joe Wilson's bill (H.R. 186), that expands concurrent receipt
    for servicemembers who were medically retired with less than 20 years
    of service (Chapter 61 retirees) and would be phased-in over 5 years.
    This proposal mirrors the administration's proposal from the 110th
    Congress. In 2008, Congress voted to expand eligibility for Combat-
    Related Special Compensation (CRSC) coverage to Chapter 61 retirees and
    the proposed legislation would, in effect, extend eligibility for
    Concurrent Retirement and Disability Pay (CRDP) to all Chapter 61
    retirees over 5 years.
                                     usfspa
        FRA again urges Congress to take a serious look at the Uniformed
    Services Former Spouses Protection Act (USFSPA) with a goal of
    addressing inequities in the law and amending language therein to
    ensure that the Federal Government is adequately protecting
    servicemembers against State courts that ignore provisions of poorly
    written law. As noted above, marriage problems may also be associated
    with suicide rates.
        The USFSPA was enacted 29 years ago, the result of congressional
    maneuvering that denied the opposition an opportunity to express its
    views in open public hearings. The last hearing, in 1999, was conducted
    by the House Veterans' Affairs Committee rather than the Armed Services
    Committee which has oversight authority for amending the law.
        Few provisions of the USFSPA protect the rights of the
    servicemember, and none are enforceable by the Department of Justice or
    DOD. If a State court violates the right of the servicemember under the
    provisions of USFSPA, the Solicitor General will make no move to
    reverse the error. Why? Because the act fails to have the enforceable
    language required for Justice or the Defense Department to react. The
    only recourse is for the servicemember to appeal to the court, which in
    many cases gives that court jurisdiction over the member. Some State
    courts also award a percentage of veterans' compensation to ex-spouses,
    a clear violation of U.S. law; yet, the Federal Government does nothing
    to stop this.
        Other provisions weigh heavily in favor of former spouses including
    divorce decrees in which the former spouse is awarded a percentage of
    the servicemember's retired pay which should be based on the member's
    pay grade at the time of the divorce--not at a higher grade that may be
    held upon retirement.
        FRA believes that the Pentagon USFSPA study recommendations strike
    a balance providing needed improvements for the former spouse and
    servicemember and are a reasonable starting point for reform.
                            reserve early retirement
        The Reserve retirement age provision in the NDAA for Fiscal Year
    2008 reduces the age requirement by 3 months for each cumulative 90-
    days ordered to active duty is effective upon the enactment of the
    legislation (January 28, 2008) and NOT retroactive to October 7, 2001.
    Accordingly the Association supports ``The National Guardsmen and
    Reservists Parity for Patriots Act '' (H.R. 181) sponsored by Chairman
    Wilson, to authorize reservists mobilized since October 7, 2001, to
    receive credit in determining eligibility for receipt of early retired
    pay. Since September 11, 2001 the Reserve component has changed from a
    Strategic Reserve to an Operational Reserve and the Association urges
    the subcommittee to support this important legislation.
                  retention of final full month's retired pay
        FRA urges the subcommittee to authorize the retention of the full
    final month's retired pay by the surviving spouse (or other designated
    survivor) of a military retiree for the month in which the member was
    alive for at least 24 hours. FRA strongly supports ``The Military
    Retiree Survivor Comfort Act'' (H.R. 493), introduced by Rep. Walter
    Jones.
        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 month thereafter. Upon the demise
    of a retired servicemember in receipt of military retired pay the
    surviving spouse is to notify the department of the death. Without
    consideration of the survivor's financial status, the 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 measure is related to a similar Department of Veterans' Affairs
    pay policy enacted 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.
                             military resale system
        FRA strongly supports adequate funding for the Defense Commissary
    Agency (DeCA) to ensure access to the commissary benefit for all
    beneficiaries. As noted by Thomas T. Gordy, President of the Armed
    Forces Marketing Council, at a recent oversight hearing by the House
    Armed Services Personnel Subcommittee, ``Since 2000, DeCA's budget has
    remained flat in real dollars, meaning they have done more with less
    for the past 11 years.'' He also reported that ``With the $1.31 billion
    DeCA received in 2010, it generated savings to military families in the
    amount of $2.69 billion.''
        The Association also strongly supports the military exchange
    systems (AAFES, NEXCOM, and MCX), and urges against revisiting the
    concept of consolidation. FRA instead urges a thorough review of the
    findings of an extensive and costly ($17 million) multi-year study
    which found that this is not a cost-effective approach to running these
    important systems.
        Our members are also concerned about the impact of the ``Tax
    Increase Prevention and Reconciliation Act'' (P.L. 109-222) on the
    Military Resale System. Withholding 3 percent on payments to vendors
    that provide products sold in exchanges and commissaries will result in
    part to higher costs being passed on to beneficiaries and reduce
    resources to support MWR programs. Accordingly, FRA asks for support to
    exempt the Military Resale System from the law which becomes effective
    on January 1, 2012.
                             fit but not deployable
        FRA appreciates the inclusion of Section 571 in the National
    Defense Authorization Act for Fiscal Year 2010 which addresses the
    discredited practice of finding a servicemember fit but nondeployable
    who is then given an administrative discharge without benefits. This
    provision requires approval by a Physical Evaluation Board (PEB) and
    requires the Secretary of Defense to make the final adjudication. The
    Association urges this subcommittee to provide continued oversight to
    ensure disabled servicemembers are adequately compensated for their
    injuries and illnesses incurred while serving our country.
                                   pcs reform
        A recent Navy Times poll indicates that nearly 41 percent of
    servicemembers had more than one problem with their most recent
    permanent change of station move (PCS). FRA supports legislation
    sponsored by Sen. Mark Begich entitled ``The Servicemembers Permanent
    Change of Station Relief Act'' (S. 472) which would authorize
    reimbursement for shipping a second POV to Alaska, Hawaii, and Guam;
    and increase PCS mileage rates from 24 to 51 cents per mile.
                           travel cost reimbursement
        FRA appreciates the NDAA for Fiscal Year 2008 provision (section
    631) that permits travel reimbursement for reservist's weekend drills,
    not to exceed $300, if the commute is outside the normal commuting
    distance. The Association urges the subcommittee to make this a
    mandatory provision. This is a priority issue for many enlisted
    reservists who must travel long distances to participate in weekend
    drills without reimbursement for travel costs. Providing this travel
    reimbursement would assist with retention and recruitment of
    reservists--particularly during the current period of increased
    reliance on these personnel to sustain the war effort and other
    operational commitments.
                           flexible spending accounts
        Many military families need flexible spending accounts that are
    available to most civilian employees and to Federal civilian workers.
    The accounts allow servicemembers to invest their earnings that are
    matched dollar-for-dollar by the Federal Government up to a specific
    amount. DOD has authority to implement flexible spending accounts but
    has elected not to do so which is why FRA supports legislation (S. 387)
    sponsored by Sens. Barbara Boxer, Richard Burr, and Kristin Gillibrand,
    and legislation (H.R. 791) sponsored by Rep. Loretta Sanchez. These
    proposals would mandate that DOD set up flexible spending accounts
    within 6 months after enactment and would require the Pentagon to study
    the feasibility of flexible spending accounts for the Reserve
    component.
                                   conclusion
        FRA is grateful for the opportunity to present these
    recommendations to this distinguished subcommittee.

        Senator Webb. Thank you very much, Master Chief Barnes.
        Colonel Strobridge, welcome.

     STATEMENT OF COL. STEVEN P. STROBRIDGE, USAF (RET.), DIRECTOR
       OF GOVERNMENT RELATIONS, MILITARY OFFICERS ASSOCIATION OF
                                AMERICA

        Mr. Strobridge. Thank you very much, Mr. Chairman.
        We very much appreciate this opportunity to present our
    views. My portion of the Coalition's testimony will cover
    healthcare issues.
        Our primary concern is protection of military beneficiaries
    against dramatic budget-driven fluctuations in this vital
    element, a servicemember's career compensation package. One
    example is the Deficit Commission's proposal to reduce the
    value of TRICARE for Life by $3,000 per year for a retiree,
    $6,000 for a couple, for older and disabled beneficiaries,
    through deductible and copayment increases. That would be a
    major about-face from what Congress saw as ``earned coverage''
    when TRICARE for Life was enacted 10 years ago. We hope the
    subcommittee would oppose inclusion of any such change in the
    budget resolution.
        We also urge the subcommittee to continue its oversight of
    wounded warrior and caregiver issues. Although we believe both
    DOD and VA are pursuing seamless transition initiatives in good
    faith, we urge joint hearings by the Armed Services and
    Veterans' Affairs Committees to track progress and any
    stumbling blocks on a wide variety of ongoing issues.
        The Coalition continues to be concerned about the adequacy
    of provider participation in TRICARE, especially for TRICARE
    Standard beneficiaries. We're grateful to the subcommittee for
    establishing statutory surveys of participation adequacy, but
    that requirement expires this year. We hope you'll renew the
    requirement and establish more specific actions to ensure
    compliance with participation standards.
        On the issue of TRICARE fees, the Coalition has a diversity
    of views, but believes strongly that the DOD proposed indexing
    methodology is inappropriate. Speaking for MOAA and the 13
    other associations that endorsed our statement, we haven't
    taken the position that TRICARE fees should never rise, but
    that Congress should establish principles in that regard to
    explicitly recognize that the bulk of what military people pay
    for their healthcare isn't paid in cash, but is paid upfront
    through decades of service and sacrifice. We're encouraged that
    the new DOD proposal does a far better job of acknowledging
    that than did those of several years ago.
        Our principal objection is to DOD's plan to index future
    TRICARE prime increases to some undetermined healthcare index
    they project to rise at 6.2 percent per year. In our view, the
    main problem is that current law leaves much of the fee-setting
    process to the Secretary's discretion. DOD went years proposing
    no changes, making beneficiaries believe there wouldn't be any.
    Then a new Secretary with a new budget situation proposed
    tripling fees, which upset beneficiaries and implied they
    hadn't earned their healthcare.
        We have statutory guidelines for setting and adjusting
    basic pay, retired pay, survivor benefits, and most other
    military compensation elements. We believe strongly that the
    law should specify several principles on military healthcare.
        First, it should acknowledge, if only as a Sense of
    Congress, that the military retirement and healthcare package
    is the primary offset for the extraordinary demands and
    sacrifices inherent in a multidecades military career.
        Second, it should acknowledge that those decades of service
    and sacrifice constitute a very large prepaid premium for their
    healthcare and retirement, over and above what they pay in
    cash. Finally, it should explicitly acknowledge that
    extraordinary upfront premium in the adjustment process by
    limiting the percentage growth in TRICARE fees in any year to
    the percentage growth in military retired pay.
        In the meantime, MOAA and TMC pledge our support to work
    with DOD and the subcommittee to find other ways to hold down
    military healthcare cost growth. We believe much more can be
    done to encourage voluntary use of the mail-order pharmacy
    system, reduce costs of chronic conditions, reduce systemic
    duplications, and cut contract and procurement costs, to name a
    few.
        Thank you. That concludes my portion of the statement.
        [The prepared statement of Mr. Strobridge follows:]
                  Prepared Statement by The Military Coalition
        Mr. Chairman and distinguished members of the subcommittee, on
    behalf of The Military Coalition (TMC), a consortium of nationally
    prominent uniformed services and veterans' organizations, we are
    grateful to the committee for this opportunity to express our views
    concerning issues affecting the uniformed services community. This
    testimony provides the collective views of the following military and
    veterans' organizations, which represent approximately 5.5 million
    current and former members of the 7 uniformed services, plus their
    families and survivors:

             Air Force Association
             Air Force Sergeants Association
             Air Force Women Officers Associated
             AMVETS (American Veterans)
             Army Aviation Association of America
             Association of Military Surgeons of the United States
             Association of the U.S. Army
             Association of the U.S. Navy
             Chief Warrant Officer and Warrant Officer Association,
            U.S. Coast Guard
             Commissioned Officers Association of the U.S. Public
            Health Service, Inc.
             Enlisted Association of the National Guard of the
            United States
             Fleet Reserve Association
             Gold Star Wives of America, Inc.
             Iraq and Afghanistan Veterans of America
             Jewish War Veterans of the United States of America
             Marine Corps League
             Marine Corps Reserve Association
             Military Chaplains Association of the United States of
            America
             Military Officers Association of America
             Military Order of the Purple Heart
             National Association for Uniformed Services
             National Guard Association of the United States
             National Military Family Association
             Naval Enlisted Reserve Association
             Noncommissioned Officers Association
             Reserve Enlisted Association
             Reserve Officers Association
             Society of Medical Consultants to the Armed Forces
             The Retired Enlisted Association
             U.S. Army Warrant Officers Association
             U.S. Coast Guard Chief Petty Officers Association
             Vietnam Veterans of America

        The Military Coalition, Inc. does not receive any grants or
    contracts from the Federal Government.
                               executive summary
    Deficit Reduction Proposals
        Cost-of-Living Adjustments (COLAs)
        A top Coalition priority is to guard against any discriminatory
    treatment of retired members of the uniformed services compared to
    other Federal COLA-eligibles and to ensure continued fulfillment of
    congressional COLA intent ``to provide every military retired member
    the same purchasing power of the retired pay to which he was entitled
    at the time of retirement [and ensure it is] not, at any time in the
    future . . . eroded by subsequent increases in consumer prices.''
        Military Pay
        The Coalition urges against short-sighted proposals to freeze or
    cap uniformed services pay raises below private sector pay growth, and
    recommends a 2012 raise of at least 1.6 percent to match Employment
    Cost Index (ECI) growth.
        Health Care Fees
        Coalition member associations hold a diversity of views concerning
    the Department of Defense (DOD)-proposed TRICARE fee adjustments for
    fiscal year 2012.
        However, the Coalition strongly objects to the DOD-proposed
    adjustment methodology that would tie TRICARE Prime fee increases for
    nondisabled military beneficiaries aged 38 to 64 in future years to an
    as-yet-unspecified measure of health cost growth for the broader
    population that DOD actuaries assume would grow at an average of 6.2
    percent per year.
        The Coalition believes that military beneficiaries from whom
    America has demanded decades of extraordinary service and sacrifice
    have earned coverage that is the best America has to offer, consistent
    with their extraordinarily high pre-paid premiums of decades of service
    and sacrifice.
        Congress needs to protect military beneficiaries against dramatic
    budget-driven fluctuations in this vital element of servicemembers'
    career compensation incentive package.
        Reducing the value of TRICARE for Life by $3,000 per year ($6,000
    for a couple) as recommended by the Deficit Commission would be
    inconsistent with military beneficiaries' sacrifices and would
    undermine Congress' intent when it authorized TFL in 2001--less than 10
    years ago.
        Reducing military retirement benefits would be particularly ill-
    advised when an overstressed force already is at increasing retention
    risk despite the current downturn of the economy and current recruiting
    successes.
        TMC believes:

             All retired servicemembers earned equal health care
            coverage by virtue of their service.
             Means-testing has no place in setting military health
            fees.
             Congress should direct DOD to pursue any and all
            options to constrain the growth of health care spending in ways
            that do not disadvantage beneficiaries.
             TRICARE Prime enrollment fees for nondisabled retirees
            under 65 should not be adjusted based on health cost increases
            for the broader population, as proposed by DOD.
             It should be Congress' responsibility, not the Defense
            Secretary's, to establish appropriate and stable parameters
            governing crucial career retention programs such as the
            healthcare package for currently serving and retired military
            members and their families and survivors.
        Military Retirement
        The Coalition strongly opposes initiatives that would
    ``civilianize'' the military retirement system and inadequately
    recognize the unique and extraordinary demands and sacrifices inherent
    in a military career.
        Reducing incentives for serving arduous careers of 20 years or more
    can only undermine long-term retention and readiness, with particularly
    adverse effects in times of war. Simultaneously increasing compensation
    for those who leave short of fulfilling a career would only compound
    those adverse effects.
        DOD Schools
        The Coalition opposes closing or curtailing DOD dependent schools
    based primarily on budget concerns. The need for the schools should
    continue to be evaluated based on the capacity of local school
    districts to provide quality educational opportunities for military
    students.
        Consolidation of DOD Retail Operations
        The Coalition supports continuing efforts to improve commissary and
    exchange program efficiency, but objects to initiatives that reduce
    benefit value for patrons and the associated retention value for the
    uniformed services.
    Wounded Warrior Care
        Institutional Oversight
        The Coalition urges joint hearings by the Armed Services and
    Veterans Affairs Committees to assess the effectiveness of current
    seamless transition oversight efforts and systems and to solicit views
    and recommendations from DOD, VA, the military Services, and
    nongovernmental organizations concerning how joint communication,
    cooperation, and oversight could be improved. In addition, the hearings
    should focus on implementation progress concerning:

             Single separation physical;
             Single disability evaluation system;
             Bidirectional electronic medical and personnel records
            data transfer;
             Medical centers of excellence operations and research
            projects;
             Coordination of care and treatment, including DOD-VA
            Federal/recovery care coordinator clinical and non-clinical
            services and case management programs; and
             Consolidated government agency support services,
            programs, and benefits.
        Continuity of Health Care
        The Coalition recommends:

             Authorizing service-disabled members and their
            families to receive active-duty-level TRICARE benefits,
            independent of availability of VA care for 3 years after
            medical retirement to help ease their transition from DOD to
            VA.
             Ensuring Guard and Reserve members have adequate
            access and treatment in the DOD and VA health systems for Post
            Traumatic Stress Disorder and Traumatic Brain Injury following
            separation from active duty service in a theatre of operations.
        Caregiver/Family Support Services
        The Coalition recommends:

             Providing enhanced training of DOD and VA medical and
            support staff on the vital importance of involving and
            informing designated caregivers in treatment of and
            communication with severely ill and injured personnel.
             Providing health and respite care for non-dependent
            caregivers (e.g., parents and siblings) who have had to
            sacrifice their own employment and health coverage while the
            injured member remains on active duty, commensurate with what
            the VA authorizes for medically retired or separated members'
            caregivers.
             Authorizing up to 1 year of continued residence in on-
            base housing facilities for medically retired, severely
            wounded, ill, and injured servicemembers and their families.
    Active Forces and Their Families
        End Strength
        The Coalition urges the subcommittee to:

             Sustain or increase end strength as needed to sustain
            the war and other operational requirements and enhance dwell
            time for servicemembers and families; and
             Sustain adequate recruiting and retention resources to
            enable the uniformed services to achieve required optimum-
            quality personnel strength.
        Family Readiness and Support
        The Coalition recommends that the subcommittee:

             Encourage DOD to assess the effectiveness of programs
            and support mechanisms designed to assist military members and
            their families with deployment readiness, responsiveness, and
            reintegration.
             Fully fund effective programs and ensure their costs
            are included in the annual budget process.
             Expand child care availability and funding to meet the
            needs of the total force uniformed services community.
             Monitor and continue to expand family access to mental
            health counseling.
             Promote expanded opportunities for military spouses to
            further educational and career goals, such as the My Career
            Advancement Account (MyCAA) program.
             Promote implementation of flexible spending accounts
            to enable military families to pay health care and child care
            expenses with pre-tax dollars.
        Permanent Change-of-Station (PCS) Allowances
        The Coalition recommends the subcommittee:

             Authorize shipment of a second privately-owned vehicle
            at government expense to Alaska, Hawaii, and U.S. territories.
             Authorize reimbursement of house-hunting expenses, as
            is done for Federal civilians.
             Authorize payment of a dislocation allowance to
            servicemembers making their final change of station upon
            retirement from the uniformed services.
             Increase PCS mileage rates to more accurately reflect
            actual transportation costs.
             Further modify the PCS weight allowance tables for
            personnel in pay grades E-7, E-8, and E-9 to coincide with
            allowances for officers in grades O-4, O-5, and O-6
            respectively. The allowance for a senior E-9 enlisted leader
            without dependents remains the same as for a single O-3,
            despite the normal accumulation of household goods over the
            course of a career.
    National Guard and Reserve
        Operational Reserve Retention and Retirement Reform
        TMC recommends:

             Authorizing early retirement credit to all Guard and
            Reserve members who have served active duty tours of at least
            90 days, retroactive to September 11, 2001.
             Eliminating the fiscal year limitation which
            effectively denies full early retirement credit for active duty
            tours that span the October 1 start date of a fiscal year.
             Modernizing the Reserve retirement system to
            incentivize continued service beyond 20 years and provide fair
            recognition of increased requirements for active duty service.
        Health Care Access Options
        The Coalition recommends:

             Requiring DOD to justify the seven-fold increase in
            TRICARE rates for individual TRR premiums for reservists who
            immediately enroll in TRR upon retirement from the Selected
            Reserve and have TRS coverage until separation.
             Authorizing TRICARE for early Reserve retirees who are
            in receipt of retired pay prior to age 60
             Permitting employers to pay TRS premiums for
            reservist-employees as a bottom-line incentive for hiring and
            retaining them.
             Authorizing an option for the government to subsidize
            continuation of a civilian employer's family coverage during
            periods of activation, similar to FEHBP coverage for activated
            Guard-Reserve employees of Federal agencies.
             Extending corrective dental care following return from
            a call-up to ensure G-R members meet dental readiness
            standards.
             Allowing eligibility in Continued Health Care Benefits
            Program (CHCBP) for Selected reservists who are voluntarily
            separating and subject to disenrollment from TRS.
             Allowing beneficiaries of the FEHBP who are selected
            reservists the option of participating in TRICARE Reserve
            Select.
        Yellow Ribbon Reintegration Program
        The Military Coalition urges the subcommittee to hold oversight
    hearings and direct additional improvements in coordination,
    collaboration, and consistency of Yellow Ribbon services between
    States.
        Reserve Compensation System
        TMC recommends:

             Crediting all inactive duty training points earned
            annually toward Reserve retirement.
             Parity in special incentive pay for career enlisted/
            officer special aviation incentive pay, diving special duty
            pay, and pro-pay for Reserve component medical professionals.
             Authorizing recalculation of retirement points after 1
            year of mobilization. A recent law change allowed certain flag
            and general officers to recalculate retirement pay after 1 year
            of mobilization. TMC believes this opportunity should be made
            available to all ranks.
        Guard/Reserve GI Bill
        TMC recommends:

             Restoring basic Reserve MGIB benefits for initially
            joining the Selected Reserve to the historic benchmark of 47-50
            percent of active duty benefits.
             Integrating Reserve and active duty MGIB laws in Title
            38.
             Enacting academic protections for mobilized Guard and
            Reserve students including refund guarantees and exemption of
            Federal student loan payments during activation.
        Family Support Programs
        TMC recommends:

             Ensuring programs are in place to meet the special
            information and support needs of families of individual
            augmentees or those who are geographically dispersed.
             Funding joint programs among military and community
            leaders to support servicemembers and families during all
            phases of deployments.
             Providing preventive counseling services for
            servicemembers and families and training so they know when to
            seek professional help related to their circumstances.
             Authorizing and funding child care, including respite
            care, family readiness group meetings and drill time.
             Improving the joint family readiness program to
            facilitate understanding and sharing of information between all
            family members.
    Health Care
        TRICARE Reimbursement Rates
        TMC urges reversal of the 30 percent cut in Medicare/TRICARE
    payments to doctors scheduled for January 2012 and a permanent fix for
    the flawed formula that mandates these recurring annual threats to
    seniors' and military beneficiaries' health care access.
        TRICARE Cost Efficiency Options
        TMC continues to believe strongly that DOD has not sufficiently
    investigated options to make TRICARE more cost-efficient without
    shifting costs to beneficiaries.
        TRICARE Prime
        The Military Coalition urges the subcommittee to:

             Require reports from DOD and the managed care support
            contractors on actions being taken to improve Prime patient
            satisfaction, provide assured appointments within Prime access
            standards, reduce delays in preauthorization and referral
            appointments, and provide quality information to assist
            beneficiaries in making informed decisions.
             Require increased DOD efforts to ensure consistency
            between the MTF and purchased care sectors in meeting Prime
            access standards.
             Ensure timely notification of and support for
            beneficiaries affected by elimination of Prime service areas
            under the new TRICARE contracts.
        TRICARE Standard
        The Coalition urges the subcommittee to:

             Insist on immediate delivery of an adequacy threshold
            for provider participation, below which additional action is
            required to improve such participation.
             Require a specific report on participation adequacy in
            the localities where Prime Service Areas will be discontinued
            under the new TRICARE contracts.
             Oppose establishment of a TRICARE Standard enrollment
            fee, since Standard does not entail any guaranteed access to
            care.
             Increase locator support to beneficiaries seeking
            providers who will accept new Standard patients, particularly
            for mental health specialties.
             Seek legislation to eliminate the limit when TRICARE
            Standard is second payer to other health insurance (OHI): e.g.,
            return to the policy where TRICARE pays up to the amount it
            would have paid, had there been no OHI.
             Bar any further increase in the TRICARE Standard
            inpatient copay for the foreseeable future.
        TRICARE For Life
        The Coalition urges the subcommittee to:

             Resist initiatives to establish an enrollment fee for
            TFL, as many beneficiaries already experience difficulties
            finding providers who will accept Medicare patients.
             Seek ways to include TFL beneficiaries in DOD programs
            to incentivize compliance with preventive care and healthy
            lifestyles.
             Resolve the discrepancy between TRICARE and Medicare
            treatment of the shingles vaccine.
        Survivors' Coverage
        The Coalition recommends restoration of TRICARE benefits to
    previously eligible survivors whose second or subsequent marriage ends
    in death or divorce.
        Pharmacy
        The Coalition urges the subcommittee to:

             Advance the use of the mail order option by lowering
            or waiving copays, enhancing communication with beneficiaries,
            and using technological advances to ease initial signup.
             Require DOD to include alternate packaging methods for
            pharmaceuticals to enable nursing home, assisted living, and
            hospice care beneficiaries to utilize the pharmacy program.
            Packaging options should additionally include beneficiaries
            living at home who would benefit from this program because of
            their medical condition (for example beginning stages of
            Alzheimer's).
             Create incentives to hold down long-term health costs
            by eliminating copays for medications for chronic conditions,
            such as asthma, diabetes, and hypertension or keeping copays at
            the lowest level regardless of drug status, brand or generic.
    Retiree Issues
        Concurrent Receipt
        The Coalition's continuing goal is to fully eliminate the deduction
    of VA disability compensation from earned military retired pay for all
    disabled retirees. In pursuit of that goal, the Coalition's immediate
    priorities include:

             Phasing out the VA disability offset for all chapter
            61 (disability) retirees, as previously endorsed by the
            President and the subcommittee;
             Clarifying the law to resolve technical disparities
            that inadvertently cause underpayment of certain eligibles for
            Combat Related Special Compensation (CRSC); and,
             Clarifying the law to ensure a disabled retiree's CRSC
            payment is not reduced when the retiree's VA disability rating
            increases, until the retiree is afforded the opportunity to
            elect between CRSC or CRDP.
        Disability Severance Pay
        The Coalition recommends:

             Further expanding eligibility to include all combat-
            related injuries, using the same definition as CRSC; and
            ultimately
             Expanding eligibility to include all service-connected
            disabilities, consistent with TMC view that there should not be
            a distinction between the treatment of members disabled in
            combat vice members with non-combat, service-caused
            disabilities.
        Former Spouse Issues
        The Coalition supports legislative action to:

             Base the award amount to the former spouse on the
            grade and years of service of the member at time of divorce
            (not time of retirement);
             Prohibit the award of imputed income while on active
            duty, which effectively forces active duty members into
            retirement;
             Extend 20/20/20 benefits to 20/20/15 former spouses;
             Permit the designation of multiple Survivor Benefit
            Plan (SBP) beneficiaries with the presumption that SBP benefits
            must be proportionate to the allocation of retired pay;
             Eliminate the ``10-year Rule'' for the direct payment
            of retired pay allocations by the Defense Finance and
            Accounting Service (DFAS);
             Permit SBP premiums to be withheld from the former
            spouse's share of retired pay if directed by court order;
             Permit a former spouse to waive SBP coverage;
             Repeal the 1-year deemed election requirement for SBP;
            and
             Assist DOD and Services with greater outreach and
            expanded awareness to members and former spouses of their
            rights, responsibilities, and benefits upon divorce.
    Survivor Issues
        SBP-DIC Offset
        The Coalition recommends:

             Repeal of the SBP-DIC offset.
             Reinstating SBP for survivors who previously
            transferred payments to children when the youngest child
            attains majority, or upon termination of a remarriage.
             Allowing SBP eligibility to switch to children if a
            surviving spouse is convicted of complicity in the member's
            death.
        Special Needs Trust
        The Coalition recommends authorizing payment of SBP annuities for
    disabled survivors into a Special Needs Trust.
        Final Retired Paycheck
        TMC recommends authorizing survivors of retired members to retain
    the final month's retired pay for the month in which the retiree dies,
    as VA survivors are allowed to retain a disabled veteran's final-month
    disability paycheck.
    Morale, Welfare, and Recreation and Quality of Life Programs
        TMC urges the subcommittee to:

             Seek report updates from DOD and the Services to
            ensure delivery of needed MWR and quality of life program
            support at gaining and losing locations affected by Base
            Realignment and Closure (BRAC) and rebasing.
             Direct DOD to report to Congress on all DOD and
            Service Active and Reserve component MWR Category A, B, and C
            Programs and Family Support/Readiness (Quality of Life [QoL]
            Programs), including the Yellow Ribbon Program.
             Protect recreational and alternative therapy programs
            that integrate MWR, fitness and other quality of life programs
            and infrastructure to facilitate warrior treatment and care and
            to promote psychological health and welfare of troops and their
            families.
    Military Construction
        The Coalition recommends the subcommittee:

             Support military construction projects that modernize
            or replace the following infrastructure to meet increased
            personnel and operational deployment requirements:

                     child development centers (CDCs) and youth
                    centers;
                     defense schools;
                     bachelor and family housing; and,
                     other traditional QoL program facilities.

             Encourage full funding of military housing repair and
            maintenance accounts to reduce backlogs and provide for safe,
            well-maintained housing units.
             Ensure that military housing privatization initiatives
            meet expected DOD-Service outcome goals and positively impact
            servicemember and family needs.
             Support a Health Facilities Program that modernizes or
            replaces Military Treatment Facilities (MTFs) and supports
            world-class health care delivery capability and capacity for
            all eligible beneficiaries.
             Ensure MWR, MILCON, housing, and family support
            construction policies and projects improve access for persons
            with disabilities.
                                    overview
        Mr. Chairman, The Military Coalition extends our thanks to you and
    the entire subcommittee for your strong support of our Active Duty,
    Guard, Reserve, retired members, and veterans of the uniformed services
    and their families and survivors. Your efforts have had a significant
    and positive impact in the lives of the entire uniformed services
    community.
        This past year was extremely arduous, with servicemembers still at
    war on two separate fronts in southwest Asia and the Nation slowly
    recovering from the recent economic crisis. Congress and the
    administration have had difficult choices to make as they attempted to
    stimulate the economy while facing record-breaking budget deficits.
        We are grateful that both the Defense Department and Congress
    placed top priority on personnel issues last year. As we enter the 10th
    year of intense wartime operations, the Coalition believes that this
    prioritization should continue for fiscal year 2012.
        Despite the extraordinary demands, men and women in uniform are
    still answering the call--thanks in no small measure to the
    subcommittee's strong and consistent support--but only at the cost of
    ever-greater sacrifices.
        Dramatic increases in suicide rates reflect the long-term effects
    of requiring the same people to return to combat again and again--and
    yet again.
        In these times of growing political and economic pressures, the
    Coalition relies on the continued good judgment of the Armed Services
    Committees to ensure the Nation allocates the required resources to
    sustain a strong national defense, and in particular, to properly meet
    the pressing needs of the less than 1 percent of the American
    population--servicemembers and their families--who protect the freedoms
    of the 99 percent.
        In this testimony, The Coalition offers our collective
    recommendations on what needs to be done to meet these essential needs.
                          deficit reduction proposals
        The National Commission on Fiscal Responsibility and Reform and
    several less publicized deficit-reduction panels have proposed a wide
    range of spending cuts, including proposed cutbacks in Federal cost-of-
    living adjustments (COLAs); defense spending, including military pay
    and retirement; and Federal health care programs, including TRICARE and
    TRICARE for Life.
        The Coalition agrees with the fiscal commission's key premise:
    ``America cannot be great if we go broke.'' The rapidly growing debt
    problem facing our country is all too real, and there is no easy fix.
    Solving this problem for the long term will involve shared pain by all
    Americans.
        Congress has improved retention and readiness by addressing a
    number of quality of life issues for the military community over the
    last decade, authorizing TRICARE For Life and TRICARE Senior Pharmacy
    coverage, establishing concurrent receipt for most severely disabled
    and combat-disabled retirees, improving pay and allowances for
    currently serving personnel, upgrading health coverage for the Guard
    and Reserve community, passing major GI Bill improvements, and
    eliminating the age-62 SBP reduction for military widows, among other
    important initiatives.
        Now, ironically, critics decry the growth in personnel and health
    care spending since 2000. To put that in context, it's important to
    recall that there were compelling reasons why all of those changes
    needed to be enacted.
        Twelve years ago, military leaders were complaining of retention
    problems as decades of pay raise caps had depressed military pay nearly
    14 percent below private sector pay. Military retirees and their
    spouses were being unceremoniously dumped from military health coverage
    at age 65 and all disabled retirees were forced to fund their own VA
    disability compensation from their service-earned retired pay. Survivor
    Benefit Program (SBP) widows suffered a 34-percent benefit cut at age
    62, and GI Bill benefits had eroded dramatically, among many other
    challenges.
        Congress' actions to address those problems were spurred in no
    small part by national concern to protect the interests of military
    people whose severe and extended wartime sacrifices have been
    highlighted on every front page and every evening newscast for nearly a
    decade.
        A more extended view of history demonstrates that public and
    congressional support for protecting military people programs can fade
    quickly in times of strained budgets or when a period of extended
    military conflict is (or is expected to be) coming to an end. That was
    true in the 1940s, 1950s, 1970s, 1980s and 1990s.
        As Congress assesses how to fairly allocate necessary sacrifices
    among the various segments of the population, the Coalition urges that
    you bear in mind that:

             Assertions about personnel and health cost growth
            since 2000 are highly misleading, because 2000 is not an
            appropriate baseline for comparison. As mentioned above, that
            was the nadir of the erosion of benefits era, when military pay
            was nearly 14 percent below private sector pay, currently
            serving members had suffered a major retirement cutback, older
            retirees and their families were being jettisoned from any
            military health coverage, disabled retirees and survivors were
            suffering dramatic financial penalties, and retention and
            readiness were suffering as a result. Congressional action (and
            spending) to fix those problems was a necessary thing, not a
            bad thing.
             No segment of the population has been called upon for
            more sacrifice than the military community. Currently serving
            military members have been asked to bear 100 percent of our
            Nation's wartime sacrifice while the broader population was
            asked to contribute to the war effort by ``going shopping.''
             Retired servicemembers, their families and survivors
            also have been no stranger to sacrifice. Hundreds of thousands
            of today's retirees served in multiple wars, including Iraq and
            Afghanistan, Gulf War I, Vietnam, Korea, and WWII eras, and the
            multiple conflicts and cold wars in between. Older retirees
            endured years when the government provided them no military
            health coverage, and those under 65 already have forfeited an
            average 10 percent of earned retired pay because they retired
            under pay tables that were depressed by decades of capping
            military pay raises below private sector pay growth.
             There is a readiness element to military compensation
            decisions beyond the budgetary element. Regardless of good or
            bad budget times, a military career is a unique and arduous
            calling that cannot be equated to civilian employment.
            Sufficient numbers of high-quality personnel will choose to
            pursue a career in uniform only if they perceive that the
            extreme commitment demanded of them is reciprocated by a
            grateful nation, and the unique rewards for completing such a
            career are commensurate with the unique burden of sacrifice
            that they and their families are required to accept over the
            course of it.
             Military members' and families' sacrifices must not be
            taken for granted by assuming they will continue to serve and
            endure regardless of significant changes in their career
            incentive package.
             History shows clearly that there are unacceptable
            retention and readiness consequences for short-sighted budget
            decisions that cause servicemembers to believe their steadfast
            commitment to protecting their nation's interests is poorly
            reciprocated.
    Cost-of-Living Adjustments (COLAs)
        The Fiscal Commission has proposed adjusting the Consumer Price
    Index (CPI) methodology to the so-called ``chained CPI'' calculation as
    a means of holding down COLA growth for military and Federal civilian
    retired pay, Social Security, and all other Federal annuities over
    time.
        Proponents of the chained CPI say it more accurately reflects
    changes in annuitants' cost of living by recognizing that their
    purchasing behavior changes as prices change. If the price of beef
    rises, for example, consumers may purchase more chicken and less beef.
        The real issue with the chained CPI is whether one is measuring
    changes in prices or changes in quality of life. If one continues the
    logical progression of the argument, consumers might find themselves
    substituting hot dogs or pasta for chicken, etc.
        The Bureau of Labor Statistics has estimated that implementation of
    the chained CPI would depress COLAs by about one-quarter of a
    percentage point per year.
        The DOD actuary estimates that inflation will average 3 percent per
    year over the long term.
        Using those two estimates, applying chained-CPI COLAs for a
    servicemember retiring at age 42 would yield about 10 percent less in
    his or her retired paycheck at age 80 relative to the current COLA
    system.
        Some members of the deficit commission previously have proposed
    delaying any COLAs on military retired pay until age 60 or later,
    barring COLAs on annuity levels above some set dollar amount, or
    reducing the CPI by one-half percent or a full percentage point per
    year.
        The Coalition believes such initiatives would constitute a major
    breach of faith with military people and constitute a grossly
    disproportional penalty.
        COLAs are particularly important to military retirees, disabled
    retirees, and survivors because they start drawing their annuities at
    younger ages than most other COLA-eligibles and thus experience the
    compounding effects over a greater number of years. To the extent that
    COLAs fail to keep up with living costs, real purchasing power
    continues to decline ever more dramatically as long as one lives.
        A top Coalition priority is to guard against any discriminatory
    treatment of retired members of the uniformed services compared to
    other Federal COLA-eligibles and to ensure continued fulfillment of
    congressional COLA intent ``to provide every military retired member
    the same purchasing power of the retired pay to which he was entitled
    at the time of retirement [and ensure it is] not, at any time in the
    future . . . eroded by subsequent increases in consumer prices.''
    Military Pay
        The Fiscal Commission's co-chairs proposed freezing ``non-combat''
    military pay and allowances for 3 years.
        The Coalition is grateful that the President exempted the uniformed
    services community from the fiscal year 2011 Federal pay freeze, and
    thanks the subcommittee for its consistent commitment to restoring and
    sustaining pay comparability with the private sector--a fundamental
    underpinning of the All-Volunteer Force.
        History has shown that capping military raises is a slippery slope
    that has never ended well.
        Throughout the 1980s and 1990s, military pay raises were
    consistently capped below private sector pay growth, causing a ``pay
    comparability gap'' which reached 13.5 percent in 1998-99, and
    contributed significantly to serious retention problems.
        Congress has made great strides in the intervening years paring the
    gap by approving military raises that have been at least .5 percent
    above private sector pay growth.
        Now that significant progress has been made and the ``erosion of
    pay and benefits'' retention-related problems have abated, some have
    renewed calls to cut back on military raises, create a new
    comparability standard, or substitute more bonuses for pay raises in
    the interests of deficit reduction.
        The Defense Department is advocating a new comparability standard
    under which each pay and longevity cell would represent the 70th
    percentile of compensation for similarly-educated civilians. A 2010
    Congressional Budget Office report asserted that, considering
    adjustments in housing allowances, military people actually are paid 10
    percent more than their civilian counterparts in terms of Regular
    Military Compensation (RMC), composed of basic pay, food and housing
    allowances, and the tax advantage that accrues because the allowances
    are tax-free.
        The Coalition believes these assertions are fundamentally flawed.
        First, the RMC concept was developed in the 1960s, when all
    servicemembers received the same allowances, regardless of location,
    and the allowances were arbitrary figures that weren't actually based
    on anything. In the interim, Congress has transformed the allowances
    into reimbursements for actual food costs and median locality-based
    housing costs.
        If one were to use the RMC comparability methodology in this
    scenario, basic pay--the largest element of military compensation and
    the one that drives retired pay--would become a ``flex'' compensation
    element. With tax rates and allowances figures set independently, a
    year in which average housing allowances rose (e.g., based on growth in
    high-cost areas) and taxes increased could actually yield a requirement
    to cut basic pay (and future retirement value) to restore
    comparability.
        Second, the Coalition is not convinced that the civilian comparison
    cohort or percentile comparison points proposed by DOD are the proper
    ones, given that the military:

             Recruits from the top half of the civilian aptitude
            population;
             Finds that only about 25 percent of America's youth
            qualify for entry;
             Requires career-long education and training
            advancement; and
             Enforces a competitive ``up-or-out'' promotion system
            to ensure progressive quality enhancements among those with
            longer service.

        A fundamental requirement for any pay comparability standard is
    that it should be transparent and understandable. The Coalition has
    asked for, but has never been provided by DOD, any data on what
    civilian comparison cohort was selected and why, and what rationale was
    used to establish a specific percentile comparison point.
        Third, the Coalition believes it is essential to recognize that
    compensation is not simply the amount one is paid. It is pay divided by
    what's required of the recipient to earn that pay. If we increase pay
    25 percent but require 100 percent more sacrifice to earn it, that's
    not a pay raise.
        In that context, today's conditions of service are far more arduous
    than anything envisioned 40 years ago by the creators of the All-
    Volunteer Force, who believed a protracted war would require
    reinstitution of the draft.
        The Coalition agrees with the approach the subcommittee has
    consistently taken--that the best comparability measure is a comparison
    of the military basic pay raise percentage with the percentage growth
    private sector pay, as measured by the Bureau of Labor Statistics'
    Employment Cost Index (ECI).
        The government uses the ECI for every other measure of private pay
    growth, and it's very transparent to government leaders and
    servicemembers alike.
        The statutory ECI-based pay raise for 2012 is 1.6 percent--the
    second-smallest raise in nearly 50 years, exceeding only the 1.4
    percent raise for 2011. The Coalition believes this is the least a
    grateful nation should do to acknowledge the continuing, extraordinary
    wartime sacrifices of currently serving members and families.
        The Coalition urges against short-sighted proposals to freeze or
    cap uniformed services pay raises below private sector pay growth, and
    recommends a 2012 raise of at least 1.6 percent to match ECI growth.
    Heath Care Fees
        The Fiscal Commission embraced the concept put forth by the Defense
    Department in past years that TRICARE benefits for retired
    beneficiaries should be brought more in line with civilian coverage by
    significantly increasing fees for retired beneficiaries and family
    members under 65. While no specific fee increases were cited, the
    implication is that they envisioned fee levels similar to those
    proposed by the Defense Department in past years, which Congress
    rejected as excessive.
        The Commission also recommended significant cutbacks in coverage by
    all Medicare supplements, including TRICARE For Life. Specifically, it
    proposed establishing a $500 annual deductible and limiting coverage to
    50 percent of the next $5,000 after the deductible--effectively
    increasing annual out-of-pocket costs for TFL-eligibles by up to $3,000
    per person per year ($6,000 for a married couple).
        The Coalition appreciates the subcommittee's consistent support in
    recent years to protect beneficiaries from disproportional health care
    fee increases.
        We continue to object strongly to simple comparisons of military
    vs. civilian cash fees, which we see as ``apple to orange'' comparisons
    that ignore most of the very great price career military members and
    families pay for their coverage in retirement.
        The unique package of military retirement benefits--of which a key
    component is a superior health care benefit--is the primary offset
    provided uniformed servicemembers for enduring a career of unique and
    extraordinary sacrifices that few Americans are willing to accept for 1
    year, let alone 20 or 30. It is an unusual and essential compensation
    package which a grateful Nation provides to a relatively small fraction
    of the population who agree to subordinate their personal and family
    lives to protecting our national interests for so many years. This
    sacrifice, in a very real sense, constitutes a pre-paid premium for
    their future healthcare.
        For all practical purposes, those who wear the uniform of their
    country are enrolled in a 20- to 30-year prepayment plan that they must
    complete to earn lifetime health coverage. In this regard, military
    retirees and their families pay enormous ``up-front'' premiums for such
    coverage through decades of service and sacrifice. Once that prepayment
    is already rendered, the government cannot simply ignore it and focus
    only on post-service cash payments--as if the past service, sacrifice,
    and commitments had no value.
        DOD and the Nation--as good-faith employers of the trusting members
    from whom they demand such extraordinary commitment and sacrifice--have
    a reciprocal health care obligation to retired servicemembers and their
    families and survivors that far exceeds any civilian employer's.
        The Coalition also believes the recent fee controversy is caused in
    part by the lack of any statutory record of the purpose of military
    health care benefits and the specific benefit levels earned by a career
    of service in uniform. Under current law, the Secretary of Defense has
    broad latitude to make administrative adjustments to fees for TRICARE
    Prime and the pharmacy systems. Absent congressional intervention, the
    Secretary can choose not to increase fees for years at a time or choose
    to quadruple fees in 1 year.
        Until a few years ago, this was not a particular matter of concern,
    as no Secretary had previously proposed dramatic fee increases.
        The experience of the recent past--during which several Secretaries
    proposed no increases and then a new Secretary proposed doubling,
    tripling, and quadrupling various fees--has convinced the Coalition
    that current law leaves military beneficiaries excessively vulnerable
    to the varying budgetary inclinations of the incumbent Secretary of
    Defense.
        The Coalition believes the law should be changed to reflect that it
    should be Congress' responsibility, not the Defense Secretary's, to
    establish appropriate and stable parameters governing crucial career
    retention programs such as the healthcare package for currently serving
    and retired military members and their families and survivors.
        The reciprocal obligation of the government to maintain an
    extraordinary benefit package to offset the extraordinary sacrifices of
    career military servicemembers is a practical as well as moral
    obligation. Mid-career military losses cannot be replaced like
    civilians can.
        Eroding benefits for career service can only undermine long-term
    retention/readiness. Today's servicemembers are very aware of Congress'
    actions toward those who preceded them in service. One reason Congress
    enacted TRICARE For Life in 2000 is because the Joint Chiefs of Staff
    at that time said inadequate retiree health care was affecting
    attitudes among active duty servicemembers.
        It's true that many private sector employers are choosing to shift
    an ever-greater share of health care costs to their employees and
    retirees, and that's causing many still-working military retirees to
    fall back on their service-earned TRICARE coverage. Fallout from the
    recession has reinforced this trend.
        In the bottom-line-oriented corporate world, many firms see their
    employees as merely another form of capital, from which maximum utility
    is to be extracted at minimum cost, and those who quit are replaceable
    by similarly experienced new hires. But that perception simply cannot
    exist in the culture of the military's All-Volunteer Force, whose long-
    term effectiveness is dependent on establishing a sense of mutual,
    long-term commitment between the servicemember and the Nation.
        The Coalition believes it's essential to bear other considerations
    in mind when considering the extent to which military beneficiaries
    should share in military health care costs.
        First and foremost, the military health system is not built for the
    beneficiary, but to sustain military readiness. Each Service maintains
    its unique facilities and systems to meet its unique needs, and its
    primary mission is to sustain readiness by keeping a healthy force and
    to be able to treat casualties from military actions. That model is
    built neither for cost efficiency nor beneficiary welfare. It's built
    for military readiness requirements.
        When military forces deploy, the military medical force goes with
    them, and that forces families, retirees and survivors to use the more
    expensive civilian health care system in the absence of so many
    uniformed health care providers.
        These military-unique requirements have significantly increased
    readiness costs. But those added costs were incurred for the
    convenience of the military, not for any beneficiary consideration, and
    beneficiaries should not be expected to bear any share of military-
    driven costs--particularly in wartime.
        Coalition member associations hold a diversity of views concerning
    the DOD-proposed TRICARE fee adjustments for fiscal year 2012.
        However, the Coalition strongly objects to the DOD-proposed
    adjustment methodology that would tie TRICARE Prime fee increases for
    nondisabled military beneficiaries aged 38 to 64 in future years to an
    as-yet-unspecified measure of health cost growth for the broader
    population that DOD actuaries assume would grow at an average of 6.2
    percent per year.
        The Coalition believes that military beneficiaries from whom
    America has demanded decades of extraordinary service and sacrifice
    have earned coverage that is the best America has to offer, consistent
    with their extraordinarily high pre-paid premiums of decades of service
    and sacrifice.
        Congress needs to protect military beneficiaries against dramatic
    budget-driven fluctuations in this vital element of servicemembers'
    career compensation incentive package.
        Reducing the value of TRICARE for Life by $3,000 per year ($6,000
    for a couple) as recommended by the Deficit Commission would be
    inconsistent with military beneficiaries' sacrifices and would
    undermine Congress' intent when it authorized TFL in 2001--less than 10
    years ago.
        Reducing military retirement benefits would be particularly ill-
    advised when an overstressed force already is at increasing retention
    risk despite the current downturn of the economy and current recruiting
    successes.
        TMC believes:

             All retired servicemembers earned equal health care
            coverage by virtue of their service.
             Means-testing has no place in setting military health
            fees.
             Congress should direct DOD to pursue any and all
            options to constrain the growth of health care spending in ways
            that do not disadvantage beneficiaries.
             TRICARE Prime enrollment fees for nondisabled retirees
            under 65 should not be adjusted based on health cost increases
            for the broader population, as proposed by DOD.
             It should be Congress' responsibility, not the Defense
            Secretary's, to establish appropriate and stable parameters
            governing crucial career retention programs such as the
            healthcare package for currently serving and retired military
            members and their families and survivors.
    Military Retirement
        Although the Deficit Commission did not make specific
    recommendations to revamp the uniformed services retirement system,
    they did recommend creating yet another commission to develop
    initiatives aimed at bringing military retirement ``more in line with
    standard practices from the private sector.''
        The Coalition's experience is that such efforts to ``civilianize''
    the military retirement program and wring budget savings from it pose a
    significant threat to long-term retention and readiness by decreasing
    the attractiveness of serving for two or three decades in uniform, with
    all of the extraordinary demands and sacrifice inherent in such
    extended career service.
        Too often, critics ignore the reality that uniformed service is
    fundamentally different from civilian employment, and a unique package
    of powerful incentives is essential to induce top-quality people to
    serve for 20 to 30 years under conditions the majority of Americans are
    unwilling to endure even for one term of service.
        In this regard, the deficit commission suggests changes such as
    those recommended by the 10th Quadrennial Review of Military
    Compensation (QRMC), which the Coalition believes fail utterly to
    recognize the fundamental purpose of the military retirement system in
    offsetting service conditions that are radically more severe than those
    experienced by the civilian workforce.
        The QRMC proposed converting the military retirement system to a
    civilian-style plan under which full retired pay wouldn't be paid until
    age 57-60; vesting retirement benefits after 10 years of service; and
    using flexible ``gate pays'' and separation pay at certain points of
    service to encourage continued service in certain age groups or skills
    and encourage others to leave, depending on service needs for certain
    kinds of people at the time.
        Reduced to its essence, this plan would take money from people who
    stay for a career in order to pay additional benefits to those who
    leave the military short of a career.
        If this system were in place today, a 10-year infantryman facing
    his or her fourth combat tour would be offered a choice between (a)
    allowing immediate departure with a vested retirement vs. (b)
    continuing under current service conditions for another 10-20 years and
    having to wait until age 57 for immediate retired pay.
        The Coalition believes strongly that, if such a system existed for
    today's force under today's service conditions, the military Services
    would already be mired in a deep and traumatic retention crisis.
        Further, the QRMC proposal is so complicated that people evaluating
    career decisions at the 4- to 10-year point would have no way to
    project their future military retirement benefits. Gate pays available
    at the beginning of a career could be cut back radically if the force
    happened to be undergoing a strength reduction later in a member's
    career.
        In contrast, the current military retirement system makes it very
    clear from the pay table what level of retired pay would be payable,
    depending how long one served and how well one progressed in grade.
        The sustained drawing power of the 20-year retirement system
    provides an essential long-term moderating influence that keeps force
    managers from over-reacting to short-term circumstances. Had force
    planners had such a system in effect during the drawdown-oriented
    1990s, the services would have been far less prepared for the post-
    September 11 wartime environment.
        Many such proposals have been offered in the past, and have been
    discarded for good reasons. The only initiative to substantially
    curtail/delay military retired pay that was actually enacted--the 1986
    REDUX law--had to be repealed 13 years later after it was demonstrated
    to inhibit retention.
        The Coalition strongly opposes initiatives that would
    ``civilianize'' the military retirement system and inadequately
    recognize the unique and extraordinary demands and sacrifices inherent
    in a military career.
        Reducing incentives for serving arduous careers of 20 years or more
    can only undermine long-term retention and readiness, with particularly
    adverse effects in times of war. Simultaneously increasing compensation
    for those who choose to leave short of fulfilling a career would only
    compound those adverse effects.
    DOD Schools
        Last November, the plan endorsed by Fiscal Commission Co-Chairs
    Simpson and Bowles recommended closing DOD Dependent and Domestic
    Elementary and Secondary Schools (DDESS) and integrating the serviced
    children into local school districts to secure savings estimated at
    $1.1 billion by 2015.
        DDESS operates some 64 schools on 16 installations and services
    more than 26,000 students of military servicemembers as well as DOD
    civilian employees.
        The schools are provided at locations where civilian schools have
    been deemed inadequate to meet the needs of military students.
        The Coalition opposes closing or curtailing DOD dependent schools
    based primarily on budget concerns. The need for the schools should
    continue to be evaluated based on the capacity of local school
    districts to provide quality educational opportunities for military
    students.
    Consolidation of Commissaries and Exchanges
        In November, the plan endorsed by Fiscal Commission Co-Chairs
    Simpson and Bowles recommended consolidating all DOD retail activities
    and raising prices in those facilities to achieve expected savings of
    $800 million by 2015.
        The Coalition has supported multiple previous initiatives to
    improve retail program efficiencies while recognizing there are unique
    service needs to be accommodated as well in operations of the exchange
    and MWR systems. Creation of the Defense Commissary Agency and
    consolidation of some ``back room'' functions among the service
    exchanges have been productive.
        The key to the Coalition has been that the benefit to store patrons
    should not be reduced. Several past efforts to reduce the commissary
    subsidy have been rejected because they failed to recognize the
    extraordinary benefit value of this key program, which delivers several
    dollars in savings to patrons for each dollar of the Federal subsidy.
    That's a very powerful ``benefit bang for the Federal buck.''
        Raising store prices can only lead to a counterproductive spiral of
    reduced benefit value, lower patronage, and eventual undermining of one
    of the Defense Department's most cost-effective benefit programs.
        The Coalition supports continuing efforts to improve commissary and
    exchange program efficiency, but objects to initiatives that reduce
    benefit value for patrons and the associated retention value for the
    uniformed services.
                              wounded warrior care
        As the Pentagon marks a decade at war, seamless transition between
    the Departments of Defense (DOD) and Veterans Affairs (VA) continues to
    be problematic in many cases for our wounded, ill, injured troops;
    disabled veterans; and their family caregivers. TMC acknowledges the
    significant progress that has been made in caring for our Nation's
    heroes and thanks the subcommittee for its leadership and oversight on
    these pressing issues, particularly in the last 4 years since the
    Walter Reed scandal that brought to light the flaws and inadequacies of
    both DOD and VA health care and benefits systems.
        But complex challenges remain in overseeing and validating massive
    policy and program changes among the military services; the DOD; the
    VA; several Centers of Excellence; a multitude of civilian contractors
    and nongovernmental agencies; and at least six congressional oversight
    committees.
        The Coalition looks forward to continued work with the subcommittee
    to address the remaining issues and fully establish systems of seamless
    care and benefits that support our transitioning wounded warriors and
    family members.
    DOD-VA Seamless Transition
        Institutional Oversight
        While many legislative changes have improved the care and support
    of our wounded warriors, the Coalition is concerned that the sunset in
    law of the DOD-VA Senior Oversight Committee (SOC) poses significant
    risks for effective day-to-day leadership and coordination of DOD and
    VA seamless transition efforts. While an informal SOC exists, the
    Pentagon has relegated responsibility and authority to lower levels of
    the agency, making it difficult for senior official involvement and
    oversight on these matters and limiting the Department's ability to
    fully establish a synchronized, uniform and seamless approach to care
    and services.
        Previously, the Coalition has expressed concern that the change of
    administration posed a significant challenge to the two departments'
    continuity of joint effort, as senior leaders whose personal
    involvement had put interdepartmental efforts back on track left their
    positions and were replaced by new appointees who had no experience
    with past problems and no personal stake in ongoing initiatives.
        Unfortunately, those concerns were realized, as many appointive
    positions in both departments went unfilled for long periods, requiring
    reorganization of responsibilities and entry of new people with little
    or no background or authority to engage systems and continue to move
    forward.
        While many well-meaning and hard working military and civilians are
    doing their best to keep pushing progress forward, leadership,
    organization and mission changes have left many leaders frustrated with
    the process.
        The Coalition urges joint hearings by the Armed Services and
    Veterans Affairs Committees to assess the effectiveness of current
    seamless transition oversight efforts and systems and to solicit views
    and recommendations from DOD, VA, the military Services, and
    nongovernmental organizations concerning how joint communication,
    cooperation, and oversight could be improved.
        In addition, the hearings should focus on implementation progress
    concerning:

             Single separation physical;
             Single disability evaluation system;
             Bi-directional electronic medical and personnel
            records data transfer;
             Medical centers of excellence responsibilities vs.
            authority, operations, and research projects;
             Coordination of care and treatment, including DOD-VA
            Federal/recovery care coordinator clinical and non-clinical
            services and case management programs; and
             Consolidated government agency support services,
            programs, and benefits.
        Continuity of Health Care
        Transitioning between DOD and VA health care systems remains
    challenging and confusing to those trying to navigate and use these
    systems. Systemic, cultural, and bureaucratic barriers often prevent
    the servicemember or veteran from receiving the continuity of care they
    need to heal and have productive and a high level of quality of life
    they so desperately need and desire.
        Servicemembers and their families repeatedly tell us that DOD has
    done much to address trauma care, acute rehabilitation, and basic
    short-term rehabilitation. They are less satisfied with their
    transition from the military health care systems to longer-term care
    and support in military and VA medical systems.
        We hear regularly from members who have experienced significant
    disruptions of care upon separation or medical retirement from service.
        One is in the area of cognitive therapy, which is available to
    retired members under TRICARE only if it is not available through the
    VA. Unfortunately, members are caught in the middle because of
    differences between DOD and VA authorities on what constitutes
    cognitive therapy and the degree to which effective, evidenced-based
    therapy is available.
        Action is needed to further protect the wounded and disabled. The
    subcommittee has acted previously to authorize 3 years of active-duty-
    level TRICARE coverage for the family members of those who die on
    active duty. The Coalition believes we owe equal transition care
    continuity to those whose service-caused illnesses or injuries force
    their retirement from service.
        The Coalition recommends:

             Authorizing service-disabled members and their
            families to receive active-duty-level TRICARE benefits,
            independent of availability of VA care for 3 years after
            medical retirement to help ease their transition from DOD to
            VA.
             Ensuring Guard and Reserve members have adequate
            access and treatment in the DOD and VA health systems for Post
            Traumatic Stress Disorder and Traumatic Brain Injury following
            separation from active duty service in a theatre of operations.
        DOD-VA Disability Evaluation System (DES)
        One of the most emotional issues that emerged from the Walter Reed
    scandal was the finding that Services were ``low-balling'' disabled
    servicemembers' disability ratings, with the result that many
    significantly disabled members were being separated and turned over to
    the VA rather than being medically retired (which requires a 30 percent
    or higher disability rating)--a trend that continues today, especially
    for those in the Guard and Reserves.
        Congress has taken positive steps to address this situation,
    including establishment of the Physical Disability Board of Review
    (PDBR) to give previously separated servicemembers an opportunity to
    appeal too-low disability ratings.
        A jointly executed DOD-VA DES pilot has been implemented and
    expanded, with positive feedback from participants that it has
    simplified the process and provided a more standardized disability
    rating outcome.
        TMC was further encouraged that wounded, ill, and injured members
    would benefit from the Dec. 19, 2007 Under Secretary of Defense
    (Personnel and Readiness) Directive Type Memorandum (DTM) which added
    ``deployability'' as a consideration in the DES decision process--
    permitting medical separation/retirement based on a medical condition
    that renders a member non-deployable.
        Unfortunately, several cases surfaced indicating the Services
    failed to incorporate the DTM in their DES process. In this regard,
    many members found ``fit'' by the PEB have been deemed by the service
    to be ``unsuitable'' for continued service--and administratively
    separated--because the member's medical condition prevents them from
    being able to deploy or maintain their current occupational skill. The
    Coalition is grateful to the subcommittee for including a provision in
    the National Defense Authorization Act for Fiscal Year 2011 prohibiting
    this practice.
        Unfortunately, some services still use other loopholes, such as
    designating disorders as ``existing prior to service''--even though the
    member was deemed fit enough to serve in a combat zone. The Coalition
    believes strongly that once we have sent a soldier, sailor, airman, or
    marine to war, the member should be given the benefit of the doubt that
    any condition subsequently found should not be considered as existing
    prior to service.
        The Coalition believes strongly that all ``unfitting'' conditions
    members should be included in the DOD disability rating, and any member
    determined by the parent service to be 30 percent or more disabled
    should continue to be eligible for a military disability retirement
    with all attendant benefits, including lifetime TRICARE eligibility for
    the member and his/her family. We do not support efforts to disconnect
    health care eligibility from disability retired pay eligibility.
        The Coalition also agrees with the opinion expressed by Secretary
    Gates that a member forced from service for wartime injuries should not
    be separated, but should be awarded a high enough rating to be retired
    for disability.
        The Coalition recommends:

             Preserving the statutory 30 percent disability
            threshold for medical retirement in order to provide lifetime
            TRICARE coverage for those who are injured while on active
            duty.
             Reforming the DOD disability retirement system to
            require inclusion of all unfitting conditions.
             Ensuring any restructure of the DOD and VA disability
            and compensation systems does not inadvertently reduce
            compensation levels for disabled servicemembers.
             Eliminating distinctions between disabilities incurred
            in combat vs. non-combat when determining benefits eligibility
            for retirement.
             Revision of the VA schedule for rating disabilities
            (VASRD) to improve the care and treatment of those wounded, ill
            and injured, especially those diagnosed with PTSD and TBI.
             Barring designation of disabling conditions as
            ``existing prior to service'' for servicemembers who have been
            deployed to a combat zone.
        Caregiver/Family Support Services
        The sad reality is that, for the most severely injured
    servicemembers, family members or other loved ones are often required
    to become full-time caregivers. Many have lost their jobs, homes, and
    savings in order to meet caregiver needs of a servicemember who has
    become incapacitated due to service-caused wounds, injuries or illness.
        The Coalition believes the government has an obligation to provide
    reasonable compensation and training for such caregivers, who never
    dreamed that their own well-being, careers, and futures would be
    devastated by military-caused injuries to their servicemembers.
        In 2009, the subcommittee authorized a special payment to an active
    duty servicemember to allow compensation of a family member or
    professional caregiver. The authorized payment was in the same amount
    authorized by the VA for veterans' aid-and-attendance needs, reflecting
    the subcommittee's thinking that caregiver compensation should be
    seamless when the member transitions from active duty to VA care, as
    long as the caregiver requirements remain the same.
        The Coalition appreciates the subcommittee's effort to sustain that
    principle in the National Defense Authorization Act for Fiscal Year
    2011 in terms of caregiver support, and urges additional steps to
    ensure that non-dependent caregivers (e.g., parents and siblings) who
    have had to sacrifice their own employment and health coverage are
    provided health and respite care while the injured member remains on
    active duty, commensurate with what the VA authorizes for medically
    retired or separated members' caregivers.
        In a similar vein, many wounded or otherwise-disabled members
    experience significant difficulty transitioning to medical retirement
    status. To assist in this process, consideration should be given to
    authorizing medically retired members and their families to remain in
    on-base housing for up to 1 year after retirement, in the same way that
    families are allowed to do when a member dies on active duty.
        Another important care continuity issue for the severely wounded,
    ill and injured is the failure to keep caregivers of these personnel
    involved in every step of the care and follow-up process. Again and
    again, we are told of clinicians and administrative people who seek to
    exclude caregiver participation and talk only to the injured member--
    despite the reality that the injured member may not be capable of
    remembering instructions or managing their appointments and courses of
    care. In many cases, this occurs even when the caregiver has a power of
    attorney and other responsibilities documented in the member's records.
        Just as Congress, DOD, and the VA have worked to get essential
    information to the wounded and their caregivers, similar efforts are
    urgently needed to educate medical providers and administrative staff
    at all levels that the final responsibility for ensuring execution of
    prescribed regimens of care for severely injured members typically
    rests with the caregivers, who must be kept involved and informed on
    all aspects of such members' treatment, appointments, and evaluations.
        The Coalition recommends:

             Providing enhanced training of DOD and VA medical and
            support staff on the vital importance of involving and
            informing designated caregivers in treatment of and
            communication with severely ill and injured personnel.
             Providing health and respite care for non-dependent
            caregivers (e.g., parents and siblings) who have had to
            sacrifice their own employment and health coverage while the
            injured member remains on active duty, commensurate with what
            the VA authorizes for medically retired or separated members'
            caregivers.
             Authorizing up to 1 year of continued residence in on-
            base housing facilities for medically retired, severely wounded
            servicemembers and their families.
                        active forces and their families
        In our overview, the Coalition expressed our collective concern
    over the stressors our servicemembers and their families are
    experiencing due to the long, repeated deployments and unrelenting
    operations tempo. In order to sustain a sufficient, highly trained and
    highly capable Active Force, the continuing overriding requirement is
    to find additional ways to ease the terrible burden of stress on
    servicemembers and their families.
    Military End Strength
        Increased end strength is the only effective way to reduce stress
    on forces and families as long as deployment requirements not only
    continue, but actually increase.
        The creators of the All-Volunteer Force never envisioned that the
    force would be deployed into combat 1 year out of 3--let alone every
    other year, as has been the case with many ground units.
        Regrettably, the scenario faced by today's forces is not unlike the
    World War II ``Catch-22'' situation described by Joseph Heller, in
    which aircrews braving horrendous enemy flak had their wartime mission
    requirements increased again and again, until they perceived that the
    sacrifices being demanded of them would never end.
        Unfortunately, many in government and among the public seem to have
    become desensitized to the truly terrible sacrifices that the current
    mismatch between missions and force levels has already imposed on those
    in uniform. They acknowledge the problem, but most assume that
    servicemembers and families will simply continue to accept these--or
    even greater--levels of sacrifice indefinitely.
        Many point to the achievement of service recruiting and retention
    goals as indicators that all is well.
        Such perceptions grossly underestimate the current stresses on the
    force and the risk that poses for readiness and national security. The
    Coalition believes any complacency about retention is sadly misplaced,
    and that the status of the current force should be viewed in the
    context of a rubber band that has been stretched to its limit. The fact
    that it has not yet broken is of little comfort.
        Well-respected studies have shown that 20 to 30 percent of combat
    returnees have experienced PTSD, TBI, or depression, and that the
    likelihood of a servicemember returning as a changed person rises with
    each subsequent deployment. Other studies have shown that rising
    cumulative family separations are having significant negative effects
    on servicemembers' children.
        These are not mere academic exercises. They are hard facts of life
    to those actually experiencing them.
        A far truer, and truly tragic, indicator of these extremely
    troubling circumstances has been the significant rise in
    servicemembers' suicide rates.
        So the Coalition is very grateful for the subcommittee's support
    for end strength increases for all services in the National Defense
    Authorization Act for Fiscal Year 2010, and for fending off the efforts
    of those who proposed cutting force levels to fund hardware needs.
        But we must not understate the reality that the increases approved
    to date will not significantly improve dwell time for military families
    anytime in the near future, given increasing operational requirements
    in Afghanistan, and recurring demands for humanitarian relief for
    natural and other disasters around the globe, whether in foreign lands
    or on home soil.
        The Coalition urges the subcommittee to:

             Sustain or increase end strength as needed to sustain
            the war and other operational requirements and enhance dwell
            time for servicemembers and families; and
             Sustain adequate recruiting and retention resources to
            enable the uniformed services to achieve required optimum-
            quality personnel strength.
    Family Readiness and Support
        A fully funded, robust family readiness program continues to be
    crucial to overall readiness of our military, especially with the
    demands of frequent and extended deployments.
        Resource issues continue to plague basic installation support
    programs. At a time when families are dealing with increased
    deployments, they often are being asked to do without in other
    important areas. We are grateful that the subcommittee included a
    provision in last year's defense bill that will help improve family
    readiness and support through greater outreach. The Department's
    establishment of a comprehensive benefits website for servicemembers
    and their families will help provide virtual assistance regardless of
    their physical proximity to installation-supported networks.
        Additionally, we urge the subcommittee to continue to press the
    Defense Department to exercise their authority to establish flexible
    spending accounts (FSAs) for servicemembers so they can participate in
    the same pre-tax program available to all other Federal employees for
    their out-of-pocket health and dependent care expenses.
        Quality education is a top priority for military families.
    Servicemembers are assigned all across the United States and the world.
    Providing appropriate and timely funding of Impact Aid through the
    Department of Education is critical to ensuring quality education
    military children deserve, regardless of where they live.
        The Coalition recommends that the subcommittee:

             Encourage DOD to assess the effectiveness of programs
            and support mechanisms designed to assist military members and
            their families with deployment readiness, responsiveness, and
            reintegration.
             Fully fund effective programs and ensure their costs
            are included in the annual budget process.
             Expand child care availability and funding to meet the
            needs of the total force uniformed services community.
             Monitor and continue to expand family access to mental
            health counseling.
             Promote expanded opportunities for military spouses to
            further educational and career goals, such as the My Career
            Advancement Account (MyCAA) program.
             Promote implementation of flexible spending accounts
            to enable military families to pay health care and child care
            expenses with pre-tax dollars.
    Permanent Change of Station (PCS) Allowances
        It's an unfortunate fact that servicemembers and their families are
    forced to incur significant out-of-pocket expenses when complying with
    government-directed moves.
        For example, the current Monetary Allowance in Lieu of
    Transportation (MALT) rate used for PCS moves still fall significantly
    short of meeting members' actual travel costs. The current rate of 24
    cents per mile is less than half the 51 cents per mile authorized for
    temporary duty travel. Also, military members must make any advance
    house-hunting trips at personal expense, without any government
    reimbursements such as Federal civilians receive.
        DOD states that the MALT rate was not intended to reimburse
    servicemembers for travel by automobile, but simply a payment in lieu
    of providing transportation in-kind.
        The Coalition believes strongly that the MALT concept is an
    outdated one, having been designed for a conscripted, single, non-
    mobile force.
        Travel reimbursements should be adjusted to reflect the reality
    that today's all-volunteer servicemembers do, in fact, own cars and
    that it is unreasonable not to reimburse them for the cost of driving
    to their next duty stations in conjunction with PCS orders.
        Simply put, PCS travel is no less government-ordered than is TDY
    travel, and there is simply no justification for paying less than half
    the TDY travel rate when personal vehicle use is essential.
        Additionally, the government should acknowledge that reassigning
    married servicemembers within the United States (including overseas
    locations) usually requires relocation of two personal vehicles. In
    that regard, the overwhelming majority of service families consist of
    two working spouses, making two privately owned vehicles a necessity.
    Yet the military pays for shipment of only one vehicle on overseas
    moves, including moves to Hawaii and Alaska, which forces relocating
    families into large out-of-pocket expenses, either by shipping a second
    vehicle at their own expense or selling one car before leaving the
    States and buying another upon arrival.
        At a minimum, the Coalition believes military families being
    relocated to Alaska, Hawaii, and U.S. territories should be authorized
    to ship a second personal vehicle, as the subcommittee has rightly
    supported in the past.
        The Coalition recommends the subcommittee:

             Further modify the PCS weight allowance tables for
            personnel in pay grades E-7, E-8, and E-9 to coincide with
            allowances for officers in grades O-4, O-5, and O-6
            respectively. While these allowances were increased slightly in
            the NDAA for Fiscal Year 2010 for E-5 through E-9 personnel,
            the personal property weight for a senior E-9 enlisted leader
            without dependents remains the same as for a single O-3,
            despite the normal accumulation of household goods over the
            course of a career.
             Authorize shipment of a second privately-owned vehicle
            at government expense to Alaska, Hawaii, and U.S. territories.
             Authorize reimbursement of house-hunting expenses
            commensurate with programs now supporting Federal civilian
            personnel.
             Authorize payment of a dislocation allowance to
            servicemembers making their final change of station upon
            retirement from the uniformed services.
             Increase PCS mileage rates to more accurately reflect
            actual transportation costs.
                           national guard and reserve
        Over 91,000 Guard and Reserve service men and women are serving on
    active duty (as of January 2011).
        Since September 11, 2001, more than 793,853 Guard and Reserve
    servicemembers have been called up, including over 250,000 who have
    served multiple tours. There is no precedent in American history for
    this sustained reliance on citizen-soldiers and their families. To
    their credit, Guard and Reserve combat veterans continue to reenlist,
    but the ongoing pace of routine, recurring activations and deployments
    cannot be sustained indefinitely.
        Guard and Reserve members and families face unique challenges in
    their readjustment following active duty service. Unlike active duty
    personnel, many Guard and Reserve members return to employers who
    question their contributions in the civilian workplace, especially as
    multiple deployments have become the norm. Many Guard-Reserve troops
    return with varying degrees of combat-related injuries and stress
    disorders, and encounter additional difficulties after they return that
    can cost them their jobs, careers, and families.
        Despite the continuing efforts of the Services and Congress, most
    Guard and Reserve families do not have access to the same level of
    counseling and support that active duty members have. In short, the
    Reserve components face increasing challenges virtually across the
    board, including major equipment shortages, end strength requirements,
    wounded warrior health care, and pre- and post-deployment assistance
    and counseling.
    Operational Reserve Retention and Retirement Reform
        Congress took the first step in modernizing the Reserve
    compensation system with enactment of early retirement eligibility for
    certain reservists activated for at least 90 continuous days served
    since January 28, 2008. This change validates the principle that
    compensation should keep pace with service expectations and serve as an
    inducement to retention and sustainment of the Operational Reserve
    Force.
        Guard/Reserve mission increases and a smaller Active-Duty Force
    mean Guard/Reserve members must devote a much more substantial portion
    of their working lives to military service than ever envisioned when
    the current retirement system was developed in 1948.
        Repeated, extended activations make it more difficult to sustain a
    full civilian career and impede reservists' ability to build a full
    civilian retirement, 401(k), etc. Regardless of statutory protections,
    periodic long-term absences from the civilian workplace can only limit
    Guard/Reserve members' upward mobility, employability and financial
    security. Further, strengthening the Reserve retirement system will
    serve as an incentive to retaining critical mid-career officers and
    NCOs for continued service and thereby enhance readiness.
        As a minimum, the next step in modernizing the Reserve retirement
    system is to provide equal retirement-age-reduction credit for all
    activated service rendered since September 11, 2001. The current law
    that credits only active service since January 28, 2008 disenfranchises
    and devalues the service of hundreds of thousands of Guard/Reserve
    members who served combat tours (multiple tours, in thousands of cases)
    between 2001 and 2008.
        The statute also must be amended to eliminate the inequity inherent
    in the current fiscal year retirement calculation, which only credits
    90 days of active service for early retirement purposes if it occurs
    within the same fiscal year. The current rule significantly penalizes
    members who deploy in July or August vs. those deploying earlier in the
    fiscal year.
        It is patently unfair, as the current law requires, to give 3
    months retirement age credit for a 90-day tour served from January
    through March, but only half credit for a 120-day tour served from
    August through November (because the latter covers 60 days in each of 2
    fiscal years).
        In addition, the law-change authorizing early Reserve retirement
    credit for qualifying active duty served after 28 Jan 2008 severed
    eligibility for TRICARE coverage until the reservist reaches age 60.
        TMC recommends:

             Authorizing early retirement credit to all Guard and
            Reserve members who have served on active duty tours of at
            least 90 days retroactive to September 11, 2001.
             Eliminating the fiscal year limitation which
            effectively denies full early retirement credit for active duty
            tours that span the October 1 start date of a fiscal year.
             Modernizing the Reserve retirement system to
            incentivize continued service beyond 20 years and provide fair
            recognition of increased requirements for active duty service.
    Guard and Reserve Health Care Access Options
        The Coalition is very grateful for sustained progress in providing
    reservists' families a continuum of government-sponsored health care
    coverage options throughout their military careers into retirement, but
    key gaps remain.
        For years, TMC has recommended continuous government health care
    coverage options for Guard and Reserve (G-R) families. Operational
    Reserve policy during two protracted wars has only magnified that need.
        DOD took the first step in the 1990s by establishing a policy to
    pay the Federal Health Benefits Program (FEHB) premiums for G-R
    employees of the Department during periods of their active duty
    service.
        Thanks to this subcommittee's efforts, considerable additional
    progress has been made in subsequent years to provide at least some
    form of military health coverage at each stage of a Reserve component
    member's life, including:

             TRICARE Reserve Select (TRS) for actively drilling
            Guard and Reserve families, with premiums set at 28 percent of
            the actual program cost. The 2011 monthly premiums are $53.16
            for individual reservists in drill status and $197.76 for
            member and family coverage.
             TRICARE Retired Reserve (TRR) for ``gray area''
            reservists who have retired from active drilling status but
            have not yet attained age 60, with premiums set to cover 100
            percent of program cost. Rates for 2011 are $408.01 for member-
            only coverage, or $1,020.05 for TRR member-and-family coverage.
             TRICARE Standard/Prime for retired reservists with 20
            or more years of qualifying service, once they attain age 60
            and retired pay eligibility.
             TRICARE for Life as second-payer to Medicare for
            career reservists with 20 or more years of qualifying service
            at age 65, provided they enroll in Medicare Part B.

        However, as noted earlier in this statement, early Reserve retirees
    who are in receipt of non-regular retired pay before age 60 are
    ineligible for TRICARE.
        TMC continues to support closing the remaining gaps to establish a
    continuum of health coverage for operational Reserve families,
    including members of the Individual Ready Reserve subject to call-up.
        The Coalition recommends:

             Requiring DOD to justify the sevenfold increase in
            TRICARE rates for individual TRR premiums for reservists who
            immediately enroll in TRR upon retirement from the Selected
            Reserve and have TRS coverage until separation.
             Authorizing TRICARE for early Reserve retirees who are
            in receipt of retired pay prior to age 60.
             Permitting employers to pay TRS premiums for
            reservist-employees as a bottom-line incentive for hiring and
            retaining them.
             Authorizing an option for the government to subsidize
            continuation of a civilian employer's family coverage during
            periods of activation, similar to FEHBP coverage for activated
            Guard-Reserve employees of Federal agencies.
             Extending corrective dental care following return from
            a call-up to ensure G-R members meet dental readiness
            standards.
             Allowing eligibility in Continued Health Care Benefits
            Program (CHCBP) for Selected reservists who are voluntarily
            separating and subject to disenrollment from TRS.
             Allowing beneficiaries of the FEHBP who are Selected
            reservists the option of participating in TRICARE Reserve
            Select.
    Yellow Ribbon Reintegration Program
        Congress has provided increased resources to support the transition
    of warrior-citizens back into the community. But program execution
    remains spotty from State to State and falls short for returning
    Federal Reserve warriors in widely dispersed regional commands.
    Military and civilian leaders at all levels must improve the
    coordination and delivery of services for the entire operational
    Reserve Force. Many communities are eager to provide support and do it
    well. But Yellow Ribbon efforts in a number of locations amount to
    little more than PowerPoint slides and little or no actual
    implementation.
        DOD must ensure that State-level best practices--such as those in
    Maryland, Minnesota, and New Hampshire--are applied for all operational
    Reserve Force members and their families, and that Federal Reserve
    veterans have equal access to services and support available to
    National Guard veterans. Community groups, employers and service
    organization efforts need to be encouraged and better coordinated to
    supplement unit, component, Service and VA outreach and services.
        The Military Coalition urges the subcommittee to hold oversight
    hearings and direct additional improvements in coordination,
    collaboration and consistency of Yellow Ribbon services between States.
    Reserve Compensation System
        The increasing demands of qualifications, mental skills, physical
    fitness, and training readiness on the Guard and Reserve to perform
    national security missions at home and abroad and increased training
    requirements indicate that the compensation system needs to be improved
    to attract and retain individuals into the Guard/Reserve. The added
    responsibility of returning to active duty multiple times over the
    course of a Reserve career require improvements to the compensation
    package and to make it more equitable with the Active component.
        TMC recommends:

             Crediting all inactive duty training points earned
            annually toward Reserve retirement.
             Parity in special incentive pay for career enlisted/
            officer special aviation incentive pay, diving special duty
            pay, and pro-pay for Reserve component medical professionals.
             Authorizing recalculation of retirement points after 1
            year of mobilization. A recent law change allowed certain flag
            and general officers to recalculate retirement pay after 1 year
            of mobilization. TMC believes this opportunity should be made
            available to all ranks.
    Guard/Reserve GI Bill
        The Coalition is most grateful to Congress for passage of the Post-
    9/11 GI Bill. The Post-9-11 GI Bill incorporates a number of major
    Coalition goals for the GI Bill including benefits that match the cost
    of education, extension of the post-service usage period to 15 years,
    and cumulative credit for Guard-Reserve service on active duty.
    However, volunteers who join the Selected Reserve were left behind in
    this legislation.
        Benefits for joining the Selected Reserve were not upgraded or
    integrated in the Post-9/11 GI Bill as TMC has long recommended.
    Moreover, these benefits are not just about the principle of
    ``proportional equity'' but also are essential to successful
    recruitment programs for the Guard and Reserve.
        TMC recommends:

             Restoring basic Reserve MGIB benefits for initially
            joining the Selected Reserve to the historic benchmark of 47-50
            percent of active duty benefits.
             Integrating Reserve and active duty MGIB laws in Title
            38.
             Enacting academic protections for mobilized Guard and
            Reserve students, including refund guarantees and exemption of
            Federal student loan payments during activation.
    Guard/Reserve Family Support Programs
        We have seen considerable progress in outreach programs and
    services for returning Guard-Reserve warriors and their families.
    Family support programs promote better communication with
    servicemembers. Specialized support and training for geographically
    separated Guard and Reserve families and volunteers are needed.
        TMC recommends:

             Ensuring programs are in place to meet the special
            information and support needs of families of individual
            augmentees or those who are geographically dispersed.
             Funding joint programs among military and community
            leaders to support servicemembers and families during all
            phases of deployments.
             Providing preventive counseling services for
            servicemembers and families and training so they know when to
            seek professional help related to their circumstances.
             Authorizing and funding child care, including respite
            care, family readiness group meetings and drill time.
             Improving the joint family readiness program to
            facilitate understanding and sharing of information between all
            family members.
                                  health care
    TRICARE Reimbursement Rates
        Physicians consistently report that TRICARE is virtually the
    lowest-paying insurance plan in America. Other national plans typically
    pay providers 25-33 percent more. In some cases the difference is even
    higher.
        While TRICARE rates are tied to Medicare rates, TRICARE Managed
    Care Support Contractors make concerted efforts to persuade providers
    to participate in TRICARE Prime networks at a further discounted rate.
    Since this is the only information providers receive about TRICARE,
    they see TRICARE as lower-paying than Medicare.
        This is exacerbated by annual threats of further reductions in
    TRICARE rates due to the statutory Medicare rate-setting formula.
        In this regard, unless Congress acts before the end of the year,
    current law will force a 30 percent reduction in Medicare and TRICARE
    payments as of January 1, 2012, which would cause many providers to
    stop seeing military beneficiaries.
        TMC urges reversal of the 30 percent cut in Medicare/TRICARE
    payments scheduled for January 2012 and a permanent fix for the flawed
    formula that mandates these recurring annual threats to seniors' and
    military beneficiaries' health care access.
    TRICARE Cost Efficiency Options
        TMC continues to believe strongly that DOD has not sufficiently
    investigated options to make TRICARE more cost-efficient without
    shifting costs to beneficiaries. The Coalition has offered for several
    years a long list of alternative cost-saving possibilities, including:

             Positive incentives to encourage beneficiaries to seek
            care in the most appropriate and cost effective venue;
             Encouraging improved collaboration between the direct
            and purchased care systems and implementing best business
            practices and effective quality clinical models;
             Focusing the military health system, health care
            providers, and beneficiaries on quality measured outcomes;
             Improving MHS financial controls and avoiding overseas
            fraud by establishing TRICARE networks in areas fraught with
            fraud;
             Promoting retention of other health insurance by
            making TRICARE a true second-payer to other insurance (far
            cheaper to pay another insurance's co-pay than have the
            beneficiary migrate to TRICARE);
             Encouraging DOD to effectively utilize data from their
            electronic health records to better monitor beneficiary
            utilization patterns to design programs which truly match
            beneficiaries needs;
             Sizing and staffing military treatment facilities to
            reduce reliance on network providers and develop effective
            staffing models which support enrolled capacities;
             Reducing long-term TRICARE Reserve Select (TRS) costs
            by allowing servicemembers the option of a government subsidy
            of civilian employer premiums during periods of mobilization;
             Working more closely with the Coalition to better
            incorporate beneficiary perspectives in encouraging use of
            mail-order pharmacy system and formulary medications; and
             Encouraging retirees to use lowest-cost-venue military
            pharmacies at no charge, rather than discouraging such use by
            limiting formularies, curtailing courier initiatives, etc.

        The Coalition is pleased that DOD has begun to act on some of these
    suggestions. We hope for further action to jointly pursue these and
    other options that offer potential for reducing costs.
    TRICARE Prime
        The Coalition is very concerned about growing dissatisfaction among
    TRICARE Prime enrollees--which is actually higher among active duty
    families than among retired families. The dissatisfaction arises from
    increasing difficulties experienced by beneficiaries in getting
    appointments, referrals to specialists, and sustaining continuity of
    care from specific providers.
        Increasingly, beneficiaries with a primary care manager in a
    military treatment facility find they are unable to get appointments
    because so many providers have deployed, have been gone PCS, or are
    otherwise understaffed or unavailable.
        The Coalition supports implementation of a pilot study by TMA in
    each of the three TRICARE Regions to study the efficacy of revitalizing
    the resource sharing program used prior to the implementation of the
    TRICARE--The Next Generation (T-NEX) contracts under the current
    Managed Care Support contract program.
        The Coalition supports adoption of the ``Medical Home'' patient-
    centered model to help ease such problems.
        The Coalition strongly advocates the transparency of healthcare
    information via the patient electronic record between both the MTF
    provider and network providers. Additionally, institutional and
    provider healthcare quality information should be available to all
    beneficiaries so that they can make better informed decisions.
        We are concerned about the impact on beneficiaries of the
    elimination of some Prime service areas under the new contract. This
    will entail a substantive change in health care delivery for thousands
    of beneficiaries, may require many to find new providers, and will
    change the support system for beneficiaries who have difficulty
    accessing care.
        To date, largely because of the delay in award of the new
    contracts, beneficiaries who live in the areas where Prime service will
    be terminated have not received any information on this and how it may
    affect them.
        The Military Coalition urges the subcommittee to:

             Require reports from DOD and the managed care support
            contractors on actions being taken to improve Prime patient
            satisfaction, provide assured appointments within Prime access
            standards, reduce delays in preauthorization and referral
            appointments, and provide quality information to assist
            beneficiaries in making informed decisions.
             Require increased DOD efforts to ensure consistency
            between both the MTFs and purchased care sectors in meeting
            Prime access standards.
             Ensure timely notification of and support for
            beneficiaries affected by elimination of Prime service areas.
    TRICARE Standard
        The Coalition appreciates the subcommittee's continuing interest in
    the specific problems unique to TRICARE Standard beneficiaries. TRICARE
    Standard beneficiaries need assistance in finding participating
    providers within a reasonable time and distance from their home. This
    is particularly important with the expansion of TRICARE Reserve Select
    and the upcoming change in the Prime Service Areas, which will place
    thousands more beneficiaries into TRICARE Standard.
        The Coalition is concerned that DOD has not yet established
    benchmarks for adequacy of provider participation, as required by
    section 711(a)(2) of the NDAA for Fiscal Year 2008. Participation by
    half of the providers in a locality may suffice if there is not a large
    Standard beneficiary population, but could severely constrain access in
    other areas with higher beneficiary density. The Coalition hopes to see
    an objective participation standard (perhaps based on the number of
    beneficiaries per provider) that would help shed more light on which
    locations have participation shortfalls of Primary Care Managers and
    Specialists that require positive action.
        The Coalition continues to oppose initiatives that would establish
    an enrollment fee for TRICARE Standard. If a beneficiary is to be
    required to pay an enrollment fee, the beneficiary should gain some
    additional benefit from enrollment. TRICARE Prime features an
    enrollment fee, but in return offers guaranteed access to care. In
    contrast, Standard offers no such guaranteed access, and beneficiaries
    typically are on their own in finding a participating provider who is
    accepting new patients.
        A source of recurring concern is the TRICARE Standard inpatient
    copay for retired members, which now stands at $535 per day. For each
    of the last several years, Congress has had to insert a special
    provision in the Defense Authorization Act to preclude increasing that
    by another $115 per day or more. The Coalition believes the $535 per
    day amount already is excessive, and should be capped at that rate for
    the foreseeable future.
        The Coalition urges the subcommittee to:

             Insist on immediate delivery of an adequacy threshold
            for provider participation, below which additional action is
            required to improve such participation.
             Require a specific report on participation adequacy in
            the localities where Prime Service Areas will be discontinued
            under the new TRICARE contracts.
             Oppose establishment of a TRICARE Standard enrollment
            fee, since Standard does not entail any guaranteed access to
            care.
             Increase locator support to TRICARE Standard
            beneficiaries seeking providers who will accept new Standard
            patients, particularly for mental health specialties.
             Seek legislation to eliminate the limit when TRICARE
            Standard is second payer to other health insurance (OHI): e.g.,
            return to the policy where TRICARE pays up to the amount it
            would have paid, had there been no OHI.
             Bar any further increase in the TRICARE Standard
            inpatient copay for the foreseeable future.
    TRICARE For Life
        When Congress enacted TRICARE For Life (TFL) in 2000, it explicitly
    recognized that this coverage was fully earned by career
    servicemembers' decades of sacrifice, and that the Medicare Part B
    premium would serve as the cash portion of the beneficiary premium
    payment. The Coalition believes that this remains true today.
        Some have proposed establishing an enrollment fee for TFL. The
    Coalition believes this is inappropriate, since beneficiaries have no
    guarantee of access to Medicare-participating providers.
        The Coalition is aware of the challenges imposed by Congress'
    mandatory spending rules, and appreciates the subcommittee's efforts to
    include TFL-eligibles in the preventive care pilot programs included in
    the NDAA for Fiscal Year 2009. We believe their inclusion would, in
    fact, save the government money and hope the subcommittee will be able
    to find a more certain way to include them than the current
    discretionary authority, which DOD has declined to implement.
        The Coalition also hopes the subcommittee can find a way to resolve
    the discrepancy between Medicare and TRICARE treatment of medications
    such as the shingles vaccine, which Medicare covers under pharmacy
    benefits and TRICARE covers under doctor visits. This mismatch, which
    requires TFL patients to absorb the cost in a TRICARE deductible or
    purchase duplicative Part D coverage, deters beneficiaries from seeking
    this preventive medication.
        The Coalition urges the subcommittee to:

             Resist initiatives to establish an enrollment fee for
            TFL, given that many beneficiaries already experience
            difficulties finding providers who will accept Medicare
            patients.
             Seek ways to include TFL beneficiaries in DOD programs
            to incentivize compliance with preventive care and healthy
            lifestyles.
             Resolve the discrepancy between TRICARE and Medicare
            treatment of the shingles vaccine.
    Survivors' Coverage
        When a TRICARE-eligible widow/widower remarries, he/she loses
    TRICARE benefits. When that individual's second marriage ends in death
    or divorce, the individual has eligibility restored for military ID
    card benefits, including SBP coverage, commissary/exchange privileges,
    etc.--with the sole exception that TRICARE eligibility is not restored.
        This is out of line with other Federal health program practices,
    such as the restoration of CHAMPVA eligibility for survivors of
    veterans who died of service-connected causes. In those cases, VA
    survivor benefits and health care are restored upon termination of the
    remarriage. Remarried surviving spouses deserve equal treatment.
        The Coalition recommends restoration of TRICARE benefits to
    previously eligible survivors whose second or subsequent marriage ends
    in death or divorce.
    Pharmacy
        The Coalition supports a strong TRICARE pharmacy benefit which is
    affordable and continues to meet the pharmaceutical needs of millions
    of eligible beneficiaries through proper education and trust. The TMC
    will oppose any degradation of current pharmacy benefits, including any
    effort to charge fees or copayments for use of military treatment
    facilities.
        The Coalition notes that due to continued legal maneuvering,
    Federal pricing still has not been implemented by the Executive Branch,
    and this failure is costing DOD tens of millions of dollars with every
    passing month. This is an excellent example of why the Coalition
    objects to basing beneficiary fees on a percentage of DOD costs--
    because DOD all-too-frequently does not act, or is not allowed to act,
    in a prudent way to hold costs down.
        The Coalition has volunteered to conduct a joint campaign with DOD
    to promote beneficiary use of lower-cost medications and distribution
    venues--a ``win-win'' opportunity that will reduce costs for
    beneficiaries and the government alike. But this will require
    additional consultation with the Coalition to ensure DOD communications
    effective address legitimate beneficiary concerns that now inhibit
    increased participation.
        The Coalition also believes that positive incentives are the best
    way to encourage beneficiaries to continue medication regimens that are
    proven to hold down long-term health costs. In this regard, TMC
    believes eliminating copays for medications to control chronic
    conditions (e.g., diabetes, asthma, high blood pressure, and
    cholesterol) are more effective than negative ones such as copayment
    increases.
        The Coalition urges the subcommittee to:

             Advance the use of the mail order option by lowering
            or waiving copays, enhancing communication with beneficiaries,
            and using technological advances to ease initial signup.
             Require DOD to include alternate packaging methods for
            pharmaceuticals to enable nursing home, assisted living, and
            hospice care beneficiaries to utilize the pharmacy program.
            Packaging options should additionally include beneficiaries
            living at home who would benefit from this program because of
            their medical condition (for example beginning stages of
            Alzheimer's).
             Create incentives to hold down long-term health costs
            by eliminating copays for medications for chronic conditions,
            such as asthma, diabetes, and hypertension or keeping copays at
            the lowest level regardless of drug status, brand or generic.
                                 retiree issues
        The Military Coalition remains grateful to the subcommittee for its
    support of maintaining a strong military retirement system to help
    offset the extraordinary demands and sacrifices inherent in a career of
    uniformed service.
    Concurrent Receipt
        In the NDAA for Fiscal Year 2003 and Fiscal Year 2004, Congress
    acknowledged the inequity of the disability offset to earned retired
    pay and established a process to end or phase out the offset for many
    disabled retirees. The Coalition is extremely grateful with the
    subcommittee's efforts to continue progress in easing the adverse
    effects of the offset.
        We were very optimistic in 2009 that another very deserving group
    of disabled retirees would become eligible for concurrent receipt when
    the White House included a concurrent receipt proposal in the Budget
    Resolution--the first time in history any administration had ever
    proposed such a fix.
        The administration's proposal would expand concurrent receipt
    eligibility over a 5 year period to all those forced to retire early
    from Service due to a disability, injury, or illness that was service-
    connected (chapter 61 retirees).
        The Coalition is dismayed that, despite the subcommittee's
    leadership efforts and White House support, the provision has not yet
    been enacted--an extremely disappointing outcome for a most deserving
    group of disabled retirees.
        Our fervent hope is that the subcommittee will redouble its efforts
    to authorize this initiative for the National Defense Authorization
    Bill for Fiscal Year 2012.
        Additionally, the Coalition is concerned that an inadvertent
    problem exists in the statutory Combat-Related Special Compensation
    (CRSC) computation formula causes many seriously disabled and clearly
    eligible members to receive little or nothing in the way of CRSC. The
    Defense Department has acknowledged the problem in discussions with the
    subcommittee staff, and the Coalition urges the subcommittee to correct
    this technical problem.
        The Coalition believes strongly in the principle that career
    military members earn their retired pay by service alone, and that
    those unfortunate enough to suffer a service-caused disability in the
    process should have any VA disability compensation from the VA added
    to, not subtracted from, their service-earned military retired pay and
    this remains a key goal in 2011.
        The Coalition's continuing goal is to fully eliminate the deduction
    of VA disability compensation from earned military retired pay for all
    disabled retirees. In pursuit of that goal, the Coalition's immediate
    priorities include:

             Phasing out the VA disability offset for all chapter
            61 (disability) retirees, as previously endorsed by the
            President and the subcommittee;
             Clarifying the law to resolve technical disparities
            that inadvertently cause underpayment of certain eligibles for
            CRSC; and,
             Clarifying the law to ensure a disabled retiree's CRSC
            payment is not reduced when the retiree's VA disability rating
            increases, until the retiree is afforded the opportunity to
            elect between CRSC or CRDP.
    Disability Severance Pay
        The Coalition is grateful for the subcommittee's inclusion of a
    provision in the NDAA for Fiscal Year 2008 that ended the VA
    compensation offset of a servicemember's disability severance for
    people injured in the combat zone.
        However, we are concerned that the language of this provision
    imposes much stricter eligibility than that used for Combat-Related
    Special Compensation.
        The Coalition recommends:

             Further expanding eligibility to include all combat-
            related injuries, using the same definition as CRSC; and
             Expanding eligibility to include all service-connected
            disabilities, consistent with TMC view that there should not be
            a distinction between the treatment of members disabled in
            combat vice members with non-combat, service-caused
            disabilities.
    Former Spouse Issues
        For a decade, the recommendations of the Defense Department's
    September 2001 report to Congress on the Uniformed Services Former
    Spouse Protection Act (USFSPA) have gone nowhere. For several years,
    DOD submitted many of the report's recommendations annually to Congress
    only to have one or two supported by the subcommittee while many others
    were dropped.
        The USFSPA is a very emotional topic with two distinct sides to the
    issue--just as any divorce has two distinct parties affected. The
    Coalition believes strongly that there are several inequities in the
    act that need to be addressed and corrected that could benefit both
    affected parties--the servicemember and the former spouse.
        But in order to make progress, we believe Congress cannot piecemeal
    DOD's recommendations. We support a collective grouping of legislation
    that would provide benefit to both affected parties. Absent this
    approach, the legislation will be perceived as supporting one party
    over the other and go nowhere.
        To fairly address the problems with the act, all affected parties
    need to be heard--and the Coalition would greatly appreciate the
    opportunity to address the inequities in a hearing before the
    subcommittee.
        The Coalition supports legislative action to:

             Base the award amount to the former spouse on the
            grade and years of service of the member at time of divorce
            (not time of retirement);
             Prohibit the award of imputed income while on active
            duty, which effectively forces active duty members into
            retirement;
             Extend 20/20/20 benefits to 20/20/15 former spouses;
             Permit the designation of multiple SBP beneficiaries
            with the presumption that SBP benefits must be proportionate to
            the allocation of retired pay;
             Eliminate the ``10-year Rule'' for the direct payment
            of retired pay allocations by the Defense Finance and
            Accounting Service (DFAS);
             Permit SBP premiums to be withheld from the former
            spouse's share of retired pay if directed by court order;
             Permit a former spouse to waive SBP coverage;
             Repeal the 1-year deemed election requirement for SBP;
            and
             Assist the DOD and Services with greater outreach and
            expanded awareness to members and former spouses of their
            rights, responsibilities, and benefits upon divorce.
                                survivor issues
        The Coalition is grateful to the subcommittee for its significant
    efforts in recent years to improve the SBP, especially its major
    achievement in eliminating the significant benefit reduction previously
    experienced by SBP survivors upon attaining age 62.
    SBP-DIC Offset
        The Coalition believes strongly that current law is unfair in
    reducing military SBP annuities by the amount of any survivor benefits
    payable from the DIC program.
        If the surviving spouse of a retiree who dies of a service-
    connected cause is entitled to DIC from the Department of Veterans
    Affairs and if the retiree was also enrolled in SBP, the surviving
    spouse's SBP annuity is reduced by the amount of DIC. A pro-rata share
    of the SBP premiums is refunded to the widow upon the member's death in
    a lump sum, but with no interest. This offset also affects all
    survivors of members who are killed on active duty.
        The Coalition believes SBP and DIC payments are paid for different
    reasons. SBP is insurance purchased by the retiree and is intended to
    provide a portion of retired pay to the survivor. DIC is a special
    indemnity compensation paid to the survivor when a member's service
    causes his or her premature death. In such cases, the VA indemnity
    compensation should be added to the SBP annuity the retiree paid for,
    not substituted for it.
        It should be noted as a matter of equity that surviving spouses of
    Federal civilian retirees who are disabled veterans and die of
    military-service-connected causes can receive DIC without losing any of
    their Federal civilian SBP benefits.
        The reality is that, in every SBP-DIC case, active duty or retired,
    the true premium extracted by the service from both the member and the
    survivor was the ultimate one--the very life of the member. This
    reality was underscored by the August 2009 Federal Court of Appeals
    ruling in Sharp v. United States which found, ``After all the
    servicemember paid for both benefits: SBP with premiums; DIC with his
    life.''
        The Veterans Disability Benefits Commission (VDBC) was tasked to
    review the SBP-DIC issue, among other DOD/VA benefit topics. The VDBC's
    final report to Congress agreed with the Coalition in finding that the
    offset is inappropriate and should be eliminated.
        In 2005 then-Speaker Pelosi and other House leaders made repeal of
    the SBP-DIC offset a centerpiece of their GI Bill of Rights for the
    21st Century. Leadership has made great progress in delivering on other
    elements of that plan, but the only progress to date on the SBP-DIC
    offset has been the enactment a small monthly Special Survivor
    Indemnity Allowance (SSIA).
        The Coalition recognizes that the subcommittee's initiative in the
    fiscal year 2008 defense bill to establish the SSIA was intended as a
    first, admittedly very modest, step in a longer-term effort to phase
    out the Dependency and Indemnity Compensation (DIC) offset to SBP.
        We appreciate the subcommittee's subsequent work to extend the SSIA
    to survivors of members who died while on active duty, as well as its
    good-faith effort to increase SSIA payments as part of the Family
    Smoking Prevention and Tobacco Control Act.
        The Coalition was extremely disappointed that the final version of
    that legislation greatly diluted the House-passed provision and
    authorized only very modest increases several years in the future.
        While fully acknowledging the committee's good-faith efforts to win
    more substantive progress, the Coalition shares the extreme
    disappointment and sense of abandonment of the SBP-DIC widows who are
    being forced to sacrifice up to $1,154 each month and being asked to be
    satisfied with a $70 monthly rebate.
        For years, legislative leaders touted elimination of this ``widow's
    tax'' as a top priority. The Coalition understands the mandatory-
    spending constraints the subcommittee has faced in seeking redress, but
    also points out that those constraints have been waived for many, many
    far more expensive initiatives. The Coalition believes widows whose
    sponsors' deaths were caused by military service should not be last in
    line for redress.
        The Coalition recommends:

             Repeal of the SBP-DIC offset.
             Reinstating SBP for survivors who previously
            transferred payments to their children at such time as the
            youngest child attains majority, or upon termination of a
            second or subsequent marriage.
             Allowing SBP eligibility to switch to children if a
            surviving spouse is convicted of complicity in the member's
            death.
    SBP and Special Needs Trusts
        Certain permanently disabled survivors can lose eligibility for
    Supplemental Security Income (SSI) and Medicaid and access to means-
    tested State programs because of receipt of SBP. Title 10 currently
    does not authorize DOD to make the payment of a SBP annuity into a
    trust, but only to a ``natural person''.
        As a result, permanently disabled military survivors are unique in
    being unable to take advantage of Special Needs Trust authority
    specifically established by Congress to protect and assist disabled
    persons who are in need of special services.
        The Coalition recommends authorizing payment of SBP annuities for
    disabled survivors into a Special Needs Trust.
    Final Retired Paycheck
        Under current law, DFAS recoups from military widows' bank accounts
    all retired pay for the month in which a retiree dies. Subsequently,
    DFAS pays the survivor a pro-rated amount for the number of days of
    that month in which the retiree was alive. This often creates hardships
    for survivors who have already spent that pay on rent, food, et cetera,
    and who routinely are required to wait several months for DFAS to start
    paying SBP benefits.
        The Coalition believes this is an extremely insensitive policy
    imposed by the government at the most traumatic time for a deceased
    member's next of kin. Unlike his or her active duty counterpart, a
    retiree's survivor receives no death gratuity. Many older retirees do
    not have adequate insurance to provide even a moderate financial
    cushion for surviving spouses.
        In contrast to the law governing military retired pay treatment of
    survivors, the title 38 statute requires the VA to make full payment of
    the final month's VA disability compensation to the survivor of a
    disabled veteran.
        The disparity between DOD and VA policy on this matter is
    indefensible. Congress should do for retirees' widows the same thing it
    did 10 years ago to protect veterans' widows.
        TMC urges the subcommittee to authorize survivors of retired
    members to retain the final month's retired pay for the month in which
    the retiree dies.
        morale, welfare, and recreation (mwr) and quality of life (qol)
                                    programs
        MWR activities and QoL programs have become ever more critical in
    helping servicemembers and their families cope with the extended
    deployments and constant changes going on in the force.
        The availability of appropriated funds to support MWR activities is
    an area of continuing concern for the Coalition. We are especially
    apprehensive that additional reductions in funding or support services
    may occur due to slow economic recovery and record budget deficits.
        BRAC actions pose an additional concern, as DOD is struggling to
    meet the September 15, 2011 deadline at many BRAC locations. Two
    reports issued by the Government Accountability Office indicate
    significant challenges remain in areas of funding, facilities, and
    overall management.
        The Coalition is very concerned whether needed infrastructure and
    support programs will be in place in time to meet the needs of
    families.
        TMC urges the subcommittee to:

             Direct DOD to report to Congress on all DOD and
            Service Active and Reserve component MWR Category A, B, and C
            Programs and Family Support/Readiness (Quality of Life [QoL]
            Programs), including the Yellow Ribbon Program. The report
            should include:

                     A current listing of individual program
                    funding levels by category--actual program expenditures
                    vs. program requirement;
                     An assessment of the effectiveness of each
                    program, including program standards and metrics; and
                     A list of recommended changes to policy,
                    including revisions in the current category program
                    listings to more accurately support wartime mission
                    requirements and the needs of the 21st century All-
                    Volunteer Force.

             Protect recreational and alternative therapy programs
            that integrate MWR, fitness and other quality of life programs
            and infrastructure to facilitate warrior treatment and care and
            to promote psychological health and welfare of troops and their
            families.
    Military Construction (MILCON)
        TMC believes MILCON Programs, including modernization and
    recapitalization, are critical elements to maintaining force, unit, and
    family readiness, and that these programs need immediate attention to
    maintain and sustain a 21st century military force.
        The Coalition recommends the subcommittee:

             Support military construction projects that modernize
            or replace the following infrastructure to meet increased
            personnel and operational deployment requirements:

                     child development centers (CDCs) and youth
                    centers;
                     defense schools;
                     bachelor and family housing; and,
                     other traditional QoL program facilities.

             Encourage full funding of military housing repair and
            maintenance accounts to reduce backlogs and provide for safe,
            well-maintained housing units.
                     Ensure that military housing privatization
                    initiatives meet expected DOD-Service outcome goals and
                    positively impact servicemember and family needs.
                     Support a Health Facilities Program that
                    modernizes or replaces Military Treatment Facilities
                    (MTFs) and supports world-class health care delivery
                    capability and capacity for all eligible beneficiaries.
                     Ensure MWR, MILCON, housing, and family
                    support construction policies and projects improve
                    access for persons with disabilities.

        Senator Webb. Thank you very much.
        Ms. Moakler, welcome.

        STATEMENT OF KATHLEEN B. MOAKLER, GOVERNMENT RELATIONS
             DIRECTOR, NATIONAL MILITARY FAMILY ASSOCIATION

        Ms. Moakler. Chairman Webb, the NMFA appreciates the
    opportunity to talk to you this afternoon about military
    families, the Nation's families.
        Last week was a rough week for military families, when they
    experienced unnecessary additional stress as the budget debate
    raged. We heard from many family members, and I'm sure your
    offices did, as well. Our Association quickly assembled
    resources and set up a Web page so families could prepare if
    pay was delayed. Our first admonition was to warn
    servicemembers and families to avoid payday lenders and to
    offer financially responsible resources.
        When it was announced that all commissaries would be
    closing, we raised awareness about how military families living
    overseas would be severely impacted. This resulted in, first,
    overseas commissaries being deemed essential, and then having
    this designation expanded to all commissaries.
        When an agreement was reached, military families breathed a
    sigh of relief, but felt as though they had been used as pawns
    in a political chess game. We hope that we never have to
    experience this type of impending crisis again, but our
    Association made sure that the concerns of military families
    were heard.
        We continue to share the concerns of military families with
    policymakers, as we have for over 40 years. In the past several
    years, we have done informal surveys on our Web site, gauging
    the pulse of families. In our most recent survey, when 1,200
    family members responded about their top priorities, over 84
    percent felt it was important that Congress and DOD focus on
    ensuring support programs--that support programs meet the needs
    of families experiencing multiple deployments. Almost 80
    percent felt that helping wounded servicemembers and their
    families should be a top priority, and 78 percent felt that
    helping surviving families was an important priority. Our top
    legislative priority, therefore, is to sustain funding for
    effective, proven military family support programs in order to
    promote readiness. Ten years of war and repeated deployments
    and reintegrations have put inordinate stress on servicemembers
    and their families, of all components.
        We know our Nation faces an austere budget environment, but
    assert that a failure to focus on the well-being of
    servicemembers and their families now will create longer-
    lasting and more expensive national security, healthcare, and
    readjustment issues at war's end and beyond.
        While both DOD and the VA continue to work on program and
    transition improvements, our wounded, ill, and injured
    servicemembers and their families face many uncertainties. We
    ask Congress to allow medically-retired servicemembers 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.
        Caregivers of the wounded, ill, and injured must be
    provided with opportunities for training, compensation, and
    other support programs because of the important role they play
    in the successful rehabilitation and care of the servicemember
    and veteran. We are concerned that the implementation of recent
    VA caregiver legislation does not extend eligibility to the
    intended range of caregivers, and that DOD and the service
    training for caregivers does not start soon enough to be
    effective during the transition.
        Our surviving families deserve our support, and I'd like to
    recognize the Gold Star Wives that are here today.
        The Coalition supports S. 260, Senator Nelson's bill, to
    end the Dependency and Indemnity Compensation offset to the
    Survivor Benefit Plan. Additionally, allowing payment of the
    SBP benefit into a special-needs trust in cases of disabled
    beneficiaries will preserve their eligibility for income-based
    support programs.
        We applaud the announcement yesterday of Joining Forces,
    the initiative sponsored by Mrs. Obama and Dr. Biden. Our
    recently released Finding Common Ground, a toolkit for
    communities supporting military families, includes easily
    achievable action items and useful resources to guide anyone
    who wants to support military families, but doesn't know where
    to start. The toolkit can be downloaded for free at our Web
    site.
        Three areas of focus for the Join Forces Initiative are
    education, employment, and wellness. We ask you to join forces
    in support of the education of military children by increasing
    the DOD supplement to impact aid and to allow school districts
    experiencing high growth due to base realignments to apply for
    impact aid funds using current student enrollments.
        Military spouses employed as teachers, nurses, registered
    dieticians, physical therapists, and the like must have a
    State-specific license or credential before working in a State.
    We urge you to help military spouses maintain their careers by
    supporting the Military Spouse Job Continuity Act, S. 697. This
    bill will provide a military spouse with a tax credit to offset
    the cost of obtaining a new license or certificate at their new
    location.
        We urge Congress, DOD, healthcare providers, and
    beneficiaries to work together to sustain quality affordable
    healthcare for all military health system beneficiaries. We
    pledge to work with Congress and DOD to identify additional
    efficiencies to reduce healthcare costs, such as organizational
    streamlining, promotion of lower-cost pharmacy options, disease
    management, and beneficiary education on healthy habits and how
    to access care more effectively.
        Another aspect of wellness is financial wellness. Congress
    has provided the Armed Forces with the authority to establish
    flexible spending accounts, yet the Service Secretaries have
    not established these important tax savings accounts for
    servicemembers. We support S. 387, which presses for the
    Service Secretaries to create----
        Senator Webb. Ms. Moakler, could I ask you summarize the
    rest of your statement? I think you've been----
        Ms. Moakler. Sure.
        Senator Webb.--going for about 10 minutes.
        Ms. Moakler. Thank you and I look forward to your
    questions.
        [The prepared statement of Ms. Moakler follows:]
                   Prepared Statement by Kathleen B. Moakler
        Chairman Webb and distinguished members of the subcommittee, the
    National Military Family Association would like to thank you for the
    opportunity to present testimony 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 servicemembers 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
    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;
             Servicemembers can have strong family lives while
            maintaining the highest state of readiness;
             Civilian family members can live fulfilling lives
            while supporting their servicemember(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. We realize support for servicemembers and their
    families is not solely provided by the government. Families promote a
    servicemember's well being. Communities 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, 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.
        We endorse the recommendations contained in the statement submitted
    by The Military Coalition. In this statement, our Association will
    expand on several issues of importance to military families:

          I.  Family Readiness
         II.  Family Health
        III.  Family Transitions
                              i. family readiness
        Policies, programs, and services must adapt to the changing needs
    of servicemembers 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
    (NDAA) 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. 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
    childcare 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 NDAA for Fiscal Year 2010
    calling for a report on financial assistance provided for child care
    costs across the Services and components to support the families of
    servicemembers 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 servicemembers and the wounded, ill, and injured, as well as
    those with special needs family members.
    Working with Youth
        Older children and teens must not be overlooked. School personnel
    need to be educated on issues affecting military students and must be
    sensitive to their needs. To achieve this goal, schools need tools.
    Parents need tools, too. Military parents constantly seek more
    resources to assist their children in coping with military life,
    especially the challenges and stress of frequent deployments. Parents
    tell us repeatedly they want resources to ``help them help their
    children.'' Support for parents in their efforts to help children of
    all ages is increasing, but continues to be fragmented. New Federal,
    public-private initiatives, increased awareness, and support by DOD and
    civilian schools educating military children have been developed.
    However, many military parents are either not aware such programs exist
    or find the programs do not always meet their needs.
        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
    nondeployed caregiver/parent and one child per family between 11 and 17
    years of age at three time points over the year. Recruitment of
    participants was extremely successful because families were eager to
    share their experiences. The research addressed three key questions:

             How are school-age military children faring?
             What types of issues do military children face related
            to deployment?
             How are nondeployed 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 research 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 then hope they will 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 a start.
        Our Association feels that 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.
    Families Overseas
        Families stationed overseas face increased challenges when their
    servicemember is deployed into theater. One such challenge we have
    heard from families stationed in EUCOM concerns care for a family
    member, usually the spouse, who may be injured or confined to bed for
    an extended illness during deployment. Instead of pulling the
    servicemember back from theater, why not provide transportation for an
    extended family member or friend to come from the States to care for
    the injured or ill family member? This has been a recommendation from
    the EUCOM Quality of Life conference for several years.
        Our Association asks that transportation be provided for a
    designated caregiver to an overseas duty station to care for an
    incapacitated spouse when a servicemember is deployed.
    Military Housing
        In 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.
        We are pleased the NDAA for Fiscal Year 2010 calls for a report on
    housing standards and housing surveys used to determine the Basic
    Allowance for Housing (BAH) and look forward to reviewing the
    recommendations once the report is available. We hope Congress will
    work to address BAH inequities.
        We ask Congress to consider the importance of family well-being by
    addressing BAH inequities.
    Commissaries and Exchanges
        Our Association thanks this subcommittee for holding two hearings
    this year to discuss the importance of sustaining Morale, Welfare, and
    Recreation (MWR) programs and the commissary and exchange systems. We
    thank you, Mr. Chairman, for emphasizing the importance of MWR ``as
    essential elements within a healthy military community.'' We agree with
    you 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 couldn't agree more and appreciates the subcommittee's
    commitment to preserving these quality programs for military families,
    especially during this era of increased budget austerity.
        Our Association is concerned about one issue raised at the recent
    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 Armed
    Services Committee 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 servicemembers 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 benefited 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 healthy 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 servicemembers 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 servicemembers 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 NDAA for
    Fiscal Year 2011 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
    servicemembers 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
    servicemembers. 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 servicemembers. 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 health care
    expenses. It is imperative that FSAs for uniformed servicemembers 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
    servicemembers that account for the unique aspects of military life
    including deployments and PCS moves.
    Financial Readiness
        Ongoing financial literacy and education is critically important
    for today's military families. Military families are not a static
    population; new servicemembers join the military daily. For many, this
    may be their first job with a consistent paycheck. The youthfulness and
    inexperience of junior servicemembers 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
    Servicemember Affairs this July. We encourage Congress to monitor the
    implementation of this office to ensure it provides adequate support to
    servicemembers 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 servicemembers, survivors, and servicemembers
    with PCS 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 FSA be
    indexed to the Cost-of-Living Allowance (COLA) to better reflect rising
    costs for services.
        Our Association asks Congress to increase the FSA by indexing it to
    COLA.
    Continuing Resolution
        As Congress begins the debate over the fiscal year 2012 budget, our
    Association is concerned about the impact of the Continuing Resolution
    and the lack of a fiscal year 2011 Defense Appropriations law on our
    military families. DOD has been forced to operate under Continuing
    Resolutions for more than 5 months. Short extensions do not allow the
    Services to adequately plan to fund upcoming programs or support
    services that are critical to supporting servicemembers and their
    families. In March, Deputy Secretary of Defense William J. Lynn III
    testified before the Senate Appropriations Committee Subcommittee on
    Defense and provided one example of how the Continuing Resolution is
    negatively impacting military families. In his written testimony, he
    stated, ``Because of the [Continuing Resolution], the Navy has had to
    reduce its notice of Permanent Change of Station moves from the usual 6
    months to two, which hurts Navy personnel and puts a greater strain on
    their families.'' Without final orders in hand, a servicemember is not
    able to prepare his family for a move by requesting medical records,
    school transcriptions, arrange the movement of household goods, or put
    their name of the housing waiting list. This is one example of a myriad
    of programs which have been reduced or cut because they do not have
    funds to operate. A series of Continuing Resolutions hurts our military
    families. Our Association recommends Congress work quickly to pass the
    Defense Appropriations Act for Fiscal Year 2011.
        Our Association urges Congress to pass the Defense Appropriations
    Act for Fiscal Year 2011 immediately. Funding delays cause the Services
    to cut essential programs, which negatively impacts military families.
                               ii. family health
        When considering changes to the health care 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 health care for all military family members.
        Family readiness calls for access to quality health care 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.
    Improving Access to Care
        Our Association continues to monitor the experience of military
    families with accessing care within both the direct care and purchased
    care segments of the Military Health System (MHS). We are concerned our
    MTFs are stressed from 10 years of provider deployments, which directly
    affects the quality, access, and cost of health care. We have
    consistently heard from families that their greatest health care
    challenge has been getting timely care in both the direct and the
    purchased care systems. Their main challenges with the direct care
    system are:

             access to their Primary Care Managers (PCM)
             availability of after-hours care
             having appointments available in MTFs for 60, 90, or
            120-day follow-ups recommended by their providers.

        Beneficiaries' main challenges with the purchased care system,
    according to TRICARE's Health Care Survey of DOD Beneficiaries 2009
    Annual Report, are difficulty in accessing personal doctors and
    specialty care.
        Our Association hears frequent complaints by families regarding the
    referral process. Families are often unfamiliar with the process at
    their MTF and in their TRICARE region and frequently report
    difficulties in obtaining an appointment within access standards.
    Often, they find that a provider on the TRICARE Managed Care Support
    Contractor's list is no longer taking TRICARE or taking new patients.
    The difficulties sometimes cause the beneficiary to give up on the
    referral process and never obtain the specialty appointment their PCM
    believes they need. Our Association is concerned with the impact these
    delays or the lack of even getting the referral is having on the
    quality of care and beneficiary outcome. We cannot stress enough how
    continuity of care is important to maintain our families' quality of
    care. We recommend Congress require a DOD report on the management of
    the referral process--both within the direct care system and between
    the direct care and purchased care sectors--and the impact on
    beneficiaries' access to care.
        We see even more issues ahead that could affect beneficiary access.
    The TRICARE Management Activity (TMA) will roll out the new TRICARE
    Third Generation (T3) contract in the TRICARE North Region beginning
    April 2011. At that time, the remaining two TRICARE Regions will still
    be operating under the existing TRICARE Next Generation (T-Nex)
    contract. Because of the recent announcement of a T3 award change in
    the South Region and subsequent protest filed, full T3 implementation
    will remain in a holding pattern, preventing contractors' renegotiation
    with approximately 66 percent of our civilian TRICARE providers. With
    the demands and uncertainties to providers in regards to health care
    reform's added requirements and expenses along with looming Medicare
    reimbursement rate changes, we are concerned about providers' long-term
    willingness to remain in the TRICARE network and about the contractors'
    ability to recruit new providers. Thus, the combination of factors may
    result in a decreased access to care for military families.
        National Guard and Reserve Member Family Access to Care
        We remain especially concerned about access to care for National
    Guard and Reserve families. These families also need increased
    education about the multiple types of TRICARE health care benefits in
    which they are eligible to participate. We recommend Congress request a
    report to assess the coordination and continuity of health care
    services for National Guard and Reserve families as they frequently
    move from activated TRICARE Prime coverage to non-activated status and
    TRICARE Reserve Select (TRS) or their employer civilian health care
    insurance plans. We also believe that paying a stipend to a mobilized
    National Guard or Reserve member for their family's coverage under
    their employer-sponsored insurance plan while the servicemember is
    mobilized may work out better for many families in areas where the
    TRICARE network may not be robust.
        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 (P.L. 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
    health care, 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
    health care and mental health care 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.
        We recommend Congress require a DOD report on the impact on
    beneficiaries of the MHS referral process.
        We ask Congress also to require a report assessing the coordination
    and continuity of health care services for National Guard and Reserve
    families as they transition from one TRICARE status to another.
        Lastly, we ask for a legislative change to allow Reserve component
    families to be given the choice of a stipend to continue their
    employer-provided care during the deployment of the servicemember.
    Pharmacy
        For several years now, our Association has cautioned about DOD
    generalizing findings of certain civilian beneficiary pharmacy
    behaviors and automatically applying them to the military population.
    As part of the President's fiscal year 2011 budget proposal, DOD
    recently announced it would adjust certain pharmacy co-payments. DOD's
    intent is to drive beneficiaries away from retail pharmacies and toward
    TRICARE Mail Order Pharmacy (TMOP) utilization, which should lower
    government costs and increase DOD savings. Our Association has long
    championed a zero co-payment for generic Tier 1 medications in TMOP and
    we applaud DOD's proposal to implement this as one of their cost-saving
    measures. While we believe the rationale behind the proposed changes is
    sound, we request that Congress require DOD to report on how these
    changes impact beneficiary behavior and health care quality outcomes.
        We do have some concerns with the proposed increase in co-payments
    for retail formulary and non-formulary medications and the impact this
    increase will have on beneficiaries who have no choice but to rely on
    the retail pharmacy for urgent non-maintenance medications. For
    example, the young families of deployed National Guard or Reserve
    members or recruiters usually do not live close to an MTF pharmacy.
    When their child needs an antibiotic for an urgent medical condition,
    such as pneumonia or an ear infection, they have no other option than
    the retail pharmacy. Currently, they pay $3 for a course of a generic
    antibiotic treatment; under DOD's proposal, they would pay $5.
    Beneficiaries who need certain medications not suited for TMOP because
    they are a narcotic or their chemical compound is not suitable for home
    delivery would also pay more under DOD's proposal.
        We are also concerned about the effect of the proposed co-pay
    changes on our wounded, ill, and injured servicemembers and those
    already medically retired. This population may be adversely affected
    because of the frequent alteration to their medication protocols by
    their health care providers in order to achieve optimum medical
    benefits for their often-changing medical conditions. Their medications
    may appear to be a maintenance drug, but are actually intended to be a
    used only for short-term relief. Sending them to the mail order for a
    90-day supply just because the co-payment is less may in fact cost the
    beneficiary and the government more because of frequent changes in
    doses. Many of the prescriptions needed by the wounded are for newly
    FDA-approved medications, which will most likely place them in non-
    Formulary Tier 3 status. This may place an unfair financial burden on
    this population because they tend to utilize a higher number of
    medications.
        Beneficiaries who have no choice in where they must obtain their
    medications should not be subjected to co-payment increases aimed at
    changing the behavior of those who do have choices. DOD must consider
    the possible effects of its co-payment changes as it plans for
    implementation and may need to devise alternative co-payment
    adjustments to protect beneficiaries during these situations. We look
    forward to discussing potential options with Members of Congress and
    DOD.
        In addition to the elimination of the TMOP co-payment for generic
    drugs as an enticement for beneficiaries to switch maintenance
    medications from retail to TMOP, we believe there are additional ways
    DOD could experience increased pharmacy savings. These include:

             Make all medications available through TRICARE Retail
            pharmacy also available through TRICARE Mail Order Pharmacy
            (TMOP)
             Provide medications treating chronic conditions, such
            as asthma, diabetes, and hypertension at the lowest level of
            co-payment regardless of brand or generic status
             Implement The Task Force on the Future of Military
            Health Care recommendation to include over-the-counter (OTC)
            drugs as a covered pharmacy benefit, thus eliminating the need
            for more costly pharmaceuticals that have the same efficacy as
            OTC options.

        The new T3 contract will provide TRICARE regional contractors and
    the pharmacy contractor with the ability to link pharmacy data with
    disease management. This will allow for better case management,
    increase adherence/compliance, and decrease cost, especially for
    beneficiaries suffering from chronic illness and multiple conditions.
    However, this valuable tool will only be available this year in the
    TRICARE North Region because the T3 contract still remains under
    protest in the remaining two Regions.
        We applaud the proposed changes to co-payments for TMOP
    participants as a way to drive more beneficiaries to TMOP to increase
    DOD efficiencies. We support the rationale behind proposed changes to
    the co-payments for the Retail pharmacy, but caution that beneficiaries
    should not be penalized for the purchase of urgent, non-maintenance
    drugs or those drugs not available via mail order.
    National Health Care Proposal
        Our Association is cautious about the changes contained in the
    Patient Protection and Affordable Care Act (P.L. 111-148) and their
    potential impact on TRICARE and CHAMPVA. We thank Congress for
    including a provision in the NDAA for Fiscal Year 2011 to allow TRICARE
    to provide coverage for TRICARE eligible young adult beneficiaries up
    to the age of 26. Military families have been asking for this added
    benefit. We await its implementation and are appreciative that DOD is
    working hard to ensure TRICARE Young Adult (TYA) Standard/Extra
    coverage is made available before beneficiaries' college age students
    graduate this May. We appreciate the inclusion of a TRICARE Young Adult
    Prime option by Congress and look forward to its implementation this
    fall, as well. We understand DOD is addressing the issue of access to
    MTFs for those eligible TYA Prime non-ID card holders. However, we
    still need congressional action to allow CHAMPVA coverage for eligible
    young adults up to the age of 26.
        Congress needs to act to provide health care coverage to young
    adults, up to the age of 26, who are eligible for CHAMPVA.
    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 health care 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 servicemembers, and survivors of servicemembers 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 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 health care
    experts cannot agree on an accurate index on which to base civilian
    health care 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 health care 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 health care 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.
        We recommend that Medicare-eligible beneficiaries using the USFHP
    be allowed to remain in the program.
        We recommend Congress encourage TMA to reach out to Sole Community
    hospitals serving large numbers of military beneficiaries and provide
    waivers if warranted.
    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 health care 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 NDAA for Fiscal Year 2011 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 health care model, where beneficiaries will be
    seen by the same health care team focused on well-being and prevention,
    is a well-known cost saver for health care 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 health care
    practices. We encourage Congress to include the recommendations of the
    Task Force on the Future of Military Health Care in this year's NDAA
    for Fiscal Year 2012. 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 health care
             Incorporating health information technology systems
            and implementing transparency of quality measures and pricing
            information throughout the MHS (This is also a civilian health
            care 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.
    Behavioral Health Care
        Our Nation must help returning servicemembers and their families
    cope with the aftermath of war. DOD, the Department of Veterans Affairs
    (VA), and State agencies must partner in order to address behavioral
    health issues early in the process and provide transitional mental
    health programs, especially during PCS moves. Partnering will also
    capture the National Guard and Reserve member population, who often
    straddle these agencies' health care systems.
        Full Spectrum of Care
        As the war continues, the call from families who need a full
    spectrum of behavioral health services--from preventative care and
    stress reduction techniques, to counseling and medical mental health
    services--is growing louder. The military offers a variety of
    psychological health services, both preventative and treatment, across
    many agencies and programs. However, as servicemembers and families
    experience numerous lengthy and dangerous deployments, we believe the
    need for confidential, preventative psychological health services will
    continue to rise. More importantly, this need will remain high even
    after military operations scale down.
        The rise in suicides among our Active Duty and Reserve component
    servicemembers demonstrates the need for these mental health services
    are at dangerous levels. In the research they conducted for us, RAND
    found military children reported higher anxiety signs and symptoms than
    their civilian counterparts. A recent study by Gorman, et. al (2010),
    Wartime Military Deployment and Increased Pediatric Mental and
    Behavioral Health Complaints, found an 11 percent increase in
    outpatient mental health and behavioral health visits for children from
    the ages of 3-8 during 2006-2007. There was an 18 percent increase in
    pediatric behavioral health and a 19 percent increase in stress
    disorders when a parent was deployed. They also found an 11 percent
    decrease in all other health care related visits. Additional research
    has found an increase in mental health services by non-deployed spouses
    during deployment. A study of TRICARE claims data from 2003-2006
    published last year by the New England Journal of Medicine showed an
    increase in mental health diagnoses among Army spouses, especially for
    those whose servicemembers had deployed for more than 1 year.
        Our research also found the mental health of the caregiver directly
    affects the overall well-being of the children. Therefore, we need to
    treat the family as a unit as well as individuals. Communication is key
    in maintaining family unit balance, especially during the deployment
    phase. Our study also found a direct correlation between decreased
    communication and an increase in child and/or caregiver issues during
    deployment. Research is beginning to validate the high level of stress
    and mental strain our military families are experiencing.
        Access to Behavioral Health Care
        The body of research focusing on the increased levels of anxiety
    and utilization of mental health services and medication causes our
    Association to be even more concerned about the overall shortage of
    mental health providers in TRICARE's direct and purchased care network.
    DOD's Task Force on Mental Health stated timely access to the proper
    psychological health provider remains one of the greatest barriers to
    quality mental health services for servicemembers and their families.
    The Army Family Action Plan identified mental health issues as their
    number three issue for 2010.
        While TMA reports significant progress by the TRICARE contractors
    in adding to the numbers of mental health providers in the networks,
    these numbers do not automatically translate into a corresponding
    increase in access. A recently published report in the March 2011 issue
    of Military Medicine, ``Access to Mental Health Services for Active
    Duty and National Guard TRICARE Enrollees in Indiana,'' found that only
    25 percent of mental health providers listed in the TRICARE
    contractor's provider list were accepting new TRICARE beneficiaries.
    Researchers stated the number one barrier to Active Duty and Reserve
    component servicemembers, and their families in obtaining mental health
    care in Indiana was the accuracy of the TRICARE mental health provider
    list. Our Association often hears from families about the number of
    times they contact network providers using the TRICARE provider list
    only to find the providers cannot meet access standards, are no longer
    taking TRICARE, or are not taking new TRICARE patients. This study
    validated what the Task Force on Mental Health heard from families
    during their investigation. Provider lists must be up-to-date in order
    to handle real time demands by military families.
        While families are pleased more military mental health providers
    are available in theater to assist their servicemembers, they are
    disappointed with the resulting limited access to providers at home.
    Families report they are being turned away from obtaining appointments
    at their MTFs and clinics and told to seek services elsewhere. The
    military fuels the shortage by deploying its mental health providers,
    even its child and adolescent psychology providers, to combat zones.
        Family members are a key component to a servicemember's
    psychological well-being. They must be included in mental health
    counseling and treatment programs for servicemembers. Families want to
    be able to access care with a mental health provider who understands or
    is sympathetic to the issues they face. We recommend an extended
    outreach program to servicemembers, veterans, and their families of
    available mental health resources through DOD and VA with providers who
    inherently understand military culture. We appreciate the VA allowing
    family member access to Vet Centers; however, we encourage them to
    develop more family-oriented programs. DOD must also look beyond its
    own resources to increase mental health access by working with other
    government agencies, such as the Substance Abuse and Mental Health
    Services Administration (SAMHSA), especially SAMHSA's Military Families
    Strategic Initiative, and encourage State agencies to provide their
    already established services and programs to servicemembers, veterans,
    and family members. DOD must also educate these other agencies about
    military culture to make the providers more effective in their support.
        Frequent and lengthy deployments create a sharp need in mental
    health services by family members and servicemembers as they get ready
    to deploy and after their return. Embedding mental health providers in
    medical home modeled clinics will allow easier access for our families.
    There is also an increase in demand in the wake of natural disasters,
    such as hurricanes and fires. DOD must maintain a flexible pool of
    mental health providers that can increase or decrease rapidly in
    numbers depending on demand on the MHS side. Currently, Military Family
    Life Consultants and Military OneSource counseling are providing this
    type of preventative and entry-level service for military families. The
    web-based TRICARE Assistance Program offers another vehicle for non-
    medical counseling, especially for those who live far from counselors.
    The military Services, along with military family members, need to be
    more aware of resources along the continuum of mental health support.
    Families need the flexibility of support in both the MHS and family
    support arenas, as well as coordination of support between these two
    entities.
        There are other barriers to access for some in our population. Many
    already live in rural areas, such as our Guard and Reserve, or they
    will choose to relocate to rural areas lacking available mental health
    providers. We need to address the distance issues families face in
    finding mental health resources and obtaining appropriate care.
    Isolated servicemembers, National Guard and Reserve, veterans, and
    their families do not have the benefit of the safety net of services
    and programs provided by MTFs, military installation based support
    programs, VA facilities, Community-Based Outpatient Centers, and Vet
    Centers. We hear the National Guard Bureau's Psychological Health
    Services (PHS) has not been established in all 50 States and is not
    working as designed to address members' mental health issues. We
    recommend that this program be evaluated to determine its
    effectiveness. We recommend the use of alternative treatment methods,
    such as telemental health; increasing mental health reimbursement rates
    for rural areas; modifying licensing requirements in order to remove
    geographic practice barriers that prevent mental health providers from
    participating in telemental health services; and educating civilian
    network mental health providers about our military culture.
        The Defense Centers of Excellence is providing a transition benefit
    for mental health services for active duty servicemembers, called in
    Transition. 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.
        The Mental Health Needs of Military Children
        Our Association is concerned about the impact of deployment and/or
    the injury of the servicemember is having on our most vulnerable
    population, children of our military servicemembers and veterans. Our
    study on the impact of the war on caregivers and children found
    deployments are creating layers of stressors, which families are
    experiencing at different stages. Teens especially carry a burden of
    care they are reluctant to share with the non-deployed parent in order
    to not ``rock the boat.'' They are often encumbered by the feeling of
    trying to keep the family going, along with anger over changes in their
    schedules, increased responsibility, and fear for their deployed
    parent. Children of the National Guard and Reserve face unique
    challenges since most do not live near a military installation. Our
    research found they have more difficulty with deployments and
    reintegration than their active duty counterpart.
        Our study respondents stated their communities did not understand
    what it was like to be military, and youth reported feeling
    misunderstood by people in their schools. We hear that school systems
    are generally unaware of this change in focus within these family units
    and are ill prepared to spot potential problems caused by these
    deployments or when an injury occurs.
        Also vulnerable are children who have disabilities that are further
    complicated by deployment or subsequent injury of the servicemembers.
    Their families find stress can be overwhelming, but are afraid to reach
    out for assistance for fear of retribution to the servicemember's
    career. They often choose not to seek care for themselves or their
    families. We appreciate the inclusion of a study on the mental health
    needs of military children in the NDAA for Fiscal Year 2010 and look
    forward to the findings.
        Suicide
        Our Association recognizes the action being taken by the Services
    and the VA to address the rising number of suicides in active duty,
    National Guard and Reserve servicemembers, and veterans. We appreciate
    the Army's recent suicide report and the DOD Suicide Prevention Task
    Force report. However, we are concerned that military and veteran
    families were not included when examining suicides. We have no idea
    whether families are also experiencing a rise in suicides and outpacing
    their civilian counterparts. Therefore, we recommend Congress require a
    DOD report on the number of family members who committed suicide, made
    a suicide attempt, or reported suicidal thoughts.
        We encourage Congress to direct DOD to include a mental health
    screening of military families each time they visit their primary
    health care provider. Providers should inquire about whether or not the
    family is experiencing a loved one's deployment. We also recommend DOD
    offer a pre- and post-deployment mental health screening on family
    members (similar to the PDHA and PDHRA currently being done for
    servicemembers).
        Caregiver Burnout
        In the 10th year of war, care for the caregivers must become a
    priority. There are several levels of caregivers. Our Association hears
    from the senior officer and enlisted spouses who are so often called
    upon to be the strength for others. We hear from the health care
    providers, educators, rear detachment staff, chaplains, and counselors
    who are working long hours to assist servicemembers and their families.
    They tell us they are overburdened, burnt out, and need time to
    recharge so they can continue to serve these families. These caregivers
    must be afforded respite care, given emotional support through their
    command structure, and be provided effective family programs. DOD
    should also take the opportunity to gather lessons learned and identify
    effective resiliency strategies deployed by our senior leaders and
    their spouses for future applications.
        Many providers have just returned home after completing a combat
    tour, only to be overwhelmed by treating active duty members, retirees,
    and their families. It can lead to provider compassion fatigue and
    create burnout. Our Association would like to be assured DOD is
    allowing these providers adequate dwell time and time to reintegrate
    with their families before returning to work. Beneficiaries rely
    heavily on MTF providers for their care, especially mental health, and
    need them to be fully ready to care for them. Providers must also be
    provided the opportunity to sharpen their practice skills, which may
    have not been used while serving in a combat zone. If they are not
    adequately addressed, this situation has the potential to negatively
    impact both the provider's ability to provide quality care and the
    beneficiary to receive quality care. We recommend Congress ask for a
    study to examine the impact the war is having on our MHS active duty
    providers and their families.
        Educating Those Who Care for Servicemembers and Families
        The families of servicemembers and veterans must be educated about
    the effects of Traumatic Brain Injury, Post-Traumatic Stress (PTS),
    Post-Traumatic Stress Disorder (PTSD), and suicide in order to help
    accurately diagnose and treat the servicemember/veteran's condition.
    These families are on the ``sharp end of the spear'' and are more
    likely to pick up on changes attributed to either condition and relay
    this information to their health care providers. Programs are being
    developed by each Service. However, they are narrow in focus targeting
    line leaders and health care providers, but not broad enough to capture
    our military family members and the communities they live in. As
    Services roll out suicide prevention programs, we need to include our
    families, communities, and support personnel.
        The DOD, VA, and State agencies must educate their health care and
    mental health professionals of the effects of mild Traumatic Brain
    Injury (mTBI) in order to help accurately diagnose and treat the
    servicemember's condition. They must be able to deal with polytrauma--
    PTS and PTSD in combination with mTBI and multiple physical injuries.
        DOD, working with the TRICARE Managed Care Support Contractors and
    Service medical leadership, must reach out to educate civilian health
    care providers on how to identify signs and symptoms of mTBI, PTS, and
    PTSD. It must educate them about our military culture. We recommend a
    course on military culture be required in all health care and
    behavioral health care college curriculums and to offer a TMA approved
    military culture Continuing Education Unit for providers who have
    already graduated. TMA should incentivize providers to take these
    courses.
        Reintegration
        Reintegration programs become a key ingredient in the family's
    success. Our Association believes we need to focus on treating the
    whole family with programs offering readjustment information, education
    on identifying stress, substance abuse, suicide, and traumatic brain
    injury, and encouraging them to seek assistance when having financial,
    relationship, legal, and occupational difficulties. We appreciate the
    inclusion in the NDAA for Fiscal Year 2010 for education programs
    targeting pain management and substance abuse for families, especially
    as DOD reports an increase in medication-related deaths and
    prescription-related substance use. We recommend Congress request DOD
    report on its outreach and the effectiveness of its educational
    programs in addressing this issue.
        Successful return and reunion programs will require attention over
    the long term, as well as a strong partnership at all levels between
    the various mental health arms of DOD, VA, and State agencies. DOD and
    VA need to provide family and individual counseling to address these
    unique issues. Opportunities for the entire family and for the couple
    to reconnect and bond must also be provided. Our Association has
    recognized this need and established family retreats under our
    Operation Purple program in the National Parks, promoting family
    reintegration following deployment.
        Our Association is noticing a potential impact on the servicemember
    and their families during the 2 week R&R scheduled during a war related
    assignment. DOD's intent is to provide time for the servicemember to
    spend quality time with their family away from the everyday stress of
    war. However, families tell us that, even though they appreciate the
    time together, they find the experience can cause increased anxiety,
    disrupt a family that has already developed successful coping skills
    during deployment, and make it hard for the family to readjust and
    regain family balance after the servicemember has returned to war.
    Families lack important support mechanisms and resources on how to
    prepare for before, during, and after the 2 week R&R. Each family
    anticipates and handles the situation differently, but all say it is
    stressful. Our Association would like a study on the impact of the 2
    week R&R on deployed families and the servicemember. This report will
    help identify what tools our families and servicemembers need to be
    better prepared and determine if the program needs to be modified.
        We recommend an extended outreach program to servicemembers,
    veterans, and their families of available psychological health
    resources, such as DOD, VA, and State agencies.
        We encourage Congress to request DOD to include families in its
    Psychological Health Support survey and perform a pre- and post-
    deployment mental health screening on family members (similar to the
    PDHA and PDHRA currently being done for servicemembers).
        Our Association recommends the ``inTransition'' program be expanded
    to provide the same benefit to active duty family members.
        We recommend the use of alternative treatment methods, such as
    telemental health; increasing mental health reimbursement rates for
    rural areas; modifying licensing requirements in order to remove
    geographic practice barriers that prevent mental health providers from
    participating in telemental health services; and educating civilian
    network mental health providers about our military culture.
        We recommend Congress require a DOD report on the number of family
    members who have committed or attempted suicide.
        We recommend Congress ask for a study to examine the impact the war
    is having on our MHS active duty providers and their families.
    Wounded Servicemembers Have Wounded Families
        Our Association asserts that behind every wounded servicemember and
    veteran is a wounded family. It is our belief the government,
    especially the DOD and VA, must take a more inclusive view of military
    and veterans' families. Those who have the responsibility to care for
    the wounded, ill, and injured servicemember must also consider the
    needs of the spouse, children, parents of single servicemembers and
    their siblings, and the caregivers. DOD and VA need to think
    proactively as a team and one system, rather than separately; and
    addressing problems and implementing initiatives upstream while the
    servicemember is still on active duty status.
        Reintegration programs become a key ingredient in the family's
    success. For the past 3 years, we have piloted our Operation Purple
    Healing Adventures camp to help wounded, ill, and injured
    servicemembers and their families learn to play again as a family. We
    hear from the families who participate in this camp, as well as others
    dealing with the recovery of their wounded servicemembers, that, even
    with congressional intervention and implementation of the Services'
    programs, many issues still create difficulties for them well into the
    recovery period. Families find themselves having to redefine their
    roles following the injury of the servicemember. They must learn how to
    parent and become a spouse/lover with an injury. Each member needs to
    understand the unique aspects the injury brings to the family unit.
    Parenting from a wheelchair brings a whole new challenge, especially
    when dealing with teenagers. Parents need opportunities to get together
    with other parents who are in similar situations and share their
    experiences and successful coping methods. Our Association believes 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
    nongovernmental 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 servicemember'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 servicemember or veteran.
        We remain concerned about the transition of wounded, injured, and
    ill servicemembers and their families from active duty status to that
    of the medically-retired. While we are grateful, DOD has proposed to
    exempt medically-retired servicemembers, survivors, and their families
    from the TRICARE Prime enrollment fee increases, we believe wounded
    servicemembers 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 servicemembers 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 health care systems alone, trying to find the right
    combination of care. Our most seriously wounded, ill, and injured
    servicemembers, 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 processor 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 servicemember 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 servicemembers 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 servicemembers and veterans, such as physical, psycho-
    social, and mental health, would be significantly compromised. They are
    viewed as an invaluable resource to DOD and VA health care providers
    because they tend to the needs of the servicemembers and the veterans
    on a regular basis. Their daily involvement saves DOD, VA, and State
    agency health care dollars in the long run. Their long-term
    psychological care needs must be addressed. Caregivers of the severely
    wounded, ill, and injured servicemembers who are now veterans have a
    long road ahead of them. In order to perform their job well, they will
    require access to mental health services.
        The VA has made a strong effort in supporting veterans' caregivers.
    DOD should follow suit and expand its definition, which still does not
    align with P.L. 111-163. We appreciate the inclusion in NDAA for Fiscal
    Year 2010 of compensation for servicemembers with assistance in
    everyday living and the refinement in NDAA for Fiscal Year 2011. 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, ill, and injured
    servicemembers 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 servicemember
    and veteran. The VA's interpretation also has the potential to impact
    the DOD's Special Compensation for servicemembers law passed as part of
    NDAA for Fiscal Year 2010 and modified in fiscal year 2011. The one
    area of immediate concern is the potential gap in financial
    compensation when the servicemember 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 clarity concerning whether an illness is
            covered, such as cancer from a chemical exposure;
             Delay in the caregiver's receipt of health care
            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 servicemembers. 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.
        The VA currently has eight caregiver assistance pilot programs to
    expand and improve health care education and provide needed training
    and resources for caregivers who assist disabled and aging veterans in
    their homes. DOD should evaluate these pilot programs to determine
    whether to adopt them for caregivers of servicemembers still on active
    duty. Caregivers' responsibilities start while the servicemember is
    still on active duty.
        Relocation Allowance and Housing for Medically-Retired Single
            servicemembers
        Active Duty servicemembers and their spouses qualify through the
    DOD for military orders to move their household goods when they leave
    the military service. Medically retired servicemembers are given a
    final PCS move. Medically retired married servicemembers are allowed to
    move their family; however, medically retired single servicemembers
    only qualify for moving their own personal goods.
        Our Association suggests that legislation be passed to allow
    medically retired single servicemembers the opportunity to have their
    caregiver's household goods moved as a part of the medical retired
    single servicemember's PCS move. This should be allowed for the
    qualified caregiver of the wounded servicemember and the caregiver's
    family (if warranted), such as a sibling who is married with children,
    or mom and dad. This would allow for the entire caregiver's family to
    move, not just the caregiver. The reason for the move is to allow the
    medically retired single servicemember the opportunity to relocate with
    their caregiver to an area offering the best medical care, rather than
    the current option that only allows for the medically retired single
    servicemember to move their belongings to where the caregiver currently
    resides. The current option may not be ideal because the area in which
    the caregiver lives may not be able to provide all the health care
    services required for treating and caring for the medically retired
    servicemember. Instead of trying to create the services in the area, a
    better solution may be to allow the medically retired servicemember,
    their caregiver, and the caregiver's family to relocate to an area
    where services already exist.
        The decision on where to relocate for optimum care should be made
    with the FRC (case manager), the servicemember's medical physician, the
    servicemember, and the caregiver. All aspects of care for the medically
    retired servicemember and their caregiver shall be considered. These
    include a holistic examination of the medically retired servicemember,
    the caregiver, and the caregiver's family for, but not limited to,
    their needs and opportunities for health care, employment,
    transportation, and education. The priority for the relocation should
    be where the best quality of services is readily available for the
    medically retired servicemember and 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 servicemembers 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.
        Servicemembers medically discharged from service and their family
    members should be allowed to continue for 1 year as active duty for
    TRICARE and then start the Continued Health Care Benefit Program if
    needed.
        Caregivers of the wounded, ill, and injured must be provided with
    opportunities for training, compensation and other support programs
    because of the important role they play in the successful
    rehabilitation and care of the servicemember and veteran.
        We request legislation authorizing medically retired single
    servicemembers to have their caregiver's household goods moved as a
    part of their final PCS move.
        Medical Power of Attorney
        We have heard from caregivers of the difficult decisions they have
    to make over their loved one's bedside following an injury. We support
    the Traumatic Brain Injury Task Force recommendation for DOD to require
    each deploying servicemember to execute a Medical Power of Attorney and
    a Living Will.
        DOD should require each deploying servicemember to execute a
    Medical Power of Attorney and a Living Will.
        Senior Oversight Committee
        Our Association is appreciative of the provision in the NDAA for
    Fiscal Year 2009 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 servicemembers, 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. Other DCoE have 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.
        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 servicemembers and their families need
    seamless, coordinated support from each.
                            iii. 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 servicemembers 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.
        We thank Congress for extending the TRICARE Active Duty Dental
    benefit to all survivors for the first 3 years. Unfortunately, the
    TRICARE Management Activity has not yet fully implemented this
    coverage. We hope a gentle nudge from Congress may speed that process
    along.
        Our Association recommends that grief counseling be more readily
    available to survivors as a TRICARE benefit.
        We also ask that the TRICARE Management Activity implement the
    legislation that expanded eligibility for 3 years of the TRICARE Active
    Duty Dental Benefit to survivors who had not been enrolled in the
    TRICARE Dental Program prior to the servicemember's death.
        Our Association still believes the benefit change that will provide
    the most significant long-term advantage to the financial security of
    all surviving families would be to end the Dependency and Indemnity
    Compensation (DIC) offset to the Survivor Benefit Plan (SBP). Ending
    this offset would correct an inequity that has existed for many years.
    Each payment serves a different purpose. The DIC is a special indemnity
    (compensation or insurance) payment paid by the VA to the survivor when
    the servicemember's service causes his or her death. The SBP annuity,
    paid by DOD, reflects the longevity of the service of the military
    member. It is ordinarily calculated at 55 percent of retired pay.
    Military retirees who elect SBP pay a portion of their retired pay to
    ensure that their family has a guaranteed income should the retiree
    die. If that retiree dies due to a service-connected disability, their
    survivor becomes eligible for DIC.
        Surviving active duty spouses can make several choices, dependent
    upon their circumstances and the ages of their children. Because SBP is
    offset by the DIC payment, the spouse may choose to waive this benefit
    and select the ``child only'' option. In this scenario, the spouse
    would receive the DIC payment and the children would receive the full
    SBP amount until each child turns 18 (23 if in college), as well as the
    individual child DIC until each child turns 18 (23 if in college). Once
    the children have left the house, this choice currently leaves the
    spouse with an annual income of $13,848, a significant drop in income
    from what the family had been earning while the servicemember was alive
    and on active duty. The percentage of loss is even greater for
    survivors whose servicemembers served longer. Those who give their
    lives for their country deserve more fair compensation for their
    surviving spouses.
        We believe several other adjustments could be made to the 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 pleased that the requirement for a
    report to assess the adequacy of DIC payments was included in the NDAA
    for Fiscal Year 2009. We are awaiting the overdue report. We support
    raising DIC payments to 55 percent of VA Disability Compensation. When
    changes are made, 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 servicemember. 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 applaud Congressman
    Walter Jones (R-NC/3rd) for introducing 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 servicemember 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.
    Implementation of the Repeal of ``Don't Ask, Don't Tell''
        Our Association has long promoted the need for support of all
    families during deployments. Parents, siblings, and significant others
    need access to information about their loved ones and access to
    resources while they undergo their own stresses and worries. Many
    family readiness groups have opened their arms to these non-ID card
    holding family members.
        We hear from families of gay and lesbian servicemembers that their
    loved ones have not sought these resources because of fear of
    disclosure. They deal with deployment alone without the support that
    military families take for granted and rely on. We hear from families
    about the children in these relationships, who many times can't let
    anyone know that Mommy or Daddy is deployed, and may not receive the
    extra support or counseling they may need.
        We hope that the repeal of the ``Don't Ask, Don't Tell'' policy
    will help make resources and support available to all those who support
    their servicemember. We understand that eligibility for many benefits,
    including medical care, housing, and assignment preferences will not be
    extended to partners of servicemembers because of Federal regulations.
    We ask that military family members be provided education and training
    to help them understand the implications of implementation and to help
    them separate fact from fiction.
        We underscore the need for military family members to be provided
    with education and training to help them understand how the repeal of
    ``Don't Ask, Don't Tell'' is being implemented and to allay any
    misconceptions and concerns they may have.
    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 servicemember or staying behind, selecting
    where a family lives within their new community, deciding whether to
    spend their financial resources on private school, or considering home
    schooling 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 DOD 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 DOD for the educational support programs
    already available to military children, such as the tutoring program
    for deployed servicemember 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 share 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 this authority.
        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 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 ask Congress to increase the DOD supplement to Impact Aid and to
    allow school districts experiencing high growth due to base
    realignments to apply for Impact Aid funds using current student
    enrollment numbers. We also ask Congress to extend DODEA's expanded
    authority.
    Voting Support for Military Servicemembers and their Families
        Our Association thanks Congress for continuing to shine a light on
    the need to protect and improve absentee voting rights for military
    families. The passage of the Military and Overseas Voter Empowerment
    (MOVE) Act of 2009 was a tremendous victory for our military community.
    The recent hearing held by the Committee on House Administration to
    evaluate the effectiveness of the MOVE Act in the 2010 elections
    demonstrates the ongoing commitment of Congress to upholding voting
    rights for military personnel serving overseas. Our Association greatly
    appreciates this effort. In addition, we want to stress the importance
    of remembering that military servicemembers and their families often
    vote by absentee ballot while stationed within the United States. It is
    not uncommon for military families to be living in one duty location
    with the servicemember and spouse each voting in a separate State,
    further complicating the absentee voting process.
        As a member of The Military Coalition (TMC) and the Alliance for
    Military and Overseas Voting Rights (AMOVR), our Association was
    instrumental in helping to pass the MOVE Act. It was an important step
    toward alleviating many of the voting issues faced by military
    families. However, individual State attempts to comply have not been
    completely effective in overcoming these difficulties. Furthermore, the
    MOVE Act did not encompass State and local elections. We are currently
    working with the Uniformed Law Commission and the DOD State Liaison
    Office to support the passage of the Uniform Military and Overseas
    Voters Act (UMOVA) in the States, to provide a State solution for
    military families and overseas voters. This legislation would assist
    States in meeting the statutory mandates of the MOVE Act and expand
    these important protections and benefits to cover State and local
    elections. Our Association is encouraging State legislatures to build
    on Federal efforts by adopting UMOVA.
    Spouse Education and Employment
        We are pleased the NDAA for 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 servicemembers 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 DOD. Many military spouses delay their education to support the
    servicemember'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 servicemember. 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 servicemember'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 NDAA for Fiscal Year 2011 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 for 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 servicemembers 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
    servicemember 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 for 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 health care system. Beneficiaries try to obtain an
    appointment and then find themselves getting partial health care within
    the MTF, while other health care is referred out into the purchased
    care network. Thus, military families end up managing their own care.
    In congruence 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 in congruence 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 health care, 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 servicemember 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
    health care 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 a DOD pilot study to identify what additional
    service(s), if any, our special needs families need to improve their
    quality of life.
        We also recommend a report examining the impact of the war on our
    special needs families.
    Families on the Move
        A 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 servicemember 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 servicemember. Families with two vehicles may ship one vehicle and
    travel together in the second vehicle. The vehicle will be shipped at
    the servicemember's expense and then the servicemember 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 servicemembers 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.
    Former Spouses
        On September 10, 2001, DOD released a report containing
    recommendations for improvements to the Uniformed Services Former
    Spouse Protection Act (USFSPA). While Congress has addressed one or two
    of the recommendations from the report in the ensuing 10 years, none of
    them have been passed. We endorse the TMC recommendation for a hearing
    on this important issue.
        We have also heard from a number of spouses who have been abandoned
    physically and financially. There can be many reasons for this, some
    related to behavioral health, some to inability of the families to
    reintegrate after many deployments. We intend to pursue this issue with
    DOD and the Services since it appears not to need a legislative fix.
    However, we do feel it is important enough to mention as a symptom of
    how our families and marriages are suffering after 10 years of war.
        Our Association recommends that legislative action be taken to
    implement recommendations of the DOD Report on the USFSPA including:

             Base the award amount to the former spouse on the
            grade and years of service of the member at time of divorce
            (not time of retirement);
             Prohibit the award of imputed income while on active
            duty, which effectively forces active duty members into
            retirement;
             Extend 20/20/20 benefits to 20/20/15 former spouses;
             Permit the designation of multiple Survivor Benefit
            Plan (SBP) beneficiaries with the presumption that SBP benefits
            must be proportionate to the allocation of retired pay;
             Eliminate the ``10-year Rule'' for the direct payment
            of retired pay allocations by the Defense Finance and
            Accounting Service (DFAS);
             Permit SBP premiums to be withheld from the former
            spouse's share of retired pay if directed by court order;
             Permit a former spouse to waive SBP coverage;
             Repeal the 1-year deemed election requirement for SBP;
            and
             Assist DOD and the Services with greater outreach and
            expanded awareness to members and former spouses of their
            rights, responsibilities, and benefits upon divorce.
    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.

        Senator Webb. Okay, thank you.
        Captain Puzon, welcome.

                STATEMENT OF CAPT IKE PUZON, USN (RET.)

        Mr. Puzon. Mr. Chairman and members of the subcommittee,
    thank you for your strong support for all servicemembers, their
    families, and survivors. They're serving relentlessly.
        My testimony will focus on a few Reserve component issues.
        First, making retroactive Public Law 110-181, Reserve Early
    Retirement Provision, is a top goal for TMC. The passage of
    legislation establishing September 11, 2001, as the eligibility
    start date for Guard and Reserve early retirement is very
    important to all our members and to those serving.
        Those most at risk from 2001 to 2008 were left out. Since
    2001, more than 800,000 men and women have answered the call to
    Active Duty, putting themselves at the same risk as all
    deployed forces, and many of them serving multiple tours.
        Unfortunately, most of those tours of 2001-2008 will not
    count towards the early retirement provision unless steps are
    taken to retroactively recognize mobilization. I believe it can
    be done through a phased-in approach, and ask that you consider
    that approach.
        Also, I believe it's clear that overseas contingency
    operations will continue as it has for the last 20 years. The
    Reserve component is an affordable, operational Reserve Force
    of choice and has answered the calls and provided the military
    and deployed to war zones when they have asked.
        Second, a continuum of care for Reserve components in the
    Individual Ready Reserve (IRR). We believe healthcare access
    for the Guard and Reserve should continue to improve with their
    increased role in our Nation's defense. We ask that you
    consider legislation to allow these reservists that go into the
    IRR--and they are deployable--that they must have access to, at
    a reasonable premium--TRICARE Reserve Select, perhaps--
    healthcare coverage.
        Finally, Reserve components' access to mental health
    professionals. We've heard a lot about that, for all the
    forces. We are all concerned about these increases in military
    suicide rate. The Reserve suicide instances have increased
    dramatically since 2006. Loss of employment, foreclosures,
    divorce, debts all face our Reserve components as they return
    from mobilization. These issues inflict a serious emotional
    toll. We ask that you support S. 325, Senator Murray's bill,
    for embedded mental health providers and to provide mental
    health care for members of the Reserve components during their
    training.
        These are just some of the top issues. With DOD considering
    a new revamping of Reserve Forces to access more operational
    commitments from the Reserve Forces, we have to consider
    addressing these issues now. If it is vital and necessary to
    deploy these forces, then it must be essential to find the
    resources, within the proposed budget, to pay for these issues.
    With efficiencies, I think it can be done.
        I'm extremely grateful for this opportunity, and I look
    forward to any questions.
        [The prepared statement of Mr. Puzon follows:]
              Prepared Statement by CAPT Ike Puzon, USN (Retired)
                                    summary
        Mr. Chairman, The Association of the U.S. Navy (AUSN) extends our
    thanks to you and the entire subcommittee for your strong support of
    our Active Duty Navy, Navy Reserve, retired members, and veterans of
    the uniformed services and their families and survivors. Your decisions
    have had a significant and positive impact in the lives of the entire
    uniformed services community.
        This past year was more than arduous, with Navy servicemembers
    still at war on two separate fronts in southwest Asia, several ongoing
    humanitarian operations, the continuous vigilance against piracy, Libya
    operations, and the Nation slowly recovering from the recent economic
    crisis. Congress and the administration have had difficult choices to
    make as they attempted to stimulate the economy while facing
    recordbreaking budget deficits.
        As we enter the 10th year of intense wartime operations, and
    worldwide deployment of the U.S. Navy, AUSN believes that
    prioritization on personnel issues should continue for fiscal year
    2012. Despite the extraordinary demands, men and women in the Navy and
    the Navy Reserve are still answering the call--thanks in no small
    measure to the subcommittee's strong and consistent support--but only
    at the cost of ever-greater sacrifices.
        Dramatic increases in suicide rates, reported divorce rates, and
    unemployment rates reflect the long-term effects of requiring the same
    people to return to combat again and again--and yet again.
        In these times of growing political and economic pressures, AUSN
    relies on the continued good judgment of the Armed Services Committees
    to ensure the Nation allocates the required resources to sustain a
    strong national defense, a sustained National Maritime Strategy, and in
    particular, to properly meet the pressing needs of the less than 1
    percent of the American population--servicemembers and their families--
    who protect the freedoms of the 99 percent.
                        executive summary of key issues
    End strength
        A major concern and priority for AUSN is the constant budgetary
    cuts to manpower. Since 2001 during war time, Navy and Navy Reserve has
    taken unnecessary cuts due to budget pressure in manpower. Navy and
    Navy Reserve Operational requirements have not subsided and the out
    look for increased usage of Navy and Navy Reserve assets grows. We
    encourage Congress to not take budget driven manpower cuts and review
    the manpower requirements as a cost savings vice a budget equalizer.
    Cost-of-Living Adjustments (COLAs)
        A top AUSN priority is to guard against any discriminatory
    treatment of retired members of the uniformed services compared to
    other Federal COLA-eligibles and to ensure continued fulfillment of
    congressional COLA intent ``to provide every military retired member
    the same purchasing power of the retired pay to which he was entitled
    at the time of retirement [and ensure it is] not, at any time in the
    future . . . eroded by subsequent increases in consumer prices.''
    Military Pay
        AUSN urges against short-sighted proposals to freeze or cap
    uniformed services pay raises below private sector pay growth, and
    strongly recommends a 2012 raise of at least 1.6 percent to match ECI
    growth.
    Military Retirement
        AUSN strongly opposes initiatives that would ``civilianize'' the
    military retirement system and inadequately recognize the unique and
    extraordinary demands and sacrifices inherent in a military career.
        Reducing incentives for serving arduous careers of 20 years or more
    can only undermine long-term retention and readiness, with particularly
    adverse effects in times of war. Simultaneously increasing compensation
    for those who leave short of fulfilling a career would only compound
    those adverse effects.
    Heath Care Enrollment Fees
        In response to member feedback on the Department of Defense
    proposal for TRICARE Prime fee increases, AUSN has embraced a policy
    that is congruent with a majority of its members.
        Health care for our serving military and their families is a matter
    of absolute necessity to sustain a fighting force. It is an obligation
    of government with a constitutional basis much higher than other forms
    of public service. When a nation puts its citizens (the military) at
    physical risk from disease, traumatic injury and death it absolutely
    owes them health care not health insurance. The military is not a
    Public Service union looking for a benefit package and should never be
    so equated! An overwhelming majority of AUSN members believe this is
    where all discussion must start.
        By extension, as a guiding principal, a primary entitlement for
    undertaking a career of unique and extraordinary sacrifices that few
    Americans are willing to accept is a range of exceptional retirement
    benefits that a grateful Nation provides for those who choose to
    dedicate a majority of their working lives to the national interest.
    DOD must work in partnership with associations, stakeholders, the
    Department of Veterans Affairs (VA) and other governmental agencies to
    ensure that our past, present and future military members and families
    receive cost effective, high quality health care. Before seeking
    increases in enrollment fees, deductibles or co-payments, the DOD and
    the Services should pursue any and all options to constrain the growth
    of health care spending in ways that do not disadvantage military
    members--past, present, and future--active duty, Reserve and veteran,
    and provide incentives to promote healthy lifestyles. Such options
    should include addressing the duplicative overhead expense of Service
    unique health care programs.
        Our members--Active, retiree, veterans, Reserve, and family--
    strongly desire to do their part in controlling the fiscal debt of this
    country. Fiscal realities demand that they do. However, our members,
    along with other servicemembers, have already invested heavily in our
    Nation. They have and continue to sacrifice in ways not recognized by
    the overwhelming majority of the American population. Military members
    and veterans earn, have earned, their health care and other benefits in
    a special way every day.
        AUSN desires to negotiate realistically but we must be very careful
    in our terminology. Bureaucrats want to frame this conversation as a
    benefit package to recruit and retain to meet requirements. We must
    never forget the military and veterans are not civilian contractors
    with the right to quit if they don't like the orders. They are
    different and Congress owes a very different debt to those citizens who
    can be ordered to potentially suffer serious losses, or die for their
    country. A nation that desires to provide guaranteed health care to all
    citizens and non-citizens alike surely can provide an extraordinary
    health care benefit to those who defend that very nation. The last
    dollar of Military Health Care should be funded before the first dollar
    is put into other social programs.
        Therefore, with these guiding principals,

             AUSN membership believes the President's fiscal year
            2012 proposed enrollment fee increase can be accepted as a one
            time increase of 13 percent. However, AUSN strongly objects to
            any future open-indexing increases based on civilian health
            care indices in future years for any TRICARE program including
            TRICARE Prime for retirees. As a whole, military (Active and
            Reserve) and former military members are by nature a healthier
            population.
             AUSN urges Congress to make the decisions on future
            increases based on what the cost-of-living allowances are for
            veterans. We are asking Congress to reject the proposal of
            open-ended indexing for future increases and to control future
            increases, if any--based solely on what the COLA is for
            retirees.
                              wounded warrior care
    DOD and VA Oversight
        AUSN urges joint hearings by the Armed Services and Veterans
    Affairs Committees to assess the effectiveness of current seamless
    transition oversight efforts and systems and to solicit views and
    recommendations from DOD, VA, the military Services, and
    nongovernmental organizations concerning how joint communication,
    cooperation, and oversight could be improved. In addition, the hearings
    should focus on implementation progress concerning:

             Single separation physical;
             Single disability evaluation system;
             Bi-directional electronic medical and personnel
            records data transfer;
             Medical centers of excellence operations and research
            projects;
             Coordination of care and treatment, including DOD-VA
            Federal/recovery care coordinator clinical and non-clinical
            services and case management programs; and
             Consolidated government agency support services,
            programs, and benefits.
    Continuity of Health Care
             Authorizing service-disabled members and their
            families to receive active-duty level TRICARE benefits,
            independent of availability of VA care for 3 years after
            medical retirement to help ease their transition from DOD to
            VA.
             Ensuring Guard and Reserve members have adequate
            access and treatment in the DOD and VA health systems for Post-
            Traumatic Stress Disorder and Traumatic Brain Injury following
            separation from active duty service in a theatre of operations.
    Caregiver/Family Support Services
        AUSN recommends:

             Providing enhanced training of DOD and VA medical and
            support staff on the vital importance of involving and
            informing designated caregivers in treatment of and
            communication with severely ill and injured personnel.
             Providing health and respite care for non-dependent
            caregivers (e.g., parents and siblings) who have had to
            sacrifice their own employment and health coverage while the
            injured member remains on active duty, commensurate with what
            the VA authorizes for medically retired or separated members'
            caregivers.
             Authorizing up to 1 year of continued residence in on-
            base housing facilities for medically retired, severely wounded
            servicemembers and their families.
                        active forces and their families
    End Strength
        AUSN strongly urges the subcommittee to:

             Sustain or increase end strength as needed to sustain
            Navy deployments for war and the continuous operational
            requirements and ensure dwell time for Navy servicemembers and
            families.
    Family Readiness and Support
        AUSN recommends that the subcommittee:

             Encourage DOD to assess the effectiveness of programs
            and support mechanisms designed to assist military members and
            their families with deployment readiness, responsiveness,
            reintegration, and health care.
             Expand child care availability and funding to meet the
            needs of the total force uniformed services community.
             Monitor and continue to expand family access to mental
            health counseling.
             Promote expanded opportunities for military spouses to
            further educational and career goals, such as the My Career
            Advancement Account (MyCAA) program.
             Promote implementation of flexible spending accounts
            to enable military families to pay health care and child care
            expenses with pre-tax dollars.
             Ensure access to mental health care programs in remote
            areas
                                 retiree issues
    Concurrent Receipt
        AUSN's continuing goal is to fully eliminate the deduction of VA
    disability compensation from earned military retired pay for all
    disabled retirees. In pursuit of that goal, AUSN's immediate priorities
    include:

             Phasing out the VA disability offset for all chapter
            61 (disability) retirees, as previously endorsed by the
            President and the subcommittee;
             Clarifying the law to resolve technical disparities
            that inadvertently cause underpayment of certain eligibles for
            Combat Related Special Compensation (CRSC); and,
             Clarifying the law to ensure a disabled retiree's CRSC
            payment is not reduced when the retiree's VA disability rating
            increases, until the retiree is afforded the opportunity to
            elect between CRSC and CRDP.
    Disability Severance Pay
        AUSN recommends:

             Further expanding eligibility to include all combat-
            related injuries, using the same definition as CRSC; and
            ultimately
             Expanding eligibility to include all service-connected
            disabilities, consistent with AUSN view that there should not
            be a distinction between the treatment of members disabled in
            combat vice members with non-combat, service-caused
            disabilities.
                                survivor issues
    SBP-DIC Offset
        AUSN recommends:

             Repeal of the SBP-DIC offset.
             Reinstating SBP for survivors who previously
            transferred payments to children when the youngest child
            attains majority, or upon termination of a remarriage.
             Allowing SBP eligibility to switch to children if a
            surviving spouse is convicted of complicity in the member's
            death.
                                  health care
    Enrollment Fees
        AUSN accepts the need to increase TRICARE Prime (for retirees 34-
    65) fees on a one time basis at 13 percent. However, AUSN objects to
    any future index increase that is solely based on civilian health care.
    Any increase must be controlled by Congress, and based only on the COLA
    for retirees.
    TRICARE Reimbursement Rates
        AUSN urges reversal of the 30 percent cut in Medicare/TRICARE
    payments to doctors scheduled for January 2012 and a permanent fix for
    the flawed formula that mandates these recurring annual threats to
    seniors' and military beneficiaries' health care access.
    TRICARE Cost Efficiency Options
        AUSN continues to believe strongly that DOD has not sufficiently
    investigated options to make TRICARE more cost-efficient without
    shifting costs to beneficiaries several GAO reports indicates that DOD
    can find more efficiencies.
    TRICARE Prime
        AUSN urges the subcommittee to:

             Require reports from DOD and the managed care support
            contractors on actions being taken to improve Prime patient
            satisfaction, provide assured appointments within Prime access
            standards, reduce delays in preauthorization and referral
            appointments, and provide quality information to assist
            beneficiaries in making informed decisions.
             Require increased DOD efforts to ensure consistency
            between the MTF and purchased care sectors in meeting Prime
            access standards.
             Ensure timely notification of and support for
            beneficiaries affected by elimination of Prime service areas
            under the new TRICARE contracts.
    TRICARE Standard
        AUSN urges the subcommittee to:

             Insist on immediate delivery of an adequacy threshold
            for provider participation, below which additional action is
            required to improve such participation.
             Require a specific report on participation adequacy in
            the localities where Prime Service Areas will be discontinued
            under the new TRICARE contracts.
             Oppose establishment of a TRICARE Standard enrollment
            fee, since Standard does not entail any guaranteed access to
            care.
             Increase locator support to beneficiaries seeking
            providers who will accept new Standard patients, particularly
            for mental health specialties.
             Seek legislation to eliminate the limit when TRICARE
            Standard is second payer to other health insurance (OHI): e.g.,
            return to the policy where TRICARE pays up to the amount it
            would have paid, had there been no OHI.
             Bar any further increase in the TRICARE Standard
            inpatient copay for the foreseeable future.
    TRICARE For Life
        AUSN urges the subcommittee to:

             Resist initiatives to establish an enrollment fee for
            TFL, as many beneficiaries already experience difficulties
            finding providers who will accept Medicare patients.
             Seek ways to include TFL beneficiaries in DOD programs
            to incentivize compliance with preventive care and healthy
            lifestyles.
             Resolve the discrepancy between TRICARE and Medicare
            treatment of the shingles vaccine.
    Survivors' Coverage
        AUSN recommends restoration of TRICARE benefits to previously
    eligible survivors whose second or subsequent marriage ends in death or
    divorce.
    Pharmacy
        AUSN urges the subcommittee to:

             Advance the use of the mail-order option by lowering
            or waiving copays, enhancing communication with beneficiaries,
            and using technological advances to ease initial signup.
             Require DOD to include alternate packaging methods for
            pharmaceuticals to enable nursing home, assisted living, and
            hospice care beneficiaries to utilize the pharmacy program.
            Packaging options should additionally include beneficiaries
            living at home who would benefit from this program because of
            their medical condition.
             Create incentives to hold down long-term health costs
            by eliminating copays for medications for chronic conditions,
            such as asthma, diabetes, and hypertension or keeping copays at
            the lowest level regardless of drug status, brand or generic.
    Health Care Fees
        AUSN believes military beneficiaries from whom America has demanded
    decades of extraordinary service and sacrifice have earned health care
    that is the best America has to offer, consistent with their
    extraordinarily high pre-paid premiums of decades of service and
    sacrifice.
        Congress needs to protect military beneficiaries against dramatic
    budget-driven fluctuations in this vital element of servicemembers'
    career compensation incentive package.
        Reducing the value of TRICARE for Life by $3,000 per year ($6,000
    for a couple) as recommended by the Deficit Commission would be
    inconsistent with military beneficiaries' sacrifices and would
    undermine Congress' intent when it authorized TFL in 2001--less than 10
    years ago.
        Reducing military retirement benefits would be particularly ill-
    advised when an overstressed force already is at increasing retention
    risk despite the current downturn of the economy and current recruiting
    successes.
        AUSN believes:

             All retired servicemembers earned exceptional health
            care by virtue of their service.
             Indexing to civilian medical care and means-testing
            has no place in setting military health care enrollment.
             Congress should direct DOD to pursue any and all
            options to constrain the growth of health care spending in ways
            that do not disadvantage beneficiaries.
                                  navy reserve
    Operational Reserve Retention and Retirement Reform
        AUSN recommends:

             Upgrade access--by providing ease to access the
            Federal Reserve in time of National Emergency or Contingency
            operations that do not impact the Active components, and
            provide the appropriate resources to do so.
             Authorizing early retirement credit to all Guard and
            Reserve members who have served active duty tours of at least
            90 days, retroactive to September 11, 2001.
             Eliminating the fiscal year limitation which
            effectively denies full early retirement credit for active duty
            tours that span the October 1 start date of a fiscal year.
             Modernizing the Reserve retirement system to
            incentivize continued service beyond 20 years and provide fair
            recognition of increased requirements for active duty service.
    End Strength
        AUSN strongly urges the subcommittee to:

             Sustain or increase end strength as needed to sustain
            Navy Reserve deployments for war and the continuous operational
            Reserve requirements and ensure dwell time for Navy Reserve
            servicemembers and families.
    Office of Chief of Naval Reserve
        AUSN strongly urges the subcommittee to:

             To Maintain the Chief of the Naval Reserve as an 0-9
            Billet as authorized by public law.
    Reserve Compensation System
        AUSN recommends:

             Create a Single Pay System--Reserve components need a
            single pay system that integrates better into the Active
            component system
             Crediting all inactive duty training points earned
            annually toward Reserve retirement.
             Parity in special incentive pay for career enlisted/
            officer special aviation incentive pay, diving special duty
            pay, and pro-pay for Reserve component medical professionals.
             Authorizing recalculation of retirement points after 1
            year of mobilization. A recent law change allowed certain flag
            and general officers to recalculate retirement pay after 1 year
            of mobilization. AUSN believes this opportunity should be made
            available to all ranks.
    Health Care Access Options
        AUSN recommends:

             Requiring DOD to justify the seven-fold increase in
            TRICARE rates for individual TRR premiums for reservists who
            immediately enroll in TRR upon retirement from the Selected
            Reserve and have TRS coverage until separation.
             Seeking a GAO review of the TRR program premium rates
            and implementation
             Authorizing TRICARE for early Reserve retirees who are
            in receipt of retired pay prior to age 60
             Permitting employers to pay TRS premiums for
            reservist-employees as a bottom-line incentive for hiring and
            retaining them.
             Authorizing an option for the government to subsidize
            continuation of a civilian employer's family coverage during
            periods of activation, similar to FEHBP coverage for activated
            Guard-Reserve employees of Federal agencies.
             Extending corrective dental care following return from
            a call-up to ensure G-R members meet dental readiness
            standards.
             Allowing eligibility in Continued Health Care Benefits
            Program (CHCBP) for Selected reservists who are voluntarily
            separating and subject to disenrollment from TRS.
             Allowing beneficiaries of the FEHBP who are Selected
            reservists the option of participating in TRICARE Reserve
            Select.

                     Reserve members must have access to proper
                    mental health care prior to deployment and after
                    deployment. Ensure access to mental health care
                    programs in remote areas

             Navy Reserve Member and Retirees that are in the
            Individual Ready Reserve--need to be recognized as honorable
            servicemembers and deserve to have access to TRR at reasonable
            rates or similar rates as TRS due to their being subjected to
            recall.
    Yellow Ribbon Reintegration Program
        AUSN urges the subcommittee to hold oversight hearings and direct
    additional improvements in coordination, collaboration, and consistency
    of Yellow Ribbon services between States and maintain this valuable
    program.
    Reserve Family Support Programs
        AUSN recommends:

             Ensuring programs are in place to meet the special
            information and support needs of families of Navy and Navy
            Reserve individual augmentees or those who are geographically
            dispersed.
             Funding programs between military and community
            leaders to support servicemembers and families during all
            phases of deployments, especially demob.
             Providing preventive counseling services for
            servicemembers and families and training so they know when to
            seek professional help related to their circumstances.
             Authorizing and funding child care, including respite
            care, family readiness group meetings and drill time.
             Improving the joint family readiness program to
            facilitate understanding and sharing of information between all
            family members and commands.
          morale, welfare, and recreation and quality of life programs
    Consolidation of DOD Retail Operations
        AUSN supports continuing efforts to improve commissary and exchange
    program efficiency, but objects to initiatives that reduce benefit
    value for patrons and the associated retention value for the uniformed
    services.
        AUSN urges the subcommittee to:

             Seek report updates from DOD and the Services to
            ensure delivery of needed MWR and quality of life program
            support at gaining and losing locations affected by BRAC and
            rebasing.
             Direct DOD to report to Congress on all DOD and
            Service Active and Reserve component MWR Category A, B, and C
            Programs and Family Support/Readiness (Quality of Life (QoL)
            Programs), including the Yellow Ribbon Program.
             Protect recreational and alternative therapy programs
            that integrate MWR, fitness and other quality of life programs
            and infrastructure to facilitate warrior treatment and care and
            to promote psychological health and welfare of troops and their
            families.
                             military construction
        AUSN recommends the subcommittee:

             Support military construction projects that modernize
            or replace the following infrastructure to meet increased
            personnel and operational deployment requirements:

                     child development centers (CDCs) and youth
                    centers;
                     bachelor and family housing; and,
                     other traditional QoL program facilities.

             Ensure MWR, Milcon, housing, and family support
            construction policies and projects improve access for persons
            with disabilities.
    Statement on Deficit Reduction Proposals
        The National Commission on Fiscal Responsibility and Reform and
    several less publicized deficit-reduction panels have proposed a wide
    range of spending cuts, including proposed cutbacks in Federal cost of
    living adjustments (COLAs); defense spending, including military pay
    and retirement; and Federal health care programs, including TRICARE and
    TRICARE for Life. The rapidly growing debt problem facing our country
    is all too real, and there is no easy fix. Solving this problem for the
    long term will involve shared pain by all Americans.
        Congress has improved retention and readiness by addressing a
    number of quality of life issues for the military community over the
    last decade, authorizing TRICARE For Life and TRICARE Senior Pharmacy
    coverage, establishing concurrent receipt for most severely disabled
    and combat-disabled retirees, improving pay and allowances for
    currently serving personnel, upgrading health coverage for the Reserve
    community who have answered the call for war.
        Now, ironically, some critics decry the growth in personnel and
    health care spending since 2000. Twelve years ago, military leaders
    were complaining of retention problems as decades of pay raise caps had
    depressed military pay nearly 14 percent below private sector pay.
    Military retirees and their spouses were being unceremoniously dumped
    from military health coverage at age 65 and all disabled retirees were
    forced to fund their own VA disability compensation from their service-
    earned retired pay. Survivor Benefit Program (SBP) widows suffered a
    34-percent benefit cut at age 62, and GI Bill benefits had eroded
    dramatically, among many other challenges. Congress' actions to address
    those problems were spurred in no small part by national concern to
    protect the interests of military people whose severe and extended
    wartime sacrifices have been highlighted on every front page and every
    evening newscast for nearly a decade.
        History demonstrates that public and congressional support for
    protecting military people programs can fade quickly in times of
    strained budgets or when a period of extended military conflict is (or
    is expected to be) coming to an end. That was true in the 1940s, 1950s,
    1970s, 1980s, and 1990s.
        As Congress assesses how to fairly allocate necessary sacrifices
    among the various segments of the population, AUSN urges that you bear
    in mind that:

             No segment of the population has been called upon for
            more sacrifice than the military community. Currently serving
            military members have been asked to bear 100 percent of our
            Nation's wartime sacrifice while the broader population was
            asked to contribute to the war effort by ``going shopping.''
            The U.S. Navy has always been a deployed force.
             Assertions about personnel and health cost growth
            since 2000 are highly misleading, because 2000 is not an
            appropriate baseline for comparison. As mentioned above, that
            was the nadir of the erosion of benefits era, when military pay
            was nearly 14 percent below private sector pay, currently
            serving members had suffered a major retirement cutback, older
            retirees and their families were being jettisoned from any
            military health coverage, disabled retirees and survivors were
            suffering dramatic financial penalties, and retention and
            readiness were suffering as a result. Congressional action (and
            spending) to fix those problems was a necessary thing, not a
            bad thing.
             Retired servicemembers, their families, and survivors
            also have been no stranger to sacrifice. Hundreds of thousands
            of today's retirees served in multiple wars, including Iraq and
            Afghanistan, Gulf War I, Vietnam, Korea, and WWII eras, and the
            multiple conflicts and cold wars in between. Older retirees
            endured years when the government provided them no military
            health coverage, and those under 65 already have forfeited an
            average 10 percent of earned retired pay because they retired
            under pay tables that were depressed by decades of capping
            military pay raises below private sector pay growth.
             There is a readiness element to military compensation
            and military health care decisions beyond the budgetary
            element. Regardless of good or bad budget times, a military
            career is a unique and arduous calling that cannot be equated
            to civilian employment. Sufficient numbers of high-quality
            personnel will choose to pursue a career in uniform only if
            they perceive that the extreme commitment demanded of them is
            reciprocated by a grateful nation, and the unique rewards for
            completing such a career are commensurate with the unique
            burden of sacrifice that they and their families are required
            to accept over the course of it.
             Military members' and families' sacrifices must not be
            taken for granted by assuming they will continue to serve and
            endure regardless of significant changes in their career
            incentive package.
             History shows clearly that there are unacceptable
            retention and readiness consequences for shortsighted budget
            decisions that cause servicemembers to believe their steadfast
            commitment to protecting their nation's interests is poorly
            reciprocated.
             The U.S. Navy has and will be a deployed force world
            wide. End strengths are critical to maintaining dwell times and
            deployed forces.
                              wounded warrior care
        AUSN urges joint hearings by the Armed Services and Veterans
    Affairs Committees to assess the effectiveness of current seamless
    transition oversight efforts and systems and to solicit views and
    recommendations from DOD, VA, the military services, and non-
    governmental organizations concerning how joint communication,
    cooperation, and oversight could be improved.
        In addition, the hearings should focus on implementation progress
    concerning:

             Single separation physical;
             Single disability evaluation system;
             Bi-directional electronic medical and personnel
            records data transfer;
             Medical centers of excellence responsibilities vs.
            authority, operations, and research projects;
             Coordination of care and treatment, including DOD-VA
            Federal/recovery care coordinator clinical and non-clinical
            services and case management programs; and
             Consolidated government agency support services,
            programs, and benefits.
    Continuity of Health Care
        Transitioning between DOD and VA health care systems remains
    challenging and confusing to those trying to navigate and use these
    systems. Systemic, cultural, and bureaucratic barriers often prevent
    the servicemember or veteran from receiving the continuity of care they
    need to heal and have productive and a high level of quality of life
    they so desperately need and desire.
        Servicemembers and their families repeatedly tell us that DOD has
    done much to address trauma care, acute rehabilitation, and basic
    short-term rehabilitation. They are less satisfied with their
    transition from the military health care systems to longer-term care
    and support in military and VA medical systems.
        We hear regularly from members who have experienced significant
    disruptions of care upon separation or medical retirement from service.
        One is in the area of cognitive therapy, which is available to
    retired members under TRICARE only if it is not available through the
    VA. Unfortunately, members are caught in the middle because of
    differences between DOD and VA authorities on what constitutes
    cognitive therapy and the degree to which effective, evidenced-based
    therapy is available.
        Action is needed to further protect the wounded and disabled. The
    subcommittee has acted previously to authorize 3 years of active-duty
    level TRICARE coverage for the family members of those who die on
    active duty. AUSN believes we owe equal transition care continuity to
    those whose service-caused illnesses or injuries force their retirement
    from service.
                                  navy reserve
        The Navy Reserve has always deployed in support of our Nations wars
    and contingency operations. Currently there are over 5,500 members
    serving in some capacity in OIF/OEF with another 1,500 being prepared
    to deploy. The Navy Reserve has maintained this pace since 2001. Over
    91,000 Guard and Reserve service men and women are serving on active
    duty (as of January 2011).
        Since September 11, 2001, more than 793,853 Guard and Reserve
    servicemembers have been called up, including over 250,000 who have
    served multiple tours. There is no precedent in American history for
    this sustained reliance on citizen-soldiers and their families. To
    their credit, Guard and Reserve combat veterans continue to reenlist,
    but the ongoing pace of routine, recurring activations and deployments
    cannot be sustained indefinitely.
        Guard and Reserve members and families face unique challenges in
    their readjustment following active duty service. Unlike active duty
    personnel, many Guard and Reserve members return to employers who
    question their contributions in the civilian workplace, especially as
    multiple deployments have become the norm. Many Guard-Reserve troops
    return with varying degrees of combat-related injuries and stress
    disorders, and encounter additional difficulties after they return that
    can cost them their jobs, careers and families.
        Despite the continuing efforts of the Services and Congress, most
    Guard and Reserve families do not have access to the same level of
    counseling and support that active duty members have. In short, the
    Reserve components face increasing challenges virtually across the
    board, including major equipment shortages, end-strength requirements,
    wounded-warrior health care, and pre- and post-deployment assistance
    and counseling.
        AUSN strongly urges the subcommittee to:

             Not allow SECDEF, the Secretary of the Navy, or Chief
            of Naval Operations to downsize the Chief of the Naval Reserve
            office to an 0-8 billet as expressed in SECDEF Memorandum--
            MAR14 2011--OSD 02974-11. This is done solely for the purpose
            of budgetary concerns and does not reflect the needs and
            requirements of the Navy Reserve or those that have served this
            country during the war time of 2001 to 2008. AUSN notes that no
            other Reserve Chief billet will be denigrated in opposition to
            Public Law that authorizes 0-9 billet for Reserve Chiefs.
    Guard and Reserve Health Care Access Options &
        AUSN is very grateful for sustained progress in providing
    reservists' families a continuum of government-sponsored health care
    coverage options throughout their military careers into retirement, but
    key gaps remain.
        For years, AUSN has recommended continuous government health care
    coverage options for Guard and Reserve (G-R) families. Operational
    Reserve policy during two protracted wars has only magnified that need.
    DOD took the first step in the 1990s by establishing a policy to pay
    the Federal Health Benefits Program (FEHB) premiums for G-R employees
    of the Department during periods of their active duty service.
        Thanks to this subcommittee's efforts, considerable additional
    progress has been made in subsequent years to provide at least some
    form of military health coverage at each stage of a Reserve component
    member's life, including:

             TRICARE Reserve Select (TRS) for actively drilling
            Guard and Reserve families, with premiums set at 28 percent of
            the actual program cost. The 2011 monthly premiums are $53.16
            for individual reservists in drill status and $197.76 for
            member and family coverage.
             TRICARE Retired Reserve (TRR) for ``gray area''
            reservists who have retired from active drilling status but
            have not yet attained age 60, with premiums set to cover 100
            percent of program cost. Rates for 2011 are $408.01 for member-
            only coverage, or $1,020.05 for TRR member-and-family coverage.
             TRICARE Standard/Prime for retired reservists with 20
            or more years of qualifying service, once they attain age 60
            and retired pay eligibility.
             TRICARE for Life as second-payer to Medicare for
            career reservists with 20 or more years of qualifying service
            at age 65 provided they enroll in Medicare Part B.

        However, as noted earlier in this statement, early Reserve retirees
    who are in receipt of non-regular retired pay before age 60 are
    ineligible for TRICARE.
        AUSN continues to support closing the remaining gaps to establish a
    continuum of health coverage for operational Reserve families,
    including members of the Individual Ready Reserve subject to call-up.
        AUSN recommends:

             Requiring a GAO audit of TRR program
             Requiring DOD to justify the seven-fold increase in
            TRICARE rates for individual TRR premiums for reservists who
            immediately enroll in TRR upon retirement from the Selected
            Reserve and have TRS coverage until separation.
             Authorizing TRICARE for early Reserve retirees who are
            in receipt of retired pay prior to age 60
             Permitting employers to pay TRS premiums for
            reservist-employees as a bottom-line incentive for hiring and
            retaining them.
             Authorizing an option for the government to subsidize
            continuation of a civilian employer's family coverage during
            periods of activation, similar to FEHBP coverage for activated
            Guard-Reserve employees of Federal agencies.
             Extending corrective dental care following return from
            a call-up to ensure G-R members meet dental readiness
            standards.
             Allowing eligibility in Continued Health Care Benefits
            Program (CHCBP) for Selected reservists who are voluntarily
            separating and subject to disenrollment from TRS.
             Allowing beneficiaries of the FEHBP who are Selected
            reservists the option of participating in TRICARE Reserve
            Select.
    Yellow Ribbon Reintegration Program
        Congress has provided increased resources to support the transition
    of warrior-citizens back into the community. But program execution
    remains spotty from State to State and falls short for returning
    Federal Reserve warriors in widely dispersed regional commands.
    Military and civilian leaders at all levels must improve the
    coordination and delivery of services for the entire operational
    Reserve Force. Many communities are eager to provide support and do it
    well. But yellow ribbon efforts in a number of locations amount to
    little more than PowerPoint slides and little or no actual
    implementation.
        DOD must ensure that State-level best practices--such as those in
    Maryland, Minnesota and New Hampshire--are applied for all operational
    Reserve Force members and their families, and that Federal Reserve
    veterans have equal access to services and support available to
    National Guard veterans. Community groups, employers and service
    organization efforts need to be encouraged and better coordinated to
    supplement unit, component, Service and VA outreach and services.
        AUSN urges the subcommittee to hold oversight hearings and direct
    additional improvements in coordination, collaboration and consistency
    of Yellow Ribbon services between States.
    Reserve Family Support Programs
        We have seen considerable progress in outreach programs and
    services for returning Guard-Reserve warriors and their families.
    Family support programs promote better communication with
    servicemembers. Specialized support and training for geographically
    separated Guard and Reserve families and volunteers are needed.
        AUSN recommends:

             Ensuring programs are in place to meet the special
            information and support needs of families of individual
            augmentees or those who are geographically dispersed.
             Funding programs between military and community
            leaders to support servicemembers and families during all
            phases of deployments.
             Providing preventive counseling services for
            servicemembers and families and training so they know when to
            seek professional help related to their circumstances.
             Authorizing and funding child care, including respite
            care, family readiness group meetings and drill time.
             Improving the joint family readiness program to
            facilitate understanding and sharing of information between all
            family members.
                                  health care
    TRICARE Reimbursement Rates
        Physicians consistently report that TRICARE is virtually the
    lowest-paying insurance plan in America. Other national plans typically
    pay providers 25-33 percent more. In some cases the difference is even
    higher.
        Unless Congress acts before the end of the year, current law will
    force a 30 percent reduction in Medicare and TRICARE payments as of
    January 1, 2012, which would cause many providers to stop seeing
    military beneficiaries.
        AUSN urges reversal of the 30 percent cut in Medicare/TRICARE
    payments scheduled for January 2012 and a permanent fix for the flawed
    formula that mandates these recurring annual threats to seniors' and
    military beneficiaries' health care access.
    TRICARE Cost Efficiency Options
        AUSN continues to believe strongly that DOD has not sufficiently
    investigated options to make TRICARE more cost-efficient without
    shifting costs to beneficiaries. AUSN has offered for several years a
    long list of alternative cost-saving possibilities, including:

             Positive incentives to encourage beneficiaries to seek
            care in the most appropriate and cost effective venue;
             Encouraging improved collaboration between the direct
            and purchased care systems and implementing best business
            practices and effective quality clinical models;
             Focusing the military health system, health care
            providers, and beneficiaries on quality measured outcomes;
             Improving MHS financial controls and avoiding overseas
            fraud by establishing TRICARE networks in areas fraught with
            fraud;
             Promoting retention of other health insurance by
            making TRICARE a true second-payer to other insurance (far
            cheaper to pay another insurance's co-pay than have the
            beneficiary migrate to TRICARE);
             Encouraging DOD to effectively utilize data from their
            electronic health records to better monitor beneficiary
            utilization patterns to design programs which truly match
            beneficiaries needs;
             Sizing and staffing military treatment facilities to
            reduce reliance on network providers and develop effective
            staffing models which support enrolled capacities;
             Reducing long-term TRICARE Reserve Select (TRS) costs
            by allowing servicemembers the option of a government subsidy
            of civilian employer premiums during periods of mobilization;
             Encouraging retirees to use lowest-cost-venue military
            pharmacies at no charge, rather than discouraging such use by
            limiting formularies, curtailing courier initiatives, etc.
             Utilizing the current GAO reviews to implement changes
            to improve efficiencies
    TRICARE Prime
        There appears to be growing dissatisfaction among TRICARE Prime
    enrollees--which is actually higher among active duty families than
    among retired families. The dissatisfaction arises from increasing
    difficulties experienced by beneficiaries in getting appointments,
    referrals to specialists, and sustaining continuity of care from
    specific providers.
        AUSN supports implementation of a pilot study by TMA in each of the
    three TRICARE Regions to study the efficacy of revitalizing the
    resource sharing program used prior to the implementation of the
    TRICARE-The Next Generation (T-NEX) contracts under the current Managed
    Care Support contract program.
        AUSN supports adoption of the ``Medical Home'' patient-centered
    model to help ease such problems.
        AUSN strongly advocates the transparency of healthcare information
    via the patient electronic record between both the MTF provider and
    network providers. Additionally, institutional and provider healthcare
    quality information should be available to all beneficiaries so that
    they can make better informed decisions.
        We are concerned about the impact on beneficiaries of the
    elimination of some Prime service areas under the new contract. This
    will entail a substantive change in health care delivery for thousands
    of beneficiaries, may require many to find new providers, and will
    change the support system for beneficiaries who have difficulty
    accessing care.
        AUSN urges the subcommittee to:

             Require reports from DOD and the managed care support
            contractors on actions being taken to improve Prime patient
            satisfaction, provide assured appointments within Prime access
            standards, reduce delays in preauthorization and referral
            appointments, and provide quality information to assist
            beneficiaries in making informed decisions.
             Require increased DOD efforts to ensure consistency
            between both the MTFs and purchased care sectors in meeting
            Prime access standards.
             Ensure timely notification of and support for
            beneficiaries affected by elimination of Prime service areas.
    TRICARE Standard
        AUSN appreciates the subcommittee's continuing interest in the
    specific problems unique to TRICARE Standard beneficiaries. TRICARE
    Standard beneficiaries need assistance in finding participating
    providers within a reasonable time and distance from their home. This
    is particularly important with the expansion of TRICARE Reserve Select
    and the upcoming change in the Prime Service Areas, which will place
    thousands more beneficiaries into TRICARE Standard.
        AUSN is concerned that DOD has not yet established benchmarks for
    adequacy of provider participation, as required by section 711(a)(2) of
    the NDAA for Fiscal Year 2008. Participation by half of the providers
    in a locality may suffice if there is not a large Standard beneficiary
    population, but could severely constrain access in other areas with
    higher beneficiary density. AUSN hopes to see an objective
    participation standard (perhaps based on the number of beneficiaries
    per provider) that would help shed more light on which locations have
    participation shortfalls of Primary Care Managers and Specialists that
    require positive action.
        AUSN continues to oppose initiatives that would establish an
    enrollment fee for TRICARE Standard. If a beneficiary is to be required
    to pay an enrollment fee, the beneficiary should gain some additional
    benefit from enrollment. TRICARE Prime features an enrollment fee, but
    in return offers guaranteed access to care. In contrast, Standard
    offers no such guaranteed access, and beneficiaries typically are on
    their own in finding a participating provider who is accepting new
    patients.
        A source of recurring concern is the TRICARE Standard inpatient
    copay for retired members, which now stands at $535 per day. For each
    of the last several years, Congress has had to insert a special
    provision in the National Defense Authorization Act to preclude
    increasing that by another $115 per day or more. AUSN believes the $535
    per day amount already is excessive, and should be capped at that rate
    for the foreseeable future.
        AUSN urges the subcommittee to:

             Insist on immediate delivery of an adequacy threshold
            for provider participation, below which additional action is
            required to improve such participation.
             Require a specific report on participation adequacy in
            the localities where Prime Service Areas will be discontinued
            under the new TRICARE contracts.
             Oppose establishment of a TRICARE Standard enrollment
            fee, since Standard does not entail any guaranteed access to
            care.
             Increase locator support to TRICARE Standard
            beneficiaries seeking providers who will accept new Standard
            patients, particularly for mental health specialties.
             Seek legislation to eliminate the limit when TRICARE
            Standard is second payer to other health insurance (OHI): e.g.,
            return to the policy where TRICARE pays up to the amount it
            would have paid, had there been no OHI.
             Bar any further increase in the TRICARE Standard
            inpatient copay for the foreseeable future.
    TRICARE For Life (TFL)
        When Congress enacted TFL in 2000, it explicitly recognized that
    this coverage was fully earned by career servicemembers' decades of
    sacrifice, and that the Medicare Part B premium would serve as the cash
    portion of the beneficiary premium payment. AUSN believes that this
    remains true today.
        Some have proposed establishing an enrollment fee for TFL. AUSN
    believes this is inappropriate, since beneficiaries have no guarantee
    of access to Medicare-participating providers.
        AUSN is aware of the challenges imposed by Congress' mandatory
    spending rules, and appreciates the subcommittee's efforts to include
    TFL-eligibles in the preventive care pilot programs included in the
    NDAA for Fiscal Year 2009. We believe their inclusion would, in fact,
    save the government money and hope the subcommittee will be able to
    find a more certain way to include them than the current discretionary
    authority, which DOD has declined to implement.
        AUSN also hopes the subcommittee can find a way to resolve the
    discrepancy between Medicare and TRICARE treatment of medications such
    as the shingles vaccine, which Medicare covers under pharmacy benefits
    and TRICARE covers under doctor visits. This mismatch, which requires
    TFL patients to absorb the cost in a TRICARE deductible or purchase
    duplicative Part D coverage, deters beneficiaries from seeking this
    preventive medication.
        AUSN urges the subcommittee to:

             Resist initiatives to establish an enrollment fee for
            TFL, given that many beneficiaries already experience
            difficulties finding providers who will accept Medicare
            patients.
             Seek ways to include TFL beneficiaries in DOD programs
            to incentivize compliance with preventive care and healthy
            lifestyles.
             Resolve the discrepancy between TRICARE and Medicare
            treatment of the shingles vaccine.
    Survivors' Coverage
        When a TRICARE-eligible widow/widower remarries, he/she loses
    TRICARE benefits. When that individual's second marriage ends in death
    or divorce, the individual has eligibility restored for military ID
    card benefits, including SBP coverage, commissary/exchange privileges,
    etc.--with the sole exception that TRICARE eligibility is not restored.
    This is out of line with other Federal health program practices, such
    as the restoration of CHAMPVA eligibility for survivors of veterans who
    died of service-connected causes. In those cases, VA survivor benefits
    and health care are restored upon termination of the remarriage.
    Remarried surviving spouses deserve equal treatment.
        AUSN recommends restoration of TRICARE benefits to previously
    eligible survivors whose second or subsequent marriage ends in death or
    divorce.
    Pharmacy
        AUSN supports a strong TRICARE pharmacy benefit which is affordable
    and continues to meet the pharmaceutical needs of millions of eligible
    beneficiaries through proper education and trust. The AUSN will oppose
    any degradation of current pharmacy benefits, including any effort to
    charge fees or copayments for use of military treatment facilities.
        AUSN urges the subcommittee to:

             Advance the use of the mail-order option by lowering
            or waiving copays, enhancing communication with beneficiaries,
            and using technological advances to ease initial signup.
             Require DOD to include alternate packaging methods for
            pharmaceuticals to enable nursing home, assisted living, and
            hospice care beneficiaries to utilize the pharmacy program.
            Packaging options should additionally include beneficiaries
            living at home who would benefit from this program because of
            their medical condition (for example beginning stages of
            Alzheimer's).
             Create incentives to hold down long-term health costs
            by eliminating copays for medications for chronic conditions,
            such as asthma, diabetes, and hypertension or keeping copays at
            the lowest level regardless of drug status, brand or generic.

        ``A Veteran--AD, Reserve, NG, or Retired is someone who, at one
    point in their life, wrote a blank check made payable to ``The United
    States of America,'' for an amount of ``up to and including my life.''

        Senator Webb. Thank you very much, Captain Puzon.
        Ms. Roth-Douquet, welcome.

     STATEMENT OF KATHY ROTH-DOUQUET, CHAIRMAN, BLUE STAR FAMILIES

        Ms. Roth-Douquet. Thank you, Senator Webb.
        This is my first time testifying, so it's--I'm thrilled to
    be at this very large table.
        Everyone may not be familiar with Blue Star Families. We're
    a nationwide nonprofit of military families from all ranks and
    Services, including Guard and Reserve. We are a chapter-based
    organization, about 2 years old; we have over 50 chapters, so
    far. This past year we have had over 1,000-percent growth. In
    addition to chapters, we're very social-media and online-
    oriented.
        We do surveys every year of our members and of other
    military families. Our surveys have consistently shown that pay
    and benefits, the operational tempo, and the effects of
    deployment on children are top concerns for families.
        Some highlights from our survey concerning benefits are
    that military healthcare, both quality and access, rate
    extremely high, and they're also a very high cause of concern.
    We take that to mean both that services vary widely from region
    to region and among the different Services, and whether you're
    in the Guard and Reserve, and the perception of the quality
    varies, perhaps, depending on the age and experience of the
    people who are experiencing the service. So, it's a good and a
    bad story.
        We've asked our members and military families what services
    they're most satisfied with. Top choices are commissary and
    exchange. TRICARE insurance and chaplain services are the
    second most popular. We think that chaplain services are a very
    important thing and a part of some of the mental health
    services that we talk about that isn't often discussed. DOD
    schools are the third most popular, with base housing next.
        I do want to mention that the post-9/11 GI Bill, which we
    thank you for sponsoring, is extremely popular. There is a lot
    of concern among families about maintaining transferability,
    and also among servicemembers who have served careers and for
    whom the education of their children is a very important
    benefit to them.
        What I would really like to highlight with you today,
    however, is a bit different than what we have been talking
    about. It's how we can better help military families and better
    provide benefits outside of DOD and government funding, but
    with government cooperation, through public-private
    partnerships. Government is often the biggest barrier to this,
    and perhaps this is an area where you can help.
        Military families do serve and do suffer burden in this
    long war, but we also believe that the government can't solve
    all ills. Groups like ours play a role, but to play it
    effectively, we have to be able to engage cooperatively with
    the DOD. Our organization started to provide spouses on the
    ground, and other family members, the ability to identify and
    be part of solving the problems that we see in our communities.
    We feel like we're experts and we have something to contribute.
    We listen to our members, to ourselves, to our annual surveys,
    and we use our position as military family members to ask for
    help. We work with government, when possible, to make our
    programs better and more effective, but we also go outside of
    government.
        For instance, we asked museums, last year, to make
    themselves free for military families. Nearly 900 signed up and
    300,000 military family members went for free. We couldn't have
    done it without the support of the National Endowment for the
    Arts and with the support of the First Lady, but this program
    didn't cost the government or military families anything, and
    yet, it provided a benefit.
        The NMFA's Operation Purple Camps are another example of
    this kind of way of providing benefits without impacting the
    budget.
        But, often we are prevented from the very institutions that
    are trying to help our families--by the DOD or other agencies--
    from doing this sort of thing.
        RAND issued a study showing that base libraries are
    underfunded. We know, from volunteering in our children's
    schools, that many young military families don't have any books
    at home. I don't want DOD to spend money on books for our
    libraries. We go out to publishers and to nonprofits, and we
    get donations of free new children's books. Our chapters bring
    them to base and National Guard locations, give them directly
    to kids, to the base and community schools and libraries for
    free. Well, on some bases, we can go on base and do that; and
    some bases, we can't. We can do it at Quantico and Little Creek
    and Camp Lejeune, but not at Camp Pendleton. We're not seeking
    any benefit. We're not raising any money. Our membership is
    free, this is just a benefit. But, often we can't provide it.
        Another example is suicide prevention. We know there's a
    big problem; it's been discussed. We know, anecdotally, that
    spouse suicide is a problem; it's not tracked by anyone. But,
    last year four spouses, alone, at Fort Bragg committed suicide.
        We also know from our surveys that families and troops
    prefer to get their information from the popular culture and
    not from government channels. So, taking that experience, we
    went to the entertainment industry, and we asked for their help
    in creating a message that would work. We went to the Sundance
    and to the Oscars, and we filmed celebrities giving messages of
    encouragement and directing servicemembers and families seeking
    help to the DOD and VA Helpline. We worked with DOD and VA
    experts on developing the program and in folding it into their
    helpline. It's not our program. It's using the outside to get
    in.
        But, now we are hearing from some general counsels that
    they can't actually use this Public Service Announcement, which
    we are willing to provide them for free, because there is some
    concern about providing an undue benefit. Well, there's no
    benefit to us, other than the reduction of people committing
    suicide. Again, we're not raising money for it. We raised money
    for it already, and again, I think this is an instance of how
    we're not being able to provide some of the service we need,
    especially in a time of budget restrictions.
        DOD can't do it all, and nor should it. When it comes to
    government budget priorities, my first priority, personally, is
    having my husband properly trained and equipped. Let's use the
    private and the nonprofit sectors intelligently and responsibly
    to help us meet some of our needs, as families. Sometimes
    nongovernmental organizations (NGO) have access or expertise,
    and can act more quickly. If NGO programs prove less effective
    or if needs shift, NGO programs are easier to end than
    government programs.
        I know many people in government are trying. Many of us got
    together, over a year ago, in White Oak, in a conference call
    to Join Forces for Family, including some members of your
    committee staff, and one of the most common complaints we heard
    from nonprofits was about DOD stovepipes, and the inability to
    work with the nonprofit sector caused concern. Doug Wilson and
    Rob Gordon were two of the co-hosts there, and they're at the
    DOD now, trying to enhance cooperation. But, it's a difficult
    thing to do.
        Many of our programs, I know many of NMFA's programs,
    succeed because we leverage the power of public and private
    entities working together. Military families serve and
    sacrifice because we love our servicemembers and we love our
    country, but not because we love the Pentagon. I think it's
    reasonable for us to look outside the Pentagon for some of
    these solutions, and outside of the individual Services. But,
    we need to coordinate with them to make sure that those
    programs are intelligent and effective.
        So, we'd like to ask for your support and leadership in
    helping us to break through some of the stovepipes and
    bureaucracy in DOD and elsewhere in government that prevent
    groups, such as ours and others who testified here today, from
    sharing the responsibility for supporting America's military.
        Thank you for your time.
        [The prepared statement of Ms. Roth-Douquet follows:]
                    Prepared Statement by Blue Star Families
        Thank you, Senator Webb, Senator Graham, and members of the
    subcommittee for inviting us here to speak to you today.
        Blue Star Families is a nonprofit of military families from all
    Services and all ranks, including National Guard and Reserve, as well
    as veterans and civilians who strongly support us, with a mission of
    strengthening military families. We support one another through the
    unique challenges of military service and ask the larger civilian
    population to help connect military families regardless of rank, branch
    of service or physical location, and empower military family members to
    create the best personal and family life possible for themselves.
        We currently have over 50 chapters nationwide and are adding more
    regularly. Our online and social media activity is equally important,
    we have thousands of new members joining on-line weekly. We have had
    1,000 percent growth in our second year. Through outreach and
    involvement with national and local organizations, civilian communities
    and government entities, Blue Star Families works hand in hand to share
    the pride of service, promote healthier families, aid in our military
    readiness, and contribute to our country's strength.
        We appreciate the opportunity to speak to the Senate Armed Services
    Committee Personnel Subcommittee on the topic of benefits. Our annual
    Military Family Lifestyles Survey has consistently shown that pay and
    benefits, the current operational tempo, the effects of deployments on
    children, spouse employment, and children's education are the top
    concerns among military families.
        Some highlights from our survey concerning benefits:

             Health Care is both an area of high concern and high
            satisfaction. Almost 39 percent of respondents said they were
            extremely/very satisfied with the quality of military health
            care. However, 24 percent said they were extremely/very
            dissatisfied. Forty-two percent said they were extremely/very
            satisfied with access to military health care, while 22 percent
            said they were extremely/very dissatisfied with it. While a
            majority of respondents (52 percent) were extremely/very
            satisfied with TRICARE, 18 percent were extremely/very
            dissatisfied.
             That Military Healthcare Access & Quality have
            relatively high extremely/very satisfied ratings yet rank
            second and third as areas in need of improvement (Mental Health
            Services, with 44 percent, was the area chosen as most in need
            of improvement) and have solid dissatisfied percentages
            suggests widely varying quality across regions, services,
            individual installations, etc.
             When asked which services they were most satisfied
            with, the top choice (with 50 percent) was the commissary and
            exchange benefit, TRICARE insurance and Chaplain services tied
            for second (with 40 percent), and Department of Defense
            Education Activity Schools came in third (36 percent). Base
            Housing came in a close fourth (with 35 percent).
             As more and more discussion centers around the post-9/
            11 GI Bill, our membership has continued to voice their support
            for the option of transferability. Yet many Members of
            Congress, including members of this panel, have advocated for
            abolishing transferability, either directly or through the
            `back door' of requiring the Department of Defense (DOD) to pay
            for transferred benefits--a requirement DOD has already stated
            it can't meet. It is unfair to ask those families who have
            sacrificed the most for the current conflicts to give up a key
            benefit that is intended to reward servicemembers for their
            dedication. It also ignores the modern reality that entire
            families are sacrificing their full potential to serve their
            country--and that a transferred benefit is still a benefit to
            the soldier, since the soldier's income is often paying for the
            spouse's or child's education.

        What I would really like to highlight in with you today, however,
    is a bit different it is how we can better help military families--
    provide benefits--outside of DOD or government funding, but with
    government cooperation, through public-private partnerships. The
    government is often the largest barrier to this, and perhaps this is an
    area where you can help.
        Military families do serve, do suffer burdens during this long war.
    But we also believe that government can't solve all ills. Groups like
    ours play a role, but to play it effectively we need to be able to
    engage cooperatively with the DOD.
        Our organization was started to provide the spouse and family
    members on the ground the ability to identify and be part of solving
    the problems they saw in their communities. We listen to our members,
    ourselves, our annual surveys, and we use our position as military
    family members to ask for help. We seek to work with government when
    possible to make our programs better, more effective, and more
    coordinated with government programs. For instance, last year we asked
    museums across the country to make themselves free for military
    families over the summer. Over 900 museums signed on, and 300,000
    troops and family members took part last summer. We couldn't have done
    it without the assistance of Rocco Landesman and the NEA, or the First
    Lady's support. This program cost the government and military families
    nothing, and has been tremendously popular. This year our goal is to
    sign up 1,500 museums and have 500,000 family members take part.
    National Military Family Association's Operation Purple Camps are
    another example of this.
        Sometimes, however, the cooperation has not been smooth, for
    instance, with our Books on Bases program. We know from experience that
    many young military kids have no books at home, maybe because of
    frequent moves or deployment pressures. A RAND survey showed that base
    libraries are under funded. My own at Parris Island seems to have had
    its heyday 40 years ago. But I don't want the DOD to solve that
    problem. I want them doing other things. So we at BSF have gone to book
    publishers and to the nonprofit KIDS and have gotten donations of free
    new children's books that our chapters can bring to give away to their
    kids, and to base and community schools and libraries, over 65,000 to
    date. The only problem is, because of differing expectations and
    requirements for nonprofits to operate on different military
    installations, some installations won't permit it. So, even though our
    chapters include spouses from their installation, even though we are
    not raising money or receiving a benefit, we are only giving away
    books--solving a problem, we can't have an event. We have given away
    books at Quantico, Little Creek, Camp Lejeune, and others, but we can't
    get on Camp Pendleton.
        As another example, recently we got involved with the issue of
    suicide prevention. Our surveys show that many families prefer to get
    their information from popular culture, rather than from official
    channels. We also know from our members that depression and thoughts of
    suicide are a problem not just for troops, but among families
    themselves.'' So working with DOD and the Veterans' Administration (VA)
    experts on the substance, we got the help of the entertainment industry
    and went to Sundance and the Oscars and got celebrities to film PSAs of
    support to help promote the DOD/VA approved help line. This did not
    cost the government anything and we are making it available to anyone
    who wants to use it for free. Many will use it, but we have also heard
    from some that the legal counsel forbids it as something that endorses
    a private program. Well, we have no program, we are just using the
    power of the popular culture to highlight the DOD/VA program. There is
    no competition here--this is the kind of thing we could do a better job
    with.
        This matters because there are tight budgets, and the DOD can't do
    it all. Nor should it. When it comes to government budget priorities,
    my first concern personally is getting my husband properly trained and
    equipped. Let's use the private and the nonprofit sectors intelligently
    and responsibly to help us meet some of these needs. Sometimes the
    nongovernmental players have access or expertise or can act more
    quickly. If nongovernment organization programs prove less effective or
    needs shift, nongovernment organization programs are easier to end than
    a government program.
        I know many people in government are trying. When many of us here
    got together last year, including some of your staff at the Senate
    Armed Services Committee, at White Oak to discuss `joining forces for
    military families' across public and private sectors, we heard over and
    over from nonprofits that DOD stovepipes and inability to work with the
    nonprofit sector caused concern. Doug Wilson was one of the co-hosts of
    that conference, as was Rob Gordon. They are both at the DOD now and
    trying to enhance cooperation, but it's difficult for everyone.
        Most BSF programs succeed because they leverage the power of public
    and private entities working together to support families. Public-
    private partnerships are key to BSFs philosophy. Military families
    serve and sacrifice because we parents, spouses, and children love our
    servicemember, and love our country, not because we love the Pentagon.
    In fact, many families prefer not to interact with `official channels.'
    So it is right and fitting that the responsibility for helping families
    falls not only to the Pentagon or the individual Services, but to the
    larger society as well.
        As one respondent said in our survey, ``The most important issue I
    feel is community support of the servicemembers and their families.
    There are many families, more than most people realize, that need that
    support to know they aren't in this war alone. Many do not seek support
    or help because of lack of availability, pride, or any number of
    reasons. Community groups, businesses, and local governments could work
    together to keep a focus on their local military families and provide
    special programs that might be outside of traditional DOD programs. It
    makes such a big difference to know others, besides just our military
    community, care that our loved ones are deploying over and over again
    and want to be part of what we are going through.''
        We'd like to ask for your support and leadership in helping us
    break through some of the stovepipes and bureaucracy at the DOD and
    elsewhere in government that prevent groups such as ours and the others
    who testify here today from sharing the responsibility of supporting
    America's military families.
        Thank you for your time and for your concern for servicemembers and
    their families.

        Senator Webb. Thank you very much.
        All of your recommendations and your full statements will
    be carefully considered by staff on both sides. We'll have
    discussions about these. We've seen these issues, some of them,
    many times before, but they will all get full consideration.
        Just as a quick comment to something that you just said,
    Ms. Roth-Douquet. We have our challenges when it comes to
    family issues. At the same time, it's amazing to me, over the
    course of my life, how much better things are for families than
    when I was a kid.
        Obviously, the first thing all of us want is for the
    serving member to be properly trained and to fulfill their
    mission and those sorts of things. I mean, when I was growing
    up, in the post-World War II military, where the U.S. military
    had expanded so dramatically during World War II, and held a
    good bit of its size, compared to what it looked like previous
    to World War II, just basic things, like family housing and
    schools, did not exist. We went, one period, for 3\1/2\ years,
    where we couldn't live with my dad. He was either deployed or
    on bases where there was no family housing available.
        One of the great memories of my earlier life was when he
    would drive 380 miles every weekend from Scott Air Force Base,
    IL, up to Saint Joseph, MO, where we were living. No
    interstate. He'd get off Friday afternoon; he'd drive, get in
    Saturday morning; come in and raise hell for 2 days; get in the
    car, drive back on Sunday night.
        I went to one school in Vandenberg Air Force Base, when
    they first opened up Vandenberg. We went from zero people to
    12,000 people in 1 year out there. Our school was an old World
    War II hospital where they put a green chalkboard in the front
    of the class and said, ``Now this is a school.'' So, it wasn't
    bad.
        But, at the same time, when I look at where we are right
    now, sometimes you have to pinch yourself to realize how much
    attention is paid to this, despite the challenges that we have.
    Everybody's eyeballs are on it up here. I think, collectively,
    up here, we're doing everything we can for the people who
    serve, which, by the way, is a little bit different than when I
    came up here on the heels of the Vietnam war, when this place
    was very divided about military service.
        I want to get all of your viewpoints, if I might, on this
    issue of medical care. I know, Colonel Strobridge, it was
    probably your assigned area, if there are varying thoughts on
    this, I really would like to hear them, because I personally
    have been struggling with this notion of modest increases, for
    the time being--but increase in TRICARE fees for certain
    retirees and, Colonel Strobridge, as you pointed out, to be
    indexed to, basically, an unknown entity.
        My immediate reaction, and my continuing reaction, has been
    the notion of a moral contract that this is--there's nothing
    written in it, there's nothing in the Constitution. I accept
    Secretary Gates' observation that there's no written guarantee.
    But, there is a notion of a moral contract.
        At the same time, I found what you said to be pretty
    interesting. It's a fresh approach. I hadn't been thinking
    about that. That's why I want to make sure I'm getting
    everybody's viewpoint here. This notion of providing an index
    that goes to the cost of living, as opposed to this unknown of
    a healthcare index--I mean, we can't solve the healthcare
    problem, in DOD. If you look at the growth in healthcare
    expenditures in the country over the past 15 years, they've
    just been off the charts. It's not a DOD management program.
    It's what's happened in healthcare, writ large. I do not think
    that people who served in the military should have that burden,
    in and of itself.
        So, I really would just like to hear from any of you, or
    all of you, on; what do you believe the notion is, in terms of
    this moral contract? What do you think about this proposed
    increase?
        We can start with Master Chief Barnes.
        Mr. Barnes. Thank you, Senator, and thanks for your
    leadership and stand on this issue. I think you're right on the
    mark with regard to your view of this as a moral contract.
        Our Association's biggest concern is the indexing part of
    the DOD proposal. Consistent with our support of past
    legislation in the Senate, sponsored by Senator Lautenberg, we
    believe that the index should be no more than the index used to
    adjust military retired pay, which is the annual Consumer Price
    Index. We've repeatedly asked for clarification from the
    Department about how they arrived at the 6.2-percent assumption
    for the $7 to $8 billion savings over 5 years by the
    Department. But, that's the area where we have the biggest
    concern, with regard to the DOD proposal.
        Again, thank you for your stand on that. I think you're
    right on the mark, particularly with regard to those that have
    served in the past that are retired from the enlisted forces,
    and many were promised free healthcare for life, and that
    remains a key part of their vision, in looking at proposals
    like this, and the more drastic past proposals that have been
    introduced by the Department between 2006 and 2008.
        Senator Webb. Thank you.
        Mr. Strobridge. Sir, if can expand on my previous comments.
    Everybody agrees, I think, that there's a moral contract. The
    issue is, exactly what does that mean? There are some people
    who say, ``Gee, I was promised free healthcare for life.''
    That's true for people who came in service before December
    1957. But, that was a long time ago. Most people, most of us
    who served, when you're on Active Duty, you have no idea what
    retirees pay. When people say, ``you'll be eligible for
    lifetime healthcare,'' people's reaction is, ``okay, that means
    I'll get what I'm getting today on Active Duty.'' Then when
    they retire, they find out, well, no. If you want to be in
    TRICARE Prime, you'll pay that enrollment fee. When you become
    Medicare-eligible, you will pay Medicare Part B premiums, which
    we've paid for 50 years.
        So, the perspective is, what is the moral contract? To us,
    the moral contract means not that we'll pay whatever civilians
    pay, but that we will recognize where we're starting from,
    number one, and recognize what that means over the years. To
    us, if we have a fee today, of TRICARE Prime, and you retire
    today at age 42 or 52 or whatever, you're going to live another
    30 years or so, plus. Over that time, cost-of-living
    adjustments are going to raise your retired pay, depending on
    what inflation is, by two or three times. We don't think,
    frankly, it's reasonable to expect that you're never going to
    have to pay even $1 more for your healthcare.
        So, to us, the reasonable way to both recognize the moral
    contract and accommodate that reasonable expectation of what
    will happen over your lifetime is that the deal will be that we
    won't raise your fees faster than we raise your compensation.
    Is that better than civilians get? Yes. But, that's because
    civilians don't pay that upfront fee of 20 or 30 years of
    service and sacrifice.
        Senator Webb. Thank you.
        Ms. Moakler?
        Ms. Moakler. I certainly agree with what Joe and Steve have
    said. But, I think it's important--and to address your concern
    about breaking with the contract or raising those fees, those
    retirees who are enrolled in TRICARE Standard are not
    experiencing an increase in fees, because they don't pay an
    enrollment fee. Only those who are enrolled in TRICARE Prime,
    where it's available--and you need to understand that it's not
    available across the entire country--are affected by this
    increase in TRICARE Prime enrollment fees. Those who use
    TRICARE Standard are already being asked to, perhaps, have a
    supplemental insurance; they pay higher cost shares and have a
    cap that they have to look at. So, we're already asking those
    who are just using TRICARE Standard to have a payment, as well.
    It's not as reflected--it's not as easy to track as the TRICARE
    Prime enrollment fee. But, they are already being asked to pay
    extra.
        Our association, when the increases were first introduced,
    4 or 5 years ago, saw the increases as inevitable and something
    that needed to be done in order to keep in line with increasing
    health costs.
        Senator Webb. Thank you.
        Captain Puzon?
        Mr. Puzon. Senator, I believe this moral contract is very
    strong, both ways, from the members and their families. They
    are very distrustful when you start messing around with it and
    mucking it up. Our members were very upset to find out, in the
    past and now recently, that we're going to try to change the
    enrollment fees and leave it alone. They're looking over their
    shoulder, what's next? So, you're actually setting a standard,
    here, of, ``Okay, that sets it, so we're going to do something
    different next time.''
        Especially if you look at the index thing, as my colleagues
    have said; most of their pay, those that are veterans, have
    gone down or not changed at all over the last 2 years, because
    of the situation. But, it remains that they want to do their
    part--they understand the deficit--but they are just not sure
    that, ``Okay, if I do this, then what's next?'' So, our members
    are very upset with us that we even signed on to accept the
    modest fee, although we saw it as a way to make--at least meet,
    halfway, DOD. But, then when you see the indexing, as
    published, they're very upset about that.
        Thank you.
        Senator Webb. Ms. Roth-Douquet?
        Ms. Roth-Douquet. We don't hear about this from our members
    much, and we don't ask about it much. I think, with the Active
    Duty, we're very concerned about resiliency, about tempo, about
    separation, about children. I think it's a sacrifice to serve,
    but it's a privilege also, and we're patriotic. We understand
    the situation our country's in. I think we need to look at the
    budget and how we need to best protect our forces and move--
    move, going forward.
        We don't have a policy position on this issue. But, I do
    want to emphasize that the moral duty goes both ways, to us to
    you, and from you to us. We understand we have a country we
    have to help protect budgetarily as well as security-wise.
        Senator Webb. All right.
        Mr. Strobridge. Mr. Chairman, may I make a comment about
    Captain Puzon's concerns about the future, which we certainly
    share? I think all of us share that.
        I think the real concern is, as we said, there's nothing in
    the current law that sets TRICARE fees. Our concern is, leaving
    it that way leaves us increasingly vulnerable every year as the
    budget concerns rise. So, to us, we see our proposal as kind of
    a prophylactic measure to get these principles in the statute,
    even if it's only as a Sense of Congress, the explicit
    statement that military people pay the bulk of their fees
    through service and sacrifice, and that's the way we're
    recognizing that is to put a limit on the fee increase, that is
    not there now. By doing that, that won't guarantee that nothing
    else will ever be done, but it establishes a principle that we
    can then look to in the future to try to keep our commitment to
    that moral contract.
        Senator Webb. That's an interesting point, and certainly
    one that I think we'll consider. It's sort of a fresh approach
    that we haven't been talking about up here.
        I thank all of you for being with us today, and for your
    insights. As I said, all of your recommendations will be
    examined by our staff. Again, thank you very much for being
    here.
        This hearing is adjourned.
        [Questions for the record with answers supplied follow:]
                   Questions Submitted by Senator John McCain
       developing leaders in the noncommissioned officer and chief petty
                                 officer ranks
        1. Senator McCain. Master Chief West, it's difficult it seems to go
    a month without some media story about abusive and failed leadership.
    Most recently, we heard about a group of chief petty officers on U.S.S.
    Stout who, according to the article, ``created an oppressive, feared,
    and hostile work environment/command climate aboard the ship.'' A chief
    petty officer from U.S.S. George H.W. Bush was sentenced last week to 6
    months in the brig for his cruelty and abuses. You have been working at
    this issue for some time. What do you view as the principal source of
    problems for the Navy, particularly the shipboard Navy, in developing
    strong chief petty officers who will lead by example?
        Master Chief Petty Officer West. I do not believe that Navy has a
    ``principal source of problems'' that hinders development of leaders at
    the senior enlisted level. We have outstanding development programs
    that produce some of the finest leaders in the world. While there have
    been some public failures of leadership within the chief petty officer
    ranks in the past year, these are isolated instances from among a chief
    petty officer community of approximately 30,000 leaders. In context,
    the vast majority of these men and women are performing an incredible
    span of missions in a highly professional manner, and in every
    operating environment imaginable.
        I believe that increased availability of rapid and transparent
    communications may be contributing to an inaccurate perception of
    increased aberrant behavior among leaders. Nonetheless, even a single
    case of misapplied or abusive authority is one too many and Navy
    leadership remains fully committed to upholding the tenets of
    responsibility, authority, and accountability. In fact, survey results
    suggest a slight upward trend over the last 2 years in response to
    questions about supervisors demonstrating Navy Core Values being
    positive role models and demonstrating ethical behavior.
        We have developed a continuum of training that begins during Chief
    Select Training, and continues with annual Chief's Mess Training at the
    unit level. The senior master chiefs in the Navy are currently
    conducting waterfront leadership seminars among chief petty officers in
    fleet concentration areas supplemented by guidance from senior fleet
    commanders, identifying expectations of those serving in positions of
    authority.
        Last year, Navy produced a video on the proper way for senior
    enlisted to conduct Career Development Boards--the primary method for
    chief petty officers to formally engage subordinates, in a coaching and
    mentoring role, to foster professional development. To support the
    pinnacle of unit-level enlisted leadership, Navy has a 2-week Command
    Master Chief/Chief of the Boat course in Newport, RI, which emphasizes
    principle-based leadership through a wide array of seminars, case study
    discussions, self-assessment tools, and engagement with the officers in
    the prospective executive officer and prospective commanding officer
    courses.

        2. Senator McCain. Sergeant Major Chandler, the Army has been under
    great stress due to its rotational demands. General Chiarelli's report
    last July 2010, ``Health Promotion, Risk Reduction, and Suicide
    Prevention in the Army,'' portrayed a personnel picture that was very
    sobering. What's your assessment about the state of the Army and its
    soldiers since taking over as Sergeant Major of the Army?
        Sergeant Major Chandler. My initial assessment is that our overall
    efforts to develop and maintain a healthy Force are effective. However,
    we are concerned by the growth of specific stress indicators within
    particular populations. The Army will continue to provide the best
    care, support and multi-disciplinary services available and we are
    committed to mitigating risk behaviors to enhance soldiers and family
    fitness.

        3. Senator McCain. Sergeant Major Kent and Chief Master Sergeant
    Roy, what do you see as the key to development of noncommissioned
    officers (NCO) who will provide the leadership needed to younger
    troops?
        Sergeant Major Kent. Staff Noncommissioned Officers (SNCOs)
    empowering NCOs to face leadership challenges is crucial to the
    development of our young marines. While formal education and military
    professional military education provide an initial means of exposure to
    leadership skills and techniques, only through situational application
    will these skills be put into practice. Experience is the key. SNCOs
    must coach, teach, and mentor their NCOs during practical exercises to
    foster leadership learning. Perhaps more importantly, SNCOs must stand
    behind their NCOs during this process and allow NCOs to build
    confidence in their own leadership abilities.
        Chief Master Sergeant Roy. The Air Force takes a deliberate
    approach to enlisted force development, which includes career
    progression with increased levels of supervisory, leadership, and
    managerial responsibilities. The foundation of NCO development is our
    institutional competencies, which otherwise stand on the three pillars
    of experience, education and training.
        Diverse personal and professional developmental paths provide our
    airmen opportunities to undertake varying degrees of challenges and
    build problem solving and resiliency skills derived from new knowledge
    and experiences. Professional Military Education (PME) plays a key role
    in the overall development of our NCOs. PME, which begins just prior to
    earning NCO status and continues throughout their careers, is part of
    the enlisted continuum of education. Additionally, off-duty education
    is essential and provides development by enhancing one's intellectual
    capability, capacity and critical thinking skills.
        Finally, we must develop a joint perspective early in their
    careers. NCOs must know and understand the culture, responsibilities,
    and the shared competencies necessary to build early interoperability
    for immediate success in the joint/deployed environment.

          predatory lending prevention and financial affairs training
        4. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy,
    predatory lending was a big problem in the Services 6 or 7 years ago.
    Servicemembers were losing their security clearances as a result of
    financial irresponsibility. How are we doing today in this regard?
        Sergeant Major Chandler. The Army's Central Clearance Facility,
    which has the responsibility to conduct investigations on Army
    personnel in order to grant security clearances, has no method to
    determine and/or verify if an individual is or claims to be a victim of
    predatory lending. However, during the past 3 fiscal years (2008-2010),
    less than 2 percent of clearance revocations or denials were for
    financial considerations.
        The Army, through Garrison Commanders, continues to work with on-
    base banks and credit unions to keep a close eye on financial readiness
    (education, predatory lending, and fees) issues. In addition, they work
    with on-base financial counselors who have direct communication and
    contact with soldiers and family members to address these types of
    concerns. Trade associations and their member banks and credit unions
    on base have also developed specialized lending products to directly
    combat predatory lending.
        Master Chief Petty Officer West. In fiscal year 2010, the
    Department of the Navy Central Adjudication Facility (DON CAF)
    adjudicated 199,378 clearances of which 1 percent were either denied or
    revoked. Financial issues were cited in 77.4 percent of the denials/
    revocations rendered by DON CAF in fiscal year 2010. This is the trend
    over the past 5 years.
        When an individual experiences extensive financial difficulties, an
    adjudicative decision is made primarily based on actions the person has
    taken to formally address and/or mitigate his/her financial situation.
    Should an individual become the victim of predatory lending practices,
    this would be taken into consideration when making an overall
    adjudicative determination. Typically, there are other issues involved,
    and, if enough evidence is presented to favorably mitigate the
    financial concerns as extenuating circumstances that are credibly
    beyond an individual's control, the individual's security clearance is
    not affected.
        It is important to note that an individual always has the
    opportunity to explain to DON CAF, via their command, the circumstances
    surrounding any financial problem or predicament. This explanation,
    along with steps taken by the individual to address the problem, is
    taken into account when adjudicating clearances.
        The primary reasons for clearances being denied or revoked as it
    pertains to financial issues include the inability or unwillingness to
    resolve debts; recurrent pattern of financial instability; history of
    not meeting financial obligations; living beyond one's means; excessive
    indebtedness; high debt-to-income ratio; unexplained affluence;
    compulsive or addictive gambling; financial problems linked to drug
    abuse, alcoholism or gambling problems; and failure to file taxes.
        Sergeant Major Kent. In the past, predatory lending was a problem.
    However, data obtained from installation-level financial counselors
    indicates that of the reported cases only a small number of marines
    have had issues with predatory lenders.
        Chief Master Sergeant Roy. We are doing well. In fiscal year 2010,
    554 security clearance related consultations were reported Air Force-
    wide; thus far in fiscal year 2011, 112 have been held. Although these
    numbers could reflect multiple appointments for the same individual, we
    believe we are making headway with this issue.
        Our Airman and Family Readiness Centers provide financial
    counseling and referral services to airmen who need assistance due to
    anticipated or known security clearance issues related to finances.
    Needs of these airmen vary widely as some are merely anticipating
    problems and want to be pro-active in prevention, while others request
    help only once their clearance is nearing adjudication and/or has been
    suspended. In addition, financial counseling services are also
    publicized to all airmen and family members through briefings,
    Commander's Calls, base websites, pamphlets and flyers.

        5. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, are
    there alternative sources now for short-term loans needed by junior
    personnel, e.g., from on-base credit unions?
        Sergeant Major Chandler. Yes, Army community Services' Financial
    Readiness programs, Army Emergency Relief, Military Banks and Defense
    Credit Unions have established programs and products designed to help
    junior servicemembers and their families resolve their financial
    crises, rebuild their credit ratings, and establish savings.
        Master Chief Petty Officer West. Yes. In 2007, the Navy-Marine
    Corps Relief Society created a $300 Quick Action Loan program to assist
    servicemembers in need and keep them from turning to predatory lenders.
    Some on-base credit unions and banks also now offer small loans that
    were previously not available, to help servicemembers resist using
    payday lenders.
        As a result of leadership focus, the number of sailors using payday
    loans has decreased. The 2011 Financial Health Quick Poll showed that
    only 2 percent of enlisted personnel used a payday loan option compared
    to 8 percent in 2006.
        Sergeant Major Kent. Yes. We worked with the Navy-Marine Corps
    Relief Society to establish a quick assist loan program that offers our
    marines a $300 interest-free loan for emergency basic living expense
    needs. In addition, our base credit unions offer short-term loans.
        Chief Master Sergeant Roy. Yes. The Air Force's primary source for
    safe, short-term, no-interest loans is the Falcon Loan program funded
    by the Air Force Aid Society and administered by an installation's
    Airman and Family Readiness Center.
        In 2008, the Air Force Aid Society (AFAS) created the Falcon Loan
    program in direct response to the alarming predatory lending practices
    for short-term loans. The Falcon Loan is a $500 on-the-spot loan which
    can be made to airmen experiencing financial difficulties. The airman
    has 10 months to repay the loan which is typically done through regular
    allotments from the airman's pay. Loan approval is less stringent than
    other types of AFAS emergency aid, however, a Falcon Loan can be
    received no more than two times in an airman's career. The loan is
    intended to preclude airmen from seeking financial help from other,
    less credible sources. AFAS reported a 20 percent decrease in Falcon
    Loans issued from calendar year 2009 and calendar year 2010. This
    decrease may suggest airmen are improving in their overall financial
    health and ability to manage their personal resources.

        6. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, how
    are the programs aimed at developing financial knowledge working out:
    are they well-received and attended and do you have any recommendations
    on how to improve these programs?
        Sergeant Major Chandler. The Army's Financial Readiness training
    enables soldiers and their families to achieve self-reliance in
    managing their financial responsibilities. The programs aimed at
    developing financial knowledge are well received and attended. In 2010,
    Army Community Service Centers provided financial readiness training to
    more than 60 percent of the junior enlisted population. Program
    improvements may be achieved through seminars conducted for soldiers
    and family members via the Virtual Resiliency Campus (VRC), a virtual
    environment that allows users to interact with each other and
    participate in individual and group activities. Basic Combat Training
    Installations have a program that provided Personal financial
    management in the first three weeks of training.
        Master Chief Petty Officer West. Navy has an effective personal
    financial management education program which appears to be well-
    received by sailors throughout their careers. Core financial management
    training subjects are delivered as mandatory training through a
    continuum of learning during a sailor's career and transition back to
    civilian life. Both officer and enlisted receive personal and
    leadership financial management training.
        Personal Financial Management (PFM) training is provided at:

             Officer and enlisted accession training sites
             Recruit Training Command post-graduation orientation
             General military training
             Career options and Navy skills evaluation program
            (mid-career course)
             Transition assistance program classes
             Local commands by Command financial specialists
             Fleet and Family Support Center (spouses invited)
             Navy Knowledge Online

        Leadership PFM training is provided at officer accession training
    sites and at key milestones in the officer and enlisted career path.
    Leadership training focuses at all levels is to ensure that leaders
    understand the link between prudent personal financial management and
    mission readiness. A sailor's prudent management of his or her personal
    finances is a cornerstone of personal and unit readiness. Navy
    leadership is also currently evaluating the following initiatives:

             Improve family participation in the PFM program
            through partnerships with the Ombudsman, family readiness
            groups, child and youth program, and School Liaison Officers to
            encourage financially fit families.
             Increase PFM programs participation in pre- and post-
            deployment events including increasing promotion of Savings
            Deposit Program for deploying Individual Augmentees (IAs) to
            achieve guaranteed earnings of 10 percent APR.
             Promote resources and services to IA families or
            families of wounded, ill, or injured servicemembers.
             A pilot program to use more junior sailors as Command
            Financial Specialists to develop a stronger peer-to-peer
            component in our program.

        Navy has an effective personal financial management education
    program which appears to be well-received by sailors throughout their
    careers. Core financial management training subjects are delivered as
    mandatory training through a continuum of learning during a sailor's
    career and transition back to civilian life. Both officer and enlisted
    receive personal and leadership financial management training.
        Personal Financial Management (PFM) training is provided at:

             Officer and enlisted accession training sites
             Recruit Training Command post-graduation orientation
             General military training
             Career options and Navy skills evaluation program
            (mid-career course)
             Transition assistance program classes
             Local commands by Command financial specialists
             Fleet and Family Support Center (spouses invited)
             Navy Knowledge Online

        Leadership PFM training is provided at officer accession training
    sites and at key milestones in the officer and enlisted career path.
    Leadership training focuses at all levels is to ensure that leaders
    understand the link between prudent personal financial management and
    mission readiness. A sailor's prudent management of his or her personal
    finances is a cornerstone of personal and unit readiness. Navy
    leadership is also currently evaluating the following initiatives:

             Improve family participation in the PFM program
            through partnerships with the Ombudsman, family readiness
            groups, child and youth program, and School Liaison Officers to
            encourage financially fit families.
             Increase PFM programs participation in pre- and post-
            deployment events including increasing promotion of Savings
            Deposit Program for deploying IAs to achieve guaranteed
            earnings of 10 percent APR.
             Promote resources and services to IA families or
            families of wounded, ill, or injured servicemembers.
             A pilot program to use more junior sailors as Command
            Financial Specialists to develop a stronger peer-to-peer
            component in our program.

        Sergeant Major Kent. Marine Corps Community Services (MCCS)
    provides a variety of classes, workshops, and training on personal
    financial management. We also offer financial links on our Marine Corps
    websites, provide one-on-one counseling, and promote Military Saves
    week to assist Marines and their family members who are having
    financial difficulties. In addition, we offer classes on home-buying,
    home selling, renting, and leasing that address current national and
    local economic conditions.
        We are in the process of creating a new Personal Financial
    Management curriculum to improve the information and services we
    provide our marines and their families. This curriculum will cover over
    20 major topics, such as: managing income/expenses/savings/credit;
    credit and debt management; saving and investing; consumer awareness;
    banking and financial services; taxes/insurance/legal issues related to
    personal finances; raising financially-fit children; the time value of
    money; and financial planning for events such as family separation/
    reunions, transition, retirement, education costs, large purchases, and
    other major life events.
        Since our personal financial management program classes are not
    mandatory, attendance varies, depending on the installation. However,
    we are in the process of creating a quarterly reporting system to track
    attendance for marines and their family members.
        In September 2011, we will conduct our third Financial Health Quick
    Poll (FHQP) to determine the level of financial stress among marines
    and their families as a result of recent economic changes and refine
    our programs in order to help marines and their families cope with
    financial stress.
        Chief Master Sergeant Roy. We believe they are working out very
    well. The Air Force financial education program is designed to make
    airmen aware of their responsibility in maintaining their personal
    financial matters and offer education and training at key points in
    their career. Newly inducted airmen receive mandatory financial
    training at two points: basic training and their first duty station.
        While at Basic Military Training, all trainees receive 3 hours of
    financial awareness training to assist them in making sound financial
    decisions early. This training focuses on the basics of financial
    management including personal responsibility, budgeting, sound spending
    habits, savings, debt strategies, credit reports, financial
    institutions, insurance, investing and consumer awareness, to include
    predatory lending.
        At their first duty station, both officers and enlisted airmen
    receive financial training within 90 days of their arrival. This
    training is mandatory and standardized across the Air Force. The
    purpose of the training is to increase understanding of pay,
    entitlements and allotments and to increase understanding of banking
    for both checking and savings. Personal financial education and
    training is also available throughout a member's career targeted for
    members and families to develop skills in budgeting and saving,
    insurance, credit management, car buying, relocation moves, investment
    tools, available counseling or assistance, and preparing for life after
    the military.

           progress in implementation of don't ask, don't tell repeal
        7. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy,
    training for Repeal Day is currently underway in each of your Services
    that will pave the way for gay and lesbian individuals to serve openly
    in the Armed Forces. What is your assessment of the effectiveness of
    the training for your Service thus far?
        Sergeant Major Chandler. The Army's Chain Teach method has been
    very effective in educating the force on the policy changes that will
    result from implementation of the repeal of Don't Ask, Don't Tell
    (DADT). It puts direct responsibility on commanders/leaders for their
    units' complete education, allowing them to personally engage their
    soldiers, civilians, and interested family members on this important
    policy change and to explain its impact and our expectations of them.
    Feedback to date continues to confirm that Army commanders and senior
    NCOs are fully capable of providing the strong leadership, clear
    instruction and proactive education that are key to successful
    implementation of DADT repeal.
        Master Chief Petty Officer West. Navy continues to assess the
    effectiveness of training. Current efforts focus on the Tier 2 leaders
    who are tasked with delivering Tier 3 training to our sailors and
    include pre and post training assessments. After analyzing assessment
    results, feedback is provided to the Master Mobile Training Teams on
    areas needing additional emphasis. Current feedback on the training
    remains positive. Additionally, Navy's DADT website received over
    100,000 hits to date where sailor questions are addressed. Over the
    past 2 weeks, the number of questions has dropped dramatically possibly
    indicating that member concerns are being adequately addressed. Based
    on these assessment tools, Navy is confident the training has been
    effective.
        Sergeant Major Kent. Feedback from the Force indicates our training
    has been effective. Marines indicate an understanding of the policy
    change and what is expected of them upon repeal. The face-to-face
    training allows marines to engage their leadership and ask those
    questions that are most important to the individual marine. The time
    allotted to prepare and train for the repeal provides the opportunity
    for marines to really consider potential impacts and ensure they are
    aware of the change in policy.
        Chief Master Sergeant Roy. The Air Force is delivering the OSD
    standardized tiered DADT repeal training. As of 6 May, the Air Force
    has trained 49 percent of the total force.
        In order to assess the effectiveness of training, we are soliciting
    subjective feedback from our Major Commands (MAJCOMs) on a bi-monthly
    basis. These reports include feedback in the following areas: policy,
    readiness, effectiveness, unit cohesion, retention, repeal related
    incidents, and barriers to repeal
        To date, the subjective reports from MAJCOMs are positive. MAJCOMs
    are indicating the training is clear, on-target, and effective. The
    standardized slides and script are ensuring a consistent, accurate
    message is provided throughout the force. There has been no significant
    issues regarding policy, effectiveness, unit cohesion, retention,
    repeal related incident, and barriers to repeal. We have addressed only
    minor concerns in readiness with respect to bed down and privacy in
    deployed locations.

        8. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, the
    ground combat forces--soldiers and marines, as well as the Special
    Forces for all Services--registered the greatest concern about the
    effects on readiness and unit cohesion of repealing the DADT policy.
    What problems do you anticipate on ships and in the field when the
    repeal takes effect?
        Sergeant Major Chandler. I do not anticipate significant or
    systematic problems from the repeal of DADT. Feedback from the field
    across all units is that this is not a significant issue to the
    soldiers. We will deal with this issue with the same professionalism
    that has marked our conduct of current operations and has been a
    hallmark of this institution for 236 years. Soldiers are expected to
    treat all others with dignity and respect, consistent with the core
    values that already exist within the Army. Harassment, bullying, or
    victimizing of any kind will not be tolerated.
        The Army is a force of over 1.1 million soldiers, and there will
    likely be inappropriate conduct by a few. Commanders and supervisors at
    all levels have the authority and responsibility to maintain good
    order, discipline and morale within their units; they should use
    existing tools (to include counseling, non-judicial punishment and
    court-martial) to deal with misconduct. Leaders will be educated on how
    to handle certain situations, and support will be provided as needed to
    ensure decisions are lawful, impartial, and promote unit cohesion.
        The Army Guiding Principles for Implementation of the Repeal of
    DADT include: standards of conduct apply to every soldier; treat each
    other with dignity and respect; emphasize our role as professional
    soldiers; and good order and discipline will be maintained at all
    times. The clear message is that respecting each other's rights is
    critical to maintaining good order and discipline. Standards of conduct
    apply equally to all soldiers and inappropriate conduct should be
    corrected appropriately.
        Master Chief Petty Officer West. Navy has seen no adverse effects
    associated with repeal training to date, and there are no significant
    problems anticipated on ships or in the field.
        Sergeant Major Kent. We do not anticipate any post-repeal problems
    that engaged leadership will not be able to successfully address. I
    expect that your marines will faithfully abide by the laws of this
    Nation and conduct themselves in accordance with their core values of
    honor, courage, and commitment. Any issues that may arise post-repeal
    will be immediately addressed upon identification.
        Chief Master Sergeant Roy. Although we cannot completely predict
    the future, we do not anticipate any major concerns or issues. To date,
    we have received only minor issues/concerns regarding bed down and
    privacy in deployed locations. However, the tiered DADT training
    clearly addresses these concerns and we anticipate that as more and
    more folks are trained, there will be fewer concerns and questions
    regarding these issues. Commanders and senior enlisted leaders continue
    to be key players in addressing these concerns and integral to ensuring
    a successful implementation.

        9. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, what
    are you hearing from your senior NCOs and Chief Petty Officers?
        Sergeant Major Chandler. Feedback to date continues to confirm
    confidence that Army commanders and senior NCOs are fully capable of
    providing strong leadership, a clear message and proactive education,
    which are key to successful implementation of DADT repeal. The Army's
    program encourages thoughtful, constructive dialogue on the subject
    between leaders and soldiers. Currently, there are no visible impacts
    on unit readiness, cohesion, or effectiveness. The most frequently
    raised questions concern whether and how implementation of DADT repeal
    might affect Army policy concerning public displays of affection,
    sharing of billeting and showering/bathing facilities, and off-duty
    clothing policies.
        Master Chief Petty Officer West. I have received extremely positive
    feedback from Navy senior enlisted sailors on the progress of our DADT
    training and implementation. The training has produced effective two-
    way dialogue at every level, and provided confidence among the force
    that leadership is taking the correct, methodical approach to
    implementing this change. Senior enlisted sailors recognize they will
    play an important role in the successful execution, and take that
    responsibility very seriously. As with all our training, DADT training
    is designed to make us a more proficient and cohesive fighting force;
    one that recognizes and respects the dedication and sacrifice of all
    men and women who serve our Nation. I'm confident we will continue to
    see the same proactive, informed engagement throughout the
    implementation process.
        Sergeant Major Kent. We are progressing well towards our program
    training goals.
        Chief Master Sergeant Roy. The overall feedback from the field is
    the training has been very well received. Our airmen indicate the
    standardized slides and script are ensuring a consistent, accurate
    message is provided throughout the force. There has been no significant
    issues regarding policy, effectiveness, unit cohesion, retention,
    repeal related incident, and barriers to repeal. We have addressed only
    minor concerns regarding bed down and privacy.

                              integration of women
        10. Senator McCain. Sergeant Major Chandler, opportunities for
    women in the Armed Forces have increased significantly during your
    Active Duty service. Some have called for elimination of all
    constraints by gender, including service in infantry and Special Forces
    units. Do you think the current Army restrictions on service by women
    in deployed Army units should be changed?
        Sergeant Major Chandler. We are conducting a review of our current
    assignment policies and regulations to ensure they are relevant and
    meet the needs of the Army. We also want to ensure all soldiers,
    regardless of gender, are provided opportunities to reach their highest
    potential. Once the review is complete, we will be briefed on the
    proposed changes and I will be in a better position to provide an
    informed opinion.

        11. Senator McCain. Master Chief West, you are a veteran
    submariner. Do you support service by women in ballistic missile
    submarines?
        Master Chief Petty Officer West. Yes, I enthusiastically support
    the integration of women on board our ballistic missile submarines.
    There are extremely capable women who have the motivation, talent and
    desire to succeed in the Submarine Force. Those were the same
    attributes I expected of the submariners when I was a Chief of the
    Boat, and the same ones that will dictate our success in the future--
    regardless of which gender the sailors happen to be. Drawing from a
    broader pool of talent increases our ability to maintain the world's
    best Submarine Force, just as it has done in other warfare communities.

        12. Senator McCain. Master Chief West, what about service by women
    in the smaller attack boats?
        Master Chief Petty Officer West. As we have done with ballistic
    missile submarines, we will need to study all the factors to understand
    the best approach for our readiness and quality of service for the crew
    on our fast attack submarines. There's no question that the
    professional expertise and motivation of women across the Fleet would
    make them a valuable asset to any type of platform as long as we take
    the necessary steps to prepare them for long-term success, and
    implement the change with due diligence.

        13. Senator McCain. Sergeant Major Kent, do you think women marines
    have been denied opportunities or promotions in the Marine Corps
    because of constraints on assignments?
        Sergeant Major Kent. Analysis of the past 3 fiscal years promotion
    statistics for in-zone officers to the grades of O4 through O6, and all
    SNCO boards, indicate that, on average, female marines were selected at
    a rate equal to or greater than their male counterparts. The Marine
    Corps' overarching selection criteria is ``best and fully qualified''
    and expectations of future potential at the next higher grade.
    Additionally, Marine Corps promotion selection boards use a ``bloom
    where planted'' philosophy that focuses on performance of duty in a
    billet rather than the assignment itself. Specific guidance, in the
    form of a precept, from the Secretary of the Navy for officer boards
    and the Commandant of the Marine Corps for Staff Noncommissioned
    Officer boards, is provided to each promotion board. Precepts
    specifically address career patterns, utilization policies, and equal
    opportunity. These precepts direct board members to ensure the
    performance of duty of those affected by assignment or utilization
    policies is given the same weight as that given to duty equally
    performed by officers (marines) who were not affected by such policies
    or practices. Additionally, female marines continue to do great things
    both in combat and in garrison. After speaking with numerous female
    marines, and hearing how they do not think it is a good idea for
    females to serve in combat elements, I agree with them and do not
    concur with assigning female marines to combat elements.

        14. Senator McCain. Chief Master Sergeant Roy, what are your views
    about opening up additional career fields for female airmen?
        Chief Master Sergeant Roy. 97 percent of Air Force Specialty Codes
    (AFSCs) are open to women. The few remaining AFSCs closed are due to
    the Secretary of Defense 13 Jan 1994 memorandum defining direct ground
    combat. Due to this Secretary of Defense policy, a select few AFSCs are
    closed and/or restricted.
        The Secretary of Defense 13 Jan 94 memo states, ``women shall be
    excluded from assignment to units below the brigade level whose primary
    mission is to engage in direct combat on the ground, as defined below.
    Direct ground combat is engaging an enemy on the ground with individual
    or crew served weapons, while being exposed to hostile fire and to a
    high probability of direct physical contact with the hostile forces'
    personnel. Direct ground combat takes place well forward on the
    battlefield while locating and closing with the enemy to defeat them by
    fire, maneuver, or shock effect. These policies and regulations may
    include the following restrictions on the assignment of women where
    units are engaged in long range reconnaissance operations and Special
    Operations Forces missions.''
        Currently, OSD has the Women in the Service Review Working Group
    examining this issue in accordance with the NDAA for Fiscal Year 2011,
    section 535, requiring the Secretary of Defense to have military
    Services review their policies and regulations restricting the
    utilization of female servicemembers.
        OSD's final report is due to Congress NLT October 2011.

                      prioritizing quality of life dollars
        15. Senator McCain. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, every
    year Congress authorizes modernization and construction of new
    facilities intended to improve the quality of military life for members
    and their families. Clearly, the improvements in quality of life for
    servicemembers and their families are a factor in the historically high
    retention being seen. What do you consider to be the highest priorities
    for modernization and construction of new facilities--barracks, child
    care centers, family housing, medical clinics, or schools?
        Sergeant Major Chandler. The Army places high priority on
    facilities that support soldiers and families. Accordingly, we fund
    barracks, child care centers, family housing, and medical facilities
    required to support Army missions identified in its five pillars: Grow
    the Army (GTA)/Global Defense Posture and Realignment (GDPR);
    Transformation; Modernization; Training Support; and Strategic
    Readiness. As for schools, which are primarily a State and local
    responsibility, we have relied on local education agencies (LEAs) to
    fund school maintenance and construction. However, the Under Secretary
    of Defense for Personnel and Readiness recognized there are facility
    and capacity deficiencies in many public schools, and surveyed all
    public schools on military installations across the United States in an
    effort to quantify the deficiencies and assist LEAs.
        Master Chief Petty Officer West. The highest priority for
    modernization and construction of new facilities to increase the
    quality of life for members and their families is to invest in
    unaccompanied housing and government owned family housing overseas.
    This includes our Homeport Ashore program to provide single junior
    sailors stationed on ships with quality housing when they are in port.
        Our sailors continue to serve the Nation in front-line operations
    and deserve suitable accommodations when returning ashore all across
    the country. Likewise, investment in family housing, primarily,
    provides suitable, affordable and safe homes for families stationed in
    foreign and overseas locations.
        Sergeant Major Kent. Thanks to the strong support we have received
    from Congress, we have made significant strides in providing more and
    better quality barracks, child development centers, and family housing.
        Since fiscal year 2008, over $2.6 billion has been invested in
    barracks, providing nearly 25,000 barracks spaces. In that same time
    frame, over $154 million has been spent on 3,100 child care spaces.
    Finally, through our private/public ventures, over 24,000 homes have
    been privatized and are providing the highest quality housing that
    Marine families have ever enjoyed. Combined, these three elements have
    significantly improved the quality of life for both married and single
    Marines.
        We are working with the DOD Educational Authority and Tri-Service
    Management Activity (TMA) to provide new and modernized schools and
    hospitals/clinics. A new hospital at Camp Pendleton and a modernized
    and expanded hospital at Camp Lejeune have been funded in recent years.
    Likewise, school improvements at Camp Lejeune and the construction of a
    consolidated elementary school at Marine Corps Base, Quantico, are
    currently in process.
        Chief Master Sergeant Roy. All quality of life-type facilities that
    support our airmen and their families are high priorities for the Air
    Force. But as we live in a fund-constrained environment, we have had to
    prioritize and focus our efforts. One Quality of Life emphasis is
    dormitories . . . getting our youngest airmen into the best housing we
    can. In fiscal year 2011, for example, we requested $213 million in
    dormitories, and in fiscal year 2012 we're requesting $484 million
    (which includes $193 million for our joint-base other Service
    partners). This represents a significantly large proportion of our $1.4
    billion fiscal year 2012 President's budget request. Family housing
    improvement is another significant Quality of Life effort. The fiscal
    year 2012 budget includes $405 million in family housing operations and
    maintenance and $85 million in overseas housing military construction.
    By early 2012, 100 percent of the continental U.S. (CONUS) housing
    inventory will be privatized, representing another significant
    milestone in improving the quality of life for our airmen and their
    families.

                            operation joining forces
        16. Senator McCain. Mr. Strobridge, Mr. Barnes, Ms. Moakler, Mr.
    Puzon, and Ms. Roth-Douquet, the White House recently announced a
    national initiative that focuses on the employment, education, and
    wellness of military personnel and their families. First lady Michelle
    Obama and Second Lady Jill Biden announced the Joining Forces
    initiative, which pulls together a variety of U.S. Government agencies,
    businesses, nonprofit groups, and media organizations in an effort to
    improve the lives of military families. General Stanley McChrystal will
    lead the effort. What role do you anticipate for The Military Coalition
    in this effort and what priority areas do you think General McChrystal
    should focus his attention?
        Mr. Strobridge. The Military Officers Association of America (MOAA)
    (and we believe other members of The Military Coalition) hopes to be an
    active partner in the Joining Forces initiative to assist in General
    McChrystal's efforts to rally U.S. Government agencies and non-
    governmental agencies to work collectively to improve the lives of
    military families.
        MOAA believes that General McChrystal should consider several
    recommendations from the recent Department of Defense (DOD) and U.S.
    Department of Agriculture Family Resilience Conference Senior Enlisted
    Advisors (SEA) townhall. When asked what they see as the top three
    military family resilience issues, the SEA responses covered the gamut
    of challenges that military families have and continue to face, such as
    post-traumatic stress disorder (PTSD), quality childcare availability,
    quality education for military children, military spouse career
    options, access to care and quality care under TRICARE, exceptional
    family member advocacy and support, and clear and concise communication
    to access services that are currently available.
        MOAA believes it will be important for the Joining Forces
    Initiative to work with each of the Services and the DOD Military
    Family Readiness Council to identify critical gaps in service. In
    working with nongovernmental organizations, agencies, and communities,
    it will be important to identify where those organizations, agencies,
    and communities can assist in filling the gaps, while educating them
    about the service and sacrifice of the All-Volunteer Force and the
    families supporting the force.
        The First Lady's tagline about Joining Forces is that everyone can
    do something. MOAA believes many nongovernmental organizations,
    agencies, and communities are willing and ready to step up to offer
    support to military families. Creating and sustaining partnerships
    between DOD and these organizations, agencies, and communities will
    benefit the military family community, and is a fiscally responsible
    approach to service and support.
        Mr. Barnes. The Military Coalition (TMC) believes Operation Joining
    Forces (OJF) is an important initiative to expand awareness and support
    of military families and complement the work of individual member
    organizations in providing support and assistance to these families.
    Each TMC organization communicates regularly with its members and can
    help increase support for OJF via these channels--in some cases as an
    adjunct or extension of other initiatives such as Employer Support of
    the Guard and Reserve (ESGR). FRA participated in the May 18, 2011
    teleconference on OJF which focused on support from religious and
    community organizations. In addition, I believe Gen. McCrystal should
    recognize that many organizations are working toward the same goal(s)
    as OJF and focus on establishing contact with TMC organizations and
    provide information and periodic updates on OJF for dissemination to
    these groups.
        Ms. Moakler. As a member of The Military Coalition, which is
    composed of primarily membership organizations with local roots, we
    understand the importance of community support for military families.
    The individual organizations of the TMC are already helping to educate
    community leaders and organizations about military families through the
    work of their chapters, through articles in their national publications
    and through their websites. The National Military Family Association
    has recently published ``Finding Common Ground: A Toolkit for
    Communities Supporting Military Families'' that dovetails nicely with
    the Joining Forces initiative, offering simple, easy to put into
    practice ways that different community groups can support military
    families. It can be found at http://www.militaryfamily.org/
    publications/community-toolkit/. The site will also show how
    communities are supporting military families by highlighting best
    practices as they surface to us.
        The three areas highlighted by the Joining Forces initiative are
    all important, however, the wellness of military families should be
    paramount. Our Association has long promoted well-being as a foundation
    for resilience. We stress how access to behavioral health care is
    essential to aid military families in coping with the many challenges
    they face with deployments. It is easy to tie the other two priority
    areas of employment and education into resilience as well. Whether it
    is a Reserve component servicemember who is hoping that his/her job is
    there when returning from deployment or a military spouse who is trying
    to create a portable and fulfilling career, the civilian community
    needs to be aware of the exceptional employee that is available to
    them. The support of the entire education community of teachers,
    counselors and administrators for our military children is essential--
    the community just needs the tools and resources to help them help our
    military children deal with the challenges they face.
        Mr. Puzon. The Military Coalition--could and will play a supportive
    role through:

        (1)  Getting the word out to all our members through our
    newsletters, magazines, and electronic means.
        (2)  We have a reach to Veterans and serving military members and
    their families--especially in the Reserve community.

        To improve the lives of military families the priority effort needs
    to be:

        (1)  Parity in pay
        (2)  In family programs that actually do reach the mass of military
    families; 1.3 million active duty, and 1.2 million Guard and Reserve
    members that are currently serving--not to mention the veterans of wars
    that have needs with their families. Needs to be a partnership with
    NGOs, VSOs, MSOs, and media to reach people in remote areas.

        Ms. Roth-Douquet. Our 2010 Military Family Lifestyle Survey, which
    has been quoted in the Presidential Directive, Strengthening our
    Military Families, indicated that the top five areas of concern for
    military families are pay/benefits, OPTEMPO, Spouse Employment and
    Children--both with regard to their ability to get a quality education
    and the effects of deployment. The Joining Forces Initiative largely
    aligns with these areas of concern through the emphasis on wellness,
    education, and employment.
        Based on feedback heard at the recent DOD ``Forging Partnerships''
    conference, we believe priority should be placed on designating
    personnel who would have a robust boundary-spanning role into the
    community at each post. Many service groups that have existing programs
    that could benefit the lives of military families are having issues
    getting beyond the bureaucracies that are different at each
    installation. Consistent policies coupled with dedicated personnel who
    can maintain and grow programmatic community ties may be a good start
    to opening up new channels of cooperation.

                          disability evaluation system
        17. Senator McCain. Mr. Strobridge, Mr. Barnes, Ms. Moakler, Mr.
    Puzon, and Ms. Roth-Douquet, after almost 10 years of war, the number
    of individuals who are not deployable and who most likely will be
    evaluated for disabilities and discharge are very high and growing.
    While improvements have been made in the system, there simply are not
    enough medical officers, processors, and Department of Veterans Affairs
    (VA) personnel to meet the demand for evaluative services. From the
    perspective of the Coalition, what are the most serious shortfalls in
    the Disability Evaluation System that need to be addressed by the
    Services, DOD, and Congress?
        Mr. Strobridge. In a recent interview, the Under Secretary of
    Defense for Personnel and Readiness, Dr. Clifford Stanley, stated that
    he and the Army's Surgeon General are in agreement that the Integrated
    Disability Evaluation System (IDES) ``remains complex and
    adversarial.''
        The new IDES was intended to streamline the disability process
    making it more understandable and consistent by providing a single
    physical exam used by both DOD and the VA to produce the disability
    rating.
        In one regard, eliminating the Service-unique rating tables and
    requiring the two Departments to use the VA Schedule for Rating
    Disabilities has created a much more consistent rating platform.
        However, the reality remains that DOD and the VA still render
    separate ratings: VA rates all service-connected disabilities/medical
    conditions while DOD rates only those conditions that are considered
    ``unfitting.''
        This practice perpetuates two separate and distinct ratings by DOD
    and VA, with the DOD rating being typically lower. MOAA believes this
    dual-rating process counters Congressional intent for the IDES.
        Another practice that remains unchanged from the legacy DES
    continues to allow the Services to subjectively eliminate service-
    connected medical conditions from consideration in the Physical
    Evaluation Board (PEB) process, thus creating even greater rating
    inconsistencies in different Services' ratings awards for
    servicemembers having the same medical conditions.
        Even when DOD provides clear guidance to the Services to eliminate
    rating inconsistencies, the Department often does not exercise
    sufficient oversight to ensure the guidance is, in fact, consistently
    applied by each Service. Unfortunately, the Services seem to interpret
    the lack of active oversight as tacit acceptance of their different
    interpretations.
        All of these practices lead to confusion and distrust by the
    wounded, ill, and injured servicemembers going through the IDES (as
    well as the legacy DES)--probably the IDES's most serious shortfall.
        Addressing this shortfall is imperative. Servicemembers cannot
    understand why their medical conditions that are aggravated or incurred
    during their service are rated by the VA as ``service-connected'' are
    subsequently dismissed by the Service's Physical Evaluation Board (PEB)
    and not included in their final rating disposition. They--and we--also
    cannot understand how different Services are allowed to apply different
    rules and award different disability ratings to servicemembers who have
    the same medical condition.
        Providing a single disability rating for servicemembers found unfit
    for duty that includes all service-connected disabilities/medical
    conditions--used by both DOD and VA--would eliminate confusion and
    provide much more consistent ratings between the parent-Services.
        Another significant shortfall is the system's gap when it comes to
    National Guard and Reserve members. We have received several reports
    that identify problems for Guard and Reserve members who were called to
    active duty and subsequently demobilized, and then had a medical
    condition that manifests or worsens after demobilization.
        In many cases, the Guard and Reserve and their parent Services have
    failed to provide their Guardsmen and reservists due process by
    affording them the opportunity to have their disabling conditions
    reviewed by a Medical Evaluation Board and subsequent PEB.
        Too often, the disconnect begins while the Guard and Reserve member
    is still on active duty and told to have any medical ``problems'' taken
    care of by the VA and discouraging them from applying for disability
    before separating.
        Call it a failure of leadership or a shortfall of the Disability
    Evaluation System, but either way this is a significant problem that
    needs to be addressed.
        Mr. Barnes. The most serious shortfalls in the disability
    evaluation system are:

        (1)  Despite significant additional resources and manpower
    authorized and funded in recent years, the backlog of disability claims
    continues to increase. The solution not only requires adequate staffing
    and resources, it also involves more automation of a streamlined
    disability rating system to address this challenge.
        (2)  There is a continuing need to improve collaborative efforts
    between DOD and VA, including strengthening the Senior Oversight
    Committee (SOC) efforts. Despite some progress toward the goal of a
    truly ``seamless transition'' process for transitioning personnel
    instituted since the 2007 Walter Reed Army Medical Center revelations,
    significant challenges remain. There is strong bi-partisan support to
    reform the system and Members of Congress have made clear that they
    want to eliminate delays and improve the antiquated paper claims
    process to eliminate bureaucratic disputes and ensure more uniformity
    between branches of the military and the VA in how they rate
    disabilities.

        The Integrated Disability Evaluation System (IDES) is a major part
    of the claims process and the recently streamlined process which
    initially involved a pilot program in a limited number of sites has
    been established as a standardized program. The IDES requires only one
    physical exam and only one rating, is currently deployed at 73 sites
    and is scheduled to be fully deployed in September 2011. Along with
    Deputy Secretary of Defense William J. Lynn III, Deputy VA Secretary W.
    Scott Gould reported on IDES, SOC and other issues during a May 18,
    2011 Senate Veterans Affairs Committee hearing and noted that the pilot
    program was extended to more sites and officially ended in March 2010
    and was then renamed as IDES. Over 5,800 servicemembers have completely
    transitioned from referral, to IDES to veteran status, and as of April
    30, 2011 there were 13,762 active cases in the IDES process. Prior to
    IDES, it took an average of 540 days for the VA and DOD processes to be
    completed and the goal under IDES is to complete the process within 295
    days, while simultaneously shortening the period until delivery of VA
    disability benefits after separation from approximately 166 days to 30
    days.
        Despite this progress, problems remain including certifying each
    site's operational capabilities and other issues detailed in the
    December 2010 GAO Report citing staffing shortages, and inadequate IT
    solutions. There has been a noticeable improvement over the previous
    processes since only one physical exam is required and there is only
    one rating. The IDES also continues to allow the claimant to receive
    pay and other benefits and has reduced processing time. That said,
    continuing Congressional oversight is essential to this program along
    with improved coordination between DOD and VA bureaucracies.
        There is also strong TMC support for the administration's efforts
    to create a joint Virtual Lifetime Electronic Record (VLER). A VLER for
    every servicemember would be a major step toward the goal of a truly
    seamless transition from military to veteran status for all
    servicemembers and would permit a DOD, VA, or private health care
    provider immediate access to a veteran's health data. There is some
    sharing now between DOD and VA, but information in the private sector
    is invisible to VA. The VLER strategy would utilize secure messaging
    standards, similar to that which is used for email, to securely relay
    information between sources.
        Ms. Moakler. The caring of our wounded warriors is an integral part
    of the cost of war. We can no longer make them languish for months as a
    disability claim works its way through the process. This problem is
    especially acute for members of the Reserve component who are often
    separated from their families during the process. While we know that
    several measures have been adopted to speed the process including the
    hiring of extra claims adjusters and the implementation of the
    Integrated Disability Evaluation System (IDES), claims backlogs still
    exist.
        As an Association focused on military families, we are not experts
    in the Disability Evaluation System. We join with other members of the
    Military Coalition in supporting efforts to create a Joint VLER for
    every servicemember. We also agree on the need for using the most
    modern technology, combined with adequate resources and staffing. While
    there have been great strides, the VA and DOD still need to improve
    cooperation between the departments, working with Congressional
    oversight.
        Mr. Puzon. There is disparity between DOD and VA on disability
    evaluation--that can be solved through serious legislation that
    mandates it to be the same. There seems to be no coordination between
    DOD and VA. There is no coordination on disability evaluation of
    Reserve components! This does need to be addressed now. The problems
    are not necessarily the need for more hires--but, the policy of Reserve
    components vs Active Duty--case in point: Fort Lewis--fiasco on
    approach to returning Guard and Reserve. This also is the case in some
    Navy approach to Navy Reserve members returning. There needs to be
    standardization between DOD, VA, and the Services especially for the
    Reserve components.
        Ms. Roth-Douquet. We haven't specifically polled our membership on
    this issue. Anecdotally, some of the things we hear are that female
    veterans are concerned about their healthcare at veterans facilities.
    In fact, a Veterans Administration Office of Inspector General report
    recently issued found that female military members returning from Iraq
    and Afghanistan are more likely to be diagnosed with mental-health
    conditions than their male counterparts. The report also found that
    women are much more likely to suffer from major depression and to have
    a harder time transitioning back to civilian life after combat service
    than men. Finally, the report found that payment for PTSD claims is
    denied at a higher rate for women than for men, and denies a higher
    rate of male veterans' claims for mental health conditions other than
    PTSD. Blue Star Families was involved in creating awareness about women
    veteran issues in meetings with Senator Mark Warner and were glad to
    see an official study undertaken. Now is the time to follow through on
    these findings to make sure our female veterans are getting the best
    care we can provide them with.

                   education of school aged military children
        18. Senator McCain. Mr. Strobridge, Mr. Barnes, Ms. Moakler, Mr.
    Puzon, and Ms. Roth-Douquet, last year, we received testimony from DOD
    witnesses that more than half of the 300 local educational agencies
    serving military children were not meeting academic standards in
    reading/language, arts, and/or math. Are you aware that a DOD grant
    program, which provided grants to improve learning opportunities for
    military kids at 284 local schools, was cut in the DOD efficiencies
    initiatives?
        Mr. Strobridge. The MOAA is not aware that either of the DOD grant
    programs was cut in the DOD efficiencies initiatives.
        Mr. Barnes. I was not aware that the $58 million DOD grant program
    was reduced as part of the department's efficiencies initiatives
    affecting 284 schools beginning in fiscal year 2012. In addition, I
    learned that other TMC organization were likewise unaware of the
    reductions.
        I strongly agree that providing access to quality education for
    military children is very important to the All-Volunteer Force and is a
    key aspect of issues and programs associated with family readiness and
    support. As noted in TMC's 2010 statement to both the HASC and SASC,
    quality education is a top priority to military families and questions
    about the caliber of schools in new duty stations are among the first
    asked upon receipt of PCS orders. In a recent FRA survey of legislative
    priorities (early 2011), quality of schools for dependent children was
    ranked as ``very important'' by 58 percent of active duty respondents
    and came in sixth out of 13 priorities. And related to this issue is
    the importance of adequately funding of the Impact Aid program via the
    Department of Education along with supplemental funding for the program
    via the annual NDAA and Defense Appropriations legislation.
        The best ways to enhance options to ensure that all military
    dependent children receive high quality educations regardless of the
    locale are to:

        (1)  Support expansion of the number of States (currently 39 with
    the latest being Vermont) participating in the Military Interstate
    Children's Compact Commission to help provide for the consistent
    treatment of military children transferring between school districts
    and States in conjunction with frequent moves associated with permanent
    change-of-duty station (PCS) moves.
        (2)  Ensure adequate support for schools educating military
    children via supplemental Impact Aid funding addressed in the annual
    defense authorization and appropriations bills.
        (3)  Sustain support for DOD schools via the Department of Defense
    Education Activity (DODEA) which currently provides education to 84,000
    military and civilian children in 194 schools.

        Ms. Moakler. Our Association was unaware that DOD grant program was
    cut in the DOD efficiencies initiative. We were advocates of the grant
    program which allowed DODEA to award $58 million to 44 school districts
    serving approximately 77,000 military-connected students in over 284
    schools in fiscal year 2009. We are pleased to learn that there will be
    no impact to the 3 year grants awarded to date since the efficiencies
    do not take effect until fiscal year 2012 but are disappointed that the
    program has been cut.
        Mr. Puzon. I was not aware that the DOD grant program was cut in
    efficiencies initiatives. First--the DOD efficiencies that are
    identified are some times just `paper money' cuts--and, never really
    achieve efficiencies as recently reported in press reports. The Senator
    Grassley report shows that DOD can not `police' itself--and achieve
    efficiencies. Therefore cutting people programs--across the board--is
    the only way DOD can realistically say it is cutting. Cutting
    inefficient programs is a good thing. However, as our educational
    system seems to decline--yearly, it seems counter productive to cut any
    educational program that assist our youth.
        Ms. Roth-Douquet. We were not aware of this grant program.

        19. Senator McCain. Mr. Strobridge, Mr. Barnes, Ms. Moakler, Mr.
    Puzon, and Ms. Roth-Douquet, do you agree that providing access to a
    quality education for our kids is a readiness requirement for the All-
    Volunteer Force?
        Mr. Strobridge. The MOAA wholeheartedly believes that providing
    access to a quality education for military dependents is a key
    readiness requirement for the All-Volunteer Force. According to the
    Department of Defense State Liaison Office, military dependents attend
    6-9 different schools over the course of a parent's military career.
    Given increased operational tempo and deployments, military children
    are often facing additional stressors associated with the absence of
    one or, in some cases, both parents throughout the school year.
        MOAA is pleased that 36 States have signed on to the Interstate
    Compact on Educational Opportunity for Military Children. We have
    found, however, that due to budget restraints in many States, military
    families, who are changing duty stations, are experiencing a lack of
    quality education and educational services due to inconsistent
    standards and budget shortfalls State by State. The reality remains
    that there are States which do not have the financial means to provide
    comparable course placement and educational services. The amount of
    Impact Aid received by schools with high concentrations of military
    children has become a critical source of funding, and we are concerned
    that delaying Impact Aid payments and/or lowering Impact Aid amounts
    will have a very adverse impact for many military children in public
    school settings. Additionally, in some instances, we are aware that
    military families have made the difficult decision to intentionally
    separate the family from the servicemember's place of duty to allow
    their children to remain in a quality educational environment rather
    than have the family accompany the servicemember to a new duty station.
    MOAA believes that is not a choice that any military family should have
    to make.
        Mr. Barnes. See answer to question #18.
        Ms. Moakler. Our Association has long held the belief that
    providing access to a quality education for our military children is a
    critical readiness issue. As we have stated in testimony, our 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 servicemember 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 family's decision to remain in the
    Service.
        In addition to providing a quality education for our children,
    schools are an integral component of family readiness. Since they are
    the one constant in a military family's life, they often serve as a
    safety net for families who may need assistance. This support has been
    critical for our military families who have endured tremendous stress,
    multiple deployments, and extended separations during these past 10
    years of war.
        Mr. Puzon. I agree providing quality education is a National
    Security issue and is a readiness requirement--however, I do not agree
    that it is going to happen solely through our public education as it is
    today. I support charter schools and voucher systems--nationally, since
    the public education system has declined rapidly in the last 20 years.
    If we agree it is a National Security issue and readiness issue--then,
    we need to do something different than we have done in the last 30
    years. It is not keep assisting the public schools to fail.
        Ms. Roth-Douquet. We absolutely do. Our 2010 Military Family
    Lifestyle Survey showed military child education to be one of the top
    five areas of concern for our military families. Twenty-six percent of
    respondents listed children's education as one of their top three
    concerns Between frequent moves and servicemember time away from home,
    many parents worry about their children getting a good education. A
    full 34 percent were ``least or not confident'' that their children's
    school is responsive to the unique military family life.
        Based on the survey, most spouses are confident that they can make
    decisions regarding their child's future, education and extracurricular
    school activities during the absence of a military parent, yet still 71
    percent indicated that they would like more support for their children
    during a deployment.
        Additionally, there was a high saturation of references to
    transitions and school related topics. For example, for the questions
    relating to military children, including open ended questions,
    ``school'' was mentioned 1,008 times and transitions or moving was
    mentioned 1,458 times. Academics, grades, extra-curricular, classes,
    teachers, and education were all prevalent concerns.
        These concerns are well founded. On average, a military student
    transfers to different school divisions more than twice during high
    school. Most military children attend schools in six to nine different
    school divisions from kindergarten to 12th grade. A need for
    standardization across the States was a common theme in open-ended
    questions. Many parents expressed sadness, concern and anger that their
    military children could be penalized or delayed in achieving their
    educational goals because of inflexible and conflicting curricula from
    State to State.

        20. Senator McCain. Mr. Strobridge, Mr. Barnes, Ms. Moakler, Mr.
    Puzon, and Ms. Roth-Douquet, what are the best ways to go about
    enhancing the options to ensure that all military dependent children
    receive highest quality educations, regardless of where they are
    stationed?
        Mr. Strobridge. According to a recent Government Accountability
    Office (GAO) study, Impact Aid played a necessary role for most public
    schools supporting military dependent children. However, delays in
    delivering Impact Aid payments make it extremely burdensome for local
    school districts in planning for and preparing annual budgets. MOAA
    supports reviewing the process of distribution of Impact Aid to
    significantly reduce payment delays and establish reasonable timelines
    for delivery. MOAA also concurs with the GAO recommendation urging the
    Secretary of Education, in partnership with the Secretary of Defense,
    to highly consider requiring school districts to identify military
    dependent students as a reportable subgroup on their academic outcomes,
    to include test scores and high school graduation rates.
        A critical component to ensuring military dependent children
    receive the highest quality education is through a continued
    partnership between the Department of Education and DOD. Persistent and
    effective oversight to the 13 objectives established in the Memorandum
    of Understanding between the Department of Education and DOD will
    ensure this partnership is sustained for the highest quality of
    education, not only for military dependent children, but for all
    school-age children.
        The Domestic Dependent Elementary and Secondary Schools (DDESS)
    operated at 16 military installations continue to play an important
    role for over 26,000 military dependent students. The DDESS provide
    standardized curriculum, allowing for continuity for military dependent
    children who are DODEA students. One venue for ensuring high quality of
    education would be to evaluate public schools aboard installations, and
    those which do not meet or exceed DDESS standards should be transferred
    to the authority of the DODEA and fall under the jurisdiction of the
    Secretary of Defense as provided under Public Law 97-35.
        In some instances, MOAA is aware the public school system is not
    equipped to handle the influx of dependent military children brought on
    by Base Realignment and Closure (BRAC). MCB Camp Lejeune, NC is an
    example of a military installation that has six DODEA schools aboard
    the installation, with approval for one additional DODEA school to open
    in the fall of 2011. Two public elementary schools have also opened in
    Onslow County, NC, in the last 3 years to accommodate the growing
    population of dependent military children. MOAA believes it is
    imperative that all circumstances surrounding the continued existence
    and establishment of DODEA schools are reviewed before reducing or
    eliminating funding, and/or transferring authority of the installation
    schools over to the State's public school system. Additionally, MOAA
    noted that funding was authorized but not appropriated for fiscal years
    2008, 2009, and 2010 for BRAC (GAO report on Impact Aid). Inconsistent
    funding for BRAC continues to have a negative impact on the communities
    involved in the force structure changes, including the education
    community.
        Another recommendation to help ensure high quality education
    regardless of duty station is to open the DODEA Virtual School program
    to all military dependent children (high-school age) who do not reside
    aboard installations. The Virtual School Program was designed to ease
    transition requirements, allowing students to enroll in courses they
    need and filling gaps regardless of their location. MOAA supports
    extending the DODEA Virtual School program to all military dependent
    children enrolled in high school.
        Mr. Barnes. See answer to question #18.
        Ms. Moakler. Ensuring that all military dependent children receive
    a quality education regardless of where they are stationed is one of
    our Association's top priorities. We consistently advocate for
    appropriate and timely funding of Impact Aid through the Department of
    Education. We also believe that school districts experiencing high
    levels of growth, due to military base realignment, should be able to
    apply for Impact Aid funds using current student enrollment numbers
    rather than the previous year. We continue to be a consistent voice on
    increasing DOD Supplemental funding for schools educating large numbers
    of military connected students. Our Association has long believed that
    both Impact Aid and the DOD Supplemental funding are critical to
    ensuring that school districts can provide quality education for our
    military children.
        In addition to Impact Aid, State support of the Interstate Compact
    on Educational Opportunity for Military Children has helped ease many
    of the transition issues facing military families. Although the Compact
    does not specifically address the quality of education our children
    receive, it greatly impacts military children's educational experience
    overall. Our Association continues to advocate for its passage in all
    50 States, territories, and the District of Columbia to ensure that all
    military children will be covered by the Compact.
        Our Association was also pleased that the President's recent
    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 appreciate the
    Department of Education committing to making military families one of
    its priorities for its discretionary grant programs and for finding
    ways to strengthen military families within the Reauthorization of the
    Elementary and Secondary Education Act. The Department is also seeking
    new ways to collect and report data pertaining to military connected
    children. We believe that including military children as a reportable
    subgroup will help determine where they attend school, enable
    additional support, and ultimately strengthen the education they
    receive.
        With more than 90 percent of military-connected students now
    attending civilian schools, our Association is pleased that DOD 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 DODEA's purview. We appreciate the educational
    support programs already available to military children through DOD,
    such as the tutoring program for deployed servicemember families, and
    DODEA's virtual high schools. Our Association believes these programs
    are making a difference and would be beneficial to all military
    families.
        Mr. Puzon. I do agree that Congress does need to address military
    dependent children quality education needs. Where they are stationed--
    does make a difference.
        Ms. Roth-Douquet. The Council of State Governments (CSG), in
    cooperation with DOD, worked with a variety of stakeholders and drafted
    a model compact, The Interstate Compact on Educational Opportunity for
    Military Children. We strongly support our peer military community
    organizations in efforts to provide standardization and ease of
    transfer of our military children.
        However, in order for this agreement to have a meaningful and
    lasting impact on our local schools, we need strong support from the
    Federal Government to encourage local districts to educate themselves
    and to implement the Compact.
        In spite of the fact that many States have adopted the Compact, due
    to the local nature of education, many military parents are still being
    thrust into the role of individually advocating for their children by
    educating local school officials regarding the rights of their children
    and the purpose of the Compact.
                                     ______

                 Questions Submitted by Senator Scott P. Brown
                          basic allowance for housing
        21. Senator Brown. Sergeant Major Chandler, according to recent
    policy guidance provided by the Army G-1, activated Guard soldiers
    mobilized for deployment collect Basic Allowance for Housing (BAH)
    based upon their Primary Duty Station (PDS), rather than their Primary
    Home of Record (PHOR). Upon mobilization to deploy, these Guardsmen are
    issued orders releasing them from their Title 32, Active Duty status
    and provided orders calling them to Active Duty status under Title 10.
    These orders call them to duty from their PHOR, rather than their PDS
    from which they commute on a regular basis for training. As a result,
    these soldiers stand to lose, in some cases, thousands of dollars. Army
    National Guard (AGR) soldiers on Active Duty under Title 32, receive
    BAH based on their PDS for the purposes of a permanent change of
    station, however, not their PHOR, including shipment of household goods
    and movement of their dependents. These soldiers and their families
    made financial plans based on the higher BAH. Please provide
    clarification on the rational for the change in policy, the possibility
    of providing an exception to policy for the soldiers who were issued
    mobilization orders under the promise of a higher BAH, and the Army's
    way ahead?
        Sergeant Major Chandler. Statute and the Joint Federal Travel
    Regulation (JFTR) provide that the BAH rate for Reserve component
    soldiers will be based on the soldier's primary residence rather than
    the PDS when called/ordered to active duty from their primary residence
    in support of a contingency operation. The Defense Travel Management
    Office, the proponent for the JFTR, directed the Army to amend and
    clarify the BAH paragraph in the Army's Personnel Policy Guidance (PPG)
    to be consistent with the statute and the JFTR.
        OSD has advised the Army that neither the law nor the JFTR provides
    the authority to grant an exception to policy to allow Active Guard and
    Reserve (AGR) soldiers mobilized in support of a contingency operation
    from their primary residence to receive BAH based on their PDS rather
    than their primary residence.
        The National Guard Bureau with the support of the Army G-1 and
    Assistant Secretary of the Army (Manpower and Reserve Affairs)
    submitted a Continuum of Service legislative proposal for the upcoming
    cycle that will allow continuation of benefits for AGR soldiers, to
    include BAH, when ARNG AGR soldiers change status from Title 32 to
    Title 10.

                              unemployment issues
        22. Senator Brown. Sergeant Major Chandler, Master Chief Petty
    Officer West, and Chief Master Sergeant Roy, the Department of Labor's
    Veterans Employment and Training Service runs a 2-day Transition
    Assistance Program for out-processing servicemembers and their spouses
    to help prepare them for the civilian job market. Currently this
    program is mandatory for marines. With veteran unemployment above the
    National average, do you think this training should be mandatory for
    all out-processing soldiers, sailors, and airmen?
        Sergeant Major Chandler. More than 60 percent of soldiers
    separating take advantage of the Transition Assistance Program.
    However, the Army does not intend to make the requirement mandatory at
    this time. The Army will monitor and evaluate the Marine Corps model
    and if warranted make adjustments.
        Master Chief Petty Officer West. Yes. I do believe the Department
    of Labor's 2-day Transition Assistance Program should be mandatory.
    Currently, we strongly encourage all out-processing sailors to take
    advantage of the Department of Labor's Veterans Employment and Training
    Service 2-day program.
        Additionally, Navy sponsors a robust transition assistance program
    (TAP), which is required by Federal law to be available prior to
    retirement or separation for all servicemembers to help them to
    transition smoothly from military to civilian life. Their families are
    also invited to attend. TAP provides a variety of transition services
    including counseling, information on education options, computerized
    job banks, resume writing assistance, and help with the employment
    interviewing process.
        Chief Master Sergeant Roy. Air Force has a mandatory pre-separation
    counseling provided by our installation Airman and Family Readiness
    Center staffs. We also have an outstanding Transition Assistance
    Program. This two and half day Department of Labor Employment Seminar
    is voluntary but well attended. In 2010, participation rate for the
    seminar was a robust 97.5 percent of separating/retiring airmen.

        23. Senator Brown. Sergeant Major Chandler, I am particularly
    concerned about soldiers leaving the Army. During the next 2 years, the
    Army will off-ramp its temporary end-strength increase of 22,000
    soldiers. Most of these soldiers will be junior soldiers. During
    General Dempsey's confirmation hearing, he stated that almost 30
    percent of young soldiers are unemployed after leaving the Service.
    What is the Army doing to ensure these soldiers are prepared for jobs
    in the civilian sector?
        Sergeant Major Chandler. The Army Career and Alumni Program (ACAP)
    has counselors world-wide to ensure that separating soldiers and their
    families are informed about employment assistance, effects of a career
    change, relocation assistance, education and training, health and life
    insurance, finances, Reserve affiliation, veteran benefits, and
    continuation of service. This information is provided through a series
    of workshops over a period of days. Specific to preparing a soldier for
    employment in the civilian sector, ACAP provides Federal Resumes and
    Application Seminar, Interview Preparation and training in Advance
    Resume Writing.

        24. Senator Brown. Sergeant Major Kent, in your prepared testimony
    you discuss new initiatives that the Marine Corps has started to help
    marines transition from the Marine Corps to the private sector. Can you
    share some of these improvements and their effectiveness in preparing
    marines for employment in the civilian workforce?
        Sergeant Major Kent. In his 2010 Planning Guidance, our Commandant
    directed the Marine Corps to conduct a ``bottom-up'' assessment of the
    Transition Assistance Management Program (TAMP) and Personal &
    Professional Development programs and services to revolutionize the
    process, embrace best practices, and ensure we are providing the right
    educational and career assistance to Marines leaving the Corps. In
    response, we have established a goal to make the Marine Corps' TAMP
    more value-added for our Marines. We will transform the current 2-3 day
    workshop from an event-driven to a process-driven program and support
    service. TAMP will have four ``military-to-civilian'' pathways:
    Employment; Career/Technical Education; College/University; and
    Entrepreneurial.
        We have developed a plan which will inventory and assess critical
    components of TAMP, based on the following phases:

             Phase I will focus on 180 days pre/post EAS. This
            phase will include an inventory of capabilities; an assessment
            of current operations for redundancies and gaps; a requirement
            that our TAP Workshop core curriculum and electives be
            standardized (with well-defined learning objectives and exit
            outcomes); and an adoption of best practices.
             Phase II and III are still in development. These
            phases will be based upon metrics of effectiveness that will be
            adopted, used, and assessed by Headquarters Marine Corps and
            all installations to continuously improve TAPs and other
            services.

                     guard and reserve mental health issues
        25. Senator Brown. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, in
    2010 Active Duty suicides went down, while National Guard and Reserve
    suicides doubled. The Active Army has implemented the Comprehensive
    Soldier Fitness (CSF) program to combat the mental health issues facing
    the Army, with success. What plans do each of your Services have to
    implement these types of programs into the Guard and Reserve training
    to create a more resilient Reserve Force?
        Sergeant Major Chandler. The current focus for Army National Guard
    (ARNG) and Reserve component (RC) soldiers for resilience, risk
    reduction and suicide prevention includes the application of the Army's
    CSF program. Both components are utilizing Master Resilience Trainers
    (MRTs) and Resilience Trainer Assistants (RTAs) to increase assets
    available to commanders to improve soldier resiliency and unit
    readiness. To date, the ARNG has trained 295 MRTs and 326 RTAs; the RC
    has trained 309 MRTs.
        A component of the resilience training is the Global Assessment
    Tool (GAT) which each soldier can take to receive an assessment of
    their strength dimensions (emotional, familial, social and spiritual).
    Over 234,948 ARNG and 172,800 RC soldiers have taken the GAT.
    Additionally, there are various comprehensive resilience modules (CRMs)
    to help improve or enhance their resilience areas based upon their
    results of the GAT. Family members have access to the GAT and also
    family specific CRMs as well.
        Master Chief Petty Officer West. We continue to build a culture of
    support for psychological health and suicide prevention 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 to provide suicide
    and sexual assault prevention training regularly at all levels and to
    destigmatize and normalize buddy-care and help-seeking behavior to
    address mental health or any other readiness issues as early as
    possible. Reserve Psychological Health Outreach Program (PHOP) teams,
    consisting of licensed mental health providers, are embedded in Navy
    Reserve communities regionally. They support Commanders in identifying
    reservists and family members who may be at risk for stress injuries
    following deployments or other transitions and provide outreach,
    support, mental health screenings, referrals and follow-up to local
    mental health resources to assist with problem resolution, build
    psychological resilience and promote growth. They also participate in
    assessment and training during demobilization and pre-deployment unit
    activities. Along with mental health referrals, many successful
    referrals by the PHOP teams involve helping reservists and their
    families with financial, health, employment and other concerns that can
    affect psychological health and impact performance and unit, individual
    and family readiness. Experts in finding resources for the unique needs
    of individual reservists and their families, both governmental (DOD,
    VA, other Federal and State services) and within the local communities
    where reservists live, these providers make outreach contacts with all
    demobilizing reservists and are available for consultation as needed,
    including providing after hours on-call coverage. Another effective
    tool is the Returning Warrior Workshops (RWW), a two day weekend
    program designed specifically to support the reintegration of returning
    reservists and their families following mobilization. PHOP teams serve
    as facilitators at Yellow Ribbon Reintegration Program (YRRP) signature
    events that provide support as needed and build resilience and promote
    post-traumatic growth. In addition, the DOD Joint Family Assistance
    Program (JFSAP) is available to support geographically isolated
    reservists and Commands with financial and mental health counseling.
    Families OverComing Under Stress (FOCUS), 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.
        Sergeant Major Kent. By direction of the Commandant, the Marine
    Corps has developed a resiliency model featuring identified
    vulnerabilities (social, physical, psychological, and spiritual),
    interdependencies (Marine, Unit, Family, and Installation/Community),
    cohesion requirements, and an analytical framework that prescribes
    necessary actions/planning areas to enhance or grow resiliency
    including: (1) strengthen; (2) mitigate; (3) identify, (4) treat; and
    (5) return. With the model complete, we have begun action to inventory
    current capabilities, assess effectiveness and future operations
    utility, and identify gaps/redundancies. We have brought the key
    entities charged with resilience programming together to leverage our
    existing assets in institutionalizing resilience training and program
    offerings across the Corps. Marine and Family Programs is currently
    developing a resiliency measurement that will allow individuals, units
    and the Corps to assess resiliency and, based on that assessment,
    intervene to improve psychological resilience.
        Additionally, the Marine Corps has implemented the following
    programs to create a more resilient total force, which includes our
    reserves:

             The Never Leave a Marine Behind suicide prevention and
            awareness education series trains Active and Reserve marines to
            recognize the warning signs for suicide, to foster personal and
            unit resiliency, to know where to go for behavioral health
            care, to engage helping services early, and in the case of
            senior leaders, how to manage command climate to reduce the
            risk of suicide.
             The Operational Stress Control and Readiness (OSCAR)
            program is being implemented at the Battalion/Squadron level,
            training Marines and medical and religious ministry personnel
            to prevent, identify, and manage stress problems as early as
            possible. These unit OSCAR team members are easily accessible,
            known to the unit members, and know the unit members. They can
            quickly recognize unusual changes in behavior, and increase the
            likelihood marines will talk about stress.
             A communication skills program, developed by the Army,
            is being pilot-tested to help families identify strengths they
            bring to deployment, prepare for experiences they and their
            marines may have during the deployment, and manage stress
            reactions after deployment.
             The Marine Corps is currently piloting a 24-7 by
            marine-for-marine counseling line, available to all marines,
            whether Active, Reserve, or veteran, and their loved ones. The
            DSTRESS Line is being piloted in the Western United States.
             The Marine Corps Behavioral Health Information Network
            (BHIN) is a web-based clearinghouse for the latest information
            and tools for Active and Reserve marines on prevention and
            other resources concerning behavioral health. These free
            educational materials are excellent tools that will assist
            units and installation support services in their efforts to
            educate the military community about building resiliency,
            recognizing reactions and determining the need for help. The
            materials, which are available in print and media form, include
            brochures, wallet cards, posters, workbooks, Quick Series, and
            DVDs.
             In addition, Marine Forces Reserve (MARFORRES) has
            implemented the Psychological Health Outreach Program (PHOP)
            which provides Psychological Health professionals at six
            regional MARFORRES sites to screen and refer Selected Marine
            Corps Reserve (SMCR) personnel for behavioral health services.
            Marines who are referred to the program can be screened for
            behavioral health issues, medically referred, and provided a
            road to recovery. Outreach members will 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.

        Chief Master Sergeant Roy. The Air Force recently implemented the
    Comprehensive Airman Fitness program. The goal of this program is to
    help our total force and family members better cope with the stresses
    of military life. One of the core components is to incorporate
    ``resilience'' principles into all of our training platforms such as
    accessions, PME, and technical training. Reserve and Guard members go
    through the same accession points as active duty, so everyone will have
    the same initial exposure to resilience. Like their active duty
    counterparts, our Guard and Reserve members will receive additional
    resilience training as they progress through their career but it will
    be tailored to their unique situation; geographically dispersed with
    extremely constrained drill time.
        Air Reserve component (ARC) is in the planning stages of an Air
    Force Smart Operation for the 21st century event, ``ARC Access to
    Community Services for Psychological Well-Being.'' The scope of this
    event is to effectively provide a mechanism to refer and connect
    Reserve and Guard airmen and their families to appropriate mental
    health and resiliency resources, and monitor progress in an effort to
    better achieve positive outcomes. We will be considering all
    possibilities in the current resource-limited environment, including
    regional teams, wing-level, ARC-dedicated personnel, and expansion of
    the role of the ARC liaison at Medical Treatment Facilities. Once
    approved, we will press forward with this event.
        We also have a Wingman Day, currently planned twice a year, in
    which Comprehensive Airman Fitness and Resilience is taught and
    practiced. The goal of Wingman Day is to build resilient airmen,
    through activities emphasizing awareness, accountability, team
    building, and communication utilizing interactive discussion.

        26. Senator Brown. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, the
    military has dedicated a lot of time and resources improving the
    quality of life for military families. Reserve and Guard families face
    the unique situation of not being collocated on military bases and near
    other military families. Families become the watchdogs that the command
    structure is for the Active Duty soldiers. While their soldier is
    mobilized, what is being done to educate Guard and Reserve families on
    the signs and symptoms of PTSD and suicide?
        Sergeant Major Chandler. The Army National Guard (ARNG) and the
    Reserve component (RC) have a number of programs to educate family
    members about PTSD and suicide prevention.
        The ARNG has Family Assistance Centers (FACs) and Family Readiness
    Groups (FRGs) which host several events during pre-deployment,
    deployment and redeployment with guest speakers and trainers presenting
    information on suicide prevention, behavioral health, PTSD, mild
    Traumatic Brain Injury (mTBI), resiliency training, coping skills, and
    parenting. The ARNG has FACs located in each State and territory to
    minimize the impact that the geographic dispersed families have in
    accessing service providers. There are currently 381 FACs serving
    military Families.
        The RC recognizes that any solution to assuring our soldiers can
    confidently seek treatment for PTSD and depression must include their
    Families. The RC has included training for Army Reserve Families on
    identifying signs of PTSD and suicide at various Yellow Ribbon events.
    Recently the Army approved 53 Health Promotion, Risk Reduction and
    Suicide Prevention civilian positions that will be geographically
    dispersed throughout the continental United States in support of Army
    Reserve soldiers and their families.
        Master Chief Petty Officer West. When our sailors 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 servicemembers 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 an 8-week, skill-based, trainer-led intervention that
    addresses difficulties which 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
    servicemembers, families, and community providers have received FOCUS
    services.
        In addition to FOCUS, Navy Reserve Psychological Health Outreach
    Program (PHOP) teams provide training on signs and symptoms and Combat
    and Operational Stress and suicide prevention for Navy reservists and
    their families at predeployment and postdeployment events. They provide
    outreach to returning reservists who may be at risk for stress
    injuries, and provide mental health screening and support and resources
    to assist with problem resolution and to build psychological resilience
    and promote growth. Experts in finding local resources for any needs,
    they make outreach contacts, and are available as needed, including
    after hours on call. Another effective tool 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. It reviews signs and symptoms of stress
    injuries and suicide risk and makes available counselors and Chaplains.
    PHOP team members facilitate at RWWs and provide screening and training
    to families at other YRRPs and Command predeployment events to educate
    family members about combat/operational stress and signs and symptoms
    of suicide risk.
        Sergeant Major Kent. The Marine Corps is implementing the following
    programs to educate Guard and Reserve families on the signs and
    symptoms of post traumatic stress disorder (PTSD) and suicide:

             We are piloting a 24-7 by marine-for-marine counseling
            line, available to all marines, whether Active, Reserve, or
            veteran, and their loved ones. The DSTRESS Line, which is
            currently being piloted in the Western United States, provides
            access to counselors who can help family members identify the
            warning signs for suicide, and how to intervene to save a life.
             The YRRP is a DOD-wide effort that calls for
            informational events and activities for National Guard and
            Reserve servicemembers and their families to facilitate access
            to services supporting their health and well-being throughout
            the deployment cycle. The informational events and activities,
            known as Yellow Ribbon Events, take place during all phases of
            the deployment cycle with post-deployment events conducted at
            the 30, 60, and 90 day points after the servicemember returns
            home.

                     Yellow Ribbon Events provide interactive and
                    informative seminars on communication; stress
                    management; post-military career opportunities; money
                    management; health education; parental skills; suicide
                    prevention; resiliency training; and other life-skills
                    training.
                     In addition to these seminars, YRRP provides
                    access or referrals, through our relationships with
                    other federal and non-Federal entities, to support
                    services for issues concerning mental health and
                    substance use disorder; traumatic brain injury; housing
                    stabilization; and family support.
                     YRRP also offers access to employment
                    resources and career counseling to support those
                    servicemembers facing unemployment/underemployment or
                    who have career concerns after being demobilized/
                    redeployed.

             The Marine Corps Behavioral Health Information Network
            (BHIN) is a web-based clearinghouse for the latest information
            and tools for marines, families and professionals on prevention
            and other resources concerning behavioral health. These free
            educational materials are excellent tools that will assist
            units and installation support services in their efforts to
            educate the military community about building resiliency,
            recognizing reactions, and determining the need for help. These
            materials, which are available in print and media form, include
            brochures, wallet cards, posters, workbooks, Quick Series, and
            DVDs.
             The Marine Corps also delivers Deployment Cycle
            Training on the normal and expected emotional responses to each
            phase of the deployment cycle and present an opportunity for
            family members to have their questions answered. In the post-
            deployment workshop, family members learn about the Combat
            Operational Stress Continuum. Examples are given of normal
            stressors, which are expected to resolve on their own. Examples
            are also given of more serious stress responses, attitudes and
            behaviors, which are more severe or persistent, along with
            suggestions of appropriate resources. Signs and symptoms of
            PTSD are described in the continuum, along with instruction on
            how and when to take action.

        Chief Master Sergeant Roy. First and foremost, the ARC provides
    education and resources for families on deployment related conditions
    through unit leadership. Air Force regulations specifically direct unit
    commanders and first sergeants to proactively contact and provide
    support for family members of deploying ARC members. The unit commander
    also tasks various support agencies, including Airman and Family
    Readiness, to ensure that families are contacted and provided for. The
    Yellow Ribbon Program offers resources on PTSD and suicide mitigation
    and is offered to ARC members and their families pre-deployment, during
    deployment, and 30 and 60 days post deployment.
        The Air National Guard (ANG) assigns an individual to more than
    half its wings (with plans to eventually cover all wings) to provide
    education on PTSD and suicide prevention through Yellow Ribbon events.
    This individual is available to answer any questions the ANG member or
    family member may have related to PTSD, suicide mitigation, or other
    psychological health related questions or resource availability. Family
    Program Managers also work with ANG family members during a spouse's
    deployment, providing access to information on PTSD and suicide
    awareness.
        The Air Force Reserve Command (AFRC) employs three regional teams
    to locate resources and provide case facilitation for AFRC members and
    their families for psychological health issues, including PTSD and
    suicide. AFRC also has the Wingman Project
    (www.AFRC.WingmanToolkit.org) that provides education about suicide
    prevention. The Wingman Toolkit has been targeted and distributed to
    Air Force Reserve members.
        Finally, Military OneSource and the Military Family Life Consultant
    Program are both available to family members and can provide
    information and guidance on PTSD and suicide. The unit commander is
    responsible for educating families about these services.

                               diversity roadmap
        27. Senator Brown. Chief Master Sergeant Roy, in your prepared
    statement you discuss the Diversity Roadmap that the Air Force
    published last fall. Please provide some of the initiatives the Air
    Force is implementing to address the issue of diversity within the
    force.
        Chief Master Sergeant Roy. In a nation where about only 25 percent
    of our youth are eligible or able to serve in an all-volunteer military
    and a defense department striving to remain connected to the Nation we
    serve, it is necessary to maintain a diverse Air Force to overcome
    today's increasingly complex challenges.
        In the fall of 2010, we published strategic guidance including a
    policy directive and Air Force Diversity Strategic Roadmap, which
    provides priorities, goals and specific actions for implementation of
    diversity initiatives. Formalizing the Roadmap into an Air Force
    Instruction will provide the Total Force its final piece of strategic
    guidance. Woven into the instruction will be vetted recommendations of
    the Military Leadership Diversity Commission. We anticipate completion
    of the instruction by the end of September 2011.
        We furthered the institutionalization of diversity by holding the
    inaugural Diversity Senior Working Group in October 2010. Showcasing
    senior leader commitment, the Chairman of the Joint Chiefs, Secretary
    and Chief of the Air Force along with 60 vice commanders from the major
    commands and senior leaders from the Pentagon participated.
    Participants were given five things they could do to promote diversity
    within their sphere of influence. These include making diversity a
    personal commitment by participating in two outreach events per year,
    adding a diversity message in speeches, identifying key positions and
    implementing hiring practices with a diversity lens, analyzing
    mentoring programs and determining how to resource diversity within the
    major commands and wings.
        Finally, to advocate equity, diversity and inclusion at the U.S.
    Air Force Academy, a Chief Diversity Officer position was created and
    filled in December 2010. Charged with working with Congress on
    diversity issues, promoting institutional and classroom diversity and
    uniting diversity efforts around the Academy to increase various
    agencies' effectiveness, the Chief Diversity Officer serves as the
    strategic leader, diversity advocate and principal adviser to Academy
    leaders.

                                family programs
        28. Senator Brown. Sergeant Major Chandler, from fiscal year 2007
    to fiscal year 2010, the Army has more than doubled its investment into
    family programs. Undoubtedly, families are an integral part of a
    successful military. American Psychologist recently highlighted the
    Army's success in family programs in its special issue on CSF. One of
    the issues and recommendation was that ``many programs for military
    children and families are not evaluated at all.'' What is being done to
    identify the most effective family programs, so as to avoid duplicative
    programs?
        Sergeant Major Chandler. The Army has longstanding annual
    assessment tools that measure the quality and cost of family support
    services, programs, and facilities. The Installation Status Report and
    the Common Levels of Support assessment processes monitor program
    quality, quantity, and applied resources against well-defined
    standards.
        The Army conducts a host of surveys and also benefits from surveys
    conducted by DOD. The Survey of Army Families monitors and assesses
    soldier and family use of and satisfaction with support services and
    programs. Families who use these services tell us they are helpful,
    appreciated, and positively impact their lives. Other surveys, such as
    the Sample Survey of Military Personnel, portray positive correlations
    between soldiers' use of support services and their desire to stay in
    the Army, unit esprit de corps, and satisfaction with Army life. A 2009
    Army-wide assessment of officers and NCOs depicted increasing
    satisfaction with Army life, increasing ability of leaders to balance
    their career and family life, and increasing satisfaction with the
    Army's support for soldiers and families. Overall, these tools inform
    us that Army family programs positively influence job satisfaction,
    family life, resiliency, and readiness.
        The Army recently conducted a ``Holistic Review'' of the Army
    Family Covenant to ensure efficient delivery of programs and services
    to those who need them most. As a result, the Army is transforming Army
    Community Service (ACS) with the goal of ACS becoming the key
    integrator for installation-wide support services.
        Additionally, the Army's 2010 Health Promotion, Risk Reduction, and
    Suicide Prevention Report provided a roadmap to conduct a new
    evaluation of support services. The goal of this analysis is to
    determine the right mix of Army programs to ease soldier and family
    transitions, strengthen resiliency and coping skills, increase help-
    seeking behavior, and reduce the stigma of seeking help.
        Army family programs ensure soldiers and family members continue to
    be strong and resilient. 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.
                                     ______

                  Questions Submitted by Senator Kelly Ayotte
                                family programs
        29. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, in
    your written statements, I was struck by the quantity of programs that
    each Service has created to serve troops and their families. These
    programs represent good faith efforts to maintain the readiness of the
    All-Volunteer Force and to help our troops and their families cope with
    the accumulated strain of a decade at war. To what degree are the
    Services methodically and objectively measuring the performance of
    these programs?
        Sergeant Major Chandler. The Survey of Army Families (SAF) is an
    Army-wide survey conducted every 4 to 5 years by the Family and Morale,
    Welfare and Recreation Command (FMWRC). It provides data on the
    attitudes and behaviors of non-military spouses of Active Duty soldiers
    about the quality of life in the Army, identifies emerging family
    issues, assesses progress in resolving Army Family Action Plan issues,
    and supplements other studies on Army families. Additionally, the SAF
    provides data on the effectiveness of family programs including Family
    Readiness Groups, services assisting spouses and Families in preparing
    for a soldier's return, Army Child, Youth & School Services, recreation
    programs, Army Community Service (ACS) programs and services and other
    programs designed to enhance the quality of life for soldiers and
    Families.
        In collaboration with the Family Life Development Center at Cornell
    University, FMWRC has developed logic models and outcome measures for
    each core Family Program area. Monthly data to support outcome measures
    is collected through a centralized online database system, the Central
    Tracking System. In addition, ACS centers are accredited tri-annually
    to ensure compliance with legislative and regulatory requirements. As
    part of the accreditation process, ACS centers survey soldiers and
    their Families regarding their satisfaction level with services
    available to them which provides a unique opportunity to look at the
    relevance and importance of individual programs and services to
    soldiers and family members.
        The Installation Status Report is a performance measurement tool
    used by installation leaders and managers to provide a standardized
    reporting process, view critical planning and management data, serve as
    a baseline of data used at all levels from the installation to Army
    staff to justify funding, assist in the management of installations,
    and identify critical areas in need of attention.
        Master Chief Petty Officer West. Recurring performance measurement
    of Family Readiness Programs is a high priority within the Navy.
    Program performance of Child Development Centers, Child Development
    Homes, and School Age Care programs is accomplished through national
    accreditation and annual inspection by Navy inspectors. Peer-review and
    certification of Navy Fleet and Family Support Programs occurs every 3
    years, with mid-cycle review of installation programs provided by
    regional Fleet and Family Support Program staff. Detailed performance
    standards for both Navy Child and Youth Programs (CYP) and Fleet and
    Family Support Programs (FFSP) are in place, with installation programs
    reporting their performance against these standards on a quarterly
    basis. Joint Base supported and supporting commands report quarterly on
    family readiness program performance against Joint Base Common Output
    Level Standards. Detailed output data is collected for both Navy CYP
    and FFSP and analyzed on a recurring basis to validate installation
    performance.
        A senior level customer survey is conducted annually by Navy
    Installations Command, including senior level satisfaction with the
    performance of Navy CYP and FFSP. Needs assessment and customer
    satisfaction data is collected at least annually by installation CYP
    and FFSP managers. A web-based, Navy-wide CYP and FFSP customer survey
    has been administered for the past 2 years. A quarterly Tone of the
    Force Report is provided to the Chief of Naval Operations that includes
    key sailor and family readiness metrics. Additionally, questions
    regarding use of and satisfaction with family readiness programs are
    included in personnel surveys conducted by the Bureau of Naval
    Personnel.
        Among the most accurate measurements of performance in my
    estimation, is simply talking with sailors to gauge their satisfaction.
    They deliver positive feedback when programs are effective, and provide
    unvarnished honesty when programs miss the mark. It is a continuous and
    evolving dialogue among Navy leadership and the Fleet because both
    groups understand the importance of quality-of-service efforts and
    constantly seek.
        Sergeant Major Kent. In his 2010 Planning Guidance, our Commandant
    directed us to: ``Review and Improve Family Readiness--Evaluate all
    Marine Corps Family Team Building Programs and make recommendations on
    optimum span of control, where we require further assistance to our
    families, and where we should streamline to erase redundancy.'' To
    respond to the Commandant's concerns, we have developed a deliberate
    process which will, in effect, objectively measure the effectiveness
    our programs and services by marines and families who utilize them. As
    part of this process, we are taking the following actions:

             Conducting focus groups with unit commanders,
            associated sergeants major, and respective spouses to obtain
            their insights on the effectiveness of Marine Corps Family
            programs; identify unmet needs of marines and families; and
            acquire recommendations to fix identified deficiencies. A
            follow-on web-based survey will reach all unit commanders and
            Sergeants Major who could not participate in the focus groups.
            This survey will be extended to NCOs to obtain their
            perspectives as well.
             Initiating operational planning teams to review the
            structure of the Unit, Personal and Family Readiness and Marine
            Corps Family Team Building Programs to redefine staffing
            requirements.
             Launching a web-based program prioritization tool that
            will be sent to Active and Reserve unit commanders and
            sergeants major to ask them to prioritize the utility of our
            Marine Corps Family Programs based on their contribution to
            unit and family readiness.

        Chief Master Sergeant Roy. The Air Force uses web-based management
    information systems to track all airmen, family readiness, child and
    youth programs, and services offered to airmen and their families. This
    system also includes participation rates. The data provided by these
    tools is visible to leadership at the installation, major commands and
    Headquarters Air Force levels. The captured data is used to conduct
    trend analysis and provide a vector on focusing our resources where
    they may have the greatest positive impact on airmen and their
    families. Air Force-wide assessments and surveys are also conducted to
    objectively measure performance.
        The Air Force Community Assessment is conducted every 2 years and
    is designed to assist installation helping agencies better meet the
    needs of servicemembers and their families. Topics covered in the
    survey include personal and family adjustment, individual and family
    adaptation, community well-being, deployment, resilience, post-
    traumatic stress and help-seeking stigma. This assessment provides a
    means to ensure community interventions are timely, focused and data-
    driven and has been instrumental in determining the strengths and needs
    of Air Force communities and tailoring programs at the installation,
    major command and Air Force levels. Previous survey results are
    credited with expanding financial counseling programs to members and
    their families, developing a user-friendly support network for Air
    Force single parents and setting up marriage-support seminars for
    junior enlisted members and their spouses.
        The Caring for People Survey objectively measures the relationship
    between services provided and readiness and retention to effectively
    allocate our resources. The survey was conducted in 2008 and 2010 and
    allowed total-force airmen, civilians, retirees, and spouses an
    opportunity to tell Air Force leaders how they can better address
    services within health and wellness, airmen and family support,
    education and development, and housing and communities. Insights from
    the 2008 survey and subsequent focus groups spurred the development of
    several initiatives for improving fitness facilities, dining
    operations, housing and allocating funds to target single airmen.
        The robust trend analysis and Air Force community-wide surveys we
    conduct serve to gauge the well-being of airmen and their families and
    measures the success of meeting their needs through the programs and
    services offered.

        30. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, to
    what degree do the programs in one Service benefit from the lessons
    learned from programs in another Service?
        Sergeant Major Chandler. The Services benefit from sharing lessons
    learned through two primary joint Services meetings. One is the
    Chairman of the Joint Chiefs of Staff (CJCS) Family Support Meeting and
    the second is the Military Family Readiness Council.
        The CJCS meets regularly with Service Vice Chiefs, Senior Enlisted
    Advisors, and select spouses to address concerns and share best
    practices that will strengthen and enhance servicemember and family
    programs. The meetings cover five major topics:

             Child Care
             Employment and Empowerment of the Military Spouse
             Educational and Developmental Excellence
             Family/Community Strategic Communication
             Medical

        The Military Family Readiness Council reviews and makes
    recommendations to the Secretary of Defense regarding family readiness
    policy and plans, monitors requirements for support of family
    readiness, evaluates and assesses the effectiveness of family readiness
    programs and activities, and submits reports on family readiness to the
    Secretary of Defense.
        Other venues the Services utilize for sharing lessons learned
    include program manager meetings and various training and conference
    opportunities.
        Master Chief Petty Officer West. Services participate in monthly or
    quarterly in various Joint Family Readiness Working Groups to share
    best practices and lessons learned. The Navy Personal Financial
    Management, Ombudsman and Family Readiness Program initiatives are the
    most current examples of best practices that have been shared with or
    implemented by DOD and the other services. Child and Youth Program
    managers across DOD meet monthly in all functional areas to share
    lessons learned and to air challenges for possible best practice
    solutions. Another example where sharing information among the services
    provided ease in establishing new processes was with the Exceptional
    Family Member Program (EFMP). Navy benefited by reviewing Marine Corps'
    EFMP program practices prior to implementing the Navy EFMP Liaison
    program. Spouse employment is another area where lessons learned from
    another branch of Service have been implemented DOD-Wide (Military
    Spouse Employment Partnership Program).
        Sergeant Major Kent. In his 2010 Planning Guidance, the Commandant
    directed us to institutionalize resiliency across the Marine Corps to
    better prepare our marines for the inevitable stress of combat
    operations and enable them to cope with the challenges and rigor of
    life as a marine, both deployed and in garrison. To do this, we have
    taken lessons learned from the Army Comprehensive Soldier Fitness
    program and applied key principles that fit with the Marine Corps'
    values and ethos. We have also leveraged existing practices occurring
    within the Air Force and capitalized on their work in the resiliency
    field. Moving forward, we are in the process of leveraging existing
    assets in a collaborative process that will combine the ``best
    practices'' of physical, psychological, spiritual, and social fitness
    and 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. This program will ultimately
    provide our marines and their leaders with the best available skills
    and tools to increase individual resiliency training throughout the
    unit forming, training, deployment, and post-deployment phases. We will
    continue to consider other Services' programs and benefit from lessons
    learned to enhance our own overall capability.
        Chief Master Sergeant Roy. The Child, Youth and Family Programs
    representatives from each of the Services headquarters benefit from
    regular forums and working groups intended to benchmark programs and
    share lessons learned. The Office of the Deputy Assistant Secretary of
    Defense, Military Community and Family Policy hosts a monthly working
    group for Child and Youth Program Managers from each Service, in
    addition to a monthly working group for Military and Family Support
    Program Managers from each Service. These forums are used to work
    challenges collectively, share successes and discuss emerging policy.
    Examples of other shared forums include the Joint Transition Assistance
    Program Managers forum, the Joint Spouse Employment forum, the Personal
    and Family Readiness forum, the Military Connected Students and Student
    Liaison Services forum, the Exceptional Family Member Program working
    group, and the Childhood Obesity working group.
        Several programs have been developed as a result of these joint
    forums. One example is the military child care subsidy program
    administered through the National Association for Child Care Resource
    and Referral Agencies. This program provides child care subsidies to
    quality civilian child care programs for military members who cannot
    access on-installation child care programs. Another program, currently
    in development, is a joint military child care waiting list which will
    improve consistency and efficiency in our military child care programs.
    The Services also work jointly on partnerships with the USDA/4-H and
    the Boys and Girls Clubs of America to provide enhanced programming and
    expanded opportunities for military youth.
        Another example is the Military Spouse Employment Program which is
    being adapted from an Army initiative and will be officially launched
    shortly to serve all military spouses. The goal of this ``purple''
    program is to ``develop partnerships with firms in the private sector
    to enhance employment opportunities for spouses of members of the armed
    forces and to improve job portability.''
        In 2010, the Headquarters Child and Youth Program Managers from the
    Air Force and the Navy partnered to conduct and fund a joint training
    conference for their installation child development and youth programs.
    Over 350 child and youth program managers attended the joint event.
        The 2011 DOD/USDA Family Resilience Conference titled ``Forging the
    Partnership'' was another large scale venue which brought together
    members from every Service for opportunities to share lessons learned.
    Installation staff members presented and attended workshops on current
    and emerging practices and participated in interactive sessions.

        31. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, to
    what degree do the Services share overhead and resources in order to
    reduce the costs of these programs?
        Sergeant Major Chandler. The Services benefit from sharing lessons
    learned through two primary joint Services meetings. One is the
    Chairman of the Joint Chiefs of Staff Family Support Meetings and the
    second is the Military Family Readiness Council. By sharing the lessons
    learned, the Services are able to identify and implement cost savings
    and gain efficiencies. However, the Services do not generally share
    overhead and resources.
        Master Chief Petty Officer West. Fleet Readiness Programs are
    funded, for the most part, through the Services' Operation and
    Maintenance budgets, with each service responsible for providing family
    readiness programs and services for all military members and their
    families within their geographic areas of responsibility. Duplication
    or overlap is relatively low both within and outside the United States.
    In areas where there is overlap between the services at the local level
    or installations with co-located sister service tenant organizations,
    Navy fleet readiness program managers coordinate with their
    counterparts from other services to maximize resources and ensure
    military members and their families are well-served. On programs or
    initiatives of benefit to all the Services, Service and DOD fleet
    readiness program managers coordinate efforts, sharing overhead and
    resources to develop and implement initiatives, thereby reducing cost.
    For example, the Services and DOD are currently coordinating efforts to
    develop a web-based tool for families across DOD to request childcare
    services through the installation nearest to their preferred location,
    regardless of branch of service. Additionally Navy, Army and Marine
    Corps utilize DLA Troop Support Prime Vendor Program for essential food
    services.
        Sergeant Major Kent. Since our program is still in the development
    phase, we have not had an opportunity to share overhead and resources
    with other Services to reduce the costs, but we will look for ways to
    do so in the future.
        Chief Master Sergeant Roy. All family programs located on an Air
    Force installation support any eligible DOD user. Conversely, family
    programming offered by other Services can also be accessed by airmen
    and their families. Base Realignment and Closure (BRAC) and Joint
    Basing have formalized this approach and all Services are working to
    ensure programs, information, and resources are shared and applicable
    to all Services. Additionally, Air Force family support and child and
    youth program managers meet, as a minimum, quarterly with their Sister
    Service counterparts. These meetings allow the cross flow of
    information and sharing of resources and awareness of the total range
    of services available to members and families. The Services also share
    best practices and Office of the Secretary of Defense--Military
    Community and Family Policy resources.
        We have had many examples of opportunities where we have shared
    resources and overhead. One is a series of joint planning sessions to
    create a more comprehensive Exceptional Family Member Program across
    DOD. Another is the Joint Services Military Spouse Employment
    Partnership under development. We are taking an existing Army
    initiative and contract which is being expanded to enhance employment
    opportunities for Air Force, Navy and Marine spouses, with shared cost
    for overhead and program operations. We have also partnered with the
    Navy to co-sponsor Child/Youth Program training which reduced overall
    training costs. Joint Family Support Assistance Centers, funded through
    OSD, provide outreach and support that augments the installation family
    centers and the National Association of Child Care Referral and
    Resource Agency contracts shared with the Navy help reduce costs for
    civilian community child care. The Services also share 4-H grants that
    promote youth development and leadership skills. All of the separating
    and retiring members and their families share Transition Assistance
    Services. And as mentioned, BRAC and Joint Basing are creating more
    opportunities to formalize processes for shared program costs.

                              resiliency programs
        32. Senator Ayotte. Sergeant Major Chandler and Sergeant Major
    Kent, using the Army's CSF program and the Marine Corps' Combat and
    Operational Stress Control (COSC) resiliency training as an example,
    what metrics do you use to measure resiliency and what do those metrics
    tell you about the performance of these two resiliency programs?
        Sergeant Major Chandler. The program of record for resilience
    development within the Army community is the CSF program. The metric
    that the Army uses to measure resilience is the Global Assessment Tool
    (GAT), a 105 item questionnaire required to be completed annually by
    all soldiers, from Private to General. To date, the GAT has been
    completed over 1.2 million times. An ongoing program evaluation will
    give us an idea of the performance of the CSF program, and we
    anticipate having initial results in the next 4-6 months.
        Sergeant Major Kent. The COSC utilizes metrics from external
    evaluations, such as the Joint-Mental Health Advisory Team (JMHAT).
    These metrics include unit factors (small-unit leadership, cohesion and
    readiness), stigma, barriers to care, training, and positive impact of
    deployment.
        The most recent JMHAT, due for public release in May 2011, reports
    that unit cohesion, perceptions of unit readiness, and NCO leadership
    are significantly improved from previous assessments. Significant
    increases in the adequacy of and access to training for suicide
    prevention and stress have reduced stigma and perceived barriers to
    care.
        We believe these indicators show that the COSC program, as well as
    other behavioral health integrated efforts, is having a positive
    influence on resiliency.

        33. Senator Ayotte. Sergeant Major Chandler and Sergeant Major
    Kent, to what degree do your two resiliency programs share overhead and
    resources to reduce costs?
        Sergeant Major Chandler. The Army's CSF program does not share
    overhead with the Marine Corps. However, CSF has allowed several
    marines and sailors to attend the MRT course at the University of
    Pennsylvania on a non-reimbursable basis. Additionally, CSF has a
    memorandum of agreement with the Air Force's Air Combat Command to
    train five airmen per month at the MRT course at the University of
    Pennsylvania.
        Sergeant Major Kent. The COSC program utilizes materials from the
    Army's Comprehensive Soldier Fitness program as well as other Services'
    best practices and resources. The COSC program is utilizing the family
    resiliency training components from Comprehensive Solider Fitness
    program and will be pilot-testing these training components next month
    at Camp Lejeune, NC.
        In April 2011, over 100 Explosive Ordnance Disposal Marines
    attended the Air Force Deployment Transition Center as they returned
    from Operation Enduring Freedom. These marines received critical
    reintegration and decompression time after a difficult deployment.
        Partnerships such as these have significantly reduced costs
    associated with program development, implementation, and sustainment
    and we will continue to do so in the future.

        34. Senator Ayotte. Sergeant Major Chandler and Sergeant Major
    Kent, are lessons learned shared between resiliency programs?
        Sergeant Major Chandler. Yes, lessons learned are shared.
    Specifically, CSF has provided lessons learned to other Services when
    those Services began marshalling resources for their own programs.
        Sergeant Major Kent. Yes. Working with the Defense Centers of
    Excellence (DCOE) for Psychological Health and Traumatic Brain Injury,
    all Services assist in our resiliency efforts. Over the past year, DCOE
    has held quarterly meetings which have allowed the Services' resiliency
    program managers to discuss Service-specific program activities,
    lessons learned, and best practices. These meetings are valuable and
    are utilized heavily in our resiliency efforts.

        35. Senator Ayotte. Sergeant Major Chandler and Sergeant Major
    Kent, can you provide a specific example where a resiliency program
    changed based on input from another Service?
        Sergeant Major Chandler. The Army's CSF program has not changed
    based on input from other military Services.
        Sergeant Major Kent. We are utilizing lessons learned from the
    Army's Comprehensive Soldier Fitness program and are currently pilot-
    testing family resiliency training modules for implementation. The Navy
    and the Marine Corps resiliency programs are very similar and now share
    a common doctrine which was released in December 2010. This shared
    doctrine allows the Marine Corps and Navy to better integrated efforts.
    The Marine Corps also recently partnered with the Air Force's
    Deployment Transition Center at Ramstein Air Force Base to support
    reintegration and decompression efforts for marines returning from
    Afghanistan.

        36. Senator Ayotte. Sergeant Major Kent, are you aware of the
    Army's Master Resiliency Trainer Program at the University of
    Pennsylvania, and if so, do you know if the Marine Corps has sent any
    marines to this training?
        Sergeant Major Kent. Yes, we are aware of the Army's Master
    Resiliency Trainer program. In fact, our COSC program just received
    five spaces and we plan to send our Operational Stress Control and
    Readiness (OSCAR) Master Trainers to attend this training within the
    next few months. Although we believe our OSCAR training and the Army's
    Master Resiliency Training are similar, we are excited about the
    opportunity to attend this training and have the goal of implementing
    best practices and lessons learned from this course.

                    consolidating medical command structures
        37. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, in
    March 2011, the Government Accountability Office (GAO) released a
    report titled, ``Opportunities to Reduce Potential Duplication in
    Government Programs, Save Tax Dollars, and Enhance Revenue.'' In this
    report, GAO estimated that realigning DOD's military medical command
    structures and consolidating common functions could increase efficiency
    and result in projected savings ranging from $281 million to $460
    million annually. Do you support realigning DOD's military medical
    command structures and consolidating common functions?
        Sergeant Major Chandler. No, not until DOD has reviewed the
    desirability of establishing a unified medical command.
        Master Chief Petty Officer West. I am privileged to have the
    opportunity to see firsthand the outstanding health care being provided
    by our Navy medical personnel to servicemembers, their families and
    retirees and their families. At sea, in theatre and in medical
    treatment facilities, I know our sailors, as well as all
    servicemembers, are receiving the quality health care they need and
    deserve. Regarding the organizational construct of the Military Health
    System and evaluation of the Government Accountability Office
    assessment, I defer to DOD.
        Sergeant Major Kent. I see firsthand the outstanding health care
    being provided by our Navy medical personnel to servicemembers,
    retirees, and their families. At sea, in theater, and in medical
    treatment facilities, I know our marines and sailors, as well as all
    servicemembers, are receiving the quality health care they need and
    deserve. Regarding the organizational construct of the Military Health
    System and evaluation of the Government Accountability Office
    assessment, I defer to DOD.
        Chief Master Sergeant Roy. We do not favor the establishment of a
    unified military medical command.
        The Air Force Medical Service is fully integrated with the Line of
    the Air Force, and medical personnel are key members of the Wing
    commander's team to accomplish the Wing Mission. When Air Force units
    deploy, their medics deploy with them. The unified medical command
    would sever that close relationship at the expense of our existing
    effective organizational structure. We can drive unity of effort within
    current authorities without the expense of establishing a unified
    medical command and disrupting the effective alignment of medics to
    Service oversight. The synergy created by close alignment of Air Force
    medics to our operational mission should not be put at risk in a new
    unified command structure.
        Today's Service oversight of medical assets created the most
    effective system for treatment of casualties in the history of warfare.
    Modular and highly capable medical units such as Expeditionary Medical
    Support (EMEDS) and highly efficient air evacuation operations would
    not exist without the close alignment of our medics to Air Force
    operational missions. Deployed to our theater hospitals and supporting
    our air evacuation system, Air Force medics have safely returned over
    86,000 U.S. casualties to their families from Operations Enduring
    Freedom and Iraqi Freedom. Every day our medics are saving lives of
    soldiers, sailors, marines, airmen, civilians, coalition forces, friend
    and foe alike under the watchful eye of Air Force commanders.

        38. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, would
    consolidation of these medical command structures streamline
    operations, eliminate duplication, and achieve cost savings?
        Sergeant Major Chandler. Without a thorough review by DOD regarding
    Service-unique medical command structures, it is unknown if
    consolidation will streamline operations, eliminate duplication, or
    achieve cost savings.
        Master Chief Petty Officer West. I am privileged to have the
    opportunity to see firsthand the outstanding health care being provided
    by our Navy medical personnel to servicemembers, their families and
    retirees and their families. At sea, in theatre and in medical
    treatment facilities, I know our sailors, as well as all
    servicemembers, are receiving the quality health care they need and
    deserve. Regarding the organizational construct of the Military Health
    System, I defer to DOD.
        Sergeant Major Kent. I see firsthand the outstanding health care
    being provided by our Navy medical personnel to servicemembers,
    retirees, and their families. At sea, in theater, and in medical
    treatment facilities, I know our marines and sailors, as well as all
    servicemembers, are receiving the quality health care they need and
    deserve. Regarding the organizational construct of the Military Health
    System and evaluation of the Government Accountability Office
    assessment, I defer to DOD.
        Chief Master Sergeant Roy. The Air Force does not support
    establishment of a unified military medical command among the military
    departments because of concerns that it would not streamline
    operations, eliminate duplication, and achieve cost savings.
        We believe a more effective and efficient joint medical solution
    can be attained without the expense of establishing a unified medical
    command. Changes to doctrine can be made within current authorities and
    do not require a new unified medical command. Service specific and
    joint medical doctrine must be improved to assure Service capabilities
    are fully interoperable and interdependent to bolster unity of effort.
    The Services should continue integrating common medical platforms to
    reduce redundancy and lower costs.
        A unified medical command may not achieve the intended synergy or
    unity of effort. All models of the unified medical command to date do
    not include medical forces intrinsic (line funded vs. Defense Health
    Program funded manpower authorizations) to Service line units. A
    unified medical command would not oversee medical forces serving in
    these line units. Air Force line funded medics represent 5 percent of
    Air Force medical personnel; Navy shipboard assets represent 25 percent
    of medical personnel; and Army line Tables of Organization and
    Equipment (TOE) funded medics represent 48 percent of Army active duty
    medics. The Air Force ability to meet operational medical requirements
    would be disproportionately compromised in current models for unified
    medical command.
        Any new unified medical command will require new systems and
    structure to oversee component headquarters and assigned forces. This
    will drive even higher costs. If a unified medical command follows the
    example of the current Joint Task Force, National Capitol Region
    Medical (JTF CAPMED), it is highly unlikely there will be cost savings.
    There is no need for a fourth military Service and establishing such in
    the form of a unified medical command, without the discipline and
    historical rule sets that govern existing Services, will likely drive
    costs much higher. Even more critical, a unified medical command may
    not be as responsive to the needs of Service warfighters as is the
    current oversight by the Services.
        BRAC 2005 created many opportunities for joint oversight of medics.
    Given time to mature, these initiatives along with the Service Surgeon
    Generals' efforts to consolidate oversight of common support functions
    (information management, contracting, military health facility
    construction and financial management) in the new co-located medical
    headquarters will reduce redundancies. Adoption of a single Service
    accounting system to allocate Defense Health Program dollars and
    improve accountability would do more to reduce costs than a unified
    medical command.

        39. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, was
    the consolidation of medical command functions considered during the
    development of the efficiencies initiatives?
        Sergeant Major Chandler. Consolidation of Services for medical
    command functions was not a part of the Army's efficiencies
    initiatives.
        Master Chief Petty Officer West. The health care efficiency
    initiatives were developed by DOD. I would necessarily defer questions
    regarding specific considerations contained in the proposals to DOD.
        Sergeant Major Kent. The health care efficiency initiatives were
    developed by DOD. I would necessarily defer questions regarding
    specific considerations contained in the proposals to DOD.
        Chief Master Sergeant Roy. The consolidation of medical command
    functions were not considered during the development of the
    efficiencies initiatives. However, the Air Force has taken considerable
    steps to provide synergy of effort with our sister Services, as well as
    internally to the Air Force Medical Service which maintains Air Force
    unique capabilities in-line with Title 10 responsibilities.
        The Air Force accomplished a major transformation initiative under
    the Secretary of the Air Force and Air Force Chief of Staff Program
    Action Directive 07-13. This mandated a consolidation of management
    headquarters activities that eliminated redundancy across the Air
    Force, and consolidated all management activities related to clinical
    activities to a single ``reach-back'' agency. The establishment of the
    Air Force Medical Operations Agency in San Antonio provides the savings
    in this effort to fully fund direct war-fighting support, eliminate
    redundancy across the Major Command Surgeons Offices, and provides
    capabilities to the Major Commands and Numbered Air Forces.
        In addition, our BRAC-directed co-located headquarters efforts have
    resulted in a Defense Health Headquarters campus of like-type
    headquarters functions that will ensure enhanced cross-talk and synergy
    across the Services medical functions. As a result, the Defense Health
    Headquarters will position joint venture activities for greater success
    and efficiency in the Military Health System.

                             individual augmentees
        40. Senator Ayotte. Sergeant Major Chandler, Master Chief Petty
    Officer West, Sergeant Major Kent, and Chief Master Sergeant Roy, each
    of the Services has developed a variety of personnel programs to help
    troops and their families cope with the stress of repeated deployments.
    Many of these programs focus on the deployment of large u. However,
    every year the Services deploy thousands of individual soldier,
    sailors, airmen, and marines as IAs. These individuals deploy by
    themselves or in small groups to and from theater. Can you discuss the
    challenge that IAs present and describe how your Service has attempted
    to ensure these individuals also receive the pre- and post-deployment
    training and services they need?
        Sergeant Major Chandler. Many of the challenges that existed in the
    war's early years have been mitigated through more effective
    communication early in the process between the deployed individual and
    the Continental U.S. Reception Center (CRC) Battalion. The CRC
    established liaisons within each of the major commands and defense
    contracting companies operating in theater to ensure the deployed
    individual received the necessary information regarding pre- and post-
    deployment requirements. Additionally, the CRC Family Readiness
    outreach ensures family support regardless of geographic location.
        Master Chief Petty Officer West. IAs 2A are an integral part of
    Navy's ongoing efforts to support Overseas Contingency Operations. The
    primary challenges of achieving mission proficiency and unit cohesion
    are accomplished through training.
        All IAs attend NMPS/ECRC (Navy Mobilization Processing Site/
    Expeditionary Combat Readiness Center) for 5 days for medical, admin
    and uniforms. They also process through NMPS during post-deployment.
        IAs deploying to CENTCOM AOR receive additional training at Navy
    Individual Augmentee Combat Training (NIACT), or an equivalent extended
    combat skills curriculum depending on the requirement, for skills in
    shooting and driving, for a final medical record review, and for weapon
    issue.
        Additional mission specific training may be required as dictated by
    the capability requested.
        In addition, IAs process through the Warrior Transition Center in
    Kuwait, between post-deployment and final out-processing at NMPS, to
    provide combat stress control services and final in-theater
    administrative support.
        Finally, all IAs are afforded the opportunity to attend Returning
    Warrior Workshops at some point following their deployment to
    participate in group discussions about their experiences. The Returning
    Warrior Workshops are conducted in various locations around the
    country, and cost for attendance is borne by the member's command.
        Sergeant Major Kent. The most challenging aspect of IAs is the
    ability to provide the same level of support for deployment education
    as an Active Duty marine. Since IAs mobilize individually, they do not
    have the opportunity to attend pre/post-education classes with their
    entire unit and must be given one-on-one training or connected with the
    Gaining Force Command (GFC) predeployment training. In addition, since
    there is no set ``pre-deployment'' workup timeline for those accepting
    IA volunteer billets, providing the pre-deployment training is
    challenging.
        To address these challenges, the Marine Corps provides support
    through the local Family Readiness Officers (FROs) and/or unit in the
    area and through our Unit, Personal and Family Readiness Program's
    YRRP. Together with the GFC, FROs serve as a resource for IA marines
    and their families that assist them with accessing appropriate YRRP
    courses covering the entire spectrum of pre- to post-deployment
    education support.
        Chief Master Sergeant Roy. We have worked hard to ensure our
    augmentees are cared for before, during, and after their deployment.
    Services for airmen and their families across the four phases of the
    deployment cycle (pre-deployment, deployment, re-deployment and post
    deployment) have been standardized to ensure continuity across the Air
    Force. Deployment is addressed as a process, not an event. Programs and
    services for deployed single and married airmen and their families are
    designed to meet their needs and allow the airmen to keep their minds
    on the mission. These services are provided to those who deploy as
    units, in small groups, or individually. Tasked airmen are identified
    to Airman and Family Readiness Center staff by their unit deployment
    managers and the members are contacted and briefed. Sustainment
    assistance, information and referral resources are made available to
    families while the member is deployed and follow-up is provided during
    redeployment and reintegration.

        [Whereupon, at 3:08 p.m., the subcommittee adjourned.]

    DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
                   2012 AND THE FUTURE YEARS DEFENSE PROGRAM

                                  ----------

                             WEDNESDAY, MAY 4, 2011

                                   U.S. Senate,
                             Subcommittee on Personnel,
                                   Committee on Armed Services,
                                                        Washington, DC.

     CONTINUATION OF TESTIMONY ON THE ACTIVE, GUARD, RESERVE, AND CIVILIAN
                               PERSONNEL PROGRAMS

        The subcommittee met, pursuant to notice, at 2:03 p.m. in
    room SR-222, Russell Senate Office Building, Senator Jim Webb
    (chairman of the subcommittee) presiding.
        Committee members present: Senators Webb, Hagan,
    Blumenthal, Graham, Chambliss, Brown, and Ayotte.
        Committee staff member present: Leah C. Brewer, nominations
    and hearings clerk.
        Majority staff members present: Jonathan D. Clark, counsel;
    Gabriella E. Fahrer, counsel; and Gerald J. Leeling, counsel.
        Minority staff members present: Diana G. Tabler,
    professional staff member; and Richard F. Walsh, minority
    counsel.
        Staff assistants present: Jennifer R. Knowles and Christine
    G. Lang.
        Committee members' assistants present: Juliet Beyler and
    Gordon Peterson, assistants to Senator Webb; William Chapman,
    assistant to Senator McCaskill; Tressa Guenov, assistant to
    Senator McCaskill; Roger Pena, assistant to Senator Hagan;
    Jeremy Bratt, assistant to Senator Blumenthal; Clyde Taylor IV,
    assistant to Senator Chambliss; Charles Prosch, assistant to
    Senator Brown; Brad Bowman, assistant to Senator Ayotte; and
    Taylor Andreae and Sergio Sarkany, assistants to Senator
    Graham.

            OPENING STATEMENT OF SENATOR JIM WEBB, CHAIRMAN

        Senator Webb. The subcommittee will come to order.
        I'm informed that Senator Graham is running about 15
    minutes late this afternoon, so I'm going to go ahead and get
    my opening statement on the record and begin the testimony from
    our guests today. Then when Senator Graham comes, I'll stop and
    see if he wants to say a few words at that time.
        We're meeting today to receive testimony from the
    Department of Defense (DOD) on the Active, Guard, Reserve, and
    civilian personnel programs contained in the administration's
    National Defense Authorization Request for Fiscal Year 2012 and
    Future Years Defense Program.
        With us today are senior DOD leaders, with whom we hope to
    discuss not only DOD personnel policy, but specific budget
    items in furtherance of our subcommittee's oversight
    responsibilities, which I take very seriously.
        There is no greater responsibility for Congress and
    military leaders than to care and provide for our
    servicemembers and their families, but, in doing so, we must
    ensure that we are appropriately managing our taxpayers'
    dollars.
        Our military--Active, Guard, and Reserve--is still engaged
    in the longest sustained period of major conflict in our
    Nation's history. We look forward to learning what programs and
    priorities the Department has identified and implemented to
    make certain that our servicemembers, civilian personnel,
    retirees, and their families receive the support and benefits
    they have earned, commensurate with their service.
        Having grown up in a military family that has a continuing
    tradition of service, I'm well aware of the unique challenges
    facing our military families, both in the Active Duty and
    Reserve components. They're dealing with high operational
    tempos, the stress of multiple deployments, and dwell times
    that still fall short of the Department's goals for many units
    and significant numbers of individuals. I have a special
    appreciation for the obligation to see to the needs of our
    servicemembers and their families.
        The All-Volunteer service has worked well over the past
    quarter century. We must guarantee that the All-Volunteer model
    continues to produce the world's best military. However, as I
    have said in the past, an All-Volunteer Force is not an all-
    career force, a fact we must not forget in planning for the
    future and also in taking care of the needs of those who still
    maintain a citizen soldier tradition and return to their home
    communities after one period of service.
        We've also entered a new era in the use of our Guard and
    Reserve Forces, who played critical roles during this period of
    sustained conflict, in ways not envisioned at the inception of
    the All-Volunteer Force.
        This subcommittee will continue to explore changes needed
    to employ our Reserve component forces as an operational force.
    In this regard, I encourage Under Secretary Stanley and
    Assistant Secretary McCarthy to elaborate on their stated views
    on the need for additional tools for force management as we
    draw down our Active Force levels and to obtain additional
    authorities to mobilize Reserve components in the future.
        This subcommittee faces a very clear challenge this year
    with respect to the need to control the increasing costs of our
    personnel. The total personnel-related base budget in the
    Department's fiscal year 2012 request, including the cost of
    providing healthcare to servicemembers, their families, and
    retirees, amounts to $175 billion, or about 32 percent of the
    overall DOD base budget. However, while we must achieve savings
    in our Defense programs, we need to do this in a way that does
    not unfairly impact military benefits for a force that has
    served us so well. To that end, I am pleased that we have the
    DOD comptroller with us today so that we can engage in a more
    detailed budget discussion.
        As I stated at our first subcommittee hearing last month, I
    intend to take a hard look at DOD programs, their
    justification, what they cost, and whether they are achieving
    their stated goals. I've also expressed my own reservations on
    the administration's proposal to increase TRICARE Prime
    enrollment fees for retirees. While I have strong reservations
    regarding the administration's proposed enrollment fee
    increases, based on the fact that retirees have earned this
    healthcare benefit through their years of service--a moral
    contract, in my view--I do plan to keep an open mind about
    initiatives to improve the efficiency and effectiveness of our
    military healthcare benefits.
        To ensure that the Department obtains the greatest return
    on investment for every dollar it spends, Congress must do its
    part to make sure that funded programs are effective and
    efficient, in keeping with our roles as stewards of the public
    trust and of taxpayer dollars.
        I welcome our witnesses to today's hearings: The Honorable
    Clifford Stanley, Under Secretary of Defense for Personnel and
    Readiness; The Honorable Robert Hale, Under Secretary of
    Defense, Comptroller, and Chief Financial Officer; The
    Honorable Dennis M. McCarthy, Assistant Secretary for Reserve
    Affairs; and The Honorable Jonathan Woodson, Assistant
    Secretary for Health Affairs, and director of the TRICARE
    Management Activity.
        I'd like to take a moment to recognize Secretary McCarthy,
    who will be leaving the Department this year after nearly 2
    years serving as Assistant Secretary of Defense for Reserve
    Affairs. I'd like to acknowledge his many contributions, both
    as a civil servant and his long career with the Marine Corps,
    both Active and Reserve.
        Secretary McCarthy, we appreciate your service to your
    country, and look forward to hearing your testimony.
        General McCarthy. Thank you, Mr. Chairman.
        Senator Webb. I look forward to hearing each of your
    testimony about personnel overall, and the health and budget
    status of our military. As always, I encourage you to express
    your views candidly and to tell us what is working well, and to
    raise any concerns and issues you may want to bring to this
    subcommittee's attention. Let us know how we can best assist
    our servicemembers and their families to ensure that our
    military remains steadfast and strong.
        As I mentioned, Senator Graham will be here forthwith. At
    this point, rather than waiting for an opening statement--or
    for him to make an opening statement, we will interrupt the
    hearing when he arrives and ask that he do so.
        So, why don't we just go ahead and begin. Under Secretary
    Stanley, welcome, and we look forward to hearing your
    testimony.

       STATEMENT OF HON. CLIFFORD L. STANLEY, UNDER SECRETARY OF
                  DEFENSE FOR PERSONNEL AND READINESS

        Dr. Stanley. Good afternoon, Senator Webb and Senator
    Hagan. I'm looking forward to talking with you this afternoon,
    and I thank you for this opportunity to testify today.
        First, I respectfully request that my written statement be
    made a part of the record.
        I look forward to continuing to work with you on our total
    force of Active, National Guard, and Reserve servicemembers, as
    well as our civilian workforce, and the dedicated families that
    support them.
        Senator Webb. I should point out that each of your full
    written statements will be entered into the record at the
    beginning of the time that you're recognized for your
    testimony. Feel free to give whatever comments you wish.
        Dr. Stanley. Absolutely. Thank you, Senator.
        My focus is total force readiness; it's caring for our
    people and creating a culture of relevance, effectiveness, and
    efficiency. I view total-force readiness as a mental, physical,
    emotional, and spiritual state of preparedness and resilience.
    This involves enabling training, equipping, and supporting the
    total force when they are deployed, and ensuring that they and
    their families have the care and support they need and deserve
    when they're at home.
        As we examine the total and All-Volunteer Force that first
    emerged in 1973, we intend to go beyond the scope of the
    Active, Guard, and Reserve Force. Particularly, we are looking
    at the roles of civilians--that play in serving and supporting
    our force, and most especially how families and volunteers fit
    into the total-force equation.
        We've placed emphasis on our civilian workforce to include
    civilian hiring, career and leadership development, support of
    our civilian expeditionary workforce, and a transition to a
    more systematic approach to fully integrate civilians in total-
    force planning and requirements.
        In 2010, the Department made positive and meaningful
    progress toward reforming civilian hiring practices.
    Nevertheless, I continue to push hiring reform, and I actually
    refer to it, more accurately, as ``employment reform,'' towards
    an aggressive reduction in the number of days it takes to hire
    a civilian employee. I'm increasing our emphasis on the
    civilian competency development framework, enhanced leadership
    development programs, and senior executive talent management
    initiatives.
        As a designated proponent of the total force for the
    Department, one of the challenges that I have confronted is to
    assure that I had the proper cognizance over the resources
    necessary to support our workforce, and most especially our
    warfighters and their families. To accomplish this, I have
    undertaken a number of active steps to ensure thorough
    oversight of the resources and financial management of the
    Office of the Under Secretary of Defense for Personnel and
    Readiness level. My financial oversight, as the Under Secretary
    of Defense for Personnel and Readiness, represents nearly $40
    billion in direct DOD resources. With responsibility for the
    management of manpower for the DOD total force, it is also
    critical that I provide effective policy direction that
    supports pay, allowances, and other programs that constitute
    nearly two-thirds of the overall DOD budget.
        I also cannot overemphasize how essential it is that we
    continue to work on providing a quality of life commensurate
    with the quality of service for our military, and most
    especially their families. We'll work to do everything possible
    to support our military families. It is our military families
    who support our servicemembers, who support our Nation.
        I'd like to thank the committee for all you do for our
    dedicated servicemembers and their families. I look forward to
    your questions.
        That concludes my statement.
        [The prepared statement of Dr. Stanley follows:]
                 Prepared Statement by Hon. Clifford L. Stanley
        Senator Webb, Senator Graham, and members of this distinguished
    Subcommittee, thank you for inviting us to testify before you on the
    Personnel Overview for the Department of Defense (DOD).
        It has been a year since I appeared before this subcommittee as the
    new Under Secretary of Defense (USD) for Personnel and Readiness, and
    it has been a year of building a team. We now have Dr. Jonathan Woodson
    as the Assistant Secretary of Defense for Health Affairs in place to
    help address the many challenges in the Military Health System, as well
    as some other new key leaders within USD Personnel and Readiness. It
    has also been a year of changing the culture, working on our critical
    thinking, and striving to improve timeliness and the quality of
    products that better inform decisionmaking across the Department and
    enhance relationships with Congress. During this past year, I've
    focused on honoring, protecting and improving the lives of our airmen,
    soldiers, sailors, marines, and their families. This next year will
    show that while my focus has not changed, I've refined my priorities to
    better serve our servicemembers and their loved ones.
        As the Under Secretary of Defense for Personnel and Readiness my
    focus is: Total Force Readiness, Caring for Our People, and creating a
    Culture of Relevance, Effectiveness and Efficiency. I view Total Force
    Readiness as a mental, physical, emotional, and spiritual state of
    preparedness and resilience. This involves enabling training, equipping
    and supporting the Total Force when they are deployed and ensuring that
    they and their families have the care and support they need and deserve
    at home. Caring for Our Total Force and their families are both a
    mission imperative and an ethical responsibility. Our Personnel and
    Readiness organization strives for the same sense of selfless service
    demonstrated by servicemembers and their families. To achieve a Culture
    of Relevance, Effectiveness and Efficiency, we need to prepare the
    force to manage risks, preserve assets and meet the challenges of a
    dynamic operational environment. We need to increase emphasis on
    agility, flexible force structures, responsive force-shaping policies,
    and integrated personnel management processes. We will continue to
    experience global competition for educated, skilled, and an experienced
    workforce. Therefore, it is more imperative than ever for DOD to have
    the right personnel policies to attract, retain, train, educate, and
    sustain the right talent.
        Our Total Force of Active and Reserve military, government
    civilians, and contracted private sector employees must deliver the
    readiness commanders expect, require, and deserve. Under any
    circumstance, readiness is costly, and the Department's resources are
    finite. We must thoughtfully plan with the premise that our uniformed,
    All-Volunteer Force (AVF) is the implicit assumption upon which all our
    commanders' plans are predicated. We cannot fail to provide commanders
    with the numbers and kinds of Active and Reserve personnel that they
    require. To that end, our Total Force Manpower costs must be reduced to
    a level that is consistent with both an acceptable readiness risk and
    the sustainment of the AVF, and we are compelled to do so by addressing
    the Total Force as a whole:

             Military: While not the largest single element of
            Total Force costs, our ``per capita'' uniformed costs are
            typically (by skill) the greatest and, if we have uniformed
            members in excess of true needs, we also add unnecessarily to
            our Health Care expenses. Aside from assuring that personnel
            related costs, such as targeted compensation, yields the best
            return on investment, we can also ensure that:

                     Our uniformed personnel requirements are
                    absolutely military essential; where appropriate, we
                    must assign work to other elements.
                     Our Active and Reserve Force balance is well-
                    reasoned.

        Our military pay request for fiscal year 2012 is $154.05 billion
    for 2,269,700 Active Duty, Guard, and Reserve. This does not, however,
    include other costs required for sustaining the AVF.

             Government Civilians: While we are not arbitrarily
            freezing government civilian positions in any particular area,
            resource constraints have prompted guidance to the Department
            that any increase to civilian funding levels must be based upon
            compelling need. Some increases could also be driven by the
            resultant net Total Force savings, such as:

                     In-sourcing services if a cost-analysis
                    demonstrates such action would save the Department
                    money.
                     The conversion of inherently governmental, but
                    non-military essential, positions from uniformed to
                    less costly civilian performance.

        Our civilian payroll for fiscal year 2012 is projected to be $69.9
    billion for 783,702 full time equivalents.
        Contracted Services: This is currently the largest cost element of
    the Total Force. The Department is committed to enhancing it
    understanding of what we contract for and why. We must also look at
    whether the returns justify the investments, and if alternative Total
    Force solutions are less costly. As we have seen in the last decade,
    expenditures on contracts have steadily increased, and as an element of
    the Total Force, must be comprehensively reviewed to ensure necessary
    reductions do not risk readiness and the delivery of critical
    capabilities. The congressionally-mandated Inventory of Contracts for
    Services must continue to be improved so that it can be used by
    managers for these purposes.
        In accordance with the National Defense Authorization Act (NDAA)
    for Fiscal Year 2011 and recent appropriations bill, OUSD P&R is
    working with all DOD organizations, to move towards collecting data
    from the private sector firms providing services for the Department.
    Preliminary guidance is currently in coordination. In the past few
    years, we have seen the Army make judicious and highly cost-effective
    decisions regarding contracts governance by relying on both their
    inventory process and internally-developed information system. OUSD P&R
    is engaged to assist the Departments of the Navy and Air Force, to
    enhance their service contracting governance ability by leveraging the
    Army system as directed in the fiscal year 2011 appropriations bill;
    and to also assist the Defense Agencies and Field Activities as they
    report their plans to collect this information.
        The components are currently compiling what will be an improved
    fiscal year 2010 Inventory of Contracts for Services that is due to
    Congress by June 30. We will continue to work with Congress to make
    further progress in this important effort.
        The Department is expanding the procedures it uses to determine
    military and DOD civilian manpower requirements to provide a single,
    coherent process for determining ``total force requirements''--i.e.,
    requirements for military and DOD civilian manpower and contract
    services. Having visibility of future total force requirements will
    enhance strategic planning throughout the Department.
        To achieve our critical missions in support of the Warfighter, I am
    focused on several key priorities. My top priority is the future
    sustainment and enhancement of the Military Health System and Wounded
    Warrior Support to ensure quality health care for our servicemembers,
    their families and retirees. In addition to the specific initiatives
    included in the Department's fiscal year 2012 budget, I believe we need
    to do a `deeper dive' into healthcare reform, to include Wounded
    Warrior support. The four azimuths for this `deep dive' into healthcare
    reform are to assure readiness; improve population health; enhance the
    patient experience of care; and responsibly manage the cost of care.
        My second priority is to look at how we support our military
    families, with an emphasis on education--both for our children and
    spouses. Given the hardship and stress put on military families due to
    frequent moves, I believe it is imperative that military children and
    spouses have the best educational opportunities. The third priority
    focuses on our civilian workforce, to include civilian hiring, career
    and leadership development, support for our Civilian Expeditionary
    Workforce, and the transition to a more systematic approach to fully
    integrate civilians in Total Force planning and requirements. In 2010,
    the Department made positive and meaningful progress toward reforming
    its civilian hiring practices. Nevertheless, I continue to push hiring
    reform towards an aggressive reduction in the number of days it takes
    to hire a civilian employee. I am increasing our emphasis on a civilian
    competency development framework, enhanced leadership development
    programs, and senior executive talent management initiatives. Also, my
    efforts continue to effectively source expeditionary mission challenges
    with a ready, trained, and cleared civilian workforce. Finally, my
    overarching focus as the USD(P&R) is Readiness and Relevance. Each day
    I strive to work to ensure that we do all we can to gain and maintain
    readiness of the Force, while remaining the most relevant in everything
    we do to help our warfighters and their families.
        As the designated proponent of the Total Force for DOD, and as I
    look across the enterprise within Personnel and Readiness, one of the
    challenges that I have confronted is to ensure that I have the proper
    cognizance over the resources necessary to support our workforce, and
    most especially our warfighters and their families. To accomplish this,
    I have undertaken a number of tangible steps to ensure thorough
    oversight of resource and financial management at the OUSD(P&R) level.
    My financial oversight responsibilities as the USD(P&R) represent
    nearly $40 billion in direct DOD resources. With responsibility for the
    management of manpower for the DOD Total Force (with associated
    military and civilian personnel and contracted services costs) I also
    must ensure that I provide effective policy direction that supports
    pay, allowances, and other programs that constitute nearly two-third of
    the overall DOD budget.
        I will address funding for separate programs under the purview of
    the Office of the Under Secretary of Defense for Personnel and
    Readiness for fiscal year 2010-2012 as appropriate, while allowing the
    Assistant Secretaries of Defense for Reserve Affairs and Health Affairs
    to address Reserve component and the Defense Health Program funding
    levels within their respective written statements. The Under Secretary
    of Defense for Comptroller will address the fiscal year 2012 Military
    Health Care efficiencies within his own statement.
                                active component
    Recruiting
        For the second year in a row, all active Services not only met
    their numerical recruiting goals, but also exceeded their recruit
    quality targets--with highest marks since 1992. Previous years were
    marked by a growing economy, low unemployment, reluctance of
    influencers of youth (e.g., parents and teachers) to recommend military
    service, low propensity among youth to serve in the military, and
    increased recruiting goals of the Army and Marine Corps to support
    overseas contingency operations. Even in that demanding recruiting
    environment, the All-Volunteer Force (AVF) proved itself successful,
    with the Services meeting or exceeding recruiting goals since 2005.
        In fiscal year 2010, the Services exceeded their recruiting goal of
    165,000 by 434, accessing 160,601 first-term enlistees and an
    additional 4,833 individuals with previous military service. Thus far
    this year, active duty recruiting efforts show continued success.
    Through March, all Services met or exceeded both quantity and recruit
    quality objectives for the Active-Duty Force. The Army recruited 34,264
    new soldiers, with a 33,600 recruiting goal, for a 102 percent year-to-
    date accomplishment rate (Table 1). Notably, for the third year in a
    row, the Army is exceeding the DOD Benchmark of 90 percent of new
    recruits being High School Diploma Graduates, with 100 percent of Army
    recruits holding that credential year to date. Additionally, the Navy,
    Marine Corps, and Air Force are each exceeding these benchmarks as well
    (Table 1.)

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        While we have had, and continue to have, recruiting success, I do
    not take these recent successes for granted, nor do I assume the
    current favorable recruiting environment will continue. Already we are
    seeing growth in the economy and positive changes in the labor market,
    which historically present challenges to recruiting. There also are
    long-term trends that are disturbing. Although the overall youth
    population is large, only a relatively small proportion of American
    youth is qualified to enlist. It is an unfortunate fact that much of
    the contemporary youth population is currently ineligible to serve.
    Medical disqualification, with obesity a large contributing factor,
    removes about 35 percent, drug or alcohol abuse removes about 18
    percent, and almost another 23 percent do not meet our enlistment
    standards for reasons including criminal misbehavior, low aptitude
    scores, or having more dependents than can reliably be accommodated in
    their early career.
        Adding to these, other factors affecting recruiting efforts are
    that only about 75 percent of our young people graduate with a high
    school diploma; high numbers of youth going to college directly from
    high school; and continuing concerns about overseas contingency
    operations with its associated high operations tempo. Acknowledging and
    understanding these factors and the need to expand our recruiting areas
    for the Active and Reserve components, we continue to enhance DOD
    influence in underserved communities by working with local school
    administrators, specifically from Title I school districts, and
    implementing programs like the DOD Science and Technology Academies
    Reinforcing Basic Aviation and Space Exploration (STARBASE) Program
    that have potential long-term impacts on students' on-time high school
    graduation; college enrollment; and interest in learning science,
    technology, engineering and mathematics. DOD STARBASE is an outreach
    and educational program that focuses on science, technology,
    engineering, and mathematics (STEM) by providing students
    underrepresented in the STEM areas of study and careers with 25 hours
    of instruction through an inquiry-based curriculum with ``hands-on,
    minds-on'' experiential activities and exposing them to military's
    technological environment to solidify their attachment to and
    engagement with learning. In addition, we are working collaboratively
    with State Governors by sharing resources and supporting programs like
    the National Guard Youth Challenge Program, to provide at risk youth--
    16-18 year old high school dropouts--with the values, life skills,
    education, and self-discipline necessary to succeed as productive
    citizens.
        It is important that we have a military that reflects the society
    it defends, both in the enlisted ranks and our commissioned officers.
    This is particularly important as less than 1 percent of the American
    public serves in uniform. To that end, we are pleased that some of our
    most prestigious colleges and universities are now re-thinking their
    previous positions with regard to Reserve Officers Training Corps
    (ROTC) programs. This will provide more opportunities for college
    students to think about seeking commissions in the U.S. military.
        To meet these challenges, we continually review our recruiting
    programs to align funding and policies with current realities. Each of
    the Services has made significant adjustments to recruiting programs in
    light of our austere fiscal environment, and continues to look for
    additional cost savings--but we must be cautious and resist the
    temptation to cut too deeply and too fast. Stable and adequate
    investments in recruiting resources are necessary to maintain our long-
    and force management needs, history has shown that the time required to
    redeploy advertising/marketing campaigns and/or qualified recruiters is
    significant. I cannot emphasize this imperative too much. Additionally,
    the Department and the Services must retain the flexibility to manage
    their recruiting programs with the resources provided. Along with a
    core mission of providing essential market research to the Services,
    Joint Advertising, Market Research and Studies (JAMRS) also projects
    the Department-level message to influencers (parents, teachers,
    counselors, and coaches), a group that serves as a primary source of
    advice for enlistment age youth, a message that needs to continue. I
    feel that JAMRS is one of our most cost-effective recruiting programs.
        The Montgomery GI Bill (MGIB) has been a cornerstone of our active-
    duty military recruiting efforts since 1985, and a major contributor to
    the success of the All-Volunteer Force. We are now in the second year
    of the new Post-9/11 GI Bill, the most extensive restructuring of post-
    service education benefits since the introduction of the original World
    War II GI Bill. The Post-9/11 GI Bill appears to enhance our recruiting
    efforts even more. We hope that the provision in the new program that
    allows career servicemembers to transfer their unused GI Bill benefits
    to immediate family members, long requested by both members and their
    families, will mitigate negative retention impacts. Early results look
    favorable, with over 180,000 career servicemembers already approved to
    share their earned educational benefits with their family members. We
    are monitoring the effects of this implementation very closely to gauge
    impact on retention, particularly first-term retention.
        As usual, we appreciate this Committee's untiring support of our
    recruiting programs and look forward to working together to ensure
    future success.
    Military Decorations and Awards
        The Department continues to work in concert with the Services to
    appropriately recognize and laud the accomplishments, both valorous and
    non-valorous, of our soldiers, sailors, marines, and airmen. In today's
    All-Volunteer Force, appropriately recognizing the accomplishments of
    our servicemembers, while simultaneously maintaining the time-honored
    prestige of our most revered military decorations, is fundamental to
    maintaining esprit-de-corps and a motivated force.
        The Department is committed to recognizing the valorous acts of our
    Service men and women. The President of the United States awarded the
    Medal of Honor to U.S. Army Staff Sergeant Salvatore Guinta last
    November for his conspicuous gallantry during Operation Enduring
    Freedom. The Department is diligently processing additional Medal of
    Honor nominations for the President's consideration, including
    nominations for other living servicemembers. Additionally, the
    Department recently completed its review of the Medal of Honor award
    process as requested by the House Armed Services Committee.
    Force Management
        Of the many possible futures that could come to pass in the next 5
    years, the Department may find itself faced with force management
    challenges that are far greater than those we have experienced since
    September 11. Ongoing operations in Iraq, Afghanistan, and elsewhere,
    budgetary pressures, urgent equipment reset and modernization needs,
    economy-driven retention fluctuations, changing acquisition schedules,
    and the turmoil in the Middle East will each contribute to the need for
    a force that is potentially far different from the one that exists
    today. Responsibly managing the required force reduction, while
    ensuring our warriors are properly transitioned to veteran status, is a
    responsibility taken very seriously and one which my organization is
    helping to facilitate. In this instance, more than most, the cliche is
    appropriate; the Department must ensure we have the right people, in
    the right place, at the right time.
        As part of our ongoing efforts, DOD is examining different exit
    strategies to achieve the necessary force drawdown to realize the
    Secretary's and the Services' agreed upon budget reductions, while
    doing so with the full appreciation for the sacrifices of the soldiers,
    sailors, airmen, and marines on behalf of our Nation. Maintaining
    readiness while humanely reducing our force structure will be the major
    challenge in the years ahead.
        The Department has proven itself adept at maintaining the All-
    Volunteer Force through two major conflicts. There are significant
    incentives to bring in and retain the right force mix of personnel. The
    area where we could use your help is in creating a system of force
    management tools focused on a means to compassionately reduce the force
    as operations subside. These tools, some of which have previously
    expired in law, provide the necessary flexibilities to transition the
    Department from a fully engaged footing to one of more routine
    engagement around the globe. Drawdown programs and strategies provide
    targets to create a more balanced force and ensure we retain the right
    skills and talent to be a more productive and agile force able to meet
    emerging needs.
        DOD will need to maximize use of existing statutory authorities and
    potentially propose new authorities to surgically shape the force. Our
    current authorities do not provide the level of fidelity required to
    target career fields for early retirement or early discharge boards.
    This will be necessary to address future force shaping needs to meet
    dynamic changes in missions resulting from an ever-changing
    environment. Having a range of options to grow or reduce the force in
    specific skill areas is vital to the full spectrum of missions. The
    large standing armies of the past had an inherent ability to react to
    emerging threats by leveraging mass against new demands. This depth,
    which served to mitigate risk, will not be present in the future force.
    Reduced numbers equates to reduced redundancies. Accession, retention,
    and development decisions will need to be targeted with unprecedented
    fidelity in a constrained budget environment.
        The bottom line is that the Department must aggressively manage a
    precise, surgical drawdown of the force to ensure readiness is not
    impacted, our warriors and their families are protected, and the
    military departments and combatant commands are able to meet their
    missions in a hyper-dynamic global environment.
    Retention
        Throughout this force adjustment, retention will be critical. Even
    during peak operations in Iraq and Afghanistan, the Department
    continues to be very successful in attaining enlisted retention goals.
    All Active components met or exceeded their respective retention goals
    in every measurable category. The Services and the Department
    anticipate continued success in the upcoming year and are already
    meeting or exceeding the monthly goals for early fiscal year 2011.
        Despite the overall strength of enlisted retention over the last
    few years, there remain critical shortages in many low density/high
    demand skills and other ``hard-to-retain'' skills, such as explosive
    ordnance disposal specialists, linguists, intelligence and
    counterintelligence analysts, and pararescue operators, that justify
    the continuation and application of the statutory bonus authorities.
    The Selective Reenlistment Bonus (SRB) and the Critical Skills
    Retention Bonus (CSRB), as authorized by 37 U.S.C. 308 and 37 U.S.C.
    355 respectively, are among the most effective as incentives to
    attract/retain qualified personnel in critical military specialties.

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        The Department's process to manage bonuses is very well defined. A
    skill is critical if it meets one or more of the following: (a)
    technical skills requiring high training and/or replacement costs; (b)
    skills in high demand in the civilian sector; (c) challenging to
    recruit into; (d) crucial to combat readiness or capabilities; and (e)
    low density/high demand (those skills that are in high demand for
    current operations yet are low density due to less requirements during
    peacetime). All requests from the Services must have substantive
    justification that clearly outlines the need for the bonus for that
    skill, payment amount and method, and expected retention results.
    Designations do not exceed 3 years unless provided for by congressional
    extension of the statutory bonus authority. The complementary authority
    of the CSRB is the Selective Reenlistment Bonus (SRB). The SRB is under
    the authority of the Service Secretaries and is not centrally managed
    by the Department. However, applications of the bonus authorities are
    reviewed at the Department level.
    Stop Loss
        As of March 18, 2011, all Services reported there are no designated
    specialties being held under the provisions of Stop Loss. There are
    approximately 162 soldiers still receiving ``Stop Loss Special Pay.''
    These soldiers sustained injuries or illnesses while subject to Stop
    Loss and are currently receiving medical treatment. They are assigned
    or attached to Warrior Transition Units (WTUs).
        Two Stop Loss Special Pays have been enacted, which allow a payment
    of up to $500 per month, for members whose service (retroactive to
    September 11, 2001) has been extended by use of the Stop Loss
    authority. These pays were appropriated and authorized by Congress, and
    enacted by the President to recognize the significant sacrifices made
    by soldiers, sailors, airmen, and marines since September 11. The
    Department implemented both pays, active and retroactive, and
    appreciates the support of Congress to compensate members for the
    unique circumstances presented by the use of this policy, while still
    preserving our ability to react with discretionary authority as
    dictated by future circumstances. The Department estimated 145,000
    individuals are eligible for the Retroactive Stop Loss Special Pay
    Program and, as of April 15, 2011, we have paid approximately 90,000
    personnel, totaling more than $325 million. The Services and the
    Department used the additional time Congress provided to continue to
    engage in extensive and persistent outreach initiatives. Additional
    interviews were conducted with the military interested press and
    national media. The Army sent certified direct letters to remaining
    veterans that did not respond to previous notification efforts. We also
    reached out to recipients of Post-9/11 GI Bill education benefits
    through Veterans Benefit Administration (VBA) and Associate
    Organizations (Joint Hometown News, Guard and Reserve Public Affairs,
    and ROTC detachments). We will continue to seek media coverage
    opportunities to remind those eligible to apply. Additionally, the
    extensions of the 2011 budget Continuing Resolution has allowed the
    Department to receive more than 16,000 additional claims from our brave
    service men and women. The deadline for eligible servicemembers,
    veterans and their beneficiaries to apply for Retroactive Stop Loss
    Special Pay has been extended to October 21, 2011, allowing more time
    to those eligible apply for the benefits they've earned under the
    program guidelines.
        We thank you for your support in recognition of their sacrifices.
    End Strength Management
        Meeting end strength is a priority of the Department. The table
    below depicts the fiscal year 2010 Active Duty authorizations
    (prescribed and actual) and fiscal year 2011 authorized levels which
    the Department intends to achieve in order to meet all of its current
    mission requirements. The Secretary of Defense has authority granted
    under the terms of the President's National Emergency declaration to
    increase statutory strength levels prescribed by the NDAA if needed to
    meet a specific mission. The Services have implemented recruiting,
    retention, and force shaping policies and programs to achieve end
    strengths for fiscal year 2011. These end strengths will provide the
    ground forces needed to meet the strategic demands, eliminate the need
    for the use of Stop Loss, and mitigate persistent capability shortfalls
    which will reduce stress and demands on servicemembers and families by
    increasing dwell time.

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    Women in Combat
        Another force management issue is Women in Combat. The Department
    is in the process of reviewing, in coordination with the military
    departments, the laws, policies, and regulations, including the
    collocation policies, which restrict the service of female members in
    the Armed Forces. The review is timely, in that the Military Leadership
    Diversity Commission's (MLDC) final report to the President and
    Congress, released earlier this month, included a recommendation
    regarding the Department's combat assignment policy. Additionally, the
    review coincides with the Army's ongoing consideration of its policy
    that precludes collocating female soldiers with units below the brigade
    level whose primary mission is to engage in direct ground combat. Both
    will serve to help inform the Department's judgment on this issue and
    our response to Congress.
        The Department looks forward to providing Congress with the results
    of the extensive review of all gender-restrictive policies upon
    completion, as required. Of course, such a comprehensive and expansive
    review, of such a longstanding time-tested policy, especially during a
    period of ongoing combat operations, must be conducted deliberately and
    methodically, but without delay.
    Sexual Assault Prevention and Response (SAPRO)
        The Department's position on sexual assault is clear: One sexual
    assault is one too many.
        The department-wide policy on sexual assault prevention has been in
    place since 2005. In just this past year alone, we have made
    significant strides to prevent and respond to this crime. But we know
    we must do more.
        Since 2006, the rate of reported unwanted sexual contact has been
    reduced by one-third, dozens more investigators, field instructors,
    prosecutors and lab examiners have been hired; more and more victims
    are stepping forward to report assaults and the percentage of alleged
    sexual assault offenders facing court-martial proceedings has
    increased. Funding levels over time for SAPRO are reflected in Table 4,
    below.

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        While efforts are beginning to pay off, there is still work to do
    to integrate and improve our efforts. Please know I take this issue
    very personally and am committed to addressing it swiftly and
    comprehensively. Preventing sexual assault within our military is a
    leadership responsibility, and we must all be held accountable for
    eliminating it from our ranks.
    Repeal Don't Ask, Don't Tell
        On 22 December 2010, the President signed the enactment of the
    repeal of 10 U.S.C. Sec. 654, ``Policy concerning Homosexuality in the
    Armed Forces.'' Subsequently, the Secretary of Defense directed me to
    lead the implementation process for the Department.
        As the Secretary testified, the Department is committed to
    executing this change in a purposeful and responsible manner. By
    organizing a DOD Repeal Implementation Team, we have been able to
    synchronize the implementation of all the Services' policy changes,
    education and training, and communication strategies. It is important
    that we implement this change in law at once across the Department.
    Directed by the Secretary of Defense's Terms of Reference, the Repeal
    Implementation Team has ``operationalized'' the Comprehensive Working
    Group's Support Plan for Implementation and signed policy changes on
    January 28, 2011, and delivered standardized training materials to all
    Services on February 4, 2011. The predominant form of training will be
    by commanders and leaders, but the Services will also use various forms
    of training including Mobile Training Teams, Chain Teaching, Computer-
    Based Training, Digitally Assisted Training, or combinations of these
    techniques. The Department has purposefully told the Services to take
    the time necessary to get this done right, but not 1 minute more. As a
    result, the Services are carefully executing a deliberate and thorough
    roll out of the necessary training. The timing for each will vary due
    to their size, operational schedules and the most efficient and
    effective methods to deliver the training. Of note is the fact that
    each of the Services has completed their review of policies and has
    begun delivering training.
        Rest assured, we are committed to making this historic change in a
    timely manner that is consistent with standards of military readiness,
    effectiveness, unit cohesion, and recruiting and retention of the Armed
    Forces.
    Compensation
        The Department continues its strong commitment to provide a secure
    standard of living and quality of life to those who serve in uniform,
    while at the same time balancing the demands of an All-Volunteer Force
    engaged in hostilities around the world. Our budget requests reflect
    this commitment. Soldiers, sailors, airmen, and marines continue to
    express healthy satisfaction with the full pay and benefits the
    Military Services provide. The generosity of current military pay and
    benefits has generated high retention across each of the Military
    Services. This has occurred despite the stresses and burdens associated
    with the high deployment tempo and partially because of the current,
    challenging economy. As a result, today's military compensation
    compares very well with that in the private sector.

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        Over the past decade, the Department and Congress together have
    faced a host of challenges in ensuring military compensation remains
    adequate to recruit and sustain America's All-Volunteer Force. A little
    over a decade ago, the Department did not always meet its recruiting
    and retention goals. The success of our combined efforts in improving
    the competitiveness of military compensation over the past several
    years resulted in the current and sustained success across each of the
    Services in meeting or exceeding overall recruiting and retention
    goals.
        To ensure tomorrow's military remains as ready and capable as it is
    today, we must not take for granted today's recruiting and retention
    successes. Yet, at the same time, the Department recognizes the intense
    fiscal pressures the country faces and the need to control rising
    personnel costs. The Department is committed to efficient spending of
    the appropriation authorized for personnel. Through a comprehensive,
    holistic approach, the Department intends to leverage its compensation
    tools to sustain recruiting and retention success while also
    restraining entitlement growth.
        Ensuring tomorrow's high-quality military also requires the
    Department to advocate for maintaining military compensation at levels
    competitive with the private sector. Highlighting this commitment to
    our personnel, in the fiscal year 2012 budget the Department requested
    an increase in military basic pay for all servicemembers of 1.6
    percent, which equals the earnings increase seen in the private sector
    as measured by the annual change in the Employment Cost Index.
        In the search for budget cuts and efficiencies, many groups, such
    as the National Commission on Fiscal Responsibility and Reform, the
    Defense Business Board, the Government Accountability Office, and
    others have compared military and private sector compensation, noted
    differences in the structure of compensation packages, and offered
    advice and suggested changes. We know the military is different from
    the private sector. Military compensation has evolved over time and is
    successfully recruiting and retaining today's military force. In the
    search for efficiencies, all areas, including compensation, need to be
    continually reexamined.
        One area we are in the midst of examining is the Department's use
    of Imminent Danger Pay. Together with the Military Services and the
    Joint Staff, we are reviewing all locations currently designated as
    eligible for the pay. As part of that review, we are considering
    alternatives to the current Imminent Danger/Hostile Fire Pay structure
    that differentiate payments based upon varying levels of danger or risk
    as well as proximity to combat.
        As you may already know, the President tasked the 11th Quadrennial
    Review of Military Compensation (11th QRMC) to review four areas:
    combat compensation; compensation and benefits for the National Guard
    and Reserves; compensation for wounded warriors, caregivers and
    survivors; and incentive pays for critical career fields, specifically
    mental health professionals, linguist/translators, remotely piloted
    vehicle operators and Special Operations Forces. Additionally, the QRMC
    is assessing where military compensation ranks compared to the private
    sector.
        This QRMC was given an unusually short period in which to conduct
    its review and develop recommendations. It has 1 year to complete the
    review (which began in May 2010) and is required to preview its
    recommendations with the White House prior to completing the review.
        Although some additional analysis is still required, the research
    institutions supporting the QRMC provided their initial assessments to
    the QRMC. Based on that research, the QRMC has developed its initial
    findings and preliminary recommendations, which are being sent to the
    White House.
        It would be premature for me to discuss possible recommendations
    until they have been delivered to the White House. But I think I can
    safely say that the QRMC is finding that improvements could be made in
    how we compensate those sent into combat and how we compensate the
    Guard and Reserve that is more consistent with their current and future
    use. Once the recommendations have been delivered to the White House,
    the QRMC plans to brief the committee's staff on its findings and
    recommendations, and will be available to answer any questions.
        One area where we have noted success is in targeting special and
    incentive pays and bonuses. Unlike broad and expensive across-the-board
    basic pay increases, these pays provide us the flexibility to narrowly
    and efficiently target specific skills, occupational specialties,
    experience, and the quantity and quality of personnel filling those
    positions. At less than 5 percent of the military personnel budget,
    these efficient, targeted pays provide a significantly greater impact
    on the ability of the Department to meet its personnel needs. The
    amount spent on these pays has declined, especially when compared to
    previous expenditures. As we continue our search for efficiencies, we
    will continue to rely on the effective and efficient use of these pays.

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        Overall, the state of military compensation is healthy, and it
    contributes mightily to our success in achieving our recruiting and
    retention goals, after almost a decade at war. As we look forward, the
    Department continues to focus on restraining the growth of mandatory
    entitlements while leveraging cost-effective discretionary pays and
    bonuses. The Department is committed to carefully managing both the
    compensation tools and the resources provided by Congress and
    continuing to search for efficiencies throughout the compensation
    system.
    Travel Simplification and Transformation
        Although the Military Services and defense agencies attempt to be
    good stewards of taxpayer dollars while meeting their mission
    requirements, their efforts are complicated by layers of law, appellate
    decisions, and regulatory oversight pertaining to travel. Over a period
    of approximately 60 years, title 37 travel authorities have become
    overly detailed and prescriptive, seemingly covering almost every
    travel situation. An unintended consequence is that new legislation is
    required to address new travel situations, such as travel authorities
    for those caring for wounded warriors or for those accompanying
    servicemembers to Yellow Ribbon events.
        To simplify travel, we believe that the travel authorities that
    exist today should be considered for consolidation and reform. This
    will allow us to streamline travel and to look for ways to consolidate
    and replicate rule sets that garner efficiencies for the Department.
    Initiatives such as elimination of receipts, simplifications of
    allowances, and others have the potential to provide the Department
    with efficiencies that will generate a savings without having the
    traveler bear the burden of the cost. Further, travel efficiencies can
    result from both a reduction of direct and indirect costs. Direct costs
    are the outlays for the conduct of travel, such as lodging and
    transportation. Indirect costs include outlays for managing the travel
    enterprise, such as the administrative costs of processing complex
    travel vouchers. With more flexible statutory authorities, the
    Department would be better able to leverage private sector practices.
    We are confident this will result in simplified travel rules for the
    traveler, reduced outlays for the Department, and increase mission
    flexibility for leaders.
        This transformational endeavor is being overseen by the Defense
    Travel Management Office, the single focal point for commercial travel
    within DOD. The DTMO brings visibility and coherence at the enterprise
    level, and partners across the government and private sector to
    maintain an in-depth perspective of the travel industry and to
    determine the best practices and standards for DOD travel.
                               reserve component
    Envisioning the Reserve Component as Part of the Operational Force
        During a decade of sustained engagement in combat operations, the
    Reserve components (RC) of our Armed Forces have been transformed, from
    a strategic force of last resort to an operational Reserve Force that
    provides full-spectrum capability to the Nation in addition to its
    traditional role as a Strategic Reserve. Repeated combat deployments,
    as well as peacekeeping and humanitarian relief missions, have produced
    an operationally resilient force that fully expects to be employed on a
    periodic basis. This new force represents a 10-year investment in
    resourcing commitments and the personal sacrifice of servicemembers and
    their families. That investment can reliably provide DOD with essential
    operational capabilities and strategic agility. Good stewardship
    demands that we continue to capitalize on this investment in order to
    maintain Guard and Reserve readiness, relieve stress on the Active
    component, and provide force structure options in a resource
    constrained future. Representing the views of numerous stakeholders
    across the entire Department, the QDR-directed Comprehensive Review of
    the Future Role of the Reserve component provides a foundation upon
    which to build a cohesive execution strategy that preserves current
    Total Force competencies, efficiently integrates multiple capabilities,
    and leverages Reserve component value.
        1. Readiness Requirements
        The fiscal year 2012 budget request supports the Ready Reserve,
    including the Individual Ready Reserve, totaling about 1.1 million
    members, and contributing 43 percent of the total military end strength
    at a cost effective level of 9 percent of the total base budget. To
    maintain the Guard and Reserve as an integral part of the Operational
    Force into the future and ensure these forces are ready and available
    when needed, we must: (1) program the training and use of the Reserve
    components into Service base budgets; (2) continue to use supplemental
    funding to deploy the Reserve component for contingencies; and (3)
    develop a national strategic communication plan that explains to the
    American people why the Guard and Reserve are important to the Nation
    and how the Department plans to use those forces in the future.
        2. Continuum of Service, End Strength and Readiness Management
        Meeting Reserve component end strength objectives is a priority of
    the Department. The table below depicts the current prescribed and
    actual end strengths for the Reserve components. The Department's
    Continuum of Service efforts have contributed to the six DOD Reserve
    components remaining within the variance allowed for their
    congressionally-mandated end strength objective. The Services have
    implemented recruiting, retention, and force shaping policies and
    programs to achieve end strengths for fiscal year 2011. We appreciate
    the congressional support of the fiscal year 2011 end strength levels
    and the legislative initiatives that assist in recruiting and retaining
    Reserve component servicemembers. These end strengths will provide the
    Reserve components the forces necessary to meet strategic demands while
    maintaining a dwell consistent with Departmental policy.

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        Personnel and medical readiness continue to be a priority for the
    Department. Of the end strength figures outlined above, approximately
    72,000 are in the training pipeline for the Reserve components and are
    not immediately available for mobilization. Additionally, as of the
    first quarter of fiscal year 2011, the RC has a Fully Medically Ready
    rate of 63 percent, which is below the DOD goal of 80 percent. The
    lower RC Medically Ready rate is due to a significant number of members
    who are deemed Not Medically Ready (17 percent)--disqualifying dental
    condition is the principal factor. However, DOD is diligently working
    to make medical and dental services more available to RC members, and
    as of the first quarter of fiscal year 2011, all components have met or
    exceeded the Dental Readiness goal of 75 percent, which will have a
    positive impact on overall medical readiness.
        3. Dwell, Stress on Force
        The RC provides an operational capability and strategic depth in
    support of the national defense strategy. It is imperative that
    predictability in the use of RC forces be maximized. On January 17,
    2007 the Secretary of Defense established planning objectives for
    involuntary mobilization of Guard and Reserve units at 1 year mobilized
    to 5 years dwell time (1:5). Today's global demands require a number of
    selected Guard/Reserve units to be remobilized sooner than this
    standard. The intention is that such exceptions will be temporary and
    that we move to the broad application of 1:5 as soon as possible.
    Exceptions to policy began at the 1:4 threshold and for the past 6
    months 10 percent of the members involuntarily mobilized have had less
    than a 1:4 dwell. This trend has consistently improved since the policy
    was established. This is due in part to widespread volunteerism and
    Service management of deployment cycles.
    Training and Recruiting the Reserve Component as Part of the
            Operational Force
        The Regional Integrated Training Environment (RITE) Concept is a
    joint effort that identifies and matches Services' training
    requirements to a vast network of local training facilities and
    resources. The purpose of the RITE initiative is to help sustain the
    total force readiness posture and surge capability as determined by
    service rotational readiness models while reducing overhead training
    costs through innovative management of facilities, training assets,
    advance simulators and Joint Virtual Live and Constructive (JLVC)
    capability, pooled, shared equipment, and coordinated through a web-
    based scheduling/visibility program. As the concept matures,
    collaboration will expand with key internal and external DOD
    stakeholders.
    Employing a Rotational Reserve as Part of the Operational Force
        Every day for the past 9 years over 20,000 Reserve component
    servicemembers have served on active duty as volunteers. These
    individuals have the time and life style situation to serve more than
    the 1 weekend per month and 2 weeks per year that have long been
    considered standard for Guard and Reserve personnel. The Department
    should adopt methods to leverage this willingness to serve in order to
    fulfill the part-time and temporary demands of its combatant commands,
    major command headquarters, and the Defense agencies. One of several
    options to institutionalize differentiated service in the Reserve
    component is for DOD to create Reserve component units staffed by
    personnel willing to serve more frequently or for longer periods of
    time in order to support such tasks as Theater Security Cooperation,
    Building Partner Capacity, HD, Defense Support to Civil Authorities,
    and the Services' institutional support missions. Service in these
    units would be voluntary; the member would join knowing full well the
    conditions of service. Realizing a differential service commitment
    would require the development of contracts or agreements that would
    commit willing Guard or Reserve members to serve in units requiring
    higher rates of mobilization or access. This type of differential
    service commitment has been in use successfully in high optempo units
    such as aviation for some time, but with the Reserve component now
    playing a larger role in many ongoing mission areas, expanded
    utilization of differential service contracts would be beneficial. Such
    differentiation within the Reserve component would provide an
    additional sourcing option for units, teams, and personnel for
    contingency operations or emergencies.
        Future planning envisions an era of persistent conflict where some
    type of RC activation authority will be required to augment the AC to
    maximize effectiveness and efficiency of the Total Force. At present,
    we have sufficient authority to mobilize RC forces, however, as
    directed (by the Senate Armed Services Committee conference report S.
    Rept. 111-201, page 138) we have analyzed our access authorities to
    support long-term utilization of the RC as part of the operational
    force. We foresee an authority gap when the Nation is faced with
    persistent demands on the Total Force but does not have specific
    operational missions, a national emergency or war situation. This
    authority gap exists for some, but not all, of the full spectrum of
    military missions, including training, security force assistance and
    building partnership capacity, that our RC is specifically well suited
    to perform as a complementing part of the Total Force. We are reviewing
    potential changes to existing statute to close this authority gap to
    further increase dwell for the Active component while maintaining RC
    readiness.
    Reintegrating and Continued Care of the Reserve Component as Part of
            the Operational Force
        1. Resilience Training & Preparation
        Resiliency is at the core of the Yellow Ribbon Reintegration
    Program (YRRP) mission. Since its inception in 2008, there has been an
    ever increasing focus on resiliency building and training for the
    National Guard and Reserve Forces. In response to growing awareness
    regarding the connection between post-traumatic stress (PTS), substance
    abuse, criminal activity or suicide and ``bounce back'' ability,
    Reserve component (RC) members and their families are being offered
    training to enhance their resiliency skills. The RCs have incorporated
    resiliency skills into their training protocols which are available to
    activated servicemembers. The objective of the YRRP is to ensure the
    readiness and well-being of National Guard and Reserve servicemembers
    and their families by providing dynamic events, information, services,
    referrals, and proactive outreach opportunities throughout the entire
    deployment cycle.
        Resilience training, one component of a comprehensive program, has
    been added to assist members of the Armed Forces with building mental
    and emotional resiliency to successfully meet the demands of the
    deployment cycle. YRRP staff members have attended Service and DOD-wide
    training events and are scheduled to attend additional sessions in 2011
    to ensure the unique requirements of the National Guard and Reserve are
    incorporated into the resilience training approach.
        As part of the YRRP, services and information that foster
    resiliency are provided at the pre-deployment, during deployment, and
    the 30, 60, 90 day post-deployment events. The Yellow Ribbon
    Reintegration Program implemented a Cadre of Speakers program, hiring
    facilitators who specialize in resilience training and who are
    available to YRRP event planners across the country. These facilitators
    also work with Military and Family Life Counselors and chaplains to
    provide critical support around resilience issues at YRRP events,
    ensuring individual assistance is available for each family or
    servicemember as required.
        Additionally, other sessions and resources focus on marriage and
    children, substance abuse awareness, financial counseling, anger
    management, employment assistance and Department of Veterans Affairs'
    information regarding benefits and medical care eligibility. To find an
    event or additional resources, a RC member, commander, planner, or
    family member can access information at http://www.yellowribbon.mil/.
        2. Family Programs
        In both the Active and Reserve components, servicemembers and their
    families have made tremendous sacrifices for our Nation and they
    continue to do so. Guard and Reserve families rely on their local
    leaders and communities for support. DOD and its partners in
    governmental and non-governmental organizations have worked to
    coordinate support systems and communicate available resources to our
    servicemembers and their families. We all know that the work to
    strengthen and support military families is never complete and DOD
    continually strives to identify gaps in our support and to link
    appropriate community resources.
        Throughout a servicemember's continuum of service, DOD strives to
    put in place a viable support system. A coordinated network of support
    with defined processes serves the needs of military families in
    geographic locations closest to where they reside. Additionally, as
    stated in the Presidential Report on Strengthening Our Military
    Families, there have been positive reviews from States successfully
    implementing a one-stop resource to handle State-wide military family
    issues using Inter-Service Family Assistance Committees (ISFACs). These
    locally-based committees work to build community capacity and
    strengthen networks of support. DOD plans to build on these grassroots
    efforts to benefit geographically dispersed Active, Guard, or Reserve
    servicemembers and families.
        3. Employment Initiative Program (EIP)
        One of the greatest challenges facing our Nation right now is
    unemployment and underemployment, and these related problems are
    especially severe for those in the Guard and Reserve or for those
    leaving active military service. Whether they are soldiers, sailors,
    airmen, coast guardsmen, or marines completing active duty, or members
    of the Guard and Reserve returning from deployment, many of these great
    men and women return home to an uncertain future because of the tough
    job market.
        The promise of a secure job provides servicemembers and their
    families with stability and peace of mind. In the December 2009 Status
    of Forces Survey of Reserve Component Members, servicemembers across
    six of the seven Reserve components (Coast Guard Reserves not included)
    self-reported a 12 percent unemployment rate, although the highest
    unemployment rate across all components was 22 percent among junior
    enlisted troops in the rank of E1-E4. As this data is self-reported,
    many of these younger troops are likely to be students. The total
    number of respondents was 20,238 (from an estimated population of 822k)
    RC servicemembers.
        In accordance with NDAA 2011 requirement to provide transitioning
    servicemembers with employment information, the Assistant Secretary of
    Defense for Reserve Affairs has focused resources on ensuring
    servicemembers have a civilian job that provides stability in their
    civilian life and allows them the time and resources to contribute to
    our national defense by serving in the Guard and Reserve. During fiscal
    year 2010, the YRRP aligned with Employer Support of the Guard and
    Reserve (ESGR) and Family Programs. This was accomplished to create
    synergy and realize efficiencies for the servicemembers and families
    served by YRRP, ESGR and Family Programs' missions. Since ESGR's
    creation in 1972, the focus has been on developing and promoting
    employer support for Guard and Reserve service. In fiscal year 2011,
    ESGR placed additional emphasis on the employment arena and now assists
    servicemembers throughout the entire employment cycle. The current
    employment challenges led to the implementation of EIP.
        The overall intent of EIP is to take full advantage of all ESGR,
    Yellow Ribbon, and Family Programs, in partnership with public and
    private entities, to enhance employment opportunities for
    servicemembers and their families, especially focusing on those
    completing active duty tours and our Wounded Warriors. Of note, ESGR
    possesses a very strong network of over 4,700 volunteers located
    throughout the Nation. EIP will leverage the volunteer network to meet
    the requirements of this mission.
        At the national leadership level, DOD is working in a collaborative
    effort with Federal agencies--including the Department of Labor,
    Department of Veterans Affairs, Small Business Administration and the
    Office of Personnel Management--to create efficiencies, enhance the
    employment process and serve as an effective resource for
    servicemembers and employers. In addition, ESGR has worked with
    specific associations to enhance the overall effectiveness of this
    program. One example is ESGR's work with the Society for Human Resource
    Management (SHRM). The more than 263,000 HR professionals of SHRM are
    instrumental in engaging with employers while determining meaningful
    employment opportunities for servicemembers.
        EIP has a high-tech and high-touch approach. The high-tech approach
    is comprised of the Employer Partnership of the Armed Forces Web site
    www.employerpartnership.org which provides employers with the ability
    to post available jobs and allow servicemembers to post resumes and
    make a job connection. The high-touch approach comes through a series
    of employment related events being conducted with YRRP Events and State
    specific job events.
        ESGR is positioned to meet the challenge of ensuring servicemembers
    have quality civilian job opportunities. Pilot programs conducted in
    fiscal year 2010, consisting of job fairs, transition assistance and
    job training sessions, proved valuable in helping servicemembers at the
    local level. This community-based approach will be a pivotal element in
    EIP as it continues to develop.
                          readiness of the total force
        Military readiness is not an abstract concept that can be reduced
    to colors on a chart--it involves a complex series of factors and
    indicators that must be evaluated and managed carefully. For example,
    our Services are achieving or exceeding their recruiting goals and have
    exceptional retention rates. In addition, the Force is combat
    experienced and proficient in a wide range of operations, including
    irregular warfare and stability operations. However, equipment
    readiness and training for conventional warfare have suffered during
    the same period. It is in this complicated environment that Personnel
    and Readiness works to maintain and sustain the Readiness of the Total
    Force through support to the combatant commanders, as well as the
    military Services.
    Readiness and Deployments
        Multiple deployments to Iraq and Afghanistan have increased the
    stress on our servicemembers and their families, and some would argue
    have reduced the readiness of the Department. However, our forces are
    combat experienced and proficient in a wide range of real world
    operations. They are no doubt the best trained and equipped force in
    the world. The All-Volunteer Force is healthy, and our Services are
    achieving or exceeding their recruiting and retention goals with
    quality people. In short, our forces remain ready to execute the
    missions assigned to them by the President.
        We have focused on preparing our ground combat forces for the
    operations they face in Iraq and Afghanistan. This means there is less
    focus on the type of training we have done in the past such as large
    scale ground maneuver warfare (i.e. tank on tank). We can and will
    rebalance this training when needed to make certain our forces are
    prepared to meet the needs of our combatant commanders in a complex and
    uncertain security environment.
        We also carefully manage the dwell time of our forces across the
    Department, and have limited unit deployments and mobilizations to 1
    year. We have also balanced the additional forces for Afghanistan
    against those coming available from the draw-down in Iraq. We are
    meeting the Operation New Dawn responsible drawdown plan goals. The
    Army had 25 Brigade Combat Teams (BCTs) deployed to Operation Iraqi
    Freedom and Operation Enduring Freedom in 2008, 21 BCTs deployed in
    2010, and are projecting to have 50 percent fewer BCTs deployed in 2012
    as compared to 2010. The Army projects the average unit boots on the
    ground to dwell ratio to improve to approximately 1:2 for Active
    component units and 1:4 for Reserve component units in 2012. We are
    making excellent progress toward our dwell goal of 2 or more years at
    home for every year deployed with nearly 70 percent of the Active Force
    meeting or exceeding this goal.
    Suicide Prevention
        Suicide prevention is a very important issue within the Readiness
    portfolio. The loss of even one life to suicide is heartbreaking; it
    degrades the readiness of the force and has a profound impact on both
    the unit and the family members left behind. Many factors contribute to
    the suicide rate. One factor relates to leadership. Each Service
    acknowledges the important role that leaders, both officer and NCO,
    play in building resiliency among those under their command. In 2010,
    there were 294 servicemembers who committed suicide while on active
    duty, down from a total of 310 in 2009. While this is not a significant
    decrease, we have arrested the steady increases in overall active duty
    suicides that began in 2006. I believe this is due largely to our
    increasing emphasis on resilience across the Department highlighted by
    programs such as the Army's Comprehensive Soldier Fitness. This program
    is designed to develop and institute a holistic fitness program for
    Soldiers, families, and Army civilians in order to enhance performance
    and build resilience. To date, the Army has trained 3, 253 Master
    Resilience Trainers to facilitate this goal. The other Services are
    developing or enhancing similar programs and benchmarking off the
    Army's success.
        There have been several studies and task force reports (DOD, Army
    and RAND) released over the past year each with multiple observations
    and recommendations. The Deputy Assistant Secretary of Defense for
    Readiness is currently leading a team of senior Officers and Executives
    from the Department in an effort to examine these reports and devise an
    implementation plan based on the recommendations that will enhance our
    suicide prevention efforts across the Department.

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    Focus/Highlight RC and RC Suicide Prevention Strategy
        The Army National Guard reported 112 suicides in 2010 (145 total
    with Army Reserve added) which was up significantly from the previous
    year (80 total Army Guard/Reserve), which is a cause for concern. This
    already complex issue becomes even more complex when dealing with our
    Reserve component because of their continuous transition from military
    to civilian life. Nevertheless, the Department is committed to
    addressing this issue in our Reserve component. We currently have a
    Director of Psychological Health in each of our 54 States and
    territories who acts as the focal point for coordinating the
    psychological support for Guard members and their families. The NDAA
    mandated that the Department expand suicide prevention and community
    healing and response training under the Yellow Ribbon Reintegration
    Program. We have made some progress here and are in the process of
    reinvigorating this effort with input from a Reserve Component
    Stakeholder Group comprised of all of the Reserve and National Guard
    components, Reserve Affairs Yellow Ribbon representatives and members
    of the Defense Centers of Excellence. Additionally, we are examining
    ``peer-to-peer'' programs, such as New Jersey Vet2Vet, to see what role
    these types of programs can play in reducing suicides.
    The Suicide Prevention and Risk Reduction Committee
        The Suicide Prevention and Risk Reduction Committee serves as a
    forum for inter-Service and Veterans Affairs partnership and
    coordination. Chaired by the Defense Centers of Excellence, its members
    include the Suicide Prevention Program Managers from all Services,
    representatives from the National Guard and Reserves, the Department of
    Veterans Affairs, and other key governmental organizations. This
    organization has led the way in standardizing suicide reporting and
    data collection, forming key partnerships, growing the DOD/VA Suicide
    Prevention Conference into a nationally recognized event, and
    addressing several key suicide prevention issues. I plan to continue to
    mature this body, making it more inclusive and effective as a venue for
    collaboration across DOD and Veterans Affairs.
    Drug Demand Reduction Initiative
        Illegal and prescription drugs remain readily available to DOD
    servicemembers. The use of illegal drugs and the misuse of prescription
    drugs are both a symptom and problem that fuels the worsening of other
    conditions; such as deployment stress, suicides, and workplace safety
    resulting in degradation of unit readiness. Based on a recommendation
    of the Chairman of the Joint Chiefs of Staff, we are taking a new
    systematic approach to counter an emerging drug abuse problem in the
    military. The Department's current demand reduction approach will be
    expanded to include prescription drug testing and integrated with the
    Readiness Office's suicide and accident reduction efforts. As part of
    this effort, we plan to further target applicant testing, improve
    random drug testing in CONUS and in theater, and expand testing to
    include commonly abused prescription drugs.
    Military Leadership Diversity Commission
        The MLDC, mandated by the NDAA for Fiscal Year 2009 and referred to
    as the MLDC, is scheduled to release its final report directly to the
    President and Congress in mid-March 2011. The draft final
    recommendations described on the MLDC public web site provide an
    insight into the content of the final report.
        The draft report reflects over 12 months of work performed by 31
    appointed commissioners in response to the MLDC Charter to conduct a
    comprehensive evaluation and assessment of policies that provide
    opportunities for the promotion and advancement of minority members of
    the Armed Forces, including those who are senior officers.
        Specific recommendations define diversity as individual
    characteristics consistent with DOD core values; require diversity to
    become an institutional priority; make leading diverse groups a core
    competency; and call on Congress to mandate annual DOD diversity
    reports. Other key final recommendations address the following areas:

             Retention programs for women
             Activities that will expand the pool of qualified
            candidates
             Eliminating the ``combat exclusion policy'' for women
             Ensuring transparency throughout the promotion system
             Conducting senior-level annual accountability reviews,
            and
             Aligning organizational structures to ensure a focus
            on diversity.

        My staff and I stand ready to accept the decision of the President
    and Congress as relayed by the Secretary of Defense to address the
    findings and recommendations stated in the MLDC report.
    Language, Regional, and Cultural Capabilities
        The Department is continuing its work to ensure our Total Force is
    prepared for a full range of varying and complex missions that our
    current and future security environment requires which includes
    building expertise in foreign languages, regional and cultural skills.
    DOD invested $652 million in fiscal year 2010 to support language and
    culture instruction to achieve higher proficiencies for the Total Force
    in these skills. This investment includes: (a) pre-accession training
    and education at the Service Academies and ROTC; (b) improved resident
    and non-resident language and culture training for uniformed language
    professionals and for General Purpose Forces; (c) provided monetary
    incentives to individuals to identify, sustain and enhance for foreign
    language proficiency; and (d) we strengthened foreign language
    proficiency testing and readiness reporting.
        The fiscal year 2011 budget focuses on sustaining gains achieved in
    previous years and continuing to build a solid foundation to meet
    future demands. The baseline funding in fiscal year 2011 is projected
    at $735 million (does not include MILCON). This includes establishing
    Language Training Detachments to provide and sustain commanders'
    requirement for culturally based language training for general purpose
    forces, support the Afghanistan/Pakistan Hands program, and expand the
    role of English language training for partner nation personnel.
        The fiscal year 2012 budget focuses on sustaining gains achieved in
    previous years and continuing to build a solid infrastructure in which
    to meet future demands. The baseline funding request of $792 million in
    fiscal year 2012 supports redirected language and culture instruction
    to achieve higher proficiencies for the Total Force in these skills.
    This includes $46 million in fiscal year 2012 for Language Training
    Detachments to provide and sustain commanders' needs for general
    purpose forces, support the Afghanistan/Pakistan Hands program, and
    expand the role of English language training for partner nation
    personnel. Today, the Department is moving ahead on several fronts to
    develop strategic direction, create effective policies, and refine
    processes for generating language, regional, and cultural capabilities.
        We recently published the Language, Regional and Cultural Strategic
    Plan that sets out our strategic direction in providing our warfighters
    with the capabilities needed to meet the diverse operational needs of
    the 21st century. In January 2011, we convened a DOD Summit on Language
    and Culture. Over 300 leaders from across the DOD, other U.S.
    Government agencies, industry, and academia met to discuss and propose
    innovative solutions to the key challenges facing the Department and
    the greater Nation.
        We also published counterinsurgency training guidance to require
    language and culture training for forces deploying to theater. The
    Department is tracking compliance with this training and tying language
    and cultural preparation of deployed forces to unit readiness
    reporting. This represents an enduring organizational change in how the
    Department views these capabilities. We are implementing a standardized
    requirements identification process. This process will identify the
    capabilities and capacity to ensure that the right mix of language and
    regional skills are developed to meet mission needs. In the past,
    demand signals were incomplete and did not always reach force
    providers.
        The Department supports the efforts of our Nation's educational
    system to produce more graduates with language and culture skills. It
    has established more robust language requirements for our Service
    Academies and established programs and incentives for our Reserve
    Officers' Training Corps. We are expanding the DOD Educational Activity
    foreign language program to provide a model for building foreign
    language skills pre-Kindergarten through 12th grade. These initiatives
    will ensure a strong return on investment. The results will be an
    increased capability in these skills which can be leveraged and
    expanded to meet needs in today's dynamic and complex world.
                             military health system
    Health Budgets and Financial Policy
        The Defense Health Program (DHP) budget request reflects that we
    are operating in an environment where financial resources are limited,
    and that specific actions must be undertaken to better manage the rise
    of health care costs. In many respects, our challenges in this area are
    not unlike those experienced by other public and private organizations
    that are similarly experiencing escalating health care costs--driven by
    an aging population, a continued increase in expensive new medical
    technologies and pharmaceuticals, and increased utilization of
    services. In our circumstance, however, we must also be aware that the
    exponential growth in health costs can pose a long-term threat to
    competing defense priorities.
    DHP Future Health Care Costs TRICARE--MHS Costs
        In the budget proposed by the Department, we have included a number
    of specific initiatives that both ensure we continue to provide the
    finest health benefit in this country for our active and retired
    servicemembers and their families, and also puts us on a long-term path
    to proper financial stewardship of the taxpayers' dollar. First, we are
    focused on internal efficiencies. From targeted reductions in non-
    patient care contractor support to greater optimization of our medical
    supply chain, we are pursuing a range of initiatives that offer real
    reductions in our budget. Second, we are pursuing a more equitable
    management of benefits across all health care programs. We are
    continuing to align civilian provider payment policies with Medicare,
    as Congress has long directed. Finally, for working age retirees, we
    are proposing minor changes to out-of-pocket costs that are
    exceptionally modest and remain well below the inflation-adjusted out-
    of-pocket costs enjoyed in 1995, when TRICARE Prime was first
    introduced. We have incorporated numerous safeguards--grandfathering in
    all current enrollees to unique programs; phasing-in new reimbursement
    methodologies for providers; and excepting certain beneficiaries
    (survivors and medically retired servicemembers) from any enrollment
    fee changes--in order to protect our most vulnerable beneficiaries.
    Health Affairs/TRICARE Management Activity Strategic Direction
        I am also encouraged by the long-term strategic direction of our
    medical program. The Office of Health Affairs has adopted a strategic
    construct--the Quadruple Aim--that captures the core mission
    requirements of this unique health system of ours: (1) Improved
    Readiness; (2) Improved Health; (3) Enhanced Patient Experience; and
    (4) Responsible Management of Cost. The Health Affairs leadership,
    together with the Service Surgeons General, has put into place a
    sophisticated set of strategic imperatives and quantifiable measures
    that help inform me and the Service Secretaries and Chiefs on our
    progress in meeting the most important goals for our servicemembers and
    families--that includes how we are performing in the areas of
    psychological health and traumatic brain injury, delivery of preventive
    health services, focus on outcomes and overall satisfaction with the
    delivery of health care, to name just a few.
    Mental Health Professionals
        The mental health workload has increased across the Military Health
    System (MHS) for both active duty servicemembers and family members.
    Among the reasons for this increased workload are PTSD, TBI, earlier
    identification of mental health issues, increased suicides and suicide
    attempts, and reduced stigma of seeking mental health care. This
    workload has increased the need for mental health providers. Currently,
    throughout the MHS, there are a total of 7,662 military, civilian, and
    contract employees (full-time equivalents) providing mental health
    care. This reflects a shortage of 1,025 which puts the MHS at 88
    percent fill compared to requirements. We are pursuing efforts to
    assist the Services in recruiting and retaining these critical mental
    health provider positions. These efforts include using Direct Hire
    Authority and Expedited Hiring Authority that Congress provided the
    Department to help recruit providers. Additionally, we are implementing
    the Physician and Dentist Pay Plan (PDPP) which will ensure we can pay
    critical shortage specialties, such as psychiatrists, salaries
    competitive with the private sector.
                              dod/va collaboration
        In order to take better care of our servicemembers, in particular,
    our Veterans who have served in combat, it is imperative that DOD and
    VA have a close and collaborative working relationship. While our two
    organizations have different missions, our priority is the same--taking
    care of those who have served and sacrificed for our country.
        In this effort, DOD and VA work together through a governance body,
    created by Congress, to ensure that we are in constant communication
    and work in collaboration. The formal governance council structure put
    in place to oversee development of policy and support DOD/VA joint
    initiatives and resource sharing, including information sharing is the
    Joint Executive Council (JEC), which is co-chaired by the Deputy
    Secretary of VA and the DOD Under Secretary for Personnel and
    Readiness. The JEC is the overarching council, linking the DOD/VA with
    two supporting councils: the Health Executive Council (HEC) and the
    Benefits Executive Council (BEC).
        The Health Executive Council (HEC) is co-chaired by the Assistant
    Secretary of Defense for Health Affairs and the VA Under Secretary for
    Health and reports directly to the Joint Executive Council (JEC). The
    HEC meets bimonthly and is responsible for implementing a coordinated
    health care resource sharing program. The HEC is chartered to oversee
    the development and implementation of health care related issues in the
    VA/DOD Joint Strategic Plan (JSP), oversee working groups and steering
    groups, identify opportunities to enhance mutually beneficial
    collaboration, and submit input to the JEC annual report on progress of
    the JSP for health issues. The HEC has charged 20 groups to focus on
    specific high-priority areas of national interest, achieving
    significant success in improving interagency cooperation.
        Today, most healthcare information captured by the DOD and VA is
    done so electronically and deemed necessary for the continuity of care
    and benefits administration. Currently, this information is being
    shared only as viewable data, not computable. Although both Departments
    utilize electronic health records (EHRs) and have computer systems to
    automate administrative and healthcare functions, there is not a
    widespread adoption of EHRs in the private sector among the many
    providers who deliver care to DOD and VA beneficiaries. Some
    information available in both DOD and VA EHRs is of utmost importance
    to the clinical communities treating and caring for DOD and VA
    beneficiaries. Interoperability of EHRs between the DOD and VA is the
    end-state goal of departmental healthcare information sharing. The
    purpose of EHR interoperability is to achieve a single logical (not
    physical) electronic health record view from the day an individual
    enters military service throughout their military career, and after
    they leave the military.
        The Departments continue to identify opportunities to enhance DOD/
    VA electronic health data sharing. After a December 2010 review by the
    Vice Chairman of the Joint Chiefs of Staff, DOD and VA formed six teams
    to create a collaborative approach to the EHR Way Ahead. The teams--
    Enterprise Architecture, Data Interoperability, Business Process,
    Systems Capabilities, Presentation Layer, and Missions Requirements/
    Functions--cover high-level activities needed to plan, develop and
    deploy final recommended solutions. In-progress reviews of the joint
    EHR modernization collaboration effort have been held with the Deputy
    Secretaries of the two departments and team findings are being elevated
    to the DOD and VA Department Secretaries for discussion and
    consideration.
        We believe this careful, collaborative approach will, in fact,
    enhance our decisionmaking process and lead to a solution that can be
    implemented in a more timely and coordinated manner. The EHR Way Ahead
    addresses specific challenges with the current EHR, including outdated
    legacy technologies; ongoing performance and data availability
    problems; and difficulty in using healthcare industry standards.
    World-Class Medical Care in the National Capital Region
        The Base Realignment and Closure (BRAC) construction projects at
    Bethesda and Fort Belvoir will provide nearly 3 million square-feet of
    new world-class clinical and administrative space, cutting-edge
    technology, and Americans with Disability Act lodging to meet the
    rehabilitation needs of wounded, ill, and injured servicemembers. The
    new facilities will improve the infrastructure for casualty care and
    services and better align healthcare delivery with the population
    centers of the National Capital Region (NCR) beneficiaries. The
    projects are on schedule to receive patients and clinical functions
    from Walter Reed Army Medical Center by September 15, 2011, while
    casualty care and patient safety remain the top priorities related to
    the move. The majority of the BRAC construction at both sites is
    complete and patient care is being provided in the new inpatient and
    outpatient pavilions at Bethesda. The Department is paying close
    attention to the timeliness and milestones necessary to achieve the
    final moves.
        The BRAC projects are only part of the larger transformation of
    Military Medicine in the NCR. The NCR contains a mix of nearly 40 Army,
    Navy, and Air Force Medical Treatment Facilities (MTFs), has almost
    550,000 eligible beneficiaries, and runs on an annual operating budget
    of almost $1.5 billion. Its most important patients are the casualties
    returning from the war and their families. The Department is taking the
    opportunity to substantially enhance and transform this multi-Service
    military healthcare market to provide effective and efficient world-
    class healthcare. The Joint Task Force National Capital Region Medical
    (JTF CapMed) is a standing JTF that was established to oversee the
    rationalization and realignment of medical infrastructure to achieve
    greater effectiveness and cost efficiency through the integrated
    delivery of healthcare.
        DOD's Comprehensive Master Plan (CMP) for the NCR, provided to
    Congress last year, outlined how JTF CapMed will implement an
    Integrated Healthcare Delivery System (IDS) to provide this world-class
    healthcare cost effectively. The Department has provided JTF CapMed
    with command and fiduciary authorities to manage MTFs in the NCR and
    directed that the new hospitals at Bethesda and Fort Belvoir become
    joint commands subordinate to JTF CapMed to develop best practices,
    enhance interoperability and patient safety, and combine shared
    services such as contracting, personnel, and consolidated information
    technology--ultimately improving the patient and family experience. An
    example of clinical transformation is in the direct care pharmacy
    system that will facilitate prescriptions and refills no matter where
    in the NCR they are presented, provide refills to Six Sigma quality
    standards, and alleviate traffic concerns at NCR BRAC sites.
        The Department has requested $109 million in the President's 2012
    budget ($762 million between fiscal year 2012-fiscal year 2016) to
    recapitalize medical facilities at Bethesda that the BRAC did not
    address and provide the new space required to convert to single patient
    rooms and expand support for the operating suites. These facility
    projects and the implementation of the NCR IDS by JTF CapMed are part
    of the Department's commitment to providing ``world-class'' healthcare
    in the NCR and fulfilling the requirements under section 2714 of the
    NDAA for Fiscal Year 2010.
                                wounded warriors
        Taking care of our wounded, ill, and injured servicemembers is one
    of the highest priorities of the Department, the Service Secretaries,
    and the Service Chiefs. Reforming unnecessary bureaucratic processes is
    crucial to ensuring servicemembers receive, in a timely manner, the
    care and benefits to which they are entitled. The Department's leaders
    are working to achieve the highest level of care and management and to
    standardize care among the Military Services and Federal agencies. Key
    initiatives include:

             Establishing an Integrated Disability Evaluation
            System (IDES)--to create a simpler, faster, more consistent
            process for determining which members may continue their
            military service and helping them become as independent and
            self-supporting as possible. To date, the IDES has been
            implemented in 78 locations covering over 73 percent of the
            eligible population. The DOD and VA have a strategic goal of
            moving 100 percent of eligible servicemembers into the IDES by
            end of September 2011.
             Enhancing the efforts of care coordinators who work
            closely with wounded, ill, and injured servicemembers, their
            families and their recovery teams to develop a Recovery Care
            Plan that identifies servicemember and family goals, and the
            resources they need to achieve them, such as assistive
            technology, education, employment, or housing.
             Developing and implementing an Education and
            Employment Initiative for wounded, ill, and injured
            servicemembers designed to utilize existing education benefits,
            to prepare and align wounded, ill, and injured servicemembers
            to DOD civilian positions.
             Ensuring a high standard for facilities caring for
            Wounded Warriors. Especially key are first rate hospitals as
            well as facilities and trained staff for the Service Wounded
            Warrior Programs--designed to ensure exemplary support for
            Wounded Warriors and their families.
             Working with the VA to create Virtual Lifetime
            Electronic Records, a key administration initiative, which is
            critical to improving veteran care and services by enhancing
            the availability of administrative and health information.

        The fiscal year 2012 budget request includes $2.3 billion for the
    enduring WII program (Table 9). Of this amount, $415 million provides
    for the continued support of cutting edge Wounded, Ill, and Injured
    medical research, through both the Defense Health Program and the
    Defense Advanced Research Projects Agency. This research is highly
    focused on psychological health/Post Traumatic Stress Disorder (PTSD)
    and Traumatic Brain Injuries (TBI), but also includes prosthetics,
    vision and hearing loss, and other conditions directly relevant to the
    injuries our soldiers are currently receiving on the battlefield.

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    Disability Evaluation System/Integrated Disability Evaluation System
        The genesis of the Disability Evaluation System (DES) is the Career
    Compensation Act of 1949. The DES was relatively unchanged until 2007.
    As a result of public concern and congressional interest, the Senior
    Oversight Committee chartered the DES Pilot in November 2007. The SOC
    vision for the DES Pilot was to create a ``Servicemember Centric''
    seamless and transparent DES, administered jointly by the DOD and VA.
        DOD and VA launched the DES Pilot at the three major military
    treatment facilities (Walter Reed, Bethesda, and Malcolm Grow) in the
    National Capital Region (NCR) on November 21, 2007. The DES Pilot
    successfully created a seamless process that delivers DOD benefits to
    wounded, ill and injured servicemembers and VA benefits to
    servicemembers as soon as possible following release from duty. DOD
    found the DES Pilot to be a faster, fairer, more efficient system and,
    as a result, the SOC Co-chairs (Deputy Secretary of Defense and Deputy
    Secretary of Veterans Affairs) on July 30, 2010, directed worldwide
    implementation of the process beginning in October 2010 and to be
    completed at the end of September 2011. On December 31, 2010, the first
    Integrated Disability Evaluation System (IDES) site became operational,
    which marked the end of the pilot, and the name was formally changed to
    the IDES.
        The IDES, similar to the pilot, streamlines the DES process so that
    the member receives a single set of physical disability examinations
    conducted according to VA examination protocols, proposed disability
    ratings prepared by VA that both DOD and VA can use, and processing by
    both Departments to ensure the earliest possible delivery of disability
    benefits. Both Departments use the VA protocols for disability
    examination and the proposed VA disability rating to make their
    respective determinations. DOD determines fitness for duty and
    compensates for unfitting conditions incurred in the line of duty
    (Title 10), while VA compensates for all disabilities incurred or
    aggravated in line of duty during active military, naval, or air
    service for which a disability rating of 10 percent or higher is
    awarded and also determines eligibility for other VA benefits and
    services (Title 38). The IDES permits both Departments to provide
    disability benefits at the earliest point allowed under both titles.
    Servicemembers who separate or retire (nondisability) may still apply
    to the VA for service-connected disability compensation.
        In summary, the IDES features a servicemember-centric design,
    simpler, faster, and more consistent evaluations and compensation,
    single medical exam and disability rating, seamless transition to
    Veteran status, case management advocacy, and establishment of a
    servicemember relationship with the VA prior to separation. It also
    provides increased transparency through better information flow to
    servicemembers and their families and a reduced gap between separation/
    retirement from Service to receipt of VA benefits. Active component
    members completed the program 37 percent faster than a sample of legacy
    DES cases. As of April 11, 2011, cumulative IDES enrollment is 21,328
    servicemembers with 6,893 completing the program by medical separation,
    retirement, or return to duty and 13,473 remaining enrolled.
        DOD is partnering closely with the Department of Veterans Affairs
    as we aggressively move toward IDES implementation at all 139 CONUS and
    OCONUS sites by 30 September 2011.
        The impact of each stage of the IDES expansion and cumulative DES
    population is shown below:

             Stage I--West Coast & Southeast (October-December
            2010)--(completed) 58 percent
             Stage II--Rocky Mountain & Southwest Region (January-
            March 2011)--(completed) 73 percent
             Stage III--Midwest & Northeast (April-June 2011)--90
            percent
             Stage IV--Outside Continental United States (OCONUS)/
            CONUS (July-September 2011)--100 percent

        IDES constitutes a major improvement over the legacy DES and both
    DOD and VA are fully committed to the Worldwide expansion of IDES. The
    Department is, however, continuously exploring new ways to improve the
    current system. The Secretaries of Defense and Veterans Affairs are
    currently exploring several options to shorten the overall length of
    the disability evaluation process from its current goal of 295 calendar
    days. In addition, the departments are also looking closely at stages
    of the disability evaluation system that are outside of timeliness
    tolerances and developing options to bring these stages within goal. We
    are committed to working closely with Congress in exploring new
    initiatives that can further advance the efficiency and effectiveness
    of the disability evaluation process.
    Transition Initiatives
        To strengthen our Transition Assistance Program (TAP) and reinforce
    its value to servicemembers and their families, the Department, in
    collaboration, with our partners at the Departments of Veterans Affairs
    (VA) and Labor (DOL) is committed to moving TAP from a traditional
    event-driven approach to a modern, innovative lifecycle approach. We
    are shifting from an end of military life-cycle event to an outcome
    based model that will measure success not only on the number of
    servicemembers who use the TAP process, but also on the number of
    transitioning servicemembers and their families who find the TAP
    process beneficial in assisting them with their life goals, military
    career progression, and/or new careers/meaningful employment outside of
    uniformed service. We will be implementing this strategic plan with
    focuses on information technology, strategic communications, and
    resources and performance management. The end-state for the TAP
    overhaul will be a population of servicemembers who have the knowledge,
    skills, and abilities to empower themselves to make informed career
    decisions, be competitive in the global work force and become positive
    contributors to their community as they transition from military to
    civilian life.
        As part of this effort, we launched the DOD Career Decision Toolkit
    in August 2010. The Toolkit was developed in collaboration with the
    Military Services and our TAP partners at the Department of Veterans
    Affairs and Department of Labor to help simplify the learning curve for
    transitioning servicemembers with the information, tools, and resources
    they need to succeed in the next phase of their lives. The toolkit uses
    the latest technology to consolidate the very best teaching materials
    from all the Service branches and provides thousands of on-demand
    resources to servicemembers. It is interactive, simple to use and
    portable. The toolkit includes:

             More than 3,000 on-demand information and planning
            resources
             Transition subjects such as career exploration,
            financial planning, resume creation, interviewing skills and
            compensation negotiation
             Tools that enable servicemembers to catalogue their
            military skills, training, and experience in ways that transfer
            to civilian sector
             Post-Service benefits and resources
             Resources that allow users to self-assess individual
            transition needs and plan personalized options

        We are developing an ``end-to-end'' virtual TAP delivery vehicle
    delivery platform that will provide the back-bone of the transformed
    TAP program, integrating the Guard and Reserve components, as well as
    expanding services available to family members.
        DOD has also played a supporting role with the Office of Personnel
    Management on the initiative to increase hiring veterans in all Federal
    agencies. This is now recognized as President Obama's Veterans
    Employment Initiative that directs all Executive Agencies to increase
    veteran employment. TAP is one of the programs we will use to educate
    and inform servicemembers about Federal Service career opportunities.
                      military family & community support
        The fiscal year 2012 budget continues to reflect the decision to
    shift funding for family support programs that are enduring--i.e.,
    programs that will not disappear as combat deployments and war funding
    decline--from the OCO budget to the base budget.
        The fiscal year 2012 budget includes $8.3 billion (Table 13 ) for
    family support programs vital to the morale and well-being of our
    military members and their families. Key programs include:

             Child Care and Youth Programs: Includes funding for
            child care, child and youth development programs, National
            Guard Youth Challenge Program, and child development centers.
            The fiscal year 2012 funding provides childcare spaces for over
            200,000 children.
             Morale, Welfare, and Recreation: Includes funding for
            Community Support activities, recreation programs, voluntary
            education and tuition assistance, temporary duty lodging, and
            revenue generating programs.
             Warfighter & Family Services: Includes funding for
            Family Support Centers and for counseling support services for
            Active Duty, National Guard, and Reserve members and their
            families.
             Commissary: Operations are appropriated with the
            Defense Commissary Agency (DeCA) Working Capital Fund. The DeCA
            operates 250 stores at military installations around the world
            and employ a workforce that consists of over 14,700 civilian
            full-time equivalents.
             Department of Defense Education Activity (DODEA)
            Schools: fiscal year 2012 budget supports the education of
            94,503 students in 124 schools in 12 countries and 33,779
            students in 70 schools in 7 States, Puerto Rico, and Guam.
             Spouse Employment: Funds tuition assistance and intern
            programs to support military spouses' employment opportunities,
            with full funding for the My Career Advancement Account (MyCAA)
            Program ($190 million) and funds to support the Military Spouse
            Federal Intern Program to assist in securing positions in other
            Federal agencies ($17 million).

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    Family Support--Joint Family Support Assistance Program
        On January 24th of this year at a ceremony held at the White House,
    the President, Mrs. Obama and Dr. Biden formally released the results
    of the Presidential Study Directive on Military Families endorsed by
    all the Cabinet Secretaries. This report was the result of an
    unprecedented level of intense collaboration between Federal agencies
    at the direction of the President, taking a whole of government
    approach to address the needs of military members and families by
    leveraging the collective resources and expertise of the entire
    Cabinet.
        The work reflected in the report was conducted by the Military
    Family Interagency Policy Committee (IPC), which included
    representatives from every cabinet agency, and identified and addressed
    the most pressing military family issues faced by soldiers, sailors,
    airman, marines, and coastguardsmen in the Active, Guard, and Reserve
    ranks, veterans, and especially families of the fallen. The IPC
    identified four priority areas that the Cabinet agencies would rally
    together to address:

             The first: improving the well-being and psychological
            health of military families by expanding access to counseling,
            protecting families from abusive financial practices and
            reducing homelessness among our veterans.
             The second: ensuring that military children are
            receiving the support and education they need thrive,
            especially when a parent is deployed and when making the
            difficult transition between different communities and schools.
             The third: expanding career development and
            educational opportunities for military spouses, including
            opportunities for Federal employment and working with the
            private sector to harness the incredible talents of spouses and
            veterans.
             The fourth: increasing the availability and quality of
            child care for servicemembers with children, including the many
            single parents serving the military.

        The IPC has now entered the implementation phase of the report,
    efforts which are now well underway.
        Again, while the Presidential Study Directive and the work of the
    IPC represent an unprecedented level of collaborative effort that
    recognizes the service and sacrifice of our military members, veterans,
    and especially their families, supporting military families in the long
    term simply cannot be the work of government alone.
    Child Care
        The Department continues to build child capacity that supports
    Reserve component families while the servicemember is deployed,
    geographically dispersed active duty military families, and
    servicemembers living in areas in the continental United States where
    on-installation military child care is unavailable. An initiative to
    expand the availability of quality child care programs is underway in
    13 pilot States. These States were selected based on multiple factors
    such as residential/demographic information and locations where State's
    efforts to improve the quality of child care are in tandem with DOD. In
    addition, an analysis of State licensing and oversight standards for
    the pilot States will guide efforts to provide training and technical
    assistance to improve quality of child care. Central to the success of
    this strategy is the placement of a Child Care Liaison in each pilot
    State who will work to assist in developing State-specific strategies
    that recognize the unique challenges and assets of the State and local
    communities. This individual will be tasked with developing
    communication strategies among various State partners to reduce
    duplication of effort and ensure resources are effectively utilized.
    Youth Programs
        Military youth make tremendous sacrifices and they deserve high
    quality programs and services that meet their needs. The Department has
    been recognized for providing dynamic, innovative and successful youth
    programs to nearly 660,000 military children and youth between the ages
    of 6-18 years on a daily basis around the globe. We are proud of the
    vital programs and services offered for youth during out-of-school
    hours. Today, youth programs are available where military families
    live--whether on military installations or in civilian communities. The
    programs are expanding by developing partnerships with other youth-
    serving organizations to augment the DOD programs; thereby offering a
    variety of additional resources to promote positive youth development.
    Military youth programs prepare youth to meet the challenges of
    military life, adolescence, and adulthood with programs and activities
    such as physical fitness and sports, arts and recreation, training in
    leadership, life skills and career/volunteer opportunities, mentoring,
    intervention and support services. DOD's enhanced youth programming
    also supports character and leadership development, sound education
    choices, and healthy life skills.
    Family Readiness Programs
        The Department provides family readiness programs through a network
    of Family Centers at installations worldwide that seek to prepare
    military families to effectively navigate the challenges of daily
    living experienced in the unique context of military service. Family
    Centers provide information and referral; training; and counseling
    opportunities to educate families about the potential challenges they
    may face; equip them with the skills to competently function in the
    face of such challenges; and increase awareness of the supportive
    resources available to them. The focus is to assist families with
    deployment; relocation; spouse employment; family life education
    including parenting; personal financial management; volunteer
    opportunities; and non-medical counseling.
        In fiscal year 2007, Congress mandated that the Department
    implement a Joint Family Support Assistance Program (JFSAP) to augment
    existing family programs and provide outreach and support to Active
    Duty, Guard, and Reserve military members and families who are
    geographically separated from military installations. Congress also
    mandated that the JFSAP coordinate family assistance programs and
    activities provided by Military OneSource, Military and Family Life
    Counselor Program, counselors, DOD, other Federal agencies, State and
    local agencies, and non-profit entities. In 2008, the Department
    implemented JFSAP teams at National Guard Joint Force Headquarters in
    all States and Territories to work with military and civilian resources
    to provide support and services to military families in the communities
    where they live.
    Family Advocacy Programs
        The DOD Family Advocacy Program (FAP) addresses physical, sexual,
    and emotional abuse and neglect involving Active component military
    personnel and family members who are victims and abusers. On each
    military installation with command-sponsored families, there is a FAP
    that provides services in prevention, identification, intervention, and
    treatment of child abuse and neglect and domestic abuse. We evaluate
    the effectiveness of FAP through rates of family maltreatment and
    outcome measures for prevention and treatment. Through 9 years of high
    stresses on our families due to wartime deployments our rates of such
    family maltreatment have remained relatively stable but we continue to
    monitor this carefully because of the cumulative effects of such
    stresses. For 2 consecutive years 85 percent of our new parents who
    have participated in the New Parent Support Program for at least 6
    months have had no substantiated child abuse or neglect the following
    year, and 90 percent of substantiated spouse abusers who completed FAP
    treatment have had no substantiated spouse abuse the following year,
    and we are working to develop additional outcome measures.
                               military onesource
        Military OneSource offers free, convenient, 24/7/365 days access to
    confidential resource and referral support for servicemembers and their
    families to improve the quality of their lives and the effectiveness of
    military community support efforts. Military OneSource provides over
    22,000 non-medical, short-term, solution focused counseling sessions
    per month delivered face to face, telephonically, and on line. The
    number of counseling sessions provided by Military OneSource has
    increased 930 percent since fiscal year 2005 with customer satisfaction
    consistently remaining well above 90 percent. Other Military OneSource
    services include relocation assistance, financial counseling, free tax
    filing services, document translation, child care and education
    resources, special needs consultation, elder care consultation, on-line
    library resources, and health coaching. Military OneSource Education
    and Career consultants assist almost 3,000 military spouses weekly with
    information regarding portable careers; education, training and
    licensing requirements; resume and interview preparation; and
    identifying employment resources. Additionally, we are increasing
    opportunities for military spouse careers through expansion of the Army
    Spouse Employment Partnership to Marine Corps, Navy, and Air Force
    spouses. Additionally, Military OneSource serves as a conduit to the
    Wounded Warrior Resource Center.
    Wounded Warrior Resource Center
        The Wounded Warrior Resource Center (WWRC), accessed via Military
    OneSource, provides immediate assistance to wounded, ill, and injured
    servicemembers, their families, and caregivers with issues related to
    health care, facilities, or benefits. The WWRC works collaboratively
    with the Military Services' wounded warrior programs and the Department
    of Veterans Affairs (VA) to ensure callers are promptly provided a
    specific plan of action to address their concerns within 96 business
    hours of contacting the WWRC. In fiscal year 2010, 2,046 cases for
    wounded warriors were handled. The top three issues concerning callers
    were health care (38 percent), military benefits (20 percent), and VA
    (20 percent) benefits.
    Dependents' Education Programs
        DOD is committed to ensuring that all children of military families
    are provided an education that prepares them to be successful in their
    careers, leading contributors in their communities and productive
    citizens in the 21st century. The DODEA provides quality pre-
    kindergarten through 12th grade educational opportunities and services
    to eligible military dependents around the globe. DODEA is committed to
    providing a rigorous college preparatory curriculum and closing the
    achievement gap in schools. DODEA schools consistently score very
    highly on the National Assessment of Education Progress, otherwise
    known as the ``Nation's Report Card''.
        Of the approximately 1.2 million military dependent children, DODEA
    educates approximately 86,000 in 195 schools in 12 foreign countries, 7
    States, Guam, and Puerto Rico. Where DODEA schools in overseas
    locations are not an option, DODEA also assists eligible military
    dependent students through a tuition reimbursement program.
        DODEA has a proud history of providing quality education for
    children of military families, the majority of which has been taught in
    traditional classrooms. As an organization dedicated to continually
    improving the education experience for our students DODEA launched its
    Virtual High School in Fall 2010 with approximately 45 course offering
    as a supplemental program in a variety of curriculum areas. The DODEA
    Virtual High School (DVHS) is serving approximately 891 students with
    enrollments totaling 940 thus far. Through the Virtual School Program,
    DODEA has been able to accomplish the mission of addressing secondary
    education needs for students in transition, where courses are not
    offered in a local school setting or when student situations preclude
    enrollment via a local school such as due to medical illness, schedule
    conflicts or other challenges identified by the local schools.
        Because the majority of children of military families are educated
    in public schools across our Nation, DODEA champions world-class
    education for military children in public schools by supporting
    military-connected local education agencies (LEAs). Through an expanded
    authority, set to expire in 2013, DODEA 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
    LEAs on deployment support for military children.
        DODEA, through its Partnership Program, has provided grants to over
    60 LEAs school districts, in over 800 schools and serving more than
    540,000, of which the nearly 41 percent are from military families. We
    are approving grants to help improve schools, even some that did not
    make their respective States' adequate yearly progress. All grants
    focus on enhancing student learning opportunities, student achievement,
    and educator professional development at military-connected schools.
    Some grants also have a counseling component that focuses on easing the
    challenges that military students face due to transitions and
    deployments. The grant seeks to build capacity to improve school
    climate as well as social and academic results in schools serving
    military children.
        The demands of extended wartime add to the ever-present challenges
    faced by military families. Research suggests that the children of
    deployed parents collectively experience more stress than their peers.
    While they are often described as a resilient group, the cumulative
    effects of multiple moves and significant parental absences can erode
    this resilience.
        The Department is working collaboratively with the Department of
    Education to improve the understanding of the challenges facing
    military children, and what is necessary to ensure that military-
    connected students receive an outstanding education from ``cradle
    through career.'' This effort requires a focus on not only military-
    connected students, but on their families, their communities, their
    schools and their teachers.
        Further, performance data that would allow us to identify and
    ultimately make recommendations to improve the educational outcomes for
    military children attending public schools is currently not available.
    Data collection and analysis are critically important to directing
    educational resources to those schools who are most impacted by the
    enrollment of military children. As a result, I worked with the
    Department of Education in support of a new means of collecting and
    reporting performance data of military-connected children as part of
    the reauthorization of the Elementary and Secondary Education Act.
        DOD has extended the Military and Family Life Counselor (MFLC)
    program to support and augment military-connected schools. MFLCs
    provide non-medical support to faculty, staff, parents, and children
    for issues amenable to short-term problem resolution such as school
    adjustment issues, deployment and reunion adjustments, and parent-child
    communications. There are MFLCs serving in 255 military-connected
    public schools and 65 DODEA schools. Since the end of 2009, DOD has
    provided children of active duty military with free, unlimited access
    to online tutoring, academic skills courses, and homework assistance in
    math, science, social studies, and English for kindergarten through
    12th grade (K-12) students through Tutor.com. Professional tutors
    assist military dependent students with completing homework, studying
    for standardized tests, and writing papers. The program provided
    162,570 sessions during fiscal year 2010.
        Recognizing that supporting military children takes a school-wide
    effort, DOD offers professional development to help inform school staff
    of the academic challenges that these children face. These include
    training modules and sessions on special education, as well as
    ``Students at the Center,'' an interactive educational resource for
    military families, military leaders, and school leaders.
        Finally, in an effort to ensure all of our students receive an
    education of the highest quality, I have directed two assessments on
    the effectiveness of DOD in meeting the educational needs of all
    military children and on the physical conditions of the public schools
    located on military installations. The first assessment will examine
    the effectiveness of DOD in meeting the educational needs of military
    families, layout the full scope of issues, and develop specific action
    plans for leveraging success and addressing deficiencies. We will pay
    particular attention to ensuring a world class preparatory instruction
    for science, technology, engineering, and mathematics (STEM) and
    foreign language programs. The second assessment will address the
    physical condition of the 160 public schools located on our military
    installations in the United States.
    MWR Support to Troops in Combat
        Support is critical to helping troops communicate with family and
    friends, stay physically and mentally fit, and reduce stress and
    boredom. The Department funds over 1,000 free MWR Internet Cafes in
    Iraq and Afghanistan and 135 portable satellite units, known as
    Cheetahs, to support remote locations. Cheetahs run off Humvees and can
    be set up and taken down in 20 minutes. Other MWR support includes
    fitness, sports and recreation equipment, portable movie theaters, and
    large screen televisions with DVD and video projection players and
    professional entertainment. The Department shipped over 264,400
    paperback books and 231,974 Playaways (self-contained digital audio
    books) in fiscal year 2010. Playaways now surpass paperback books in
    popularity with troops citing ease of use, convenience, and ability to
    read at night without electricity. Included in the Playaway inventory
    were 17,678 Dari and Pashto basic language/Afghan culture and 5,535
    Arabic language Playaways. The free DOD MWR Online Library offers free
    downloads of audio and e-books and access to up-to-date data bases
    offering recreation, education and career transition support. The
    ability of injured servicemembers to engage in recreation and sports is
    a very important component of rehabilitation and reintegration. Under a
    contract with Penn State University, MWR specialists are trained to
    work with medical personnel, wounded warrior units, community parks and
    recreation, and non-profits to ensure inclusive and adaptive sports and
    recreation are part of installation MWR and community recreation
    programs. The DOD Paralympics' Program continues to provide
    rehabilitation support and mentoring to injured servicemembers/veterans
    who have sustained various types of injuries. Paralympics' military
    events are conducted at 4 DOD and 14 VA Medical Treatment Facilities,
    29 Army Warrior Transition Units, 7 Marine Corps Wounded Warrior
    Battalions/Detachments, and 3 Navy and 3 Air Force locations. As an
    adjunct, training is well underway for the second annual Warrior Games
    Competition in Colorado Springs in May.
    DOD-State Initiatives
        DOD continues to work with State governments to educate their
    policy makers on the life-challenges faced by servicemembers and their
    families and to ensure that State-level policies do not disadvantage
    military families due to their transient life style. States have
    addressed several key quality of life issues, to include the impact of
    frequent school transitions experienced by military children, the loss
    of income by military spouses as a result of military moves, and the
    enforcement of the congressionally-mandated DOD predatory lending
    regulation. The response from States has affirmed their commitment to
    supporting the well-being of the Nation's fighting force. For example,
    35 States have approved the Interstate Compact on Educational
    Opportunity for Military Children, 38 States (plus DC) now provide
    eligibility for unemployment compensation to military spouses, and 32
    States (plus DC) enforce the DOD predatory lending regulation. The
    Department is continuing this effort in the 2011 State legislative
    sessions with strong emphasis on support of military families through
    the issues listed above, plus provisions to protect military parents in
    child custody decisions and provisions that can expedite occupational
    licensure processes to allow military spouses to get to work faster in
    a new State. Additionally, the Department is partnering with the
    Uniform Law Commission and the PEW Trust on the States to inform State
    legislators of the new Uniform Military and Overseas Voters Act which
    simplifies the absentee voting process by making it more uniform,
    convenient, and efficient.
    Military Voting Update
        The Department ``rolled out'' three sets of online voting
    assistance tools in the 2010 election: an online registration tool, an
    online Federal Write-In Absentee Ballot (back-up ballot) tool, and, in
    partnership with 17 States, an online absentee ballot delivery tool (up
    from only 8 States in 2008). In fact, 31 States had an online blank
    ballot delivery process in place for the 2010 election, and all States
    provided ballots electronically upon request, providing tens of
    thousands of ballots almost instantaneously. This gave the voter more
    time to return the voted ballot by mail. Online and print advertising
    was used to implement an intensive voter outreach campaign to increase
    awareness and use of the tools on the Federal Voting Assistance Program
    (FVAP) FVAP.gov Web site which stresses direct-to-voter assistance. The
    FVAP.gov website usage almost doubled over the 2006 election cycle, and
    the back-up ballot wizard usage increased three-fold.
        The Department implemented worldwide expedited return of ballots
    for overseas military voters. The Military Postal System Agency and
    U.S. Postal Service (USPS) went beyond requirements of the MOVE Act by
    providing Express Mail return delivery rather than simply expedited
    return. The result was 92 percent of overseas military ballots were
    returned to local election officials from Military Post Offices in less
    than 7 days, with the worldwide average of 5.2 days ballot return
    delivery time.
        The President's fiscal year 2012 budget fully supports the FVAP
    program. Total O&M and RDT&E funding for FVAP was $17.425 million for
    fiscal year 2010, $46.481 million for fiscal year 2011, and the
    President's fiscal year 2012 budget request for FVAP is $32.353
    million. FVAP will build on the success of the 2010 election to improve
    even more the voting opportunity in the 2012 election cycle for
    military and overseas voters.
    Special Needs: New DOD Office
        The NDAA for Fiscal Year 2010, Section 563 (10 U.S.C., 1781c)
    required the Secretary to establish an Office of Community Support for
    Military Families with Special Needs (OSN); the Military Departments to
    expand coordination of assignment for military families with special
    needs for assignments to and within the United States, and to expand
    community support to military families with special needs. It also
    required an annual report on the gaps in services, ways to address the
    gaps and future legislation.
        The OSN was officially established in September 2010 within the
    office of the Deputy Assistant Secretary of Defense for Military
    Community and Family Policy that is committed to military families with
    special needs. The Office has nine staff who have experience and
    educational backgrounds in special education, early intervention,
    physical and occupational therapy and communications. The Office
    submitted the first annual report to Congress in 2010 and is currently
    preparing the second report due April 28, 2011. Costs for the new
    office in fiscal year 2010: $1.3 million; in fiscal year 2011: $1.4
    million; and fiscal year 2012 [requested]: $1.4 million.
    Voluntary Education Opportunities
        DOD is committed to making educational opportunities available to
    our servicemembers and does this through 350 military education sites
    worldwide to include Iraq, Afghanistan, Kosovo, Sinai, Qatar and
    Kuwait. During fiscal year 2010, our Voluntary Education program helped
    fund 857,786 enrollments by 322,964 servicemembers, which resulted in
    our servicemembers earning 43,510 diplomas and 1,783 certifications/
    licensures. Servicemembers are ``blending'' their course work, taking
    both traditional and on-line courses, with approximately 71 percent of
    servicemembers taking some courses on-line. Due to the growth in on-
    line enrollments and servicemembers attending schools off our military
    installations, DOD has established a policy requiring all post-
    secondary institutions participating in the DOD Tuition Assistance (TA)
    program execute a memorandum of understanding (MOU) with DOD which sets
    certain standards of conduct for all institutions, whether they are on-
    or off-base, traditional or on-line. DOD is also developing an
    automated tracking system to document all concerns and complaints by
    students, DOD personnel and schools. The system will track the
    complaint and record its resolution. DOD is also partnering with the
    Departments of Education and Veterans Affairs to address common issues
    concerning administration of Federal education benefit programs as they
    relate to the three agencies involved and the benefits provided to
    servicemembers and veterans.
    Military Commissaries
        The commissary continues to be one of the most popular non-pay
    compensation benefits that our military members (Active, Guard, or
    Reserve,) retirees, and their families enjoy. Operated by the Defense
    Commissary Agency (DeCA), this integral element of the total
    compensation package not only does much to enhance the quality of life
    for military families, but also provides an excellent savings from
    them. Last fiscal year, the commissary provided direct savings to
    commissary customers of $2.69 billion for a taxpayer cost of $1.3
    billion. Providing savings on the patrons' overall purchases of 31.5
    percent, for those patrons who consistently use their commissary,
    savings can amount to nearly $4,400 per year for an average family of
    four, over $2,400 for a couple, and more than $1,500 for a single
    servicemember.
        Perhaps most importantly, the commissary enables troops to focus on
    their mission when deployed, improving retention by providing a ``sense
    of community'' for military personnel and their families, and providing
    access to American products around the world in a safe, secure shopping
    environment.
        As an organization, DeCA is a model for departmental efficiencies.
    DeCA has a proven history of taking cost out of the commissary system
    without decreasing the value of the benefit provided. In fact, when
    measured in constant dollars, DeCA's operating costs are only slightly
    more than one-half of what they were when the Agency activated on
    October 1, 1991. DeCA's efficiency track record continues with a fiscal
    year 2012 budget submission of $1,376.8 million.
                          civilian personnel policies
    Strategic Human Capital Management, Competency Management, and
            Civilians in the Total Force
        The Department is making progress toward developing a more
    systematic approach and enterprise tools for strategic human capital
    planning that covers over 750,000 civilian employees in over 600
    occupations. The total number of DOD civilians has evolved from 777,844
    in fiscal year 2010 to 790,497 in fiscal year 2011 and will stabilize
    at 783,702 in fiscal year 2012. For example, a Competency Management
    Framework has been designed that includes plans for the phased
    development and deployment of a tool for competency assessments
    beginning with mission-critical occupations. A proof-of-concept
    Enterprise Competency Management will undergo validation testing this
    summer and the long-range plan is to replace multiple competency
    assessment tools with a single tool for use across the Department.
    Another example is the integration of strategic workforce planning,
    competency management, hiring improvement, and leadership development
    initiatives to ensure that the Department can recruit, retain, and
    develop an agile, competency-focused civilian workforce throughout the
    employee life-cycle that is responsive to swiftly changing mission
    demands and complex challenges. These are multi-year initiatives that
    are intended to improve the Department's ability to rapidly grow,
    contract, and shift the work force in response to emerging mission and
    capability requirements. The Department also recognizes the need for
    integrated Total Force planning to better assess and manage the mix of
    Active and Reserve military, civilian, and contract requirements in
    order to leverage the best talent source available to provide short-
    term, mid-range, and longer capabilities.
    Hiring Reform
        In 2010, the Department made positive and meaningful progress
    toward reforming its civilian hiring practices. DOD completed all
    mandates of the President's Hiring Reform Memorandum of May 2010,
    including the following:

             Elimination of Knowledge, Skill and Abilities (KSAs)-
            style essays when applicants first apply for Federal
            employment;
             Allowing the submission of resumes and cover letters;
             Using the category rating approach to determine best
            qualified candidates;
             Increasing Hiring Manager involvement and
            accountability;
             Improving the speed and quality of the hiring process;
            and
             Informing applicants of their application status at
            key stages in the process.

        While meeting these mandates, the Department pushed its hiring
    reform efforts in other ways. DOD has reduced the number of days it
    takes to hire an employee by developing a common business process,
    deploying tools to automate key steps in the hiring process, and
    providing manager and human resource specialist training and job aids.
    In addition, the Department's arsenal of hiring-related metrics and
    measurements has grown, thereby enabling transparency and targeted
    improvements to the hiring process.
        In fiscal year 2010, the Department processed nearly 250,000 hiring
    actions. While doing so, DOD reduced its external hiring timeline by 25
    percent from the fiscal year 2009 baseline of 155 days to 116 days.
    This achievement exceeded DOD's fiscal year 2010 goal of 140 days. In
    addition, time to fill for all hiring actions (internal and external)
    was 75 days. As a result of this progress on the external timeline,
    DOD's yearly targets were adjusted aggressively downward to 101 days
    (originally 112 days) in fiscal year 2011, and to 80 days in fiscal
    year 2012, with quarterly goals in place to monitor progress. In the
    first quarter of fiscal year 2011, DOD continued to reduce its external
    hiring timeline to 114 days and DOD expanded its key hiring metrics to
    include tracking time to hire for ``all hires.''
        Another area of improvement is the automation of DOD's hiring
    process. DOD procured an automated staffing tool in late fiscal year
    2010 and is deploying it across DOD as an interim solution to
    approximately 70 percent of the Department in fiscal year 2011, and to
    100 percent in fiscal year 2012. In addition, DOD is working with its
    components to continue improving hiring business processes, and to
    apply enterprise technology where feasible.
        DOD is also partnering with OPM on the re-engineering of USAJOBS,
    the job posting portal used by the Federal Government, with phase 1 (of
    3) scheduled for deployment during calendar year 2011. DOD, along with
    DHS and other agencies large and small, is providing project leadership
    and personnel to OPM to complete this aggressive and ambitious
    undertaking. The USAJOBS 3.0 project is a high visibility project and
    DOD is the largest consumer of USAJOBS services. Major benefits to the
    Department include:

             Improved job search functionality and results
            relevancy
             Open architecture that encourages increased
            interoperability with Human Resource Information Technology
            (HRIT) products
             A common repository for resumes and applicant
            documentation
             Improved functionality in the areas of assessments,
            recruitment, reporting, and career exploration

        The deployment of an enterprise staffing tool and improvements to
    USAJOBS are critical initiatives; however, without the participation
    and engagement from our Hiring Managers and HR Professionals, these
    efforts have isolated impacts. As such, a primary DOD objective is to
    foster and encourage strong partnerships between Hiring Managers and HR
    Professionals. To assist these key stakeholders, DOD's Hiring Reform
    website (http://www.cpms.osd.mil/HiringReform/) was recently re-
    launched with a new look, and includes approximately 24 products in the
    Hiring Managers Toolkit, which was recognized by OPM as a best
    practice. A webinar series is in development, with content based on the
    four phases of the hiring process outlined in the Toolkit.
        The initiatives outlined represent DOD's approach to hiring reform
    implementation, an approach aligned with the Department's overall
    mission, and with its Strategic Human Capital Management objectives. A
    key success criterion is the involvement of senior leadership. As
    reported previously, the Department continues to solicit and utilize
    its cadre of senior leaders to guide its efforts, communicate and
    campaign for process improvements, and provide leadership throughout
    each hiring reform effort. We will continue to monitor these efforts
    closely, as Hiring Reform remains a high priority for the Department.
    Civilian Leadership Development
        The Defense Civilian Emerging Leaders Program (DCELP), as
    authorized by the NDAA for Fiscal Year 2010, section 1112, fills a
    critical need, by focusing, for the first time on a corporate scale, on
    developing civilian leaders at the entry and mid-level. The Department
    recognizes the need for an improved model to attract, retain, and
    deliberately develop civilian leaders to support pipeline readiness and
    enhance bench strength. We have conducted a gap analysis between
    existing programs and NDAA, section 1112, and designed a program
    framework to create a new program to recruit and develop new DOD
    civilian leaders, using proven models such as the Presidential
    Management Fellows program. Recognizing the financial environment and
    to ensure we have a sound programmatic framework, we will implement a
    DCELP pilot in September 2011 with up to 100 participants at the
    General Schedule (GS) 7 through 11 level from the Acquisition,
    Financial Management, and Human Resources career fields. The DCELP
    amalgamates leadership and technical proficiency.
        This new program will be additive to the Department's current
    leadership programs, which include the Executive Leadership Development
    Program (ELDP) and the DOD Senior Leader Development Program (DSLDP).
    DSLDP was established in 2008 to meet emergent leadership needs and
    provides a competency-based approach to the deliberate development of
    senior civilian leaders (GS 14 or 15 and equivalent grades) with the
    enterprise-wide perspective needed to lead organizations and programs
    and achieve results in the joint, interagency, and multi-national
    environments. We are pleased to report that DSLDP is entering its third
    annual cohort. DSLDP is a critical feeder pipeline for executive
    talent. Established in 1985, ELDP provides mid-level civilians (GS-12
    through GS-14 and equivalent grades) with an extensive exposure to the
    roles and mission of the DOD and Interagency partners and an increased
    understanding of, and appreciation for, today's warfighters through
    intensive hands-on field experiences. Both programs are aligned with
    the 21st century competency framework and designed to ensure
    application of critical leader competencies and have garnered success
    for their target senior grade populations. These highly competitive
    Department-wide programs will serve as building blocks for the new
    leader development framework.
        In addition to the programs just mentioned, another critical
    building block in this arena is training managers and supervisors.
    Pursuant to the NDAA for Fiscal Year 2010, Section 1113, the Department
    has established a holistic training curriculum and baseline learning
    objectives for each training topic. We are piloting this training in
    the Spring 2011 and will soon be turning our attention to developing
    the curriculum for refresher training, which the NDAA requires occur at
    least every 3 years. Also, we are partnering with OPM and vendors to
    design assessment tools that will help predict interest and success for
    aspiring supervisors, as well as, developmental tools for current
    supervisors. Those assessment tools should be available for use by
    October 2011.
    Executive Talent Management Initiatives
        In a demanding year, confronted with cutbacks related to Efficiency
    Initiative directing the drawdown of over 200 Civilian Senior
    Executives, freeze on pay increases and reduced funding for performance
    awards, we continue to seek new and innovative ways to incentivize and
    retain our Senior Executives. This year, the Department focused its
    efforts on Talent Management initiatives that will continue to prove
    our commitment to the Department's senior leadership in ways not tied
    to monetary incentives, but that will provide for career development,
    personal growth, and enhanced readiness of our executives.
        Through Talent Management Panels held in the summer of 2010, DOD
    assessed the readiness of its executives, slated executives for
    critical mission positions and identified developmental and career
    broadening assignments and programs. Through this process, our
    executive cadre received targeted feedback to help identify competency
    gaps and recommend training and development opportunities. At the
    enterprise level, the Department was able to identify and address
    mission critical gaps in its workforce. As a result of the 2010 panels,
    DOD has further refined its automated tool for Talent Management &
    Succession Planning, to include the development of additional
    capabilities for the executive's benefit.
        DOD has also implemented several developmental programs to increase
    an executive's proficiency level on specific competencies. At the
    enterprise level, we concluded a successful pilot of the Joint
    Executive Management course, which focuses on improving business acumen
    in a joint environment for a DOD executive. We also began the design of
    a Department-wide orientation program, entitled ``Vanguard'' which will
    include an emphasized focus on the national security perspective. At
    the individual level, we implemented a 360-assessment and coaching
    program for executives' self-improvement, and a mentoring and coaching
    program targeted at improving executives' personal leadership skills.
    We will continue to look for further ways to improve the entire career
    lifecycle of our executives to ensure DOD possesses a world-class
    executive cadre capable of leading the Department and ensuring its
    readiness to fully support DOD's warfighting efforts.
    Civilian Expeditionary Workforce
        The Department is working to better employ the talents of our
    civilian workforce to meet expeditionary mission challenges, especially
    those not directly related to war fighting. Global security challenges
    require adequate civilian capacity to conduct complex operations,
    including those missions that require close military-civilian planning
    and cooperation in theater. Since 2001, more than 43,000 Department
    civilians have been involved in contingency operations around the
    globe. Currently, from all sources, approximately 4,800 civilian
    employees are serving in the Central Command theater.
        In response to these imperatives, the Department institutionalized
    the Civilian Expeditionary Workforce (CEW) to provide deployable
    civilian experts to support military operations, contingencies,
    emergency operations, humanitarian missions, disaster relief, and
    stabilization and reconstruction operations. The CEW is designed to
    enhance the Department's ability to work alongside and help build the
    capacity of partner defense ministries and provide surge support where
    needed. Today, the CEW is a Capability-Based Volunteers program. In the
    future, after the DOD Directive governing CEW is revalidated, the CEW
    will encompass a pre-identified subset of the Department's emergency
    essential and volunteer civilian workforce by skill sets and
    capabilities, who are trained, ready, cleared, and equipped for rapid
    response and quick assimilation into new environments. Since June 2010,
    CEW deployments have increased by 51 percent, from 171 deployed
    civilians to 353 as of the end of February 2011. Civilians deployed
    under the CEW receive general and theatre-specific, urban training, and
    are eligible for the same health care benefits in-theatre as deployed
    military personnel, including medical evacuation and access to hospital
    services.
        With the support of Congress, the Department has obtained important
    incentives and benefits to help compensate for the inherent risks of
    deployment. The Department continues to identify pertinent issues and
    propose fully integrated solutions to ensure force health protection,
    surveillance, deployment benefits, and medical care for civilians who
    have been injured, wounded, or have contracted diseases while deployed
    in support of contingency operations. We have worked in partnership
    with OPM, the Department of State, and the Department of Labor to
    ensure all similarly-situated Federal civilians receive consistent and
    equitable benefits commensurate with the risks of deployment. In this
    endeavor, working with our partner agencies, we developed proposed
    legislation to provide a standard benefits package for all Federal
    employees.
    New DOD-wide Performance Management System, Redesigned Hiring, and
            Workforce Incentives
        The NDAA for Fiscal Year 2010 mandated new DOD-wide personnel
    authorities, including a fair, credible, and transparent performance
    management system that links employee bonuses and other performance-
    based actions to performance appraisal, and redesigned appointment
    procedures that will better meet mission needs; and provided
    discretionary authority to establish the DOD Civilian Workforce
    Incentive Fund for incentive payments for individual and team
    performance and to attract applicants or retain employees with
    particular or superior qualifications or abilities. The NDAA requires
    these authorities to be developed in coordination with OPM and that
    their development, design, and implementation are subject to collective
    bargaining obligations. Executive Order 13522, Creating Labor
    Management Forums to Improve Delivery of Government Services, allows
    employees and their union representatives to have pre-decisional
    involvement in decisions relating to all workplace matters to the
    fullest extent practicable.
        The Department has been mindful of its responsibility to work with
    exclusive representatives of DOD employees, involve the workforce, and
    not constrain the development of the new authorities. In the interest
    of building an effective relationship between management and labor, the
    conference originally planned for April 2010 to begin exploring ideas
    for these authorities was postponed to give time for further
    collaborative discussions between labor and management with respect to
    a pre-design conference to help identify broad concepts for the NDAA
    personnel authorities mentioned above. The October 2010 reports to
    Congress covered the jointly designed, planned, and led New Beginnings
    Conference held in September 2010, the first mutually agreeable date.
        Since the September conference, DOD has continued to engage the DOD
    unions on these authorities. A joint planning group met in mid-December
    to identify requirements for the start-up of the design effort. A
    second planning meeting was held January 20, 2011, with follow-up
    teleconferences on February 4 and 11. There are three joint design
    teams--performance management, hiring, and workforce incentive fund--
    with equal representation between management and DOD unions. Each team
    has a management and labor co-lead. Team members are from the DOD
    components, OPM, and Federal Managers' Association and include line
    managers, union officials, employees at various grade levels, and human
    resources professionals from the National Capital Region and well
    beyond.
    Marketing DOD Employment Opportunities
        The Department values the experience and commitment of our
    servicemembers and places special emphasis on supporting transitioning
    servicemembers, wounded warriors, and veterans in their search for
    employment. We continue our efforts to actively reach out to our
    veterans to assist them in their civilian employment search with
    aggressive marketing and outreach programs, transition assistance
    programs, career fairs, and benefits counseling and assistance.
        The Department continues this tradition in support of Executive
    Order 13518, the Veterans Employment Initiative. In January 2010, the
    Department stood up the DOD Veterans Employment Program Office to
    promote veterans recruitment, training and development throughout the
    Department.
        DOD aggressively promotes/markets veterans hiring through DOD's
    Hiring Heroes Program, veterans outreach events, and assistance to
    veterans with navigating the application process in their search for
    employment.
        To facilitate hiring, the Department manages nationally recognized
    Hiring Heroes Career Fairs, conducting 8 to 10 events throughout the
    United States each year. These events are specifically designed for and
    marketed to wounded, ill, and injured servicemembers, transitioning
    military, veterans, and their families to assist them in their search
    for employment. Since April 2005, 40 Hiring Heroes Career Fairs have
    been conducted, reaching over 13,800 job seekers and 2,388 employers.
    In 2010 alone, 9 career fairs were conducted, resulting in 297
    placements. Six Hiring Heroes Career Fairs are scheduled for fiscal
    year 2011 at Fort Sam Houston, TX (2); Fort Riley, KS; Camp Pendleton,
    CA; Fort Lewis, WA; and Walter Reed Army Medical Center. These events
    are marketed through the military services, Transition Assistance
    Program Offices, Civilian Personnel Centers, Wounded Warrior Transition
    Brigades, Military Treatment Facilities, Department of Labor and
    Veterans Affairs, and numerous Veterans Service Organizations using
    posters, flyers, emails, Facebook, Twitter, Web sites, et cetera.
        The www.DODVets.com Web site provides veterans and transitioning
    servicemembers with information on employment opportunities, veterans'
    preference, special hiring authorities, Q&As, as well as a calendar of
    recruitment events for veterans conducted throughout the United States.
    The Web site also provides Hiring Managers with information on veterans
    hiring authorities.
        The Student Training and Academic Recruitment (STAR) Program is
    another innovative recruitment program developed by the Department.
    Students are hired as on-campus representatives to promote DOD as the
    ``Employer of Choice'' and to market (through peer-to-peer interactions
    such as information sessions, special events and one-on-one) DOD's
    various and diverse employment and scholarship opportunities. The
    program is designed to create a cost effective way to market to and
    recruit students in academic studies which mirror DOD's mission
    critical occupations and to provide a year-round DOD presence on
    campus. The main goal of the program is to build a competent, diverse,
    and a highly-skilled civilian workforce, ready to meet 21st century
    global challenges and to support the Department's national security
    mission. The STAR Program is currently active at 5 universities,
    Michigan Technological University, Houghton, MI, University of Puerto
    Rico at Mayaguez, Mayaguez, PR, Tennessee State University, Nashville,
    TN, Morgan State University, Baltimore, MD and Rochester Institute of
    Technology/National Technical Institute for the Deaf, Rochester, NY. To
    date, the STAR program has resulted in permanent Federal career
    opportunities for 10 of the participating students.
    National Security Personnel System Transition
        The NDAA for Fiscal Year 2010 repealed the statutory authority for
    the National Security Personnel System (NSPS) and requires that all
    covered employees be transitioned by not later than January 1, 2012, to
    the statutory pay and personnel system that last applied or that would
    have applied if NSPS had never been implemented, as appropriate. The
    law also requires that employees not suffer a loss of or decrease in
    pay upon conversion out of NSPS due to its repeal. The rules of the
    gaining pay and personnel system apply to determine employee placements
    and pay setting.
        The termination of NSPS and the transition of all employees and
    positions are on schedule to be completed by the statutory deadline.
    Before drawdown began in late February 2010, there were approximately
    226,000 employees covered by NSPS. Because 75 percent of them occupied
    positions with origins in the General Schedule (GS) system, the
    Department's goal was to transition most employees back to GS during
    fiscal year 2010. The DOD components assessed their readiness and
    determined NSPS transition schedules based on the following criteria:
    least possible disruption to mission and hardship to employees,
    existence of classified positions under the successor personnel system,
    existence of legacy performance management systems, and information
    technology capability.
        During fiscal year 2010, approximately 172,000 employees
    (representing 76 percent of the NSPS population) were transitioned out
    of NSPS to GS. As of September 30, 2010, approximately 53,000 employees
    remained covered by NSPS and will be transitioned in calenar year
    2011--approximately 44,000 by the end of June, another 8,000 by
    October, and the remaining employees before the statutory deadline.
    Employees are being transitioned in calendar year 2011 to the
    acquisition workforce personnel demonstration project, Navy alternative
    personnel system (``China Lake''), new laboratory personnel
    demonstration projects as required by section 1105 of NDAA, and to GS.
    Employees going to GS during calendar year 2011 include those assigned
    to designated healthcare occupations for which the Department had long
    considered implementing alternative pay and qualification systems under
    special authority and those affected by special situations, including
    employees who were deployed or who were subject to 2011 BRAC actions. A
    report to Congress at the end of April 2010 described steps taken for
    the reclassification of NSPS positions and the initial plan for
    transitioning employees and organizations from NSPS. The first
    semiannual report on transition progress, transmitted in October 2010,
    provided information on the transition of employees to the GS system
    during fiscal year 2010. Reports at the end of April and October 2011
    will include information about the transition of the remaining
    employees covered by NSPS.
    Disestablishment Initiatives
        In August 2010, Secretary Gates announced a set of initiatives
    aimed at increasing efficiencies, reducing overhead costs and
    eliminating redundant or low priority functions. These initiatives
    included the decision to disestablish the Office of the Assistant
    Secretary of Defense for Networks and Information Integration, the
    Business Transformation Agency, the Joint Chiefs of Staff J-6 Command,
    Control, Communications, & Computer Systems organization and a
    recommendation for the closure of the United States Joint Forces
    Command.
        Since the announcement, the Department has engaged and met with
    various leaders of the affected organizations to discuss their way
    forward. We also established a Personnel and Readiness Transition Team,
    to work with the affected organizations to help them develop a
    transition strategy that is designed to be attentive to the needs of
    the affected population, transparent, and facilitates access to
    transition programs and tools. For the past 6 months, the team has been
    working closely with the affected organizations by assisting them with
    workforce analysis, timelines, and to identify necessary steps in
    implementing the disestablishment actions. We have leveraged best
    practices and lessons learned from BRAC actions and incorporated those
    lessons into our planning efforts.
        With the final approval of the recommended actions, my staff
    continues to work closely with the leadership in the affected
    organizations by assisting them to develop their final implementation
    plans. We are providing specific human resources policy guidance,
    assistance with outplacement tools and programs and information to
    implement the associated personnel actions. We have launched a web page
    with links to the affected organizations to communicate with the
    affected workforce and to help answer questions and alleviate anxiety.
    We are committed to working with leaders of affected organizations to
    do everything possible to assist their employees in order to facilitate
    a smooth transition and mitigate any adverse impact on the affected
    workforce.
    Pay Freeze
        The Department implemented the pay freeze in accordance with
    statute, issued clear guidance, and ensured that the President's intent
    with regard to pay adjustments was applied in a fair and equitable
    manner across the Department. Although the pay freeze legislation
    covers most civilian DOD employees, we recognize that there may be
    exceptions based on extraordinary circumstances. Special rates may be
    approved under extraordinary recruitment or retention evidence and
    availability of funding for particular occupations. In the past couple
    of years, staffing challenges arose in specific medical occupations and
    in highly skilled and qualified blue collar occupations. The DOD pay
    freeze exception policy is currently under review. We have already
    instituted a review process whereby overseas commands can petition DOD
    for exclusions to the pay freeze based on the criteria developed with
    OPM and the State Department.
    Insourcing
        We understand that, across the entire department, we must do a
    better job of managing our Total Force of Active and Reserve military,
    government civilians, and contracts for services. Moreover, in the
    absence of change our Total Force costs, and associated health care
    expenses, will become prohibitively more expensive. Predictable
    consequences will include inadequate recapitalization, and a severely
    degraded future readiness.
        To that end, we are changing how we strategically look at the Total
    Force, both as we execute our mission and plan across the Future Years
    Defense Program. This not only includes the development and
    promulgation of policies, but is contingent on providing managers with
    the tools, resources, and information necessary to achieve the outcomes
    we desire in this increasingly austere fiscal environment. Among other
    things, while we must deliver an All-Volunteer Force as a large and as
    capable as our commanders require, we must also ensure that we
    consistently challenge assertions of military essentiality, only
    planning for uniformed personnel if necessary. Similarly, the balance
    between Active and Reserve Forces must be judicious and well-reasoned.
        DOD is committed to meeting its statutory obligations under Title
    10 to annually review its contracted services, identifying those that
    are more appropriately performed by the government workforce and
    should, therefore, be in-sourced. This includes services that are
    inherently governmental and could include services closely associated
    with inherently governmental work; that provide unauthorized personal
    services; or that may otherwise be exempted from private sector
    performance (to mitigate risk, ensure continuity of operations, build
    internal capability, meet and maintain readiness requirements, etc).
    While some contracted services may be identified for in-sourcing, some
    services determined to be no longer required or of low priority may be
    reduced in scope or eliminated, while other required services will
    continue to be provided by the private sector.
        Additionally, partnering with USD (AT&L), the military departments,
    and others, P&R is ready to meet its newly delineated responsibilities
    under Title 10, and improve how the Department accounts for its
    contracted services. Collectively, the actions being taken will improve
    the long-term utility of the inventory of contracts for services; more
    adequately ensure the representation of Total Force management equities
    during the review process; and improve the Department's ability to
    accurately and holistically assess its contracted workload and the
    services being delivered in the context of applicable statutes,
    policies, and regulations. These changes are critical to improve the
    Department's ability, over the next several years, to more effectively
    manage individual contracts and workload associated. This will ensure
    we achieve the right balance in our workforce, aligning inherently
    governmental activities to military and civilian workforces and
    commercial activities to the most cost effective service provider--be
    that military, civilian, or contracted support.
        Those contracted services that meet the necessary criteria
    (consistent with governing statutes, policies, and regulations) will be
    in-sourced, by:

             absorbing work into existing government positions by
            refining duties or requirements;
             establishing new positions to perform contracted
            services by eliminating or shifting equivalent existing
            manpower resources (personnel) from lower priority activities;
            and
             on a case-by-case basis, requesting an exception to
            the civilian limits the Secretary has asked the Department to
            adhere to.

        Our in-sourcing efforts are focused on rebalancing the workforce,
    rebuilding critical internal capabilities (including the acquisition
    workforce), and reducing operational risks and are consistent with the
    reforms to government contracting that President Obama called for in
    March 2009: addressing overreliance on contractors; appropriately
    aligning inherently governmental activities to government performance;
    performing functions efficiently and effectively; and protecting the
    public's interest while providing the best value for taxpayers.
        Lastly, while there has been significant focus over the past few
    years on in-sourcing, the Department recognizes that insourcing is just
    one of many management tools and is not a one-size-fits-all solution.
    Not all in-sourcing is good, just as not all out-sourcing is bad. The
    private sector is, and will continue to be, a vital source of
    expertise, innovation, and support to the Department's Total Force.
        We appreciate Congress' concern related to public-private
    competitions under OMB Circular A-76. I will soon be submitting a
    report that is the result of nearly 18 months of policy and `best
    practice' review. Our report will make recommendations to improve the
    end-to-end public-private competition process. We believe that a
    public-private competition process can be a useful tool for our
    commanders and managers to use to validate an organization's manpower
    and other requirements; drive a more consistent delivery of mission
    critical support and services to our servicemembers and families; and
    deliver readiness while minimizing fiscal opportunity costs to meet the
    compelling needs of the Department.
        In summary, we must have a Total Force that provides our commanders
    the enabling manpower they require. However, we must also ensure that
    its costs do not deprive those same commanders and our forces of the
    technologies, platforms, and systems that will translate into necessary
    capabilities.
                                   conclusion
        We are confronted with three fundamental and related challenges as
    we transition the end strength of our forces and execute efficiencies
    within the Department and the Services. First, we must continue to
    attract and retain high quality, motivated individuals for Active and
    Reserve military service and we must maintain an enthusiastic and
    skilled civilian workforce. Second, we need to work together with this
    Congress in creating a system of force management tools focused on a
    means to compassionately reduce the force as operations subside. Third,
    we must constantly weigh sufficiency against the risks of an uncertain
    future. As we invest in our human capital, we must do so judiciously.
    While our future challenges may often seem without bounds, our
    resources are not. We are faced with hard choices, as a Department and
    as a Nation, of allocating our resources the best we can to win the war
    at hand while taking care of our most valuable asset--our men and women
    in uniform. I look forward to working with this Congress to meet these
    challenges over the coming year and beyond.

        Senator Webb. Thank you, Secretary Stanley.
        Mr. Hale, welcome.

     STATEMENT OF HON. ROBERT F. HALE, UNDER SECRETARY OF DEFENSE,
                COMPTROLLER, AND CHIEF FINANCIAL OFFICER

        Mr. Hale. Well, thank you, Mr. Chairman, Senator Hagan,
    Senator Ayotte. I appreciate the opportunity to be here to
    testify.
        I'm going to focus on our overall budget very briefly, and
    our efficiency proposals. I'll concentrate on the proposed
    healthcare initiatives.
        As you said, I submitted a statement for the record.
        Let me begin with the overview of the budget.
        We asked for $553.1 billion in base budget authority in
    fiscal year 2012, and it is intended to reinforce three
    priorities that Secretary Gates has established. First, it
    reaffirms our commitment to take care of the All-Volunteer
    Force. Secretary Gates has called this a ``national asset.'' I
    couldn't agree more. It is our highest priority. Second, the
    fiscal year 2012 base budget continues to rebalance the
    Department's capabilities to improve our ability to prevail in
    current conflicts. Third, it enhances the capabilities for
    conflicts we may face in the future.
        The budget also furthers the reform agenda that Secretary
    Gates started in fiscal year 2010. For this fiscal year, we
    propose continuing this cost-cutting, with an emphasis on
    business operations. Our plans propose savings of $170 billion
    in fiscal year 2012 through 2016. These savings will be
    achieved in a variety of ways, through a number of
    reorganizations in the departments, through some selected
    termination of weapons systems, through infrastructure changes,
    and particularly by changes in our business processes.
        Included in this package of efficiencies are proposed
    changes in the military health system, and I'll focus on those.
        In 2012, the budget includes $52.5 billion to support the
    military health system and its 9.6 million beneficiaries. We
    take pride in providing beneficiaries the best medical care,
    and we will do nothing to interfere with that goal. I want to
    underscore that commitment. But, the costs of the military
    health system have nearly tripled in the last decade, from $19
    billion in 2001 to the present request for more than $52
    billion.
        Our challenge is daunting, but real. We have to find ways
    to maintain the quality of healthcare, but slow the growth in
    costs. Meeting that challenge begins with streamlining
    operations at our headquarters. Health Affairs, for example, is
    reducing its headquarters staff by more than 700 contractors. I
    think there are people up at this table that can do better than
    I at describing where they're headed in doing that.
        Additional reforms will involve beneficiaries. We are
    proposing a modest increase in TRICARE enrollment fees for
    working-age retirees; those under age 65. Congress introduced
    fees for TRICARE in the mid-1990s, when the program was
    created. Since then, those fees have not been changed, in
    dollar terms, at all. Had they been indexed to a medical index,
    the fee which is, today, $460 for families; and TRICARE Prime
    would have been more than $1,000. Instead, retiree out-of-
    pocket-cost expenses have fallen from 27 percent of healthcare
    costs in 1995 to 11 percent today. The administration's
    proposal will increase fees for working-age retirees by a
    modest $5 a month for families and $2.50 a month for
    individuals. Beginning in 2013, future enrollment fees will be
    increased based on growth in the per capita national health
    expenditures.
        Indexing to national health expenditures will stabilize
    cost-sharing in TRICARE, though it will stabilize it at a level
    much more favorable to retirees than what Congress envisioned
    in the 1990s. These modest first-ever increases in TRICARE fees
    will save an estimated $434 million in 2012 through 2016, and
    more than $1 billion through fiscal year 2021. I'll mention a
    number of dollars throughout. But, if we don't, or aren't
    allowed to do this, then we will have to look for other
    changes. We're not going to see increases in the Defense
    budget. We will have to look for other changes in the support
    and training we provide to our military.
        We also plan to change copays for pharmaceuticals to
    provide incentives for beneficiaries to choose the most cost-
    effective options for prescriptions; namely, the use of generic
    drugs and the delivery of prescriptions by mail. These reforms
    will save over $2.5 billion between 2012 and 2016. So, they're
    particularly important, both to the quality of healthcare, but
    also to our budget.
        DOD proposes a regulatory change that will eliminate
    special subsidies for sole community hospitals that serve
    military beneficiaries. Current rates to sole community
    hospitals (SCH) are substantially higher than what is paid to
    most other hospitals treating military personnel. Federal law
    requires that we adopt Medicare rates at these hospitals, to
    the extent practical. That's what we're proposing.
        In addition to complying with the law, this change will
    save the health system $395 million between 2012 and 2016. We
    will phase in this change slowly over at least 4 years, in
    order to avoid adverse effects on care provided at the affected
    hospitals.
        Lastly, we propose equitable treatment for all Medicare-
    eligible military retirees. Under current law, a few Medicare-
    eligible enrollees are allowed to remain in the Uniformed
    Services Family Health Plan (USFHP), a plan involving six
    hospitals, whether they enroll in Medicare Part B, or not. They
    are the only retirees using the military health benefits who do
    not have to enroll in Medicare when they become age eligible.
    This is the one area where we need legislative authority to
    require those who are part of the USFHP to join Medicare, just
    like all the other retirees.
        Moreover, under current law, the six Federal family health
    plans--programs--receive claim payments that exceed Medicare
    rates. We seek legislation that will permit us to reimburse
    those plans in the same manner as we do for most other
    hospitals serving military beneficiaries. We will make these
    USFHP changes very gradually, fully grandfathering all who are
    currently over age-65 and in the Family Health Plan. So, it
    will take place over a number of years.
        The Federal Government, as a whole, would save money under
    this plan; it's not a lot, but there are modest savings. The
    Department savings from this proposal would be very
    substantial. We budget on an accrual basis for these. That is,
    we're looking out over the whole career of an individual and
    setting aside money to pay for it. So, we immediately see major
    effects. Our budget would be reduced by $3.2 billion over the
    5-year period from 2012 to 2016. So, it's very important to us,
    budgetarily.
        I particularly ask the committee's support for provisions
    affecting the sole community hospitals, and for legislation to
    permit changes in the USFHP. These proposals will permit the
    Department to comply with the law and treat all our hospitals
    and retirees equitably.
        Taken together, DOD's healthcare proposals are reasonable
    and fair to all, we believe. None of our proposals would affect
    Active Duty servicemembers. That's an important point. The
    proposals are strongly supported by the Secretary of Defense--
    you heard him comment on them in his oral statement when he
    testified before the House Armed Services Committee; also by
    the Chairman of the Joint Chiefs--he also commented on them
    verbally; and indeed, by all our senior military leaders--they
    sent a rare 24-star letter of support to Congress, earlier this
    year, in support of these healthcare changes.
        These proposals generate savings that will help us pay for
    needed training and equipping of the Armed Forces. Indeed, as I
    said, if we don't get authority to do this, we'll face major
    holes in the military budget. So, that may be very hard to
    handle in difficult budgetary times. But, most importantly, the
    congressional support for these proposals will lay the
    groundwork for a sustainable future for the military healthcare
    system.
        Mr. Chairman, that concludes my oral remarks. When my
    colleagues are finished, I'd be glad to hear your questions.
        [The prepared statement of Mr. Hale follows:]
                   Prepared Statement by Hon. Robert F. Hale
        Senator Webb, Senator Graham, members of the committee, thank you
    for the opportunity to speak about the budget of the Department of
    Defense and our efficiency proposals, especially our proposed health
    care initiatives.
        I will address these military health care issues with a focus on
    their financial aspects. I appreciate the leadership of the Under
    Secretary of Defense (Personnel and Readiness), and from his staff, on
    broader issues related to personnel in the Department.
        I would like to begin with a brief overview of the President's
    Budget for the entire Department including our overall efficiency
    initiative. I will then focus on our health care proposals.
                              base budget request
        Mr. Chairman, the Department's budget for fiscal year 2012 includes
    $553.1 billion in discretionary budget authority and continues and
    reinforces three priorities laid down by Secretary Gates for the
    Department:

             First, it reaffirms our commitment to take care of the
            all-volunteer force, America's greatest strategic asset. We
            propose a 1.6 percent military pay raise, $8.3 billion for
            family support programs, and $52.5 billion for military health
            care.
             Second, the fiscal year 2012 base budget continues the
            rebalancing of the Department's capabilities in order to
            improve our ability to prevail in current conflicts, such as
            the unconventional war in Afghanistan. For example, we plan to
            invest $4.8 billion to purchase unmanned aerial vehicles and
            $2.3 billion for cyber activities.
             Third, the President's budget for fiscal year 2012
            maintains and enhances capabilities for the conflicts we may
            face in the future. Included are a restructured but substantial
            Joint Strike Fighter program, a new tanker program, an
            aggressive shipbuilding program, a new ground combat vehicle,
            and many other initiatives.

        In addition to these three broad priorities, the budget for fiscal
    year 2012 furthers the reform agenda that Secretary Gates launched in
    fiscal year 2010 and which continues in this budget. In fiscal years
    2010 and 2011 that agenda included steps to curtail or eliminate
    programs that have fully satisfied procurement needs, as well as those
    that are seriously troubled or provided capabilities too narrow to
    justify their expense. More than 20 programs were restructured or
    eliminated, among them further production of the F-22 and the C-17
    aircraft, the program for the new VH-71 Presidential helicopter, the
    Navy's DDG-1000 ship program, and the Army's Future Combat System
    (FCS). These difficult decisions resulted in substantial savings.
        For fiscal year 2012, we propose to continue our cost-cutting with
    emphasis on business operations. Our plans save $178 billion in fiscal
    year 2012 to fiscal year 2016 through efficiencies and streamlining of
    programs. The Armed Services identified about $100 billion of savings,
    which they are reinvesting to improve combat capability. The remaining
    $78 billion in Defense-wide savings was used to accommodate reductions
    in the defense topline and to support the administration's efforts to
    reduce the Federal deficit.
        These savings will be achieved through reform of DOD's
    organizational structure, weapons programs, infrastructure, and
    business processes. We propose to terminate or consolidate
    organizations in all the military departments. We will terminate the
    Marine Corps' Expeditionary Fighting Vehicle, end procurement of the
    Army's SLAMRAAM surface-to-air missile, and make other changes in
    weapons programs. Changes in business processes include consolidation
    of data centers, improvements in weapons sustainment, reductions in
    acquisition costs, and elimination or streamlining of lower-priority
    support tasks in order to accommodate a civilian personnel freeze and
    reductions in funding for contractors. Included in this package of
    efficiencies are proposed changes to the Military Health System (MHS).
                            health care efficiencies
        The fiscal year 2012 budget includes $52.5 billion to support the
    MHS and its 9.6 million eligible beneficiaries, including Active Duty
    servicemembers and their families, military retirees and their
    families, dependent survivors, and certain eligible Reserve component
    members and their families. Starting this year, the MHS is adding the
    TRICARE Young Adult Program, which extends benefits for certain
    dependents in accord with the National Defense Authorization Act for
    Fiscal Year 2011.
        We take pride in providing MHS beneficiaries with the best medical
    care, and we will do nothing to reduce the quality of that care. But
    the costs of the Military Health System have nearly tripled in little
    more than a decade, from $19 billion in 2001 to the present request of
    more than $52 billion. The challenge we face: find ways to maintain
    quality health care while slowing the growth in costs.
        Efforts to achieve this are by no means new. To date, more than
    $1.65 billion in annual savings have been implemented. The 2007
    National Defense Authorization Act prohibited employers from offering
    incentives to employees to drop employer-based health insurance in
    favor of TRICARE. Savings of $500 million were achieved thanks to
    rebates from pharmaceutical manufacturers for retail prescriptions.
    Matching payments to Medicare rates for outpatient care in hospitals
    and ambulatory centers will save another $900 million. Enhanced fraud,
    waste, and abuse detection and prosecution are expected to net another
    $137 million. By standardizing medical supplies and equipment, we are
    producing another $30 million in annual savings.
        These achievements are noteworthy, but we must do more. As a
    result, the Department has proposed additional headquarters reforms,
    changes in the TRICARE system that will better balance responsibilities
    for health between DOD and the people we serve, shifts in pharmacy co-
    pays designed to encourage efficiency, and changes to ensure that costs
    to individuals and payments to hospitals are consistent throughout the
    military medical care system.
                           headquarters efficiencies
        Greater efficiencies begin with streamlined operations at
    headquarters. Health Affairs is reducing headquarters staff by more
    than 700 contractor positions, as well as promoting greater sharing of
    services and capabilities between the Armed Services. We are currently
    devising specific plans to accommodate these reductions, plans that
    include approaches such as contract consolidation and the efficiencies
    in Information Technology (IT) support. Other efficiencies are
    anticipated with the conclusion of the BRAC process and consolidation
    of medical headquarters for Health Affairs, the TRICARE Management
    Activity, and the Service Surgeons General.
                            tricare enrollment fees
        Additional reforms will involve beneficiaries. We are proposing a
    modest increase in TRICARE enrollment fees for working age retirees.
    Congress introduced fees for TRICARE in the mid-1990s, when the program
    was created. Since then, annual fees have not been changed in dollar
    terms. Had they been indexed to Medicare, fees of $460 for families
    would have grown to more than $1,000 by fiscal year 2010. Instead,
    retiree out-of-pocket expenses actually fell from 27 percent of total
    health care costs in 1995 to 11 percent in fiscal year 2010.
        The administration's proposal will increase fees for working-age
    retirees by a modest $5 per month for families and $2.50 per month for
    individuals, which will raise the annual fee from $460 to $520 for
    families and from $230 to $260 for individuals. Beginning in 2013,
    future enrollment fees will also be increased based on growth in per
    capita National Health Expenditures. Note that the increases will only
    affect the 1.6 million retirees in TRICARE Prime who are younger than
    65 years of age. Disabled retirees and survivors will be exempted.
        These modest, limited, first-ever increases will save an estimated
    $434 million in the fiscal year 2012-2016 period and $1.5 billion
    through fiscal year 2021, money that will help to maintain a strong,
    well-trained military.
                                pharmacy co-pays
        We plan to change co-pays for pharmaceuticals to provide incentives
    for beneficiaries to choose the most cost-effective options for
    prescriptions, namely use of generic drugs and delivery of
    prescriptions by mail. Co-pays are eliminated altogether for generic
    drugs ordered through the mail order program, which will mean a savings
    to beneficiaries of $3 per prescription. Most non-generic drugs are
    available via mail order with no increase in co-pays. For retail
    pharmacies, co-pays are increased by $2 to $3 per prescription. We
    estimate that these reforms will save over $2.5 billion between fiscal
    year 2012 and 2016 and, again, help to maintain a strong military even
    in lean times.
        In addition, changes in co-pays are expected to improve patient
    care. It has been noted that patients with chronic conditions requiring
    regular medications are actually more likely to comply with their
    medical regimen when the prescriptions are delivered to their homes.
                            sole community hospitals
        DOD proposes a TRICARE regulatory change that will eliminate
    special subsidies for Sole Community Hospitals (SCHs) that serve
    military beneficiaries. Current rates for the SCHs are more than twice
    as high as what is paid to other acute TRICARE network and non-network
    hospitals covered under this proposal and 29 percent higher than
    commercial insurers are paying for the same services. Federal law
    requires that we adopt Medicare rates to the extent practicable. By
    implementing this regulatory change at SCHs, we can save the Military
    Health System $395 million between fiscal year 2012 and 2016.
        We realize that this proposal will have an impact on the revenue
    streams of certain hospitals, but that impact should be modest for all
    but a handful of hospitals. TRICARE accounts for less than 1 percent of
    inpatient admissions at the vast majority (81 percent) of SCHs and less
    than 5 percent of inpatient admissions at 95 percent of these
    hospitals. We propose phasing this change in over the next 4 years for
    all affected hospitals, and we will work with those who are most
    affected to minimize disruptions.
                                usfhp enrollees
        Lastly, we propose to provide equitable treatment for all Medicare-
    eligible retirees by offering a single program design across the
    country. Under current law, Medicare-eligible enrollees are allowed to
    remain in the Uniformed Services Family Health Plan (USFHP), whether
    they enroll in Medicare Part B or not. They are the only military
    retirees using military health benefits who do not have to enroll in
    Medicare when they become eligible. We seek legislative authority that
    will require those who are part of the USFHP to join Medicare upon
    reaching age 65. Under current law, the six USFHPs receive claims
    payments that exceed Medicare rates. We seek legislation that would
    permit us to reimburse these plans in the same manner as we do for all
    other Medicare-eligible retirees. Our plan will fully grandfather all
    of those who are already in USFHP, but would require future USFHP
    enrollees to transition to Medicare and TRICARE for Life once they
    become Medicare-eligible. Future retirees covered by the proposal would
    still be able to obtain services from providers associated with USFHP
    as long as the providers accept Medicare.
        We believe that it is not appropriate to treat individuals
    differently just because they join a particular plan. Nor is it
    appropriate to provide a few hospitals with special subsidies. This
    proposal is estimated to reduce Federal outlays by $34 million over the
    fiscal year 2012-2016 period and $279 million over the next decade.
    Because DOD budgets for this program on an accrual basis, the
    Department's savings from this proposal would be substantial. Under our
    proposed changes, DOD accrual contributions are reduced by $3.2 billion
    over the 5-year period, fiscal year 2012-2016.
                                   conclusion
        I want to emphasize that none of our proposals would affect costs
    to Active Duty servicemembers. Also, there will be no change in
    enrollment fees for medically retired servicemembers or survivors of
    servicemembers.
        These proposals represent a package of incentives and changes in
    payments and benefits that we believe are reasonable and fair to all.
    Most importantly, they lay the groundwork for a strong and sustainable
    future for the military health care system. The proposals generate
    savings that will help to pay for needed training and equipping of the
    Armed Forces.
        Mr. Chairman, that concludes my statement. My colleagues and I
    welcome the committee's questions.

        Senator Webb. Thank you very much, Secretary Hale.
        I would now like to call on Senator Graham, who has
    arrived, as predicted.
        Senator Graham. Thank you.
        Senator Webb. We welcome you to this hearing. I think you
    said you had three hearings going at the same time.
        Senator Graham. Yes. I just met with General Petraeus's
    wife, who is now in charge of protecting our military men and
    women from predatory lending practices. That was something I
    wanted to come and talk to our committee about.

                  STATEMENT OF SENATOR LINDSEY GRAHAM

        Senator Graham. Mr. Chairman, as always, I have really
    enjoyed our working relationship. I think we've done a pretty
    good job, if I say so myself, of keeping the men and women well
    equipped and well trained.
        On the healthcare front, this is really a difficult
    situation. You're talking about 16.5 percent of the DOD's
    budget, by 2028, being healthcare cost. Now, that's doubling in
    less than 20 years.
        Are you retired?
        Senator Webb. I am a retired marine, yes.
        Senator Graham. Okay. He's a retired marine. I, one day,
    hope to be a retired Air Force officer.
        I guess what I'm going to say is that I understand what the
    administration's trying to do. We have to move this debate
    forward on sustainability. We haven't had a premium increase
    since 1989. Some of the fees to be increased, proposed by the
    administration, I think, is something we should all consider. I
    respect the House. But, eventually you're going to have to make
    some very draconian choices between healthcare and operational
    needs. That's not where we want to find ourselves.
        Secretary Hale, your idea of trying to get a better bang
    for our buck, looking at programs to make them more efficient,
    improving the quality of care while lowering cost, is
    absolutely essential.
        Secretary McCarthy, we're going to miss you. You've been a
    really good, stalwart advisor to this committee.
        To the rest of you, I appreciate your involvement.
        But, Mr. Chairman, somebody eventually is going to have to
    address this. We are just putting the DOD budget in an
    unsustainable Hobson choices here. I am convinced, with a
    little forward thinking, that people in my income level, when I
    retire, could be able to contribute a little bit more to save
    the system and free up some dollars for operational needs and
    the force of the future.
        I look forward to working with you and the administration
    to try to find out a way to make this happen. I support your
    2012 budget.
        Healthcare's important to our men and women; TRICARE for
    the Guard and Reserve was a good move. Worked with Secretary
    Clinton. The GI Bill was a good move. We're seeing astonishing
    results there. People are signing up to be able to transfer
    their benefits to their children. We now need to talk about
    transferring to grandchildren. I know this is not the
    healthcare piece. But, I had a National Guard guy from South
    Carolina say, ``You know, I got three grandkids. Why can't I
    transfer my GI benefits to my grandkids?'' That shows you that,
    in the Guard and the Reserve, you have some people who've been
    around a while. [Laughter.]
        They may not be many, but I want to help them if we can.
        Thank you all. Together maybe we can find some rational way
    to move forward to reform healthcare within DOD.
        Senator Webb. Thank you very much, Senator Graham.
        As always, it's been great working with you on this
    subcommittee.
        Secretary McCarthy, welcome.

     STATEMENT OF HON. DENNIS M. McCARTHY, ASSISTANT SECRETARY OF
                      DEFENSE FOR RESERVE AFFAIRS

        General McCarthy. Mr. Chairman, Senator Graham, and members
    of the subcommittee, I can say without hesitation that it's
    always an honor to appear before a committee of the U.S.
    Senate, and especially since this is probably my last
    opportunity to do so.
        As always, I thank the committee and your staff for all
    that you've done for the men and women in uniform, especially
    for those whose it's my responsibility to serve, the members of
    the Reserve and National Guard. They have benefited greatly
    from the concern and the expertise that you've brought to bear
    on their behalf.
        As I believe you know, the 2010 Quadrennial Defense Review
    directed what it called a Comprehensive Review of the Future
    Role of the Reserve Component and the Balance Between Active
    and Reserve Forces. That review was completed earlier this
    year. Secretary Gates has just approved the report and directed
    that its analysis be part of the budgetary review for fiscal
    year 2013 and beyond. I believe this report will be extremely
    valuable in describing the ways that the National Guard and
    Reserve can contribute to our defense in coming years.
        Clearly, the Reserve components are at a point of
    transition. The last 10 years have been dominated, as you
    pointed out, Senator, by a demanding period of sustained
    mobilization that was never previously envisioned. Congress,
    DOD, and the military departments, and, most importantly, the
    men and women of the Reserve and Guard, and their families,
    have all adjusted to this reality. But, now as we draw down our
    forces in Iraq, and with a relatively small RC footprint in
    Afghanistan, the demand on Guard and Reserve for combat service
    is declining, at least temporarily.
        We can use this opportunity to move in one of two
    directions. We can return the Reserve and Guard to their pre-
    September 11 role as a Strategic Reserve, or we can find ways
    to continue to judiciously use the Reserve component as a part
    of the operational force. Having spent many years in direct and
    personal communication with the men and women serving in the
    post-September 11 Reserve components, I can tell you that most
    of them do not want to go back on the shelf as a purely
    strategic Reserve. Several of the Service Chiefs' posture
    statements indicate that they agree with their troops on this
    issue.
        Everyone serving in the Guard and Reserve today either
    enlisted or reenlisted since September 11, knowing full well
    the demands and expectations flowing from that decision. I
    believe we will all agree they've performed magnificently and
    have become accessible, well trained, and resilient. Their
    families and their employers have also demonstrated resolve and
    perseverance that some once doubted.
        The question before us now is, How can the Nation best
    preserve and utilize this hard-earned capability? Maintaining
    training and equipment readiness, balancing accessibility with
    judicious use, both will be essential. Continuing work on both
    law and policy will be necessary. But, the human capital that's
    resident in the Reserve and Guard is of such high quality that
    any failure to use their talents would be wasteful and
    destructive of the capability that they have achieved.
        Although I'll be leaving active service, I know that the
    team at Personnel and Readiness will continue to support this
    committee's efforts to develop legislative tools that our
    citizen warriors need to succeed.
        Thank you again for the opportunity to testify, and I look
    forward to your questions.
        [The prepared statement of General McCarthy follows:]
                 Prepared Statement by Hon. Dennis M. McCarthy
                                     exsum
        Chairman Webb, Ranking Member Graham, and members of the
    subcommittee; I thank you for your invitation to participate in this
    hearing. This is my second appearance before this committee in my
    current role, and I welcome the opportunity to give you my perspective
    on what I perceive to be a roadmap to the future of your Reserve
    components (RC).
        After a decade of sustained engagement in combat operations, the
    Reserve components of our Armed Forces have transformed, from a
    strategic force of last resort to a dependable operational force that
    provides full-spectrum capability to the Nation. Today there are over
    100,000 National Guard and Reserve men and women on active duty around
    the world and at home, serving in missions ranging from combat in
    Afghanistan to defending the air space here in Washington, to
    humanitarian relief efforts in Japan.
        In order to best utilize the Nation's 10 year investment in your
    Guard and Reserve Forces, they must be:

             1. Accessible: Expansion of 12304 enables future planning for
            an era of persistent conflict where augmenting the AC force in
            specific missions can occur without an authority gap.
             2. Used Judiciously: The RC are highly capable and possess
            many of the same capabilities as the AC, and have volunteered
            to serve at an incredible rate. Many of these individuals have
            the time and desire to serve more than the traditional standard
            for Guard and Reserve personnel; and the Department should find
            a way to leverage this willingness. In many cases, the Guard
            and Reserve Forces should be the first choice for recurring or
            predictable missions within their capability, which will
            contribute to the sustainability of both the Active and Reserve
            components. Putting in use rotational availability models allow
            for continued movement towards the Department objective of 1
            year mobilization for 5 years dwell time for the RC.
             3. Ready: Our RC forces need to continue to be maintained at
            the highest level of readiness, to include not only
            servicemember training and medical readiness, but also family
            and employer readiness. Our dedicated Guard and Reserve
            servicemembers receive support in a holistic manner, and we
            have worked, through both the Yellow Ribbon Reintegration
            Program and the Employer Support of Guard & Reserve Programs to
            give access to community, State, and Federal level assistance
            programs to servicemembers and their support networks before,
            during, and after deployments. This includes resilience
            training.
              Programs like these that ensure support during a
            servicemember's continuum of service assists our Reserve
            components in attracting the best and brightest to join. The
            Services have implemented recruiting, retention, and force
            shaping policies that you have authorized, and will achieve end
            strengths for fiscal year 2011, which provide the RC with
            forces necessary to meet strategic demands and maintain dwell
            consistent with policy.
              RC readiness also includes being able to work and train in
            quality facilities, and maintaining the current level of
            equipment that is available for training and preparation.
            Current funding for reset and maintenance of RC equipment comes
            out of Supplemental appropriations, but as we move away from
            dependence on these funds, it is important to include funding
            in base budgets to maintain and repair the equipment that is
            currently accessible to the RC.

        Chairman Webb, Ranking Member Graham, and members of the
    subcommittee; I thank you for your invitation to participate in this
    hearing. This is my second appearance before this committee in my
    current role, and I welcome the opportunity to give you my perspective
    on what I perceive to be a roadmap to the future of your Reserve
    components (RC). The Senate Armed Services Committee has always been
    very supportive of our National Guard and Reserve Forces. On behalf of
    those men and women, our Citizen Warriors, their families and
    employers, I want to thank you for all your help in providing for them
    as they have stepped up to answer the call to duty. We will do
    everything in our power to merit your continued support.
        After a decade of sustained engagement in combat operations, the
    Reserve components of our Armed Forces have transformed, from a
    strategic force of last resort to a dependable operational force that
    provides full-spectrum capability to the Nation. Repeated combat
    deployments, as well as peacekeeping and humanitarian relief missions,
    have produced an operationally resilient force that fully expects to be
    utilized on a periodic basis. This new force represents a 10-year
    investment in resourcing the Nation's commitments and the personal
    sacrifice of servicemembers, their families and employers. That
    investment can reliably provide the Department of Defense (DOD) with
    essential operational capabilities and strategic agility in a cost-
    effective manner well into the future. Good stewardship demands that we
    continue to capitalize on this investment in order to maintain Guard
    and Reserve readiness, relieve stress on the Active component, and
    provide the widest array of force structure options in a resource
    constrained future.
                             an indispensable force
        Today there are over 100,000 National Guard and Reserve men and
    women on active duty around the world and at home, serving in missions
    ranging from combat in Afghanistan to defending the air space here in
    Washington. They serve alongside Regular component personnel,
    civilians, and contractors. They are experienced; many having served
    multiple tours in combat and are now leading people in combat. They are
    skilled; bringing many needed civilian skills to the military such as
    cyber, agriculture, law enforcement, and medical. We would not have
    been able to do what we have done over the past 10 years without them
    and I don't believe we can do what lies ahead of us without them.
        There are three key fundamentals going forward for the RC. They
    must be accessible, they must be used judiciously to best advantage,
    and they must be ready.
    Accessibility
        With experienced, ready units and individuals, and the prospect of
    persistent conflict access to the RC in the future will be a key
    successful employment of the RC in the Total Force.
                            proposed change to 12304
        Future planning envisions an era of persistent conflict where some
    type of RC activation authority will be required to augment the Active
    component (AC) to maximize effectiveness and efficiency of the Total
    Force. At present, we have sufficient authority to mobilize RC forces
    for current operations. However, as directed (by the Senate Armed
    Services Committee conference report S. Rept. 111-201, page 138), we
    have analyzed our access authorities to support long term utilization
    of the RC as part of the operational force. We foresee an authority gap
    when the Nation is faced with persistent demands on the Total Force but
    does not have specific named operational missions, a national emergency
    or war situation. This authority gap exists for some, but not all, of
    the full spectrum of military missions, including training,
    peacekeeping, and building partnership capacity, that our RC is
    specifically well suited to perform as a complementing part of the
    Total Force. Closure of this authority gap will help increase dwell for
    the Active component while maintaining RC readiness and could be
    accomplished by the following:
        In response to your request and the request of the Services for
    ``assured access'' to the RC, we propose expanding the existing
    authority in title 10, U.S.C., section 12304, commonly referred to as
    the Presidential Reserve Call-up statute. Our proposal does not change
    the requirement for Presidential action to invoke the access authority,
    nor does it change the number of personnel affected or the frequency
    and duration of active duty. Our modification enables use of the
    existing statute for the full spectrum of military missions while
    adhering to the existing policy of no more than 1 year activated out of
    every 6. The proposal also limits the number of Reserve personnel who
    can be involuntarily activated for purposes other than an operational
    mission or threat or attack by terrorists or weapons of mass
    destruction. Our proposal includes a requirement for the Department to
    identify the manpower and associated costs of known RC utilization in
    the President's budget justification materials, providing Congress
    final oversight on any implementation of the expanded authority to
    access the RC.
    Judicious Use
        With increased use comes an equal demand to make sure we use the RC
    judiciously and to best advantage. Every member of the RC has
    volunteered since September 11 with the expectation that they will be
    judiciously used and given meaningful work to do. DOD and the Services
    should continue to meet this expectation.
        The Reserve components are highly capable and possess many of the
    same capabilities as the AC, but we have to be conscious of family and
    employment obligations. We believe that missions that are predictable
    can be accomplished on a rotational basis, and missions that are more
    enduring are best suited for the RC. We are encouraged by the inclusion
    of the RC in these models and believe it will reduce stress on the
    force overall, AC and RC, preserve readiness gains in the RC, provide a
    cost effective way to maintain Total Force capability, and preserve the
    All-Volunteer Force.
    Volunteerism
        Every day for the past several years over 20,000 Reserve component
    servicemembers have served on active duty as volunteers. These
    individuals have the time and desire to serve more than the 1 weekend
    per month and 2 weeks per year that have long been considered standard
    for Guard and Reserve personnel. The Department is investigating
    methods to leverage this willingness to serve in order to fulfill the
    part-time and temporary demands of the combatant commands, major
    command headquarters, and the Defense agencies. One consideration is
    for DOD to create Reserve component units staffed by personnel willing
    to volunteer to serve more frequently or for longer periods of time in
    order to support such tasks as Theater Security Cooperation, Building
    Partner Capacity, Homeland Defense, Defense Support to Civil
    Authorities, and the Services' institutional support missions.
        This type of differential service commitment has been used
    successfully in high OPTEMPO units such as aviation for some time, but
    with the Reserve component now playing a larger role in many ongoing
    mission areas, expanded utilization of differential service contracts
    would be useful. Such differentiation within the Reserve component
    would provide an additional sourcing option for units, teams, and
    personnel for contingency operations or emergencies.
                        all-volunteer total force policy
    Dwell
        The RC provides both operational capability and strategic depth in
    support of the national defense strategy. It is imperative that
    predictability in the use of RC forces be maximized. On January 17,
    2007 the Secretary of Defense established planning objectives for
    involuntary mobilization of Guard and Reserve units at 1 year mobilized
    to 5 years dwell time (1:5). Today's global demands require a number of
    selected Guard/Reserve units to be remobilized sooner than this
    standard. The intention is that such exceptions will be temporary, and
    that we move to the broad application of 1:5 as soon as possible.
    Reduce Stress
        The processes by which roles and missions are assigned to the
    Nation's Guard and Reserve Forces should be characterized by a belief
    that those forces and individuals can, and in many cases should be, the
    first choice for recurring or predictable missions within their
    capability. Such strategic planning will provide more efficient and
    effective utilization of defense assets.
        Assessing Departmental requirements in this fashion will also
    contribute to the sustainability of both the Active and Reserve
    components. Utilizing the Guard and Reserve in this manner, to best
    advantage, increases the capacity of the Total Force and will reduce
    the burden on all forces by relieving Active-Duty Forces that would
    otherwise execute the mission, by increasing their dwell to deployment
    ratio and by sustaining that force for future use.
        Rotational availability models in use today are essential to
    ensuring that the Guard and Reserve are trained and ready when needed.
    Using the Reserve component on a rotational basis maintains their
    readiness and expands their availability and capabilities. The Services
    should continue to refine rotational availability models to achieve
    improved predictability for the Total Force in accordance with stated
    Department deployment to dwell objectives.
       realigning and provisioning the reserve component as part of the
                               operational force
    Realigning capabilities (High Demand/Low Density Missions)
        Balancing and aligning capabilities within and between components
    is an ongoing process. In recent years, the Department has realigned
    over 180,000 positions and has plans to realign roughly another 120,000
    over the coming years. The RC has been a full partner in this
    realignment, assuming roles in the missions that are currently in
    demand across the Department. The RC is well suited for roles and
    missions that are recurring and predictable, and the typically more
    permanent assignments of RC members lend themselves to missions that
    benefit from establishment of habitual relationships, long-term
    planning and engagement. This approach also helps reduce stress on the
    Active Force while preserving readiness and capability within the Total
    Force.
        The Army, Navy, Marine Corps, and Air Force Reserve are currently
    adding or are planning to add capability to high demand, low density
    areas such as Civil Affairs, Intelligence, Cyber, Special Forces, and
    Military Police. These capabilities have been in high demand over the
    past 10 years, and all indications suggest they will continue to be in
    high demand in the future with Security Cooperation/Building Partner
    Capacity potentially moving to the forefront of Department missions.
    The RC is particularly well suited for these types of missions and
    capabilities.
                                   readiness
    Readiness Requirements
        One of my key priorities is to preserve the readiness gains made in
    the RC. These gains can be sustained by continued use of the RC as a
    rotational operational force. Periodic, predictable deployments will
    further enhance the RC's capabilities, maintain their readiness over
    time, add value to the Total Force and provide future capability and
    capacity.
        To meet the full spectrum of DOD missions and maintain RC readiness
    gains, the RC needs to be appropriately resourced as requested in the
    fiscal year 2012 budget to provide continued access to training
    equipment, facilities, ranges, and to be recapitalized with the same
    types of equipment and systems that reside in the AC.
    Individual Member Readiness
        At the most basic level, readiness starts with the servicemember.
    Our personnel receive the same individual and basic training as all
    military members, so we start out on equal footing. Our members also
    receive effective and efficient skill training matched to their
    mission. We are continuously reviewing and adjusting these training
    requirements in order to make most efficient use of our traditional
    member's limited time during monthly unit training assemblies. Pre-
    mobilization training makes RC individuals and units as ready as any AC
    unit going into a deployment. However, now that the department depends
    on RC assets for many missions there is a need to be medically ready to
    serve in any operational capability; whether in an overseas contingency
    or locally in the homeland. Medical and dental readiness levels can be
    maintained with adequate funding, support, facilities, and alternative
    approaches.
    Individual Medical Readiness
        We continue to monitor the Individual Medical Readiness of the
    National Guard and Reserve to ensure availability of ready Reserve
    component members for deployment, as it continues to be a priority for
    the Department. Additionally, as of the first quarter of fiscal year
    2011, the RC has a Fully Medically Ready rate of 63 percent, which is
    below the DOD goal of 80 percent. The lower RC Medically Ready rate is
    due to a significant number of members who are deemed Not Medically
    Ready (17 percent) for numerous reasons of which disqualifying dental
    condition is a principal factor. However, DOD is diligently working to
    make medical and dental services more available to RC members. Although
    we still need to improve, as of the first quarter of fiscal year 2011,
    all components have met or exceeded the Dental Readiness goal of 75
    percent, which will have a positive impact on overall medical
    readiness.
        We support the Integrated Disability Evaluation System (IDES) to
    assess the fitness and care of wounded RC members ensuring they are
    appropriately identified and processed in a timely manner. We continue
    to support our RC wounded warriors enabling a swift return to their
    civilian lives.
    Reserve Component End Strength
        Meeting Reserve component end strength objectives is a priority of
    the Department. The following table depicts the current prescribed and
    actual end strengths for the Reserve components. The Department's
    Continuum of Service efforts have contributed to the six DOD Reserve
    components remaining within the variance allowed for their
    congressionally-mandated end strength objective. The Services have
    implemented recruiting, retention, and force shaping policies and
    programs to achieve end strengths for fiscal year 2011. We appreciate
    the congressional support of the fiscal year 2011 end strength levels
    and the legislative initiatives that assist in recruiting and retaining
    Reserve component servicemembers. These end strengths will provide the
    Reserve components with the forces necessary to meet strategic demands
    while maintaining a dwell consistent with departmental policy.

           FISCAL YEAR 2011 RESERVE COMPONENT END STRENGTH OBJECTIVES
    ------------------------------------------------------------------------
                                                               Actual as of
                     Service                     Objective     January 2011
    ------------------------------------------------------------------------
    Army National Guard.....................         358,200         363,995
    Army Reserve............................         205,000         205,849
    Navy Reserve............................          65,500          64,677
    Marine Corps Reserve....................          39,600          39,949
    Air National Guard......................         106,700         106,643
    Air Force Reserve.......................          71,200          70,359
                                             -------------------------------
      Total.................................         846,200         851,472
    ------------------------------------------------------------------------

        Of the end strength figures outlined above, there are
    servicemembers in the training pipeline for the Reserve components who
    are not immediately available for mobilization.
    Recruit Operational Ready Reserve Strength
        Thus far, for 2011, Reserve recruiting efforts show continued
    success. Through January, all Reserve services have met or exceeded
    both quantity and recruit quality objectives. Notably, for the third
    year in a row, the Reserve components exceeded the DOD Benchmark of 90
    percent of new recruits being High School Diploma Graduates, with 93
    percent of Reserve component recruits holding that credential.

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        It is important that we have a military that reflects the society
    it defends, both in the enlisted ranks and our commissioned officers.
    This is particularly important as less than 1 percent of the American
    public serves in uniform. To that end, we are pleased that some of our
    most prestigious colleges and universities are now re-thinking their
    previous positions with regard to ROTC programs. This will provide more
    opportunities for college students to think about seeking commissions
    in the U.S. military.
        We continually review our recruiting programs to align funding and
    policies with current realities. Each of the Services has made
    significant adjustments to recruiting programs in light of our austere
    fiscal environment, and continues to look for additional cost savings--
    but we must be cautious and resist the temptation to cut too deeply and
    too fast. Stable adequate investments in recruiting resources are
    necessary to maintain long-term success. Although enlistment incentives
    can be adjusted quickly to meet market fluctuations and force
    management needs, history has shown that the time required to redeploy
    advertising/marketing campaigns and/or qualified recruiters is
    significant. I cannot emphasize this imperative enough.
        The Montgomery GI Bill-Selected Reserve (MGIB-SR) has been a
    cornerstone of our military recruiting efforts since 1985, and a major
    contributor to the success of the All-Volunteer Force. We are now in
    the second year of the new Post-9/11 GI Bill, the most extensive
    restructuring of post-service education benefits since the introduction
    of the original World War II GI Bill. The Post-9/11 GI Bill appears to
    enhance our recruiting efforts even more. We hope that the provision in
    the new program that allows career servicemembers to transfer their
    unused GI Bill benefits to immediate family members, long requested by
    both members and their families, will prove widely beneficial. Although
    full utilization data is not yet complete, early results look
    favorable. For example, through fiscal year 2009, the VA has received
    and processed over 578,000 enrollment certifications and 237,000
    changes to enrollments for Veterans attending school under the Post-9/
    11 GI Bill. In 2010, the VA was able to increase its daily completions
    of PGIB enrollment certifications from an average of 1,800 per day
    during October to nearly 7,000 per day.
        As indicated earlier, the benefit may be transferred to the
    member's dependents. As of April 2010, a total of 240,888 dependents
    have been identified for transfer (based on applications submitted by
    servicemembers) since the program began accepting applications in June
    2009. The potential transfer population includes spouses, children,
    stepchildren, and pre-adoptive children. As of February 2011,
    approximately 181,144 Post-9/11 GI Bill transfer applications submitted
    by servicemembers have been approved by their respective Service
    component.
        On January 4, 2011, the President signed the Post-9/11 Veterans
    Educational Assistance Improvements Act of 2010--providing additional
    benefit options that include the eligibility of National Guard and
    Reserve members who were inadvertently omitted from the original Bill,
    vocational and other non-college degree training, and living stipends
    for those enrolled in distance learning programs. This makes the Post-
    9/11 GI bill the most comprehensive educational benefit in our Nation's
    history, making it an appropriate benefit for our service men and women
    supporting the ongoing overseas contingency operations.
         training and recruiting the reserve component as part of the
                               operational force
    Initial/Individual Training/Skills Training
        The Reserve components are working with the Services to ensure that
    training institutions and facilities are resourced to meet the needs of
    the total force, with resident, nonresident or distance learning, to
    include RC personnel. Much improvement has occurred in this direction,
    but we will continue to monitor implementation until institutionalized.
    Regional Integrated Training Environment
        The Regional Integrated Training Environment (RITE) concept is a
    joint initiative that identifies and matches Service training
    requirements to a network of local training facilities and resources.
    Still in the formative stages, the purpose of the RITE initiative is to
    help sustain the Total Force readiness posture, and surge capability as
    determined by Service rotational readiness models while reducing
    overhead training costs. This is done through innovative management of
    facilities, existing training assets, simulators and Joint Live,
    Virtual, Constructive capability, pools of shared equipment, and
    coordination through a web-based visibility/scheduling system. As the
    concept matures, collaboration will expand with key internal and
    external DOD stakeholders.
    Innovative Readiness Training (IRT)
        The Innovative Readiness Training (IRT) program is an outstanding
    volunteer training opportunity for our National Guard and Reserves.
    IRT's focus is to provide varied and challenging training opportunities
    that exercise the Mission Essential Task List (METL) requirements of
    combat support and combat service support units and individuals. Each
    year new training opportunities are presented by Federal, State, or
    local government agencies or nonprofits to the Services. Military units
    are provided METL training in a realistic, hands-on setting while
    providing quality services to underserved communities throughout the
    Nation. Examples of IRT activities include infrastructure development,
    constructing rural roads and runways, small building and warehouse
    construction; and providing medical and dental care to medically
    underserved communities. These opportunities result in interoperability
    and readiness training, ensuring our Nation always has a fully capable
    National Guard and Reserve.
    Training and Intelligence
        The Defense Intelligence Agency (DIA) led the Joint Reserve
    Intelligence Program (JRIP) to restructure 398,000 square feet of
    classified workspace and 4,035 workstations in 28 sites throughout the
    United States. These sites enable drilling reservists to provide real
    world operational support to the COCOMs, Combat Support Agencies and
    Service Intelligence Centers, concurrently enabling training to be
    supplanted by real word intelligence support, the highest possible form
    of training. In fiscal year 2010, the JRIP averaged over 4,500 people
    per month using just one of the 28 sites. COCOM support was further
    enhanced by the infusion of $11 million of DIA-man-day funding and $16
    million of COCOM/Service man-day funding for duty at the JRIP sites.
    These efforts resulted in even greater savings in reduced travel and
    per diem costs, coupled with improved quality of life for Reserve
    component members by serving in their local region.
    Equipment Procurement, Reset
        Unlike other areas of the Defense budget, there currently is no
    Reserve-specific appropriation for equipment that mirrors the active
    force. The RC relies on the Active procurement account and
    congressional action in the National Guard and Reserve Equipment
    Appropriation (NGREA). Yet it is usually difficult to determine how
    much of the active procurement appropriation is specifically intended
    for the Reserve components and tracking subsequent execution. We
    currently use the Equipment Delivery Report to help us follow the money
    from appropriation to delivery. At that point the DOD Directives should
    ensure equipment movement between the Reserve and Active are
    appropriately documented. Full transparency and accountability can only
    be achieved through a full life cycle, enterprise approach to Reserve
    equipping. The life cycle includes requirements determination, budget
    requests, appropriation, purchase, and delivery of hundreds of
    thousands of pieces of equipment. Plans to return borrowed RC equipment
    are included as key deliverables in this process. All Services have
    made tremendous strides in coming together to equip the Total Force.
    Line Item P-1R
        The P-1R is the Reserve component allotment of the overall DOD
    Procurement Program (P-1). Congress requires each P-1 budget submitted
    by the President to Congress to specify amounts requested for
    procurement of equipment for the National Guard and Reserve components.
    However, the P-1R has historically been treated as a non-binding
    projected subset of the service Procurement Programs. To achieve
    Congressional and DOD mandated transparency, the Services should
    develop comprehensive and accurate projected funding and equipment
    quantities in the P-1R and include this as a separate budget line in
    their request.
    Resetting
        Currently, funding for reset of equipment returning from theatre
    for the Guard and Reserve comes from a supplemental appropriation. As
    we prepare to move away from reliance on these supplemental funds, it
    is important to have a continued source of funding built into the
    budget for RC equipment reset. It is critical that the Guard & Reserves
    are able to continue to train on high quality equipment for which funds
    have already been allocated.
    Military Construction
        There is a direct correlation between readiness and facilities,
    particularly in the Reserve component. The move from a Strategic
    Reserve to an Operational Reserve doesn't change the fact that we owe
    our Guard and Reserve members quality facilities in which to work and
    train. The combined fiscal year 2012 RC Military Construction (MILCON)
    program request of $1.2 billion is less than last year's request;
    however, it will help alleviate some of their most urgent facility
    deficiencies. Despite Congress' generous RC MILCON appropriations in
    the past, future fiscal realities suggest that future budgets will
    decline. Therefore, we must approach future construction with the
    intent to exploit joint use military construction projects as much as
    possible. We are currently leading an effort to revise current DOD
    guidance that will facilitate smarter consolidation and joint use of RC
    facilities.
                         family and employer readiness
    Family
        Prepared and resilient family members are a vital support system
    for each servicemember. Our dedicated military men and women require
    support in a holistic manner. Support for our servicemembers should
    come from both the Federal and State levels and this support needs to
    include well-established family support programs. Since September 11,
    over 802,000 Guard and Reserve members have mobilized resulting in
    America's most experienced, best-trained, best-equipped Reserve
    component ever. To sustain this force, we need continued support for
    the families of those in uniform, and their employers. We are working
    aggressively to sustain continued community support from neighbors,
    relatives, churches, local businesses and State-based Federal
    programs--such as those from Department of Labor, Small Business
    Administration, and Veterans Affairs.
        Reserve Affairs is also pleased that the Presidential Report on
    Strengthening Our Military Families highlighted a program for
    implementing a one-stop resource to handle State-wide military family
    issues using Inter-Service Family Assistance Committees (ISFACs). These
    locally-based committees work to build community capacity and
    strengthen networks of support. DOD has built on these grassroots
    efforts to benefit geographically dispersed Active, Guard, or Reserve
    servicemembers and families utilizing the Yellow Ribbon Reintegration
    Program (YRRP).
        Throughout a servicemember's continuum of service, YRRP strives to
    put in place a viable support system. A coordinated network of support
    with defined processes serves the needs of military families in
    geographic locations closest to where they reside. The work to
    strengthen and support military families is never complete and DOD
    continually strives to identify gaps in our support and to link
    appropriate resources from all stakeholders. It is important to note
    that Yellow Ribbon Reintegration Program is not a ``war time only''
    requirement, but must remain an enduring mission to ensure the
    continued resilience of servicemembers and their families.
    Employer
        Employer Support of the Guard and Reserve (ESGR) engagement has
    grown significantly in recent years. The vision is, ``to develop and
    promote a culture in which all American employers support and value the
    military service of their employees with ESGR as the principal advocate
    within DOD.'' ESGR has a footprint in all 50 States, U.S. Territories,
    and DC with over 4,700 volunteers assisting employers and
    servicemembers on a daily basis. In striving to enhance employer
    support, ESGR relies on recognition programs where employers are
    recognized for outstanding support of Guard and Reserve servicemembers
    and their families. One example is the Secretary of Defense Employer
    Support Freedom Award, where 15 employers are honored for their
    outstanding support of Guard and Reserve members and their families
    annually during September at the Reagan Center in Washington, DC. In
    this current year 4,049 employers were nominated by servicemembers or
    their families. This is an increase from the 2,470 that were nominated
    in fiscal year 2010. With current ongoing global operations, combat-
    related and humanitarian, the support of employers and families has
    never been more critical to our national defense. The data in the
    following table shows the improving trend of some of ESGR's programs
    and activities over the last 3 fiscal years:

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Despite all of the good work already accomplished by ESGR members,
    I believe more must be done. In 2010, I formed the Family and Employer
    Programs and Policy (FEPP) office within the Office of the Secretary of
    Defense for Reserve Affairs to align ESGR, the Yellow Ribbon
    Reintegration Program and Family Support Office under one directorate
    to ensure we are working together to create synergy and realize
    efficiencies for the servicemembers and families served by YRRP, ESGR
    and Family Programs' missions. In fiscal year 2011, ESGR placed
    additional emphasis on the employment of servicemembers and now assists
    them throughout the entire employment cycle.
        One of the greatest challenges facing our Nation is unemployment
    and underemployment, and these related problems are severe for those in
    the Guard and Reserve, or for those leaving active military service.
    Whether they are soldiers, sailors, airmen, coast guardsmen, or marines
    completing active duty, or members of the Guard and Reserve returning
    from deployment, many of these great men and women return home to an
    uncertain future because of the challenging job market.
        The promise of a secure job provides servicemembers and their
    families with stability and peace of mind. The December 2009 Status of
    Forces Survey of Reserve component members indicated that
    servicemembers across six of the seven Reserve components (Coast Guard
    Reserve not included) self-reported a 12 percent unemployment rate. The
    highest unemployment rate across all components was 22 percent among
    junior enlisted troops in the rank of E1-E4. As this data is self-
    reported, many of these younger troops are likely to be students. The
    total number of respondents were 20,238 (from an estimated population
    of 822,000) RC servicemembers.
        The current employment challenges led to the implementation of the
    Employment Initiatives Program (EIP). EIP is now ESGR's highest
    priority and is an outgrowth of ESGR's existing outreach programs
    already in place, with a focus on employment. The overall intent of EIP
    is to take full advantage of all ESGR, Yellow Ribbon, and Family
    Programs, in partnership with public and private entities, to enhance
    employment opportunities for servicemembers and their families,
    especially focusing on those completing active duty tours and our
    Wounded Warriors. During fiscal year 2010, ESGR conducted several Pilot
    Programs to determine the activities and best practices to support the
    EIP. Some examples include but are not limited to: Job Fairs,
    Transition Assistance Programs, Strategic Partnering at the State and
    Local levels.
        The EIP will assist our Citizen Warriors and at the same time it
    will help those American businesses that are looking for employees
    possessing skill-sets, integrity and vast experience resident in the
    U.S. military.
                       resilience training & preparation
    Yellow Ribbon--Understand Psychology of Military Service Family
            Programs
        The objective of the YRRP is to ensure the readiness and well-being
    of National Guard and Reserve servicemembers and their families by
    providing dynamic events, information, services, referrals, and
    proactive outreach opportunities throughout the entire deployment
    cycle. Resiliency is a priority of the YRRP mission. Since its
    inception in 2008, there has been an ever increasing focus on
    resiliency building and training for the National Guard and Reserve
    Forces. In response to growing awareness regarding the connection
    between post-traumatic stress (PTS), substance abuse, criminal activity
    or suicide and ``bounce back'' ability, Reserve component members and
    their families are being offered training to enhance their resiliency
    skills.
        As part of the YRRP, services and information that foster
    resiliency are provided at the pre-deployment, during deployment, and
    the 30, 60, 90 day post-deployment events. The Yellow Ribbon
    Reintegration Program implemented a Cadre of Speakers program, hiring
    facilitators who specialize in resilience training and who are
    available to YRRP event planners across the country. These facilitators
    also work with Military and Family Life Counselors and chaplains to
    provide critical support around resilience issues at YRRP events,
    ensuring individual assistance is available for each family or
    servicemember as required.
        Additionally, other sessions and resources focus on marriage and
    children, substance abuse awareness, financial counseling, anger
    management, employment assistance and Department of Veterans Affairs'
    information regarding benefits and medical care eligibility. To find an
    event or additional resources, an RC member, commander, planner, or
    family member can access information at http://www.yellowribbon.mil/.
    Resilience and Suicide Prevention
        Suicide prevention is a very important issue for Reserve Affairs.
    The loss of even one life to suicide is heartbreaking and has a
    profound impact on both the unit and the family members left behind. As
    noted by the DOD Task Force on the Prevention of Suicide by Members of
    the Armed Forces, many factors contribute to the military suicide rate.
    One factor relates to leadership. Each Service acknowledges the
    important role those leaders, both Officers and NCOs play in building
    resiliency among those under their command. In 2010, there were a total
    of 294 active duty servicemembers (including 26 Active Reserve) who
    committed suicide, which is down from 310 in 2009. However, among our
    non-active National Guard and Reserve, there were an additional 178
    suicides in 2010. For the Army National Guard, this was a doubling of
    their suicide rate from 2009. The Services, along with Reserve Affairs,
    have taken these rates very seriously and have committed resources to
    significantly reduce this trend. The National Guard currently has a
    Director of Psychological Health in each of our 54 States and
    territories who acts as the focal point for coordinating the
    psychological support for Guard members and their families.
    Additionally, Reserve Affairs has established a Stakeholder Core Group
    whose mission is to address suicide prevention, intervention, post-
    vention and surveillance issues across all of the RC. Reserve Affairs
    has also included training materials on resiliency for Yellow Ribbon
    Reintegration Program events.
                          dod youth outreach programs
    Science and Technology Academies Reinforcing Basic Aviation and Space
            Exploration
        I continue to support the President's education agenda through two
    youth outreach programs in order to achieve our national security
    objectives; the DOD STARBASE and National Guard Youth Challenge
    programs.
        The President has stated that it has never been more important for
    young Americans to be proficient in science and mathematics and he made
    enhancing the learning of science and math a national priority. The DOD
    STARBASE program provides elementary and secondary school students with
    real-world applications of science, technology, engineering and math
    through heuristic learning, simulations and experiments. The strength
    of the program lies in the three-way partnership between the military,
    the local communities and the school districts. Senior military leaders
    such as Admiral Roughead agree that the DOD STARBASE Program is a
    productive investment in the future of our youth, building and
    enlarging the talented recruits we need.
        The fiscal year 2012 budget allows the program to serve over 65,000
    students from approximately 1200 schools and 350 school districts which
    includes schools from American Indian communities in Mississippi,
    Oklahoma, and South Dakota. Over 605,000 youths have attended the
    program and pre and post testing shows a significant improvement in
    student's understanding and interest in math and science and in
    pursuing further education. Currently, there are 60 DOD STARBASE
    Program sites on military facilities in 34 States, the District of
    Columbia, and Puerto Rico.
    National Guard Youth Challenge Program
        The President has also addressed the high school dropout crisis. My
    staff and I have been working with the Office of Management and Budget
    to challenge States, industries, and non-profits to invest in
    intervention programs like the National Guard Youth Challenge Program.
    I am also working with General McKinley, Chief of the National Guard
    Bureau, to provide oversight and management of the Program by
    collaborating with Governors to eliminate State resident issues; and to
    ensure every qualified high school dropout has an opportunity to attend
    the program. The Challenge program is currently operating in 27 States
    and Puerto Rico. Its goal is to improve the education, life skills and
    employment potential of America's high school dropouts. We provide
    quasi-military based training, supervised work experience to advance
    the program's core components. The core components include obtaining a
    high school diploma or equivalent, developing leadership, citizenship,
    life coping and job skills and improving physical fitness, health and
    hygiene. Since the program's inception over 100,000 students have
    successfully graduated from the program. The average cost per Challenge
    student is approximately $16,000. The fiscal year 2012 budget will
    support increasing annual enrollment and/or start up new programs in
    States that have the fiscal resources to match the cost-share funding
    requirements and to sustain the program's viability in States that have
    budget limitations.
        These two successful DOD youth outreach programs provide the
    Department a unique connection to the American public and working with
    our most valued resource--our young people.
                                   conclusion
        The National Guard and Reserve continue to be a mission-ready
    critical element of our National Security Strategy. The requirement for
    our Reserve components has not, and should not lessen. Our Reserve
    components must continue their expanded role as an Operational Reserve
    in all facets of the Total Force. To lose the training, experience and
    integration of the Reserve components by relegating them to a strategic
    Reserve would squander a resource we can't afford to waste. The nation
    continues to call and the Reserve components continue to answer that
    call. But in answering that call, we shouldn't lose sight of the need
    to balance their commitment to country with their commitment to family
    and civilian employers. That is why relieving stress on the force is
    absolutely essential; utilizing our Guard and Reserve as a component of
    the Total Force is so crucial; and continuing to train and equip the RC
    to maintain our investment and experience is so critical.
    Predictability will enable our families to build resiliency, as well as
    foster understanding with our employers. I realize the path forward
    will not be easy, but together with support of legislative proposals
    mentioned above we can ensure an operational, trained and fully
    prepared Reserve component. I have included in the following annexes
    multi-year (2010-2012) funding levels and justifications for programs
    within my jurisdiction and oversight that will enable the Reserve
    components to achieve these goals. Thank you very much for this
    opportunity to testify on behalf of our great Guard and Reserve Force.

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Webb. Thank you, Secretary McCarthy.
        Secretary Woodson, welcome.

     STATEMENT OF HON. JONATHAN WOODSON, M.D., ASSISTANT SECRETARY
     OF DEFENSE FOR HEALTH AFFAIRS, DIRECTOR OF TRICARE MANAGEMENT
                                ACTIVITY

        Dr. Woodson. Thank you very much.
        Mr. Chairman, members of the committee, thank you for the
    opportunity to appear before you today to discuss the future of
    the military health system, and in particular our priorities
    for the coming year.
        This is my first appearance before this committee in my
    role as Assistant Secretary of Defense for Health Affairs. I
    want to first express my deep gratitude for the warm and
    helpful guidance both you and your staffs have privately
    offered me in my first 4 months in this position.
        Our fiscal year 2012 budget for the Defense Health Program
    and related medical activities supports the priorities of our
    strategic framework, the quadruple aim: improving readiness,
    improving population health, the patient care experience, and
    responsibly managing our costs of care.
        First, from the perspective of medical readiness, I want to
    acknowledge the performance and courage of our military medical
    professionals serving in combat theaters. I recently returned
    from Afghanistan, 2 days ago, and can attest to the skill,
    commitment, courage, and patriotism of our medics serving in
    harm's way.
        These attributes were exemplified by Captain Joshua
    McClimans, a 31-year-old nurse, husband, father of two young
    children, on his second deployment, assigned to the 352nd
    Combat Support Hospital. On April 22, he was killed by indirect
    fire and gave his last full measure of devotion to this
    country, as Lincoln once said.
        I attended his memorial service at Forward Operating Base
    Solerno and talked with fellow unit members. Although deeply
    saddened by the events, these true professionals soldiered on
    and continued their medical mission, in support of other
    brothers and sisters in harm's way.
        I ask that we all here today remember Captain McClimans,
    the eight Air Force personnel and the one civilian killed last
    week, as well as their families, in our thoughts and prayers.
        The military health system has achieved historic reductions
    in disease and injuries through improved public health and
    preventative medicine strategies. For servicemembers wounded in
    combat, their likelihood of survival after a medic arrives
    remains at historic and unmatched levels. My responsibility is
    to ensure that we sustain the high level of performance.
        Our budget continues to support the foundation which our
    achievements have been built on: a robust medical research and
    development program that focuses on battlefield illnesses and
    injuries, to include prevention, diagnosis, treatment for
    traumatic brain injury, post-traumatic stress, and depression.
        Second, we improve the health of populations we serve. The
    fiscal year 2012 budget focuses resources on efforts to
    increase our behavioral health providers, both within the
    system and within our private-sector partners. We are also
    targeting funds to improve access to behavioral health
    providers throughout the country. We are investing in
    preventative-care approaches that are intended to lower the
    rates of tobacco use, alcohol abuse, and obesity.
        Third, we must enhance the patient-care experience. We
    propose continued expansion of the patient-centered medical
    home, our central initiative to improve access to care,
    population health, and overall patient satisfaction. We
    continue to invest in modernizing our military hospitals and
    clinics around the world. Thanks to you and your unwavering
    support, our construction programs will allow wounded, ill, and
    injured servicemembers to be treated in the finest medical
    facilities in the world.
        This year, we look forward to opening two showcase
    facilities in the National Capital area: the new Walter Reed
    National Military Medical Center and our new Community Hospital
    at Fort Belvoir.
        Finally, we recognize that emerging Federal fiscal policy,
    combined with the ever increasing healthcare costs, demand that
    we take additional steps to be even more responsible stewards
    of the taxpayers' dollars. As Secretary Gates and Chairman
    Mullen have repeatedly declared, we, the Department, must
    tighten our belts, just as many Americans have done over the
    last several years.
        In our proposed budget, we share the responsibility for
    cost control among all participants. We have first focused on
    internal efficiencies within DOD, the TRICARE Management
    Activity, and Health Affairs, and then the civilian provider
    community, and finally, with our beneficiaries, for whom we've
    proposed a very modest change to select out-of-pocket costs. We
    have gone to great lengths to protect patients enrolled in
    existing programs and beneficiaries who have special needs and
    circumstances that must be considered. We have met with the
    beneficiary organizations on these proposals. I am gratified
    that many have viewed our proposals reasonable and fair.
        Our proposed budget keeps fidelity with our core
    principles. We will never lose our focus on commitment to a
    high quality and world class healthcare system for all members
    of the Armed Forces, and for their families, who served, past
    and present, and who will serve in the future.
        I am both pleased and proud to be here today with you to
    represent the men and women who comprise the military health
    system. I look forward to answering your questions.
        Thank you very much.
        [The prepared statement of Dr. Woodson follows:]
               Prepared Statement by Hon. Jonathan Woodson, M.D.
                               executive summary
        The proposed total funding for the Military Health System (MHS) in
    fiscal year 2012--combining both the Defense Health Program (DHP) and
    other appropriations that fund MHS activities--is $52.5 billion, a 4.8
    percent increase over the fiscal year 2011 request. This request
    reflects investments in the four strategic priorities for the Military
    Health System in the fiscal year 2012 Defense Health Program: Assure
    Readiness; Improve Population Health; Enhance the Patient Experience of
    Care; and Responsibly Manage the Cost of Care.
    I. Assure Medical Readiness
        We continue to invest in medical research and development
    supporting the full spectrum of military medical operations and issues.
    Particular emphasis this year supports a comprehensive DOD/VA research
    effort aimed at understanding the interventions that work to prevent
    suicide. We also continue our extensive research into the early
    identification diagnosis, and treatment of traumatic brain injury;
    support for the emerging efforts around regenerative medicine; and
    other research that spans the mental and behavioral health fields.
    II. Improve Population Health
        The fiscal year 2012 budget focuses resources on efforts to
    increase our behavioral health providers, both within the direct care
    system and with our private sector partners. We are also targeting
    funds in fiscal year 2012 to lower the rates of tobacco use, alcohol
    abuse, and obesity. This will include initiatives that introduce
    positive patient incentives that reward healthy behaviors.
    III. Enhance the Patient Experience of Care
        MHS proposes over $53 million in new spending for its continued
    expansion of the Patient-Centered Medical Home (PCMH)--our central
    initiative to improve access to care; population health and overall
    patient satisfaction. The fiscal year 2012 budget also requests $1.1
    billion in medical military construction funds for 14 patient care and
    3 nonpatient care projects, including replacement of the Landstuhl
    Regional Medical Center in Germany.
    IV. Responsibly Manage Costs
        While we maintain that efforts to control the long-term health care
    cost trends in the Department are more appropriately focused on
    encouraging healthy behaviors, and reducing unnecessary utilization of
    health services, there are actions we propose to introduce in fiscal
    year 2012 to begin the process of better managing our spiraling health
    care costs. We have a proposed budget for a set of specific initiatives
    that will save the department almost $7.9 billion in fiscal year 2012-
    2016. These initiatives can be grouped as follows (and summarized in
    the Table at the bottom of this Summary):
    Internal Efficiencies
        TRICARE Management Activity contractor overhead will be reduced by
    over $183 million in savings in fiscal year 2012 alone. This is in
    addition to other savings from aggressive monitoring and pursuit of
    fraud, waste and abuse; redirection of prescription drug purchases to
    more economically advantageous outlets through mail order or MTF
    pharmacies; and redirection of medical care from Emergency Rooms to
    urgent care centers. A national nurse advice line will also be
    introduced to assist with access and redirection of care where
    appropriate. The MHS will continue to identify and implement
    initiatives that take advantage of joint purchasing, greater
    optimization of the medical supply chain, and increased shared services
    across all of the Service branches.
    Equity in Programs and Provider Payment
        The MHS is pursuing a more equitable management of benefits across
    all health care programs by aligning our reimbursement policies with
    Medicare. In fiscal year 2012, payments for care provided by facilities
    designated as Sole Community Hospitals will align with Medicare
    reimbursement levels, saving almost $400 million over 5 years. Payment
    adjustments will be phased-in over 4 years to mitigate the impact.
        Additionally, MHS proposes to amend the Uniformed Services Family
    Health Plan (USFHP) enrollment policies so that they align with all
    other TRICARE providers for dual-eligible Medicare/TRICARE
    beneficiaries. All current enrollees will be grandfathered into the
    current program. Upon reaching age 65, Medicare will become the primary
    payer for these beneficiaries and TRICARE will be second payer. Once
    Medicare-eligible, these beneficiaries may continue to see the same
    providers that they do today; the reimbursement process by which both
    Medicare and TRICARE contribute payments will be the only change.
    Modest Changes of Beneficiary Out-of-Pocket Costs
        MHS proposes an increase of $2.50 per month (or $5.00/month per
    retiree family) for enrollment in TRICARE Prime--the first increase in
    enrollment fees proposed since the TRICARE Prime benefit was introduced
    in 1995. For the longer term, MHS proposes to index this enrollment fee
    in order to establish more predictable and modest fee changes over
    time. MHS also recommends minor adjustments in prescription drug
    copayments that include both reductions and increases in copays, the
    increase or decrease dependent upon the outlet selected by
    beneficiaries.
        All of the MHS proposals have been carefully considered and
    numerous safeguards have been incorporated: grandfathering in current
    enrollees to unique programs; phasing-in new reimbursement
    methodologies for providers; and excepting certain beneficiaries
    (survivors and medically retired servicemembers) from any changes--in
    order to protect the most vulnerable beneficiaries and providers.

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        Mr. Chairman, members of the subcommittee, thank you for the
    opportunity to appear before you today to discuss the future of the
    Military Health System (MHS), and in particular, our priorities for the
    coming year.
        This is my first public appearance before this Subcommittee in my
    role as the Assistant Secretary of Defense for Health Affairs, and I
    want to first express my deep gratitude for the warm and helpful
    guidance both you and your staffs have privately offered to me in my
    first 4 months in this position.
        The people who comprise the MHS have a well-deserved reputation for
    exceptional professional performance and personal courage. I believe
    deeply that military medicine has proven itself time and again as a
    learning organization, capable of self-critical analysis and
    substantive improvement in those areas where it falls short of its own
    and others' expectations.
        We begin 2011 on a strong foundation. Our medical achievements on
    the battlefield, in combat hospitals, and in the air continue to set
    new standards for medical outcomes in war . . . anywhere in the world.
        We are fortunate to have the continued, substantive support of both
    Congress and the White House. This support has been greatly enhanced by
    the very public effort led by the First Lady and Dr. Jill Biden to
    highlight the contributions of military families to our national
    security, and to focus on how the broader American community can
    acknowledge this and support military families on the homefront. Within
    the MHS, we are engaged in this effort, and I will illustrate some of
    our efforts in this testimony.
        Even with our successes, challenges remain. First, we continue to
    provide medical treatment to servicemembers in combat in some of the
    most austere environments on the planet. There is nothing routine about
    this, regardless of how long we have been at war. I will not waver from
    my primary focus to ensure the medical readiness of all of our Armed
    Forces, and the readiness of the MHS to deliver highly trained medical
    professionals to support them.
        International events and ongoing humanitarian crises also remind us
    that we must be prepared to respond to additional events on a moment's
    notice at the direction of national command authorities. Readiness is
    more than the center of our strategic plan; it's our fundamental
    obligation and reason for being.
        A key component of our readiness obligations is to ensure we
    sustain the confidence of the servicemembers who we support here at
    home, and who have borne the greatest burden of war--the servicemembers
    with serious wounds, visible and invisible, along with their families
    who sacrifice, who grieve, and who carry their own wounds from this
    conflict. We will continue to dedicate our time and resources to our
    care for wounded warriors and their families.
        Finally, we must also operate in an environment that recognizes
    financial resources are limited. The Department has put forward
    specific proposals to address the rising costs of military health care.
    But, it is important to note that this is not our first step at cost
    control. Over the last several years, we have taken a number of actions
    that have produced real savings to the Government and the taxpayer, to
    include: introduction of the Outpatient Prospective Payment System
    (OPPS), targeted efforts to increase the use of the TRICARE Mail Order
    Program (TMOP); a TRICARE Pharmacy Fraud and Abuse surveillance system;
    and expanded access to urgent and primary care facilities to redirect
    care away from Emergency Room care whenever clinically appropriate.
        Today, I will explain the actions we are taking to address the
    financial challenges we face, and the process by which we selected the
    proposals put forward in this budget.
        From the broadest overview possible, the proposed total funding for
    the MHS in fiscal year 2012--combining both the Defense Health Program
    (DHP) and other appropriations which fund MHS activities--is over $52
    billion (Table 1). This reflects continued investments in readiness,
    patient care activities, research and development and medical military
    construction.

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        In the pages that follow, I will outline our programmatic
    priorities for the fiscal year 2012 Defense Health Program. I have
    organized this testimony and our priorities around the MHS' strategic
    framework--the Quadruple Aim. This framework best captures the core
    mission requirements of our unique system: Assure Readiness; Improve
    Population Health; Enhance the Patient Experience of Care; and
    Responsibly Manage the Cost of Care. Undergirding these four priorities
    are our Learning and Growth requirements, and I will outline our
    efforts in these areas as well.
                          iv. assure medical readiness
        Within the MHS, we have established an Individual Medical Readiness
    (IMR) metric to determine the medical preparedness of each
    servicemember to deploy. Overall, the medical readiness of our forces
    remains sound, and for the last 2 years we have seen continuous
    improvement in readiness each quarter, across both the Active and
    Reserve components (Figure 1). Within the Reserve component, medical
    readiness is below our benchmarks. We find that, in general, the
    individual reservists can quickly be elevated to a prepared status
    during the pre-deployment period (e.g., complete health assessments and
    by ensuring minor dental procedures and immunizations, etc. are quickly
    performed). We are in the process of engaging with commanders,
    particularly in the Reserve component, to focus attention and
    corrective action on these matters within their units.

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        In addition to our focus on the medical readiness of our current
    force, we are also building upon our medical research and development
    programs that are essential to our future readiness posture. We are
    advancing our understanding--and the understanding of the broader
    American and global health community--of how to prevent, diagnose, and
    treat scores of military related illnesses and injuries. We are
    transferring our knowledge from the research bench to the battlefield,
    and lives are being saved.
        The MHS medical research and development investment priorities for
    fiscal year 2012 are focused on early Diagnosis and Treatment of Brain
    Injury; Polytrauma and Blast Injury Diagnostics and Treatments;
    Countermeasures against Operational Stressors and Optimizing Health,
    Performance, and Fitness; Definitive and Rehabilitative Care
    Innovations Required to Reset our Wounded Warriors; Psychological
    Health and Well-Being for Military Personnel and Families; Prevention,
    Diagnosis and Treatment of Wound Infections and Militarily Relevant
    Infectious Diseases; and Military Medical Training Systems and Health
    Information Technology Applications.
        It is not possible to reflect on every research project or program
    initiative in our portfolio, but I would like to highlight just a few
    high-interest areas and point out where we are seeing particularly
    promising results and programs that will continue to maintain high-
    level interest and oversight in the coming year.
        Our servicemembers continue to incur more than 20,000 cases of
    Traumatic Brain Injury (TBI) every year. Although the vast majority of
    TBI incidents are diagnosed as ``mild'' and resolve with rest, the
    Department of Defense has implemented numerous programs within the last
    3 years to provide early identification, diagnosis and treatment for
    those who sustain a traumatic brain injury.
        TBI research continues to be fast-tracked to bring findings from
    research being done into clinical practice as soon as possible. Key
    areas of promise include understanding injury related blast dynamics,
    rapid field assessment of mild TBI to include identification of
    objective biomarkers to be used in the identification and diagnosis of
    concussion, and TBI innovative treatment modalities such as the ongoing
    clinical trials for neuroprotectants.
        We have recently teamed with the Department of Veterans Affairs and
    academia on the Military Suicide Research Consortium to better
    understand the interventions that are most successful in our suicide
    prevention efforts.
        We are also planning a comprehensive research effort, spread across
    3 fiscal years (fiscal year 2011-2013) to study the indicators/
    predictors of violence in servicemembers. We envision a retrospective
    and a prospective effort, that will examine DOD populations and develop
    a scientifically based list of behavioral indicators of potential
    violence.
        Our efforts in regenerative medicine are now starting to focus on
    taking our products out of the science and technology realm and into
    clinical trials. These efforts focus on limb and digit salvage,
    craniofacial reconstruction, scar-less wound healing, burn repair, and
    compartment syndrome.
        Lastly, we are focusing our efforts on innovative combined
    pharmacologic and psychotherapeutic approaches to treat Post Traumatic
    Stress Disorder.
                         v. improving population health
        The Department continues to seek ways to mitigate the development
    of mental health disorders, and to reduce the number of suicides in our
    Armed Forces. We engage in a number of preventive, diagnostic and
    treatment approaches to reduce the incidence of these disorders, if
    possible, and to identify and treat those impacted.
        Together with the line community, both officer and enlisted, we
    have undertaken a Department-wide effort to reduce and eliminate the
    stigma associated with seeking mental health care. There are
    indications that this effort is working. For example, we are seeing
    that significantly more servicemembers who are referred for mental
    health care seek it out, and stay in treatment. We are encouraged by
    this trend and will continue to do our part to ensure that these trends
    continue.
        We know that mental health conditions, like most medical
    conditions, are treatable. Most patients with Post Traumatic Stress
    (PTS) symptoms recover without treatment in a few months, and many
    recover with medication and/or psychotherapy. With your help, over the
    past 2 years we have made a tremendous investment in behavioral health
    care, adding nearly 2,000 behavioral health providers to our military
    hospitals and clinics, and 10,000 more to the networks (Table 2). By
    embedding mental health providers in our primary care clinics, we have
    improved access to mental health services for all of our beneficiaries.
        The mental health workload has increased across the Military Health
    System (MHS) for both active duty servicemembers and family members.
    Among the reasons for this increased workload are PTSD, TBI, earlier
    identification of mental health issues, increased suicides and suicide
    attempts, and reduced stigma of seeking mental health care. This
    workload has increased the need for mental health providers. Currently,
    throughout the MHS, there are a total of 7,662 military, civilian, and
    contract employees (full time equivalents) providing mental health
    care. This reflects a shortage of 1,025 which puts the MHS at 88
    percent fill compared to requirements. We are pursuing efforts to
    assist the Services in recruiting and retaining these critical mental
    health provider positions. These efforts include using Direct Hire
    Authority and Expedited Hiring Authority that Congress provided the
    Department to help recruit providers. Additionally, we are implementing
    the Physician and Dentist Pay Plan (PDPP) which will ensure we can pay
    critical shortage specialties, such as psychiatrists, salaries
    competitive with the private sector.

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        To enhance services available to National Guard, Reserve, and
    Active Duty families who live in remote areas without easy access to
    installation-based psychological support, military and civilian
    providers are collaborating to educate local healthcare providers on
    military culture and treatment of psychological problems that military
    families encounter. We have also introduced the TRICARE Assistance
    Program (TRIAP), which offers 24/7 web chat with a licensed counselor,
    recognizing that family stress can often occur outside of normal
    provider hours, or in locations that do not have readily accessible
    counseling services. We continue to fund an initiative with the
    Department of Health and Human Services to place 200 Public Health
    Service officers, who are credentialed mental health clinicians, in our
    military treatment facilities (MTFs).
        We are also working to improve the health and lifestyle behaviors
    of our beneficiaries, and we will be using funds in fiscal year 2012 to
    advance this goal. Our focus is to lower the rate of obesity, tobacco
    usage, and binge drinking, and, more generally, help beneficiaries make
    healthier choices. As an example, obesity efforts will target children,
    active duty members nearing retirement (retirees experience marked
    increases in weight upon separation from the military), and patients
    with identified illness (e.g., diabetes, certain cancers) who will
    benefit from weight management. This effort includes initiatives with
    patient-level incentives to encourage healthy behaviors as well as
    partnerships with military bases and communities to create healthier
    work environments and help motivate other beneficiaries to make the
    healthier choice the preferred choice.
                  iii. enhance the patient experience of care
        The MHS is fully engaged in implementing a new approach to primary
    care in our MTFs. Known as the Patient-Centered Medical Home (PCMH),
    the principles focus on developing a cohesive relationship between the
    patient and the provider team. We view the PCMH as a transformative
    effort within our system, with the potential to positively affect all
    aspects of our strategic focus--readiness, population health, patient
    experience and per member cost. With approximately 655,000 patients
    enrolled in developing PCMH practice sites, the results have been very
    promising--various sites have reported improved preventive service
    compliance, reduced use of the emergency room, and more timely care
    provided. Continued investment in and implementation of the PCMH is a
    top priority for the MHS.
        One major new program that emerged from the NDAA for Fiscal Year
    2011 is a new and important benefit in TRICARE--extension of TRICARE
    coverage to adult dependents up to age 26. This provision in the NDAA
    ensures that TRICARE now complies with all elements of the Patient
    Protection and Affordable Care Act, or the national health care reform
    law.
        The MHS continues its important commitment to upgrade our health
    care facilities in the Continental United States and throughout the
    world. Table 2 provides a summary of both appropriated and requested
    military medical construction funds from 2008-2012.
        The new Walter Reed National Military Medical Center, the new San
    Antonio Military Medical Center, and the new community hospital at Fort
    Belvoir will open their doors in 2011. These facilities will serve as
    showcases for leadership in patient-centered care, patient safety
    standards, environmental responsibility and sustainability, and medical
    quality and outcomes. These achievements could not have occurred
    without the sustained interest and investments by Congress.

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        This year's budget request includes funding for 14 patient care and
    3 non-patient care projects. It includes the replacement of one of our
    largest, oldest, and most critical overseas hospitals, the Landstuhl
    Regional Medical Center. This project consolidates Landstuhl and
    Ramstein medical facilities into one convenient location, closer to the
    Ramstein flight line. The new facility will support three theaters and
    is sized to serve the peacetime beneficiary population with an
    expansion capability to address surge from medium intensity conflicts
    similar to the current Overseas Contingency Operations.
        Progress continues on vital chemical/bio-defense facilities at Ft.
    Detrick, MD and Aberdeen Proving Ground, MD. The first National Capital
    Region (NCR) Comprehensive Master Plan project in support of world-
    class standards begins in fiscal year 2012. All of our new clinical
    construction projects will comply with world-class standards and
    evidence-based design principles.
        I am grateful for your unwavering support of our construction
    program through the last several years that will allow our wounded,
    ill, and injured servicemembers to be treated in the finest medical
    facilities in the world.
                          v. responsibly manage costs
        Today, we are cognizant that the Federal budget deficits and long-
    term debt require all Federal agencies to be even more responsible
    stewards of the taxpayers' dollars. As Secretary Gates and Chairman
    Mullen have repeatedly declared, we in this Department must tighten our
    belts just as so many Americans have done over the last several years.
    We share the Secretary's concerns that the exponential growth in DOD
    health care costs can pose a long-term threat to our defense
    capabilities.
        In our proposed budget, we have included a number of specific
    initiatives that, viewed as a whole, can set us on the right path to
    long-term financial health. Secretary Gates, Chairman Mullen and the
    Joint Chiefs have all spoken on this issue consistently and with
    clarity--we will continue to provide the finest health benefit in the
    country for our active and retired servicemembers and their families.
        Table 4 highlights each of the major initiatives we proposed, along
    with their projected savings over the FYDP. Our initiatives acknowledge
    there is a shared responsibility for cost control in our system--
    starting with our own internal operational efficiencies, and then
    including both the provider and beneficiary communities. I will explain
    our rationale for each of these provisions below.

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    Internal Efficiencies
        We have benefited from lessons learned in previous efforts to
    control rising military health care costs. First, the Department has
    looked internally as our number one priority to find and implement
    efficiencies. In the coming year, we will reduce TRICARE Management
    Activity contractor overhead by a substantial amount--over $183 million
    in savings in fiscal year 2012 alone. Our actions will be carefully
    considered, and will not detract from any activities that directly
    support patient care, although some management programs will either be
    eliminated or significantly reduced.
        This is in addition to other actions we have undertaken that
    include more aggressive monitoring and pursuit of fraud, waste and
    abuse; redirection of prescription drug purchases to more economically
    advantageous outlets through mail order or MTF pharmacies; and
    redirection of medical care from Emergency Rooms to urgent care
    centers. In fiscal year 2012 we plan to introduce a national nurse
    advice line that will further assist us in this effort, and provide an
    alternative access point for information and referral for our
    beneficiaries.
        Together with the Surgeons General, we will continue to identify
    and rapidly implement other initiatives that take advantage of joint
    purchasing, greater optimization of our medical supply chain, and
    increased shared services.
    Equity in Programs and Provider Payment
        Second, we are pursuing a more equitable management of benefits
    across all health care programs.
        Congress has long directed us to align our reimbursement policies
    with those of Medicare. We will continue to make the necessary
    regulatory changes to follow the law. In 2012, we will adjust our
    payments for care provided by facilities designated as Sole Community
    Hospitals to also align with Medicare reimbursement levels, saving
    almost $400 million over 5 years. DOD recently adopted a similar change
    with the implementation of the Outpatient Prospective Payment System
    (OPPS), and successfully implemented a phased-in approach to reduce the
    impact on our civilian provider network.
        We recognize that adjustments to payment formulas will have an
    impact on the projected revenue streams of the hospitals covered under
    this rule change and we are sensitive to revenue projections in
    planning for large capital outlays for construction and major medical
    equipment purchases. We determined that 4 years provides a reasonable
    time period for phase-in for the payment adjustments.
        We also seek to ensure all healthcare providers are reimbursed in
    the same manner regardless of their geographic location. We propose to
    amend our Uniformed Services Family Health Plan (USFHP) enrollment
    policies so that they align with all other TRICARE providers. All
    current enrollees will be grandfathered into the current program. In
    our budget, we propose that all future USFHP enrollees will convert to
    TRICARE For Life benefits upon reaching Medicare eligibility.
        Future enrollees will still be eligible to enroll in the USFHP if
    they are not Medicare-eligible.
        Future Medicare-eligible enrollees will be treated the same as all
    other dual-eligible DOD-Medicare beneficiaries in the country. Upon
    reaching age 65, Medicare will become the primary payer for these
    beneficiaries and TRICARE will be second payer. Once Medicare-eligible,
    these beneficiaries may continue to see the same providers that they do
    today; the reimbursement process by which both Medicare and TRICARE
    contribute payments will be the only change.
        Through this proposal DOD will achieve greater equity across the
    TRICARE program--all Medicare-eligible beneficiaries will be treated
    the same. Second, the U.S. Government will save money, not just DOD.
    DOD currently pays more than the U.S. Government will pay jointly under
    our proposed plan.
    Modest Changes of Beneficiary Out-of-Pocket Costs
        Finally, for working age retirees, we are proposing minor changes
    to out-of-pocket costs that are exceptionally modest, manageable and
    remain well below the inflation-adjusted out-of-pocket costs enjoyed in
    1995, when TRICARE Prime was first introduced. We have proposed an
    increase of $2.50 per month (or $5.00/month per retiree family) for
    enrollment in TRICARE Prime--the first increase in enrollment fees
    proposed since the TRICARE Prime benefit was introduced in 1995. For
    the longer term, we have also proposed to index this enrollment fee in
    order to establish more predictable and modest fee changes over time.
        When these proposals were first introduced with the submission of
    the President's budget in February, the administration had not yet
    selected the appropriate health care inflation index. As part of this
    process, we met with the beneficiary organizations, and we developed a
    set of criteria that should be used to determine the right index. These
    criteria included:

             Relevance--an index that most closely aligned with the
            health care costs experienced by this population
             Independence--an index determined by an independent,
            external agency rather than internally (DOD) established index
             Transparency--an index in which the methodology is
            publicly available
             Clarity--an index in which the calculations are
            understandable to all
             Fairness--an index that, when considering all factors
            influencing health costs, is determined to be a fair and
            accurate model for the costs experienced by the Government and
            the beneficiary for services delivered

        In recent weeks, working closely with the Office of Management and
    Budget, we considered and evaluated six separate indices in this
    process, and believe that the National Health Expenditures (NHE) per
    Capita model as best meeting the criteria we used above. Figure 4 below
    highlights the average annual percentage increases in health costs
    using the various options.

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        As part of our proposals, we also recommend minor adjustments in
    prescription drug copayments that include both reductions and increases
    in copays, the increase or decrease dependent upon the outlet selected
    by beneficiaries. We want to offer incentives to use the most
    appropriate and cost-effective outlet for their needs, and believe the
    minor changes to this copayment will be accepted and assist us in this
    goal. I have been heartened by support expressed by leading beneficiary
    organizations for this change. We have made progress in the last few
    years in encouraging beneficiaries to elect prescription drug home
    delivery, and we believe this proposal will accelerate the adoption of
    this option as it has demonstrated greater medication compliance while
    saving on overall costs for the beneficiary.
        Our proposals have been carefully considered. We have incorporated
    numerous safeguards--grandfathering in all current enrollees to unique
    programs; phasing-in new reimbursement methodologies for providers; and
    excepting certain beneficiaries (survivors and medically retired
    servicemembers) from any changes--in order to protect our most
    vulnerable beneficiaries and providers. None of these proposals affect
    the free healthcare we deliver to our active duty servicemembers.
                              learning and growth
        The foundation of our success lies with our training and education
    systems. Chief among these educational institutions is our Nation's
    outstanding medical university--the Uniformed Services University of
    the Health Sciences (USU) located here in Bethesda, MD. Since the first
    class graduated in 1980, USU alumni have become an integral part of our
    military health system and many of USU's graduates are assigned in key
    leadership positions throughout each of our Service Medical
    Departments.
        The value of a USU education was never more evident than following
    the recent tragic shooting that occurred in Tucson. In the aftermath of
    this tragedy, it was the medical education received at USU that laid
    the foundation in medical training that the University of Arizona
    Health Science Center's Chief Trauma Surgeon, Dr. Peter Rhee, called
    upon as he provided the initial care and treatment to Representative
    Gabrielle Giffords. His extensive military experiences proved extremely
    beneficial in providing the best care possible to the Congresswoman.
    When he needed to consult on her care plan to ensure his approach was
    optimal for her condition, he called upon his USU classmate,
    neurosurgeon Dr. James Ecklund and USU's Interim Chief of Neurology,
    Dr. Geoffrey Ling.
        USU is a national treasure and its value to our Nation is seen
    every day in the battlefields of Iraq and Afghanistan, in the care we
    provide worldwide to our very deserving service men and women, in the
    research being carried on in the fields of traumatic brain injury and
    post-traumatic stress disorder, and in the many laboratories conducting
    research on emerging infectious disease and many other public health
    issues.
        Our system is also buttressed by a strong and deepening
    relationship with our Federal partners, particularly in our interaction
    and sharing with the Department of Veterans Affairs. We continue to
    increase the number of sharing agreements between DOD and VA medical
    facilities, facilitated by the DOD/VA Joint Incentive Fund. We
    appreciate that the NDAA for Fiscal Year 2010 extended this very
    valuable program until September 30, 2015.
        We are also working closely with the VA to enhance DOD/VA
    electronic health data sharing, and to create a long-term architectural
    framework that benefits both Departments and the people we serve.
    Beginning with a December 2010 review, led by the Vice Chairman of the
    Joint Chiefs of Staff, DOD and VA have made substantial progress in
    developing a solution that can be implemented in a timely and
    coordinated manner. The Electronic Health Record (EHR) Way Ahead
    addresses specific challenges with the current EHR, including outdated
    legacy technologies; ongoing performance and data availability
    problems; and difficulty in using healthcare industry standards.
        In fiscal year 2012, we plan to introduce elements of the EHR Way
    Ahead, our long-term plan to replace our existing electronic health
    record. The details of the management structure to oversee the Way
    Ahead, the requirements development process and the outreach and
    engagement with the private sector will follow the important work that
    is underway now to finalize the details of our strategy.
                                   conclusion
        Our overall proposed budget for fiscal year 2012 reflects our
    commitment to readiness, population health, an enhanced patient
    experience of care, and continued responsible management of costs.
        I will never lose our focus on those members of our Armed Forces in
    combat. I will honor the sacrifices of so many servicemembers and
    families. I have always been personally inspired by the commitment and
    dedication of our soldiers, sailors, airmen, marines, and coast
    guardsmen. The highlight of my career as a surgeon has been caring for
    the wounded warrior on the battlefield. These talented young men and
    women, who have been asked to shoulder the responsibilities for
    defending this Nation and have suffered the consequences of nearly a
    decade of war, deserve the best medical care both at home and abroad.
        I am both pleased and proud to be here with you today to represent
    the men and women who comprise the Military Health System, and I look
    forward to answering your questions.

        Senator Webb. Thank you, Secretary Woodson.
        As I mentioned, all of your full statements will be entered
    into the record. More importantly, they will be useful to us
    and to staff, in terms of evaluating programs and ongoing
    staff-to-staff discussions as we move forward with the
    authorization of the DOD budget this year.
        I'm going to ask a couple of questions, and then I'm going
    to call on Senator Ayotte for any questions that she might
    have. Then depending on who else comes, I know I will have
    other questions. We'll just proceed in that manner.
        Let me start by asking Secretary Stanley--you mentioned, in
    your brief opening statement, your oversight of the civilian
    workforce. Who is in charge of the contracting force? Not just
    defense contractors here inside the Beltway, but contractors
    writ large, such as the hundreds of thousands that we are using
    in places like Iraq and Afghanistan.
        Dr. Stanley. I know that's not under my cognizance here. Is
    that acquisition, technology, and logistics (AT&L)?
        Mr. Hale. Well, they would report to the commanders in the
    installations involved. Oversight of contracting policy would
    be AT&L.
        Senator Webb. So, who hires, fires, and pays?
        Mr. Hale. It would be the commanders----
        Senator Webb. How many contractors are we paying?
        Mr. Hale. I only laugh, because we are much pilloried for
    our lack of full accounting of contractors. We're getting
    better. For operation and maintenance (O&M) contractors who are
    in the 300,000 range, is our best estimate of full time
    equivalents. But, I would tell you that there are----
        Senator Webb. Excuse me, what are the 300,000?
        Mr. Hale. For contractors funded by the Operation and
    Maintenance account, that's the operating costs, and it's the
    main source of funds for them. But, there's around 300,000--
    there are others working in the other accounts, as well. We
    haven't got a full count there yet. We were working hard,
    something Congress directed us to do, some years ago. We're
    working on it.
        Senator Webb. Well, we hear wildly varying numbers as to
    how many contractors are being paid each year by DOD, and by
    whom, and how much. Do you know how much of the DOD budget goes
    into independent contracting?
        Mr. Hale. Mr. Chairman, if you want to look at--Ash Carter
    likes to use this number, and I think it's the right one--about
    40 percent of our money pays for all of our employees, that's
    military and civilian. The rest goes to contractors in some
    way, that would include all the weapon system cost, but most of
    that is contracted out, eventually, to private companies. But,
    many people, when they think of contractors, are thinking more
    of what you alluded to, the Kellogg, Brown, and Root (KBR)
    contractors in Afghanistan that are performing those services.
    That would be more--for those funded by Operation and
    Maintenance, more the 300,000.
        Am I helping? I sense not.
        Senator Webb.--kind of--we're kind of getting there. This
    is a really relevant question, in terms of whether or not we
    get the DOD budget under control, as your testimony indicated.
    It's one that people are having a hard time getting an answer
    for.
        When I was Assistant Secretary of Defense for Reserve
    Affairs, many years ago, we talked total force as being Active
    Duty, Guard, and Reserve, and then the civilian workforce. We
    have so many people, who are now contracting force, who are
    doing, at a minimum, quasi-military functions, the types of
    things that military people used to do, who are not actually
    being counted when we talk about the size of the DOD workforce.
    But, they clearly are a part of the DOD workforce. When we
    start looking at how to trim a DOD budget back, I think this is
    a good place to look. Wouldn't you agree?
        Mr. Hale. Yes, and so would the Secretary of Defense. Out
    of the efficiency initiative have come direction to make some
    cuts in particular categories of contractors, staff augmentee
    contractors. But, the Services, as they have looked for
    efficiencies, have chosen to make other cuts, as well. So, I
    think you will see some, I hope, surgical reductions in
    contractors.
        That said, we couldn't fight without them. We are, as you
    suggested, very dependent on contractors for support in the
    wartime theater and many other places. So, we need them to be
    an important part of our team, we just need to make use of them
    economically.
        Senator Webb. Whether or not we could fight without them,
    we deserve to be able to have the same oversight over how they
    are used and the discretion that is put into play, in terms of
    when they're used. As you mentioned, these are O&M accounts,
    and there's a lot of money that floats out to the commanding
    units under O&M accounts, where they have an enormous amount of
    discretion. We're talking about increasing TRICARE, for
    instance and we're at a point here where we have to get from
    the nice-to-haves to the needs-to-have. In my experience, I've
    been up here, now, 4\1/2\ years--that's been eluding the
    oversight of Congress.
        So, we would like to follow up with you on this and see if
    we can't actually get an accurate count as to where they are
    and the functions that they are performing, to see if we can't
    put some of the same sort of stringency in these analyses as we
    do in others.
        Mr. Hale. We'll do our best.
        Senator Webb. Thank you.
        Another question with respect to the healthcare system. I
    believe you made a comment that the cost of the DOD healthcare
    system has tripled in the last 10 years. Is that an accurate
    statement?
        Mr. Hale. Yes, roughly. We went from about $19 billion to
    $52.5.
        Senator Webb. How does that compare, say, per capita, with
    the increase in overall health--national health during that
    period? I say ``per capita'' because the part of it is numbers
    and part of it is per-person numbers.
        Mr. Hale. It would be faster--I don't have that. We added
    some important benefits, during this period, Mr. Chairman.
    TRICARE for Life stands out, and that's quite expensive. I
    mean, it probably was the right thing to do, but it was
    expensive. So, it's clearly grown more quickly. I'll have to
    give you for the record the exact--unless, Jon, do you know?
        Dr. Woodson. We have actually looked at this, and we've
    mapped it against the national healthcare expenditures index,
    which is one of our proposals. It maps directly, so that if you
    look at the rising costs of healthcare in the civilian--it's
    mapping directly. Part of that, of course, is that we pay for
    retirees who receive their care in integrated networks and on
    the economy. So, obviously, we're influenced by those same
    factors, in terms of the rising costs.
        Senator Webb. Right. So, the point could fairly be made
    that this is not the result of inefficiencies; it's the result
    of a national phenomenon.
        Dr. Woodson. You're correct. In fact, we've looked at our
    costs and the buckets that they fall into--and I believe this
    is in my written statement--but, in fact, as a healthcare
    management agency, if you will, we spend far less on
    administrative costs and contribute much more--80 percent of
    our costs or so are for the direct delivery of care, either
    within the network or in integrated networks. So, what happens,
    in terms of the use of technology utilization and the way
    medicine is practiced in our society at large directly reflects
    in our costs, just like it does everywhere else.
        Mr. Hale. Mr. Chairman, I'd like to add to that.
        I think most businesses in America are looking to hold down
    healthcare cost growth. We're in the same situation. Even if
    the growth has been similar, we all need to slow it.
        Senator Webb. Yes. I wouldn't disagree with you at all on
    that. It's just--the way that this has been characterized so
    often in the media has been a DOD issue, and it's a national
    issue in which DOD is attempting put some efficiencies into, in
    my view.
        Senator Ayotte.
        Senator Ayotte. Thank you very much, Mr. Chairman.
        I want to thank our witnesses for their service to our
    country. Really appreciate your being before the committee
    today.
        I just wanted to follow up to the chairman's question,
    Secretary Hale. Have there been any internal DOD analyses or
    external reports comparing the costs of using, for example, a
    full-time military personnel versus a contractor--to look at--
    if we needed to perform the same function, does it make more
    sense to expand our force versus use the contractor? I just
    don't know if that's already been worked--work that's been
    done.
        Mr. Hale. I don't know of any overall study. It's going to
    be very dependent on the job. Military personnel are fairly
    costly. They move a lot, there's a lot of training, all of
    which is good; it's one of the reasons we were able to succeed
    this weekend. So we need to continue to do that. But, if it is
    a job that's going to stay put, you're probably better with a
    civilian employee. Contractors are generally, I think probably
    fair to say, for many jobs, more expensive than civilians. But,
    they also provide the benefit that you can hire them and
    terminate them, if you need to, more quickly.
        I know I'm not answering your question. I don't know of any
    simple study that says one is more costly than the other. I
    think it would be quite dependent on the nature of the work.
        Dr. Stanley. Senator, if I might add, one of the things
    that weighs in on this, not necessarily directly, but
    tangentially, is hiring reform. I call it employment reform.
    Because one of the things that's happened is that the
    contracting business, at least in some areas, not necessarily
    in all the areas that Senator Webb was talking about in combat
    or in theater, actually are a direct result, or at least
    tangentially happening, because of the fact that the hiring
    process is so cumbersome. I have to confess to you, that's just
    sort of some of the things that happen. So, we're looking at
    that. But, I haven't seen, as your question asks, any direct
    correlation or studies on this.
        Senator Ayotte. Secretary Stanley, is there a movement
    within DOD to reform that?
        Dr. Stanley. Absolutely.
        Senator Ayotte. Recommend a proposal? I don't know if it
    will require congressional approval, but I think that's an
    excellent thing to make it more efficient, in terms of how
    hiring is done. I also think one of the issues we need to
    address is how contracting is done--both in terms of the
    criteria that are used but also in terms of our efficiency in
    contracting. So, I appreciate that that's something that you're
    already beginning to undertake.
        Dr. Stanley. Yes.
        Dr. Woodson. If----
        Senator Ayotte. Excuse me, Secretary Woodson?
        Dr. Woodson. I just wanted to add to the comments that one
    of the issues around contracting, and of course it depends on
    the specific situation, but you need to look at the tail. So,
    the issue of retirement benefits, and we're talking about
    healthcare here. Sometimes, for limited-purpose projects, it is
    more cost efficient to hire a contractor, because you're not
    paying benefits in perpetuity or after retirement. So, all of
    those factors need to be considered into whether or not a
    contractor is a cost-efficient way of doing business.
        Senator Ayotte. Thank you, Secretary Woodson. I would agree
    with you on that. But, I do think that it would be important to
    have that kind of data as we make these decisions on, number
    one, accountability of contractors, but also whether it makes
    sense, costwise, to either: (a) have more civilian employees;
    or (b) expand our contractor force. I certainly appreciate that
    there are--situations arise where you don't need a permanent
    employee, because it's an immediate short-term project. So, I
    think that flexibility needs to be there. But, reviewing this
    process when we're in a difficult fiscal time is very
    important, in terms of the decisions that we have to make here.
        Secretary Stanley or Secretary McCarthy, whoever you think
    is most appropriate to answer this question--the fiscal year
    2011 Defense appropriation allotted $16 million to outreach and
    reintegration services under the Yellow Ribbon Reintegration
    Program. I understand that this money was actually provided to
    the Office of the Under Secretary of Defense for Reserve
    Affairs rather than the National Guard Bureau. So, in other
    words, as I understand it, it was provided to the Office of the
    Secretary of Defense for Reserve Affairs, as opposed to Guard.
    Can you let me know what the status is of these funds, and
    whether they'll be provided to National Guard programs to focus
    on outreach and reintegration?
        I signed a letter, among 43 Members of Congress, focusing
    on 8 States, 1 of them being New Hampshire. Because, as you've
    already pointed out, Mr. Secretary, we've asked so much of our
    Guard and Reserve, in terms of Active deployment. Making sure
    that the programs are in place for the whole deployment cycle
    and reintegration--particularly with our civilian soldiers,
    though, the challenges are even greater because they don't come
    back to that support system of a base, where everyone's gone
    through the same thing; they go back into a civilian setting.
    In the past, before Armed Services hearings, I've highlighted
    what I think is an excellent program in the State of New
    Hampshire and these funds appropriately should go to that
    purpose.
        So, I wanted to get your take on what will be done with
    them.
        Will the Guard have an opportunity to apply for those? How
    will that move forward?
        General McCarthy. Senator, those funds, recently released
    with the passage of the Appropriation Act, are actively being
    worked. The Yellow Ribbon Reintegration Program Office, which
    reports to me, is actively engaged with those eight particular
    States to fund those programs, through the National Guard, in
    each of those States. So, I checked on that just today. I know
    that----
        Senator Ayotte. Thought I might ask that. [Laughter.]
        General McCarthy. Absolutely.
        But, Ron Young, who leads that effort, is directly
    engaged.He tells me that he expects that, within the next few
    weeks, they will have completed working with each of those
    eight States.
        Senator Ayotte. Well, we really appreciate your efforts in
    that regard. Certainly, as I've said in the past, New Hampshire
    has a program that we've been measuring the metrics of, in
    terms of reintegration. The fact--it's been measurable
    progress. I really appreciate your work on that, given what
    we've asked of our Guard and Reserve.
        General McCarthy. Dr. Stanley and I met with the Adjutant
    General of New Hampshire, about 3 or 4 months ago, and talked
    about that program specifically. So, we're on target with that.
        The Yellow Ribbon Reintegration Program is, frankly, one of
    the most important things that we can do. If we're going to
    continue to use the Reserve component as a part of the
    operational force, that can't be seen just as a wartime-only
    effort. That's something that we have to continue to do, to
    keep faith with the men and women of the Reserve component and
    their families.
        Senator Ayotte. Thank you very much.
        One of the things I do think when you--is going forward,
    how do we handle this reintegration issue with the Guard, that
    I think is important from our program, is that it's a public/
    private partnership. So, we're able to actually reduce costs
    because we've engaged the private sector, as well. Because in
    very difficult fiscal times, we have to look at ways we can do
    this. The private sector wants to engage on this. So, I
    appreciate what you've said today.
        Also wanted to follow up, Secretary Stanley, in your
    statement, you say that some of the prestigious universities
    are now rethinking their policies that exclude Reserve Officers
    Training Corps (ROTC) on campus. I think you've said--I noted
    Stanford University recently voted to invite ROTC back. They
    hadn't had them on campus since Vietnam. I'm really please
    about that. Can you tell me, are there any other universities
    that receive Federal funding that--who still prohibit ROTC
    programs or recruiters on campus?
        Dr. Stanley. I have to take the question for the record, in
    terms of the actual universities.
        [The information referred to follows:]

        Currently, no universities are in violation of the Solomon
    Amendment for Reserve Officers Training Corps (ROTC) Program issues.
    However, there are two schools, the Vermont Law School and William
    Mitchell College of Law, which are in violation of the Solomon
    Amendment for denying recruiter access.
        All Ivy League colleges are in compliance with the Solomon
    Amendment and all have ROTC affiliation either through host or cross-
    town agreements. DoD is obliged to enforce the Solomon Amendment, which
    denies Federal funding to institutions that either prevent ROTC from
    being on campus or that interfere with participation by their students
    in ROTC on campus or at another institution.

        Dr. Stanley. I have a little history in this, in that, in
    the 1980s, as a major on Active Duty, I actually went around to
    a bunch of schools----
        Senator Ayotte. Oh, were you?
        Dr. Stanley.--trying to get ROTC back on the campuses. Over
    the years, for different reasons, different schools decided not
    to have ROTC on campus. Things have changed, this is a new day,
    and now they're welcoming back.
        So, I'd like to take, for the record, to get the specific
    schools, because I'm certain there are some out there, as they
    start looking at the issues again about service to our Nation.
        Senator Ayotte. I appreciate that and look forward to your
    answer on that, Secretary Stanley.
        I remain very concerned that, I think, that it's really
    important that ROTC be allowed on campuses, and particularly
    campuses that are going to accept Federal funds, because they
    need to allow access to our recruiters, and their students to
    be able to have access to those recruiters. So, I appreciate
    that, very much.
        Thank you very much, Mr. Chairman.
        Senator Webb. Thank you, Senator Ayotte.
        I tend to agree with your comment, too, by the way, on
    ROTC, have for a long time.
        I have a series of questions here. I don't know, would you
    like to rotate? Senator, are you finished or----
        Senator Ayotte. I do have a couple more, but we could----
        Senator Webb. Okay, let me----
        Senator Ayotte. It's up to the chairman.
        Senator Webb. Okay, let me ask a couple, and then I'll give
    back to you, if you like.
        Secretary Hale, what's the size of the accrual accounts now
    in DOD?
        Mr. Hale. The accrual for military retirement would be, I
    think, about $25 billion. You let me fix that for the record.
        There's about $10 billion for the trust fund for TRICARE
    for Life.
        Jon, have I forgotten any?
        Mr. Hale. I think those are the main ones.
        Senator Webb. Are you still at about 51 cents on retirement
    account accruals?
        Mr. Hale. Oh, per dollar of pay?
        Senator Webb. Right.
        Mr. Hale. I don't think it's that high. I think it'd be--
    $20-$25 billion, and we got about 100 and--$100 billion. It's
    more like 25 to 30 percent.
        Senator Webb. Okay. It's gone down significantly since I
    was in the Pentagon.
        Mr. Hale. You probably have the numbers sitting there from
    your staff.
        Senator Webb. No, no. [Laughter.]
        Mr. Hale. Okay.
        Senator Webb. Actually, that was just from my time in the
    Pentagon.
        Mr. Hale. I was waiting, Mr. Chairman.
        Senator Webb. I think we were putting 51 cents out on the
    accrual accounts when I was in the Pentagon. So, it was a
    considerable shift, when they decided to do that, back in the
    1980s.
        Mr. Hale. It was 1976, actually.
        Senator Webb. It was pay-as-you-go retirement program, when
    they started requiring the accrual accounts that----
        Mr. Hale. I helped the late Les Aspin, while I was at the
    Congressional Budget Office----
        Senator Webb. Yes, I remember----
        Mr. Hale.--work that out. Twenty-one billion to--$20
    billion--point--$20.9 billion in fiscal 2012 for the retirement
    accrual.
        Senator Webb. This was an Aspin initiative, I remember
    that.
        Mr. Hale. Yes, it was.
        Senator Webb. Secretary McCarthy, I can't resist asking you
    a couple of questions, sort of as you're approaching departure
    in your job, just some thoughts from you on the structuring of
    your office, from the time that I held that same position many
    years ago, I think there were two major differences, and I want
    to get your thoughts on this, from the time that I was
    Assistant Secretary for Reserve Affairs. The first is that
    there was no Under, and I met, every morning, with the
    Secretary of Defense, in a staff meeting, which was very
    valuable, in terms of articulating Guard and Reserve issues.
        The second is that the relationship with the National Guard
    was, I'm sure, different, because the Chief of the National
    Guard had just been elevated to a three-star position and now
    it's a four-star position. If you look at the job description
    of the current Chief of the National Guard and his official
    page, it says he is responsible for formulating, developing,
    and coordinating all policies, programs, and plans for all
    National Guard personnel, principal advisor to the Secretary of
    Defense, through the Chairman of the Joint Chiefs, on National
    Guard matters; principal advisor to the Secretary Chief of
    Staff of Army, Secretary Chief of Staff of Air Force on all
    National Guard issues.
        So, two questions for you. As you are departing, having
    been an incumbent here, how comfortable are you that the policy
    issues, with respect to Guard and Reserve, are under the rubric
    of your office in a line to the Secretary of Defense? What's
    your relationship with the Guard, since that position's been
    elevated to a four-star?
        General McCarthy. If I could, the second one's easier than
    the first, so I'll start with that, if you don't mind.
        The relationship that I've had with General McKinley, in
    his role as the chief of the National Guard Bureau, and,
    frankly, with all of the Reserve component chiefs, has been
    nothing short of spectacular. It's certainly, a part, due to
    personalities, theirs and mine, I guess. But, we've had a
    cordial and professional working relationship, without
    conflict, as I could have imagined. Structurally, you're
    absolutely right, it may not always necessarily be that way,
    but that's certainly the way it's been during my tenure.
        With regard to the larger question of the position of
    Assistant Secretary of Defense, one thing's been very clear to
    me, and that is that, when Congress insisted on having a
    Senate-confirmed civilian appointee with specific
    responsibility for Reserve Affairs, they knew what they were
    doing.
        I'm going to be leaving office in 3 weeks, or something
    like that, and I'm in the process of preparing an out-brief for
    both Secretary Stanley and Secretary Gates. Frankly, I think in
    my duty of loyalty to them, I ought to tell them first what I
    think about that. I intend to. I would like to be able to come
    back to you, either formally or informally, and share my views.
    They'll be exactly the same views that I'll give to the
    Secretary. But, I, frankly, if you will permit me, I would
    prefer to give my report to him first, before I share it even
    with the Senate of the United States.
        Senator Webb. By all means. Again, I appreciate your many
    years of service, in and out of uniform, and wish you well.
        Senator Brown.
        Senator Brown. Thank you, Mr. Chairman.
        Secretary Hale, I was wondering if you could comment on the
    DOD's plan to terminate the USFHP.
        Mr. Hale. Well, Senator, we're not terminating the plan at
    all. It would continue. Those in it would be welcome to
    continue using it. What we propose is to have the same rules
    applied to the USFHP as apply to all other military retirees;
    namely, the retirees would be required to join Medicare,
    Medicare Part B, and the hospitals involved would receive the
    same claims payments. But, the program would continue.
        Senator Brown. Well, it's one of the highest-rated
    healthcare plans, though, in the military health system in
    2010, isn't that right?
        Mr. Hale. I'll accept your word. I hear very good things
    about it, and so we have no reason to terminate it, and have no
    plans to terminate it, that I'm aware, now or in the future.
    I'd ask either Dr. Stanley or Dr. Woodson to speak out.
        Dr. Woodson. That's exactly correct. We don't have any
    plans to terminate it. I think what we plan to do is bring
    payment in line with other beneficiaries. So, for example, the
    average cost for a Medicare-eligible beneficiary in the USFHP
    is about $19,000 there's a range but about $19,000. Other
    beneficiaries that exercise the use of Medicare, we pay about
    $4,500. The real issue is that, over the years, these hospitals
    were given special benefits. They are on solid plans, in terms
    of the delivery of care, so we don't want to lose them. It's
    just that, in 2011, we need to change our business model to
    remain solvent and keep the benefit of health insurance solid
    for the future--future retirees. We can't afford to pay these
    excessive amounts for these Medicare-eligible----
        Senator Brown. So, you're looking at, what, saving $3
    billion over a 5-year period?
        Dr. Woodson. Right.
        Senator Brown. Is that accurate?
        Dr. Woodson. Right.
        Senator Brown. So, if--the proposed legislation, is
    enacted, it would basically force future retired members of the
    military to disenroll from the program that they--apparently is
    the highest-rated healthcare plan in the military health
    system, into, quite frankly, a plan that is not as high rated.
        Dr. Woodson. Well, they could keep their same doctors and
    go to the same hospitals. About 92 percent----
        Senator Brown. Right but they don't get the same plan and
    the same benefits.
        Dr. Woodson. The care should be the same. About 92 percent
    of the doctors in the USFHP do accept Medicare. Of course, they
    may not be accepting new Medicare individuals, but these would
    be old patients. They could keep their doctors and----
        Senator Brown. Are you sure of that? So you're guaranteeing
    the people that are listening that when they're forced to
    disenroll, that they will absolutely be able to enroll and keep
    their same doctors?
        Dr. Woodson. Well, I just came out of practice a few weeks
    ago, before assuming this position, and I would, personally,
    never send a patient who has been with me away after I've
    established a relationship with them over years, because their
    insurance changed. So, the issue is that the payment scheme
    would be different for these doctors, under the proposed
    changes. But, the beneficiaries could keep their same doctors.
        Senator Brown. Well, you're saying there's going to be a
    payment-scale difference between--with the doctors.
        Dr. Woodson. Right.
        Senator Brown. So you're basically saying that you have a
    group of retirees who are getting the best healthcare,
    according to the highest-rated healthcare plan in the military
    health system. They're on that system, they're marching along,
    they're enjoying it. Then, all of a sudden, at age 65, when
    they potentially need it the most, they're going to be forced
    to disenroll and go into a plan, where obviously, you would
    never kick them out, but there are others that would say, ``You
    know, what I'm not going to let them in because I'm not getting
    the reimbursements.'' I mean can you, any of you, guarantee
    that, in fact, every retiree, or the majority of the retirees,
    will get that same care and attention that you would do?
        Dr. Woodson. Well, we would certainly work with them to
    make sure that the beneficiaries were protected. The issue is
    that, actually, the health plans would do fairly well under the
    proposals that we are putting forth because, in fact, TRICARE
    for Life, which would be the copay, would pay 20 percent,
    Medicare would pay 80 percent, so they would get 100 percent of
    the payment. So, I think the incentives for dismissing these
    patients would be extraordinarily small.
        Senator Brown. Mr. Chairman--just to shift a little bit--
    well, I have to be honest with you, a lot of the complaints and
    comments I get about Medicare and the care that they get,
    people are, they don't go, and they don't like it, for a
    reason. Whether it's the patient or the doctor--and the fact
    that we're going, from the highest-rated healthcare plan in the
    military system to something that could be dramatically worse,
    it concerns me.
        Dr. Woodson. Yes, and I appreciate your concern, Senator.
    But in 2011, we have to look at all participants, plans,
    providers, and ask, What is the best value? Excessive payments
    to a certain segment, really, in a time of efficiencies----
        Senator Brown. Well, wouldn't you merely just address the
    payment scheme or this payment situation, instead of shifting
    them onto a Federal system that is going to be, I think, quite
    frankly, overburdened at that point in time?
        Mr. Hale. Senator, I'd like to add. I think you have to ask
    yourself, and Congress does, whether or not we want to treat
    one group of retirees totally different than we treat everybody
    else in the military. Is that the right thing to do? We think
    not. We are treating them different
        Senator Brown. Based on what?
        Mr. Hale. We don't require that the people in the Family
    Health Program enroll in Medicare, and we pay the hospitals a
    good deal; the claims payments are much higher. It doesn't seem
    right to us that the care throughout the system is good.
        Senator Brown. Can't you negotiate a better payment
    arrangement with them, instead of closing down, then shutting
    down and transfer----
        Mr. Hale. Well, I don't think we're closing them down. As
    Dr. Woodson said, the doctors would stay there--incidentally,
    we fully grandfather everybody who's currently over 65, or that
    is our proposal, so that it would affect them only as new
    people reached age 65. So, we do this very gradually. We just
    don't think, in this period of time, it's appropriate to single
    out a group and say, ``We're going to treat you better.'' It
    just seems wrong to us.
        Senator Brown. Thank you, Mr. Chairman.
        Senator Webb. Thank you, Senator Brown.
        Senator Ayotte, do you have follow-on questions?
        Senator Ayotte. Two followups, Mr. Chairman.
        One was, Secretary Stanley, in your written statement,
    you've highlighted the large percentage of American youth who
    are ineligible to enlist in the military, due to either a
    medical disqualification or drug and alcohol abuse, a criminal
    background, lack of an education. Going forward, especially as
    the economy improves, how concerned are you about the
    relatively small pool of young Americans to be eligible to
    serve in our armed services?
        Dr. Stanley. Well, thank you, Senator, for the question.
    Very concerned, first of all. Actually, part of our strategic
    plan, as we've been working with the Services, is to actually
    focus early on--I mean, we've already started working, quite
    frankly, from elementary school and on up, in a number of
    areas, from science, technology, engineering, and mathmetics
    education, things like that. Some of the things we've already
    talked about, in terms of programs, even from Yellow Ribbon
    Reintegration, how we take care of our wounded warriors right
    now, that actually fits in part of the picture of taking care
    of our people.
        But, having people in the population that are qualified to
    enlist is a very big concern. So, being able to not only keep
    the people that we have--because one of the things the data
    also tells us is that we have a lot of people in a world or a
    society where so many people don't serve, many of the people
    who are serving actually are prodigy of people who have served.
    So, there are things that we can do on Active Duty or when
    you're dealing with Active or Guard and Reserve that actually
    help that part of the population. So, we're looking at it
    holistically, working closely with the Services--working
    relationship--but definitely working long-term.
        Senator Ayotte. What's your view on the National Guard
    Youth Challenge Program as one of the methods to address some
    of the challenges of reaching out to young people that want to
    enlist?
        Dr. Stanley. I'm going to make one comment and then ask
    Secretary McCarthy to say something.
        What I've heard about the program has been phenomenal. I
    have not seen it personally. But, what it has done, in terms of
    the data points I've seen, it's made a difference and turned
    some lives around.
        Secretary McCarthy.
        General McCarthy. I certainly agree with that. The Youth
    Challenge Program has been a huge success. But, frankly, it's a
    kind of a stopgap. It's getting people very late in the
    process. It's usually best directed toward kids who are already
    in some degree of difficulty. So, it's not the answer, by any
    stretch of the imagination, but what it has done is very
    impressive and very remarkable.
        Senator Ayotte. Thank you.
        Secretary Hale, we've been talking a lot about healthcare
    costs today, which is a big concern, not only within the
    Defense budget, with our overall fiscal state of the country.
    In a GAO report, there was a recommendation that estimated that
    realigning DOD's military medical command structures and
    consolidating common functions could increase efficiencies and
    result in cost savings.
        I would ask, I guess, the whole panel and would start with
    you, Secretary Hale, whether you support realigning the DOD's
    military command structures? Was this something that has
    already been considered during the development of the
    efficiency initiatives?
        Mr. Hale. The answer to both, at least speaking personally,
    is yes. I should say, yes, it was considered. We didn't go
    forward with it at the time. I think it needs to be looked at
    again. Like all organizational changes, it has its contentious
    parts, and we need to work through them and make sure that we
    don't damage the quality of management in the healthcare
    system. But, I think it is something that we need to look at,
    and will look at.
        Dr. Stanley. I'd just make a comment. We are looking at it,
    but to go much further than that statement right now would
    probably not do the process very much good, because we're going
    to work with the Services, work with the Joint Staff, and work
    with the Office of the Secretary of Defense staff as we move
    forward in looking at how we organize, medically.
        Senator Ayotte. I can't help myself, but what are the most
    contentious parts that you have to address, if we were to move
    forward in this?
        Dr. Stanley. What I've seen, personally, has been, Senator,
    actually, we have service cultures differences. When we get
    out--and I was in theater, about 1 week before Secretary
    Woodson. Out there, they're doing it, and they're there. The
    closer you get to Washington, DC, it gets a little bit more
    challenging.
        Senator Ayotte. I can understand that. [Laughter.]
        Dr. Stanley. I was in San Antonio last week, watching,
    looking at what they're doing there.
        We have cultural issues that have built up over the years--
    good cultural issues--that have helped align and allow our
    Services to do what they do in theater, in combat, the way it
    should be. What we're looking at now, though, are more
    efficient ways--from pharmacies to not buying duplicate sets of
    equipment, to a doctor. There are a number of different things
    to look at in how we train to do that in our total force. This
    is a part of what we're looking at.
        Senator Ayotte. Well, I would ask all of you really to give
    us close examination of this. I think that's something that we
    would all like to hear about. Because, as we look to the fiscal
    state of where we are right now, if we can consolidate in a way
    that's going to save money and still serve our military
    appropriately, then we need to move forward with that. So,
    thank you.
        Senator Webb. Just as one quick follow-on to what Senator
    Ayotte just said, and I'm going to then yield to Senator Graham
    and Senator Chambliss.
        What percentage of the potential enlistment pool in the
    United States is ineligible to enlist or does not qualify to
    enlist? It's a very high number.
        Dr. Stanley. Of the people who are out there in civilian
    life, right now?
        Senator Webb. Of the age cohort, what percentage does not
    qualify to enlist?
        Dr. Stanley. I heard three-fourths, Senator. It's a
    significant number.
        Senator Webb. I've heard around--up to two-thirds--does not
    meet enlistment----
        Dr. Stanley. I think you're probably right. It's
    significant.
        Senator Webb.--criteria, either because of physical or a
    variety of reasons. I find that astounding.
        Dr. Stanley. Same here.
        Senator Webb. I mean, if you even look at the Vietnam
    cohort, one-third of everyone in that age group served; 9
    million out of 27 million people in that age group actually
    served. We're saying that, of today's cohort, only one-third
    would even fit the profile in order to attempt to enlist? This
    is the number that I've heard. Can anybody verify that?
        Dr. Stanley. We can verify it. I've heard different
    numbers, yes.
        Senator Webb. If so, I mean maybe----
        Dr. Stanley. That number's staggering.
        Senator Webb. I can't believe two-thirds of America's youth
    can't meet the mark. I'm wondering if your might take a look at
    that and see where the impediments are.
        Dr. Stanley. We'll take that for the record.
        [The information referred to follows:]

        We have studied this issue in detail. In 2007, we developed an
    estimator that would project the number of 17-24 year-old youth who are
    qualified and available for service. We focused on this group because
    it comprises about 90 percent of our non-prior service accessions
    annually.
        The number of youth qualified and available for military service
    consists of youth who are mentally, medically, and otherwise eligible
    for service, and who are free of family commitments that would make
    them unavailable for duty.
        To estimate the number of youth that are qualified, we developed
    disqualification filters for those individuals that would be
    disqualified based on Department of Defense standards.
        Youth may be disqualified for more than one reason; however, we
    used a hierarchy of disqualifications so that only one disqualification
    applied to any one person. First, 9 percent of the youth population is
    disqualified due to a low aptitude score on the Armed Forces
    Qualification Test. Next, 35 percent are disqualified for medical
    conditions or physical fitness issues owing mainly to asthma, obesity,
    and other childhood maladies. Of the remaining population, 19 percent
    are disqualified for substance abuse (drugs and alcohol). Finally, 6
    percent are disqualified based on the number of dependents under age 18
    they have, and another 5% for questionable conduct or law violations.
        Combined, the data demonstrate that only about 25 percent of
    today's youth are qualified to serve.
        Data also show that of these 25 percent qualified, 11 percent are
    enrolled in college, and therefore not available to serve. Summed this
    way, only about 15 percent of the youth are qualified and available for
    military service.

        Senator Webb. We may want to reevaluate--I don't want--you
    don't have to lower the standards, but you may want to
    reevaluate the standards that are being used, or at least take
    a look at them.
        Dr. Stanley. Will do, Senator.
        Senator Webb. Senator Graham.
        Senator Graham. Thank you, Mr. Chairman.
        That is a stunning statement. I knew it was high, but two
    out of three, three out of four.
        General McCarthy, what do we need to do, if anything, when
    it comes to mobilization legislation, regarding the Guard? What
    does ``Operational Reserve'' mean in the 21st century?
        General McCarthy. Senator Graham, we kind of lapsed into
    this term ``Operational Reserve.'' One of the problems with it
    has always been there wasn't a----
        Senator Graham. To me, it means you're going to go a lot,
    yes.
        General McCarthy.--there wasn't a consistent definition.
    What I've chosen to say, and what's contained in the report, is
    using the Reserve as a part of the operational force. I think
    that resonates with people that, when a Reserve--either
    individual or a unit--and obviously I mean Guard or Reserve--
    either individual or a unit comes on Active Duty, they
    seamlessly integrate with the Active component force. That's
    what we have to shoot for. We have to do that periodically. We
    have to do it in a right balance so that we're not over--we're
    not asking people to do that more than they can manage or that
    they're families and employers can manage. But, that's the
    goal, is to get so that we can use a portion of the Reserve
    component as a part of the operational force.
        I believe we do need a slight modification of our
    authority. The Department has sent over a legislative proposal.
    We've talked about it with the committee staff and with the
    staff in the House. I'm hopeful that we will expand our
    authority so that the President can continue to call some
    number of reservists to Active Duty without the necessity of an
    emergency, because that will enable the Reserve component to
    serve even when there is not a declared emergency.
        Senator Graham. What are the statutory limitations on
    service? Two years?
        General McCarthy. Right now, we can call people only if
    there is an emergency, whether it's a declared war or a
    declaration of national emergency or something less.
        Senator Graham. Right.
        General McCarthy. The period of service is not to exceed 2
    years of consecutive military service.
        Senator Graham. Now, I've been told, at one point during
    the height of the Iraq/Afghanistan engagement, that 55 percent
    of the people flying the tanker force were Guard members or
    reservists, and about three-fourths those people, if they had
    not chosen to volunteer, had exceeded their statutory service
    period, and they just agreed to keep working. Is that true?
        General McCarthy. Well, I can't verify the precise number,
    but the Air Force, in particular, has always preferred--both as
    an institution and the people--always preferred to use
    volunteers. They've done remarkably well with that. They can
    put teams together, allowing people to volunteer as it suits
    their other schedule. So they have made tremendous use of that,
    where as in the Army and the Marine Corps tend more to mobilize
    as units.
        Senator Graham. Okay.
        General McCarthy. But, the high proportion of the tanker
    force from the Air Force Reserve and the Air Guard is a
    longstanding fact.
        Senator Graham. Secretary Hale and Secretary Stanley, the
    idea of drawing the Army down by 40,000, the Navy, 9,000, the
    Marines, 16,000, the Air Force, 10,000, is that a wise decision
    right now, given the uncertainties of where the world is going?
        Dr. Stanley. Well, first of all, Senator, thank you for the
    question. The conditions on the ground will dictate, obviously,
    where they actually go to. So, there have been some planning
    assumptions made, now. The Marine Corps actually stepped up and
    said, ``We want to go to that particular level.''
        Senator Graham. Okay.
        Dr. Stanley. But, what we have to look at now is exactly
    what happens in Afghanistan and Iraq, the timing and pace of
    those.
        Senator Graham. So, this is a work in progress, still.
        Dr. Stanley. This is a work in progress, as we speak. But,
    the planning has to be done.
        Senator Graham. Sure.
        Dr. Stanley. The budget, as we are talking here today,
    actually there are things happening now that will affect the
    budget in the future. This is why it's--you have your planning
    assumptions.
        Mr. Hale. Let me just add, the drawdown on the Marines is
    in fiscal year 2015 and 2016.
        Senator Graham. Right.
        Mr. Hale. It's 15,000 to 20,000. The Army is 27,000, also
    in fiscal year 2015 to 2016. As Dr. Stanley said, it's
    conditions-based. We have several years to reevaluate those
    conditions.
        Senator Graham. Okay.
        Mr. Hale. You mentioned the drawdown in the Air Force. I'm
    not familiar with that one. I don't think, at least from 2011
    to 2012----
        Senator Graham. I'm sorry, it's civilian positions in the
    Air Force.
        Mr. Hale. Oh, civilians. Well, yes, that would----
        Senator Graham. From an Air Force point of view, more and
    more things are being done by civilians, from the time I came
    on Active Duty to now.
        Mr. Hale. Well, we are looking into--the Secretary has
    directed us to find lower-priority missions and activities we
    can do without in order to hold down our support costs. I think
    that's what you're seeing there.
        Senator Graham. One last question. The healthcare component
    of the budget. I know you've made some proposals about fee
    increases. From a political point of view, it's very hard to
    ask men and women in uniform to sacrifice more than they've
    done--the retired force. The way you treat your retirees
    depends how well you can recruit and retain.
        Having said that, there has to be some way forward. I've
    talked to a lot of the service organizations out there. There
    seems to be an understanding, by different service groups,
    that, slowly but surely, we need to adjust the reality that
    this is unsustainable.
        Secretary Hale, how do we get from here to there?
        Mr. Hale. Well, gradually, it seems to me, is the right
    start. That is our proposal. You may remember, 2 to 3 years
    ago, the administration made much more far-reaching proposals
    for changes in the TRICARE fees. They would have doubled, over
    a period of 4 or 5 years. Many hundreds of dollars, over that
    period. We're talking about $5 a month, for those in the Prime,
    family care, and a gradual indexing to a healthcare index.
        So, I think we all respect the service that men and women
    do, and we expect a very generous plan, and I think they have
    the right to expect it. We are providing that. But, I agree
    with the implication of your statement, Senator, if we don't do
    something, as Secretary Gates said, at some point, it will fall
    of its own weight. I think we need a very gradual transition.
        Senator Graham. Secretary Woodson?
        Dr. Woodson. It perhaps is useful to bring some numbers to
    this, just as illustrations. Since the inception of TRICARE and
    no fee increases, benefits and retirements have increased 50
    percent. But, if we go forward--and let's take an example of a
    lieutenant colonel, O-5, whose pension is $48,000 a year in
    2011----
        Senator Graham. What's an O-6 pension? [Laughter.]
        Dr. Woodson. It depends on the years of service.
        Senator Ayotte. I'm married to an O-5, so----
        Dr. Woodson. But, assuming $48,000 a year, in 2012, over 10
    years, assuming a COLA of 3 percent per year, the pension will
    grow by $16,000. At the same time, even if you accept the
    generous increase in prime enrollment fees of 6.25 percent,
    applying the same metrics--the price would only grow by about
    $428.
        So, what we're saying is that, because we're indexing the
    increase in fees to a smaller amount, even if they had a rise,
    it doesn't eat up the COLA, is what I'm saying.
        Senator Graham. Gotcha.
        Dr. Woodson. So, it's about fairness and protecting this
    very generous benefit for the future, for individuals who will
    serve in the future and, in fact, will need healthcare, as
    well.
        Senator Graham. Thank you. I have a letter from a bunch of
    generals who say we need to be thinking about doing exactly
    what you said. I would like to introduce it into the record.
        Thank you all for your service.
        [The information referred to follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Webb. Thank you, Senator Graham.
        Senator Blumenthal, welcome. Since Senator Chambliss has
    been waiting, I'm going to go ahead and call on him.
        Senator Chambliss. Thanks, Mr. Chairman. It's always a
    scary thought, to his friends, that Senator Graham is a colonel
    in the Air Force Reserve. [Laughter.]
        Thank goodness you all don't let him carry a gun.
    [Laughter.]
        Senator Webb. For the record, when my dad was a colonel in
    the Air Force, I think he made $14,000 a year. So, we've come a
    long way, folks. It's been a long time.
        Senator Chambliss. Secretary Stanley and Secretary
    McCarthy, I understand there's been some confusion or lack of
    consistency regarding how the provision authorizing early
    receipt of retired pay is being interpreted at DOD. Since I'm
    the author of that provision, I want to state my intent, for
    the record.
        First, my intent was to reward servicemembers who perform
    Active Duty for significant periods. We had to bound the
    provision somehow, so we set the period during which members
    would be required to serve an aggregate of 90 days of duty to
    be the confines of a single year--fiscal year 2010 or fiscal
    year 2011, whatever. The intent was not that a servicemember
    should be rewarded to any aggregate duty of 90 days that they
    served over their Reserve career. Now, that's what we intended,
    and I'm going to ask you all to comment on that.
        Second, my intent was to reward servicemembers who were
    activated, mobilized, deployed, or called to duty in support of
    a contingency operation. In my view, this should include any
    duty, in the continental United States (CONUS) or outside
    CONUS, that is related to a contingency operation or a national
    emergency, regardless of the specific type of the order the
    member is called to duty under.
        Now, both Secretaries, with that explanation, I'd just like
    for you all to give me your feedback on how DOD is interpreting
    the current statute, what ambiguities you believe may exist in
    that language, and the extent to which the services are
    interpreting the provision differently. Anybody else has a
    comment, you're welcome to, but I think you two would probably
    be the most appropriate.
        Dr. Stanley. Senator Chambliss, I'm not going to say much
    right now, only because I haven't seen it yet. I'm going to be
    openminded when I look at it. Your explanation actually will
    help me when I receive it, because I know it's coming my way.
        General McCarthy. Senator Chambliss, the main problem that
    I am aware of is the first one that you mentioned, bounding the
    90-day period by saying ``within the same fiscal year.''
    Clearly, the statutory language includes that bounding
    provision.
        Where we've run into a problem is where someone serves, for
    example, 45 days on one side of the fiscal year followed
    immediately, consecutively, by 45 days on the other side of the
    fiscal year. The interpretation of the Office of General
    Counsel has been, that service doesn't meet the standards of
    the statute because it crosses 2 fiscal years. We're trying
    very hard to figure out a way to carry into effect your intent
    of rewarding 90 days of continuous service, and to work around
    this provision of ``within the same fiscal year.'' We have not
    yet found a solution that everybody can live with, in part
    because there's money associated with it, appropriation
    associated with it. But, I think that everybody is working in
    good faith to try to figure out a way to solve that.
        Senator Chambliss. Okay. Actually, Senator Tester and I
    have an amendment that we're going to offer in the
    authorization bill this year that I think will clarify that.
    Because that can happen, and obviously it has happened, and we
    want to try to straighten that out. It's the 90 consecutive
    days that's the most important thing, rather than the fiscal
    year. So, I think, with what he and I are going to try and do
    in the authorization bill this year will get that clarified.
        General McCarthy. Thank you.
        Senator Chambliss. Thanks, Mr. Chairman.
        Senator Webb. Thanks, Senator Chambliss.
        Senator Blumenthal.
        Senator Blumenthal. Thank you, Mr. Chairman.
        I just want to say, at the outset, I thank Senator
    Chambliss for his legislative proposal, which I have supported,
    on Reserve retirement credit.
        Thank you--even more important, thank you gentlemen for
    your service, both now and in your past, and the men and women
    who are sitting behind you in this room and who are serving
    under you, or with you, in DOD. I think all of us in the
    Senate, all of us in the Nation--are grateful for the great
    work that you are doing.
        I want to focus, just briefly, on, first of all,
    homeownership. Secretary Stanley and Secretary McHale, the
    stimulus bill in Congress greatly expanded the resources
    available under the DOD Home Ownership Assistance Program to
    help servicemembers who are changing their duty station,
    particularly in light of the Base Realignment and Closure
    Commission process. I wonder if you could speak, today, to the
    resources available to continue that program, what DOD is
    looking to do to make it more sustainable.
        Also, equally important, I am very concerned about issues
    relating to mortgage fraud and foreclosures, both inside and
    outside of the military community, but particularly as it
    affects the military community. I wonder if you could comment
    on both the home ownership program and the susceptibility of
    the military community to that kind of fraud, whether it's
    related to the homeownership program or not, and what the
    Defense Department is doing to aid the military community.
        Thank you.
        Mr. Hale. Well, I'm going to have to give you specifics for
    the record, Senator, on the HAP Program--homeowner.
        I think we're okay, financially. We were worried, because
    we had no experience, or not much experience, with this kind of
    program, and this is quite extensive. We formulated a set of
    rules which we thought were reasonable and, I believe, have
    kept within the bounds of the money that Congress appropriated.
    I don't know exactly how much has been obligated as of now.
    We'll get it for you, for the record. But, I think we're okay.
    I'm certainly not hearing any financial problems with the
    program.
        [The information referred to follows:]

        Congress appropriated $555 million in the American Recovery and
    Reinvestment Act of 2009 for the Expanded Homeowners Assistance Program
    (HAP). The Department has obligated 100 percent of those funds.
    Additionally, Congress appropriated $300 million in fiscal year 2010
    for Expanded HAP benefits, which the Department continues to execute.
    The Department continues to evaluate the Expanded HAP and may seek
    future appropriations as necessary. As part of the HAP, the Department
    has authority to purchase homes from eligible servicemembers and
    surviving spouses and then re-sell those properties. Proceeds from the
    sale of those homes are then deposited into the HAP in order to provide
    benefits to additional eligible personnel. In fiscal year 2011, the
    Expanded HAP account has received $44.8 million in proceeds from the
    sale of government-owned homes.

        Dr. Stanley. Senator, I've been personally engaged on the
    fraud end of it, even before we got to just the mortgage piece,
    of taking care of our service men and women, and the
    Servicemembers Civil Relief Act, working with Department of
    Treasury, looking at ways to ensure that our service men and
    women are not taken advantage of in lots of different fora, and
    not just homeownership. So, it's a big issue, from the
    readiness standpoint, because if you're not ready at home, you
    are not going to be ready when you go forward. So, it's a
    significant readiness issue that we're focused on. I agree with
    Secretary Hale, we'll get back to you on specifics.
        [The information referred to follows:]

        In order to address the situation, legal protections for military
    personnel were established. Specifically, the Servicemembers Civil
    Relief Act (SCRA) (codified at 50 U.S.C. App. Sec. Sec. 501-597b)
    offers servicemembers protections from the improper foreclosure
    practices that are not available to the general public. This provides
    servicemembers who have a qualifying mortgage obligation (one created
    pre-service) with protections not available to the public at large, at
    least in those States that would allow non-judicial foreclosure.
        Section 533 of SCRA protects against the non-judicial sale,
    foreclosure, or seizure of the property of a servicemember that is
    secured by a mortgage obligation that originated before the period of
    the servicemember's active duty. This means that a court must enter a
    valid order before the sale, foreclosure, or seizure of such property
    can take place, and such an order cannot be entered absent a return of
    service (proof to the court that the servicemember has been served with
    a copy of the foreclosure lawsuit) and an opportunity for the
    servicemember to be heard by the court.
        Furthermore, section 521 of SCRA provides additional protections
    against default judgments when a servicemember does not appear before a
    court, and section 522 provides the servicemember the opportunity to
    delay a proceeding when he or she does appear but cannot proceed
    because of military service. The default judgment protections of
    section 521 are particularly important in the foreclosure context. It
    provides an interlocking protection with section 533.
        As noted above, for a qualifying pre-service mortgage obligation,
    no sale, foreclosure, or seizure can take place against a servicemember
    unless there is a valid court order. To issue a valid order, a court
    must comply with section 521, which indicates that if the respondent
    does not appear and there is reason to believe he or she is a
    servicemember, then the court must appoint an attorney to represent the
    absent servicemember. A key element of that representation is that the
    attorney must try to find the servicemember and attempt to delay the
    proceedings until the servicemember can be located and can appear
    before the court.

        Senator Blumenthal. Well, I appreciate that. Are there
    measures that we can take that would assist you in stopping
    this kind of fraud, or simply the institutions that are pushing
    the envelope in taking advantage of our military men and women,
    perhaps just barely within the law, but exploiting their
    vulnerability at a point when they're trying to get ready to
    serve abroad, and their families being at home, and that kind
    of exigency?
        Dr. Stanley. Senator, my instincts say yes. Then we'd like
    to get back to you and work closely with you on it, because
    this is really important, from a readiness standpoint. If
    you're not ready, as I said, you're not going to fly the plane,
    you're not going to shoot straight. There's a whole lot of
    things that are going to happen. So, I'd like to get back to
    you, on the record, on that and do that.
        [The information referred to follows:]

        Thank you for your offer of assistance. We believe there are areas
    within the Servicemember's Civil Relief Act that could be amended to
    help protect our servicemembers. We will consult with the Office of
    Management and Budget and submit the necessary legislative proposal for
    your consideration.

        Senator Blumenthal. Well, I really appreciate that. I would
    very much like to work with you and other members of this panel
    and your staff on this issue, because I regard it as very
    important. I commend and thank you for your interest.
        Mr. Hale. Senator, I do have facts. We have obligated most
    of the $555 million that was appropriated under the Stimulus
    Act, about 98 percent. I think, in most cases, we have
    completed the periods of time when people could take advantage
    of it. There'll still be outlays, as folks actually move. But,
    it's higher than I thought. So, we'll check.
        I'll stand by my statement, though. To my knowledge, no one
    has come to me and said, ``We're going to run out of money.''
    So, I think we're okay.
        Senator Blumenthal. If you develop additional facts, please
    feel free to get them to me.
        I just want to say to Secretary Woodson, for some years, as
    you probably know, the Yale Center for Emergency Preparedness
    and Disaster Response has worked with the United States
    Northern Command to develop national strategies and conduct
    training for civilian military collaboration in integrated
    medical and public health preparedness, and these kinds of
    activities. Their preparedness and expertise really align with
    a large number of medical preparedness and response projects
    across the country. I'd like to see that work continue. I think
    it serves the national interest. I ask that you make yourself
    available to meet with my staff, possibly with me, with the
    director of the program, to see what role they may have in
    working with you to jointly address this continuing challenge,
    and the coordination of civilian and medical resources. If you
    would be available, I would greatly appreciate it.
        Dr. Woodson. I'd be very happy to meet with you. In a prior
    life, I had something to do with that. So, I would be very
    happy to meet with you.
        Senator Blumenthal. Great. Let me just ask one last, sort
    of, open-ended question, and you should feel free to get back
    to me on this one, as well. Traumatic brain injury, post-
    traumatic stress disorder, there may have been questions about
    it before now, but, obviously, as our Reserve engage in more of
    the front-line battle, they will be susceptible to it. We've
    heard various estimates, from the Chairman of the Joint Chiefs
    of Staff, Admiral Mullen, and others, that there's a very high
    rate of nondiagnosis or misdiagnosis, as high as 30 percent, of
    those two conditions. So, I wonder if you care to comment on
    it.
        General McCarthy. Senator, you're absolutely right. That is
    a challenge for the Reserve component that, in some ways, is
    exactly the same as the Active component but, in some ways, is
    very different, because you get some many Reserve component
    members who, after they complete their service in combat, kind
    of blend back into a civilian community and don't have the day-
    to-day association with military leaders and observers that
    they would have if they were still on Active Duty.
        I believe, personally, that we're doing a better job on the
    post-deployment health assessments. Not that we don't have a
    long way to go, but I do think we are doing better than we
    were, some years ago, on that. I also believe that the Yellow
    Ribbon Reintegration Program, which has these recurring
    meetings and recurring opportunities for people to come back
    together and to be exposed to some of the science and some of
    the--frankly, the art of recognizing these kinds of problems,
    is very important, and will remain so. So--I've made the point
    already this afternoon--the Yellow Ribbon Program, we might
    have thought of it, originally, as just a short-term wartime-
    only program. I think it's more than that. I think it's
    something that we should view as a longer-term requirement.
    Obviously, we won't be doing it at the same rate we were doing
    it a few years ago, but we will still have the requirement as
    we deploy members of the Guard and Reserve.
        Senator Blumenthal. Well, I appreciate that. I think it's
    very important, again, if there are ways that members of the
    committee can assist you, particularly with the traumatic brain
    injury and the post-traumatic stress disorder aspects. Sitting
    where you are, right now, Sergeant Major Kent of the Marine
    Corps--and I know, as a marine, you are familiar with his
    service--commented on the extent and the seriousness of this
    problem, as did others on that day. So, I appreciate your
    attention to it. Thank you.
        Thank you, again, to all of you for being here today, and
    your very helpful testimony.
        Dr. Woodson. Senator, if I may make a few comments----
        Senator Blumenthal. Sure.
        Dr. Woodson.--in regards to that, because, obviously, in
    Health Affairs, we've been very much involved and concerned
    about the invisible wounds of war and the signature injuries of
    these last 10 years of war.
        I just returned from Afghanistan, and I can tell you we
    have a robust treatment protocol in place to pick up just about
    every concussed soldier who might be within the radius of 50
    meters of a blast injury, to include an evaluation they go
    through to assess for concussion, and referral at the earliest
    possible moment, and to record that data for longitudinal
    followup.
        On the other end of behavioral health, we've added 12,000
    new behavioral health specialists to our integrated TRICARE
    network, and then increased, by 2,000, the number of behavioral
    health specialists on Active Duty.
        We do have some recruitment challenges, particularly in
    psychiatrists, but the Air Force is about 93-percent full. We
    continue to work strategies, in terms of scholarships, et
    cetera, to get the behavioral health specialists trained and on
    Active Duty.
        So, we've done a lot, still need to do more, in terms of
    behavioral health specialists.
        But, as it relates to the Guard and Reserve, every State
    has a behavioral health coordinator. There is abundant outreach
    to identify resources within each State and coordinate the care
    of any reservist or guardsman that might need behavioral
    health. Again, more to do, but we're working vigorously to meet
    the needs.
        Senator Blumenthal. That's very helpful. I'm glad you added
    that comment.
        Again, thank you for your service and for being here today.
        Thank you.
        Senator Webb. Thank you, Senator Blumenthal. Just as a
    follow-on to that line of questioning, I can say things are
    incredibly different than they were in the post-Vietnam period,
    on these issues. I was up here as a committee counsel from 1977
    to 1981, and the casualty flow from Vietnam had been so much
    higher than what we're seeing now. In fact, the 1 year that I
    was in Vietnam, 12,000 Americans died. That's twice as many as
    have died in Iraq and Afghanistan, combined in the entire 10
    years of war, and the mood in the country was different. The
    level of knowledge was so much different. We did a lot of
    pioneering work, in terms of post-traumatic stress disorder, on
    the Veterans Committee up here during that period. It was a new
    concept in terms of what people were trying to examine. It was
    pioneered not by the government, but initially, by the disabled
    American veterans organization, themselves, which had a high
    percentage of Vietnam-disabled soldiers and marines,
    particularly. They funded their own project called the
    Forgotten Warrior Project because they could see that something
    wasn't right and it wasn't being examined. The attention that's
    being given right now, at all levels, is just incredible
    compared to what was going on then.
        The issue of traumatic brain injury is to me something
    completely new. I think so much of it comes from the improvised
    explosive devices, where people are inside vehicles and you
    have this echoing impact that a regular blast, in other wars,
    did not really experience. I'm very committed to seeing more
    research done on this, and continuing to do the sorts of things
    that Secretary Woodson was talking about--monitoring people
    early on and getting some sort of a tracking on that area.
        I have one final question here, and it really goes to how
    we're measuring some of our special pays and incentives. I
    don't know if you all are familiar with an article that was in
    the Washington Post on March 18 by an Iraq and Afghanistan
    veteran named Michael Cummings. It's called, ``I Didn't Deserve
    My Combat Pay.'' Are you familiar with this article? It is not
    a mean-spirited article at all. This is an individual who
    served in hard combat in Afghanistan, and then had a pretty
    relaxed tour in Iraq, and basically was pointing out some
    inconsistencies that I think are fair, in terms of evaluation.
    I'd like to get your thoughts on them. In fact, Secretary
    Stanley, maybe you could take this article and give us a
    response.
        [The information referred to follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Webb. One of the things he points out was that
    people who serve in Bahrain, Qatar, Kuwait earn the same tax-
    exempt benefits as troops in Iraq and Afghanistan. I'm reading
    from his article, by the way. ``Sailors in Bahrain can bring
    their families to live with them while still earning $225 a
    month in imminent-danger pay. He mentioned in here a contingent
    that came in from the States for a change-of-command ceremony,
    where they were on the ground for 2 days and they got 2 months
    of combat pay plus all the tax differentials, because it was
    the end of the month and the beginning of the next month.
        I don't know why that happens. I think we have computers
    now--you can figure out how many days people are in theater, if
    you're paying these sorts of benefits. But also, it--I think
    two of you are former marines; I'm a former marine--that's a
    huge leadership question, too, when you turn around to people
    who are out there really having to do the hard work, and you
    can turn around and say somebody came in for a change of
    command for 2 days and got this huge break.
        He says in this article, ``Military commanders say, `Don't
    just complain about the problem. Offer a solution.' '' He has a
    whole paragraph here with his solution. I'm not saying these
    are the answers, but I would like to get your thoughts,
    Secretary Stanley, on where some of these things are. If
    they're justified, fine.
        [The information referred to follows:]

        I'm familiar with the article by Michael G. Cummings, which states
    that members serving in Bahrain, Kuwait, and Qatar earn the same tax-
    exempt benefits as troops in Iraq and Afghanistan. He also mentions a
    situation where the dates of visitors to a combat zone for a change of
    command ceremony straddled 2 months and resulted in the payment of 2
    months of imminent danger pay and tax free treatment of salaries, known
    commonly as the combat zone tax exclusion.
        A member serving in any area designated by the President as a
    combat zone is eligible for the combat zone tax exclusion. Currently,
    Bahrain, Kuwait, and Qatar, as well as Iraq and Afghanistan are
    designated as combat zones, and members who serve in these locations
    are eligible for the combat zone tax exclusion. Members serving in
    these locations receive $225 per month.
        In addition to the combat zone tax exclusion, commanders can
    recommend an area as eligible for imminent danger pay based upon
    conditions on the ground. An area may be designated if there is an
    impending danger of members being exposed to hostile fire or
    explosions, or being subject to the threat of physical harm or imminent
    danger on the basis of civil insurrection, civil war, terrorism, or
    wartime conditions.
        The Department and Central Command are both aware of Mr. Cumming's
    concern and have taken steps to prevent or minimize this type of
    potential abuse of combat zone tax exclusion or imminent danger pay.
    From our review, we conclude that the perceptions of widespread abuse
    are not supported by the data. All travel into the Central Command area
    of responsibility is screened, pre-approved and conducted on official
    military orders. Thus we have little reason to believe that the
    identified short duration trips, including their timing, were for
    anything other than mission requirements. The Department is, however,
    currently reviewing policies to ensure the potential for abuse is
    minimized.
        Periodically, the Under Secretary of Defense for Personnel and
    Readiness conducts a world-wide review and solicits updated threat
    assessments from commanders in each of the areas to ensure the
    designation of an area as eligible for imminent danger pay remains
    appropriate. The Department is validating and recertifying all
    worldwide locations designated for HFP/IDP. Decision to continue or
    remove the HFP/IDP designation by area are expected by the end of 2011.
    Furthermore, the Department is on schedule in transitioning the legacy
    Special and Incentive Pay authorities to the new, more flexible
    authorities provided by Congress. The legacy authority authorizing HFP/
    IDP is expected to be transitioned to its new authority later in 2011.
    Under the new authority, the Department will be able to prorate HFP/IDP
    based upon time actually spent in the HFP/IDP area and will be able to
    implement a more tiered pay structure for HFP/IDP that differentiates
    pay based upon proximity to danger.

        Senator Webb. But, I think this young veteran deserves an
    answer. I think he deserves a response. It's very fair and very
    supportive of the people who've had to serve, in general.
        I appreciate all of you coming today and spending time with
    us.
        As I said, your full testimony not only will be in the
    record, but will be read carefully by staff. We will probably
    have other staff-to-staff comments, and we appreciate what
    you're doing for our country.
        Secretary McCarthy, my best to you as you depart.
        I look forward to sitting down and talking with him when
    you feel comfortable doing that.
        Thank you very much.
        [Questions for the record with answers supplied follow:]
                   Questions Submitted by Senator John McCain
             army and air national guard--a total force multiplier
        1. Senator McCain. Secretary McCarthy, I'm interested in your view
    of the role of the Army and Air National Guard in your Total Forces.
    There is no question that Guardsmen have been essential contributors in
    Iraq and Afghanistan. We need to have a clear understanding from the
    Office of the Secretary of Defense (OSD), the Army, and the Air Force
    about how the National Guard should best be employed in an era of tight
    budgets.
        Secretary McCarthy. Guardsmen have indeed been essential
    contributors to operations in Iraq and Afghanistan, and will continue
    to play key roles in the future. Continuing to use the Guard and
    Reserve as part of the Total Force will allow the Department to
    maintain capabilities and capacities at less overall cost given the
    increasingly tightened budget environment across the whole of
    government.
        We recently completed, and the Secretary of Defense reviewed, a
    report entitled The Comprehensive Review of the Future Role of the
    Reserve component, which was directed in the 2010 Quadrennial Defense
    Review. The review enjoyed strong participation from offices within
    OSD, the Joint Staff, Services, and combatant commands. The report
    proposes several options in which the Guard and Reserve may be utilized
    to best advantage in the future.
        In general, these include missions that are predictable, relatively
    consistent over time, and whose success can be substantially enabled by
    long-term personal and geographic relationships. Such activities
    include providing forces in support of large-scale conventional
    campaigns, stability operations, steady state engagement activities,
    humanitarian assistance, and disaster relief, homeland defense and
    defense support to civilian authorities, and institutional support
    tasks. Using the Guard and Reserve for these types of missions, within
    the Service's force generation models when applicable, will preserve
    the hard earned experience and training from the past 10 years,
    solidify the country's investment in the Reserve component, and reduce
    the operational stress on the Active Forces.

        2. Senator McCain. Secretary McCarthy, I'd like to hear about the
    objectives of the legislation you support on enhanced involuntary
    mobilization authority.
        Secretary McCarthy. Our intent with the enhanced involuntary
    mobilization authority is to assure access to the Reserve component in
    an era of persistent conflict. Broad authority to order the Reserve
    component to Active Duty in somewhat limited amounts is needed to
    augment the Active component and cost effectively utilize the total
    force as we continue to pursue our national security objectives in the
    near and foreseeable future. Over the last 3 years, Reserve component
    personnel on involuntary Active Duty have declined from around 150,000
    personnel to 90,000 personnel today. As we pursue an end state with
    many of our high demand missions, we expect to see a further decline,
    but not an elimination of, demand for Reserve component personnel. Due
    to the structure of our highly combat experienced total force and the
    expectation that an era of persistent conflict will present the
    military with high demand for limited resources, we project a need for
    significant numbers of Reserve component personnel to serve on active
    duty performing a wide variety of roles to augment the Active
    component, thus generating the necessary forces to shape and respond to
    international events. We anticipate an environment with multiple
    commitments ranging from low intensity military operations against
    hostile forces, presence-based deterrence operations directed towards
    nation states, to the need to engage multiple partners to build theater
    security around the world. We believe the military will have to
    sustain, for the foreseeable future, operations somewhere below the
    level of a national emergency or a contingency operation yet somewhere
    above the intensity level normally associated with peacetime. The
    current involuntary mobilization authorities do not adequately support
    this variety of mission sets, nor is it appropriate for the intensity
    of military operations anticipated.

        3. Senator McCain. Secretary McCarthy, what is your view of the
    appropriate role of the National Guard? Stated differently, what does
    the term ``Operational Reserve'' look like for the National Guard as
    it's implemented in the years ahead? Please describe what the proposed
    legislation will do if enacted.
        Secretary McCarthy. First, it is our view that the term
    ``Operational Reserve'' is somewhat misleading and restrictive. The key
    concept is to continue to use the Reserve Component in operational
    roles and missions in the future and effectively manage them as part of
    the operational force. In the 1990s, as Active component and Reserve
    component end strength drew down and the world continued to be a
    dangerous place, we increasingly relied on the National Guard and the
    Reserves to support military mission requirements in Bosnia, Kosovo,
    and MFO Sinai as well as to meet daily operational requirements in
    training and other support roles.
        While not fully implementing an ``Operational Reserve,'' we were
    nonetheless migrating toward a transformation of the way the Reserve
    component was being utilized. Recognizing this change, the Department
    set about transforming the Guard and Reserve from a predominantly
    strategic force to a sustainable Reserve Force with both operational
    and strategic roles. Much like the Active component, it is important to
    note that the Guard and Reserve have strategic forces at one end of the
    spectrum and operational forces at the other end of the spectrum. Our
    policies on mobilization, force structure rebalancing, personnel
    management, training, readiness, equipping, and family and employer
    support have changed significantly to facilitate the increased
    utilization of Reserve component personnel in these operational roles.
    I believe recent history supports the conclusion that proper
    utilization of the National Guard and Reserve reduces the burden on all
    forces--a Presidential priority. The proposed legislation will enhance
    the Department's ability to gain access to Reserve component units and
    personnel in order to meet operational requirements and national
    security objectives.

                         reducing the cost of personnel
        4. Senator McCain. Dr. Stanley and Secretary Hale, the cost of
    manpower in the All-Volunteer Force, not surprisingly, has increased
    significantly over the last 10 years. Other than reducing the numbers
    of Active Duty, Reserve, and civilian personnel in the Department of
    Defense (DOD), we need to understand how you would act to reduce the
    cost of personnel. Do you expect DOD to propose changes to the military
    pay and compensation system, e.g., retirement system, with the
    objective of reducing costs, and what do you consider to be the areas
    most in need of change?
        Dr. Stanley. The Department is seizing upon available opportunities
    to achieve greater efficiency in military pay and compensation in order
    to reduce costs. At the appropriate time we will propose changes to the
    larger components of the military compensation based on a carefully
    analyzed, fully considered, holistic examination of the military
    personnel and compensation systems.
        In light of the fiscal pressures the country faces, the Department
    is pursuing a comprehensive, holistic approach to accomplish more with
    fewer resources. The Department has committed to the following goals:

        (1)  Controlling rising personnel costs
        (2)  Restraining entitlement growth
        (3)  Leveraging its compensation tools to sustain recruiting and
    retention success.

        While we consider possible changes to larger components of military
    compensation, we remain mindful that these types of changes need to be
    carefully analyzed, considered, and studied to ensure that they do not
    adversely impact our ability to maintain a ready force. Additionally,
    any changes must also take into account the military's up or out
    system, the need to grow and develop our own leadership internally, and
    the many additional burdens and sacrifices borne by our military
    members.
        The retirement system is a frequent target to identify cost
    savings, and many groups have suggested alternatives. The retirement
    benefits, by not vesting until the member has 20 years of service, play
    an important role in fostering retention. Members most influenced by
    the draw of the retirement system are those in the critical, mid-career
    grades and years. Retaining these members is critical, as the
    Department has invested significantly in their leadership training and
    professional development. Any changes to the retirement system must
    ensure we continue to retain these members and protect our investment
    in them.
        Secretary Hale. Given the current fiscal crisis facing the Nation,
    and the push to find additional savings and efficiencies across the
    Federal budget, everything, including military compensation, needs to
    be on the table. Since the late 1990s, significant across-the-board and
    targeted pay raises coupled with substantial increases to housing and
    subsistence allowances have dramatically improved military
    compensation. Even without accounting for other cash payments such as
    special/incentive pays and recruiting and retention bonuses or generous
    non-cash and deferred benefits such as healthcare, education benefits,
    retirement, and paid time-off, studies have shown that military members
    across the ranks earn more than at least 70 percent of civilians with
    similar education and experience (i.e., military pay ranks in at least
    the 70th percentile for all experience levels, both officer and
    enlisted).
        Therefore, we believe it is appropriate to conduct a comprehensive
    review of the military pay and benefits structure to include the many
    in-kind and deferred benefits (e.g., retirement system) that are often
    very expensive and which may not be the right answer for today's
    servicemembers. While it may be possible to restructure our military
    pay and benefits in a way that reduces costs, we need to proceed
    carefully with a clear understanding of how any adjustments will impact
    the Department's ability to attract and maintain the All-Volunteer
    Force.

                        reductions in active-duty forces
        5. Senator McCain. Dr. Stanley and Secretary Hale, despite ongoing
    combat operations and concern about dwell time, it appears that
    budgetary pressures are going to force reductions in the number of
    Active Duty military personnel: Army down 49,000; Navy down 9,000;
    Marines down 16,000; and the Air Force will downsize 10,000 civilian
    positions and take reduction-in-force measures to bring down the number
    of Active-Duty airmen. What personnel cuts will be imposed, in your
    opinion, and what will be the time frame to accomplish these cuts?
        Dr. Stanley. In compliance with Secretary of Defense guidance, the
    Department is working closely with the Services to bring down end
    strength as outlined in the table below while maintaining mission
    readiness. My staff, in concert with experts from the Services, is
    carefully managing the way ahead in force management to ensure the
    Services are ready to meet the challenges we face now and in the
    future. The following table indicates Active component end strength
    through fiscal year 2016.

                            ACTIVE COMPONENTS PROJECTED END STRENGTH (FISCAL YEARS 2012-2016)
    ----------------------------------------------------------------------------------------------------------------
                                                                                  Fiscal Year
                                                         -----------------------------------------------------------
                                                             2012        2013        2014        2015        2016
    ----------------------------------------------------------------------------------------------------------------
    Army................................................     547,400     547,400     547,400     533,900     520,400
    Navy................................................     325,700     322,300     319,900     319,002     320,300
    Marine Corps........................................     202,100     202,100     202,100     192,100     182,100
    Air Force...........................................     332,800     332,800     332,800     332,800    332,800
    ----------------------------------------------------------------------------------------------------------------
    Source: Defense Resource Data Warehouse March 11, 2011

        As far as the Air Force civilian workforce, it will continue to
    grow but the growth will be less than previously planned due to OSD
    directed efficiencies taken in the fiscal year 2012 President's budget
    request. Currently, the Air Force is conducting a strategic review of
    all civilian positions and this effort is being worked concurrently
    with fiscal year 2013 budget development. Until their strategic review
    is completed, the Air Force recently announced that it will use hiring
    controls as a bridging mechanism in fiscal year 2012. Once the
    strategic review is complete, the Air Force will work to rebalance its
    civilian workforce by realigning resources from lower priority areas to
    higher priority missions to operate within approved funding levels.
        Secretary Hale.
    Army
        In July 2009, the Secretary of Defense announced a decision to
    temporarily increase the Army's active-duty end strength by up to
    22,000 from 547,400 to 569,400 for a period of 3 years. This increase
    was necessary in the short-term to ensure deploying units were properly
    manned and to eliminate the routine use of stop-loss authority prior to
    the drawdown of forces in Iraq and as an increase in forces in
    Afghanistan was beginning. As planned, the drawdown of this 22,000
    temporary end strength will begin in the spring of 2012, and the Army
    will return to its permanently authorized end strength by the end of
    fiscal year 2013.
        An additional reduction of 27,000 Active-Duty Army end strength is
    programmed to begin in fiscal year 2015. This reduction is based on the
    President's and NATO's strategy for Afghanistan, which indicates the
    number of troops deployed there will be significantly reduced by the
    end of 2014. If this assumption proves incorrect or global conditions
    change, this reduction will need to be reassessed. However, even with
    these reductions, the Army's end strength will be nearly 40,000 larger
    that it was prior to the war.
    Navy
        The Navy currently plans to reduce its Active-Duty end strength by
    approximately 9,000 from the fiscal year 2011 authorized level of
    328,700 by the end of fiscal year 2014. The reductions are planned at
    roughly 3,000 per year for fiscal year 2012 through fiscal year 2014
    and will be achieved through various efficiency actions to streamline
    operations and headquarters elements, as well as realignments of
    additional construction battalions and Maritime Expeditionary Security
    Forces from the Active to the Reserve component.
    Marine Corps
        Similar to the Army, current plans call for the Marine Corps to
    begin reducing Active-Duty end strength between 15,000 and 20,000
    starting in fiscal year 2015 based on the strategy for Afghanistan.
    Again, if this assumption proves incorrect or global conditions change,
    this reduction will need to be reassessed. However, even with these
    reductions, the Marine Corps end strength will be 7,000 to 12,000
    larger than it was prior to the war.
    Air Force
        The Air Force civilian workforce will actually continue to grow in
    fiscal year 2012 to 182,199 compared to the fiscal year 2010 level of
    179,044; but the growth will be less than was previously planned prior
    to the development of efficiency initiatives included in the fiscal
    year 2012 President's Budget. The Air Force is conducting a strategic
    review of all civilian positions to ensure that their future use of
    civilian resources matches their long-term priorities, and they have
    recently announced hiring controls until their strategic review is
    completed.
        The Air Force officer corps ended fiscal year 2010 2,335 over
    authorized end strength. The Air Force is reducing accessions and using
    voluntary and involuntary separation programs to get the officer force
    back to authorized end strength by the end of fiscal year 2012.

        6. Senator McCain. Dr. Stanley and Secretary Hale, for the Army and
    Marine Corps, how will these reductions affect dwell time, assuming we
    are still deploying units to Afghanistan?
        Dr. Stanley. These end strength reductions should not have
    significant impact on Army or Marine Corps dwell time. We are carefully
    managing the dwell time of our forces across the Department, and have
    limited unit deployments and mobilizations to 1 year. We have balanced
    the forces for Afghanistan against those coming available from the
    draw-down in Iraq. Comparing 2008 to 2010, we have drawn down over
    100,000 personnel from Iraq while deploying an additional 64,000 to
    Afghanistan. The Army is making good progress toward our dwell goal of
    2 or more years at home for every year deployed with nearly 70 percent
    of the Active Force meeting or exceeding this goal. Similarly, the
    Marine Corps has approximately 1,500 fewer personnel deployed in 2010
    as compared to 2008 and their Active component's deployment to dwell
    ratio is close to the 1:2 goal.
        Secretary Hale. If the number of troops and units deployed to
    Afghanistan is not significantly reduced at the end of 2014, as
    currently assumed, then the Department would likely relook at the Army
    and Marine Corps end strength reductions programmed to begin in fiscal
    year 2015 to ensure that dwell times will not return to where they were
    before the grow-the-force initiatives.

        7. Senator McCain. Dr. Stanley and Secretary Hale, how can the Army
    achieve a 1:2 dwell ratio with these kinds of cuts?
        Dr. Stanley. We have met the Operation New Dawn responsible
    drawdown plan goals. In 2008 the Army had 22 Brigade Combat Teams
    (BCTs) deployed, and are projecting to have 36 percent fewer BCTs
    deployed in 2012. The Army projects the average unit boots on the
    ground to dwell ratio to improve to approximately 1:2 for Active
    component units and 1:4 for Reserve component units in 2012.
        Secretary Hale. Achieving the Active Force planning objective of a
    1:2 dwell ratio is highly dependent on the level of demand for
    deploying troops/units. Planned reductions in Army end strength are
    scheduled to follow significant reductions in troop demand in both Iraq
    and Afghanistan based on current assumptions. If the reduction in the
    demand for troop deployments does not occur as planned, the risk to
    individual dwell time will need to be assessed as part of any decision
    to proceed with the end strength drawdowns.

        8. Senator McCain. Dr. Stanley, what do we need to do to avoid
    being accused of breaking faith with servicemembers who have served
    honorably--probably deployed more than once--who would like to stay on
    Active Duty but may be pink-slipped?
        Dr. Stanley. The Department has collaborated with Service Force
    Management experts and submitted several legislative proposals for the
    NDAA for Fiscal Year 2012 that will provide the Services the
    flexibility needed to achieve force reductions while maintaining
    readiness and taking care of our servicemembers. Maintaining readiness,
    while fairly restructuring to a post-conflict force, is our goal.

                    integrated disability evaluation system
        9. Senator McCain. Dr. Stanley, DOD and the Department of Veterans'
    Affairs (VA) have greatly improved disability processing with the
    Integrated Disability Evaluation System (IDES). Long delays still exist
    in the Services in performing medical evaluation boards and in
    completing the process. In the Army this is particularly serious
    because of the thousands of non-deployable soldiers who count against
    Army end strength. This looms as a growing risk to Army readiness. What
    is your office doing to address the Army's problem, i.e., growing
    backlog of soldiers in IDES?
        Dr. Stanley. In order to determine the most feasible path forward
    on this issue, the two Secretaries met to directly engage on how to
    reduce the IDES cycle time so the numbers of servicemembers processing
    through the system can be more efficient and effective. The goal is a
    more fit and healthy fighting force and the total well-being of the
    force. The following steps were taken:

        (1)  We convened a joint IDES Tiger Team to explore improvement
    opportunities to delays and processing, including modifying the IDES
    proof of concept to test a process that might streamline and reduce the
    amount of days to get through the process, and long-term strategic
    modifications.
        (2)  We recommended policy adjustments, as identified by the Tiger
    Team, that could help streamline the IDES. We plan to test those during
    the proof of concept.
        (3)  We worked closely with VA to improve Information Technology
    (IT) solutions which will enhance timeliness and efficiency across all
    stages of IDES.

        Most significantly, the Department of the Army is now submitting
    increased budget line items to provide for additional staff,
    facilities, and equipment to organize train, and operate the IDES for
    their soldiers.
        Work continues on all fronts to improve the IDES--and we are
    absolutely committed to improvement. In the end, we are confident that
    a more efficient and effective IDES will emerge, Military Department
    readiness will be enhanced, and all servicemembers will be processed
    through the IDES at a pace which is less than the existing amount of
    days and appropriate for each servicemember.

                      prioritizing quality of life dollars
        10. Senator McCain. Dr. Stanley, every year Congress authorizes
    modernization and construction of new facilities intended to improve
    the quality of military life for members and their families. Along with
    pay and benefit improvements, this clearly has had a positive impact on
    morale and a high retention rate. What do you consider to be the the
    highest priorities for modernization and construction of new
    facilities--barracks, child care centers, family housing, medical
    clinics, or schools?
        Dr. Stanley. I agree with the Secretary that direct support of the
    operations in theater is the Department's highest priority. And only
    second to that is taking care of our wounded, ill, and injured
    servicemembers. While we may not be able to modernize and construct new
    facilities for all barracks, child care center, family housing, medical
    clinics, and schools at any given time, I will prioritize supporting
    the operations and taking care our servicemembers as my top priorities.
    However, we continually identify and address weaknesses or any areas
    that are insufficient or lacking. In short, we are continuously
    examining and assessing our needs and how to best use our limited
    resources to best support the war and improve the quality care for our
    servicemembers and their families.

                 sexual assault prevention and response efforts
        11. Senator McCain. Dr. Stanley, preventing and responding properly
    to incidents of sexual assault remains a high priority for each of your
    Services, and progress has been made. Is the military a safer place for
    women to serve than before September 11?
        Dr. Stanley. Yes, we believe the military is a safer place for
    women--and men--to serve than before September 11, 2001. In fact, our
    most recent data indicates that:

        (1)  In 2010, the data collected by the Department suggests that
    there were one third fewer incidents of sexual assault against women,
    and half the number of sexual assault incidents against men, than there
    were in 2006.
        (2)  Servicemembers may now click, call or text for confidential
    assistance, available 24 hours a day/7 days a week, from the
    Department's new victim assistance hotline called DOD Safe Helpline.
        (3)  An overwhelming majority of servicemembers understand the need
    and desire to help prevent fellow servicemembers from harming
    themselves or others in a social setting.
        (4)  Over 90 percent of servicemembers are now able to recognize
    situations that may pose a risk for sexual assault and identify an
    effective action to prevent harm to a potential victim.
        (5)  More than ever, a greater proportion of servicemembers are now
    reporting the sexual assaults committed against them.
        (6)  Sexual Assault Response Coordinators and Victim Advocates are
    stationed in garrison and are forward deployed, providing 24/7
    assistance, at every DOD installation in the world.
        (7)  In 2010, of the cases where DOD has the authority and
    sufficient evidence to take action, over half of alleged offenders had
    court-martial charges preferred against them--up from one-third in
    2007.
        (8)  Secretary Gates has assigned a General/Flag Officer with
    operational experience to provide direct oversight of the Sexual
    Assault Prevention and Response Program office.

        Still there is much work to be done. One sexual assault is one too
    many. Until we achieve our vision, we will continue to integrate sexual
    assault prevention into military culture, improve our assistance to
    victims, encourage reporting and hold offenders appropriately
    accountable.

        12. Senator McCain. Dr. Stanley, do you think that new legislation
    is needed to enhance the Sexual Assault Prevention Programs in DOD? If
    so, what legislation would you propose be enacted?
        Dr. Stanley. At this time, I am firmly of the opinion that we do
    not need new legislation. To date, the Department has received a great
    deal of assistance in improving its sexual assault prevention and
    response programs. For example, since 2004, there have been eight
    congressional hearings, five investigative body reviews, and four
    Government Accountability Office reviews addressing DOD sexual assault
    programs. Each of these activities has provided greater insight and
    information, and has resulted more than one hundred recommendations
    that have been incorporated into six separate National Defense
    Authorization Acts. Additional legislation is not required; we need
    time to implement the recommendations already made and that are in
    progress and would be redundant and duplicative at this time. Moreover,
    the Department tracks its progress against each of the 136
    recommendations, as well as the 744 sub-tasks, required to implement
    those recommendations. The progress has been reported to your
    Committee, at least twice yearly in March and December, in our Annual
    Reports.

           progress in implementation of don't ask, don't tell repeal
        13. Senator McCain. Dr. Stanley, training for Repeal Day is
    currently underway in each of your Services that will pave the way for
    gay and lesbian individuals to serve openly in the Armed Forces. What
    is your assessment of the effectiveness of the training for your
    Service thus far?
        Dr. Stanley. Thus far, training has been very effective, especially
    in emphasizing leadership, professionalism, discipline, and respect. I
    have personally attended this training and believe it is where it needs
    to be to ensure our leaders are ready for repeal. In addition, every 2
    weeks I receive an in-depth analysis of the progress of training.

        14. Senator McCain. Dr. Stanley, the ground combat forces--soldiers
    and marines, as well as the Special Forces for all Services--registered
    the greatest concern about the effects on readiness and unit cohesion
    of repealing the Don't Ask, Don't Tell policy. What problems do you
    anticipate on ships and in the field when the repeal takes effect?
        Dr. Stanley. Because I have great confidence in the commanders in
    the field, I do not anticipate major problems. By emphasizing
    leadership, professionalism, discipline, and respect, we expect that
    our forces will successfully carry out this change in policy.

                           joining forces initiatives
        15. Senator McCain. Dr. Stanley, the White House recently announced
    a national initiative that focuses on the employment, education, and
    wellness of military personnel and their families. First lady Michelle
    Obama and Dr. Jill Biden announced the Joining Forces initiative, which
    pulls a variety of government agencies, businesses, nonprofit groups,
    and media organizations in an effort to improve the lives of military
    families. General Stanley McChrystal will lead the effort. What actions
    is DOD taking in response to the Joining Forces initiative?
        Dr. Stanley. The Department has been coordinating with the White
    House on the Joining Forces initiative since November 2010 and for all
    White House family support initiatives. Actions taken to date have been
    to advise the White House on the key challenges facing military
    families, to help facilitate installation visits and visits with troops
    and families of all components, and to participate in numerous working
    groups and events sponsored by the White House that deal with military
    family support. The Department continues to work closely with the
    Offices of the First Lady and Dr. Biden in an advisory capacity.
        Awareness among Americans who do not wear the uniform about the
    strengths, challenges, and unique needs of our military families and to
    rally our communities to support them in the long-term. Specifically,
    Joining Forces is focusing on key areas impacting our military families
    which include employment, education, and wellness. As DOD cannot
    provide all the resources our military families may need to empower
    them to thrive, partnerships with other government agencies,
    businesses, non-profits, and local community groups are key to
    providing sustained networks of support which in turn will keep our
    families strong and resilient throughout the military lifecycle.
    Joining Forces complements the Presidential Study Directive on Military
    Families, another unprecedented effort where a whole-of-government
    approach was leveraged to identify and resource the most critical needs
    of our military members and families.
        Much in the spirit of Joining Forces, the Department has been
    working one program in particular since Fall 2010 which has been
    socialized with the White House and the Congressional Military Family
    Caucuses and met with great interest: the Military Spouse Employment
    Partnership Program, or MSEP. An extension of the very effective
    program run by the Army since 2003, MSEP will connect corporate America
    to the extremely talented and educated cadre represented by our
    military spouses across all the military Services, including the Coast
    Guard, for jobs and careers. We are looking forward to a mid-summer
    launch of the MSEP program.

        16. Senator McCain. Dr. Stanley, what priority areas do you think
    General McChrystal should focus his attention on?
        Dr. Stanley. The priority areas on which General McChrystal and the
    Center for a New American Security (CNAS) should focus are contained
    within the intersection of the areas of emphasis of the two recent
    White House-directed efforts that highlight military family support
    which resulted from collaboration with the Military Services and the
    Cabinet. The first of the initiatives is the Presidential Study
    Directive on Military Families which points out the following four
    government-wide efforts: enhance the well-being and psychological
    health of the military family, ensure excellence in military children's
    education and their development, develop career and educational
    opportunities for military spouses, and increase child care
    availability and quality for the Armed Forces. The second is the
    Joining Forces initiative which is a comprehensive national initiative
    to mobilize all sectors of society to give our servicemembers and their
    families the opportunities and support they have earned, especially in
    the areas of education, spouse employment, and family wellness. I
    support both initiatives and the key elements of the focus areas that
    the White House has already chosen to emphasize through the Joining
    Forces initiative: military family employment, education, and wellness.
    These are also key elements of my fiscal year 2012-2016 Strategic Plan.
        However, if I were to select one priority area within the
    intersection of these two initiatives on which General McChrystal
    should focus, I would advise that he concentrate on military spouse
    employment. For too long, the challenges of managing a military family
    have prevented many spouses from securing long-term, fulfilling
    employment. Employers must understand that military spouses possess the
    necessary skills and attributes that make them excellent hires,
    especially in management and leadership positions. Offered the right
    kind of positions--those that are flexible, virtual, and portable--in
    growing, 21st century career fields, our military spouses can make an
    immediate impact on any company they may work for. With portable and
    virtual positions--the trend in today's global workforce environment--
    they can keep the same job throughout multiple Permanent Change of
    Station (PCS) moves, allowing them to retain seniority, vacation time,
    and positions of management. For our spouses who are teachers and
    health care workers for example, challenges with accreditation and
    certification can prevent seamless movement between school districts
    and states. Addressing these types of issues could allow rapid re-
    hiring and re-employment of spouses in their new location after leaving
    a similar job at their old duty station. We stand by to advise and
    assist General McChrystal and the White House on this matter which
    directly impacts spouse, family, and servicemember wellness.
                                     ______

                 Questions Submitted by Senator Lindsey Graham
              dod support for military families in times of crisis
        17. Senator Graham. Dr. Stanley, support for military families
    counts most in times of crisis. We have heard reports that military
    families received little or no assistance or information from DOD in
    the days preceding the potential shutdown of the government last month,
    and also there was confusion regarding evacuation of families and
    support personnel such as teachers in the wake of the tsunami in Japan.
    What role did your office play in planning for these contingencies?
        Dr. Stanley. Though there is specific guidance for continuing
    program operations during times of crisis, each crisis is evaluated
    separately in relation to the gravity of the impact on military
    families.
    Support to Military Families During the Potential Government Shutdown
        DOD developed an internal DOD plan in the event a shutdown was to
    occur. Several Principal level staff within the Office of the Secretary
    of Defense were specifically engaged in the plan's development,
    although the Comptroller was assigned the lead. Because the ultimate
    goal was to avoid shutdown, plan details were provided to the workforce
    only as necessary, with the objective to minimize alarm to the
    workforce. In preparation for the shutdown, my Deputy Assistant
    Secretary of Defense for Civilian Personnel Policy (DASD CPP) led the
    planning efforts associated with preparing the Department's civilian
    workforce in the event of a shutdown. The DASD CPP personally
    coordinated extensively with the leadership of the Office of Personnel
    Management (OPM) to ensure DOD's shutdown plan was consistent with OPM
    rules and requirements. The DASD CPP worked in partnership with the
    Office of the USD (Comptroller) to establish guidance to identify
    personnel excepted from the shutdown, and ensured that letters of
    notification to the workforce were properly staged in the event a
    shutdown was to occur. Under the direction of the DASD CPP, the
    Civilian Personnel Management System (CPMS) website (http://
    www.cpms.osd.mil) was updated with answers to Frequently Asked
    Questions to keep the DOD workforce informed.
        There was particular concern during the shutdown planning for how
    this may have affected servicemembers and their families--particularly
    the commissaries and the schools. The Office of Military Community &
    Family Policy within P&R ensured that commissaries would be able to
    stay open during a shutdown and careful consideration of all
    consequences of this decision were examined. As soon as the decision
    was made, the information was disseminated immediately.
        Department of Defense Education Activity (DODEA) ensured that
    schools remained opened and military families were routinely advised
    through electronic and print media.
    Support to Military Families during the Tsunami in Japan
        During the crisis in Japan, P&R quickly established strong working
    relationships with the Joint Chiefs of Staff, the Defense Continuity &
    Crisis Office, U.S. Forces Japan, the Pacific Command, and the Services
    to provide policies and activities to support servicemembers, DOD
    civilians, and dependants. P&R created a Crisis Management Taskforce as
    well as a Crisis Response Cell to ensure timely and accurate
    information and support to those in the crisis. Specific examples are
    highlighted below:

             The CPMS established a website (http://
            www.cpms.osd.mil/disasters/japandisaster.html) for civilian
            employees that listed information on the authorized voluntary
            departure, travel assistance for families leaving and returning
            to Japan, as well as, a compendium of other pertinent web links
            to Military OneSource, Services Japan information websites,
            TRICARE, and others.
             Military Community & Family Policy (MC&FP) Military
            OneSource websites were developed for both military and
            civilian dependants who chose to accept voluntary departure
            from Japan.
             DODEA ensured that the correct information about
            authorized departures was distributed throughout Japan. The
            authorized departure was only for dependents of military and
            civilian employees. It was not for military or civilian
            employees assigned in Japan. DOD provided the permission to
            authorize single parent teachers, who had school-aged
            dependents electing evacuation, to escort their dependents to
            the United States, and then return to Japan for work.

        A crisis center, which was operational within one day following the
    disaster, was the critical link for sharing information concerning
    families with the Services and involved agencies. Additionally, teams
    were dispatched to every receiving point for incoming aircraft
    containing Japan evacuees. These teams met the families in the terminal
    and began providing immediate assistance to the families concerning
    dependent education.
        DOD provided a wide range of student support to those who transited
    to the United States, from working with school districts to relax
    school boundaries and requirements, to assigning two high school
    assistant principals to the United States to support the students who
    did not return to Japan.

        18. Senator Graham. Dr. Stanley, looking back, what lessons were
    learned?
        Dr. Stanley. The compounded crises of the Japan Earthquake/Tsunami/
    Nuclear incident and the potential government shutdown provided
    valuable insight into how we should prepare for future crises. We have
    developed a Continuity of Operations planning document to support any
    potential shutdown of government operations in the future and will
    recommend that other DOD components create a similar plan of action. In
    reference to the Tsunami in Japan, my staff involved in the Japan
    crisis conducted a comprehensive after action review and captured
    several lessons learned that will be included in future internal
    Personnel and Readiness crisis management planning. These lessons
    learned include the need to develop stronger avenues of communication
    with the combatant commands and Services leadership to support their
    needs during a crisis.

        19. Senator Graham. Dr. Woodson, how is DOD ensuring that
    servicemembers and their families are protected from any health risks
    following the devastating tsunami in Japan?
        Dr. Woodson. DOD has initiated a series of coordinated actions to
    protect our servicemembers and their families against possible health
    risks resulting from the tsunami. Specifically:

        (1)  The U.S. Pacific Command (PACOM), with support from
    specialized health surveillance teams from across DOD, continues to
    monitor radiation levels and evaluate possible toxic hazards throughout
    the region.
        (2)  USPACOM implemented force health protection measures, such as
    monitoring installations for excessive radiation levels, distributing
    radiation dosimeters to those who were most likely to experience
    elevated radiation exposures (within 125 nautical miles of the
    Fukushima plants), establishing maximum radiation dose guidelines for
    individuals engaged in the relief effort, and distributing potassium
    iodide to mitigate the absorption of radioactive iodine, if required.
        (3)  Whole body radiation scans are conducted to measure internal
    radiation doses for those servicemembers considered to have the highest
    potential for radiation exposure by virtue of having performed duties
    within the ``hot'' or ``warm zone'' around the nuclear reactor plant.
        (4)  On March 21, 2011, the Under Secretary of Defense (Personnel
    and Readiness) directed the Services and Defense Agencies to report,
    retroactive to March 11, 2011, the specific, once daily location of
    each member of the DOD-affiliated population on the mainland of Japan.
    This population included all servicemembers and their families, DOD
    civilian employees and their families, and DOD contractors.

        DOD will use the above data, in conjunction with data collected
    from monitoring activities, to develop an exposure registry to link
    each individual in the DOD-affiliated population in Japan with
    estimated radiation exposures. The exposure registry will be available
    if needed for diagnosis, treatment, claims adjudication by the
    Department of Veterans Affairs, or if needed to conduct health studies.

                           reducing health care costs
        20. Senator Graham. Dr. Woodson, DOD has proposed five cost-saving
    initiatives which are currently being considered by the subcommittee.
    In your view, are there additional ways to bring health care costs
    down, beyond those that require a larger contribution from
    beneficiaries?
        Dr. Woodson. We believe there are additional ways to bring the
    health care costs down that do not involve a larger contribution from
    the beneficiaries. The Department is currently undertaking a
    comprehensive and thoughtful review to identify additional options to
    reduce health costs while maintaining and improving quality, safety and
    access. For example, we are currently conducting an extensive review
    and analysis of activities across the Military Health System (MHS),
    focusing the reprioritization of critical mission requirements;
    consolidation of like/similar activities or support functions across
    multiple organizational units; opportunities for in-sourcing, if
    appropriate; and elimination of non-value added functions. In addition,
    we are implementing the Patient Centered Medical Home model which
    evidence shows also lowers the overall cost of care through improved
    care delivery, coordination and management of enrolled patients. We
    have recently joined the National Partnership for Patients initiative
    with DHHS and other partners to reduce hospital-acquired conditions and
    readmissions. This initiative is the right thing to do for patients and
    has the potential to save money across all health care systems. We are
    working to provide accessible options for patients, whose conditions
    can be treated in alternative locations, decreasing emergency room
    utilization and associated costs. We are also encouraging increased use
    of mail order pharmacy to simplify access to medications at an overall
    lower cost to the MHS. Finally, we continually assess our patient care
    service contracts to provide best value.

                         mental health and the reserves
        21. Senator Graham. Dr. Woodson and Secretary McCarthy, I am
    impressed by reports of the increased numbers of military and civilian
    mental health providers both within the Services and in the TRICARE
    networks. How much of the increase in mental health capability is
    reflected in the Reserves?
        Dr. Woodson and Secretary McCarthy. Mental health providers have
    always been fully accessible to our Reserve component members. As with
    the active Duty Services, the members of the Reserve component have
    also seen an increase in mental health providers throughout the system.
    The TRICARE network includes 50,000 mental health providers, while
    there are more than 6,000 mental health providers in our military
    treatment facilities. This includes tele-mental health treatment of
    diagnosed mental disorders (medically-supervised, secure audio-visual
    conferencing available online at www.tricare.mil/telementalhealth), as
    well as the web-based TRICARE Assistance Program demonstration project,
    which covers short-term, non-medical issues (www.tricare.mil/triap) and
    uses audiovisual telecommunications systems such as video chat and
    instant messaging to access existing behavioral health centers in the
    Reserve component member's region. reservists can obtain information
    about these benefits and assistance in accessing them from the
    Department's Yellow Ribbon Program which supports reservists and their
    families with information on benefits and referrals before, during, and
    after deployment. Additionally, mental health services provided by
    Department of Veterans Affairs hospitals and clinics have improved
    access to care in areas where the TRICARE and military facilities have
    a lesser presence. Reserve component servicemembers who are on active
    duty for more than 30 consecutive days can access these providers
    through TRICARE Prime, and they also have access to them during 180
    days pre/post deployment coverage and after that while participating in
    TRICARE Reserve Select, which now has more than 74,000 covered
    reservists, and TRICARE Retired Reserve.
        In addition, the TRICARE Management Activity (TMA) and its three
    Regional Offices are in the midst of an initiative to reach out to the
    Psychological Health Directors assigned the Adjutant General Staff in
    each of the 54 states and territories to provide them with current
    information about TRICARE and behavioral health.
        Another resource available to reservists for mental health support
    is Military OneSource. Military OneSource helps Reserve component
    members with a multitude of needs and is private and confidential. In
    addition to 24-hours a day, 7 days a week, toll-free access to a
    consultant, including international calling options, other counseling
    options include face-to-face counseling, telephone, online and email
    consultations, and financial consulting. Military OneSource also links
    to the National Suicide Prevention Lifeline. The National Suicide
    Prevention Lifeline is a 24-hour, toll-free, confidential suicide
    prevention hotline available to anyone in suicidal crisis or emotional
    distress. Those requiring counseling for long-term medical issues will
    be referred to TRICARE or a military treatment facility.
        Further, reservists not on Active Duty, but who have previously
    deployed, have access to mental health benefits provided by the
    Veterans Administration.
        The Defense Centers of Excellence for Psychological Health &
    Traumatic Brain Injury (DCoE) is another source of mental heath support
    for reservists through its Web-based Real Warriors Resilience,
    Recovery, and Reintegration Campaign. In addition, support is also
    available for reservists from DCoE's After Deployment Web-based
    offering and from its smart phone behavioral health applications.

        22. Senator Graham. Dr. Woodson and Secretary McCarthy, who is
    looking at the question of the requirements for mental health support
    within the Reserve components in light of a new operational Reserve?
        Dr. Woodson and Secretary McCarthy. The Department fully intends to
    support the mental health needs of our Reserve component
    servicemembers. It is clear that these needs are not static and will
    arguably increase as continuing operations and the multiple deployments
    that are required by them continue. Reserve and Health Affairs are
    collaboratively reviewing mental health issues and are actively seeking
    ways to meet current and future mental health demands. In addition, the
    Department has provided the Risk-Adjusted Model for Staffing (PHRAMS)
    staffing model to the Services to assist them in estimating the need
    for mental health providers based on the risk of mental health problems
    our servicemembers face due to their deployment experiences.
        To further support reservists' mental health, the Reserve component
    is implementing mental health assessments as prescribed by NDAA 2010,
    Section 708, to identify mental health conditions, including post-
    traumatic stress disorder, suicidal tendencies, and other behavior
    health conditions that require additional treatment/care. These
    assessments will be conducted during four time frames: within 2 months
    prior to deployment and three post-deployment assessments, 3-6 months,
    7-12 months, and 16-24 months. The Air Force Reserve and Guard have
    completed 2,268 pre-deployment assessments with 3 members requiring
    referrals. Navy and Marine program will be fully functional by August
    and the Army Reserve/Guard is awaiting Army AD electronic form
    implementation.

                financial systems for the defense health program
        23. Senator Graham. Secretary Hale and Dr. Woodson, improving DOD's
    financial systems has been a priority for DOD but not much progress has
    been made. Does the Defense Health Program, which is a single
    appropriation for all three Services, still utilize separate financial
    accounting systems, and if so, why?
        Secretary Hale. The Department is committed to improving the
    financial systems that supports DOD. Multiple systems are used to
    manage the Defense Health Program (DHP) appropriation because the
    funding and resources are divided and managed by the TMA as well as
    each of the Service components. The DHP funding is not the exclusive
    source of the Military components' resources and funding to support
    healthcare activities within each component. When the Defense Health
    Program was created, it was pulled together from four separate
    appropriations, Army, Navy, Air Force, and DOD. Each of these entities
    had, and continues to have, different accounting and finance systems.
    In order to track expenses in the appropriation, the Department has
    developed a methodology to reconcile, after the fact, an execution of
    funds which is consistent across the Services and TMA. Although we have
    more than one system to manage the DHP via the Service accounting
    systems, having a single appropriation ensures a uniformed benefit. The
    DHP continues to look for ways to unify information, improve resource
    management and this may evolve to single enterprise resource planning
    (accounting) system.
        Dr. Woodson. The Department is committed to improving the financial
    systems that support our defense system. Multiple systems are used to
    manage the DHP appropriation because the funding and resources are
    divided and managed by the TMA as well as each of the Service
    components. The DHP funding is not the exclusive source of the Military
    components' resources and funding to support healthcare activities
    within each component. When the Defense Health Program was created, it
    was pulled together from four separate appropriations, Army, Navy, Air
    Force, and DOD. Each of these entities had, and continues to have,
    different accounting and finance systems. In order to track expenses in
    the appropriation, the Department has developed a methodology to
    reconcile, after the fact, an execution of funds which is consistent
    across the Services and TMA. Although we have more than one system to
    manage the DHP, having a single appropriation ensures a uniformed
    benefit. The DHP continues to look for ways to unify information,
    improve resource management and this may evolve to single enterprise
    resource planning (accounting) system.

                       suicide in the reserve components
        24. Senator Graham. Secretary McCarthy, as you acknowledge in your
    statement, the increase in suicide among non-Active Duty National Guard
    and Reserve is of great concern. According to the Army National Guard,
    for example, the number of suicides increased sharply for 2009 in which
    62 occurred, and 2010 in which 113 occurred. Over half of the Army
    National Guard soldiers who committed suicide had never deployed, and
    only about 15 percent were unemployed. Yellow Ribbon is not solely a
    suicide prevention program, it is only available to members who have
    deployed, and according to your testimony in fiscal year 2012 will be
    the final year of funding. What are your thoughts on the adequacy of
    suicide prevention resources available to the Reserve components, and
    what else needs to be done?
        Secretary McCarthy. Concern remains heightened for the Reserve
    component but I am committed to addressing this issue. National Guard
    and Reserve are given the same suicide prevention and resilience
    training from their respective branches as the active duty. However,
    the ability to take advantage of installation based resources is very
    limited for the Reserve component servicemembers and their families who
    often live in communities far from their units or installations of
    assignment. The National Guard, which operates in 54 States or
    territories, have various programs and services available through State
    or community organizations, but they vary based on geographic
    dispersion, available resources, and staffing levels. Even more
    complicated for servicemembers in the Reserves is that many times they
    do not live in the State in which they drill. So State-based programs,
    which can benefit members of the Guard, might not be readily available
    to the Reserves. Improved alignment and joint sharing of information
    and resources could benefit members across the Reserve component.
        Currently, there is a Director of Psychological Health in our Guard
    and Reserve Headquarters as well as in each of our 54 States and
    territories who acts as the focal point for coordinating the
    psychological support for Guard members and their families. I have
    established a Suicide Prevention Stakeholder Working Group, which has
    identified several items that would improve services and better support
    to the Reserve component and their families and is working toward
    implementing these reforms.
        Further, I believe we need to look harder at ways in which we can
    expand the access to behavioral health treatment for Reserve component
    servicemembers, especially in isolated and remote areas and in
    emergency situations. We also need to work closer with the Department
    of Veterans Affairs to support efforts in suicide prevention,
    intervention, and postvention.
        Finally, we should consider ways in which we can provide behavioral
    health care treatment to Reserve component servicemembers regardless of
    deployment status.

      defense center of excellence for psychological health and traumatic
                                  brain injury
        25. Senator Graham. Dr. Woodson, in February 2011, the Government
    Accountability Office (GAO) published a very disappointing report on
    the DOD Center of Excellence for Psychological Health and Traumatic
    Brain Injury, which was established in the aftermath of Walter Reed to
    develop excellence in response to psychological and brain injuries. It
    found several performance problems as well as lack of a clear mission.
    I understand that a new management team is now in place at the Center
    of Excellence for Psychological Health and Traumatic Brain Injury. What
    improvements do you see in the future at this Center of Excellence?
        Dr. Woodson. To address the concerns of the GAO and Congress, the
    Defense Centers of Excellence for Psychological Health and Traumatic
    Brain Injury (DCoE)'s new leadership is working diligently to ensure
    that it is a functional, disciplined, focused and accountable
    organization that performs at the highest level. The identified
    management priorities, as well as completed improvements are listed
    below.
        DCoE management priorities:
        DCoE's mission and priorities are focused on the following
    parameters of success:

             Develop a thorough and comprehensive base of knowledge
            in the evaluation, diagnosis, treatment and rehabilitation of
            PH/TBI injuries.
             Provide consistent, timely, accurate, comprehensive
            and focused information on PH/TBI to the military Services and
            DOD colleagues.
             Develop a thorough and comprehensive analysis of gaps
            in research and aggressively advocate filling those gaps.
             Leverage DCoE's knowledge and clinical expertise to
            improve the system of care.

        Improvements that have been made:

             DCoE's new leadership has established or improved upon
            several planning, monitoring, and execution alignment processes
            since February 2011. These improvements are fundamental to
            ensure DCoE's future as a disciplined, focused, and accountable
            organization.

        Future Service Alignment of DCoE:

             In April 2011, the Department submitted the Report to
            Congress on the DOD Medical Centers of Excellence (CoEs) that
            described the future strategic direction of the CoEs.
             The report outlined a plan to establish a Military
            Health System (MHS) CoE Advisory Board, which will be
            responsible for policy guidance and oversight of the CoEs.
             The report outlined the decision process to align DCoE
            under the U.S. Army Medical Research & Material Command (MRMC)
            through a plan to be established by the MHS CoE Advisory Board
            and MRMC Commander.

                 education opportunities for military children
        26. Senator Graham. Secretary Hale, I commend the priority Dr.
    Stanley has established for improved educational opportunities for
    military children. His testimony describes the Partnership Program in
    which grants are provided to over 60 local educational agencies for
    specific improvements in academic performance of military children.
    According to information provided to the committee, funding for this
    program was lost as a result of DOD efficiencies initiatives. We had
    been assured that family and education programs were protected in the
    efficiencies initiatives. Why was this grant program eliminated?
        Secretary Hale. The Department determined that it would be more
    cost effective to replace grants to local education agencies (LEAs)
    with alternative means of outreach during the Department's Improving
    Business Operations fiscal year 2012 review.
        The first 2 years of the grant program introduced new opportunities
    to military-connected students attending public schools. The projects
    funded through the grants have brought educational support to raise
    student achievement, professional development to teachers, and student
    support services to address the socio-emotional needs of military-
    connected children. The data to date demonstrate that grantees are on
    track to achieve their grant project goals. The lessons learned will
    assist DODEA in providing the alternative means of outreach.
        Although DODEA will no longer fund the grants program as a vehicle
    for supporting the education of military-connected students attending
    LEAs, the DODEA has requested $4.9 million in the fiscal year 2012
    President's budget to provide an alternative means of outreach, by
    aligning the needs of military children with education programs with
    proven results. The DODEA will provide targeted support to LEAs by
    building a support and transition team to implement and oversee
    programs that provide targeted support to LEAs and also, whenever
    possible, comprehensive support programs for military children.

                           health care costs savings
        27. Senator Graham. Secretary Hale, you served as a member of a
    Task Force in 2007 created by Congress to examine the future of
    military health care, and one of the recommendations of that task force
    was that DOD should commission a study and possibly a pilot program
    aimed at better coordinating insurance practices among those retirees
    who are eligible for private health insurance as well as TRICARE. What
    was the Task Force's thinking on that approach at the time and was this
    recommendation ever acted upon?
        Secretary Hale. The Task Force believed that resolving issues
    related to the coordination of private insurance and TRICARE offered
    the potential to provide retirees with better health care while also
    helping to control growth in DOD medical costs. They identified two
    general approaches: The government paying all or part of the retiree's
    premium for the employer's health plan or employers paying all or part
    of the TRICARE enrollment fees. The Task Force also emphasized that use
    of either option must be strictly voluntary on the part of the retiree.
        The Department conducted an analysis in October 2008, addressing
    the Task Force's approaches. The analysis looked at four different
    scenarios and found there is a large degree of uncertainty and risk
    involved in DOD providing an ``other health insurance'' (OHI) subsidy
    to retirees. The cost impact from fiscal year 2009 through fiscal year
    2015 was estimated to range from a savings of $4.4 billion to a cost
    increase of $4.7 billion. All scenarios evaluated led to very large
    initial cost increases to achieve net savings.
        The Department also reviewed the results of the Institute of
    Defense Analyses (IDA) study on providing OHI subsidies that was
    prepared in January 2008 for the Tenth Quadrennial Review of Military
    Compensation (QRMC). This study concluded that due to relative cost of
    OHI and the continual decline of TRICARE premiums and copayments in
    real terms, DOD costs would increase under such an initiative no matter
    what subsidy amount was used.
        Based on the results of these analyses, the Department did not
    believe undertaking a pilot program to further explore this issue was
    warranted. However, it was noted that if the TRICARE fee or benefits
    structure changes, and, depending on the impact of national health care
    reform on the availability and cost of OHI, reevaluation may be
    warranted.

        28. Senator Graham. Secretary Hale, has DOD considered ways to
    better coordinate TRICARE and private insurance as a cost saving
    measure, and would DOD be open to ideas to involve civilian employers
    of military dependents and retirees in a shared opportunity to reduce
    DOD health care costs?
        Secretary Hale. The Department implicitly involves civilian
    employers of military dependents and retirees in helping to lower the
    cost of TRICARE by actively identifying those TRICARE beneficiaries who
    have other health insurance and ensuring that the other health
    insurance is the primary payer for the beneficiaries' health care. Our
    contractors have processes in place to periodically validate the
    existence of other health insurance as a part of their double coverage
    plan.
        With respect to subsidies, the QRMC, Volume II, July 2008, issued
    their report in which they considered an ``Other Health Insurance''
    subsidy. The QRMC conjectured that an ``other health insurance''
    subsidy may be an innovative way for DOD to encourage individuals with
    other health insurance options to opt out of TRICARE, thereby reducing
    DOD health care costs. However, cost analyses revealed that DOD costs
    would increase under such an initiative, no matter what subsidy amount
    was used. We are, however, continuing to evaluate alternatives that
    would involve civilian employees in our efforts to reduce TRICARE
    costs.

        29. Senator Graham. Dr. Stanley, section 726(b) of the National
    Defense Authorization Act for Fiscal Year 1997 states the following:
    ``Total capitation payments for health care services to a designated
    provider shall not exceed an amount equal to the cost that would have
    been incurred by the Government if the enrollees had received such
    health care services through a military treatment facility, the TRICARE
    program, or the Medicare program as the case may be.'' I understand
    that each year DOD, as directed by this law, determines annual payment
    rates to the Uniformed Services Family Health Plan (USFHP) based on a
    variety of factors that measure what the Government would spend if the
    Plan's enrollees were receiving care from the other sources mentioned
    in section 726(b). The methodology that is used includes adjustments
    for such elements as health status and geographic cost differences. I
    understand also that a recent independent analysis commissioned by DOD
    concluded that this rate setting methodology complies with section
    726(b) and is actuarially sound. So it would seem that the President's
    budget proposal simply shifts costs to Medicare without saving the
    Government any money. Is this accurate? If not, please clarify any
    misunderstanding I may have based on what I just described.
        Dr. Stanley. Under this proposal, the administration estimates a
    net savings to the government of $279 million over the next decade.
    While current law precludes DOD from spending more on the USFHP than it
    would cost the government to provide care through TRICARE for Life
    (TFL) and Medicare, the law requires negotiation and mutual agreement
    between the Secretary of Defense and designated providers in
    determining payments to the USFHPs. 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 difference
    between the historically used rates and estimates derived from the
    actual data accumulated for Medicare-eligible TRICARE beneficiaries.

        30. Senator Graham. Dr. Stanley, recognizing that the ceiling rate
    for designated providers is recalculated annually and that those
    calculations withstand the analysis required by law, it appears there
    would be no future savings. Could you please explain how DOD is
    assuming future savings?
        Dr. Stanley. The administration estimates the proposal will save
    the government $279 million over the next decade. While current law
    precludes DOD from spending more on the USFHP than it would cost the
    government to provide care through TRICARE for Life (TFL) and Medicare,
    the law requires negotiation and mutual agreement between the Secretary
    of Defense and designated providers in determining payments to the
    USFHPs. 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 difference between the historically
    used rates and estimates derived from the actual data accumulated for
    Medicare-eligible TRICARE beneficiaries.
                                     ______

                 Questions Submitted by Senator Saxby Chambliss
                        servicemembers civil relief act
        31. Senator Chambliss. Dr. Stanley and Secretary McCarthy, the
    number of service men and women experiencing significant financial
    problems with their mortgage companies and banks is unfortunately well
    known. While the operational tempo of our Armed Forces will hopefully
    decrease following the withdrawal of our combat forces from Iraq, the
    OPTEMPO will likely still remain high and we will continue to rely on
    our Reserve components to meet operational requirements for the
    foreseeable future. With this in mind and if private lenders continue
    to violate or ignore the provisions of the Servicemembers Civil Relief
    Act (SCRA), what adjustments do you believe may be necessary to SCRA to
    protect the interests of our service men and women?
        Dr. Stanley and Secretary McCarthy. The SCRA should be amended in
    two ways:

        (1)  The SCRA (codified at 50 U.S.C. App. Sec. Sec. 501-597b)
    should be amended to make it easier for the lending industry to
    properly apply the 6 percent interest rate cap. Section 527 requires
    the servicemember to provide the lender with a copy of his or her
    official orders to show the period for which the 6 percent interest
    rate cap should apply. These orders, however, can be difficult to
    understand and interpret.

        Section 535 defines military orders to include ``any notification .
    . . from the servicemember's commanding officer, with respect to the
    servicemember's current or future military duty status.'' This
    basically allows the commander to write a letter clearly stating when
    the servicemember is or will be on active duty. This definition,
    however, only applies to section 535, and not to the 6 percent interest
    rate cap section, which, as noted, still requires a copy of the more
    complicated official orders.
        If the definition of military orders found in section 535 were made
    applicable to the entire SCRA by moving it to section 511--the
    definition section, which is applicable to the entire Act--then the
    lending industry could more readily determine when a servicemember was
    eligible for the 6 percent interest rate cap.
        This amendment would also make it easier for the lending industry
    to determine when the interest rate applied to Reserve component
    servicemembers who had received orders but had not yet reported for
    active duty. The SCRA extends some of its protections and benefits
    (including the 6 percent interest rate cap) to those with orders even
    though they have not yet reported for duty. Determining when the orders
    were received can be complicated. But if servicemembers were allowed to
    provide a letter from their commander, the period of applicability
    could be stated clearly.

        (2)  The SCRA should be amended to extend mortgage foreclosure
    protections to all servicemembers' mortgages, not just those secured by
    pre-service obligations. Section 533 provides protections against the
    non-judicial sale, foreclosure, or seizure of the property secured by a
    mortgage obligation that originated before the period of the
    servicemember's active duty.

        This means a court must enter a valid order before the sale,
    foreclosure, or seizure of such property can take place, and such an
    order cannot be entered unless and until the creditor files a lawsuit
    against the servicemember, gets service of the suit on the
    servicemember, and the servicemember has an opportunity to come into
    court and seek relief from the foreclosure. If the property is secured
    by a mortgage obligation created after the period of active duty, then
    the SCRA does not provide these protections.
        Losing one's home to foreclosure almost inevitably leads to a
    cascade of financial complications. If it occurs while on active duty,
    these complications are no less painful and disruptive to mission
    accomplishment just because the obligation was created while on active
    duty, rather than prior to entering active duty.
          To ensure that servicemembers remain focused on the military
    mission, the mortgage foreclosure protection should be extended to
    cover all servicemembers' mortgage obligations, not just pre-service
    ones.
        Such expanded protection would also simplify the process for the
    lending industry. If such an amendment were adopted, the foreclosing
    creditor would only have to determine whether the servicemember is on
    active duty at the time of the proposed sale, foreclosure, or seizure
    (or was on active duty within the 9 months preceding the sale,
    foreclosure, or seizure). The foreclosing creditor would not have to
    sort through a possible series of prior mobilizations to determine the
    status of the servicemember at the origination of the mortgage
    obligation.

           uniformed services employment and reemployment rights act
        32. Senator Chambliss. Dr. Stanley and Secretary McCarthy, the
    Uniformed Services Employment and Reemployment Rights Act (USERRA)
    protects millions of people, largely National Guard and Reserve
    members, as they transition between their Federal duties and civilian
    employment. USERRA is intended to eliminate or minimize civilian
    employment disadvantages resulting from service in the Reserve
    components and protect the rights of those members when they deploy.
    Since September 11, 2001, over 500,000 citizen soldiers have been
    mobilized to fight the war on terrorism. Many American soldiers have
    served more than one tour of duty and may be required to serve more.
    Additionally, the need for American troops in other parts of the world
    and at home continues, whether for conflict management or in response
    to natural disasters. While some would argue that it is statistically
    reasonable for the number of employment discrimination complaints filed
    by service men and women during this time period to have increased--
    based on the number of deployments--the data needed to make such a
    judgment remains incomplete. Furthermore, data from a 2004 DOD survey
    showed that at least 72 percent of National Guard and Reserve members
    with USERRA problems never sought assistance for their problems,
    raising questions as to whether complaint numbers alone can fully
    explain USERRA compliance or employer support. Finally, the time it
    takes to process USERRA complaints, while somewhat improved, remains
    unacceptable when you are speaking in terms of whether or not a veteran
    and/or his family will lose their home due to a negligent or willfully
    mistaken foreclosure action. In light of these factors, do you see the
    need for any changes to USERRA to address these issues or provide
    additional protection to our Guard and Reserve members?
        Dr. Stanley and Secretary McCarthy. Yes, there is a need to
    reexamine USERRA to ensure the law protects servicemembers and to
    promote the employer support necessary to sustain the Total Force.
    Based on the heightened operations of the last 10 years and anecdotal
    evidence gathered by ESGR Volunteers and Ombudsman, USERRA in its
    current form should be reviewed. USERRA has not been significantly
    overhauled since 1994 when it was first enacted. There have been minor
    amendments to USERRA, such as those resulting from the Veterans Benefit
    Improvement Act of 2008, to improve and enhance compensation and
    pension, housing, labor and education, and insurance premiums.
        Based on ESGR's view statistically, USERRA complaints and inquiries
    have risen since September 2001, but the number of cases handled by
    ESGR impact less than 0.01 percent of all Reserve component members.
    While the number of USERRA inquiries has increased, the average number
    of cases has remained fairly consistent over the last 3 years. Through
    the second quarter of fiscal year 2011, ESGR has handled 1,470 cases, a
    slight decline from the same quarters in fiscal year 2010. Please refer
    to ESGR's fiscal year 2010 Annual report for further details on the
    metrics that measure USERRA Inquiries (page 30). In part, the increase
    in inquiries may be attributed to:

        (1)  increased deployments and training in response to global
    events
        (2)  the U.S. economy
        (3)  ESGR's proactive Outreach Programs

        While USERRA does not specifically cover or add protections
    involving foreclosures, other Federal acts and programs do. The
    Veterans Benefit Act 2010 addressed some of the concerns associated
    with mortgages, homelessness and insurance for veterans. As for the
    timeliness to resolve a USERRA case, ESGR resolved cases within 10.27
    calendar days during fiscal year 2010. Further details of our
    historical response rates may also be found on page 30 of the ESGR
    fiscal year 2010 Annual Report.
        While the above factors focus on servicemembers, there are some
    indications that employer fatigue from 10 years of continuous combat
    operations may also be driving the need to revisit USERRA. To verify
    the impact on employers, ESGR is sponsoring two efforts:

        (1)  The ``2011 Department of Defense National Survey of
    Employers'' was sent to a cross-section of 80,000 civilian employers
    across America. The survey currently runs through July 6 with results
    expected late in fiscal year 2011.
        (2)  As a companion piece to this survey, ESGR is sponsoring a
    study to examine the results of the survey and incorporate information
    gleaned from four regional focus groups of civilian employers. The
    focus groups will participate in questions formulated based on the
    survey results and used to provide meaningful narrative to a report
    summarizing both efforts. The collective efforts of these employer
    engagements should be available late in calendar year 2011.

        [Whereupon, at 3:43 p.m., the subcommittee adjourned.]

    DEPARTMENT OF DEFENSE AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR
                   2012 AND THE FUTURE YEARS DEFENSE PROGRAM

                                  ----------

                            WEDNESDAY, MAY 11, 2011

                                   U.S. Senate,
                             Subcommittee on Personnel,
                                   Committee on Armed Services,
                                                        Washington, DC.

       CONTINUATION OF TESTIMONY ON ACTIVE, GUARD, RESERVE, AND CIVILIAN
                               PERSONNEL PROGRAMS

        The subcommittee met, pursuant to notice, at 1:35 p.m. in
    room SR-232A, Russell Senate Office Building, Senator Jim Webb
    (chairman of the subcommittee) presiding.
        Committee members present: Senators Webb, Blumenthal,
    Graham, and Ayotte.
        Majority staff members present: Jonathan D. Clark, counsel;
    Gabriella E. Fahrer, counsel; and Gerald J. Leeling, counsel.
        Minority staff members present: Diana G. Tabler,
    professional staff member; and Richard F. Walsh, minority
    counsel.
        Staff assistants present: Jennifer R. Knowles and Breon N.
    Wells.
        Committee members' assistants present: Nick Ikeda,
    assistant to Senator Akaka; Juliet Beyler and Gordon Peterson,
    assistants to Senator Webb; Jeremy Bratt, assistant to Senator
    Blumenthal; Clyde Taylor IV, assistant to Senator Chambliss;
    Brad Bowman and Adam Hechavarria, assistants to Senator Ayotte;
    and Andrew King and Sergio Sarkany, assistants to Senator
    Graham.

            OPENING STATEMENT OF SENATOR JIM WEBB, CHAIRMAN

        Senator Webb. The subcommittee will come to order.
        I'd like to begin by apologizing to Senator Graham for
    knocking his water over when he was on his way. It had nothing
    to do with the delay in his arrival. [Laughter.]
        Senator Graham. I deserve it; I was late.
        Senator Webb. We meet today to receive the testimony from
    the Military Services on their Active, Guard, Reserve, and
    civilian personnel programs, in review of the National Defense
    Authorization Request for Fiscal Year 2012 and the Future Years
    Defense Program.
        I welcome our witnesses to today's hearing. The Army
    witnesses are The Honorable Thomas Lamont, Assistant Secretary
    of the Army for Manpower and Reserve Affairs and Lieutenant
    General Thomas Bostick, the Deputy Chief of Staff, G-1, United
    States Army. The Navy and Marine Corps witnesses are the
    Honorable Juan Garcia III, Assistant Secretary of the Navy for
    Manpower and Reserve Affairs; Vice Admiral Mark Ferguson III,
    Chief of Naval Personnel; and Lieutenant General Robert
    Milstead, Jr., Deputy Commandant for Manpower and Reserve
    Affairs, United States Marine Corps. The Air Force witnesses
    are The Honorable Daniel Ginsberg, Assistant Secretary of the
    Air Force for Manpower Reserve Affairs and Lieutenant General
    Darrell Jones, Deputy Chief of Staff for Manpower, Personnel,
    and Services, United States Air Force.
        Your complete statements have all been received. Without
    objection, all will be included in the record of this hearing,
    at the end of your oral statements.
        This is the third in a series of hearings, as we prepare to
    mark up the National Defense Authorization Act for Fiscal Year
    2012. In our first hearing, we received testimony from the
    senior noncommissioned officer of each Service regarding the
    state of enlisted personnel, force readiness, and family
    readiness. We also received testimony from representatives from
    military service organizations on their views of the needs of
    military personnel and their families.
        In our second hearing, we received testimony from the Under
    Secretary of Defense for Personnel Readiness, the Assistant
    Secretaries of Defense for Reserve Affairs and Health Affairs,
    and the Department of Defense (DOD) Comptroller. These
    officials testified about the personnel programs of DOD, and
    discussed efficiency initiatives included in the DOD budget
    submission.
        During these hearings, it became clear that the contracting
    workforce was not being evaluated as a part of the total force,
    even though contractors are performing many functions
    previously performed by military service personnel. The
    subcommittee has asked for more information about this
    component of the total force.
        Today, we will focus on military personnel policy and
    issues of the military Services, through the testimony of the
    Assistant Secretaries for Manpower and Reserve Affairs and the
    military personnel chiefs of each Service. I expect to discuss
    not only personnel policy programs and policies, but specific
    budget items, in furtherance of our subcommittee's oversight
    responsibilities.
        As I've said in the other two hearings, I take this
    oversight very seriously. There's no greater responsibility for
    Congress, and for our military leaders, than to care and
    provide for our servicemembers and their families. But in doing
    so we must ensure that we are effecting the relationship as
    stewards of the taxpayers' dollars, as well.
        As I've also said in earlier hearings, our military
    continues its engagement in the longest sustained period of
    major conflict in our Nation's history. Military personnel are
    challenged by high operational tempos, the stress of multiple
    deployments, inadequate dwell times, and an inefficient
    disability evaluation system. Our military families, by and
    large, are successfully dealing with the stress associated with
    frequent and lengthy deployments into dangerous war zones, but
    many are experiencing serious challenges. Because of my own
    experience, and my family's tradition of military service, I'm
    well aware of these challenges. I do appreciate our obligations
    to see the needs of servicemembers and their families, and I
    take that responsibility very seriously.
        The All-Volunteer Force has worked remarkably well over the
    past quarter century. We must ensure that the All-Volunteer
    model continues to produce the world's best military. It's
    important to recognize that we have an All-Volunteer Force, not
    an all-career force. We need to ensure that programs and
    policies also support those who serve in the military for a
    period less than a career before returning to their civilian
    communities. The contributions of these individuals are just as
    important as the contributions of career servicemembers.
        We also have entered a new era in the use of our Guard and
    Reserve Forces. They have played critical roles during this
    period in ways never envisioned at the inception of the All-
    Volunteer Force. This subcommittee will continue to explore
    changes needed to employ our Reserve component forces as an
    operational force.
        I look forward to hearing your testimony about the
    personnel issues of your Services. I'm aware that each of the
    Services are facing challenges in managing its forces over the
    next few years. Current plans require the Army to reduce end
    strength by 22,000 in fiscal year 2013, and an additional
    27,000 by the end of fiscal year 2016. The Marine Corps is
    planning to reduce end strength by 15,000 to 20,000, during the
    periods 2015 to 2017. Because of unusually high retention
    rates, the Navy and Air Force are implementing mandatory
    separation procedures in an effort to reduce end strength to
    authorized levels by the end of this fiscal year.
        As always, I would request that each of you discuss your
    challenges and how you plan to address these challenges, with
    particular emphasis on any legislative authorities you believe
    would be needed to shape your forces. Reducing the size of the
    force is never easy. It's important that it's done in a manner
    that respects the service of everyone who has given so much
    during this period of continuing conflict. Also, I would
    encourage you to express your views candidly, tell us what's
    working well, and raise any concerns and issues you may want to
    bring to this subcommittee's attention.
        Senator Graham, do you have any opening remarks?

                  STATEMENT OF SENATOR LINDSEY GRAHAM

        Senator Graham. Thank you, Mr. Chairman. As always, I enjoy
    conducting these hearings with you. I think our staffs work
    well together, and we have a lot of experience to offer the
    Senate about how to shape the force.
        Last week was about healthcare. We're having, I think, an
    unsustainable increase in healthcare cost in DOD. We're going
    to have to make some hard choices, sooner or later, because it
    affects everything we'd like to do in every other area.
        Disability evaluation systems, General Bostick, Secretary
    Lamont, I don't think you mention it in your written statement,
    if you would talk to us about the 20,000 nondeployable soldiers
    that are waiting some type of evaluation. What can we do to
    expedite their decision? How do we deal with the fact--not only
    are we going to reduce the Army, as Senator Webb indicated, but
    also, if you have 20,000 nondeployable, that goes into who can
    go to the fight. To me, that is a personnel issue we need to
    come to grips with.
        As many of you know, I'm a member of the Air Force Judge
    Advocate General (JAG) Corps. The recommendation to take three
    brigadier-general positions out of key major commands was
    opposed by General Schwartz and Secretary Donley. Secretary
    Ginsberg, I just want you to know, from my point of view,
    that's a decision that I think I have to push back on, because
    I'm fairly familiar with how the Air Force legal community
    operates. I think it would do more harm than good to reduce
    those brigadier general spots that serve the Air Force well.
        On the Navy-Marine side, we have a manning of 830 military
    attorneys. An independent review said we need 950. I'd like to
    know how we solve that problem.
        Basically, we're going to reduce the force, with the view
    that there must be some peace dividend that I don't see coming
    anytime soon. I do hope we can reduce our forces in
    Afghanistan, slowly but surely. We're going to withdraw most of
    our forces from Iraq. But, at the same time, just because of
    the operational tempo that we've experienced in the last
    decade, when you draw your forces down, that means those who
    are left are going to have to do more. I just really question,
    is that a wise decision? I'd like to get comments from each of
    you about how you think that affects retention and recruiting.
    How do we reduce this force? What kind of system do we come up
    with to reduce? Do we tell people they can't retire at 15
    years? What do we do?
        So, with that, I look forward to hearing your testimony.
        I really appreciate working with you Senator Webb.
        Senator Webb. Thank you very much, Senator Graham.
        We will begin with Secretary Lamont and just move across
    the table, from my left to my right.
        Secretary Lamont, welcome back, and we're very interested
    in hearing your testimony.

    STATEMENT OF HON. THOMAS R. LAMONT, ASSISTANT SECRETARY OF THE
                 ARMY FOR MANPOWER AND RESERVE AFFAIRS

        Mr. Lamont. Thank you, Mr. Chairman, Senator Graham, other
    members of the subcommittee. I'm glad to be here. Thank you for
    taking the time to explore these very important topics, so
    crucial to our Nation's defense today and in the future.
        For nearly 2 years, I've served as the Army Assistant
    Secretary for Manpower and Reserve Affairs. During that time,
    we have worked hard to meet the challenges facing the Army and
    to prepare our force for the future. Our Army is stretched and
    strained. However, the resilience, determination, and values
    displayed by our soldiers, Army civilians, and families is
    remarkable. I am honored to serve such a committed group of
    individuals.
        To lessen the strain on our soldiers, we need to make the
    most of the force we have. Maintaining appropriate strength and
    developing the proper force mix in our Active and Reserve
    components will be critical to the future of our force. Our
    effort to create a more appropriate total force policy
    continues. We want to partner with you and all the other
    stakeholders to codify the Reserve component as an operational
    force and to develop better career models for our soldiers and
    civilians.
        We will make the changes necessary regarding the realities
    of our fiscal situation as well. We are moving forward with
    personnel efficiencies and aggressively enacting cost-saving
    measures throughout our Army. We are committed to the work
    associated with managing our resources properly, even as we
    conduct the largest transformation since World War II, the 2005
    base realignment and closure initiative, as well as fighting
    two major conflicts and completing our modular conversions. The
    Army personnel community is focused on maintaining the
    unprecedented quality of the All-Volunteer Force in order to
    accomplish the missions at hand and to prepare the Army for the
    challenges of tomorrow.
        Please know that the Army is filled with devoted civilian
    and military leaders, committed soldiers, and dedicated
    families. We certainly have challenges, but we have significant
    opportunities, as well. One of our most significant
    opportunities is to capitalize on lessons learned over the past
    10 years to create a force that is the right size with the
    right capabilities with the best-developed military and
    civilian leadership.
        In closing, our Army is a total force that has been tested.
    We've been successful, and now we are focused on planning for
    the future while maintaining our strength. We appreciate the
    subcommittee's support in accomplishing all we've done, and we
    look forward to your support in the future.
        Thank you very much. I look forward to your questions.
        [The joint prepared statement of Mr. Lamont and General
    Bostick follows:]
      Joint Prepared Statement by Hon. Thomas R. Lamont and LTG Thomas P.
                                  Bostick, USA
                                  introduction
        Chairman Webb, Senator Graham, distinguished members of this
    subcommittee, thank you for the opportunity to appear before you on
    behalf of America's Army. The U.S. Army exists to serve the American
    people, and defend the Nation.
        After nearly 10 years at war, our soldiers, civilians, and families
    are stretched and strained, yet still resilient. Their dedicated
    service and sacrifice deserve the very best services, programs,
    equipment, training, benefits, lifestyle, and leadership available.
    With Congress' help, the Army has reached its objective end strength,
    which combines ``Grow the Army'' and Temporary End Strength Increase
    (TESI). This enabled our success in Iraq and Afghanistan.
        With the reduction in forces in Iraq and Afghanistan, the Army must
    prepare to draw down our forces in a deliberate and careful manner.
    Thank you for your steadfast commitment to our soldiers, their
    families, and our civilian workforce. By supporting our personnel
    initiatives you ensured sustainment and well-being of our All-Volunteer
    Force.
                               strategic overview
        More than 1.1 million soldiers have deployed to combat, impacting
    not only those soldiers, but their families and employers as well.
    Additionally, Army civilians shoulder a majority of the Generating
    Force mission, and 30,000 civilians have deployed into harm's way.
        Despite this unprecedented operational demand, the Army is on track
    to achieve a sustainable deployment tempo for our forces and restore
    balance to the Army beginning in fiscal year 2012. We will continue to
    face challenges on multiple fronts including an ever increasing
    nondeployable population resulting from multiple deployments. This
    problem, coupled with an inefficient disability system, does not
    effectively support Army Readiness, our soldiers, and their families.
        We must continue to work a solution between the Services, the
    Department of Defense (DOD), and VA to streamline the disability system
    with improved coordination for health care, compensation, and benefits.
    We remain aware of the difficult economic conditions at home. These
    conditions will give greater impetus to our efforts to seek 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, health, 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. Our efforts must remain focused on
    the preservation of our most precious resource, our people.
        In fiscal year 2012, the base military personnel appropriation
    comprises the largest portion of the Army's budget at $60.68 million or
    42 percent. The table below shows the fiscal year 2010 execution
    (excluding OCO) and the fiscal year 2011 and fiscal year 2012 base
    budget requests for military personnel for all three components. The
    increase from fiscal year 2011 to fiscal year 2012 is due primarily to
    changes in inflation rates for military basic pay and personnel
    allowances.

                            [In millions of dollars]
    ------------------------------------------------------------------------
                                                      Fiscal Year
         Military Personnel Account      -----------------------------------
                                           2010 \1\      2011        2012
    ------------------------------------------------------------------------
    Personnel (AC, NGB, and USAR).......     $53,381     $53,994     $55,606
    Medicare-Eligible Retiree Health           5,035       5,057       4,972
     Care...............................
                                         -----------------------------------
      Total.............................     $58,416     $59,050     $60,578
    ------------------------------------------------------------------------
    \1\ Not depicted in fiscal year 2010 Military Personnel Cost of War was
      $12.2 billion.
    Fiscal year 2011 OCO request is $11.9 billion and fiscal year 2012 OCO
      request is $8.1 billion.
    Fiscal year 2010 figures represent execution amounts.

                                  end strength
        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--nondeployable soldiers, temporary requirements
    in various headquarters and transition teams, our wounded warriors, and
    elimination of Stop-Loss--have impacted our ability to adequately man
    units for deployment. As a result, the Secretary of Defense approved an
    additional temporary end strength increase of 22,000 soldiers, 7,000 of
    whom joined us in early fiscal year 2011. Army end strength will return
    to the congressionally-approved Active component end strength of
    547,400 by the end of fiscal year 2013. For fiscal year 2012, the Army
    National Guard end strength will remain 358,200 and the USAR will
    maintain 205,000.
        As of April 2011, the last soldier retained under Stop Loss for
    deployment purposes was separated. This reflects an overall reduction
    from the January 2009 baseline of 13,217 stop-lossed soldiers. TESI and
    the implementation of voluntary stabilization programs for each
    component enabled us to eliminate Stop Loss, while minimizing the
    impact on unit readiness.

                            [In millions of dollars]
    ------------------------------------------------------------------------
                                                      Fiscal Year
                                         -----------------------------------
                                             2010        2011        2012
    ------------------------------------------------------------------------
    Temporary End Strength Increase       $1,108 \1\      $1,245      $1,143
     Request............................
    ------------------------------------------------------------------------
    \1\ Fiscal year 2010 includes TESI and overstrength execution. Fiscal
      year 2010 figures represent execution amounts.

        We continue to make significant progress in our efforts to restore
    balance. Increasing time between deployments for our soldiers and
    building greater predictability for soldiers and families continues to
    be one of our key concerns. Despite the short-term impact of the recent
    surge of troops to Afghanistan, we expect the ratio of Boots on Ground
    (BOG) time to dwell time to improve as demand decreases. This will ease
    the constant pressures on our forces as they move through the
    rotational cycle of the Army Forces Generation (ARFORGEN) model.
                recruiting and retention (officer and enlisted)
        Our soldiers are the Army's most important resource, and our
    ability to meet the challenges of the current and future operational
    environment depends on our ability to sustain the All-Volunteer Force.
    The pace and demand of the operational environment over the last
    several years has caused us to focus on high-volume recruiting with an
    emphasis on quality benchmarks. The shift in the economy combined with
    our initiatives in marketing, advertising, and hard work of our
    recruiters has allowed us to be more selective.
        Despite the challenges of an Army engaged in two protracted
    conflicts, the Army exceeded its enlisted recruiting and retention
    missions for fiscal year 2010 and is confident it will meet its goals
    for fiscal year 2011. The Army National Guard reduced their accessions
    in fiscal year 2010 to remain under the congressionally-mandated end
    strength ceiling. The Army met its quality benchmarks for new recruits
    in fiscal year 2010. We are projected to build the fiscal year 2012
    entry pool to as much as 50 percent of the fiscal year 2012 mission by
    the end of fiscal year 2011. We will continue to monitor trends and
    make adjustments as required.
        In fiscal year 2010, with congressional support, the Army spent
    $4.4 billion on recruiting and retention. In fiscal year 2011, the Army
    plans to spend $4.4 billion to fund contracts written between fiscal
    year 2007 and fiscal year 2010 due to continued obligations of
    anniversary payments to soldiers.
        Recently, incentive contracts have dropped dramatically for new
    accessions. Average recruiting bonuses dropped from over $13,000 in
    fiscal year 2009 to just under $3,000 in fiscal year 2011, and are only
    used to incentivize longer-term enlistments in a small percentage of
    critical skills. These incentives are only used to ensure the success
    of the total Army recruiting and retention missions and to shape the
    force to meet specific grade and skill requirements.
        Our fiscal year 2012 request of $3.7 billion reflects the
    efficiencies undertaken in these activities based on a more favorable
    recruiting and retention environment with a high percentage of the
    budget dedicated to prior year payments. The amount budgeted for
    contractual payments is anticipated to decrease until fiscal year 2015,
    when requirements will likely increase due to a stronger economy.
        The reductions/efficiencies taken in recruiting and retention are
    in support of the Secretary of Defense's plan to reallocate funding to
    more critical programs. These reductions went primarily to resource the
    increased number of field grade officers that the Army is currently
    growing. Additionally, increases were made to medical special pays to
    ensure that shortages in high demand specialties were addressed, and
    finally, resources were aligned to fully fund the more senior force
    structure that the Army is experiencing.
        In fiscal year 2010, the Active Army accessed the highest
    percentage of high school diploma graduates since fiscal year 1992
    (increasing from 94.7 percent in fiscal year 2009 to 98.3 percent in
    fiscal year 2010). The Army met its skill-set needs, achieving over 99
    percent Military Occupational Specialty (MOS) precision. We entered
    fiscal year 2011 positioned for continued success, with 33,276 future
    soldiers in the delayed entry pool. The last time the delayed entry
    pool topped 33,200 was in 1996.
        The Army also has developed valuable new tools to screen non-high
    school graduates and other applicants for attributes indicating
    potential for success in a military career. Assessment tools such as
    the Army's Tailored Adaptive Personality Assessment System (TAPAS)
    offer the Army the option to consider high potential soldiers
    regardless of their educational background. The TAPAS instrument
    enhances the selection of soldiers regardless of their education
    credentials by screening out low motivated, high attrition risk
    applicants and provides a scoring of applicants to predict the
    likelihood of success as a soldier. The TAPAS is under development by
    the Army but has already been used as a screening tool to evaluate and
    screen out a small number of low motivated CAT IV Army applicants. To
    date, more than 157,000 Army and Air Force applicants have been tested
    with the Army's TAPAS instrument and the Navy expects to begin to use
    the instrument with their recruits before the end of the second quarter
    of fiscal year 2011.
        Additionally, recruits scoring in the upper range (50-99 percent)
    on the Armed Forces Qualification Test (AFQT) remain well above the
    Department of Defense (DOD) policy (DODI 1145.01, September 20, 2005)
    on quality marks of 60 percent, and recruits who scored in the lower
    range (30 percent and below) on the AFQT decreased 0.7 percent. The
    Army collectively decreased the number of ineligibility waivers
    provided for enlistments and appointments by 4.20 percent from the
    previous fiscal year.
        Despite our success in recruiting, the Army and the Nation face a
    silent epidemic with increased obesity and decreased graduation rates
    in certain parts of the country. Currently, less than one in four 17-24
    year-olds are eligible, primarily due to physical and educational
    requirements. One in five youths fails to graduate high school.
    Increased obesity rates among young people also provide fewer potential
    recruits that are eligible to serve. One in five youths, 12-19 years
    old, is currently overweight, compared to 1 in 20 in the 1960s. This
    trend is projected to grow to 1 in 4 by 2015.
        The Army continues to retain soldiers at tremendously high levels,
    while engaged in the longest period of conflict for our All-Volunteer
    Force. The Army surpassed the total Army retention goal, each year,
    since 2002. Soldiers reenlist for three top reasons which include their
    current command climate, job satisfaction, and the quality of life in
    the Service.
        Additionally, retention rates within the last 12 months are
    slightly higher due to the current state of the economy. In fiscal year
    2010, the Active Army reenlisted 68,105 soldiers towards an annual
    mission of 60,000. Soldiers extending to complete deployments with
    their units represented 8,100 of the total. The Army Reserve reenlisted
    10,921 soldiers, exceeding their annual goals by 6 percent. The Army
    National Guard accomplished their mission as well by achieving 106
    percent of their assigned mission; a total of 32,156 soldiers.
        During fiscal year 2010 and into fiscal year 2011, retention
    bonuses were carefully monitored and adjusted to ensure that the Army
    met its retention goals while remaining fiscally responsible. As we
    posture for future reductions in the size of our force, the Army is
    using lessons learned from past reductions to ensure that today's
    decisions maintain the viability of tomorrow's All-Volunteer Force.
    Retention policies will emphasize retention of soldiers with high
    potential coupled with appropriate force alignment and structure.
        The Army's programs to recruit and retain both officers and
    enlisted soldiers with critical skills have been effective. For
    enlisted soldiers, the Enlistment Bonus, the Selective Reenlistment
    Bonus, Critical Skills Retention Bonus (CSRB), and the Student Loan
    Repayment Program (SLRP) are proven tools that remain effective for
    filling critical skills. The SLRP is especially effective in attracting
    high potential recruits who have some college experience or plan to
    attend college after the Army. All bonuses are being used very
    selectively. Projected spending in Army enlistment recruiting,
    retention, and education incentives will decrease 26 percent in 2012.
        The U.S. Military Academy (USMA) and ROTC both continue to offer
    precommissioning incentives. These consist of offering new officers
    their post, branch of choice or graduate schooling. From fiscal year
    2006 through fiscal year 2010, there were approximately 7,500
    participants. These incentives have increased longevity by 40 percent
    for newly-commissioned, high-performing USMA and ROTC officers, and
    have improved the historical loss rates of recent years by adding 3
    guaranteed years of active service to these officers' initial obligated
    service. This specific gain is based on rates for Army Competitive
    Category officers remaining on active duty after 8 years of service
    from their commissioning date. The historical rate for continued
    service beyond the obligatory 8-year point is 47 percent of officers.
    The projected rates for year groups 2006-2010 who took the incentives
    cited are between 62 percent and 69 percent across all commissioning
    sources. In absolute terms we are retaining an additional 7,500
    officers across these groups. When considering USMA alone, our
    improvements across these year groups range from the historical average
    of 40 percent (beyond the 8 year obligation) of West Point officers to
    between 54 percent and 59 percent. Again, in absolute terms we will
    retain an additional 1,700 West Point graduates through these
    initiatives.
        The rapid growth of the Army over the past 10 years to meet the
    needs of a new modular and expeditionary force combined with the
    requirements of Overseas Contingency Operations in two combat theaters
    have resulted in an officer structure that is not optimally balanced to
    meet Army needs. Our accelerated growth of personnel to match the
    manning requirements of new unit designs has been very successful, but
    we are still working to achieve a balanced inventory of skills and
    grades for the force in a steady state operating environment.
        The Army's use of the CSRB for captains contributed significantly
    to officer retention over the past several years. Retention rates
    within company grade officers, as well as majors, allowed the Army to
    keep pace with officer requirements as we grew the force. Our under-
    accession in the mid-1990's officer year groups left the Army with too
    few officers in these year groups to attain full manning strength at
    major. Our adjustment of officer force structure, combined with high
    retention and mandated end strength reductions, will allow us to
    achieve full manning at Major grade much sooner than we originally
    predicted. The Reserve component continues to maximize their use of the
    CSRB, while the Active component has reduced the overall usage as
    officer target levels are met.
        In response to adjustments to officer structure, the Army will
    balance modest reductions in officer accessions across all cohorts over
    the next 4 years. Both these actions will help to mitigate the effects
    of downsizing on the officers currently in career development at
    company grades, There will be opportunities to cross level skills in
    the Active component, change components from Active to Reserve, and
    employ some company grade officers in field grade positions wherever
    there is potential for return on that investment. Involuntary
    separations will likely be used in force reductions; however, the Army
    is committed to utilizing voluntary or incentivized separations as
    available.

                            [In billions of dollars]
    ------------------------------------------------------------------------
                                                          Fiscal Year
                 Program Description              --------------------------
                                                     2010     2011     2012
    ------------------------------------------------------------------------
    Enlisted Army Incentives.....................     $2.1     $2.1     $1.5
    Other Military Recruiting and Retention            2.3      2.3      2.2
     Programs....................................
    Army Recruiting and Retention................      4.4      4.4      3.7
    ------------------------------------------------------------------------
    Fiscal Year 2010 figures represent execution amounts.

       transforming the army's reserve components into an ``operational
                         force'' (operational reserve)
        The war-time experiences of the past decade validate the need to
    institutionalize the policies, procedures and legislation conducive to
    achieving the most efficient utilization of the Total Force, by
    transitioning the Reserve components into an operational force.
    Transitioning to an Operational Reserve will require policy decisions
    on additional resources for the two Army Reserve components (RC) within
    the base budget, including additional resources for RC collective
    training, full-time manning and medical/dental readiness.
        The Reserve components make up 51 percent of the Army's manpower.
    Moreover, many of the capabilities that the combatant command would
    prefer to use in Theater Security Cooperation either do not exist in
    sufficient quantities in the Active component, but reside in the RC.
    For example, approximately 90 percent of the Army's Civil Affairs
    forces are in the USAR.
        In the near term, we must ensure that the RC is capable of
    providing enduring proportional support to the Army's force generation
    supply model: 1 Corps, 5 Divisions, 20 Brigade Combat Teams, and 90,000
    enablers (1/5/20/90) through fiscal year 2014.
        Transforming the Army's Reserve components into an operational
    force provides an 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. Investing in the RC as an operational force will
    position the Army to better manage the risks of declining resources for
    the Army.
                            army total force policy
        The ASA (M&RA) is developing an ``Army Total Force Policy'' for the
    Secretary of the Army. The policy will define the role of the Army
    National Guard and Army Reserve as an operational force;

              ``The ARNG and USAR provide operational capabilities and
            depth to rapidly expand and sustain the Army's capacity to
            support U.S. defense requirements across the spectrum of
            conflict (peace to war).'' (Draft Army Total Force Policy)

        The Army Total Force Policy will promote a balanced and integrated
    Total Force. The ARFORGEN process will ensure operating forces are
    employed as ``integrated expeditionary force packages''.
        Integrating Active and Reserve Forces for training and deployment
    requires a common Active and Reserve ``boots-on-the-ground'' policy, to
    be approved by the Secretary of the Army.
        Procedures, processes and authorities for validating pre-deployment
    readiness of Army forces should be consistent and uniform for Active
    and Reserve Forces.
        Manpower programs will promote a continuum of service, cross-
    component assignments, and common standards and provide equal
    opportunities for professional development, regardless of component.
        Training programs will promote common standards and equal
    opportunity via a revised ``One Army'' school system, while
    capitalizing on capabilities and investments made in the Reserve
    component training facilities over the past decade.
        The Army has a historic opportunity to achieve the most cost-
    effective Total Force through transitioning the RC into an operational
    force. The ``Army Total Force Policy'' will promote an operational
    environment in which Active and Reserve Forces are able to serve
    together in peacetime and train and deploy together as an integrated
    Total Force for operations.
                     individual ready reserve mobilization
        The Individual Ready Reserve (IRR) is a category of the Ready
    Reserve, and is composed of those members of the Ready Reserve who are
    not serving in Selected Reserve units or assignments, or in the
    Inactive National Guard. The availability of IRR soldiers is important
    to the Army's mission of providing properly trained and equipped units
    of sufficient strength to meet contingency operations or mobilization
    requirements.
        Since September 11, 2001, approximately 538,000 soldiers were
    members of the IRR. Of that total population 31,885 soldiers were
    mobilized and a total of 12,524 soldiers deployed to the Central
    Command (CENTCOM) Area of Responsibility after No Shows, Exemptions,
    and Early Release from Active Duty were factored.
        An effective IRR program is based on several factors, including the
    soldiers' understanding of their obligations, access to benefits and
    support, and time to adjust personal affairs prior to mobilizations.
        In an ongoing effort to validate the readiness of the IRR, the Army
    continues to implement the IRR Muster program, and is piloting a new
    IRR affiliation program.
        Approximately 5 months after entering the IRR program, soldiers
    will be ordered to muster duty. Afterward, soldiers are required to
    muster each year they remain in the IRR.
        Through the muster program, the Army established a partnership with
    the Department of Veterans Affairs to use VA medical centers as muster
    sites for the added opportunity of connecting soldiers to VA services.
    During fiscal year 2010, the Army spent approximately $2.57 million to
    muster 12,500 soldiers, contributing 2,100 soldiers returning to Army
    Reserve formations. The Army plans to muster 14,000 IRR soldiers at an
    estimated cost of $3.01 million in fiscal year 2011 and expects to
    impact 2,500 soldiers returning to Army Reserve formations. In fiscal
    year 2012, the Army plans to muster approximately 20,000 soldiers for a
    total program cost of $4.8 million.
        The IRR affiliation program affiliates a soldier with a local Army
    Reserve unit (and will potentially include Army National Guard units).
    While there is no obligation for the IRR soldier to engage with the
    unit, the potential benefit of established communication between the
    unit and the soldier will enhance HRC's ability to maintain
    accountability and reliable contact information on IRR soldiers.
    Advantages to JRR soldiers include the opportunity to participate in
    unit drills for retirement points, SRP annually, and use the unit's
    support structure to assist the soldier and family as needed while in
    the IRR.
                                quality of life
        The strength of our Army is tied to the strength of Army families.
    We must provide our Army the best possible care, support and services
    by establishing a cohesive holistic Army-wide strategy to synchronize
    and integrate programs, processes and governance. One of the programs
    designed to accomplish this is the Army Family Covenant.
        The Covenant institutionalizes the Army's commitment to provide
    soldiers and families a quality of life commensurate with the quality
    of service they provide to our Nation. The Army Family Covenant
    incorporates programs designed to build strength and resilience in our
    Families. These services and programs help mitigate stress from
    multiple deployments and frequent military moves.
        The Covenant focuses on the following: standardizing soldier and
    family programs; increasing access to and quality of health care;
    improving soldier and family housing; ensuring excellence in our
    schools and, youth and child care services; expanding education and
    employment opportunities for family members; improving soldier quality
    of life in recreation, travel, and the Better Opportunities for Single
    Soldiers (BOSS) program; and improving relationships with local
    communities and marketplaces. From fiscal year 2007 to fiscal year
    2010, the Army more than doubled its investment in Family programs.
    These various programs are intended to provide a broad spectrum of
    support and include important programs as Mobilization and Deployment
    Readiness, Family Advocacy, New Parent Support, Army Spouse Employment
    Partnership, Survivor Outreach Services, Family Assistance Centers
    (ARNG), Yellow Ribbon Reintegration, Army Reserve Teen Panel, Army
    Affiliated Child Care & Youth Programs and Core Community Recreation
    Programs and Services.

                            [In millions of dollars]
    ------------------------------------------------------------------------
                                                      Fiscal Year
              Convenant Program          -----------------------------------
                                             2010        2011        2012
    ------------------------------------------------------------------------
    Family MWR Command (FAPC)...........    $   60.3    $   38.9    $   35.1
    Army Community Service (QACS/VFRA/         373.5       434.9       371.9
     QPSG)..............................
    Child Care Services (QCYS)..........       426.5       410.1       411.0
    Youth Programs (QCYS)...............       134.5       163.8       154.0
    Community Recreation (QDPC).........       292.4       275.9       257.4
    ------------------------------------------------------------------------
    Family Programs.....................     1,287.2     1,323.6     1,229.2
    ------------------------------------------------------------------------
    Voluntary Ed/Tuition Asst (VACE/           395.4       377.4       355.4
     VATA)..............................
    Supplemental/OCO....................        47.7        53.5        53.5
                                         -----------------------------------
      Total Family Programs.............    $1,730.3    $1,754.5   $41,638.1
    ------------------------------------------------------------------------
    Fiscal year 2010 figures represent execution amounts.

                  civilian personnel and workforce development
        Department of the Army civilian employees provide vital support to
    soldiers and families in this era of persistent conflict. They share
    responsibility for mission accomplishment by delivering combat support
    and combat service support--at home and abroad. Civilians comprise 23
    percent of the Army Force, yet are 60 percent of the generating force.
    This generating force performs support missions of training, supplying
    and engineering the force. Today, the Army Civilian Corps has over
    311,000 appropriated fund employees with 4,130 currently serving in
    harm's way in the CENTCOM area of operations.

                            [In billions of dollars]
    ------------------------------------------------------------------------
                                                      Fiscal Year
                Civilian Pay             -----------------------------------
                                             2010        2011        2012
    ------------------------------------------------------------------------
                                               $24.4       $23.8       $23.3
    ------------------------------------------------------------------------
    Fiscal year 2010 figures represent execution amounts.

    ------------------------------------------------------------------------
                                                      Fiscal Year
         Full-Time Equivalents (FTE)     -----------------------------------
                                           2010 \1\    2011 \1\    2012 \1\
    ------------------------------------------------------------------------
    Army funded.........................    $173,142    $180,107    $178,918
    External funded.....................      47,505      57,267      55,133
    Revolving fund......................      29,824      27,947      23,317
                                         -----------------------------------
      Total.............................    $250,471    $265,321   $257,368
    ------------------------------------------------------------------------
    \1\ Civilians funded by OCO and Civil Works appropriations which are not
      captured as any part of the Army's budget submission.

        Since September 11, 2001, we increased the civilian workforce in
    military functions from 222,000 to 286,654 (plus 24,694 Civil Works)
    due to overseas contingency operations, Defense Health Program
    increases, Family and Soldier Support initiatives, acquisition
    workforce growth, in-sourcing functions performed by contractors,
    military technician increases, and military-to-civilian conversions. In
    fiscal year 2009, the Army saved significant resources by in-sourcing
    949 contractor positions to Army civilian positions. Overall, 7,736
    civilian positions were filled by in-sourcing, as of February 1, 2011.
        Approximately 25,000 Army civilian positions are affected by BRAC
    2005. We expect a large number of transfers and some separations to
    occur between now and September 2011. In fiscal year 2010 over 3,200
    employees relocated with their positions; 1,920 employees were eligible
    for some type of retirement and chose to retire; 680 employees were
    placed in positions via the DOD Priority Placement Program (PPP); and
    800 employees left their positions because they applied and were
    selected for positions within the DOD or other Federal agencies. For
    those employees who are being displaced or separated as a result of
    BRAC, Army offers an outplacement service program to assist them in
    their transition to other jobs either within the Federal service or to
    the private sector.
        The Department of the Army implemented a Civilian Workforce
    Transformation plan that will invigorate development of the Civilian
    Workforce by addressing critical issues of structure, accession,
    development, retention and succession planning to ease the transition
    from one generation to the next. Examples of the Army's initiatives in
    the area of Civilian Workforce Transformation include:

             Structure. Introduction of an enterprise-based,
            requirements-driven, civilian structure that will better
            support all phases on the Civilian Human Capital Life-cycle.
             Acquire. An accessions program for all new Army
            civilians provided through acculturation training, program
            evaluation and adjustments tailored to requirements.
             Develop. Progressive, sequential functional/leadership
            development training for civilians consistent with Army values.
             Distribute. Central selection and placement of high
            performing civilians against required Army Enterprise
            positions.
             Sustain. Fully integrated IT structures that support
            Army Career Tracker and Civilian Development Programs.

        By the end of fiscal year 2011, the Army will document and
    promulgate a reformed civilian hiring process, and will implement a
    comprehensive executive competency-based leadership development
    program. By second quarter fiscal year 2011 the path and resource
    requirements for 100 percent of the workforce will be covered by
    professional career program management. Additionally, by first quarter
    fiscal year 2012, the Army will initiate education, training, and an
    experiential development program for its enterprise leadership cohort.
    The Army will also fully deploy a competency-based management system
    for SES talent acquisition, development and succession planning. Thus
    far, funding in support of CWT is executed with current year funding.
    Beyond that remains pre-decisional.
        The Civilian Workforce Transformation will provide civilian
    employees with a defined ``roadmap'' for success with training and
    development opportunities to assist achievement of career goals. It
    will provide commanders the right workforce with the right skills to
    meet current and future mission needs. It will provide the Army a
    predictable and rational method to articulate requirements and make
    decisions about resourcing in a fluid environment. It will provide the
    Nation with the investment in human capital required to effectively
    manage the Institutional Army.
                     army military equal opportunity policy
        The Army is the leader in Military Equal Opportunity (MEO) policy
    and practice. Commanders at all levels are responsible for sustaining
    positive MEO climates within their organizations, enhancing Army
    Readiness. To remain relevant within the ever-changing environment in
    which we operate, the Army is revising its MEO policy by integrating
    and institutionalizing equal opportunity goals, objectives and training
    practices. This effort will strengthen the foundation of the Army's
    Human Capital Strategy. Since fiscal year 2009, the Army has invested
    $3.2 million to include $O.8 million in fiscal year 2011, and expects
    to invest another $2.0 million in fiscal year 2012 for MEO personnel
    services support, database and survey systems, outreach support, and
    training contracts for implementation.
                    sexual assault and harassment prevention
        The Army's goal is to eliminate sexual assault and harassment by
    creating a climate that respects the dignity of every soldier. The Army
    Sexual Harassment/Assault Response and Prevention (SHARP) Program
    reinforces the Army's commitment to eliminate incidents of sexual
    harassment and assault. This will be accomplished through a
    comprehensive policy that centers on awareness and prevention; training
    and education; victim advocacy; and response, reporting, accountability
    and program assessment. The Secretary of the Army and the Chief of
    Staff of the Army remain personally involved and reinforce to all
    soldiers and leaders the importance of preventing sexual assault and
    harassment.
        The Army launched a comprehensive sexual assault prevention
    strategy that requires leaders to establish a positive command climate
    where sexual assault is clearly not acceptable. The strategy further
    encourages soldiers to execute peer-to-peer intervention personally,
    and to not tolerate behavior that could lead to sexual assault.
        This strategy consists of four integrated phases and extends
    through calendar year 2016 as we work to be the Nation's leader in
    sexual harassment and sexual assault prevention.
        Phase I (Committed Army Leadership) provides training on best
    practices and allows commands the opportunity to develop prevention
    plans to support the Army strategy.
        Phase II (Army-wide Conviction) includes educating soldiers to
    understand their moral responsibility to intervene and stop sexual
    assault and harassment. This phase has been delivered to installations
    worldwide.
        Phase III, which the Army is now focused on, is dedicated to
    ``Achieving Cultural Change'' and fosters an environment free from
    sexual harassment and sexual assault.
        The final phase is ``Sustainment, Refinement, and Sharing.'' Here,
    the prevention program continues to grow while motivating national
    partners to support our efforts to change generally accepted negative
    social behaviors. The end state is the total elimination of the crime
    of sexual assault.
        A key component of I.A.M. Strong is a comprehensive effort to
    improve the investigation and prosecution of sexual assault cases. The
    Army formally investigates every allegation of sexual assault reported
    through an unrestricted report. Although this practice may contribute
    to a seemingly high number of investigations, more importantly, it
    demonstrates the Army's commitment to eradicate this crime within its
    ranks.
        The Army enhanced its investigation and prosecution capabilities by
    hiring 30 additional special investigators and adding 15 special
    prosecutors; and hired 33 of 35 additional lab examiners at the U.S.
    Army Criminal Investigation Laboratory which supports all of DOD and
    the military Services in processing forensic evidence.
        During fiscal year 2010, the Army conducted trial advocacy training
    for approximately 500-600 Judge Advocates responsible for the
    prosecution and defense of sexual assault cases. This training is
    delivered to Judge Advocates in the United States and in deployed
    environments. During fiscal year 2011, the Army's Office of the Judge
    Advocate General (OTJAG) will execute 38 training programs with
    emphasis on the prosecution of sexual assault cases.
        The Army has approximately 774 collateral duty personnel serving as
    Deployable Sexual Assault Response Coordinators (SARCs) in brigades and
    higher and approximately 17,000 collateral duty personnel serving as
    unit victim advocates in battalions and below. In addition, the Army
    has 38 full-time civilian SARC and 171 collateral duty civilian
    installation victim advocates.

                            [In millions of dollars]
    ------------------------------------------------------------------------
                                                          Fiscal Year
                                                  --------------------------
                                                     2010     2011     2012
    ------------------------------------------------------------------------
    SHARP (Sexual Harrassment)...................    $53.3    $28.6    $24.8
    ------------------------------------------------------------------------
    Fiscal year 2010 figures represent execution amounts.

                           suicide prevention program
        The loss of any soldier is a tragedy, particularly when it could
    have been prevented. One suicide is too many and we are working hard to
    address the suicides across the total force. There were 156 suicides by
    Active-Duty soldiers during 2010, a slight decrease from 162 suicides
    in 2009. However, there were 147 suicides by Non-Active Duty members of
    the Army Reserve and National Guard. This represents an increase of 80
    suicides over the 2009 report. The surveillance, detection and
    intervention systems that we use to monitor the Active-Duty Force have
    limited abilities to assist our soldier/citizens--who are not full-time
    and reside in civilian communities away from their units. Approximately
    50 percent of these ARNG and USAR suicide deaths have no deployment
    history.
        The Army Health Promotion, Risk Reduction and Suicide Prevention
    (HP/RR/SP) Report 2010 is the foundation for a systemic effort to
    address suicide. This report has identified critical gaps throughout
    the system that resulted in increased high risk behavior and adverse
    outcomes. Additionally, partnering with national mental health
    professionals refines and improves our programs, including the Army
    Study to Assess Risk and Resilience in Servicemembers. This is the
    largest study of suicide and mental health among military personnel
    ever undertaken.
        Leaders across the Army are using all of these efforts to improve
    the health of the force, decrease high risk behavior and stem the rate
    of suicides. Only through increased vigilance and attention to each
    soldier will this problem within our ranks cease to exist.

                            [In millions of dollars]
    ------------------------------------------------------------------------
                                                          Fiscal Year
                                                  --------------------------
                                                     2010     2011     2012
    ------------------------------------------------------------------------
    HP/RR/SP (suicide)...........................    $29.4    $54.6  $52.4 \
                                                                          1\
    ------------------------------------------------------------------------
    \1\ Fiscal year 2010 figures represent execution amounts.

                          army substance abuse program
        The Nation's persistent conflict has created symptoms of stress for
    our soldiers, including an increase in alcohol and drug abuse. The Army
    Substance Abuse Program (ASAP) is a commander's program that uses
    prevention, education, deterrence, detection, and rehabilitation, to
    reduce and eliminate alcohol and drug abuse. It is based on the
    expectations of readiness and personal responsibility.
        In March 2010, the Army conducted a counselor requirements analysis
    based on each installation's average daily client census with a ratio
    of 1 counselor: 30 patients. Patient caseload was as high as 60/
    counselor at some installations. The 1:30 ratio is an accepted ratio
    based on literature and counselor input. Applying this ratio yielded a
    requirement of 562 counselors assuming a 20 percent growth in number of
    patients.
        An Army priority in this area includes the hiring of more
    counselors. There is a finite pool of qualified substance abuse
    counselors nationwide and the Army is competing with private industry,
    the Department of Veterans Affairs, and State and local governments.
    The Army currently has hired 384 of the 562 counselors needed. The Army
    is increasing the use of recruiting, relocation, and student loan
    reimbursement incentives to attract more qualified candidates, and are
    developing a ASAP Counselor Internship Program which will allow
    students with Masters degrees to work in a supervised internship for up
    to 2 years as they attain their licenses and substance abuse counselor
    certifications.
        The Confidential Alcohol Treatment and Education Program (CATEP),
    began in July 2009 and offers confidential alcohol treatment to
    qualified soldiers. For these soldiers, the chain of command is not
    informed of the soldiers enrollment as was previously customary. This
    pilot program was initially offered at Fort Lewis, Fort Richardson, and
    Schofield Barracks. An initial assessment was conducted in March 2010,
    and the Secretary of the Army directed that the pilot be expanded to
    include Forts Carson, Riley, and Leonard Wood. The initial assessment
    showed moderate success in attracting soldiers and placed more career
    NCOs and younger officers into treatment. Soldiers who participated in
    CATEP were very positive about the opportunity to take care of their
    issues without commander knowledge and were more motivated as patients.
    Some soldiers informed their commanders about their enrollment and
    these commanders had a high acceptance of the program. The program will
    be assessed again during April and May 2011 and a decision will be made
    by the Secretary regarding expansion of the confidential treatment and
    education to the remainder of the Army. As of April 8, 2011, 743
    soldiers sought CATEP treatment and 519 were/are enrolled, and 150 were
    referred to alcohol education or other services. The increase in
    funding depicted In the table below is attributable to two events:

        (1)  transfer of dollars from MEDCOM to IMCOM to pay for
    counselors, and
        (2)  a $41.3 million increase during POM 12-16 for counselor hires,
    prevention coordinators, and prevention initiatives.

                            [In millions of dollars]
    ------------------------------------------------------------------------
                                                          Fiscal Year
                                                  --------------------------
                                                     2010     2011     2012
    ------------------------------------------------------------------------
    ACSAP........................................    $34.6    $36.4   $109.5
    ------------------------------------------------------------------------
    Fiscal year 2010 figures represent execution amounts.

                               women in the army
        On January 13, 1994, the Secretary of Defense issued the Direct
    Ground Combat Definition and Assignment Rule. The rule remains in
    effect today and prohibits the assignment of women to units below the
    brigade level whose primary mission is to engage in direct combat on
    the ground.
        The Army's current assignment policy (Army Regulation 600-13, 27
    Mar 92) allows women to serve in any officer or enlisted specialty or
    position except in those specialties, positions, or units (battalion
    size or smaller) which are assigned a routine mission to engage in
    direct combat, or which collocate routinely with units assigned a
    direct combat mission.
        On March 2, 2010, in the context of a changing operational
    environment, with emerging requirements and missions, the Army
    initiated a routine cyclic review of its assignment policy for female
    soldiers. The purpose of the review was to assess the current Army
    policy alignment with DOD policy. The Army recently completed the
    ``assessment'' phase of the cyclic review and will submit results and
    recommendations to Army Senior Leadership for decision. If approved,
    the Secretary of Defense will be the final authority to implement these
    changes. Congress will be notified prior to any implementation.
        Women in the Army have and continue to serve this Nation with honor
    and distinction in the roles, positions, units, and specialties in
    which they are allowed to serve. They are vital to the readiness and
    success of the Army, DOD, and the Nation. The Army will continue to
    honor this service, and move forward as required to meet the needs of
    the Nation and of the Total Force.
                            congressional assistance
        As the Army prepares for reductions in the force, we will need
    appropriate legislative authorities to drawdown accurately and
    appropriately. Reformation of the physical disability system will
    require continued dialogue and possibly statutory change to provide our
    service members the transition they deserve. Once the economic
    environment improves, the Army will need to make greater use of
    incentives, and will need congressional help to do so. The continued
    support of Congress for competitive military benefits and compensation,
    along with incentives and bonuses for soldiers, families, and for the
    civilian workforce are critical in helping the Army be the employer of
    choice.
                                   conclusion
        With your help, we have invested a tremendous amount of resources
    and deliberate planning to preserve the All-Volunteer Force. This
    includes transforming the RC into an Operational Reserve. We must
    maintain vigilance to protect these investitures for the future of the
    force. We need to sustain the quality of life of our force now and in
    the future. While we begin to transform to a smaller Army, we remain
    dedicated to improving readiness, building resilience and rebalancing
    the force by fiscal year 2012. The well-being and balance of our force
    are absolutely dependent upon your tremendous support. The Army is
    proud of the high caliber men and women whose willingness to serve, is
    a credit to this great Nation.
        To conclude, I wish to thank all of you for your continued support,
    which has been vital in sustaining our All-Volunteer Army through an
    unprecedented period of continuous combat operations. With your
    support, we will continue to work toward restoring balance and
    sustaining the high quality of our Army for the duration of the current
    fight, and Into the foreseeable future. Chairman Webb, and members of
    the subcommittee, I thank you again for your generous and unwavering
    support of our outstanding soldiers, civilian professionals, and their
    families.
                                     ______

      Joint Executive Summary by Hon. Thomas R. Lamont and LTG Thomas P.
                                  Bostick, USA
        After nearly 10 years at war, our soldiers, civilians, and families
    are stretched and strained, yet still resilient. The Army reached its
    objective end strength, which combines ``Grow the Army'' and Temporary
    End Strength Increase. Now the Army must prepare to drawdown this force
    in a deliberate and careful manner. Army end strength will return to
    the congressionally-approved active component end strength of 547,400
    by the end of fiscal year 2013. For fiscal year 2012, the Army National
    Guard end strength will remain 358,200 and the U.S. Army Reserve will
    maintain 205,000. The Army is on track to achieve a sustainable
    deployment tempo for our forces and restore balance to the Army
    beginning in fiscal year 2012. We will continue to face multiple
    challenges on multiple fronts including an ever increasing non
    deployable population resulting from multiple deployments. This
    problem, coupled with an inefficient disability system, does not
    effectively support Army Readiness, our soldiers and their families.
        In fiscal year 2012, the base military personnel appropriation
    comprises the largest portion of the Army's budget at $60.6 billion or
    42 percent. In fiscal year 2010, with congressional support, the Army
    spent $4.4 billion on recruiting and retention. In fiscal year 2011,
    the Army plans to spend $4.4B to fund contracts written between fiscal
    year 2007 and fiscal year 2010 due to continued obligations of
    anniversary payments to soldiers. Recently, incentive contracts have
    dropped dramatically for new accessions. Average recruiting bonuses
    dropped from over $13,000 in fiscal year 2009 to just under $3,000 in
    fiscal year 2011, and are only used to incentivize longer term
    enlistments in a small percentage of critical skills. In fiscal year
    2010, the active Army experienced the highest percentage of high school
    diploma graduates since fiscal year 1992 (increasing from 94.7 percent
    in fiscal year 2009 to 98.3 percent in fiscal year 2010). The Army met
    its skillset needs, achieving over 99 percent Military Occupational
    Specialty precision. We entered fiscal year 2011 positioned for
    continued success, with 33,276 future soldiers in the delayed entry
    pool. The last time the delayed entry pool topped 33,200 was in 1996.
    The Army collectively decreased the number of ineligibility waivers
    provided for enlistments and appointments by 4.20 percent from the
    previous fiscal year.
        In fiscal year 2010, the Active Army reenlisted 68,105 soldiers
    towards an annual mission of 60,000. Soldiers extending to complete
    deployments with their units represented 8,100 of the total. The Army
    Reserve reenlisted 10,921 soldiers, exceeding their annual goals by 6
    percent. The Army National Guard accomplished their mission as well by
    achieving 106 percent of their assigned mission; a total of 32,156
    soldiers. During fiscal year 2010 and into fiscal year 2011, retention
    bonuses were carefully monitored and adjusted to ensure that the Army
    met its retention goals while remaining fiscally responsible.
        From fiscal year 2007 to fiscal year 2010, the Army more than
    doubled its investment in Family programs. These various programs are
    intended to provide a broad spectrum of support and include important
    programs as Mobilization and Deployment Readiness, Family Advocacy, New
    Parent Support, Army Spouse Employment Partnership, Survivor Outreach
    Services, Family Assistance Centers (ARNG), Yellow Ribbon Reintegrate,
    Army Reserve Teen Panel, Army Affiliated Child Care & Youth Programs,
    and Core Community Recreation Programs and Services.
        Since September 11, 2001, we increased the civilian workforce in
    military functions from 222,000 to 286,654 (plus 24,694 Civil Works)
    due to overseas contingency operations, Defense Health Program
    increases, Family and Soldier Support initiatives, acquisition
    workforce growth, in-sourcing functions performed by contractors,
    military technician increases, and military-to-civilian conversions.
        The Department of the Army implemented a Civilian Workforce
    Transformation plan that will invigorate development of the Civilian
    Workforce by addressing critical issues of structure, accession,
    development, retention and succession planning to ease the transition
    from one generation to the next.
        While we begin to transform to a smaller Army, we remain dedicated
    to improving readiness, building resilience and rebalancing the force
    by fiscal year 2012. The well-being and balance of our force are
    absolutely dependent upon congressional support.

        Senator Webb. Thank you very much, Secretary Lamont.
        General, welcome. General Bostick?

    STATEMENT OF LTG THOMAS P. BOSTICK, USA, DEPUTY CHIEF OF STAFF
                             G-1, U.S. ARMY

        General Bostick. Chairman Webb, Senator Graham, members of
    the Subcommittee on Personnel, thank you for this opportunity
    to appear before you to represent the 1.1 million soldiers
    serving around the globe, as well as over 300,000 civilians and
    their families.
        Our All-Volunteer Army is now in its 10th year of
    continuous combat operations. More than 1.1 million soldiers
    have deployed, and over 30,000 Army civilian have also deployed
    into combat. This impacts not only the soldiers and the
    civilians, but their families, as well.
        Our soldiers and families are feeling the stress of
    repeated deployments, but they remain extraordinarily
    resilient. The programs, that you have supported, aimed at the
    health of the force and quality of life, are helping to
    preserve the All-Volunteer Force.
        Despite this unprecedented operational tempo, the Army is
    on track to restore balance by 2012. Increasing dwell time is
    the most important thing we can do to improve the health of the
    force. Beginning with units that deploy this October and later,
    they can expect to return home for 2 years, for the Active
    component, and 4 years, for the Reserve component.
        As the Army prepares for reducing its end strength, we must
    prevail in ongoing combat operations, prevent and deter
    conflict, prepare for future threats, and preserve and enhance
    the All-Volunteer Force. There is no doubt that the Army of the
    future will be, and should be, different than the Army of
    today. There are changes in the environment, different threats,
    and emerging technology that we need to take advantage of, and
    we must be adaptable enough to do so. We must continue to
    provide the quality of care and support that our Army requires.
    We will work with this Congress as we move forward on a broad
    front to address the challenges of 10 years of war.
        With this subcommittee's help, your Army was able to
    attract, recruit, and retain very talented and committed young
    men and women, and exceeded our recruiting and retention goals
    once again.
        To conclude, I want to thank you for your continued
    support, which remains vital to sustain our All-Volunteer Force
    through unprecedented periods of continuous combat operations.
        I look forward to answering your questions.
        Senator Webb. Thanks very much, General Bostick.

     STATEMENT OF HON. JUAN M. GARCIA III, ASSISTANT SECRETARY OF
               THE NAVY FOR MANPOWER AND RESERVE AFFAIRS

        Mr. Garcia. Thank you, Mr. Chairman, Senator Graham. Thank
    you for the opportunity to speak about the sailors, marines,
    and civilians who comprise the Department of the Navy.
        At any given time, approximately 75,000 sailors and marines
    are underway aboard ships or forward-deployed. When counting
    those deployed, those actively training and preparing to
    deploy, and those supporting forward operations, 40 percent of
    the Navy and nearly a third of the marines are in involved in
    maintaining our forward presence and supporting contingencies.
        In developing our budget request, we added 6,800 billets to
    the operational forces of the Navy. To source these billets
    without increasing Navy's end strength, we reduced or
    consolidated 8,400 billets, streamlining many staffs and shore
    activities. The marines will face different challenges as they
    reduce end strength by more than 15,000 while ensuring that
    current missions, particularly in Afghanistan, continue to be
    fully supported.
        Our fiscal year 2012 budget request for recruiting and
    retention represents a reduction from fiscal year 2011. Both
    Services are performing well in officer and enlisted
    recruiting. However, accession bonuses remain critical to
    achieving Navy and Marine Corps goals for health professionals,
    nuclear operators, and Special Warfare/Special Operations
    personnel. Because we're experiencing historic retention rates,
    we've made selected reductions in retention bonuses, although
    retention behavior indicates we must apply bonus programs to
    critical skill areas that remain relatively insulated from
    changes in the economic environment.
        At a time when 1 percent of this Nation has served in
    uniform, we're expanding the number universities and campuses
    with Reserve Officer Training Corps (ROTC) presence, to ensure
    that the office ranks are open to young men and women from all
    segments and all regions of the country. Our fiscal year 2012
    education and training budget represents an increase from
    fiscal year 2011. However, the majority of this increase
    represents investments in critical mission areas, such as
    missile defense, antisubmarine warfare, and the National
    Aeronautics and Space Administration (NASA) and cyberwarfare--
    cyberforce.
        Our fiscal year 2012 budget request for servicemember and
    family programs is an increase from fiscal year 2011 to support
    our continuum of care and address the physical, psychological,
    and family readiness of our sailors and marines. We continue to
    emphasize suicide and sexual assault prevention programs.
        In the past 12 months, the Navy and Marine Corps have
    mobilized approximately 12,000 reservists in support of
    operational requirements. Recognizing the personnel costs are
    the largest part of the Department of the Navy's budget, we're
    collaborating with the Office of the Secretary of Defense (OSD)
    and our sister Services to review the future role of the
    Reserve component as part of our integrated total force.
        The Department of the Navy is leading the way in both
    innovative therapeutic treatments and in civilian hiring of our
    wounded warriors. Naval Sea Systems Command has excelled in
    bringing disabled veterans on board, hired 282 in calendar year
    2011 and, to date, are half way to their current goal of hiring
    a wounded warrior per day.
        Despite the challenges, we can think of no more rewarding
    job than to represent and advocate for the nearly 630,000
    sailors and marines and 190,000 civilian employees.
        To that end, we wish to thank the committee members for
    their support of our great men and women in our Navy and Marine
    Corps, and look forward to your questions.
        Thank you.
        [The joint prepared statement of Mr. Garcia, Admiral
    Ferguson, and General Milstead follows:]
     Prepared Statement by Hon. Juan M. Garcia, VADM Mark E. Ferguson III,
                USN, and Lt. Gen. Robert E. Milstead, Jr., USMC
                               executive summary
        The Department of the Navy's fiscal year 2012 manpower and
    personnel budget request appropriately balances risk in supporting the
    readiness requirements of the fleet and joint force, growth in emerging
    mission areas, and essential programs that provide for the care of our
    sailors and marines and their families. Our active budget request will
    support an active end strength of 325,700 within the Navy and 202,100
    within the Marine Corps.
    Personnel Efficiencies
        In developing our budget request, we reviewed current operations,
    our procurement profile, and readiness requirements. This review
    indicated a requirement to add a total of approximately 6,800 billets
    to the operational forces of the Navy across the Future Years Defense
    Program (FYDP) to support new and current warfighting platforms. To
    source these billets without additions to the Navy's overall end
    strength, we identified efficiencies in staff structure and shore
    activities, and reduced capacity in other areas of the force. This
    review resulted in a reduction or consolidation of approximately 8,400
    billets in the Fleet, squadron staffs, and shore activities.
        The Marine Corps will continue to shape its force to meet ongoing
    requirements, fill critical military occupational specialties and
    retain vital leadership with combat experience. Bonuses will remain
    critical to this effort, allowing the Marine Corps to fill hard-to-
    recruit positions such as crypto-linguists and reconnaissance marines.
    It is important to note that only 8 percent of new recruits receive an
    enlistment bonus and the Marine Corps budget for enlistment bonuses has
    decreased from $75 million in fiscal year 2008 to $14.7 million in
    fiscal year 2012. In addition, Selective Reenlistment Bonus funding has
    decreased from $468 million in fiscal year 2009 to $108.6 million in
    fiscal year 2012.
    Sailor, Marine, and Family Care
        Our fiscal year 2012 budget request represents an increase from
    fiscal year 2011. This increase supports expansion of our comprehensive
    continuum of care to more effectively address the medical, physical,
    psychological, and family readiness needs of sailors and marines and
    their families, and our continued emphasis on suicide and sexual
    assault prevention programs.
    Recruiting
        Both the Navy and Marine Corps continue to experience strong
    performance in our recruiting programs across both the officer and
    enlisted force. Our fiscal year 2012 budget request for recruiting
    represents a reduction from fiscal year 2011. These programs include
    accession incentives, advertising and recruiter support. Accession
    bonuses remain critical to achieving our goals for health
    professionals, nuclear operators, and special warfare/special
    operations within the Navy. However, a favorable recruiting environment
    has enabled us to reduce the number of those eligible for accession
    bonuses.
    Retention
        Along with current economic conditions, our new policies are
    encouraging longer-term career behavior, contributing to high retention
    across the force. Our fiscal year 2012 budget request represents a
    decrease from fiscal year 2011. While we have been able to make
    selected reductions in retention bonuses, retention behavior indicates
    we must continue to apply bonus programs to critical skill areas that
    require significant investments in training and education and remain
    relatively insulated from changes in the economic environment.
    Learning and Development
        Our fiscal year 2012 education and training budget represents an
    overall increase from fiscal year 2011. The majority of this increase
    represents investments in curricula, training technology, and
    instructors for critical mission areas such as missile defense, cyber
    and anti-submarine warfare.
        Chairman Webb, Senator Graham, and distinguished members of the
    subcommittee, thank you for the opportunity to speak about the sailors,
    marines, and civilians who comprise the Department of the Navy.
        These are difficult and stressful times for the Sea Services, but
    our people continue to rise to the challenges. We are pleased to report
    that both the Navy and the Marine Corps are recruiting and retaining
    high-quality individuals who are excelling at meeting our global
    commitments whether they are combat operations, or humanitarian
    assistance. It is our distinct honor and privilege to represent and
    advocate for the nearly 630,000 sailors and marines, both Active Duty
    and Reserve, and 190,000 civilian employees who are always prepared to
    respond to whatever our Nation demands.
        This statement provides details of service-specific initiatives and
    various supporting data, but it is important to note the Department of
    the Navy as a whole faces many common challenges and shared solutions
    that we wish to highlight for your attention.
        The Sea Services will continue to face myriad operational
    requirements even as we strive to achieve greater efficiency. The Navy,
    after a decade of declining strength, will level out its active duty
    end strength at 320,300 by fiscal year 2016, 6,800 billets of which the
    Navy plans to move from shore support functions to sea duty to enhance
    our operational readiness. This restructuring includes administrative
    consolidations to eliminate headquarters staffs of a destroyer
    squadron, three submarine squadrons, a strike group, and a carrier air
    wing. Not only will those shifts mean that the important work ashore
    must be performed by fewer sailors, but also that sailors will likely
    spend more time at sea away from their families. The marines will face
    different but equally challenging issues as they take the initial steps
    toward a reduction in end-strength of more than 15,000 while ensuring
    that current missions, particularly in Afghanistan, continue to be
    fully supported.
        All of these changes must occur while both Services continue to
    meet evolving national security threats and complete their many
    assigned missions. At any given time, approximately 75,000 sailors and
    marines are either underway aboard ships or forward-deployed. In fact,
    including those deployed and those actively training/preparing to
    deploy or supporting forward operations, 40 percent of the Navy and
    nearly 33 percent of the marines are involved in maintaining our
    forward presence and supporting contingencies, as we speak.
        While these changes will prove difficult, they must be accomplished
    without sacrificing our highest priorities including the care and the
    recovery of our wounded, ill, and injured servicemembers. The
    Department of the Navy is leading the way in both innovative
    therapeutic treatments and in civilian hiring of our Wounded Warriors.
    The Naval Sea Systems Command has excelled in bringing disabled
    veterans on board; hiring 282 disabled veterans in the past year, with
    a current goal of one new hire a day. Both our Safe Harbor Program and
    our Wounded Warrior Regiments continue to build on lessons learned and
    to improve the support they provide. Along with this top priority, the
    Department of the Navy is engaged in a wide range of other initiatives
    and projects we would like to highlight for you.
        At a time when 1 percent of the Nation has served in uniform, we
    are expanding the number of ROTC units to ensure that the officer ranks
    are open to young men and women from all segments and all regions of
    the country. Our two newest host programs at Arizona State and Rutgers
    Universities reach geographic areas not previously covered, and are at
    large schools with recognized technical and engineering programs. At
    the same time, the anticipated repeal of Don't Ask, Don't Tell is
    providing the opportunity to expand ROTC participation at various Ivy
    League schools. In the area of quality of life for our active duty
    families, we are giving special attention to expanding spouse-
    employment opportunities and to supporting our exceptional family
    members. We are also moving forward on the introduction of women in
    submarines. Eighteen female officers have commenced their 15-month
    nuclear training and will report to Ohio-class submarines by the end of
    this year.
        These and many other initiatives are occurring during a period of
    intense activity for the Sea Services. Not since World War II has the
    Department of the Navy been actively engaged in as many areas of the
    globe as we are today. In addition to ongoing efforts in Iraq and
    Afghanistan, we continue to confront pirates in the Indian Ocean and
    drug traffickers in the Caribbean. The recent Japan earthquake and
    tsunami highlighted the Navy's ability to quickly execute humanitarian
    assistance/disaster relief operations while simultaneously evacuating
    over four thousand dependents and civilian employees to various safe
    havens. The events comprising what's been called the ``Arab Spring''
    have raised the profile and highlighted the capabilities of our
    constant presence in that part of the world. However, equally important
    as winning wars, is preventing wars. We are committed to engaging our
    global partners. DON personnel are executing a variety of humanitarian
    missions, such as Provide Comfort; and are building multi-national
    coalitions to improve maritime safety and security, as in the Pacific
    Partnership, Africa Partnership Station and UNITAS. Our Service men and
    women have responded professionally and bravely to all these
    challenges, but the operating tempo is taking a toll. In the past 12
    months the Navy and Marine Corps have mobilized 11,675 reservists and
    filled 468 Individual Augmentee assignments to keep up with operational
    requirements.
        We must plan for the future while conducting today's missions, and
    anticipating emerging threats. In an exceptionally tight fiscal
    environment, we must find efficiencies and other opportunities to save
    scarce resources. Recognizing that personnel costs are the largest part
    of the Department of the Navy's budget, we are collaborating with OSD
    and our sister Services to review the future role of the Reserve
    component as part of our integrated Total Force.
        An emerging threat that requires new thinking in workforce
    development is cyber warfare. The Department of the Navy is creating
    small and highly capable communities of military and civilian personnel
    to serve in our cyber workforce. Given the unique nature and pace of
    cyber warfare, the Department is exploring innovative approaches to
    hiring and retaining active, Reserve and civilian employees.
        We constantly explore manpower efficiencies and cost savings across
    the Department. Some savings will be difficult, but are needed to
    ensure the Department can focus its limited resources on operational
    priorities. We have reduced the eligibility for and size of bonuses and
    special pays for our servicemembers; have instituted a 2-year salary
    freeze for civilian employees, and have reduced the number of Flag and
    General Officers, and Civilian Executive positions. We are exploring
    options to reduce healthcare cost to the Department without reducing
    benefits or increasing costs to our servicemembers, their families and
    our retirees. Initial study into options for providing medication via
    mail order indicates significant savings can be achieved.
        Finally, let me touch on a topic of great concern throughout the
    Sea Services and the Department of Defense as a whole. Simply put, the
    rate of suicide among our active duty members remains unacceptably
    high. While we know that in a population as large as ours it will be
    impossible to prevent every case, our position remains firm that even a
    single suicide is one too many. The Navy and Marine Corps are focusing
    their efforts on early intervention and in adapting the military
    culture to encourage seeking needed help early. The entire Department
    of Navy leadership team remains committed to finding the most effective
    ways of preventing suicides among our servicemembers.
        Despite the challenges, we can think of no more rewarding job than
    serving our brave sailors and marines. To that end, we wish to thank
    the committee members for their continuous and unwavering commitment to
    the support of our great men and women in our Navy and Marine Corps
    who, each day, unhesitatingly answer the call to duty simply because
    their nation has asked, and it is the right thing to do.
        The following service specific information is provided for the
    committee. We look forward to your questions.
                        a ready and capable global navy
        On a given day, more than 44,000 sailors are deployed and nearly
    half of our 288 ships are underway around the globe. Our Navy has more
    than 14,000 Active and Reserve sailors on the ground and approximately
    10,000 at sea in the Central Command (CENTCOM) Area of Responsibility
    (AOR) supporting joint and coalition operations.
        Overall, the tone of our force remains positive. Our 2010 Navy
    Total Force Survey results revealed sailors are generally satisfied
    with the quality of their leadership, benefits, compensation, and the
    opportunities Navy provides for personal growth and development. With
    our sustained operational tempo, we remain vigilant concerning stress
    on our sailors and their families and continue to carefully monitor the
    health of the force. The results of our 2010 Behavioral Poll indicate
    the majority of sailors are coping with stress in positive ways by
    talking to family members and friends, taking advantage of the
    resources provided by chaplains and Fleet and Family Support Centers,
    and using their chain of command to proactively address concerns.
    Additionally, the majority of sailors report being satisfied with the
    level of support provided by their leadership to help them and their
    families effectively cope with stress, to include both pre-deployment
    and post-deployment assistance.
        Our fiscal year 2012 budget request will enable us to continue to
    meet the operational demands of the fleet and the joint force while
    optimizing personnel readiness. Our active budget request of $29
    billion consists of $27.2 billion for Military Personnel Navy (MPN) and
    $1.85 billion in related Operations and Maintenance Navy (OMN). Our
    Reserve budget request consists of $1.96 billion for Reserve Personnel
    Navy (RPN) and $6.4 million in related Operations and Maintenance Navy
    Reserve (OMNR). Our budget request supports Active end strength of
    325,700 and Reserve end strength of 66,200.
        To address critical manning challenges for our ships, squadrons,
    submarines, and other operational units, our fiscal year 2012 budget
    increases manpower at sea and reduces manpower assigned to our shore
    infrastructure. While we believe this transition is manageable, it will
    present challenges to our ability to maintain sea-shore flow for some
    of our enlisted sailors and sustain manning levels across the force in
    the near-term as we execute these billet shifts.
        Additionally, Navy has placed end strength previously funded by the
    Overseas Contingency Operations (OCO) appropriation into our baseline
    program for fiscal year 2012. We are also projecting a gradual
    reduction of Individual Augmentee (IA) demand in Iraq and Afghanistan
    as ground forces withdraw.
                          navy personnel efficiencies
        In developing our budget request, we reviewed current operations,
    our procurement profile, and readiness requirements. This review
    indicated a requirement to add a total of approximately 6,800 billets
    to the operational forces across the Future Years Defense Program
    (FYDP). This requirement includes the addition of 3,900 billets across
    the FYDP to support new warfighting platforms. In fiscal year 2012
    alone, we are adding billets for a new Riverine Squadron, Littoral
    Combat Ship (LCS) manning, and the E-2D Advanced Hawkeye.
        Our review also indicated a requirement to add approximately 2,900
    billets across the FYDP to support current warfighting platforms. In
    fiscal year 2012, we are adding approximately 1,800 billets to existing
    platforms. For the submarine force, we are adding billets to support
    information technology, nuclear plant operations, and strategic weapons
    management. For the surface force, we are adding billets to support
    Ballistic Missile Defense and returning billets at sea to support
    damage control and firefighting capabilities, safety of navigation,
    preservation, material condition, and underway watch-standing.
    Additionally, this budget adds billets at Regional Maintenance Centers
    for sailors with sea-intensive specialties in response to the Fleet
    Review Panel. These assignments will provide sailors the opportunity to
    further develop critical craftsmen skills, particularly in the areas of
    surface engineering, combat systems, and deck ratings.
        To source these billets without additions to our overall end
    strength, we identified efficiencies in staff structure and shore
    activities, and reduced capacity in areas of the force commensurate
    with anticipated reductions in future demand for ground force enablers.
    This review resulted in a reduction or consolidation of approximately
    8,400 billets in the Fleet, squadron staffs, and shore activities
    across the FYDP. Specific efficiencies will include:

             Disestablishment of a destroyer squadron staff, three
            submarine squadron staffs, a strike group staff, and a carrier
            air wing staff
             Consolidation of the staff of Commander, Second Fleet
            with U.S. Fleet Forces Command
             Horizontal staffing reductions across Navy shore
            activities
             Disestablishment of a helicopter anti-submarine
            squadron and consolidation of two patrol squadron special
            projects units and two Fleet air reconnaissance squadrons
             Reductions in recruiting, education, and training
            staffs, bands and NJROTC units.

        Additionally, we reduced both billet seniority and structure in
    selected Restricted Line and Staff Corps communities. This efficiency
    produced additional billets for the operational forces. As part of the
    Office of the Secretary of Defense flag and general officer review, we
    proposed to eliminate 9 and reduce the seniority of 15 flag officer
    billets, affecting 15 percent of our flag officer billet structure.
         building resilience through a comprehensive continuum of care
        Our fiscal year 2012 budget request of $164.2 million for sailor
    and family care supports expansion of our comprehensive continuum of
    care to address the medical, physical, psychological, and family
    readiness needs of sailors and their families. Navy's Operational
    Stress Control Program, Navy Reserve Psychological Health Outreach
    Program, Warrior Transition Program, Returning Warrior Workshop, Navy
    Safe Harbor, and our Medical Home Port Program continue to be the
    critical elements of this continuum.
        Navy's Operational Stress Control (OSC) program addresses the
    psychological health of sailors and their families by encouraging
    sailors to seek help for stress reactions before they become stress
    problems, promoting strong leadership involvement, and increasing
    awareness of support programs and resources. The fiscal year 2012
    budget request supports our continuing focus of helping Navy leaders
    recognize and respond to stress reactions among our sailors.
        The Navy Reserve Psychological Health Outreach program was
    established to improve the psychological health and resiliency of
    Reserve component (RC) sailors and their families. Teams of
    psychological health outreach coordinators and outreach team members
    located at the five regional Reserve commands provide psychological
    health assessments, education, and referrals to mental health
    specialists. In fiscal year 2010, these teams conducted mental health
    assessments for more than 1,600 RC sailors, made outreach calls to over
    2,400 returning RC sailors, and conducted approximately 300 visits to
    Navy Operational Support Centers (NOSCs) around the country, providing
    basic OSC awareness training to more than 23,000 RC sailors and staff
    members.
        The Warrior Transition Program (WTP) provides a place and time for
    sailors serving as Individual Augmentees to decompress and transition
    from the war zone to life back home. Small group discussions
    facilitated by chaplains and medical personnel prepare sailors for
    resumption of family and social obligations, return to civilian
    employment, and reintegration with the community. In fiscal year 2010,
    376 WTP workshops for 7,056 sailors were conducted in Kuwait.
        Returning home impacts the sailor, his or her family, employer, and
    community. Returning Warrior Workshops (RWWs) are reintegration events
    that honor returning warriors and their families for their service,
    provide information about resources available to assist them with
    reintegration, and raise awareness of symptoms associated with combat
    stress. Returning Warrior Workshops fulfill the Yellow Ribbon
    Reintegration Program statutory requirement for an activity 60 days
    post-mobilization that focuses on reconnecting members and their
    families with service providers from the Initial Reintegration Activity
    to ensure that members and their families understand the benefits to
    which they are entitled and resources available to help them overcome
    the challenges of reintegration. RWWs are designed to remove stigma
    that may prevent people from seeking appropriate support during the
    potentially challenging demobilization and reintegration process. More
    than 34 RWWs are planned through fiscal year 2012 to direct sailors and
    their families to the support programs that best address their needs.
        Navy Safe Harbor remains the Navy's lead organization for
    coordinating the non-medical care of wounded, ill, and injured sailors,
    coastguardsmen, and their families. Through its network of Recovery
    Care Coordinators and Non-Medical Care Managers at 12 locations across
    the country, Safe Harbor provides exceptional, individually tailored
    assistance to an enrolled population of over 600 wounded, ill, and
    injured. Over the past year, we have increased our support for
    community reintegration through the Anchor Program, which pairs members
    with volunteer RC sailors in their communities, and initiated the
    Adaptive Athletics Program, designed to support long-term recovery and
    rehabilitation through whole-body training and education. Additionally,
    we signed Memoranda of Agreement with the Departments of Labor and
    Veterans Affairs (VA) to ensure greater access to employment services
    and support programs and provide assistance in navigating the
    transition from military medical care to VA medical care. The fiscal
    year 2012 budget request supports our enduring goal to provide the
    highest quality care to our wounded, ill, and injured.
        We remain committed to ensuring our sailors and their families have
    ready access to high quality health care services. Our Medical Home
    Port Program is a team-based model focused on optimizing the
    relationship between patients, their providers, and the broader
    healthcare team. Mental health providers are embedded within our
    Medical Home Ports to facilitate regular assessment and early mental
    health intervention. This model enables sailors to be treated in the
    settings in which they feel most comfortable and reduces the stigma
    associated with the care they receive. Additionally, improving early
    detection and intervention in the primary care setting reduces the
    demand for time-intensive intervention in our mental health specialty
    clinics.
                 suicide prevention: all hands, all of the time
        Our sailors face challenges while deployed and at home making
    suicide prevention an ``all-hands--all of the time'' effort, involving
    the sailor, family members, peers, and leadership. The results of our
    2010 Behavioral Quick Poll indicate the majority of sailors are
    confident in their ability to effectively respond to a sailor who talks
    about suicide and the ability of their commands to support sailors
    seeking help for suicidal thoughts or actions.
        In 2010, we conducted more than 25 unit level suicide prevention
    coordinator briefings and training workshops around the world and
    provided training to more than 200 installation suicide prevention
    coordinators at our first Navy Suicide Prevention Coordinator Training
    Conference. We remain committed to creating an environment in which
    stress and other suicide-related factors can be more openly recognized,
    discussed, and addressed, and where seeking help is a sign of strength.
    This includes maintaining a solid foundation of suicide prevention
    coordinators, refreshing mental health provider skills, providing
    installation first responders with the skills necessary to respond to
    behavioral emergencies, and raising family awareness of suicide risk,
    warning signs, and support resources.
        Navy's calendar year 2010 suicide rate of 10.9 per 100,000 sailors
    represents a decrease from the 2009 suicide rate of 13.3 per 100,000
    sailors. Though we recognize any loss of life to suicide is a tragedy,
    this rate is below the national rate for the same age and gender
    demographic of 18.7 per 100,000 \1\ individuals.
    ---------------------------------------------------------------------------
        \1\ National Center for Injury Prevention and Control (2007).
    Standardized U.S. suicide rates are adjusted for Navy demographics.
    ---------------------------------------------------------------------------
                         sexual assault: not in my navy
        The goal of Navy's Sexual Assault Prevention and Response (SAPR)
    program is to eliminate sexual assault by fostering a culture of
    prevention, response, and accountability. This includes comprehensive
    education and training, collaboration with the Naval Safety Center on
    messaging that emphasizes the negative relationship between alcohol and
    sexual assaults, 24/7 response capability for victim support,
    standardized worldwide reporting procedures, and a system of
    accountability that protects all sailors. We have also issued
    additional reporting guidance to commanding officers to ensure the
    first flag officer in their chain of command is aware of every sexual
    assault that occurs, as well as command actions taken to prevent future
    incidents. Although Navy reports of sexual assault increased in fiscal
    year 2010, it is possible that this increase in reporting is the result
    of more sailors coming forward to seek help, providing a preliminary
    indication that our outreach and education efforts are resonating with
    the force. We continue to monitor this trend closely and focus our
    education efforts on prevention and bystander intervention.
        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 U.S. Navy.
                     shaping manpower for the future force
        Our force stabilization efforts remain focused on maintaining a
    balanced force in terms of seniority, experience, and skills to meet
    Fleet and joint requirements while staying within our authorized end
    strength. We continue to execute the following measures:

             ``High-Year Tenure'' separations for sailors at
            selected pay grades and years of service
             ``Perform-to-Serve (PTS)'' reenlistment review process
            that requires conversion to undermanned specialties or
            separation in Zone A (0-6 years), Zone B (6-10 years), and Zone
            C (10-14 years)
             One-year time-in-grade retirement waivers for select
            senior enlisted and officers
             Early transition for enlisted, allowing them to
            separate up to 12 months before the end of their active
            obligated service
             Monthly probationary officer continuation and
            redesignation boards
             Annual performance-based continuation boards for
            senior enlisted in pay grades E7-E9 with more than 20 years of
            service

        Due to high retention, we are experiencing an excess of active
    senior Unrestricted Line (URL) officers. To balance the force and
    ensure sufficient senior officers are available at the right time in
    their careers to serve in critical fleet billets, we will conduct in
    July 2011 an active Unrestricted Line Captain and Commander Selective
    Early Retirement Board (SERB). This board will consider URL Captains
    with at least 4 years time in grade and commanders who have twice
    failed to select for promotion to captain. At this time, we project
    approximately 120 URL Captains and 120 URL commanders will be selected
    for early retirement.
        We are projected 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.
              recruiting and retaining a highly-skilled workforce
        Last year marked the third consecutive year that we achieved
    officer recruiting goals in the active component and enlisted
    recruiting goals in both the Active and Reserve components. The Reserve
    component achieved 95 percent of our fiscal year 2010 officer goal.
    While we anticipate that we will meet our aggregate recruiting goals
    this year, the increased demand for critical specialties in support of
    operations in Iraq and Afghanistan will present a challenge,
    particularly within the Reserve component.
        The fiscal year 2012 budget requests $292 million for our
    recruiting programs, a reduction of $41.8 million from fiscal year
    2011. These programs include accession incentives, advertising, and
    recruiter support for our active and Reserve recruiters. To offset
    reductions in paid media advertising, we continue to expand our use of
    social media and other technologies to broaden our outreach efforts and
    generate recruiting leads. Navy Recruiting Command has over 135,000
    active followers across 19 prominent social media sites, to include 15
    Facebook communities of interest. However, it is the face-to-face
    contact with recruiters in the field that is the cornerstone of our
    sustained recruiting success in attracting high-quality, diverse
    individuals, particularly as the economy begins to improve. Our budget
    request ensures that the recruiting force remains appropriately sized
    and has the necessary resources to achieve continued success.
        Accession bonuses remain critical to achieving our goals for health
    professionals, nuclear operators, and special warfare/special
    operations. To meet increased demands for these skills, we maintained
    bonus levels for nuclear officers and health professionals and continue
    to offer enlisted accession bonuses to special warfare/special
    operations and other critical ratings. A favorable recruiting
    environment has enabled us to reduce the number of ratings eligible for
    an accession bonus from 67 in 2008 to 6 in 2011. The fiscal year 2012
    active budget request of $76.1 million for accession incentives
    represents a decrease of $39.0 million from fiscal year 2011.
        We continue to closely monitor retention behavior across the force
    and project we will meet our fiscal year 2011 overall officer and
    enlisted retention goals. While we have been able to make selected
    reductions in retention bonuses, sailor retention behavior indicates we
    must continue to apply bonus programs to critical skill areas that
    require significant investments in training and education and are less
    responsive to changes in the economic environment.
                              recruiting--enlisted
        In this fiscal year to date, we have met or exceeded our Active and
    Reserve recruiting goals each month. We continue to exceed Department
    of Defense (DOD) quality standards in all recruit categories as shown
    in Table 1.

                              TABLE 1. ACTIVE AND RESERVE COMPONENT ACCESSIONS AND QUALITY
    ----------------------------------------------------------------------------------------------------------------
                                                     Fiscal Year 2010              FYTD 2011  (as of 30 April 2011)
                                             -----------------------------------------------------------------------
                                               Attained      Goal       Percent    Attained      Goal       Percent
    ----------------------------------------------------------------------------------------------------------------
    Total Active............................      34,180      34,140       100.1      18,482      18,453       100.2
    Total Reserve...........................       6,669       6,654       100.2       4,685       4,659       100.6
    HSDG \1\................................      35,995  95 percent        97.4      20,006  95 percent        98.5
    TSC \2\ I-IIIA..........................      30,653  70 percent        83.0      17,818  75 percent       87.8
    ----------------------------------------------------------------------------------------------------------------
    \1\ HSDG--High School Diploma Graduate; DOD standard is 90 percent; Navy standard is 95 percent.
    \2\ TSC--Test Score Category (Aptitude Level); DOD standard is 60 percent; Navy standard is 75 percent.

        Last year, we were successful in meeting our recruiting goals for
    nuclear and special warfare/special operations ratings and are well-
    positioned to meet this year's targets as shown in Table 2. These
    ratings remain our top enlisted recruiting priorities.

                                 TABLE 2. NUCLEAR AND SPECIAL WARFARE/SPECIAL OPERATIONS
    ----------------------------------------------------------------------------------------------------------------
                                                     Fiscal Year 2010              FYTD 2011  (as of 30 April 2011)
                                             -----------------------------------------------------------------------
                                               Attained      Goal       Percent    Attained      Goal       Percent
    ----------------------------------------------------------------------------------------------------------------
    Nuclear Field...........................       2,981       2,981       100.0       1,603       1,601       100.1
    SPECWAR/SPECOPS.........................       2,153       2,144       100.4       1,034       1,022       101.2
    ----------------------------------------------------------------------------------------------------------------

                              recruiting--officer
        We achieved our general and medical officer recruiting goals in the
    active component, but fell short of meeting these goals in the Reserve
    component as shown in Table 3. Although we accessed more Reserve
    officers in fiscal year 2010 than fiscal year 2009, a 13 percent
    increase in fiscal year 2011 goals and high officer retention in the
    Active component will continue to challenge Reserve officer recruiting.

                                     TABLE 3. ACTIVE AND RESERVE OFFICER ACCESSIONS
    ----------------------------------------------------------------------------------------------------------------
                                                     Fiscal Year 2010              FYTD 2011  (as of 30 April 2011)
                                             -----------------------------------------------------------------------
                                               Attained      Goal       Percent    Attained      Goal       Percent
    ----------------------------------------------------------------------------------------------------------------
    Active General Officer \1\..............       1,538       1,518       101.3       1,268       1,359        93.3
    Reserve General Officer \1\.............       1,171       1,213        96.5         629       1,414        44.5
    Active Medical Officer \2\..............         876         866       101.3         570         843        67.6
    Reserve Medical Officer \2\.............         349         387        90.2         203         395        51.4
    ----------------------------------------------------------------------------------------------------------------
    \1\ Does not include accessions from the U.S. Naval Academy or Naval Reserve Officer Training Corps.
    \2\ Medical Officer includes Medical Corps, Nurse Corps, Dental Corps, and Medical Service Corps.

        Health care professionals remain a recruiting priority through
    fiscal year 2012, especially within the Reserve component where several
    specialties are undermanned. To address shortfalls among Reserve health
    professionals, the fiscal year 2012 budget request supports an
    affiliation bonus for prior service medical department officers, as
    well as an accession bonus for direct commission nurse corps officers
    with specific qualifications. Additionally, certain health
    professionals are eligible for special pays, school loan repayment, and
    a monthly stipend while pursuing a critical wartime specialty.
                              retention--enlisted
        We continue to experience high retention across the force as shown
    in Table 4.

                                     TABLE 4. FISCAL YEAR 2010 ACTIVE NAVY RETENTION
    ----------------------------------------------------------------------------------------------------------------
                                                                               Fiscal Year 2010 Achievement
                                                                     -----------------------------------------------
                          Active Navy Retention                                                         Fiscal Year
                                                                        Reenlisted       Benchmark         2010
                                                                                                         (Percent)
    ----------------------------------------------------------------------------------------------------------------
    Zone A (0-6 yrs)................................................          16,930          12,600             134
    Zone B (6-10 yrs)...............................................          10,845           8,300             131
    Zone C (10-14 yrs)..............................................           7,750           5,800             134
    ----------------------------------------------------------------------------------------------------------------

        Along with current economic conditions, our new policies are
    encouraging longer-term career behavior. Sailors are committing sooner
    to stay for longer periods of time. In addition, we are experiencing
    higher retention of female servicemembers, especially within our
    critical technical and warfighting skilled areas. Although this
    behavior affords Navy increased predictability of future personnel
    readiness, higher retention also contributes to increasing competition
    for reenlistment opportunities.
        Attrition, defined as sailors who are discharged prior to the end
    of their contract, declined for both Active and Reserve. For active
    duty in fiscal year 2010, we saw declines in misconduct-related
    discharges by 10 percent and training-related discharges by 12 percent
    from the previous year. Reserve enlisted attrition rates also continue
    to trend lower than the historical average of 28 percent. This is
    evidence of the higher quality force we are recruiting.
        We remain challenged in meeting nuclear retention goals as a result
    of what we assess to be a growing demand for Navy's highly trained
    nuclear-qualified sailors in the civilian industrial base. We remain
    focused on retaining sailors with critical skills in high demand in the
    civilian sector, as well as sailors in specialties that continue to
    experience high operational tempo in support of OCO, such as special
    warfare/special operations and independent duty corpsmen. Our Selective
    Reenlistment Bonus (SRB) programs remain an important tool to retain
    these highly-skilled sailors.
        We continue to closely monitor retention behavior and adjust SRB
    levels in response to observed behavior. Over the past 16 months, we
    adjusted SRB levels five times, reducing the number of skill areas
    eligible for SRB by 31 percent compared to fiscal year 2010, and
    adjusting or maintaining existing bonus levels for those skills
    eligible for SRB. In fiscal year 2011, only 34 ratings of 84 receive
    SRB, and the pool of eligible sailors is 6.5 percent of our active
    enlisted force. This represents a reduction of over 54 percent in the
    pool of SRB eligible sailors from fiscal year 2009. We continue to
    structure our award plan to target high-demand skill sets that remain
    relatively insulated from changes in the economic environment, to
    include special warfare/special operations, intelligence, medical,
    cryptology, and nuclear ratings. Our fiscal year 2012 active budget
    request includes $95.9 million for new SRB contracts, a reduction of
    $35.7 million from fiscal year 2011.
        The SRB budget for Selected Reserve sailors was reduced by 31
    percent in fiscal year 2011, and further reduced by another 10 percent
    in our fiscal year 2012 budget request, reflecting a total decrease of
    $875,000. This reduction is the result of a realignment of resources
    within the Navy Reserve Comprehensive Bonus Strategy to target RC
    officers and enlisted personnel in our most critical specialties.
                               retention--officer
        Overall, Active and Reserve officer retention rates continue to
    increase in part due to targeted incentive pays, improved mentoring,
    more flexible career options, and increased emphasis on life-work
    initiatives. Female unrestricted line (URL) retention past the initial
    minimum service requirement (MSR) has increased in the last 4 years in
    both the surface warfare (from 19 percent for Year Group 2001 to 33
    percent for Year Group 2004) and aviation communities (from 14 percent
    for Year Group 1998 to 27 percent for Year Group 2001).\2\ We continue
    our efforts to improve the health of Selected Reserve (SELRES) officer
    communities by 2014 through initiatives such as targeted officer
    affiliation and retention bonuses, increased accession goals, and
    Continuum of Service programs focused on ``Recruit Once, Retain for
    Life.''
    ---------------------------------------------------------------------------
        \2\ Because Minimum Service Requirement (MSR) is different for
    Surface Warfare (5 years) and Aviation (7 years), two comparable year
    groups (i.e., includes women who are past their initial service
    obligation) were examined to more accurately capture overall URL female
    retention.
    ---------------------------------------------------------------------------
        We remain focused on junior officer retention, especially within
    select communities where we are challenged to meet our retention goals.
    Retention of junior officers for operational department head tours is a
    critical metric for monitoring the health of these communities.
    Although the overall loss rate for junior officers increased slightly
    from fiscal year 2009 to fiscal year 2010, the surface and submarine
    communities met their retention goals for the second year in a row.
        After more than 10 years of war, we are seeing increased stress on
    our Naval Special Warfare community. Sustained operational tempo,
    decreased dwell time, and deployment unpredictability have contributed
    to a decrease in junior officer retention, particularly at the
    lieutenant commander (O-4) level. Mentorship and increased access to
    family support programs and operational stress control resources remain
    our primary tools to mitigate the effects of stress on these sailors
    and their families. Additionally, our fiscal year 2012 budget request
    includes $7.4 million for targeted incentive pays to retain these
    critical officers.
        We have experienced slight improvements in medical community loss
    rates trends, largely due to competitive incentives and bonuses. Select
    subspecialties continue to require attention, to include dentistry,
    clinical psychology, social work, physician assistants, general
    surgery, preventive medicine, family medicine, and nurse anesthetists.
    Our fiscal year 2012 budget request includes $253.7 million for special
    and incentive pays to retain these critical medical professionals.
        We continue to conduct comprehensive reviews of many of our special
    and incentive pay and bonus programs to adjust bonus levels in response
    to retention behavior. In addition to adjustments to enlisted Special
    Duty Assignment Pay (SDAP) and SRB, we reduced officer bonuses in the
    aviation, surface warfare, and intelligence communities over the last
    year. Additionally, we restructured our Submarine Support Incentive Pay
    program to more efficiently address shortfalls at specific career
    points. We anticipate further reductions to retention bonuses for
    selected officer communities in fiscal year 2011 in response to strong
    retention behavior. As we execute these actions, we will continue to
    monitor retention rates and adjust our incentive programs as necessary.
             learning and development: navy's asymmetric advantage
        Education and training are strategic investments, enabling us to
    develop a highly-skilled force to meet the demands of the Maritime
    Strategy and the joint force. Our fiscal year 2012 education and
    training budget of $1.5 billion supports increased investments in
    curricula, training technology, and instructors for critical mission
    areas such as missile defense, cyber, and anti-submarine warfare.
    Additionally, we continue to focus training investments in LCS to
    include the Virtual Ship Centric Training Strategy. Initiated in 2010,
    this strategy includes a series of seaframe variant unique and common
    simulators combined with actual seaframes to address multiple training
    needs for LCS. Simulators continue to present significant opportunities
    for increasing training capability, capacity, and effectiveness across
    the fleet, while minimizing stress on equipment and risk to the safety
    of our sailors. The fiscal year 2012 budget request supports continued
    investments in simulator technologies.
        We remain committed to the professional development of our enlisted
    and officers. Navy offers several college-focused incentives, including
    the Navy College Fund, the Navy College Program for Afloat College
    Education (NCPACE), and tuition assistance (TA). We continue to use
    management controls to remain within our fiscal authority. As part of
    the transformation of our Voluntary Education Program, we established
    the Virtual Education Center (VEC) in July 2010. Prior to the VEC,
    requests for TA were processed at local Navy College Offices around the
    country. The VEC provides centralized management of TA requests,
    sailors' academic transcripts, and virtual counseling. This
    transformation has decreased paperwork and processing time while
    increasing the accessibility of educational opportunities for sailors.
        To guide sailors in their professional development, we created
    learning and development roadmaps that provide detailed information
    about required training, education, qualifications, and assignments
    throughout their careers. Last year, we completed all 86 enlisted
    roadmaps, and officer roadmaps for 4 subspecialties: financial
    management, operations research, education and training management, and
    foreign area officer. We continue to leverage civilian credentialing
    programs through Navy Credentialing Opportunities Online, bolstering
    the professional qualifications of sailors in all ratings and
    increasing sailor equity in their professional advancement.
        To develop leaders who are strategically-minded, capable of
    critical thinking, and adept in naval and joint warfare, Navy has a
    progressive continuum of professional military education for E1 to O9.
    Junior enlisted personnel are able to pursue professional military
    education through distance learning while senior enlisted personnel are
    afforded the opportunity to attend the Senior Enlisted Academy (SEA)
    which graduated 455 senior enlisted sailors in fiscal year 2010.
        Officers have the opportunity to pursue advanced education through
    the Naval Postgraduate School (NPS), the Naval War College (NWC), other
    service and joint colleges, and several Navy fellowship and scholarship
    programs. For the 2010-2011 academic year, more than 1,700 Active and
    Reserve officers (resident and non-resident) are enrolled in NPS
    graduate degree programs, including 245 international students from 46
    countries. We expect that about 304 officers will complete Joint
    Professional Military Education (JPME) Phase I and 235 officers JPME
    Phase II through in-resident courses in 2011. More than 3,000 non-
    resident opportunities to receive joint education are planned for
    fiscal year 2011 through courses delivered in conjunction with graduate
    degree programs at NPS, Fleet seminar programs offered in 20 fleet
    concentration areas, and electronically via the web or CD-ROM. We
    continue to increase opportunities for Reserve officers to pursue JPME
    through Fleet seminars and Advanced Joint Professional Military
    Education (AJPME), a 40-week blended academic program to obtain JPME
    Phase II credit. These non-resident opportunities provide the
    flexibility necessary for Active and Reserve officers to balance joint
    education requirements with personal and operational demands.
        Cultural, historical, and linguistic expertise remain essential to
    fostering strong relationships with our global partners and enhancing
    our ability to effectively execute missions in multinational
    environments. In fiscal year 2010, Navy's Language, Regional Expertise,
    and Culture (LREC) program provided language and cultural training to
    over 100,000 sailors and 36 flag officers heading to overseas
    assignments. In addition, we recently expanded the Navy Reserve
    Language Culture and Pilot Program to include all Selected Reserve
    personnel. The fiscal year 2012 budget request supports continuing
    efforts to enhance foreign language capabilities and regional expertise
    to include $24.5 million in fiscal year 2012 and $134.9 million across
    the FYDP for Navy Foreign Language Proficiency Bonuses to incentivize
    proficiency in languages critical to Navy's missions. Our request also
    supports expansion of opportunities for overseas study, language and
    cultural immersion, and professional exchanges with foreign navies for
    Naval Academy midshipmen and full implementation of an in-country
    language immersion training program for Foreign Area Officers.
    Additionally, we will continue to participate in Maritime Security
    Cooperation activities and support the joint force in Afghanistan and
    Pakistan with enhanced language and cultural capabilities through the
    AFPAK Hands Program.
                         competing for the best talent
        We continue our efforts to attract, recruit, and retain the
    Nation's best talent to meet Navy's mission through recognition of Navy
    as a Top 50 organization. Top 50 organizations encourage innovation and
    focus on performance, while taking care of their people through
    programs and policies that support a culture of trust, respect, and
    collaboration. In December 2010, Navy received several awards for
    Business Excellence in Workplace Flexibility from the Alfred P. Sloan
    Foundation, recognizing initiatives introduced in nine different
    organizations across the Navy to promote flexible work options while
    achieving business goals. For the second year in a row, Navy received a
    prestigious Workforce Management Magazine Optimas Award for its ``Navy
    for Moms'' program, becoming the first organization to have won back-
    to-back awards in the 20-year history of this award and one of only
    eight organizations to have received an Optimas Award twice.
        Navy continues to receive recognition for its high quality training
    and development programs. In the 2 years since Navy began participating
    in the American Society for Training and Development (ASTD) awards
    program, no organization has won more awards for ``Excellence in
    Practice.'' Most recently, Navy was honored by Training Magazine as one
    of the premiere training organizations in the country, ranking seventh
    out of 125 organizations that were recognized. We remain committed to
    seeking out best practices across industry and benchmarking our
    programs against the best in the Nation.
        We continue to compete for the best talent in our Nation's colleges
    and universities. The Naval Reserve Officers Training Corps (NROTC)
    program has 60 units located at 73 host institutions with 86 cross-town
    institution agreements. Of the total 159 NROTC affiliated colleges and
    universities, 16 schools rank in the top 25 of U.S. News and World
    Report's Best National Universities of 2011, including three Ivy League
    affiliations. While the NROTC program has more than sufficient capacity
    for our current requirements, the Navy recognizes the value of
    engagement and presence on the campuses of American's elite colleges
    and universities and appreciates the high quality educational
    experience provided to our future military leaders at these
    institutions.
        We recognize the value of diverse ideas, perspectives, and
    experiences to remaining competitive in an increasingly global
    environment, and our Navy draws strength and innovation from this
    diversity. NROTC made significant increases in diversity enrollment
    over the past 2 years. As a result, the NROTC class of 2014 joins the
    U.S. Naval Academy class of 2014 as the most diverse classes in our
    history. In recognition of our efforts, Navy received DiversityInc's
    Top Federal Agency for Diversity Award, ranking number 5 of 30 agencies
    for excellence in leadership commitment, human capital, communications
    and supplier diversity. Additionally, Navy's Strategic Diversity
    Working Group (SDWG) was recognized as one of the Nation's top ten
    national Diversity Councils by the Association of Diversity Councils.
        Our internal survey data show that organizational support of life-
    work integration and the availability of flexible career options are
    key to attracting, recruiting, and retaining the talent of a new
    generation entering the workplace. Our sailors and their families
    continue to benefit from comprehensive parental support programs, to
    include paternity and adoption leave, extended operational deferment
    for new mothers, and expanded childcare. We thank Congress for their
    support of these programs. We continue to assess innovative ways to
    support life-work integration while meeting mission requirements
    through initiatives such as Career Intermission, telework, and other
    flexible work options.
                              women in submarines
        This past year, the Secretary of the Navy and Chief of Naval
    Operations authorized the integration of female officers into the
    submarine force. This will enable our submarine force to leverage the
    tremendous talent and potential of the women serving in our Navy. For
    the first phase of integration, female officers will be assigned to two
    ballistic missile (SSBN) submarines and two guided missile (SSGN)
    submarines, which have the space to accommodate female officers without
    structural modifications. 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. The plan also integrates female supply corps officers onto SSBNs
    and SSGNs at the department head level.
        We continue to examine the cost effectiveness of design
    modifications to all classes of submarines to accommodate mixed-gender
    crews without adversely impacting habitability standards or operational
    capabilities, as well as the manning policies necessary to maintain a
    stable and sustainable population of women in the submarine force.
                        repeal of don't ask, don't tell
        Following the President's signature of the statute authorizing the
    repeal of section 654 of Title 10, U.S.C., commonly referred to as
    ``Don't Ask, Don't Tell'' (DADT), Navy is actively preparing for final
    repeal. We will carry out the implementation process in a prompt,
    thorough, and deliberate manner. We are preparing the necessary
    policies and regulations to implement this change in the law and will
    provide training to sailors and leaders at all levels. The central
    message of this training will emphasize the principles of leadership,
    professionalism, discipline, and respect. Training will be provided
    using a tiered approach to ensure all personnel receive the appropriate
    level of training:

             Tier 1 training will be provided to experts who may
            deal frequently with repeal issues, such as chaplains, judge
            advocates, military law enforcement personnel, fleet and family
            support center personnel, personnel support professionals,
            equal opportunity advisors, recruiters, senior human resource
            officers, and public affairs officers. Community leaders within
            each of these disciplines will develop and deliver the required
            training.
             Tier 2 training will be provided to senior leaders and
            command leadership.
             Tier 3 training will be provided to Active and Reserve
            sailors, Navy civilians who supervise military personnel, and
            Department of Defense contractors, as required by their
            position and responsibilities.

        We are providing regular updates to the Office of the Secretary of
    Defense as we execute this training.
                              continuum of service
        We continue to strive for a continuum of service approach to
    retention. Our goal for the continuum of service initiative is to
    achieve a seamless transition between the Active and Reserve
    components, and the civilian workforce, to meet mission requirements
    and encourage a lifetime of service. We are making progress in
    addressing the barriers impeding a quick and efficient transition
    between components to meet changing workforce demands. Since the
    establishment of the Career Transition Office (CTO) in May 2009,
    average transition time has decreased from more than 30 days to 5 days.
    We recently integrated our Fleet Rating Identification Engine (Fleet
    RIDE) application, a tool that provides a comprehensive assessment of
    sailors' qualifications for Navy enlisted ratings, with our Perform to
    Serve initiative. This further facilitates the Reserve affiliation
    process by providing each Active component sailor with information
    about Reserve opportunities and the ability to apply for a Reserve
    component quota. Additionally, we established an Intermediate Stop (I-
    Stop) to enable transitioning sailors to report directly to their
    gaining Navy Operational Support Center once they have made the
    decision to transition from active duty to the Reserve component.
    Finally, we continue to work towards implementing a Total Force
    Integrated Pay and Personnel System. Our goal remains to transition
    sailors between the Active and Reserve components within 72 hours.
                                   conclusion
        Our mission remains to attract, recruit, develop, assign, and
    retain a highly-skilled workforce for the Navy. We continue to:

             Align the personal and professional goals of our
            workforce with the needs of the joint force, while ensuring the
            welfare of our sailors and their families.
             Deliver a high-performing, competency-based, and
            mission-focused force to meet the full spectrum of joint
            operations.
             Provide the right person with the right skills at the
            right time at the best value to the joint force.

        Our fiscal year 2012 Active and Reserve budget requests support the
    critical programs that will ensure continued success in delivering the
    human component of the Maritime Strategy and key capabilities for the
    joint force.

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                                  your marines
        Americans expect their marines to be ready to respond when our
    country is threatened; to arrive on the scene anywhere in the world
    with minimal notice; and to fight and win our Nation's battles. To this
    end, the individual marine is the Corps' most sacred resource and, as
    Deputy Commandant for Manpower & Reserve Affairs, marines are my
    mission.
        The young men and women who fill our ranks today recognize the
    global, protracted, and lethal nature of the challenges facing our
    Nation, and their dedicated service and sacrifice rival that of any
    generation preceding them. Marines and their families know that their
    sacrifices are making a difference, that they are part of something
    much larger than themselves, and that their Nation stands behind them.
                                  end strength
        In fiscal year 2010, the Marine Corps achieved both its accession
    and retention missions and maintained its 202,100 Active component end
    strength. For fiscal year 2011, we continue with this success, meeting
    all recruiting and retention missions, and the quality of our force has
    never been higher.
        Even with our retention and overall end strength successes, the
    Marine Corps must continue to shape our force to meet continuing
    requirements, fill critical military occupational specialties (MOSs),
    and retain vital leadership with combat experience. Bonuses remain
    critical to this effort, allowing the Marine Corps to fill hard to
    recruit positions, such as crypto linguists and reconnaissance.
    Enlistment bonuses also allow us to ship new recruits at critical times
    to balance recruit loads at the depots and meet school seat
    requirements. Finally, it is important to note that only 8 percent of
    new recruits receive an enlistment bonus, and the Marine Corps budget
    for enlistment bonuses has decreased from $75 million in fiscal year
    2008 to $14.7 million in fiscal year 2012.
        Selective Reenlistment Bonuses (SRBs) similarly allow us to shape
    our career force. SRBs target critical MOSs and allow us to laterally
    move marines to these MOSs. There are currently 14 of 211 occupational
    specialties where the on-hand number of marines is less than 90 percent
    of what is required. It is critical that we meet our first-term
    retention goals. It should be noted that our SRB funding has decreased
    from $468 million in fiscal year 2009 to $108.6 million in fiscal year
    2012.
        Your Marine Corps already provides the ``best value'' for the
    defense dollar. At any given time, approximately 30,000 marines are
    forward-deployed in operations supporting our Nation's defense.
                              marine corps reserve
        Our Reserves continue to make essential contributions to our Total
    Force efforts in Overseas Contingency Operations. Over the last few
    years, as we concentrated on building our Active component to 202,100,
    we fell short of our Reserve component authorized end strength of
    39,600. In 2009 and 2010, we refocused our recruiting and retention
    efforts toward achieving this end strength. These efforts included
    increasing our Reserve non-prior service recruiting mission, lowering
    our attrition, doubling our incentives budget from $12 million to $24
    million, and expanding the population eligible to receive incentives.
    As a result, we achieved over 99 percent of our authorized end strength
    in fiscal year 2010. Though our incentives budget has been reduced to
    $8.7 million in fiscal year 2011, we project an end strength of 39,589,
    less than 1 percent below our authorized level.
        Our focus has now shifted to targeting our incentives to critically
    short specialties and grades within units identified for future
    deployments in support of operational requirements.
        Company grade officer recruiting remains our most challenging area.
    Historically, our Active component has been the exclusive source of
    senior lieutenants and captains for the Marine Corps Reserve, and it
    remains a center of gravity 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 opportunities to continue their service 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: the Reserve Enlisted Commissioning Program;
    the Meritorious Commissioning Program--Reserve; and the Officer
    Candidate Course--Reserve (OCC-R). Since 2004, these 3 programs have
    produced a total of 379 lieutenants for the Marine Corps Reserve. The
    OCC-R program has been the most successful of the three Reserve
    commissioning initiatives. 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 Reserve Officer
    Commissioning Programs and affiliation bonuses are keys to meeting
    grade strength requirements in critical billets by the end of fiscal
    year 2015. We are also looking at increasing the ceiling for officer
    affiliation bonuses to attract officers to chronically hard-to-fill
    units.
        Altogether, these programs, combined with our prior service
    recruiting efforts, should provide for at least 90 percent manning of
    critical combat arms and engineer company grade officer billets by
    September 30, 2015.
                                   recruiting
        The Marine Corps is unique in that all recruiting efforts (officer,
    enlisted, regular, Reserve, and prior-service) fall under the direction
    of the Marine Corps Recruiting Command. Operationally, this provides us
    with tremendous flexibility and unity of command in order to annually
    meet our objectives.
        Our recruiters continue to make their recruiting goals in all areas
    in support of our Total Force. Our focus is always to recruit quality
    men and women with the right character, commitment, and drive. To meet
    the challenges in today's recruiting environment, it is imperative that
    we maintain our high standards both for our recruiters and those who
    volunteer to serve in our Corps. We also remain mindful that the Marine
    Corps should reflect the diverse face of our Nation and be
    representative of those we serve.
        In fiscal year 2010, we achieved over 100 percent of our enlisted
    and officer recruiting goals for both the Active and Reserve
    components. We accessed over 99 percent Tier 1 high school diploma
    graduates and over 72 percent in the upper Mental Groups of I-IIIAs,
    both exceeding Department of Defense quality standards.
        In fiscal year 2011, we will again meet our annual recruiting
    mission, to include all quality goals. Additionally, we expect to have
    a strong population of qualified individuals ready to ship to recruit
    training as we enter fiscal year 2012.
        Filling company grade officer billets for our Selected Marine Corps
    Reserve units is traditionally our greatest challenge. As mentioned
    above, the OCC-R has proven to be the most successful of our Reserve
    officer recruiting programs.
        We thank you for the generous support you have provided to us and
    look forward to working with you to ensure success in the future.
                                   retention
        Retention complements recruiting as one of the vital elements of
    building and sustaining the Marine Corps. For enlisted retention, we
    seek to retain the best and brightest marines in both our first-term
    and career force to provide proven technical skills, experience, and
    noncommissioned officer and staff noncommissioned officer leadership
    needed to meet our demanding mission.
        In fiscal year 2010, the Marine Corps reenlisted 14,265 marines.
    This achievement represented a 28 percent retention rate among the
    eligible First-Term Alignment Plan (FTAP) population compared to a
    historical average of 24 percent. We also achieved an unprecedented 79
    percent retention rate among the career Subsequent Term Alignment Plan
    (STAP) population, the highest ever, while maintaining all quality
    standards.
        For fiscal year 2011, retention achievement remains on track and
    exceptionally strong. As of April 12, 2011, we have achieved
    approximately 96 percent of our FTAP and 112 percent of our STAP goals,
    respectively.
        Our continuing retention success remains largely attributable to
    two important, enduring themes. First, marines are truly motivated to
    ``stay marine'' because they are doing what they signed up to do--
    fighting for and protecting our Nation. Second, they understand our
    service culture is one that rewards proven performance and takes care
    of its own.
                                   diversity
        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.
                keeping faith with marines, sailors and families
        Just as our marines are required to be in a constant state of
    readiness, so must our families. Our Nation has been at war for a
    decade, placing unprecedented burdens on marines, sailors, families,
    wounded warriors and the dependents of the fallen. We know that in
    order to develop, maintain, and sustain their personal and family
    readiness and resiliency, we must provide innovative programs and
    services that are timely and relevant. Our approach to caring for
    marines, families and relatives of our fallen marines is based on our
    unwavering loyalty. This concept also applies to single and married
    marines, families, wounded warriors and marines transitioning from the
    Service.
        In his 2010 Planning Guidance, our Commandant directed us to ``look
    across the entire institution and identify areas that need improvement
    and effect positive change.'' Specifically, he directed us to evaluate
    all of our family readiness programs to determine which require
    enhancement and/or expansion and which can be streamlined to reduce
    redundancy. This is not just about efficiencies; it is also about
    effectiveness. As part of that mandate, we have been directed to
    continue our behavioral health program integration, institutionalize
    resiliency training, and reorganize and improve our Transition
    Assistance Management Program.
    Family Readiness
        In 2010, the Marine Corps increased baseline funding for family
    support programs by $110 million to ensure an appropriate wartime
    footing. Programs benefitting from this measure include: 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. As we continue the process of providing marines
    and their families with the most effective and relevant services, we
    are assessing all of our family support programs, identifying gaps and
    overlapping or duplicative efforts, and looking for opportunities to
    develop partnership programs and share resources with other agencies.
        Some of our notable accomplishments include the following:

             Established over 400 full-time civilian Family
            Readiness Officers to facilitate family contact and provide
            critical information and referral services to support the
            resiliency needs of marines and their families.
             Developed an inventory of Deployed Support and
            LifeSkills Education and Training courses to address the
            challenges of military, personal, and family life.
             Transformed the Exceptional Family Member Program to
            ensure that enrolled family members are provided a continuum of
            care, while providing the sponsor the opportunity for a
            successful career.
             Established school liaisons that form strong
            partnerships with schools and other supporting agencies to
            improve access and availability to quality education.
             Implemented program and infrastructure enhancements at
            remote and isolated commands, including investments in child
            care, single marine programming, fitness and recreation
            centers, and recreational equipment to support deployed
            marines.
             Increased Marine Corps child care capability from 64
            percent to 73 percent with projection to meet 80 percent of
            potential need by fiscal year 2012.
             Partnered with the Marine Corps Recruiting Command
            (MCRC) to conduct the first online survey of all MCRC personnel
            and their spouses in order to assess their views on key quality
            of life issues (financial, housing, health care, communication,
            and services) and to determine any perceived gaps in support.
    Deployed and Warrior Support
        Deployed support is one of the most important services we provide.
    Our Exchange, Recreation and Fitness, and Communication services not
    only boost and maintain morale but also help to reduce mission-related
    stress.

             Exchange. Ongoing missions in Afghanistan include the
            operation of two Direct Operation Exchanges at Camps
            Leatherneck and Dwyer, and one Tactical Field Exchange at Camp
            Delaram II.
             Recreation and Fitness. We assist in providing sports,
            recreational, and fitness equipment to units throughout Helmand
            Province with the joint support of USFOR-AJI. This
            transportable equipment includes sports/recreation cooler kits
            filled with sports gear and board games, electronic game kits,
            Theater-in-a-Box kits, and fitness equipment for use in austere
            environments.
             Communication. Morale satellite services are available
            to forward operating bases, combat outposts, and other austere
            locations. We have delivered 13 satellite communications
            systems to units in Afghanistan. Each system has two phones
            that provide 6,000 free minutes per month and five laptops that
            allow internet browsing, social networking and chat/video
            capabilities to deployed marines.
                              family care programs
    Exceptional Family Member Program (EFMP)
        The most tender of our families, those enrolled in the Marine Corps
    EFMP, have strongly endorsed the improvements we have made to their
    level of support and to providing a continuum of care. Year after year
    since our program expansion, we have gained the trust of our families.
    This is demonstrated through increasing enrollments and reduction in
    issues experienced by families relocating to new duty stations. I am
    proud to state that DOD and the other Services recognize our EFMP as a
    premier, full-service program based on the quality and efficiency of
    program operations.
        Our EFMP sponsors will always be an advocate for their special
    needs family member, but when families need legal help, our EFMP
    attorneys are ready to assist with obtaining benefits and services
    under Federal and State education and disability laws, special needs
    trusts, landlord-tenant issues, and other legal areas.
        In 2001, EFMP had 4,500 enrolled family members. This number has
    grown to over 10,000 today. We believe our enrollments will continue to
    increase.
        In the past year, we have taken multiple actions to transform the
    program, including:

             Utilizing Family Case Workers to support families
            during relocation, deployments, and life events and to assist
            families with gaining access to medical, educational, and
            financial support services.
             Establishing installation-level Training Education
            Outreach specialists to provide training and support for
            families and the programs that support them.
             Utilizing a Continuation on Location policy that
            ensures the assignment and relocation process is sensitive to
            EFMP family needs and meets statutory stabilization
            requirements.

        In addition, the Marine Corps continues to underwrite the cost of
    up to 40 hours of short-term respite care per month for enrolled
    families. To date, we have provided more than 450,000 hours of respite
    care. Since the cost is underwritten by the Marine Corps, families are
    able to use their TRICARE Extended Care Health Option benefit for
    needed therapies and equipment. Nevertheless, challenges remain, such
    as:

             the lack of portability of services for adults with
            autism;
             the inability of military families to gain access to
            Medicaid;
             the difficulty in accessing therapeutic and mental
            health support, such as adult and pediatric care; and
             national economic impacts and subsequent State budget
            cuts, particularly at local and State levels, which may impede
            school districts' abilities to provide special education
            services.

        To address some of the State access issues, we have partnered with
    the National Council on Disability to study this problem. Results are
    under review.
    Children, Youth, and Teen Programs
        Whether parents are working, experiencing family emergencies, or
    needing respite from single parent responsibilities connected to
    deployments, child care services remain a high priority quality of life
    requirement. In 2010, we provided 13,431 child care spaces and met 73
    percent of potential need requirements. Within these totals, we are
    caring for approximately 2,500 special needs children.
        The Marine Corps, with your support, is executing an aggressive
    military construction program and is opening six new child development
    centers in fiscal year 2011 and five more in fiscal year 2012.
    Nevertheless, as you might expect, the demand for quality child care
    on-and-off installation continues to grow. To address this growing
    demand and help further define requirements, we are working on a Child
    Development Program and Facility Master Plan. This plan will evaluate
    on-and-off-base access, unmet need, and will provide prioritized
    recommendations for meeting the need across the Marine Corps. We
    anticipate results this summer.
        In 2011, we will work with Marine Forces Reserve and MCRC to
    identify opportunities to enhance availability of child care for
    marines and their families serving on independent duty and at locations
    that are separated from military bases and stations. In addition, we
    are partnering with the Boys & Girls Clubs of America for developmental
    youth programs, and working to identify ways to better support our
    youth and teens affected by a parent's deployment. We have reviewed the
    results of the National Military Family Association and RAND Study
    related to impacts on youth from deployments and are considering ways
    to address this situation.
    School Liaison Program
        To help school-aged children of marines flourish in new school
    environments, our School Liaison Program partners with Local
    Educational Agencies (LEAs) to raise the educational capacity and
    academic performance of our military children. Supporting more than 80
    school districts surrounding major Marine Corps installations, our
    school liaisons provide LEAs with information on Marine Corps families'
    needs and access to beneficial training and counseling services. Marine
    parents have the comfort of talking with and being supported by a local
    education expert who provides meaningful insight and support to new
    transfers and those with questions on local education policies. In
    addition, school liaisons provide Marine parents with connections to
    online curricular resources that are linked to State standards,
    permanent change-of-station checklists to assist with pre-relocation
    planning and registration in the receiving school districts, online
    tutoring and other resources.
    Personal and Professional Development
        Our Commandant has directed the Marine Corps to conduct a ``bottom
    up'' assessment of our Transition Assistance Management Program and our
    Lifelong Learning Program to revolutionize the process, embrace best
    practices, and ensure we are providing the right educational and career
    assistance to marines leaving the Corps. Today, our program is
    primarily a training event. We have established a goal to transform
    this from an event into a process and to make the Marine Corps'
    Transition Assistance Management Program a model for DOD.
        From 2009 to 2010, the Marine Corps 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. These teams identified issues,
    stakeholders and a conceptual framework for improved services and ways
    to integrate Marine Corps Community Services transition assets. Key
    stakeholders involved in this process include servicemember recruiters,
    commanders, Unit Transition Coordinators, and most importantly--our
    marines and their family members.
        With our predominately first-term force, we are committed to
    reaching our marines at designated touch points, helping them develop
    roadmaps that support their Marine careers, and better equipping them
    to reintegrate back into civilian life upon leaving active duty
    service. We have developed an end-to-end process improvement plan, are
    initiating actions, and are integrating existing capabilities that
    directly improve the quality of support provided to our marines. In the
    future, our transition assistance will become a personal and
    professional development process that will reintegrate marines into the
    civilian sector with the knowledge, skills, and abilities to better
    leverage their Marine Corps time and experience into meaningful
    careers. Some of our actions include:

             Establishing the new Personal and Professional
            Development program and incorporating ``transition assistance''
            with a continuum of services designed to fully exploit the
            potential of all marines and prepare them to transition to
            civilian life.
             Establishing formal processes to initiate periodic
            lifecycle contact to offer education, career, and financial
            advice/counseling to marines and their families.
             Creating an Individual Development Plan, with
            execution and delivery of required transition services.
             Assisting marines with navigating the Department of
            Veterans Affairs benefit process. Based on feedback from
            surveyed marines, we know they want and need this kind of
            assistance. To address this issue, we will modify existing
            websites to improve access and enhance opportunities for
            separating marines to speak directly to Marine Corps support
            personnel who are trained to remove benefit processing
            barriers.
             Expanding public and private sector employment
            opportunities. We know from our surveys that marines do not
            expect a ``job handout''. Rather, they want to be leaders and
            strong contributors to our Nation. They have told us that they
            want to improve their networking skills and learn how to
            connect with employers and mentors. We are in the process of
            revamping our transition workshops to focus on these needs and
            are working on ways to incorporate more networking
            opportunities into our job fairs.
             Connecting and expanding available educational
            opportunities. The Post-9/11 GI Bill provides marines a
            wonderful educational opportunity. In an effort to expand this
            opportunity, we have initiated a Leader Scholar Program on the
            west coast which includes academic institutions who value
            Marines' service commitment and pledge to provide them special
            enrollment consideration; we now have 75 participating
            institutions and have a goal of 100 by the end of this year.
             Assisting marines with education enrollment processes
            to enable them to gain access to academic institutions that
            provide business education skills that private industry
            demands.
             Improving the current Active-to-Reserve transition
            process to better educate marines on Reserve opportunities to
            retain the best talent. An enhanced, streamlined transition
            process will increase the number of valuable, trained marines
            who consciously choose to affiliate with the Reserves.

        We believe our efforts will result in an innovative program that
    addresses the Commandant's concerns, assists our families with their
    education and career goals, and meets the needs of our marines as they
    progress through their military life cycle, whether a single enlistment
    or a lifetime of military service, and transition to a successful post-
    military career.
    Behavioral Health Integration
        Sixty-four percent of our marines are under 25 years-old.
    Associated with this young force are inherent high-risk factors that
    include relationship and coping skills, isolation, combat-related
    wounds, and substance abuse. Furthermore, since September 11,
    behavioral health needs have become increasingly complex with
    individuals often requiring assistance in a number of areas at one
    time. The anticipated drawdown of marines deployed to Afghanistan will
    likely result in additional behavioral healthcare requirements as
    marines return and readjust to the garrison environment.
        Marines with three or more deployments have been identified as
    particularly at risk. As a result, our Combat Operational Stress
    Control (COSC) Program is currently developing a policy that will
    direct commanders to conduct face-to-face interviews with marines who
    have had three or more deployments. These commanders' interviews will
    identify marines at some level of elevated risk, allow commanders to
    engage their marines (pre- and post-deployment), and provide an
    opportunity for intervention (medical and non-medical).
        As directed by the Commandant, we continue to move forward with
    fully integrating our Marine Corps behavioral health programs--Family
    Advocacy, Combat Operational Stress Control, Suicide Prevention, Sexual
    Assault Prevention and Response, and Substance Abuse. We have
    established a Behavioral Health Branch at our headquarters for Marine
    and Family Programs, Manpower & Reserve Affairs, and are working to
    ensure that the programs and services that stem from this integration
    will be seamlessly woven into the larger support network of command
    structures and the health and human services across the Corps and are
    in concert with building resilience and strengthening marines and
    families.
    Sexual Assault Prevention and Response
        Marine Corps' leadership has initiated aggressive actions to
    elevate and highlight the importance of the Sexual Assault Prevention
    and Response (SAPR) Program and institutionalize a zero-tolerance
    policy. SAPR is focused on several key initiatives:

             Prevention: Commanders are accountable for creating a
            climate in which sexual assault will not be tolerated and
            building trust within their units that enables victims of
            sexual assault to report the crime. Bystander intervention
            training has been identified as an evidence-based best practice
            for engaging marines in their role in sexual assault
            prevention. New video-based bystander intervention training is
            in development with a completion date of April 2011.
             Risk Reduction: Alcohol has a tremendous impact on the
            prevalence of sexual assault. Research on best practices for
            addressing risk reduction, consent, and raising awareness
            within the Marine Corps is forthcoming in 2011.
             Offender Accountability: The Trial Counsel Assistance
            Program and a Joint Mobile Training Team were implemented in
            2010 to provide training for 40 Marine Corps investigators and
            prosecutors on best practices in handling sex crimes.
            Following-up on the success of the Case Review Project in 2009,
            the Judge Advocate Division Military Law Branch is reviewing
            closed cases of sexual assault to develop lessons learned. This
            information will be disseminated in the form of training
            techniques for investigators and prosecutors.
             Victim Advocacy: During 2010, SAPR Program Managers
            were hired at 18 installations to heighten sexual assault
            prevention efforts by serving as master trainers and reporting
            coordinators. A 24/7 Helpline was established across all
            installations to provide victims with emotional support,
            information on reporting options, and critical resources.
    Suicide Prevention
        During calendar year 2010, we saw a nearly 30 percent decrease in
    the number of suicides within our Total Force (52 in calendar year
    2009; 37 in calendar year 2010). Yet even one suicide is still one too
    many. It is premature for us to be able to identify what specific
    initiative(s) have resulted in this decrease. For the past several
    years, we have been, and will continue to be, engaged on multiple
    fronts:

             Established a DSTRESS Line pilot in TRICARE Region
            West for all our marines, sailors, and families which provides
            24/7, anonymous counseling designed to assist with problems at
            an early stage. The phones are manned by veteran marines, our
            former corpsmen, and by licensed counselors specifically
            trained in our culture.
             Leadership engagement and discussion of issues at
            senior leader forums and Executive Force Preservation Boards.
             Our ``Never Leave a Marine Behind'' suicide prevention
            training series is being expanded. In November 2010, we
            provided a junior marine module as well as an update to the
            existing award-winning NCO module. In development for release
            in March 2011 are SNCO and officer modules that will help
            leaders to manage command climate in a way that builds
            resilience and encourages help-seeking in their marines.
             Working with the American Association of Suicidology
            to develop training programs for unit-level prevention
            officers.

        We believe our training and other prevention efforts will help our
    marines and their family members maintain readiness and win their
    personal battles.
    Combat and Operational Stress Control (COSC)--Resiliency Training
        Stress issues affect all marines and families regardless of
    deployment. Assisting marines who show signs of stress and preventing
    combat and operational stress is one of our highest leadership
    priorities. 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 in coping with the challenges of life as
    a marine.
        Instruction founded and focused on our core values helps provide
    some of this resilience and enables effective operations, especially in
    irregular warfare and complex environments. A program combining the
    ``best practices'' of mental, spiritual and physical fitness will
    instill in our marines the resiliency to better endure the stressors of
    combat.
        Our COSC program's goal is to help Commanders and Marine leaders
    maintain their warfighting capabilities and, with assistance from
    medical personnel, reduce the impact of negative stress reactions. By
    providing tools and resources to assist marines with coping with the
    challenges of combat and the rigor of life as a marine, our COSC
    program implements activities focusing on force preservation and
    readiness and the long-term health and well-being of our marines and
    their families. COSC, with other behavioral health initiatives,
    aggressively combats these problems by strengthening marines,
    mitigating stress, identifying those who are at risk, and providing
    treatment when necessary, with the overall goal of reintegrating
    marines back into the force.
        Our Operational Stress Control and Readiness Program (OSCAR) embeds
    mental health professionals in operational units and provides training
    that helps the OSCAR team identify and mitigate negative stress
    reactions. The OSCAR team is comprised of three groups: Providers
    (mental health professionals), Extenders (other medical and religious
    personnel), and Mentors (selected unit marines) who are trained to
    quickly intervene when marines show signs of stress reactions.
    Currently over 1,900 marines are trained as mentors.
        In fiscal year 2011, COSC will sustain and improve OSCAR training
    by conducting a RAND evaluation, working with units who utilized OSCAR
    training while in combat environments, and providing refresher training
    to OSCAR trainers. Extenders are receiving formal OSCAR training at
    Field Medical Schools, which began in January 2011 and which also
    supports institutionalizing OSCAR enhancing resiliency training.
        Our COSC program continues to show positive results as indicated by
    outside evaluations and assessments. Despite increased exposure to
    heavy combat, marines surveyed in Afghanistan in July 2010 indicated
    increased protective factors including unit resilience, small-unit
    cohesion, perceived readiness, and improved climate towards asking for
    help. This assessment also revealed increased training effectiveness in
    managing combat/deployment stress and significant reduction in stigma
    associated with seeking behavioral health treatment.
    Casualty Assistance
        The Marine Corps' Casualty Assistance Program is committed to
    ensuring that families of our fallen marines are always treated with
    the utmost compassion, dignity, and honor. Our Casualty Assistance
    Program actively seeks opportunities to improve survivor assistance and
    has a demonstrated record of taking quick, effective action as needed.
        The Headquarters Casualty Section is a 24-hour-per-day operation
    manned by marines trained in casualty reporting, notification, and
    casualty assistance procedures. Next-of-kin (NOK) are notified in-
    person by a marine in uniform--a Casualty Assistance Calls Officer
    (CACO)--and a chaplain whenever possible. Notifications are typically
    completed within 4 hours of receipt of the casualty report. Marine
    CACOs are there for the NOK--to assist with burial arrangements,
    applications for benefits and entitlements, contact with benevolent and
    philanthropic organizations, and obtaining reports of investigation.
        Within days of the incident, families are connected to
    representatives from the Tragedy Assistance Program for Survivors
    (TAPS), a nationally recognized provider of comfort and care to those
    who have suffered the loss of a military loved one and are experts at
    ``taking care of the heart''. TAPS services are no-cost and available
    24/7.
        Approximately 60 days following the death, we reach out to the NOK
    to help resolve any residual issues and let them know we are available
    to them for as long as they need us.
                            wounded warrior regiment
        In his 2010 Planning Guidance, our Commandant reiterated his
    commitment to ``enhance the capabilities of the Wounded Warrior
    Regiment to provide added care and support to our wounded, injured, and
    ill (WII).'' Moreover, he affirmed the need to sustain the Regiment for
    the long-term given the wounds of the war and that the Regiment also
    provides care for our marines who are not combat wounded, but are
    injured in training or other accidents, suffer from diseases, and other
    tragedies. Congress and the Nation may rest assure that the Marine
    Corps, through the Regiment, will continue to meet the Commandant's
    intent and the needs of this Nation's wounded, ill, and injured (WII)
    marines.
        The Regiment serves the Marine Corps Total Force--active duty,
    Reserve, retired and veteran marines. It is positioned in locations
    around the country and abroad in order to establish a personal
    relationship with WII marines and their families. Its strategic reach
    allows for resources and services to be delivered to WII marines and
    their families regardless of their recovery location. The Regiment
    maintains administrative and operational control of two Wounded Warrior
    Battalions located at Camp Pendleton, CA, and Camp Lejeune, NC. Each
    battalion has detachments located at military treatment facilities and
    Department of Veterans Affairs Polytrauma Rehabilitation Centers. The
    span of the Regiment extends across the globe from Landstuhl, Germany,
    to Okinawa, Japan, and throughout the continental United States.
        The complexity of WII marines' care requires a heightened level of
    coordination between various medical and non-medical care providers.
    There is no ``one-size-fits-all'' approach to care and the Regiment
    delivers a cross-section of services and resources to WII marines and
    families. We continue to refine our support capabilities and grow our
    care model to ensure we promote healing the ``whole'' marine. Through
    synchronization of our programs and resources and external programs, we
    strive to help each WII marine focus on their abilities to heal
    medically while strengthening their mind, body, spirit, and family
    through mandatory participation in programs covering a wide range of
    activities, such as academic endeavors, internships, physical fitness,
    and community service. Highlights of our program include:

             Marine Section Leaders. The Section Leader combines
            the discipline and standards of the Marine Corps with an
            understanding of the obstacles WII marines face, while serving
            as their advocate to ensure coordinated medical and non-medical
            recovery efforts. Section Leaders are key to the recovery
            process as they oversee the integration of the Marine's medical
            recovery process with productive and meaningful non-medical
            activities that build strong minds, bodies, and spirits.
             Recovery Care Coordinators. The Regiment has a fully
            operational Recovery Coordination Program. Recovery Care
            Coordinators (RCCs) are assigned to certain active duty WII
            marines to help them and their families develop Comprehensive
            Transition Plans to define and meet their individual goals for
            recovery, rehabilitation, and reintegration. RCCs and section
            leaders work together to help WII marines transition. RCCs
            serve as the ultimate point of contact for WII marines to help
            them identify needs, define goals, and meet their goals.
             Medical Section. The Regiment's Medical Section
            includes a Regimental Surgeon, Nurse Case Manager, and Clinical
            Services staff who work with public and private medical
            providers to ensure the best care for WII marines, particularly
            in the areas of Post-Traumatic Stress (PTS) and Traumatic Brain
            Injury (TBI). They also work hand-in-hand with the Bureau of
            Navy Medicine to environmentally scan for new and emerging
            treatment protocols and advise the commanding officer regarding
            medical issues and emerging technologies and treatments
            impacting WII marines.
             Warrior Athlete Reconditioning (WAR) Program. The
            Regiment's WAR Program strengthens the marine's body through
            physical activity and nutrition to develop lifelong healthy
            habits. Under this program, marines engage in both physical and
            cognitive activities outside the traditional therapy setting.
            Activities are individualized to the WII marines' needs, and
            encompass over 18 areas--from aquatic training to yoga.
             Family Support. Support for WII marines and families
            is unique and staff often perform non-traditional family
            support roles at all of its locations. Family support staff
            often work in hospital-type environments and rely on
            nontraditional resources, such as charitable organizations,
            Veterans Service Organizations, and Federal and State agencies.
             Reserve Support. Our Reserve Medical Entitlements
            Determination Section maintains oversight of all cases
            involving reservists who require medical care beyond their
            contract period for service-connected ailments. The Regiment
            also has Reserve-specific RCCs who provide one-on-one support
            and resource identification for reservists who often residing
            in remote and isolated locations.
             Transition Support. To enhance community
            reintegration, the Regiment's Transition Support Cell, manned
            by marines and representatives from the Departments of Labor
            and Veterans Affairs, proactively reaches out to identify
            employers and job-training programs that help WII marines
            obtain positions in which they are most likely to succeed and
            enjoy promising and fulfilling careers.
             District Injured Support Cells. Our District Injured
            Support Cells are mobilized Reserve marines located throughout
            the country to conduct face-to-face visits and telephone
            outreach to WII marines and their families. They maintain
            oversight of the welfare and quality of life of all WII marines
            convalescing at home and all OEF/OIF WII marine veterans.
             Sergeant Merlin German Wounded Warrior Call Center.
            Our Sergeant Merlin German Wounded Warrior Call Center extends
            support to marines and families through advocacy, resource
            identification and referral, information distribution, and care
            coordination. The Call Center has clinical services staff that
            provide immediate assistance and referral for marines with
            psychological health issues and/or PTS/TBI. Outreach is an
            important aspect of our non-medical care delivery and
            management. The Call Center also conducts outreach calls to
            offer assistance on a wide variety of issues, such as service
            disability ratings, awards, employment, financial assistance,
            education, and benevolent organizations. A recent feature to
            the Call Center is the addition of social media experts who
            actively manage the Regiment's Facebook page.

        The Marine Corps is committed to the long-term care of its wounded
    warriors and their families and will continue to provide for their
    care. As warrior care evolves and innovates, we will continue to adjust
    to ensure we are providing the best support possible. Your WII marines
    are highly motivated, focused on their abilities, and remain in the
    fight. The Marine Corps is grateful for the exceptional support that
    you have provided to our marines and the families who support them.
                                civilian marines
        Civilian marines provide an invaluable service to the Corps as an
    integral component of our Total Force. With a population of 35,000, the
    civilian workforce is as lean and efficient as our Active-Duty Forces.
    The ratio of civilians to marines is 1:6, compared to about 1:2 in the
    other Services and DOD-wide. Civilian marines work in true partnership
    with our marines and play an important role in current combat
    operations, research and development, and acquisition. They are
    critical assets which provide support to the Total Force, especially
    our marines returning from deployment and their families, and to Base
    and Station operations. Civilians are the ``force multiplier,''
    enabling our marines to accomplish missions across all aspects of
    expeditionary operations and warfare. Dozens of civilians are currently
    forward deployed supporting combat operations. The civilian labor
    budget represents less than 5 percent of the Marine Corps fiscal year
    2012 budgetary submission, demonstrating that our ``best value'' for
    the defense dollar applies to our civilians as well as our marines.
                                   conclusion
        As we continue to deploy and fight in Afghanistan and other parts
    of the world, the Marine Corps will be required to meet many
    commitments, both at home and abroad. To continue to be successful, we
    must always remember that our individual marines are our most precious
    asset, and we must continue to attract and retain the best and
    brightest into our ranks. Marines are proud of what they do. They are
    proud of the ``Eagle, Globe, and Anchor'' and what it represents to our
    country. With your support, a vibrant Marine Corps will continue to
    meet our Nation's call.
        Thank you for the opportunity to present this testimony.

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Webb. Thank you, Secretary Garcia.
        Admiral Ferguson, welcome.

      STATEMENT OF VADM MARK E. FERGUSON III, USN, CHIEF OF NAVAL
                          PERSONNEL, U.S. NAVY

        Admiral Ferguson. Thank you. Chairman Webb, Senator Graham,
    and distinguished members of the subcommittee, thank you for
    the opportunity to review our fiscal year 2012 budget request.
        We believe our request appropriately balances risk in
    supporting the readiness requirements of the fleet, growth in
    new mission areas, and the essential programs that provide for
    the care of our sailors and their families. The extraordinary
    people of our Navy are serving around the globe, with nearly 50
    percent of our ships underway or deployed.
        Our forward-deployed naval forces give us the flexibility
    to respond rapidly around the globe. We have witnessed this
    unique capability over the past few months, where naval forces
    on scheduled deployments were quickly on hand in the waters off
    Japan, after the devastating earthquake and tsunami, to deliver
    humanitarian assistance to the Japanese people. Simultaneously,
    halfway around the globe, our ships, submarines, and aircraft
    were on station in the Mediterranean to set the conditions for
    a multinational no-fly zone over Libya. In the central command
    region, naval forces remained on call to support our ground
    troops and Special Operations Forces.
        To sustain this force, we continue to adapt our family
    support programs to meets the needs of our sailors and their
    families. We monitor the health of the force through surveys
    and retention data, which indicate sailors are satisfied with
    their leadership, benefits, and compensation.
        Your support has made this possible.
        In developing our fiscal year 2012 budget request, we
    review current operations, our procurement profile, and
    readiness requirements. This review indicated the need to add
    approximately 6,800 billets to the operating forces. To source
    these billets without additions to our overall end strength, we
    reduced or consolidated approximately 8,400 billets in the
    fleet, squadron staffs, and shore activities.
        Additionally, the Navy has placed end strength, previously
    funded by supplemental appropriation, into our baseline program
    for fiscal year 2012 and beyond. We assess that our Active and
    Reserve end-strength request will meet our 2012 projected
    requirements.
        We continue to attract, recruit, and retain the Nation's
    best talent. Your Navy's received over 20 national awards, over
    the past year, recognizing accomplishments in workplace
    flexibility, management, training, recruiting, and workforce
    development.
        On behalf of the men and women of the U.S. Navy and their
    families, I extend my sincere appreciation to the committee and
    Congress for your support. I look forward to your questions.
        Thank you.
        Senator Webb. Thank you, Admiral Ferguson.
        General Milstead, welcome.

      STATEMENT OF LT. GEN. ROBERT E. MILSTEAD, JR., USMC, DEPUTY
     COMMANDANT FOR MANPOWER AND RESERVE AFFAIRS, U.S. MARINE CORPS

        General Milstead. Chairman Webb and Ranking Member Graham,
    it's my privilege to appear before you today.
        The Marine Corps is our Nation's expeditionary force in
    readiness, and we're ready to respond to today's crisis with
    today's force, today. The individual marine is our Corps' most
    sacred asset. The quality of our force has never been better.
    Part of my job is to make sure it stays that way.
        Regardless of any future force-structure changes, the
    challenge of shaping our force with the right grades, combat
    experience, and skills to fulfill operational requirements will
    remain. We appreciate your continued support for the tools and
    the funding to succeed.
        A top priority of our Commandant is to keep faith with our
    marines, sailors, and their families; and, through program
    improvements, and with your continued support, we are doing
    just that. Marines are proud of their eagle, globe, and anchor
    and what it represents to our country. With your support, a
    vibrant Marine Corps will continue to meet our Nation's call.
        I look forward to answering your questions.
        Senator Webb. Thank you, General.
        Secretary Ginsberg, welcome.

     STATEMENT OF HON. DANIEL B. GINSBERG, ASSISTANT SECRETARY OF
             THE AIR FORCE FOR MANPOWER AND RESERVE AFFAIRS

        Mr. Ginsberg. Thank you, Chairman Webb and Ranking Member
    Graham. I appreciate the opportunity to come and testify before
    you today. Your committee plays a vital role in overseeing the
    DOD, and we deeply appreciate your support, in the Air Force.
        I begin with Secretary of the Air Force Donley's recent
    words that our most valuable asset is our people. I recently
    returned from a trip to Afghanistan with Secretary Lamont and
    can report that your airmen are making an incredible
    contribution to the joint and coalition warfight. Whether in
    the realm of air medical evacuation, forward airbase resupply,
    close air support, or intelligence, surveillance, and
    reconnaissance, the Nation's airmen are applying every ounce of
    their skills, talents, and energy to support their partners.
        We have a total force that is indeed fully engaged in
    today's fight. We have deployed more than 42,000 airmen, and
    engaged significant stateside forces in support of global
    operations. There are approximately 10,000 deployed Guard and
    Reserve airmen supporting every combatant commander.
        Under Secretary Donley's leadership, we are building on our
    longstanding commitment to taking care of our airmen and their
    families by establishing the Air Force Sense of Community,
    which is an outgrowth of last year's highly successful Year of
    the Air Force Family Initiative. This plan will strengthen our
    ties to one another, increase our operational abilities, and
    ensure our Air Force community is best positioned to meet
    future commitments and requirements.
        In the all-important realm of wounded warrior and survivor
    care, we have significantly improved the Air Force Survivor
    Assistance, Recovery Care, and Air Force Wounded Warrior
    Programs. Our family liaison officers, recovery care
    coordinators, medical caseworkers, Air Force wounded-warrior
    consultants, and community readiness consultants provide
    immediate and direct care for our airmen and their families
    through recovery, rehabilitation, and reintegration into the
    Air Force or into the civilian community.
        Also, at the direction of Secretary Donley, we developed a
    plan to integrate the three Air Force component personnel
    management systems into one system. The strategic intent of
    this effort, which we call ``3-in-1 integration,'' is to
    establish a single, uniform system for Air Force personnel
    management, optimizing existing systems already in place. This
    effort will greatly improve efficiency, personnel management,
    and promote uniformity in policies and processes, to the extent
    practicable.
        I look forward to answering your questions, and thank you
    for your continued support of the Air Force.
        [The joint prepared statement of Mr. Ginsberg and General
    Jones follows:]
       Joint Prepared Statement by Hon. Daniel B. Ginsberg and Lt. Gen.
                             Darrell D. Jones, USAF
                                  introduction
        Chairman Webb, Senator Graham, and distinguished members of the
    subcommittee, we thank you for the opportunity to appear before you on
    behalf of America's airmen. In an era of evolving requirements, diverse
    mission sets, and constrained budgets, our Air Force faces an ever
    increasing set of challenges as we seek balance between winning today's
    fight and countering the threats of tomorrow. This objective will not
    be achieved easily and will increase in complexity as we realize the
    cumulative impact of being at war continuously for the past decade. As
    the Air Force's Assistant Secretary for Manpower and Reserve Affairs
    and Deputy Chief of Staff for Manpower, Personnel and Services, it is
    our mandate to help deliver fully-qualified and ready airmen for the
    Joint Warfighter while meeting the essential needs of these airmen and
    their families. As part of this charge, we remain dedicated to ensuring
    we organize and develop our Total Force so we are prepared to meet the
    challenges of the 21st century.
                     military and civilian personnel budget
        Towards this end, our personnel budget submission reflects this
    focus as we have requested $30.5 billion in MilPers and $7.8 billion
    for CivPers for the regular component in fiscal year 2012. This
    decrease of $600 million in CivPers from fiscal year 2011 levels is
    primarily due to a return to fiscal year 2010 manning levels. For the
    Air National Guard, we have requested $2.2 billion for CivPers to pay
    our Title V and Title 32 (dual status military technicians) civilians
    and $3.1 billion for MilPers. This is a $10 million increase over
    fiscal year 2011 primarily due to price growth in pay, BAH, incentives,
    and Retired Pay Accruals, alleviated to a degree by targeted program
    reductions. For the Air Force Reserve we have requested $1.7 billion
    for MilPers and $1.2 billion for CivPers.
        As part of our overall focus on efficiencies, the Air Force will
    not increase our civilian workforce to planned levels and will follow
    the Secretary of Defense's intent to maintain civilian full-time
    equivalents near the fiscal year 2010 levels. This will require some
    workforce rebalancing and we are conducting a strategic review to
    determine areas where we most need our valuable civilian personnel in
    the future. We are conducting this review concurrent with the
    development of our fiscal year 2013 budget. In order to maintain
    alignment of our workforce against our most critical missions and take
    care of our current workforce as we determine our long-term needs, we
    have recently instituted hiring controls to ensure the size of our
    workforce is consistent with our available civilian pay dollars. We
    will monitor the size of our workforce closely over the next months and
    adjust controls accordingly, but we'll continually focus on maintaining
    the right skillsets for our missions and taking care of our civil
    servants.
                    airmen in the joint and coalition fight
        More than 97,000 Total Force airmen are currently forward stationed
    or deployed worldwide supporting combatant commanders. Another 133,000
    provide daily strategic mobility, space and missile capabilities,
    command and control, and intelligence, surveillance, and reconnaissance
    to joint warfighters. In all, 43 percent of the Total Force directly
    supports combatant commander requirements every day.
                                  end strength
        The fiscal year 2011 programmed Total Force end strength is 702,367
    which is comprised of 332,200 active duty, 192,267 civilians, 71,200
    Reserve, and 106,700 Air National Guard personnel. In the fiscal year
    2012 budget, we have requested a Total Force end strength that will
    actually decrease to 693,099. Active duty end strength will increase by
    600 airmen to 332,800, and our civilian end strength will decrease by
    just over 10,000 to 182,199 civilians. We will also increase the
    Reserve end strength by 200 to 71,400 while the Air National Guard
    remains unchanged at 106,700. Additionally, the fiscal year 2012 budget
    captures efficiency efforts through reducing overhead and support
    functions which will allow us to shift manpower resources to our
    warfighter and readiness programs.
                                force management
        Fiscal constraints and 16-year record high retention rates compel
    the Air Force to develop voluntary and involuntary programs to manage
    our end strength. At the end of fiscal year 2010, the Air Force
    exceeded its end strength of 331,700 by approximately 2,300 officers
    while meeting enlisted end strength levels. We expect to exceed our
    fiscal year 2011 end strength by approximately 900 officers and could
    reach well above this level by fiscal year 2012 if we do not continue
    efforts to manage attrition. We have reduced and delayed officer and
    enlisted accessions to help manage our total end strength. Since its
    implementation, nearly 13,000 reservists have become trained and
    available. For fiscal year 2011, we will conduct a Force Shaping Board
    for junior officers, a Reduction in Force (RIF) board for mid-grade
    officers, and Selective Early Retirement Boards (SERB) for lieutenant
    colonels and colonels. Mid-grade officers eligible for the RIF board
    will have the opportunity to apply for voluntary separation pay in lieu
    of meeting the board. Likewise, lieutenant colonels and colonels will
    have the opportunity to voluntarily retire in lieu of meeting the SERB.
    Our force management strategy is not a rapid resolution, but a
    carefully tailored, multi-year effort designed to manage the force
    along a 30-year Continuum of Service in a manner that makes required
    efficiencies while still keeping faith with our career force.
                                   accessions
        For fiscal year 2011, planned enlisted accession reductions are
    2,135 but may be adjusted before the end of the year based on losses
    and retention rates. Planned officer reductions have been adjusted to
    approximately 300, down from 439. Reductions are realized in all
    officer competitive categories, with our rated force at 97 percent
    sustainment; non-rated line at 93 percent sustainment; and non-line at
    93 percent sustainment. In fiscal year 2012, we anticipate few
    reductions in officer accessions. However, enlisted accession
    reductions are currently set for 2,037 but may be readjusted before the
    end of the year. In the past year, the Air Force Reserve experienced
    the most accessions in 16 years and the highest amount of non-prior
    service recruits in over 20 years.
               recruiting, retention, bonuses, and incentive pays
        We are completely committed to retaining high quality airmen in
    order to successfully carry out today's missions as well as our new and
    emerging missions. America has the very best Air Force in the world,
    and it takes recruiting, developing, and retaining the highest quality
    airmen to maintain that status. To do so, our fiscal year 2012 budget
    request includes $30.5 billion in military personnel funding, including
    a 1.6 percent pay increase. Although our recruiting quality and
    retention levels are at the highest in 16 years, we are allocating $630
    million for bonuses to recruit the right skill sets and retain
    experienced Airmen for today's fight and tomorrow's emerging missions.
        Our fiscal year 2012 recruiting activities budget request includes
    $65.5 million for recruiting activities and $70.6 million for
    advertising efforts, including a strategic marketing campaign which
    focuses on diversity and science, technology, engineering, and math.
        Similarly, the Air National Guard (ANG) is focusing its recruiting
    efforts on precision recruiting to fill existing vacancies. The Air
    Force Reserve has programmed $31.3 million for bonus incentives in
    fiscal year 2012 and continues to show positive gains in all retention
    categories. The Air Force Reserve uses its bonus program to meet the
    demand for critical skills deemed vital to its mission. Its bonus
    program has been pivotal to recruiting and retaining the right people
    to meet combatant commander requirements. Members with these skills are
    normally in high demand within the private sector. With continued
    funding, the Reserve will be able to offer the appropriate combination
    of bonuses for enlistment, reenlistment, affiliation and health
    professionals. To improve our chances of success, we have increased the
    number of recruiters working in the field to attract quality
    candidates.
        Even with high retention for the active duty officer force as a
    whole, there are still manning shortfalls and retention deficits in
    high-demand and new and emerging specialties that require bonuses as a
    part of a gap-closing strategy. These specialties, which contribute
    significantly to the joint fight, include contracting, control and
    recovery, public affairs, civil engineering, intelligence, logistics
    readiness, and many of our medical professionals, including mental
    health and other critical wartime skills.
        The overall Air Force budget for initial enlistment bonuses for
    fiscal year 2012 is $14.5 million, providing 4 and 6 year bonuses
    ranging from $1,000 to $17,000. This helps us target hard-to-fill,
    chronically critical, and battlefield airmen occupational specialties,
    including airborne cryptologic language analyst; combat control;
    tactical air control party; survival, evasion, resistance, and escape;
    pararescue; special operations weather; explosive ordnance disposal;
    and security forces.
        The remainder of the Air Force's recruiting bonuses attracts
    experienced health professionals in critical wartime specialties, such
    as physicians, dentists, nursing, pharmacy, public health, clinical
    psychology, and social work in order to more effectively meet validated
    health care needs. Increased operations tempo and outside competition
    are also impacting our ability to retain Health Professions Officers.
    To mitigate this situation, the Air Force Recruiting Service recruits
    Fully Qualified (FQ) Health Profession (HP) officers and Health
    Professional Scholarship Program (HPSP) candidates.
        While active duty officer retention as a whole remained strong
    through fiscal year 2010, we still need higher retention in targeted
    year groups for specific specialties including contracting; control and
    recovery; public affairs; civil engineering; intelligence; logistics
    readiness; and certain medical specialties. In order to address officer
    retention concerns, contracting, control and recovery were approved by
    OUSD(P&R) in fiscal year 2009 as critical skills and are currently
    receiving a critical skills retention bonus (CSRB). The projected CSRB
    costs for fiscal year 2012 are approximately $9 million ($2.8 million
    budgeted for control and recovery and $6.2 million for contracting).
    The Air Force also uses Cumulative Continuation Rates (CCR) to track
    retention by Air Force Specialty Code and by reenlistment zones. The
    CCR shows the expected rate an airman is likely to remain in the
    Service from year-to-year or zone-to-zone. Skills Retention Bonus (SRB)
    are also an effective tool for measuring targeted retention by AFSC and
    by zone.
                                  deployments
        As of 25 April 2011, we have more than 40,000 personnel deployed,
    approximately 5,000 of whom are fulfilling Joint Expeditionary and
    Individual Augmentee taskings working with our sister services. In
    order to meet the growing demands of combatant commanders, Air Force 6
    month tours increased from 12 percent of all deployments in calendar
    year 2004 to 65 percent of all deployments today. In October 2010, the
    Chief of Staff of the Air Force established the Air Force's baseline
    deployment tour length to be 6 months, which will be normalized for all
    airmen by October 2012. Approximately 2,700 of our deployment
    requirements, or 7 percent of all deployments, require members to be
    away for 365 days. We are committed to ensuring we fulfill deployment
    commitments while taking the greatest care of our airmen and their
    families.
        As we continue to provide air, space, and cyberspace support to
    combatant commanders, we are leveraging the capabilities resident
    within the Active, Guard, Reserve, and civilian forces, to include
    deployments and mobilization. Reserve airmen support our Nation's
    needs, providing operational capabilities around the globe.
        Today, Air Force reservists are serving in every area of
    responsibility, and there are approximately 4,300 Air Force reservists
    activated to support operational missions. Likewise there are 5,554 Air
    National Guard members deployed. In calendar year 2010, 3,739 National
    Guard airmen performed domestic missions under Title 32 including U.S.
    air defense, border security, counterdrug operations, and search and
    rescue.
        Through our Overseas Contingency Operations (OCO), we have budgeted
    $1.5 billion in fiscal year 2012 and we invest in it as an equal
    partner with our sister services and coalition team members to
    effectively pursue national security objectives around the globe. We
    have a validation process for all OCO requirements and just recently
    implemented a prioritization system to ensure our Reserve component
    man-days meet the greatest need while remaining within our appropriated
    funds.
        As the Department of Defense builds its civilian expeditionary
    workforce, Air Force civilians continue to be a significant part of the
    capability we offer to the combatant commander. For example, deployed
    civilians are currently augmenting our Office of Security
    Investigations, intelligence, logistics, comptroller, as well as
    various headquarters support positions worldwide. In addition, civilian
    employees throughout the Air Force provide vital support on a daily
    basis such as aircraft repair, purchase of equipment and supplies for
    troops, continuity at home station for deployed military, and support
    for Air Force families.
                                   diversity
        In a nation where about 75 percent of our youth are ineligible or
    unable to serve in an all-volunteer military due to educational or
    health issues, it is a military necessity to maintain a diverse Air
    Force to overcome today's increasingly complex challenges. Our Active,
    Guard, and Reserve units throughout the country this year will
    participate in symposiums, career fairs, and expositions such as the
    Joint Women's Symposium and Air Force in the Community.
        In the fall of 2010, we published strategic guidance to include a
    diversity policy directive and Diversity Roadmap, which provides
    priorities, goals, and specific actions for implementing diversity
    initiatives. Formalizing the Diversity Roadmap into an Air Force
    Instruction will provide the Total Force its final piece of strategic
    guidance. The vetted recommendations of the congressional-mandated
    Military Leadership Diversity Commission will be woven into the
    instruction. We anticipate completion of the instruction by the end of
    September 2011.
        We furthered the institutionalization of diversity by holding a
    Diversity Senior Working Group in October 2010. Showcasing senior
    leader commitment, we had participation from the Chairman of the Joint
    Chiefs, Secretary and Chief of Staff of the Air Force, in addition to
    60 senior leaders from the major commands and the Pentagon. They were
    challenged to promote diversity within their spheres of influence. The
    Air National Guard has championed this effort and created a diversity
    position, reporting directly to the Director, Air National Guard.
        As a result of our commitment to advocate equity, diversity, and
    inclusion at the U.S. Air Force Academy (USAFA), a Chief Diversity
    Officer (CDO) position was created and filled in December 2010. The CDO
    directs all diversity initiatives, policies, and programs at USAFA to
    advance inclusion as a core institutional value and increase diversity
    in all dimensions across its faculty, staff, and cadets.
        Air Force diversity is interwoven into our rich culture, heritage,
    and traditions and we will continue to emphasize the necessity to
    attract and recruit the best-qualified citizens to serve on our team,
    America's Air Force.
                         nuclear human capital strategy
        Airmen must be specifically trained, educated, and experienced
    through professional development initiatives designed to create the
    capabilities and culture this no-fail mission demands, and our Nation
    deserves. We implemented several new initiatives to enhance the
    development of our nuclear airmen and improve the management of their
    assignments. Central to our efforts is the shift to assigning the most
    ``qualified'' airman versus the most ``eligible'' airman for our key
    nuclear billets.
        Our new approach to managing enlisted talent gives us the
    capability to evaluate the entire pool of nuclear Senior
    Noncommissioned Officers (SNCOs) and select the right airmen for
    critical jobs, while also ensuring our nuclear SNCOs are vectored in
    the proper career sequence and that we are preparing them for future
    leadership roles in the Nuclear Enterprise. Our 2W2 (Nuclear Weapons
    Maintenance) and 21M (Munitions, Missile Maintenance) career fields
    have developed prioritization lists to ensure we assign the most
    qualified airmen to positions by order of importance within the Nuclear
    Enterprise.
        We also moved the screening of qualifications to serve in nuclear
    billets to earlier in our pipeline for our most stressed career fields.
    This led to greater efficiency in initial selection and training for
    nuclear-related positions, and more timely backfills for open
    positions.
                          airman and family resilience
        We are totally committed to strengthening the resilience of our
    airmen and their families. Our leadership is committed toward building
    resilient airmen who have the ability to withstand, recover, and grow
    in the face of stressors and changing demands, regardless of time,
    challenge, or location. To heighten the focus on this area, the Air
    Force established a Resilience Division within Headquarters Air Force.
    This division will build a corporate program with two distinct yet
    integrated focus areas: Airman Resilience and Family Resilience. In
    addition, we established the Deployment Transition Center at Ramstein
    Air Base, Germany in July 2010. Since the Center's inception, more than
    1,420 selected airmen have participated in this 2-day reintegration and
    decompression program while enroute to their homes from deployment.
        We are also working with the RAND Corporation to develop a
    longitudinal study on families that will begin in summer 2011. This
    study will follow more than 5,000 active duty families while tracking
    their resilience across a full deployment cycle, before, during, and
    after deployment. The information received from this study will be
    invaluable on how we treat and provide care for airmen and their
    families in the future.
        In concert with The First Lady's ``Let's Move'' family fitness
    initiative, we launched Air Force ``FitFamily,'' which meets two of
    four goals of the ``Let's Move'' initiative. FitFamily raises the
    awareness of the importance of physical fitness and healthy meals for
    the entire family. FitFamily encourages everyone to ``Get Up, Get Out
    and Get Fit--Together'' by registering online as teams, and achieving
    various participation levels through family fun activities, sports and
    fitness events, and healthy food selections.
                               suicide prevention
        Since 1997, Air Force has worked resolutely to decrease the number
    of suicides among airmen, civilian employees, and families. The Air
    Force suicide prevention program uses a multi-faceted approach to
    address the needs of a variety of individuals from different
    backgrounds and in different career fields. Air Force programs involve
    the entire Air Force community, including leaders, airmen, families,
    chaplains, and health professionals in preventing suicide. Recent
    suicide prevention initiatives include the addition of mental health
    providers in primary care clinics where airmen can obtain care without
    concern about the perceived stigma associated with mental health care.
        The annual Department of Defense/Department of Veterans Affairs
    Suicide Prevention Conference is another means by which our
    organizations and communities share research efforts, identify
    effective tools, discuss risk factors, and describe innovative
    programs. As our shared knowledge of the causes and risk factors
    associated with suicide increase, we are better prepared to create and
    tailor programs that afford our servicemembers, families, and employees
    the coping skills and help-seeking skills that minimize their
    susceptibility to suicide.
                       exceptional family member program
        Over the last 2 years we assessed available community and family
    support services for our special needs families, uncovering
    inconsistencies in service delivery. With Secretary Donley's approval,
    we implemented a new policy building an Exceptional Family Member
    Program (EFMP) which integrates enrollment and health care assistance,
    assignment coordination, and family support components into one
    seamless program.
        In fiscal year 2010, the Secretary of Defense provided $4.7 million
    in start-up funding, enabling the immediate hiring of 35 Air Force EFMP
    Coordinators to serve families at locations serving the majority of our
    17,000 airmen with special needs family members. The Air Force is
    committed to funding these positions from fiscal year 2012 forward. All
    of our active duty remaining locations have a designated staff member
    at the Airman and Family Readiness Center to provide community/family
    support assistance to families with special needs.
        Additionally, beginning in fiscal year 2012, the Air Force will add
    36 active duty social work billets which will manage enrollment and
    assistance with health care responsibilities in order to improve
    coordination of care for high-risk families.
                               sense of belonging
        The Air Force developed an actionable plan to institutionalize our
    commitments to Fostering and Maintaining a Strong Air Force Community;
    Strengthening a Sense of Belonging to the Air Force; and Improving
    Airman and Family Resiliency. These three objectives will be achieved
    and maintained through four key strategic focus areas: Housing and
    Communities, Airman and Family Support, Education and Development, and
    Health and Wellness. 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.
        We are delivering on this commitment by expanding child care
    through different programs such as the Extended Duty program, Home
    Community Care, and the new Supplemental Child Care initiative to
    provide flexibility in meeting child care needs. Through our Extended
    Duty Program, we are able to provide 14,000 free hours of child care
    each month, assisting members who work nonstandard duty hour shifts,
    weekends and evenings. Additionally, Air Force Reserve and Guard
    members are able to obtain free child care during drill weekends
    through our Home Community Care Program. Consequently, our Youth
    Program serves nearly 68,000 youths in our before and after summer
    programs, part-day preschools, and youth development camps.
        Within our Airman and Family Readiness Centers, Spouse Employment
    Assistance is one of several areas where we have concentrated our
    efforts. We continue to work closely with our Service partners on the
    advancement of the Military Spouse Employment Partnership to increase
    portable career opportunities for all of our spouses. This year we
    completed six major Morale, Welfare, and Recreation construction
    projects valued at $29 million and three major lodging construction
    projects valued at more than $207 million.
        These projects and upgrades not only greatly improve our airmen and
    their families' quality of life but also increase the readiness of our
    warriors to fulfill ongoing deployment commitments across the world.
                     sexual assault prevention and response
        Sexual assault is a crime that violates our core values. It
    undermines the environment of professionalism, respect, and discipline
    that we need to succeed. It impacts the victim, the unit, the mission,
    friends, and family. In order to better understand the extent of and
    circumstances surrounding the crime, we commissioned Gallup to conduct
    a confidential survey to measure the incidence (past 12 months) and
    prevalence (lifetime in the Air Force) of sexual assault in the Air
    Force.We provided a copy of this report to this committee in March
    2011.
        At the direction of the Secretary of the Air Force, we did a top-
    to-bottom assessment of our Sexual Assault Prevention and Response
    (SAPR) program, looking at everything from leadership steps to
    prevention, response, and accountability. Our assessment included
    recommendations from Gallup subject matter experts, the Defense Task
    Force on Sexual Assault in the Military Services, and direction from
    Congress. We are currently moving forward with improvements to the
    program.
        The Air Force projected $35.1 million to execute the Air Force
    Sexual Assault Prevention and Response program for fiscal year 2011.
    The budget funds 199 fulltime positions and program funding for
    operational expenses for all first-responder agencies and field level
    activities. The manpower positions include 175 military and civilians
    serving as Sexual Assault Response Coordinators and assistants, and 24
    dedicated investigative agents specializing in sexual assault
    investigations.
        We are committed to a strong prevention program, victim safety and
    care, and holding assailants accountable for their actions.
                      yellow ribbon reintegration program
        In addition to other Air Force programs designed to support our Air
    Force families, the Yellow Ribbon Program is a venue in which wing
    leadership, community, and State partners can address challenges facing
    airmen and their families during the deployment cycle. Through their
    Yellow Ribbon events, the Air Force effectively works partnerships with
    community organizations to ensure attendees receive information and
    counseling on a wide variety of issues through programs designed to
    help them during pre-deployment, deployment, and demobilization. These
    include programs on marriage counseling; services for children;
    substance abuse awareness and treatment; mental health awareness and
    treatment; financial counseling; anger management counseling; domestic
    violence awareness and prevention; employment assistance; and preparing
    and updating family plans. All these programs have tangible benefit for
    our airmen and their families as well as significant intangibles for
    the Reserve components. As Yellow Ribbon evolves our primary objective
    is to make a strong program even more robust and effective for those it
    serves.
                           warrior and survivor care
        Our Military Health and Non-Medical Care system achievements have
    significantly changed the face of war. We can now 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 leading to a sustained less than 10 percent died-of-wounds
    rate. This includes moving our sickest patients in less than 24 hours
    of injury to be near their loved ones within 3 days to hasten their
    recovery. Since October 2001, we safely evacuated more than 86,000
    patients. Our Centers for the Sustainment of Trauma and Readiness
    provide our medics with state-of-the-art training required for treating
    combat casualties.
        As to non-medical care, the Air Force is fully committed to caring
    for our brave wounded ill and injured airmen and their families. In
    fiscal year 2010, we programmed $13.3 million to provide non-medical
    case management, support, and assistance through the Air Force Survivor
    Assistance Program, the Recovery Care Program, and the Air Force
    Wounded Warrior Program.
        Our Wounded Warrior population has increased by 329 members to
    1,043 as of March 31, 2011. The current breakdown by component
    includes: Regular, 762; Reserve, 131; and Air National Guard, 150. Of
    this total population, 635 or 61 percent suffer from psychological
    (PTSD) illness and the remaining 408 are recovering from injuries,
    including Traumatic Brain Injury. In this regard, we place heavy
    emphasis on the performance of our Recovery Care Coordinators and their
    ability to reach our airmen in all components regardless of location.
    In keeping pace with our growing population, the Air Force has hired 32
    Recovery Care Coordinators to support 30 locations across the Air Force
    and we have increased our Air Force Wounded Warrior Care Managers from
    12 to 21 positions.
                    integrated disability evaluation system
        The Integrated Disability Evaluation System (IDES) provides support
    to our servicemembers who have potentially disabling conditions. To
    date, approximately 40 Air Force installations have implemented
    disability processing under IDES. Under IDES, there is a 5.3 percent
    rate of appeal of informal physical evaluation board decisions,
    compared to a 15.4 percent rate of appeal under the legacy process. For
    these individuals, IDES has the potential for retaining them in an
    active status for considerably longer periods of time compared to the
    legacy disability evaluation system. As a result, the Air Force is
    especially pleased to be working with the Office of Wounded Warrior
    Care and Transition Policy in developing the IDES Remodel to
    incorporate streamlined processes within the medical evaluation phase
    of IDES.
                      physical disability board of review
        As a result of the 2008 NDAA Wounded Warrior legislation, the
    Department of Defense was directed to establish the DOD Physical
    Disability Board of Review (PDBR). OSD designated Air Force as the Lead
    Component to operate and manage this congressionally directed Wounded
    Warrior program. The Air Force operates the board on behalf of the
    Secretary of Defense and provides critical reviews for all uniformed
    services, including Army, Navy, Air Force, Marine Corps, Coast Guard,
    and their Guard and Reserve components. Since its inception, the board
    has received 2,296 applications and adjudicated nearly 800 cases with
    an overall recharacterization rate of 58 percent to a disability
    retirement.
        The Department of Justice remanded a Post Traumatic Stress Disorder
    Class Action Lawsuit Litigation (Sabo, et al, v. United States) to the
    board for remediation. Nearly 1,200 individuals who were board eligible
    chose to join the suit. Since July 2010, the board has made
    recommendations to the Service Secretaries on more than 200 Sabo cases.
    Ninety-four percent of these cases have resulted in recharacterization
    recommendations to retirement.
        Since the Physical Disability Board of Review is a DOD board, OSD
    programmed the funding to the Air Force for the board's standup and
    operations through fiscal year 2012. However, due to the extended
    operational requirement of the board and existing DOD policy, the Air
    Force will now pursue proportional reimbursement from each Service to
    fund current and future year operating costs.
                             total force enterprise
        We are diligently working to develop a requirements-based
    analytical model which we hope will enable us to more effectively
    balance the mix of regular and Reserve component forces across the
    Total Force Enterprise (TFE) and put them to their most effective use.
    The end state we seek is equilibrium between demand, requirements,
    inventory, manpower, costs, and employment guidance in the new
    strategic reality of today's dynamic operational environment. As we
    continue to utilize the Reserve component as an operational force, our
    goal is to design a process that will assure we are approaching force
    structure from a total force frame of reference and achieving the
    optimal balance of capabilities in a manner that is repeatable and
    transparent.
                              continuum of service
        Continuum of Service is a personnel management construct supporting
    the most efficient use of human capital to accommodate varying levels
    of individual services commensurate with a member's ability to serve
    either part-time or full-time to effectively meet Air Force
    requirements. This will allow the Air Force enterprise to more
    efficiently meet its human capital needs. In a collaborative effort,
    the Air Force Secretariat, Air Staff, Air Force Reserve, and Air
    National Guard staffs are developing and implementing Continuum of
    Service personnel policies, guidance, programs, and initiatives in
    support of Air Force Strategic guidance and Air Force priorities such
    as modernizing organizations and developing and caring for airmen and
    their families.
        integration of air force component personnel management systems
        In late 2010, the Secretary of the Air Force directed a team of
    cross-functional leaders from across the Air Staff to develop a work
    plan to integrate the three Air Force Component Personnel Management
    Systems into a single system. This effort is charged to review, analyze
    and integrate not only data systems, but also organizations, laws,
    regulations and policies, processes, technology, and performance
    management. Our strategic intent is to establish a single, uniform
    system for Air Force personnel management optimizing existing systems
    already in place. This effort is known as the Integration of Air Force
    Component Personnel Management Systems, commonly referred to as 3-1
    Integration, with a targeted initial implementation date of calendar
    year 2012, with follow-on actions through the Future Years Defense
    Plan.
        The integration of personnel management systems across the Air
    Force is intended to improve efficiency in Air Force personnel
    management; promote uniformity in policies, processes, and regulations
    to the extent practicable across the Active Duty, Air National Guard,
    and Air Force Reserve; reduce barriers across the components; enhance
    career opportunities for a Continuum of Service; and provide better
    service to our airmen.
                             don't ask, don't tell
        We are responsible for many Don't Ask, Don't Tell repeal actions,
    including the education and training of our Total Force. Every airman
    must understand what is expected in the post-repeal environment,
    including the continuation of the Air Force's high standards of
    professional and personal conduct. To achieve this goal, we are
    aggressively implementing a systematic training program and updating
    numerous Air Force Instructions to implement policy changes on
    separations, accessions, recruiting, and sexual orientation. The
    dignity and respect of our airmen will remain a top priority, as
    always. In the Air Force, all airmen receive the opportunity to reach
    their highest potential in an environment free from personal, social or
    institutional barriers.
                                   conclusion
        Today's airmen possess an unsurpassed commitment and dedication to
    service and are a credit to the Joint Warfighter and the U.S. Air
    Force. They enable our competitive advantage against our adversaries
    and deliver dominance in air, space, and cyberspace. For these reasons,
    we will continue to recruit, train, and retain America's finest to
    serve our great Nation, and for their solemn devotion we have an
    obligation to provide the care and service they and their families
    deserve.

        Senator Webb. Thank you very much, Secretary Ginsberg.
        General Jones, welcome.

     STATEMENT OF LT. GEN. DARRELL D. JONES, USAF, DEPUTY CHIEF OF
       STAFF FOR MANPOWER, PERSONNEL AND SERVICES, U.S. AIR FORCE

        General Jones. Thank you, sir. Chairman Webb, Ranking
    Member Graham, thank you for the opportunity to appear before
    you today and represent the men and women of your U.S. Air
    Force.
        These tremendously talented men and women--officers,
    enlisted, and Air Force civilians of the total force--are the
    backbone of our Service in an era of evolving requirements,
    constrained budgets, our Air Force faces increasing set of
    challenges. As the Deputy Chief of Staff for Manpower,
    Personnel, and Services, I'll do everything I can to help
    deliver fully qualified and ready airmen to the joint
    warfighter, while meeting the essential needs of these airmen
    and their families.
        We are dedicated to properly managing our end strength.
    Unfortunately, with retention at a 16-year high, we are
    compelled to use voluntary and involuntary programs. We expect
    to exceed our end strength in fiscal year 2011, and could
    experience additional growth in fiscal year 2012, if we do not
    actively manage our force levels.
        Our force management strategy is not a quick fix, but a
    tailored, multi-year effort. Beyond existing force management
    legislative authorities, we are working with the Office of
    Secretary of Defense to seek additional legislative authorities
    to provide us the tools to better manage our end strength.
        America deserves the very best Air Force in the world, and
    that is what you have. We must recruit, develop, and retain the
    highest quality airmen from the broadest landscape to maintain
    that status. Even though quality and retention are high, we are
    obligating a portion of our budget for bonuses to recruit the
    right skill sets and retain experienced airmen in our critical
    warfighting skills. Without these funds, we will handicap our
    commanders and their ability to carry out the full range of
    missions America demands of its Air Force.
        We are committed to strengthening the resilience of our
    airmen and their families. Our goal is to build resilient
    airmen who have the ability to withstand, recover, and grow in
    the face of stressors and changing demands.
        We remain fully committed to caring for our wounded airmen.
    We continue to provide support and assistance to the Air Force
    Survivor Assistance Program, the Recovery Care Program, and the
    Air Force Wounded Warrior Program, and will do so for as long
    as needed.
        In closing, today's airmen have an unsurpassed dedication.
    They enable our competitive advantage against our adversaries
    and deliver dominance in air, space, and cyberspace. We will
    continue to recruit, train, and retain America's finest, and we
    will provide the care and service that they and their families
    need.
        To that end, we would like to thank you for championing the
    post-9/11 GI Bill and the opportunities it has provided to many
    of our airmen and their families, including my youngest, who's
    in his first year at Texas A&M University in computer science.
        On behalf of the Chief of Staff of the Air Force, we
    appreciate your unfailing support of our airmen, and we look
    forward to answering your questions today.
        Senator Webb. Thank you very much, General.
        As I mentioned at the beginning of the hearing, your full
    statements will be entered into the record immediately after
    your oral statements. They have been, and they will be again,
    thoroughly examined by staff. There may be a number of follow-
    on questions, staff-to-staff, after this hearing. All of the
    information that you provided is valuable to us as we looking
    forward to marking up the defense bill this year.
        I have a number of questions. I think what I'm going to do,
    because of the nature of the subcommittee, is, I will ask one
    and then ask Senator Graham to go ahead and ask one. Welcome,
    Senator Blumenthal. We can just rotate, rather than any one of
    us taking up a block of time the way that it's normally done on
    full committee.
        I'd like to start with this. Last week, I raised the issue,
    with Under Secretary Stanley, and also with the Defense
    Comptroller, about the nature of the contracting force, the
    civilian contractors. Many years ago, I was Assistant Secretary
    of Defense for Reserve Affairs. At that time, we were flushing
    out the structure of what we then called the ``total force,''
    which was the Active, Guard, and Reserve, and--shall we say,
    the formal civilian component of DOD. Since the post-September
    11 buildups, we have had an enormous growth in civilian
    contractors, many of whom perform what, in the past, were
    military functions. We're having a hard time getting an actual
    number from DOD as to how many civilian contractors really are
    on board at any one given time. So, I would like to ask each of
    you, however you want to do this, by service component, how you
    take into account civilian contractors when you build your
    manpower models.
        Secretary Lamont.
        Mr. Lamont. It's all part of our total force mix. Each Army
    military organization is required to maintain an inventory of
    all their functions to assess whether those functions are
    inherently governmental, closely associated, or not at all.
    From that, we determine, then, which positions can be converted
    to internal full-time employees. As we look at our total force
    policy, though, we look at all mix of all components, be it the
    Active Duty, be it the Guard and Reserve, be they civilians in
    our contractor mix--trying to create the most balanced and
    integrated total force that we have.
        On the Army side, you will find in excess of 200,000
    contractors at any given time. Like you, we have some issues
    determining precisely how many contractors we have at any given
    time. Given our drawdown that's looming----
        Senator Webb. Let me ask you one question----
        Mr. Lamont. Yes, sir.
        Senator Webb.--on that, because this is one of the issues
    that came up last week. When you say ``200,000,'' does that
    include contractors that are brought on board through block
    operations and maintenance funding that goes out to the various
    combatant commanders?
        Mr. Lamont. Yes, it does.
        Senator Webb. It does? Okay.
        Secretary Garcia?
        Mr. Garcia. A year and a half into my tenure, I shared the
    frustration with the challenge of putting a headcount on the
    contractor force. As we've wrestled with it, what we learn is
    that oftentimes a contract is let, and it's up to that
    contractor, as an entity, to determine how many folks they'll
    employ in that effort, ranging from folks operating in theater,
    obviously full-time, to part-time work, mowing the grass on
    bases.
        It came to a head during the end game of this year's budget
    process, when the remaining variable, at the end of the
    process, was that contractor figure. What we found was that it
    was a less-than-strategic effort to meet our numbers; instead,
    was applied, salami-slice style, for lack of a better term,
    across the BSOs.
        We started a 2-month initiative, a total force effort to
    drill down to ensure that each of the BSOs has a strategic
    voice in ensuring what their contractor force should be, and
    that it does not become an afterthought. In the meantime, we
    continue to drill down and put a headcount on the number of
    contractors out there, acknowledging that it's a challenge, in
    that how a given entity deploys their personnel is up to them.
        Senator Webb. So, do you know how many contractors are in
    the Department of the Navy?
        Mr. Garcia. Candidly, we do not, Mr. Chairman.
        Senator Webb. It's kind of difficult to place----
        Senator Graham. Within 50,000, can you tell us?
        Senator Webb. It's kind of difficult to place cost-
    effectiveness on the use of a contractor if you don't know how
    many you're using.
        Mr. Garcia. We concur. What we do know is what we're paying
    in--for contractors and for those services. What we're trying
    to do with this 2-month initiative is, across the BSOs, make an
    assessment of whether we're using them wisely across each one.
        Senator Webb. So, you're working toward finding a number.
        Mr. Garcia. That's right.
        Senator Webb. Okay.
        Secretary Ginsberg?
        Mr. Ginsberg. Senator, we of course recognize that, in
    addition to all Active, Guard, Reserve, and civilian manpower,
    we have a great amount of work that's being undertaken by
    contractors. One of the major muscle movements that we've been
    engaged in over the past couple years is a great deal of
    insourcing, where we took a look at some of the work that was
    being done by our contractors, and we saw that it actually
    would save money and did get the work done as effectively by
    bringing it back in house. We've been undertaking that process.
        In terms of tracking the amounts, we have a general idea.
    It's around 215,000 over the next few years. But, in terms of
    the specific granularity, that's a challenge that we're going
    to work on with our fellow Services, as well as the Office of
    the Secretary of Defense (OSD), in trying to get that
    granularity that we need.
        But, we definitely recognize, of course, that there's great
    deal of work that has contributed to the Service, and that--
    fluctuations in that realm have an impact, and that we need to
    address.
        Senator Webb. For the record, we'd like to see your best
    estimates on those numbers, as we move toward the Defense bill
    this year, which means fairly soon.
        [The information referred to follows:]

        Mr. Lamont. Army has 237,000 contractor full-time equivalents.
        Mr. Garcia. The Department of the Navy (DON) (Navy and Marine
    Corps) contracts for services and/or deliverables. The majority of
    these contracts are based on outcome and/or performance. As such,
    current contractual practices do not require the reporting of
    contractor headcount or workforce full-time equivalent (FTE) work-
    years. As required in 10 U.S.C. 2330a, the DON developed a methodology
    for estimating FTEs (due to performance based contracting) that
    reported 249,821 FTEs of contracted workload in fiscal year 2009. As
    directed in the National Defense Authorization Act for Fiscal Year
    2011, the DON is currently working with the Department of Defense (DOD)
    to adopt the Army methodology for estimating contractor FTE work years.
        Mr. Ginsberg. The Air Force contracts with private companies for
    the performance of commercial activities--we do not ``maintain'' any
    contractors. The size of this workforce is dependent on the definition
    used, but we have quantified three basic full-time equialvent
    definitions as found below:

    ----------------------------------------------------------------------------------------------------------------
                                                                              Fiscal Year
                     Definition                  -------------------------------------------------------------------
                                                        2009             2010             2011             2012
    ----------------------------------------------------------------------------------------------------------------
    All Service Contract........................                          230,000          215,000          219,000
    Title 10, Section 235.......................                          132,000          127,000          129,000
    Title 10, Section 2330a.....................         190,000            Under
                                                                      Development
    ----------------------------------------------------------------------------------------------------------------
    Definition Notes:
    1. Title 10 Section 235, Procurement of contract services: specification of amounts requested in budget excludes
      services related to research and development and services related to military construction via statue.
    2. Title 10, section 2330a, Procurement of services: tracking of purchases excluded portions of R&D Contracts
      (1, 2, and 3), leasing of equipment/facilities, and construction (OSD Direction in consultation with Congress)

        These amounts were quantified using a derived average cost
    calculation methodology to document the number of contractor full-time
    equialvents similiar to that the DOD used in the fiscal year 2009
    Service Contract Inventory per USD(AT&L), Compliance Instruction for
    Inventories of Contracts for Services, dated 10 May 2010.
    Unfortunately, this is our only alternative since we do not have a data
    collection system in place that captures this contractor full-time
    equivalent information.

        Senator Webb. Senator Graham.
        Senator Graham. Thank you, Mr. Chairman. That was an
    excellent question.
        I know it may be difficult to count, but as we try to
    figure out what force we can afford and pay for, and where's
    the best investment of taxpayer dollars, I think is very
    important that we understand, generally speaking, how many
    contractors we have.
        That gets us back to numbers of people available for the
    fight. Secretary Lamont and General Bostick, I understand there
    are 20,000 Army personnel awaiting disability evaluation
    boards, or in that system. We're supposed to draw the Army down
    by 22,000 over the next couple of years. What are we doing to
    get the people through the system? That's 42,000 people, over
    the next couple years, that will be lost to the fight. How does
    that impact the Army? Nondeployable really means you can't go
    to the fight. Doesn't mean you can't contribute, but it does
    take away.
        General Bostick. Yes, Senator. The nondeployable situation
    is just one factor in our overall challenges in manning the
    force. Congress helped us with the 22,000 temporary end
    strength increase, and that allowed us to account for not only
    the nondeployables, but the wounded warriors, and the fact that
    we had to stop using stop-loss. So, all of that 22,0000 is
    being utilized today.
        Additionally, we were supposed to stand up three additional
    brigade combat teams, and we did not do that. We did not apply
    structure to it. So, that gave us another 10,000 or so to work
    with.
        Having said that, it's bigger than the nondeployable issue,
    which we're working. It's also the fact that we're going to
    come down the 22,000, then come down 27,000. We're going to do
    that in an environment where we're still fighting a war. But,
    the physical disability evaluation system (DES), in the
    process, despite all of our efforts and despite all of the
    leadership that has gone into it--it is not functioning at a
    pace that is keeping up with the number of soldiers that go in
    there. So, it grows every month, as opposed to--the input is
    much higher than the output.
        So, we are working very closely with OSD to figure out how
    we can streamline it. We've worked closely with the VA on the
    integrated DES. So, instead of doing two physicals, we now do
    one physical. But, it takes more time on the Army time.
        But, the bottom line is, I think we have an antiquated
    medical, physical DES that needs to be revamped for the war
    that we're in, and to really meet the needs of Active, Guard,
    and Reserve soldiers and other military needs.
        Mr. Lamont. If I might just add the DES is complex,
    disjointed, hard to understand, and takes way too long. That's
    the good news.
        On top of that, it is, as you say, highly inefficient and
    truly does impact our readiness. We have to get a grip on this,
    and we are making every effort to do that, as we move hopefully
    to get to a single----
        Senator Graham. I understand it's frustrating. It's a
    balance here. You just can't throw people out. Most people want
    to stay. Being told you're disabled and unable to serve is a
    dramatic event. Some people obviously can't, and they need to
    be separated with dignity and quickly, and given the best
    treatment possible. You need a process that will convince
    people, who are challenging their decision, that they're not
    able to stay in--fair renderings of evaluations. Just let us
    know what we can do to help. This is a major problem for the
    country.
        Mr. Lamont. It's not all medical-related. We will find
    legal, being a fellow JAG--our legal issues, particularly on
    the due-process side, have expanded over the past 10 years.
    There are various other slices that contribute to the problem.
    But, medical is our largest.
        Thank you.
        Senator Webb. Let me, if I may, add something on this--but
    the disability evaluation process--is much more complex than
    any civilian model that people may try to use. I say this as
    someone who worked for 4 years as committee counsel on the
    House Veterans Affairs Committee, years ago, and represented
    many veterans--pro bono, by the way--on their disability
    claims. It's not simply people who are trying to stay in, and
    want to stay in; there are a lot of people who want to get on
    with their lives and, at the same time, have suffered some sort
    of permanent disability, with respect to having served their
    country.
        Disability law evolved out of the old private bills in
    Congress, where people who would have in other wars, would have
    had no recourse except for to get a Member of Congress to come
    in and say, ``My constituent lost a leg and we'd like the
    government to sort of help him out.'' So, part of it is whether
    an individual is able to stay on Active Duty. Another part of
    it is simply compensating people--citizen soldiers, who have
    served--for any injuries and disabilities that they incurred
    when they stepped forward to serve their country.
        I'm a little worried here. This is the reason that I'm
    raising this. I'm a little worried with this joint single-
    disability evaluation, because, in history, there are always
    two separate evaluations. There was the evaluation as to
    whether or not someone was fit to remain on Active Duty, and
    then, the second one, with the Veterans Administration (VA),
    was a lifetime evaluation. You could leave the military with a
    10-percent incurred disability during your military service,
    but that disability could get worse as you get older; and when
    you're 55, 60, 65 years old, the VA, appropriately, could rate
    you as, say, 60-percent disabled.
        What we're seeing right now, first of all, is a logjam,
    which is what Senator Graham is talking about. A lot of people
    who want to get out, who are ready to move on, who've done
    their time, can't get out. They're stuck on Active Duty until
    this process unwinds. Then, the second one is, there are people
    who are going to leave the military with a fairly small
    incurred disability that, over their lifetime, is going to
    grow. It's appropriate for us to take that into account, as
    well.
        Do you want to add anything, Senator?
        Senator Graham. I agree.
        Senator Webb. Yes. All right.
        Senator Blumenthal.
        Senator Blumenthal. Thank you, Senator Webb.
        Thank every one of you, for your service to the Nation, and
    to the people who serve with you, and particularly your work on
    recruiting and training the best-qualified people who are
    entering the military, and people given such talent and skills,
    as we've just seen over the last couple of weeks. The briefings
    that we've received have emphasized that the triumph was an
    all-service triumph, truly. Although the Navy Seals are the
    ones in the spotlight, the training and the qualifications that
    you are instilling, I think, are seen not only at the tip of
    the spear, but throughout the armed services. This leads me to
    the question, focusing on the end, when these folks leave the
    military; among them, the most talented and dedicated in their
    age group, receiving tremendous training, and those skills may
    not be directly applicable to civilian needs, but they then
    become among the highest unemployed in the whole country.
    Depending on which numbers you pick, or which ages and so
    forth, their rates are multiples of the civilian populace,
    which seems to me not only unjust and unfair, but unproductive.
        I have a general question, which I'd like to pose to you. I
    know time may not permit, and you may not have been fully
    prepared for this question. So, I would welcome anything you
    have, to follow in writing later. But, I think this is
    profoundly important for the whole Nation.
        Why is it that the unemployment rates are so high among
    that 20- to 30-year age group? What can we do about it? I've
    looked at the testimony, and there's not a lot in here, but I
    would welcome any comments that you have.
        Secretary Garcia?
        Mr. Garcia. Thank you, Senator. Thanks for raising the
    issue, and I speak for the Navy and the Marine Corps when I say
    that, candidly, our Transition Assistance Program (TAP) has not
    been sufficient. A 3- to 4-day evolution, required on the
    Marine side; but, the reality is, it's not been sophisticated
    enough, it's not been tailored for the individual. At a time
    when your Marine Corps is 60 percent under 25 years old, 40
    percent lance corporal or junior, when that junior marine gets
    out--it's highly likely that he or she enlisted right out of
    high school, has never put a resume together, and he's in the
    same room, going through the same seminar as O-5, O-6, who has
    a different set of needs as he or she makes their transition.
        What my colleagues and I are in the process of rolling out,
    a focused effort, a joint effort with the VA, with the
    Department of Labor. It's a TAP 2.0, if you will, a new TAP
    that'll roll out, Veterans Day, this November--that instead of
    being a 3- to 4-day generic slice of what one could expect,
    it'll be focused and tailored for the individual, not just a 1-
    week evolution, but one that a member can reach back to in the
    weeks and months to come, that will address what we know to be
    a major chokepoint in hiring, that is, translating the skills
    that a member learned in the Navy or the Marine Corps into
    terms that are applicable for industry, that will have avenues
    for spouse engagement, as well. In many cases, we know that
    these days, they're the principal breadwinner. It will be an
    ongoing engagement. It'll also, at the same time, address
    veterans' benefits, access to the Reserves, and be an all-
    around, 360 revisitation or reformation of the TAP experience.
        Senator Blumenthal. I was actually going to ask whether a
    sort of re-TAP, or second-round TAP, once somebody gets home,
    or where that person is going to call home, might make some
    sense. But, it sounds like you're pursuing that approach.
        Mr. Garcia. I think it's going to be productive, Senator.
        Senator Blumenthal. Thank you very much.
        Senator Webb. Senator Ayotte.
        Senator Ayotte. Thank you, Mr. Chairman.
        I want to thank all the witnesses who are here, for your
    testimony and for your leadership, for your service to our
    country, and to all of those that serve underneath you.
        Lieutenant General Bostick and the other panel members, I'm
    pleased to see, in your written statements, your repeated
    recognition of the critical contributions that our guardsmen
    and women have been playing, in terms of our national security.
    As we all know now, they are an operational force. We've needed
    their assistance to conduct the wars in Afghanistan and Iraq,
    and it's been critical.
        I want to follow up on actually a question that Senator
    Blumenthal asked you about. In the Guard and Reserve, the issue
    of unemployment--when you get back from a deployment, go back
    into your community, you're in a setting where you are not
    necessarily on a base, where you might get put right back in a
    civilian setting, where others might not understand or
    appreciate the experience you've gone through, and then also
    with the unique challenges of dealing with employment in a
    context where you're a civilian worker, and then you're called
    away and come back.
        We have a program in New Hampshire called the Deployment
    Cycle Support Program, that's been a great public-private
    partnership that I've talked to many of your colleagues before
    our Armed Services Committee about. In the fiscal year 2011
    Defense appropriation, there was $16 million allotted for
    outreach and reintegration services under the Yellow Ribbon
    Reintegration Program. I spoke with Secretary McCarthy last
    week about this program.
        Last week, Secretary McCarthy assured me that critical
    funds to continue, in our State, this Deployment Cycle Support
    Program, which has been very successful, in terms of measurable
    metrics, on reducing unemployment, on making sure that our
    guardsmen and women get the appropriate support on the mental
    health end and other services they need when they return, to
    cover the whole deployment cycle, are there. There were many of
    us that joined on a letter. There were eight States that have
    these types of programs. Secretary McCarthy assured me that
    these funds that were allocated in fiscal year 2011 were making
    their way through the system to the National Guard Bureau and
    then to the eight States, including New Hampshire.
        A week has passed, and many of the States--I can speak for
    my own, New Hampshire--are approaching the deadlines for
    putting this funding in place. If we delay any longer, we're
    going to risk a gap in service that will directly hurt our
    troops and our families.
        So, I would like to ask either Assistant Secretary Lamont
    or Lieutenant General Bostick, or whoever is the most
    appropriate individual to answer this question, Can you tell me
    the status of where these funds are and when these funds will
    be provided to the National Guard Bureau and distributed the
    eight States who have these model programs?
        We need a national way to address this. I'm proud that my
    State has a model that I think is a good one for everyone to
    examine, it's an efficient use of funds. It also brings the
    private sector in, which I think is very important. So I would
    urge you all to look at that on a national basis.
        But, right now, I'm concerned about New Hampshire, and
    wondered where we were at in getting those funds to continue
    that program.
        Mr. Lamont. I'll take the first stab at it.
        Senator Ayotte. Thank you.
        Mr. Lamont. Which--it's a very serious question, and we
    appreciate the question. But, quite candidly, I cannot tell you
    the status of those funds right now. We will try to get you an
    appropriate answer as soon as we can.
        [The information referred to follows:]

        On May 13, 2011, the State of New Hampshire received $2 million
    from the $16 million outreach funding that was appropriated by Congress
    in the fiscal year 2011 budget.

        Mr. Lamont. As a 26-year guardsman, I can tell you I share
    your concern, here. As we do any kind of transition with
    Reserve component forces, it's always considerably different
    because of their location, the geographic differences from an
    installation which has quite a bit more service and support
    available to the returning veterans on the active side--we're
    very concerned about our transition efforts for our Reserve
    component.
        We have a Yellow Ribbon Integration Program. We do try very
    hard to have employer-support relationships. We do have a
    regional service, medical centers.
        The employment situation really is a great concern. This
    goes, also, to Senator Blumenthal's question. That cohort is
    not an easy one to help right now. We're making every effort,
    as I say, to bring in these employer relationships, set them up
    into our Yellow Ribbon Programs, to have them on the ground,
    there, to meet with them.
        Also, I think the Reserves has a new program--it's called a
    ``Helmets to Hardhats Program''--in which we have any number of
    skills--for instance, if you're a military police soldier, do
    you need to go back and requalify in your State to be a law
    enforcement officer? Do you need to take that over-the-road
    test for a commercial driver's license if you are fully
    qualified in the transportation end? We are trying to find any
    number of those partnership linkages where it will assist them
    in going forward, back in their home States.
        Senator Ayotte. I very much appreciate what you're saying.
    We would love to have you up to our State to take a look at it
    and--because we've bridged those partnerships, and we're
    keeping metrics on issues like deployment retention,
    homelessness, unemployment, mental health. We've had instances
    where we've actually saved someone from committing suicide. So,
    I think that things always start, hopefully, as a pilot. You
    get measurable metrics and go forward. So, please come to visit
    New Hampshire.
        I would also say, I'm hoping, in the short term--I would
    very much like an answer on where we are on the status of the
    funds. So, if you could follow up, or if--unless someone else
    on the panel has the answer--with the status of that, it's
    something that's an immediate need. We know it's there, and
    Secretary McCarthy is committed to getting those funds where
    they're needed. So, I would appreciate that.
        Mr. Lamont. Thank you.
        General Bostick. Senator, we'll follow up. We don't have
    the answer to that today.
        [The information referred to follows:]

        On May 13, 2011, the State of New Hampshire received $2 million
    from the $16 million outreach funding that was appropriated by Congress
    in the fiscal year 2011 budget.

        General Bostick. But, I did want to say that in our own
    Army Career and Alumni Program, our Vice Chief, General
    Chiarelli, asked us to relook at that program. That report's
    coming in this May. So, we've worked that with West Point and
    with the Guard, Reserve, the VA, and Secretary Ray Jefferson,
    over at Labor. That's going to be helpful to us.
        What I would also say is that the 20- to 30-year-old age
    group is that same group that is having tough time with
    unemployment across the country. Our military reflects society,
    and where we differ is, they're part of the 1 percent that have
    worn the uniform. While the government and the military can
    help work a lot of these issues, after 4 years in recruiting,
    what I learned is that a lot of America wants to help, but they
    don't know how. Part of what I would offer is that our soldiers
    coming out may not be certified in the areas that they need. A
    truckdriver may not have the certifications, but can drive a
    truck anywhere. A medic may not have the exact certifications
    that they need, but can work anywhere.
        An educator on our platforms, or an instructor at West
    Point, coming out, may not have the certifications to go into
    an elementary school or high school. But, what can the country
    do to accept those military without those certifications, get
    them into jobs, and then allow them to work on the
    certifications as they go along?
        We're doing the same in reverse, because we are desperately
    short of alcohol and substance abuse counselors. The one thing
    that those counselors really need to be independent counselors
    is they need 2 years of study and tutelage under a supervisor.
    No one on the outside really has the time to deal with folks
    that need 2 years of study. So, we are bringing them on. We're
    making them commit to moving with us when we tell them that
    they have to move to a part of the country that is not a big
    city, and that they have to stay with us for a certain amount
    of time. But, we'd ask the country, What can you do to take our
    soldiers on?
        Senator Blumenthal. Mr. Chairman, if I could just add a
    quick footnote to that----
        Senator Webb. Sure.
        Senator Blumenthal.--really excellent question. When you
    compile those numbers for New Hampshire, could you please get
    them for the other States, as well? I recommend visiting New
    Hampshire or New England, including Connecticut. This time of
    year, it's a beautiful time to be there.
        Senator Webb. Thank you, Senator Ayotte.
        I don't think there are many issues in the military
    personnel that are more emotional or controversial than the
    issue of diversity.
        Secretary Garcia, during your confirmation hearing 2 years
    ago, there was a debate going on at the Naval Academy about
    standards. I asked you about it during the confirmation
    hearing. There were allegations that there was basically a two-
    track admissions system--one for athletes and minorities and
    the other for other folks. You indicated you were going to get
    your arms around that.
        Let me just say, I am aware, at least from the 1970s, that
    there have been DOD policies with respect to diversity. When I
    was Secretary of the Navy--every promotion board, there was a
    precept that went into the promotion board saying, ``You will
    examine issues relating to diversity.'' At the same time, we
    just had a diversity commission come out recommending more--
    different kinds of policies. I know, in the Air Force
    statement, there was some observation in there that there's
    actually an officer in charge of diversity at the Air Force
    Academy, or something to that effect.
        I'm just wondering what's going on. Secretary Garcia, why
    don't you start with the question that we had during your
    confirmation hearing?
        Mr. Garcia. Sure. Thanks for the opportunity, Mr. Chairman.
        There's been a lot of coverage, a lot of ink spilled, on
    what's been depicted as a most diverse Academy class in its
    history, and the most diverse ROTC class in its history. I
    think the real significance is that, what is the largest is the
    most number of applications from minority Americans across the
    country, in Academy history, over the last 4 to 5 years. The
    same with ROTC. If the argument goes that if you cast a wider
    net, you'll get a better candidate, that, in the mission that
    the Nation now requires of our Navy and Marine Corps, that we
    can't afford to overlook talent anywhere, I think it follows
    that recruiting and looking for candidates in regions where we
    haven't had applicants before, drawing from congressional
    districts where we haven't had applicants before--the number of
    congressional districts who send less than three qualified
    applicants, within the recruiting year, has been cut in half
    over the last 4 years. We've gone to places we just haven't
    gone before. If that's the premise, I think you can draw a
    linkage between casting that wider net and the superior
    candidate we're getting now.
        Tightly correlated with a spike in minority applications is
    a greater presence of minority midshipmen on the meritorious
    academic honor roles and a discorrelation, less of an
    appearance on attrition roles--greater graduation among
    Hispanic midshipmen. In less than a decade, it's gone from 68
    to 81 percent.
        I continue to wrestle with this, specifically in the Naval
    Academy Prep School application. But, my guiding light, my
    northern star, remains in--I guess the academy position is that
    if we continue to recruit in places we haven't been before,
    cast a wider net, we'll continue to get the best of the best.
        Senator Webb. What are your findings with respect to the
    allegations about different standards?
        Mr. Garcia. The Academy employs a whole-person structure.
    It is documented that there are midshipmen who are accepted,
    who do not have traditionally as high a board scores,
    Scholastic Aptitute Test (SAT) scores as others. But, because
    of the whole-person structure, that takes into account other
    things--less quantifiable, perhaps; life experiences--they are
    admitted. I continue to wrestle with that and the results at
    the other end; that is, the graduation end, performance end,
    retention end, performance in the fleet--to ensure that we're
    getting the best we can get.
        Senator Webb. Let me make one other suggestion. If you're
    following that formula, there are a lot of differences among
    white cultures in this country. That's something that's not
    frequently talked about. I wrote a piece in the Wall Street
    Journal about this last July. When I was in law school, the
    University of Chicago did a study of white ethnic groups, and
    they broke them down into 17 different ethnic strata, and the
    difference between the top and the bottom, in white America,
    was greater than the difference between white America and black
    America at that time, in the 1970s.
        So, if you're looking for places where people perhaps
    haven't been applying, you may want to examine areas like the
    Appalachian Mountains and areas like that.
        Mr. Garcia. Point taken, Mr. Chairman, and know that when I
    alluded to ``regions'' we disproportionally haven't heard from,
    that also includes Montana, the upper Midwest. I saw your
    Journal piece, and I take your point.
        Senator Webb. All right. Secretary Ginsberg?
        Mr. Ginsberg. Senator, I appreciate the opportunity to talk
    about our diversity initiative in the Air Force. For us, we
    consider diversity a military necessity. It's not diversity in
    the way that you would think about in, sort of, legally-defined
    equal opportunity programs--race, ethnicity, gender. It's part
    of that. It's really, like you were talking about, as Secretary
    Garcia was mentioning--making sure we're not cutting ourselves
    off from any person who is capable of contributing to the Air
    Force, whether it could be somebody from inner-city or somebody
    from a region where we don't have as many recruits coming in as
    the past.
        So, we see this as sort of a broad-reaching initiative to
    make sure we get the very best people, especially in a time
    when so many young people are not eligible to join the
    military. So, when we've looked at this, and when you can
    almost mathematically show this, that when you get people with
    different perspectives coming together and they look at a
    problem, and they look at it, time and time and time again,
    from those different angles, you get better outcomes.
        Also, there are certain career areas where we have to
    retain people. If somebody who can contribute looks in and
    doesn't see somebody like them, in whatever way, then they're
    not going to want to join the Air Force.
        This is something that the Chairman, Admiral Mullen, has
    talked about, as well as the Secretary of Defense. There are
    some dangers when the country starts looking significantly
    different--and again--not just in race, ethnicity, and gender,
    but a whole broad set of characteristics.
        So, that's really what we have a diversity policy directive
    for, and the Academy has gone out and engaged a really super
    diversity officer. That's really what we're driving for. It's
    something distinct from equal opportunity, and it's certainly
    something distinct from affirmative action, if you will.
        Senator Webb. General Bostick.
        General Bostick. Mr. Chairman, I'd say diversity is
    extremely important in the U.S. Army, as it is with the other
    Services. We compete for the talent that is out there. It's a
    broader definition, I would agree with the Air Force, of
    diversity.
        In the Army, we are experiencing some challenges as--
    minorities in our combat arms, if you're just looking at the
    minority part of it.
        But, we did meet with General Lyles, Air Force (Retired),
    and Lieutenant General Becton, Army (Retired), after they did
    the Military Leadership Diversity Commission. We understand we
    have work to do. We're looking at that commission's report. We
    also published our own diversity roadmap that the Secretary and
    the Chief of Staff signed on, and it's guiding the way ahead
    for Army.
        What we have also found in our enlisted force, that is now
    helping in our officer force--and it just gets back to what
    Secretary Garcia said, that it's really a whole-person concept.
    This notion of quality being a test score or some other metric
    has not proven successful in many universities across the
    country and, in some cases, at our Academy and in our enlisted
    force. Our Army Research Institute has developed a number of
    unique tools for us to look at our enlisted soldiers, and now
    our officers, to try to predict their behavior and whether they
    will stay with the Army for the long haul, and whether they'll
    get promoted and serve as a leader. It's a personality
    assessment, an adaptive personality assessment tool that we
    have started; I think the Navy and the other Services are
    using. What we've found out is that there are some that don't
    test as high as those on the top rung, but perform
    extraordinarily well, even better, and then they stay with the
    military. That's important for ROTC. It's important for the
    academies, and we're looking at that as well.
        Senator Webb. Thank you. This is not a question that is
    openly discussed often enough, in my view. I want to be really
    clear here. I grew up in the U.S. military, the first
    institution in this country to be racially integrated, in 1948.
    I believe very strongly that there is strength in different
    cultures working together.
        At the same time, the warning that I would have is, please
    be very careful when you lump so-called white America into one
    monolith in order to create your statistics. There are so many
    different cultures in white America that you run the risk of
    undoing the very thing you want to construct, if you're not
    careful.
        Senator Blumenthal
        Senator Blumenthal. Thank you. Thank you, Senator Webb.
        I want to go a little further in the line of questioning I
    was pursuing regarding the TAP, and focus on another area which
    may not directly link to unemployment. But, I've asked a number
    of panels about traumatic brain injury (TBI), post-traumatic
    stress disorder (PTSD), which obviously is tied to
    unemployment, and wondered if any of you would share your
    thoughts or observation about how the outreach to young men and
    women, who may not even recognize that they should be seeking
    some kind of treatment, can be done, either through the TAP
    program or through something like it.
        Mr. Garcia. Let me start out with that, if I could,
    Senator.
        Senator Ayotte referred to the use of the Guard and
    Reserve. While we don't have a Guard or Reserve that played
    heavily in a decade's worth of combat, on the Navy side, alone,
    we've deployed some 60,000 individual augmentees (IA) for year-
    long deployments. What we found, early on in the war, was that
    the reluctance--a fear of a stigma to identify--for an
    individual to stand up and to recognize--verbalize that they
    were wrestling with demons and may need some help.
        What we've done since is initiate what we call a Post-
    Deployment Health Assessment (PDHA) that no longer requires
    raising a hand. Everyone gets it, removing that stigma.
        An IA, coming back, takes a PDHA within 30 days, and then
    takes another one within 90 days, a followup. We think, in that
    sense, we've removed the challenge of raising your hand in a
    group of your buddies, taking the stigma out. We think it's
    reaped a benefit.
        Senator Blumenthal. I thank you for that answer. Commandant
    Amos and Sergeant Major Kent have spoken very persuasively and
    eloquently on this issue. I'm thinking not only of Active Duty
    members, but--and not only those as they transition out, but a
    year or so later.
        I spoke, just coincidentally, this morning to a young
    marine who has been out for probably more than a year and
    called me because he'd had an unfortunate brush with the law.
    Nothing serious, but just sort of explosive behavior when
    stopped for speeding. He got himself into more difficulty.
    Then, with his Service experience in Iraq some things clicked
    in my mind. This young man really should be seeing someone
    before he gets himself deeper into trouble.
        If there was some way to reach out to people who have been
    through these experiences and may not have been diagnosed,
    because so many of the cases are undiagnosed. That is just a
    suggestion or an observation.
        General Milstead. Senator, let me jump in here since you're
    using a marine as an example. We're very much involved in the
    PDHA, but your point is a good one. For those marines that have
    already separated from the Service and have gone on--and we've
    spoken about this--we've put our behavioral health--under the
    behavioral health umbrella, we put our combat operational
    stress, our family advocacy, our suicide prevention, our sexual
    assault prevention, substance abuse. They're all connected in
    many, many ways. But for a young marine--and this kind of goes
    back to the TAP, and I won't spend a great deal of time on what
    we're trying to do with the TAP--but, we have a de-stress line,
    we have the means that a young marine can call someone, we have
    our Marine for Life Program, that is distributed in the towns
    across America. That's one of the things in our transition
    assistance, is making sure that we turn this transition
    assistance from an event--from a 3- or 4-day event--into, as
    we've discussed, a process, something that will take care of a
    marine. We like to say, ``You're a marine for life,'' and to
    take care of marines for life, so that they can come back to us
    and they can reach back, if they begin to dance with the
    demons, something that they didn't have, that it has been
    postponed, and that they can come back and we can take care of
    them. I think that's important. We need to do a better job--and
    we're working at that--of making sure that those marines,
    before they go ashore and before they depart the Service,
    understand all those sorts of ways that they can come back.
    There are thousands of people out there, thousands of
    organizations, that want to help and we just have to connect
    them. They're all points of light, and we're working very hard
    on that.
        Senator Blumenthal. I think that's an excellent answer, and
    I thank you, General Milstead. I didn't mean to single out the
    marine. It just happened to be the one who called me this
    morning, and so it occurred to me. But, I thank you for that
    answer.
        General Jones. Senator, I think, from the Air Force
    perspective, identification, obviously, of PTSD and TBI are
    very important. As we start bringing our airmen back from the
    fight, especially those outside the wire, we've started
    utilizing the Deployment Transition Center at U.S. Air Forces
    in Europe where it allows our airmen to decompress, to talk
    about their experiences with professionals, of what they saw,
    what they experienced, and start identifying some of those
    traumatic events early on.
        Then a recent change we've also done, that I'm sure many of
    the Services also utilize, is, anyone being discharged, who has
    deployed within the last 2 years, who had any incident of PTSD
    or TBI, who is being discharged for anything less than an
    honorable discharge, is required to be evaluated by highly,
    highly skilled mental health professionals and psychiatrists.
    By doing that, we've realized that a lot of the misconduct
    that--maybe in the past, have gotten someone discharged for
    personality disorder or adjustment disorder, is really related
    back to the TBI. 61 percent of all of our airmen who we follow
    in the Wounded Warrior Program experience some portion, or some
    manifestation, of TBI or PTSD syndrome. Some, that's all that
    they experience, and that's why they're in the Wounded Warrior
    Program. Others obviously have other issues, along with that.
        So, I think the identification, through the Deployment
    Transition Center, as they roll back. I know, the marines
    recently evaluated our program at Ramstein, and have wanted to
    use that for a lot of their marines that were outside the wire,
    dealing with conflict every day. It's a great program. I'd
    encourage you to come over and see it if you ever have an
    opportunity to pass through Ramstein.
        Senator Blumenthal. Thank you. I hope to do that. Thank
    you.
        Senator Webb. Thank you, Senator.
        What percentages of your discharges are honorable these
    days, as opposed to general or other than honorable?
        General Jones. Senator, I'd have to get the for the record.
        It's obviously the great, overwhelming majority of them.
        Senator Webb. You don't have any idea?
        General Jones. I can get that for you.
        [The information referred to follows:]

        Air Force officer separations from fiscal year 2001 to fiscal year
    2011 (year-to-date):

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Air Force enlisted separations from fiscal year 2001 to fiscal year
    2011 (year-to-date):

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        General Milstead. For the Marine Corps, sir, we'd like to
    take that for the record and come back to you so that you get a
    precise answer on it.
        [The information referred to follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        General Milstead. Of course, the vast majority----
        Senator Webb. I'd be curious to see it.
        General Milstead. Yes sir. We'll come back to you with it.
        Senator Webb. I can tell you, it was 97 percent, during the
    Vietnam era. That's a readily available piece of information
    I'd like to look at, honorable versus general versus unsuitable
    versus court-martial, bad conduct, or dishonorable discharge
    just for the record.
        I'd like to throw a question out, here. I mentioned it last
    week. We've had testimony estimating that around 25 percent of
    the 17- to 24-year-olds in this country are eligible for
    enlistment, the disqualifying reasons being, generally,
    educational/physical requirements. I just find that mind-
    boggling. I know this is an enlistment-rich environment, for
    many reasons, right now. But, it's an issue that I think may
    come up, depending on circumstances in the future, and
    certainly for the health of the country, if we're talking about
    cross-sections of people coming in. Again, I go back to the
    Vietnam era because it was an era where there was conscription
    and there were a lot of people who didn't want to go in. But,
    still, one-third of the draft-eligible males during the Vietnam
    era, actually served, either on Active Duty or in the Guard and
    Reserve. Now we're saying 75 percent in this pool wouldn't even
    be able to, if these numbers are correct.
        So I'm wondering, first of all, if this really is an
    accurate figure. Second, if there's some sort of evaluation of
    the disqualifying features that could be undertaken, or should
    be undertaken.
        General Bostick.
        General Bostick. Mr. Chairman, I'd be happy to start off.
        The figure that I often use is less than 3 out of 10 are
    fully qualified to serve in the military. They're ``not
    qualified'' for several reasons, but it's education and
    aptitude. They don't have a high school diploma or they don't
    score high enough on the Armed Services Vocational Aptitude
    Battery (ASVAB); medical reasons, which include all sorts of
    things, from asthma, eyesight, hearing, bad knees; and lately,
    some of types of psychological drugs that they may have had to
    take for attention deficit disorder and that sort of thing; and
    then, finally, conduct, or misconduct--misdemeanors and
    felonies of that sort.
        So what can we do? In the area of weight, for example--I
    think weight and education are two areas that the country needs
    to go after. I think we--all the educators--and my wife is a
    principal at an elementary school here in Arlington--but,
    education is something the country needs to help us with. We're
    doing our part in the military. Education is very important if
    you're going to come into the military service. I think the GI
    Bill, tuition assistance, the emphasis of the military to say,
    ``We don't just want you in uniform. We don't want you to just
    deploy. We want you to earn your education, from high school
    all the way up to the Ph.D., if it works for you.''
        The other area is medical. Over the years, we've just
    gotten more and more overweight. One of the things that we have
    tried to do in the Army--again, working with our Army Research
    Institute--is to find those young men and women who have grown
    up eating hamburgers and other things all their life, and not
    doing the fitness kind of things that they need to do, but they
    have the motivation and strength to come in the Army. So we've
    created the Assessment of [Recruit] Motivation and Strength
    program. That would take a youngster who might be a little bit
    overweight--body mass index--but, we are assured based on this
    test that we give, that they can get through basic training. It
    has been a wonderful success. They come in. They graduate at
    the same levels as others that don't have a weight issue. Then
    they lose the weight while they're in the Army. But, I think
    the country has to take that on, and we're trying to do our
    best in the military.
        Senator Webb. Thank you. Anyone else have a thought on
    that?
        Admiral Ferguson. Senator, I would just offer that there
    was a DOD study on this issue several years ago which we can
    provide to the subcommittee which breaks down the various
    factors and reasons. But I echo General Bostick's comments that
    what we're seeing is increased disqualification rates--health
    and education seem to be the primary factors.
        [The information referred to follows:]

        The accompanying report, Estimating the Qualified Military
    Available, was developed in November 2007, by the Lewin Group, Inc., at
    the request of the Director of Accession Policy, Office of the Under
    Secretary of Defense (Personnel & Readiness).
        Estimating the Qualified Military Available Final Report reflects a
    count of youth who are mentally, medically, and otherwise eligible for
    service without requiring a waiver, and who are free of family
    commitments that would make them unavailable for duty. The Lewin Group
    developed an estimator that projected the number of 17- to 24-year-old
    youth who are qualified and available for service. This 17- to 24-year-
    old group comprises about 90 percent of non-prior service accessions
    annually. To estimate the number qualified, disqualification filters
    were developed for those who would be disqualified based on the
    Department of Defense standards. Data for developing medical/physical,
    conduct, and dependent filters came primarily from three sources:

             National Longitudinal Survey of Youth 1997 (NLSY97),
             National Health and Nutrition Examination Survey
            (NHANES), 1999-2002
             Substance Abuse and Mental Health Services
            Administration

        Youth may be disqualified for more than one reason; however, a
    hierarchy of disqualifications was used so that only one
    disqualification applied to any one person.

             9 percent are disqualified due to a low aptitude score
            on the Armed Forces Qualification Test.
             35 percent are disqualified for medical conditions or
            physical fitness issues owing mainly to asthma, obesity, and
            other childhood maladies.
             19 percent are disqualified for substance abuse (drugs
            and alcohol).
             6 percent are disqualified based on the number of
            dependents under age 18 they have.
             5 percent are disqualified for questionable conduct or
            law violations.

        Combined, the data show that only about 26 percent of today's youth
    are qualified to serve without obtaining a waiver. Data also show that,
    11 percent, although qualified, are enrolled in college, and therefore
    not available to serve. Subtracting for those in college, only 15
    percent of the 17 to 24 youth population are both qualified and
    available for military service without requiring a waiver for one or
    more sources of disqualification.
        [The Report ``Estimating the Qualified Military Available''
    follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        [The Report ``Ready, Willing, and Unable To Serve''
    follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        [The Report ``Too Fat Too Fight'' follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        General Milstead. I'll just jump in here, Senator. After
    commanding the Marine Corps Recruiting Command for about 2\1/2\
    years, the quality of young men and women that are coming in to
    the military today, is the finest that I've seen in my 35 years
    of service. I'll just use the Marine Corps' figures from last
    year. 99.7 percent of the young men and women that joined were
    at tier I; 73 percent, mental category three-alpha [3A]. You
    kind of hit it on the head. Right now, it's a buyer's market.
        But to echo what was said, it is a national issue. It's a
    national problem. It's not a military problem, per se, but it's
    a national problem. It's something that--like education, like
    suicides--that we need to take on, on a national level. I'll
    just offer that.
        Mr. Garcia. If I could just put a punctuation point on
    General Milstead's point. We're seeing the same data that you
    are, Senator, in terms of one in four of the 17- to 24-year-old
    traditional recruiting demographic is either morally,
    medically, or legally ineligible for service. But, as the
    General said, by any objective metric, ASVAB, technical
    background, traditional academic diploma holders, we're off the
    charts; we haven't been here before. The same goes in the
    officer ranks. It's never been more competitive, at least
    academically, for ROTC scholarships and academy admission.
        I would just leave with the point that every one of those
    kids who goes and stands on the yellow footprints or goes to
    Great Lakes does so knowing nothing but combat for their entire
    adult lives. So, out of that 25 percent that's left, we're
    getting an incredible cadre to raise their right hand.
        General Jones. Senator, our quality in the Air Force is
    extremely high. But, I echo what my colleagues say; it is a
    national issue with having all Americans fit for military
    service. I think the biggest thing is the physical attributes
    that we have, not because we've gotten tougher, but because the
    country's gotten softer. In the Air Force, we need to make sure
    90 percent of all of our recruits are in the top three mental
    categories. We have 60 percent as the goal for DOD. So, we're
    all experiencing, really, a high-quality standard. But, what
    that allows us to do is reduce our training costs. We used to
    program 10.5 percent attrition for basic military training.
    We're now down to 5 percent, because our recruits that come in
    are such high quality.
        But, the number of recruits, as you pointed out, the number
    of people eligible to be recruited in the military is a
    significant concern for the future.
        Senator Webb. Certainly not as I said when I started this
    question, not a question of the quality of the military today.
    That is something that could well come up in the future. I'm
    not thinking that it will, in the way we are sizing our
    military and the way that we have been taking care of, in an
    appropriate way, our military members and their families,
    including post-military assistance, such as the GI Bill. But,
    it certainly is a stunning statistic, when you look out at the
    rest of the country. Perhaps going to what Secretary Garcia,
    you were saying, being more ``embracive'' in society.
        I remember years ago, in the Marine Corps, they used to
    have a platoon down in Parris Island for the overweights.
    They'd just work them to death until they hit the weight marks,
    and then they would go on and begin their regular basic
    training. As far as I could tell, they weren't any different
    than any other marine when they came out of all that. Right
    now, I guess you don't have the need to be doing those things,
    in terms of the quality of the force. But it's just a stunning
    statistic.
        You talked about in your testimony--many of you did and I
    don't have all your testimony in front of me--but, the
    reduction in enlistment and reenlistment bonuses that are now
    being paid, what happens to that money when it's not paid? Is
    it reprogrammed into other personnel accounts?
        Secretary Lamont.
        Mr. Lamont. As an ability to reshape the force in other
    ways. What we don't need in our incentive for recruiting, for
    instance, we will look for the critical skill needs--so that we
    can add to our bonus situation there, for instance--as well as
    in our retention area, where we want to maintain those high-
    quality new captains coming out of there. So, we will provide
    any number of incentives, be it in terms of graduate school, be
    it in terms of bonus, be it in terms of assignment.
        But, yes, we reallocate those funds primarily, as I say, to
    shape the force for our critical skill needs.
        Mr. Ginsberg. Mr. Chairman, of course, in the Air Force, we
    want to make sure the budget requests that come up here are as
    accurate as possible, and that we project, in the future, how
    much we are going to need in recruiting and retention bonuses.
    So, of course, once the money's been appropriated, as the year
    goes on, we monitor it closely.
        I would say that recruiting and retention bonuses are
    absolutely vital right now, especially for filling some of our
    stressed career areas that we are having--particularly in the
    realm of retention--having some challenges.
        But we, of course, monitor it closely. We tailor it,
    because given, obviously, how scarce resources are right now,
    and that we do need to be good stewards of taxpayers' dollars,
    we want to target those as much as possible.
        Senator Webb. Thank you again for being here today, all of
    you, and for your continued dedication to the well-being of the
    people of the U.S. military and the others who are making our
    military posture successful in the total force. I appreciate
    the candor in which we've been able to conduct our discussions
    today. We will have some follow-on questions on some of these
    other areas.
        This hearing is now adjourned. Thank you.
        [Questions for the record with answers supplied follow:]
                Question Submitted by Senator Richard Blumenthal
                               prescription drugs
        1. Senator Blumenthal. Secretary Lamont, I believe that the ability
    to utilize a local pharmacy to fill prescriptions contributes to the
    quality of life for military families, by providing them crucial face-
    to-face consultations and advice on filling prescriptions and
    medication safety. This relationship has many benefits, including
    reducing the likelihood of substance abuse or using prescription drugs
    outside of their intended guidelines. Military families recognize this
    value. In 2009, more than half of TRICARE prescriptions were filled at
    pharmacies, and only 8 percent were filled by mail order. As you know,
    the Department of Defense (DOD) has proposed an increase to the co-pay
    for prescriptions filled at a beneficiary's local pharmacy in order to
    incentivize the use of mail-order prescriptions. Requiring
    beneficiaries to pay more to be able to speak to a pharmacist about how
    to properly take their medication or to fill urgently needed
    prescriptions is, I believe, inappropriate and would actually hamper
    the ability of beneficiaries to take charge of their own health. What
    are the Army's views on the importance of pharmacists in preventing
    substance abuse and do you have any concerns that by incentivizing
    military families towards a mail-order system the contribution of
    pharmacists in the fight against substance abuse may be diminished?
        Secretary Lamont. The Army views pharmacists as vitally important
    in the fight against substance abuse. At each point of service,
    pharmacists have medication profiles and can personally discuss any
    medication related issues with all beneficiaries. Mail-order
    prescriptions are intended for medications taken on a regular basis for
    chronic conditions and not intended for medications prescribed for
    acute illness or injury. Incentivizing military families towards a
    mail-order system for routine medications will not diminish the
    contribution pharmacists make to fight substance abuse.
                                     ______

                   Questions Submitted by Senator John McCain
                          tour normalization in korea
        2. Senator McCain. Secretary Lamont and General Bostick, on
    September 23, 2010, the Secretary of Defense directed U.S. Forces Korea
    and the Services to proceed with full tour normalization for Korea, as
    affordable, but not according to any specific timeline. This new policy
    will require the DOD to build facilities and infrastructure to support
    up to 14,000 families who will be stationed in Korea for up to 3 years.
    DOD's cost assessment office was directed to provide a plan by March
    31, 2011, detailing schedules and costs for this policy decision. A
    major part of the plan involved committing funds allocated for overseas
    housing allowances (OHA) as the government's contribution to a public/
    private venture called the ``Humphreys Housing Opportunity Program
    (HHOP)'' for the construction and leasing of multiple high-rise towers
    containing thousands of housing units at Camp Humphries, Korea. Are you
    aware of any cost estimates for this proposal? If so, can you provide
    them?
        Secretary Lamont and General Bostick. As directed in the September
    2010 memorandum, the Director of the Cost Assessment and Program
    Evaluation office provided a report to the Secretary of Defense that
    contained very broad options to normalize tours in Korea. To date no
    implementation decision or costing formulas have been released from
    OSD. The U.S. Forces Korea is in the process of relocating from Seoul
    to U.S. Air Guard (USAG) Humphreys under the Yongsan Relocation Plan
    (YRP). Under YRP, the United States provides housing at USAG Humphreys
    through the HHOP to support the relocation of families. The HHOP units
    deliver 1,400 family homes and support both YRP and the 3,198 Command
    Sponsored Families at USAG Humphreys during Phase I.

        3. Senator McCain. Secretary Lamont and General Bostick, at one
    time we heard the monthly OHA needed to finance this program would
    exceed $4,000 a month paid as rent, not including utilities. What is
    the projected monthly OHA rate to support the Army's housing plan at
    Camp Humphreys and has this been approved by the Secretary of Defense?
        Secretary Lamont and General Bostick. On 18 October 2010, the
    Secretary of Defense directed the Army to execute the HHOP. Currently
    the fiscal year 2011 base HHOP rate is set at $4,200 plus utilities,
    and is used as the basis for programming and cost analysis.
    Implementation of HHOP is currently under review by the Office of the
    Secretary of Defense.

        4. Senator McCain. Secretary Lamont and General Bostick, are any of
    these costs included in the President's budget request for fiscal year
    2012 or in the current 5-year plan for DOD or the Army? If so, how much
    and in what account?
        Secretary Lamont and General Bostick. The funding has not been
    annotated in the President's budget for fiscal year 2012 or the out
    years. As no decision was made to support the action, it was not
    included in the budget.

            enlisted recruiting and alternate high school education
        5. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, a high school diploma from a brick-and-
    mortar high school has been the preferred qualification for recruits
    for many years. Graduates of such high schools are designated Tier 1
    recruits. In recent years, many alternate forms of education have
    become popular, including distance learning and online public and
    private schools that are, nonetheless, fully accredited by States.
    These graduates are designated Tier 2 candidates, and, with the
    recruiting success you are having in this economy, Tier 2s are having a
    much harder time being recruited. Recognizing that DOD policies control
    in this area, what are your views about whether the Tier 1/Tier 2
    system works as advertised to reduce attrition while producing the best
    candidates your Service can get?
        General Bostick. The Army agrees the Tier 1/Tier 2 systems are
    valid predictors of trainability, knowledge, and job skill based on
    over 20 years of evidence-based analysis. To date, there has been
    limited research completed on enlistees who hold nontraditional
    alternate high school credentials such as online and distance learning
    certificates. As we study these credential holders to assess their
    trainability, attrition, and performance in comparison to GED holders,
    home school graduates, National Guard Youth Challenge graduates, the
    Army has considerable hope that research instruments such as the
    Tailored Adaptive Personality Assessment System (TAPAS) will offer a
    tool that can predict higher performance from alternate credential
    holders. Although still in its infancy, the Army has begun collecting
    data on the distance learners and online graduates to assess their
    training and first-term attrition rates.
        Admiral Ferguson. The DOD Three-Tier System has proven effective in
    selecting applicants with the greatest likelihood of completing their
    initial service obligation. Navy focus is on quality Tier I applicants
    with a corresponding correlation to lower attrition rates during
    initial enlistment.
        Of note, current Navy policy does allow for home school graduates
    to be considered as Tier I applicants, provided that they attain an
    Armed Forces Qualification Test (AFQT) score of 50 or higher on the
    Armed Services Vocational Aptitude Battery (ASVAB) and complete an
    Assessment of Individual Motivation (AIM). The AIM and ASVAB are
    utilized to assess the individual's aptitude for Navy service, and
    assists the applicant in job selection.
        General Milstead. The Marine Corps has found, through numerous
    studies over the years, the DOD Tier classification system is a very
    accurate predictor of the likely success an applicant will have in
    their first enlistment. The Marine Corps has focused on the high school
    market as our primary recruiting source for quality applicants since
    that is the educational credentialed cohort that has the lowest
    attrition. We recognize there are deserving applicants that are
    classified Tier 2, and in order for the Marine Corps to accommodate
    these applicants, we allow up to five percent of our annual accessions
    to enlist with these education credentials.
        General Jones. At this time, the Air Force embraces the DOD tier
    system as a valid screening methodology for our recruits. The Air Force
    has always been a recipient of very high quality recruits, even during
    lean times. However, we believe that additional non-cognitive measures
    could be added to improve the screening process along with proactive
    evaluation of alternative credential holders. If there are validated
    options to identify other types of graduates that will be successful
    airmen, then we fully support a modification or change to the current
    system.

        6. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, is the traditional high school experience,
    in your view, what's important? Or is it the achievement of the high
    school diploma?
        General Bostick. We believe it is a combination of both experience
    and achievement. A diploma from a traditional high school program
    offers proof that an applicant attended and completed a 12 year graded
    program of classroom instruction. Applicants who have completed these
    programs successfully have a long history of demonstrating that the
    combination of experience and achievement they have gained are
    significant indicators of the type of personal commitment which proves
    to be an asset in adjusting to Army life. A high percentage of
    individuals who do not complete a traditional high school experience
    are more apt to demonstrate lower trainability, and performance and
    higher attrition and other problems in comparison to traditional high
    school diploma graduates.
        Admiral Ferguson. Both. While a high school diploma and equivalent
    credentials are measures of academic achievement, completion of a
    brick-and-mortar high school curriculum, in itself, is also a strong
    predictor for program completion success. The traits exemplified
    through completion of a traditional high school education are similar
    to those needed to complete Navy recruit and skill level training.
        The motives behind a student's preference for alternative forms of
    education vary widely. While most of these reasons are in the best
    interest of an individual student's graduation prospects or personal
    education desires, analysis has shown non-traditional high school
    graduates to be less successful than the ``traditional'' brick and
    mortar students in completing basic military training. Experience has
    shown that, in general, students who participate in non-traditional
    forms of education have less exposure to varied social experiences and
    interaction that promote the growth and adaptability that strongly
    indicate success at Recruit Training Center (RTC). However, recognizing
    that completion of high school is not the sole indicator of success at
    RTC, alternate education students who display academic excellence are
    eligible for Tier reassignment as previously stated.
        General Milstead. We believe the traditional high school
    experience, not just a diploma, is a better indicator of how an
    individual will adapt to military life. A candidate who receives a
    diploma through the traditional high school experience has demonstrated
    the ability to succeed in a structured environment and to work at
    length in pursuit of a goal, traits that will serve them well in future
    military service. The Marine Corps remains focused on the traditional
    high school market for recruiting and appreciates the assistance of
    Congress in ensuring our recruiters have access to high schools and
    student directory information.
        General Jones. Currently, the high school diploma is our critical
    benchmark for Air Force recruiting. We know that our most successful
    first-term airmen are high school graduates. The traditional high
    school experience develops a well-rounded graduate from both a social
    and educational standpoint. The attrition data and analysis is
    conclusive-high school graduates have significantly lower attrition
    rates in training and are more likely to serve their entire first
    enlistment term. This saves valuable recruiting and training resources,
    and provides airmen with the skills and aptitude needed to perform well
    in Air Force jobs.

        7. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, would you support a pilot program to
    evaluate whether graduates of nontraditional, online public schools
    perform as well as graduates of traditional high schools?
        General Bostick. Yes, the Army would be highly supportive of such
    pilot. We think it is imperative that we begin studying applicants with
    these kind of educational credentials to assess their trainability,
    attrition, and performance in comparison to other non-traditional,
    alternate high school credentials, such as GEDs, home school graduates,
    and National Guard Youth Challenge graduates as well as in comparison
    with traditional high school diploma graduates.
        Admiral Ferguson. Navy would support a pilot program to evaluate
    whether graduates of nontraditional, online public schools perform as
    well as graduates of traditional high schools. We support evaluating
    pilot programs based on changing trends in education and their impact
    on the recruitable population.
        General Milstead. DOD provides oversight in the evaluation and
    classification of whether graduates of non-traditional or online public
    schools perform as traditional high school graduates. A standing
    military accession education committee, including representatives from
    all of the services, reviews and modifies the policies that evaluate
    whether graduates of nontraditional or online public schools perform as
    traditional high school graduates. We recommend the military accession
    education committee evaluate and recommend whether such a pilot program
    should be initiated.
        General Jones. Yes, the Air Force is supportive of pilot programs
    or studies that could valildate new options for increasing the
    potential talent pool of future airmen.

        8. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, should we retain the current system, or
    move to a new ``whole man'' evaluation of some kind that does away with
    the Tier system?
        General Bostick. The Army maintains that the current Tier systems
    are valid predictors of trainability, knowledge, and job skill and
    should be retained until a better system can be developed, studied, and
    has proven to be more credible than the current system. To date, there
    has been very limited research conducted on enlistees who hold
    nontraditional alternate high school credentials such as online and
    distance learning certificates to assess their training base and first
    term attrition rates. The Army is willing to revisit this issue after a
    study of empirical data has been conducted to determine the feasibility
    of transitioning to a different system.
        Admiral Ferguson. Until current research projects can validate a
    proven method to measure an individual's potential for success in the
    military, we recommend retaining the current Three-Tier system, since
    it has proven extremely successful in selecting individuals with the
    highest likelihood for success in the military service.
        The Navy and Army have been working on developing and fielding Non-
    Cognitive Testing Instruments to assist the Services in improving the
    selection process. While the ASVAB is a very good predictor for a
    person's aptitude, it does not provide an assessment of an individual's
    probability for success in military.
        Army has been administering its TAPAS test to potential Army
    recruits for more than 2 years, and preliminary results have indicated
    that soldiers who performed well on the TAPAS test, but scored less
    than 50 on the AFQT have attrition rates comparable to soldiers who
    scored greater than 50 on the AFQT. Based on Army's preliminary
    research findings, Navy has begun to use the Military Entrance
    Processing Centers to administer the TAPAS test to all potential future
    sailors, to determine if Army's TAPAS test is a viable predictor for
    success in the Navy.
        General Milstead. We do not recommend abandoning the Tier system.
    DOD established the current Tier system so that all of the services
    classify applicant education credentials in the same manner. This
    system has proven to be a very accurate predictor of military applicant
    attrition for well over 3 decades.
        General Jones. The current tier system has proven to be a valid
    predictor of attrition. Our position supports that of the department to
    retain the current tier system. If results from new studies and
    analyses indicate that changes are supported, then the Air Force would
    be amenable to considering alternatives.
                          disability evaluation system
        9. Senator McCain. Secretary Lamont and General Bostick, after
    almost 10 years of war, the Army is trying to move about 20,000
    nondeployable soldiers through the Disability Evaluation System (DES).
    When considered against the requirement to cut 22,000 Active Duty
    soldiers from the Temporary End Strength Increase over the next 2
    years, this looms as a significant readiness issue. What are you doing
    and what recommendations do you have to address the Army's problem with
    this large and growing backlog of soldiers in the DES?
        Secretary Lamont and General Bostick. The Army remains convinced
    statutory reform is the only sustainable way to achieve a system worthy
    of the sacrifices of our volunteer force in this era of persistent
    conflict. Although the DES is better than it was 4 years ago, the
    process remains complex, disjointed, hard to understand, and processing
    has become embarrassingly slow and unpredictable. While DOD and the
    Department of Veterans Affairs (VA) have integrated their separate
    disability systems, the laws, legal opinions, and policies specific to
    each department result in differing outcomes for the same type of
    determination; this duality creates confusion, a lack of trust, and a
    belief the Army is not being loyal to or fair with its soldiers.
        The current DES is 60 years old and was designed for a draft-based
    military in an industrial/agricultural America; its focus on disability
    and compensation is inadequate for the needs of today's professional
    military. The unintended effects of disability compensation reduce
    incentives to participate in rehabilitation or to return to work. Some
    of our soldier's believe if they get better, they will receive less
    disability compensation; they may want to work, but they also need to
    maintain their income for themselves and their families. We need to
    reform the system--our soldiers deserve a more comprehensive system
    that promotes resilience, self-reliance, re-education, and employment,
    while ensuring enduring benefits for the soldier and their families.
        The Army's current backlog is related to an inherently inefficient
    process. For perspective, a rapid improvement effort conducted at Fort
    Carson last year identified 155 distinct processing handoffs, organized
    into 10 sub-processes crossing 8 functional activities in 2
    departments. At present, the Joint DOD/VA Integrated process takes
    nearly 400 days to complete, but our soldiers active participation in
    the process is less than 30 days. More to the point, even if we were
    meeting the DOD's 295-day goal, 10 months is simply too long for our
    soldiers to wait while their future hangs in the balance.
        Although we fully support current efforts to redesign the
    Integrated Disability Evaluation System (IDES) to realize a 150-day
    process, we believe any effort to redesign the process within the
    constraints of legislation will likely have low payoff as it did in
    2007, and more importantly, these efforts divert leadership away from
    real reform. As our Surgeon General argued in 2007, attempting to speed
    up a bad system will do little more than turn a bad process into ``a
    fast bad process.'' However, we are not suggesting we do not; we
    understand effective reform will take time, and in the mean time we
    have to do what we can with the process we have. Therefore, the Army
    will continue to commit resources and leadership energy to improve our
    DES. Since 2007 the Army has increased resources dedicated to DES
    activities, conducted over 30 improvement projects, and increased
    command/leadership focus on the process. Ongoing improvement efforts
    include:

             Holding quarterly Video Teleconferences (VTC) with
            senior Army and VA leadership to identify and resolve systemic
            issues hindering efficient processing and share Best Practices/
            lessons learned.
             Simplifying Medical Evaluation Board requirements to
            reduce variability, improve quality, facilitate training of new
            examiners, and decrease redundancies.
             Providing additional resourcing to increase Medical
            and Physical Evaluation Board capacity to meet current and
            anticipated demands.
             Testing new medical evaluation and referral procedures
            at RC Soldier Medical Support Center (RC SMSC) in Pinellas
            Park, FL with the initial supporting Medical Treatment Facility
            (MTF) at Fort Gordon.
             Published a directive outlining the roles,
            responsibilities, and expectations for preparing an
            installation to transition from the Army's legacy Physical DES
            to the Joint DOD/VA Integrated DES.
             Continue to enforce existing standards for processing
            and adjudicating non-deployable soldiers.
             Continue to review and revise policies, processes and
            systems that have caused the non-deployable rate to increase.

        Finally, we believe the rehabilitation and DESs required to sustain
    an All-Volunteer Force deserve a broader national and interagency
    discussion. This discussion must focus on the Nation's responsibilities
    to the less than 1 percent of the American population who volunteer to
    ensure our Nation's security, and through no fault of their own except
    for doing their duty become Wounded, Injured, or Ill and can no longer
    serve.

     independent review panel to study the judge advocate requirements of
                           the department of the navy
        10. Senator McCain. Secretary Garcia, the Report of the Independent
    Review Panel to Study the Judge Advocate Requirements of the Department
    of the Navy (the Panel) was completed on February 22, 2011. The Panel
    recommended that the Navy's Judge Advocate General (JAG) Corps be
    manned at a level of 950 judge advocates. The Navy JAG testified to the
    Panel that his assessment was that there should be 926 JAG on Active
    Duty to meet current demands in missions including Office of Military
    Commissions and individual augmentees assignments. What is the
    Department of the Navy's plan with respect to responding to the report
    and recommendations of the Panel?
        Secretary Garcia. The Navy plans to fund 31 JAG Corps officer
    billets currently detailed to the Office of Military Commissions until
    the end of fiscal year 2015, and continue increasing the number of JAG
    Corps billets to 821 over the Future Years Defense Program (FYDP). This
    is consistent with the number of active-duty JAG Corps officer billets
    the JAG, VADM James Houck, testified before the 506 Panel are needed to
    meet baseline mission requirements (Individual Augmentee and the Office
    of Military Commissions assignments are not included in the baseline
    requirement). We have also begun to train enlisted members of the
    Legalman rating to obtain certification through the American Bar
    Association as paralegals, which will gradually ease much of the
    administrative burdens currently levied on JAG Corps officers.

        11. Senator McCain. Secretary Garcia, what is your assessment of
    the appropriate level of Active Duty JAG in the Navy and Marine Corps
    and what actions do you plan to take in this regard?
        Secretary Garcia. We have experienced increased demand for JAG
    Corps officers in areas such as operational law and support for sailors
    and their families. However, I believe the panel's estimate of the
    number of JAG Corps officers necessary to meet future requirements is
    high. For Navy Active Duty JAG Corps officers, I concur with VADM
    Houck's testimony before the 506 Panel that the number of Active Duty
    JAG Corps officers necessary to meet baseline mission requirements is
    821 (Individual Augmentee and the Office of Military Commissions
    assignments are not included in the baseline requirement). To meet
    these requirements, the Navy intends to increase the number of JAG
    Corps billets to 821 across the FYDP. This increase, coupled with our
    ongoing initiative to train enlisted members of the Legalman rating to
    obtain certification through the American Bar Association as
    paralegals, will ease much of the administrative burdens currently
    levied on JAG Corps officers.

                 sexual assault prevention and response efforts
        12. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, preventing and responding properly to
    incidents of sexual assault remains a high priority for each of your
    Services, and progress has been made. Is the military a safer place for
    women to serve than before September 11?
        General Bostick. The comprehensive Sexual Assault Prevention and
    Response (SAPR) Programs implemented across DOD and within all the
    Services have undoubtedly helped make the military safer for all
    servicemembers, female and male.
        Although Army statistics show a significant increase in the number
    of reports of sexual assault since 2001, those statistics are
    misleading as sexual assault was and is the most under-reported crime
    in the Nation. Since the Army SAPR Program began in 2004, there has
    been a steady increase in the percentage of Army victims who break
    their silence and come forward to report a sexual assault. More victims
    are reporting because they feel safer and more confident with the
    response they will receive from their chain of command, criminal
    investigators, medical personnel and prosecutors.
        Additionally, the Army has increased its focus on prevention by
    implementing a comprehensive sexual assault prevention strategy. The
    cornerstone of the Army's strategy is the ``I. A.M. Strong'' Sexual
    Harassment/Assault Prevention Campaign where the letters I-A-M stand
    for Intervene-Act-Motivate. The ``I. A.M. Strong'' messaging features
    soldiers as influential role models and outlines the Army's intent for
    all team members to personally take action and set a respectful
    standard of conduct, thereby providing a safe environment for all
    community members.
        Admiral Ferguson. Although measuring success in prevention is
    difficult, it appears that Navy's SAPR program may be contributing to a
    decrease in the incidence of sexual assault against servicemembers, as
    measured by the Defense Manpower Data Center (DMDC) 2010 Workplace and
    Gender Relations Survey of Active Duty Members. In 2006, 7.1 percent of
    active duty women, and 2.3 percent of active duty men, indicated they
    experienced unwanted sexual contact in the 12 months before the survey.
    In 2010, 4.4 percent of active duty women, and 1.1 percent of active
    duty men, indicated they experienced unwanted sexual contact in the
    prior 12 months.
        General Milstead. The Marine Corps SAPR program is focused on the
    safety, dignity, and the well-being of all marines. Our leadership has
    elevated and highlighted the importance of the SAPR Program by
    institutionalizing a zero tolerance policy, holding commanders
    accountable for establishing an environment of trust and respect, and
    developing ``Bystander Intervention'' training, an evidence-based best
    practice for engaging marines on their role in sexual assault
    prevention.
        Although not conclusive, there was a slight decrease in the
    reported number of sexual assaults from fiscal year09 to fiscal year
    2010. In addition, command actions taken on sexual assaults (e.g.
    courts-martial, non-judicial punishments, and other administrative
    actions) increased from 41 in fiscal year 2009 to 52 in fiscal year
    2010, which may correlate to greater offender accountability.
        Since September 11, the Corps has taken a comprehensive look at the
    behavioral health needs of marines. The Commandant directed the
    integration of all Behavioral Health programs, including SAPR, in order
    to provide services that are responsive to the needs of victims and
    offer evidence-based practices to marines and their families. The SAPR
    program will continue its efforts to improve overall education and
    training on the need to prevent sexual assaults.
        General Jones. Yes, we are confident that since the implementation
    of the SAPR program in June 2005, significant strides have been made to
    provide a safer environment for military women and men regarding
    preventing and responding to incidents of sexual assault. We also
    recognize that there is more to be done and will continue our efforts
    to enhance our program and aggressively work towards eliminating a
    crime that has no place in our Air Force.

        13. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, do you think that additional legislation
    is needed to enhance the sexual assault prevention programs in DOD and
    your Service?
        General Bostick. Additional legislation for sexual assault
    prevention programs is not needed at this time. The National Defense
    Authorization Act (NDAA) for Fiscal Year 2005 provided the necessary
    legislative impetus to create SAPR programs in DOD and the Military
    Services. Since then, DOD and the Services have worked very closely
    with each other and Congress to implement, assess and improve SAPR in
    the military.
        For example, three GAO reviews, the congressionally mandated
    Defense Task Force on Sexual Assault in the Military Services (DTF-
    SAMS), as well as continuous internal assessments by DOD and the
    Services have identified ways to improve how we can prevent and respond
    to incidents of sexual assault.
        This collaborative relationship among DOD, the Services and
    Congress facilitates identifying and implementing changes and
    enhancements, without the need for additional legislation.
        Admiral Ferguson. Existing laws have helped to achieve an enhanced
    and more efficient SAPR program. Navy continues to comprehensively
    evaluate our SAPR program and implement appropriate steps to eliminate
    sexual assault from the Navy. As our program evolves, we continuously
    monitor our efforts, and assess the impact of our initiatives, which
    will allow us to determine if additional legislation is required.
    Should new legislation be deemed necessary, we will recommend its
    inclusion in a future Defense Authorization request.
        General Milstead. The Marine Corps is currently working with DOD to
    implement the SAPR requirements set forth in the NDAA for Fiscal Year
    2010. We do not believe additional legislation is needed at this time.
        General Jones. Prior legislation initiated with the Ronald Reagan
    NDAA of 2005 and subsequent public laws have provided us with a robust
    framework to establish a SAPR program, while allowing integration with
    overall military readiness. We appreciate the attention Congress has
    brought to bear on this issue and the ongoing efforts to provide for
    strong prevention and response programs within the Department. For
    example, we support the recent Senate Armed Services Committee
    inclusion in the mark up of legislation to amend section 920 of title
    10, U.S.C. (article 120 of the Uniform Code of Military Justice) to
    clarify the separate sexual assault offenses. This legislation was
    requested by the Joint Services Committee on Military Justice and the
    Secretary of Defense to address deficiencies in existing law that have
    been identified by military courts and which were addressed in the
    report of the Defense Task Force on Sexual Assault in the Military
    (December 2009).

           progress of implementation of don't ask, don't tell repeal
        14. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, training for Repeal Day is currently
    underway in each of your Services that will pave the way for gay and
    lesbian individuals to serve openly in the Armed Forces. What is your
    assessment of the effectiveness of the training for your Service thus
    far?
        General Bostick. The Army's Chain Teach method has been very
    effective in educating the force on the policy changes that will result
    from implementation of the repeal of Don't Ask, Don't Tell. It puts
    direct responsibility on commanders/leaders for their units' complete
    education, allowing them to personally engage their soldiers,
    civilians, and interested family members on this important policy
    change and to explain its impact and our expectations of them. Feedback
    to date continues to confirm confidence that Army commanders and senior
    noncommissioned officers are fully capable of providing strong
    leadership, a clear message and proactive education that are keys to
    successful implementation of DADT repeal.
        Admiral Ferguson. Navy assesses the training conducted to date to
    be effective and training remains on track for completion by July 1,
    2011. The effectiveness of training is accomplished through objective
    and subjective measures. We are accounting for the number of
    individuals and units that complete training through a web-based Navy
    Family Accountability and Assessment System to preclude gaps in any
    major commands or regions.
        To measure retention of training content, we administered
    knowledge-based tests to Command Leadership teams after completion of
    Tier 2 training with results showing over 90 percent comprehension.
    Training leadership teams provide feedback on questions and concerns
    that arise during training sessions.
        Sailors also have the opportunity to submit individual questions or
    feedback about their training experiences through our Don't Ask, Don't
    Tell repeal web site. Questions posed during training sessions or
    submitted online are reviewed and responses are added to the
    ``Frequently Asked Questions'' section of the web site. Sailor feedback
    indicates the training is comprehensive, well-delivered, and effective.
    Additionally, we have observed no negative impacts to readiness,
    effectiveness, cohesion, recruiting, or retention.
        Navy is confident that the training assessment measures we have in
    place, coupled with the overall positive feedback from the force,
    indicate that the training is effective.
        General Milstead. Feedback from the force indicates our training
    has been effective. Marines indicate an understanding of the policy
    change and what is expected of them upon repeal. The face-to-face
    training allows marines to engage their leadership and ask those
    questions that are most important to the individual marine. The time
    allotted to prepare and train for the repeal provides the opportunity
    for marines to really consider potential impacts and ensure they are
    aware of the change in policy.
        General Jones. The Air Force is delivering the Office of the
    Secretary of Defense standardized tiered DADT repeal training. As of 1
    Jun 11, the AF has trained 66 percent of the total force.
        In order to assess the effectiveness of training, we're soliciting
    subjective feedback from our Major Commands (MAJCOMs) on a bimonthly
    basis. These reports include feedback in the following areas: policy,
    readiness, effectiveness, unit cohesion, retention, repeal related
    incidents, and barriers to repeal
        To date, the subjective reports from MAJCOMs are positive. MAJCOMs
    are indicating that the training is clear, on-target, and effective.
    The standardized slides and script are ensuring a consistent, accurate
    message is provided throughout the force. There has been no significant
    issues regarding policy, effectiveness, unit cohesion, retention,
    repeal related incident, and barriers to repeal.

        15. Senator McCain. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the ground combat forces--soldiers and
    marines, as well as the Special Forces for all Services--registered the
    greatest concern about the effects on readiness and unit cohesion of
    repealing the Don't Ask, Don't Tell policy. What problems do you
    anticipate on ships and in the field when the repeal takes effect?
        General Bostick. I do not anticipate significant or systematic
    problems from the repeal of Don't Ask, Don't Tell. Feedback from the
    field across all units is that this is not a significant issue to the
    soldiers. We will deal with this issue with the same professionalism
    that has marked our conduct of current operations and has been a
    hallmark of this institution for 236 years. Soldiers are expected to
    treat all others with dignity and respect, consistent with the core
    values that already exist within the Army. Harassment, bullying or
    victimizing of any kind will not be tolerated.
        The Army is a force of over 1.1 million soldiers, and there will
    likely be inappropriate conduct by a few. Commanders and supervisors at
    all levels have the authority and responsibility to maintain good
    order, discipline and morale within their units; they should use
    existing tools (to include counseling, non-judicial punishment and
    court-martial) to deal with misconduct. Leaders will be educated on how
    to handle certain situations, and support will be provided as needed to
    ensure decisions are lawful, impartial, and promote unit cohesion.
        The Army Guiding Principles for Implementation of the Repeal of
    DADT include: standards of conduct apply to every soldier; treat each
    other with dignity and respect; emphasize our role as professional
    soldiers; and good order and discipline will be maintained at all
    times. The clear message is that respecting each other's rights is
    critical to maintaining good order and discipline. Standards of conduct
    apply equally to all soldiers and inappropriate conduct should be
    corrected appropriately.
        Admiral Ferguson. We have seen no adverse effects associated with
    repeal training to date, and no significant problems are anticipated on
    ships or in the field when repeal takes effect. The Comprehensive
    Review Working Group (CRWG) study anticipated some limited and isolated
    disruption to unit cohesion and retention and concluded that the risks
    of repeal within warfighting units in a field environment or at sea,
    would remain within acceptable levels when coupled with a sustained
    commitment to core values of leadership, professionalism, and respect
    for all. While the CRWG identified potential areas of friction, Navy
    has focused its DADT Repeal training on preparing leaders with an in
    depth understanding of policy changes and discussions on
    implementation. Using informed leadership to present training to
    sailors has ensured appropriate emphasis is being placed on
    professionalism and mutual respect.
        General Milstead. We do not anticipate post-repeal problems that
    engaged leadership will not be able to successfully address. I expect
    that your marines will faithfully abide by the laws of this Nation and
    conduct themselves in accordance with their core values of honor,
    courage, and commitment. Any issues that may arise post-repeal will be
    immediately addressed upon identification.
        General Jones. Air Force is satisfied that education and training
    policies and regulations adequately address concerns of our deployed
    forces.
        Although 10 U.S.C. 654 has not yet been repealed, we have not
    received any reports from the field indicating negative operational
    impacts since legislation was passed allowing for repeal.
        Reports of concerns regarding privacy in berthing and bathroom
    areas have been limited and thus are not considered a major concern. As
    we approach completion of training, we expect fewer questions regarding
    privacy concerns; however, we will continue to closely monitor
    feedback. We also believe existing standards of conduct already are in
    place, and commanders have sufficient authority and flexibility to
    address issues arising in the future.
                                     ______

                 Questions Submitted by Senator Lindsey Graham
             mental health assessments for deployed servicemembers
        16. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the NDAA for 2010 required person-to-
    person mental health assessments at regular intervals before and after
    deployment for any member of the Armed Forces who is deployed in
    connection with a contingency operation. How is your Service
    implementing this requirement for members of the Reserve and National
    Guard?
        General Bostick. The Army is implementing this requirement through
    its Comprehensive Behavioral Health System of Care. This campaign plan
    was launched in February 2010 to standardize, synchronize, and
    coordinate behavioral healthcare across the Army and through the Army
    Force Generation cycle. Included in this initiative is the
    identification of five touch points throughout the soldier's deployment
    cycle that will provide enhanced behavioral health screening in
    compliance with section 708 of the 2010 NDAA. For Reserve and National
    Guard soldiers, three of the five screening points will occur while the
    soldier is activated and transitioning through existing deployment
    processing centers. The Army is closely working with the Reserve and
    National Guard components to implement the required Post Deployment
    Reassessment and annual screening requirements. Additionally, the Army
    is exceeding the NDAA requirements by providing in-theater assessments,
    immediate redeployment screening for returning soldiers, and annual
    enhanced screening for all soldiers regardless of deployment status.
        Admiral Ferguson. The DOD force health protection strategy already
    requires servicemembers to participate in several deployment and
    nondeployment related health screenings to include: the Pre-Deployment
    Health Assessment (DD Form 2795), the Post-Deployment Health Assessment
    (DD Form 2796), the Post-Deployment Health Re-Assessment (DD Form
    2900), and the Periodic Health Assessment (PHA). To the extent that the
    time frames for the additional mental health assessments correspond to
    those of existing health assessments, performing the assessments
    concurrently is desirable. In support of the Navy and Marine Corps,
    Navy Medicine has developed an electronic application of the mental
    health assessment and reconfigured the DD Forms 2795 and 2900 to
    streamline the process and capture the mental health assessments during
    existing processes. The Navy and Marine Corps Reserve Components (RC)
    complete these existing requirements by using organic medical assets as
    well as contract services under the Reserve Health Readiness Program
    (RHRP). RC representatives are working with the RHRP representatives at
    ASD (HA) to expand services and augment existing resources to meet the
    additional mental health assessment requirement. Implementation is
    expected to begin in July 2011.
        General Milstead. The DOD Force Health Protection Strategy already
    requires servicemembers to participate in several deployment and non-
    deployment related health screenings, to include: Pre-Deployment Health
    Assessment (DD Form 2795), Post-Deployment Health Assessment (DD Form
    2796), Post-Deployment Health Re-Assessment (DD Form 2900), and
    Periodic Health Assessment (PHA). To the extent that the time frames
    for the additional mental health assessments correspond to those of
    existing health assessments, performing the assessments concurrently is
    desirable. In support of the Navy and Marine Corps, Navy Medicine has
    developed an electronic application for the mental health assessment
    and reconfigured the DD Forms 2795 and 2900 to streamline the process
    and capture the mental health assessments during existing processes.
    The Navy and Marine Corps Reserve components complete these existing
    requirements by using organic medical assets as well as contract
    services under DOD's Reserve Health Readiness Program (RHRP). Reserve
    components representatives are working with DOD to expand services and
    augment existing resources to meet the additional mental health
    assessment requirement. Implementation is expected to begin in July
    2011.
        General Jones. As of 1 April 2011, all Air National Guard (ANG)
    Wings began conducting Deployment Resiliency Assessments (DRA) in
    compliance with the four regular intervals required by the NDAA for
    Fiscal Year 2010, section 708: 60-days pre-deployment; 90-180 days
    post-deployment; 7-12 months post-deployment; 16-24 months post-
    deployment.
        A contracted service offered by Logistics Health Incorporated (LHI)
    has been used to conduct the person-to-person DRAs. The option for
    unit-level privileged providers to conduct the person-to-person
    encounters is open to all ANG units and four ANG Wings have conducted
    DRAs locally. The ANG DRAs are tracked as part of the ANG deployment
    schedule initiated by the Pre-Deployment Health Assessment process.
        Post-Deployment DRAs are scheduled to coincide with the Post-
    Deployment Health Reassessment and the member's annual Periodic Health
    Assessment (PHA). Due dates are tracked via the Air Force's PHA and
    Individual Medical Readiness program.
        AFRC is using LHI to fulfill the requirements of the NDAA for
    Fiscal Year 2010 mental health assessments. This organization was
    already being used to contact servicemembers who have completed a post-
    deployment health re-assessment questionnaire. Implementation of the
    mental health assessments began on April 1, 2011 and is running
    smoothly, with minor changes being made to adjust for lessons learned
    during implementation.

                            unified medical command
        17. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, the Government Accountability Office (GAO) issued a
    report earlier this year stating that DOD could save $400 million by
    realigning medical assets into a single military command. I guess the
    House Armed Services Subcommittee on Personnel was listening, because
    they put it in their mark. Do you support a unified medical command,
    headed by a 4 star, with 3 subordinate commands each headed by a 3 star
    surgeon general, as a substitute for the current organization of the
    Military Health System (MHS)? If so, why? If not, why not?
        Secretary Lamont. No, not until DOD has reviewed the desirability
    of establishing a unified medical command and ensures that this new
    command will maintain and improve the care to our soldiers and their
    families.
        Secretary Garcia. Our sailors, marines, as well as all
    servicemembers and their families, are receiving the outstanding health
    care they need and deserve. I am privileged to have the opportunity to
    see firsthand the care being provided by our Navy medical personnel
    around the world--at sea, deployed with the Marines and at our medical
    treatment facilities. I have also had the opportunity to visit the
    Medical Education and Training Campus in San Antonio where our corpsmen
    are training together with their Army and Air Force counterparts in a
    joint learning environment. We have outstanding examples of our medical
    personnel working together to keep our servicemembers healthy and
    mission ready.
        The Secretary of Defense has been resolute in his commitment to
    implement efficiencies within the Department, including the MHS. DOD
    will be carefully studying potential organizational constructs that
    allow for the delivery of high quality medical care in an efficient and
    cost-effective manner. As such, we defer specific comment on any MHS
    organizational changes until the assessments have been conducted and
    evaluated by DOD and the Services.
        Secretary Ginsberg. We do not support a unified medical command. We
    do not agree there would be cost savings by the creation of a unified
    medical command.
        We believe a more effective and efficient joint medical solution
    can be attained without the expense of establishing a unified medical
    command. Changes to doctrine can be made within current authorities and
    do not require a new unified medical command. Service specific and
    joint medical doctrine must be improved to assure Service capabilities
    are fully interoperable and interdependent to bolster unity of effort.
    The Services should continue integrating common medical platforms to
    reduce redundancy and lower costs.
        A unified medical command may not achieve the intended synergy or
    unity of effort. All models of the unified medical command to date do
    not include medical forces intrinsic (line funded vs. Defense Health
    Program funded manpower authorizations) to Service line units. A
    unified medical command would not oversee medical forces serving in
    these line units. Air Force line funded medics represent 5 percent of
    Air Force medical personnel; Navy shipboard assets represent 25 percent
    of medical personnel; and Army line Tables of Organization and
    Equipment (TOE) funded medics represent 48 percent of Army active duty
    medics. Air Force ability to meet operational medical requirements
    would be disproportionately compromised in current models for unified
    medical command.
        Any new unified medical command will require new systems and
    structure to oversee component headquarters and assigned forces. This
    will drive even higher costs. If a unified medical command follows the
    example of the current JTF CAPMED (Joint Task Force, National Capitol
    Region Medical), it is highly unlikely there will be cost savings.
    There is no need for a fourth military Service and establishing such in
    the form of a unified medical command, without the discipline and
    historical rule sets that govern existing Services, will likely drive
    costs much higher. Even more critical, a unified medical command may
    not be as responsive to the needs of Service warfighters as is the
    current oversight by the Services.
        BRAC 2005 created many opportunities for joint oversight of medics.
    Given time to mature, these initiatives along with the Service Surgeon
    Generals' efforts to consolidate oversight of common support functions
    (information management, contracting, military health facility
    construction and financial management) in the new co-located medical
    headquarters will reduce redundancies. Adoption of a single Service
    accounting system to allocate Defense Health Program dollars and
    improve accountability would do more to reduce costs than a unified
    medical command.

        18. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, would establishment of a unified medical command
    help or hurt recruitment and retention of medical personnel?
        Secretary Lamont. Without a thorough study and analysis by DOD, it
    is unknown if establishment of a unified medical command would help or
    hurt recruitment and retention of medical personnel or more
    importantly, why.
        Secretary Garcia. We know how important the health care benefit is
    to our sailors, Marines and their families. Access to quality care is
    vital to force readiness as well as recruiting and retention. Our
    personnel deserve outstanding medical care and I believe we are
    providing it--around the world, each and every day.
        The Secretary of Defense has been resolute in his commitment to
    implement efficiencies within the Department, including the MHS. The
    DOD will be carefully studying potential organizational constructs that
    allow for the delivery of high quality medical care in an efficient and
    cost-effective manner. As such, we defer specific comment on any MHS
    organizational changes until the assessments have been conducted and
    evaluated by DOD and the Services.
        Secretary Ginsberg. The establishment of a unified medical command
    creates an uncertain environment for recruitment and retention of
    medical personnel. Currently, each Service offers unique opportunities
    and a Service specific culture which attracts and retains healthcare
    professionals to the Service of their choice. There are candidates who
    elect to serve in any military branch, however, most seek to be part of
    a specific Service culture. The establishment of a unified medical
    command could result in significant changes to Service culture,
    perceived quality of life (Sea, Land, or Air), Service specific
    initiatives, and professional development opportunities.
        Like the other Services, the Air Force Medical Service competes for
    fully qualified health care professionals from the private sector and
    other Federal agencies such as the Department of Veterans Affairs and
    the Public Health Service. We attract fully qualified specialists and
    retain them through competitive compensation using accession bonuses
    and other financial incentives. If accession bonuses and special pays
    were funded through a unified medical command, special attention would
    be necessary to ensure all Service operational support requirements
    were adequately covered.
        Without additional data, it remains unclear if the establishment of
    a unified medical command would help or hurt recruitment and retention
    of medical personnel.

                   education of school aged military children
        19. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, last year, we received testimony from DOD that more
    than half of the 300 local educational agencies serving military
    children were not meeting academic standards in reading/ language arts
    and/or math. Are you aware that a DOD grant program, which provided
    grants to improve learning opportunities for military kids at 284 local
    schools, was cut in the DOD efficiencies initiative?
        Secretary Lamont. Yes, the Army is aware that DOD determined it
    would be more cost effective to replace grants to local education
    agencies with an alternative means of outreach. I would defer to the
    Office of the Secretary of Defense for details on their decision to
    discontinue the program and their planned way ahead.
        Secretary Garcia. Yes, the DoN has received confirmation from the
    Department of Defense Education Activity (DODEA) that although the
    grant program is still in law, the funding to operate the entire DODEA
    Partnership Branch (which administers the grant program and other
    initiatives involving stateside local education agencies that support
    military-connected students) has been cut significantly starting in
    fiscal year 2012.
        Secretary Ginsberg. Yes, these grants effectively targeted
    assistance to school districts serving military children, particularly
    districts with the greatest needs. We had hoped to see OSD continue its
    funding of this initiative. Air Force will work closely with OSD to get
    the remaining grant funds used to the fullest extent possible.
        We have funded School Liaison Officers (SLOs) at every base to
    serve as a key resource for parents as they navigate education
    information and they also serve as a central resource for area school
    districts to help provide orientation and assistance to new teachers
    and staff on the unique needs of military children affected by PCS
    moves and deployments. In addition, we have required military leader
    participation in local school boards to voice the issues pertinent to
    military children. In March 11, we brought together our SLOs, along
    with our new Exceptional Family Member Program (EFMP) Coordinators and
    key education leaders and experts to build the partnerships to create
    optimal educational settings and opportunities for our children.
    Training our staffs and leaders in conjunction with the school
    districts and community educational resources will remain a priority
    for Air Force.
        We greatly appreciate the Congress providing $250 million this
    fiscal year for school construction which will significantly improve
    the condition and capacity of public schools on military installations.
    This core support improves the educational environments for large
    numbers of our military children. We are committed to sustaining a
    close relationship with the school districts, OSD and Sister Services,
    and the community organizations to continually improve the educational
    opportunities of military children, a critical quality of life issue.

        20. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, do you agree that providing access to a quality
    education for our kids is a readiness requirement for the All-Volunteer
    Force?
        Secretary Lamont. Yes, the Army wholeheartedly agrees that
    providing access to a quality education for our children is a readiness
    requirement for the All-Volunteer Force. Since 1999, the Army has
    undertaken many initiatives to demonstrate to families its commitment
    to ensuring that schools, communities, and military installations
    respond confidently to the complexities of frequent transitions and
    parental separations and provide families the assurance that their
    children's academic well being is a high priority. The Army actively
    collaborates with the Department of Education; DODEA; national, State,
    and local education agencies; public and private sector youth serving
    organizations; community groups; and Army and Defense Department
    agencies to build effective and enduring partnerships in support of our
    children's education.
        Secretary Garcia. I agree that quality education programs for
    children are valuable to the readiness of military families whether a
    servicemember is at home or deployed.
        Secretary Ginsberg. Absolutely. We recognize that the integration
    of children into local education systems is a major influence on morale
    and propensity to remain in the Air Force. Senior wing leadership
    involvement, as military School Liaison Officers (SLO), is required to
    ensure Air Force children are successfully integrated into local school
    systems. In saying that, we have established civilian SLO positions to
    provide even greater levels of support. Recently, the Air Force
    reemphasized the continued need for all senior leaders to stay involved
    in support of military child education issues.

        21. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, what initiatives do you have underway to address
    this?
        Secretary Lamont. Army Child, Youth & School Services programs
    exist to support military readiness by reducing the conflict between a
    soldier's mission requirements and his or her parental
    responsibilities. The Army School Support Services Strategic Plan
    addresses students' learning environments, academic skills, and
    personal management skills to produce a military school support system
    that ensures positive outcomes for military students by:

             Using community resources to reduce the impact of
            relocations and transitions of Army children
             Providing predictable support services that assist
            children with relocation, life transitions, and achieving
            academic success
             Helping parents, children, school, commanders and
            communities to access resources that facilitate school
            transitions
             Identifying barriers and developing solutions to
            ensure academic success
             Promoting parent and community involvement by
            providing tools to overcome obstacles
             Educating schools and communities on the needs of Army
            children and the impact that a military lifestyle has on
            academic success and school adjustment

        Secretary Garcia. The School Liaison program has been implemented
    within the Navy and Marine Corps to help support transitioning families
    in obtaining educational information and assistance from local school
    districts. The mission of School Liaisons is to mobilize and use
    community resources to reduce the impact of the mobile military life
    style on military school-age children and families, and to implement
    predictable support services that assist school-age children with
    relocations, life transitions and achieving academic success.
        School Liaisons provide expertise, experience and resources to
    assist military children in their transitions to different schools; to
    improve the ability of teachers and administrators in meeting the needs
    of military children; and to educate parents on the Local Education
    Agency's (LEA) academic requirements, and to provide assistance to LEAs
    on deployment support for military children.
        Additionally, we value DODEA's grant program which provides LEAs
    with financial assistance to improve academic programs for military
    children.
        We also support the Defense-State Liaison Office collaborations
    with the Council of State Governments to develop Interstate Compacts on
    Educational Opportunity for Military Children. The purpose of the
    Compact is to remove barriers to educational success imposed on
    children of military families because of frequent moves and deployment
    of their parents. Some of the issues addressed include: timely
    enrollment; student placement process; qualification and eligibility
    for enrollment, educational programs, and participation in
    extracurricular academic, athletic, and social activities; on-time
    graduation; and promoting flexibility and cooperation between
    educational systems, parents and students.
        Secretary Ginsberg. Our major initiative is the authorization of 53
    additional civilian School Liaison Officer positions, to have Air
    Force-wide coverage. The school liaisons work with parents and families
    who face the challenges of the mobile military lifestyle and associated
    transition and parental separation issues. Other initiatives include:
    Providing MAJCOM and installation guidance/emphasis on support for
    military child education issues and a comprehensive Desk Guide for
    School Liaison Officers (SLO). Also, we have funded Air Force
    membership in the Military Child Education Coalition and the Military
    Impacted Schools Association. Finally, we have standardized training
    for all SLOs as well as EFMP-Family Support Coordinators and have added
    Military Family Life Consultants for schools at selected installations.

                            special education pilot
        22. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, testimony from the Marine Corps today
    points out something important with respect to military families who
    have kids with special needs that is important: ``National economic
    impacts and subsequent State budget cuts . . . may impede school
    districts' abilities to provide special education services.'' Last year
    I proposed a pilot program to see if scholarships would help kids with
    special educational needs achieve their goals when local schools could
    not meet their Federal obligation to do so. Unfortunately, that
    provision was not agreed to in the final agreement for the NDAA. From
    your perspective, what are some of the best practices in support of
    families with kids with special needs and what more can Congress do to
    help?
        General Bostick. Army School Liaison Officers and EFMP managers
    continually collaborate with local education agencies to provide
    military children, including those with special needs, with the best
    possible education. The Interstate Compact on Educational Opportunity
    for Military Children is a best practice that removes barriers to
    educational success imposed on children of military families because of
    frequent moves and deployment of their parents by:

             Facilitating timely enrollment for children of
            military families and ensuring they are not disadvantaged due
            to difficulty in the transfer of education records from the
            previous schools or variations in age requirements
             Facilitating student placement through which children
            of military families are not disadvantaged by variations in
            attendance requirements, scheduling, sequencing, grading,
            course content, or assessment
             Facilitating qualification and eligibility for
            enrollment, educational programs, and participation in
            extracurricular academic, athletic, and social activities
             Facilitating on-time graduation for children of
            military families
             Providing for the uniform collection and sharing of
            information among States, schools, and military families
             Promoting flexibility and cooperation among
            educational systems, parents, and students to help students
            achieve educational success

        Thirty-six States have signed the Interstate Compact on Education
    Opportunity for Military Children.
        Congress can support the education of all military children by
    providing full and timely funding for the President's budget request.
        Admiral Ferguson. Navy's recent Exceptional Family Member (EFM)
    Quick Poll, conducted in March 2011, indicated that families found
    TRICARE, family support services, information and referral services,
    TRICARE Extended Care Health Option, early intervention services both
    in CONUS and OCONUS, and EFM Respite Care to be most helpful.
        The program with the highest participant satisfaction was EFM
    Respite Care. Respite Care provides specialized care to Navy families
    who have children with special needs, so they can leave the house, go
    to an appointment, or just rest, knowing that their child is being
    cared for by a qualified provider. This program provides families with
    a qualifying family member (birth to age 18), who live in designated
    areas up to 40 hours of respite care a month. Navy's EFM Respite Care
    program is currently funded with Overseas Contingency Operations
    funding.
        School Liaisons also play an important role. Although the primary
    role of the School Liaison is to empower parents to be advocates for
    their children, they also help connect families of children with
    special needs to academic support and resources that will enhance their
    success in the classroom. Resources include the Parent Handbook on
    Special Education; Special Needs Parents Toolkit, Specialized Training
    of Military Parents (STOMP); and Medicaid to assist in payment for
    services not covered by TRICARE. School Liaisons also keep our
    installation commanders updated about policies that affect children
    with special needs.
        The NDAA for Fiscal Year 2011 directs the OSD Office of Community
    Support for Military Families with Special Needs to develop a report on
    DOD educational programs and childcare provided for military dependent
    children with special needs, and whether those programs comply with
    applicable disability law. The report will address obstacles in
    obtaining special education, evidence based research, and feasibility/
    costs of enhancing and expediting special education services. We expect
    this report to provide significant information for Congress'
    consideration.
        General Milstead. Families enrolled in the Marine Corps EFMP are
    provided multiple layers of support, to include:

             Family Case Workers provide non-medical case
            management and serve as liaisons to medical, State, or
            educational providers. These case workers may attend school
            special education meetings with parents to ensure the adequate
            provision of educational services. The case workers also
            coordinate with school liaisons to address special education
            concerns that are systemic to the local education agency. This
            coordination is critical for families who are relocating and
            provides a family training to increase their understanding of
            disability-specific information and help them connect with
            other families who have similar requirements.
             EFMP attorneys provide legal advice and representation
            to families seeking Federal and/or State benefits and services
            for an exceptional family member.
             EFMP Assignment Coordinators individually screen each
            EFMP enrolled dependent to ensure that the medical and/or
            educational services can be provided at the sponsor's next duty
            station.
             Respite Care is available to all enrolled EFMP
            families and is funded by the Marine Corps. Respite care is
            intended to reduce stress on sponsor families by providing
            temporary rest periods for up to 40 hours per month.
             EFMP also provides outreach, family training, forums,
            support groups and referrals.

        General Jones. The Air Force EFMP was developed to educate and
    increase special needs awareness of service personnel in a timely,
    clear and credible format for our more than 17,000 airman enrolled in
    the EFMP, with one or more special needs family members.
        In March 2011, a joint training of EFMP-Family Support Coordinators
    and School Liaison Officers (SLO) set the stage for a collaborative,
    working relationship between these key installation education
    advocates. Training topics ranged from navigating resources, TRICARE
    services, the assignment process, medical and legal information,
    deployment support, homeschooling and the interstate compact. During
    the training, several installations presented their best practices:
    Exceptional Fitness, Sensory Movie Program, In School Support Group for
    Children with Deployed Family Members, Military Child Education Guide
    and the EFMP Multi-Disciplinary Team.
        The NDAA for Fiscal Year 2011 requires the OSD Office of Community
    Support for Military Families with Special Needs to provide Congress an
    in depth report on obstacles obtaining special education, evidence
    based research, and feasibility/costs of enhancing and expediting
    special education services.
        We expect the outcome of the report to provide significant
    information for Congress' consideration for future legislative courses
    of action. We currently do not know the extent of problems, whether
    they require intervention or further training for military families
    about the Individuals with Disabilities Education Act. A system that
    requires States and school districts to report complaints regarding
    special education issues by military families would provide valuable
    data on the extent of the problems.

                    increases in support for family programs
        23. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, all of the Services have indicated vastly
    increased support of family programs, which our families need. Are
    these enduring increases in the base budget for fiscal year 2012, or
    are these contingent on war-time funding?
        General Bostick. The enduring increases for Army Family Programs
    are in the base budget for fiscal year 2012. To divest itself from
    dependence on war-time funding, the Army identified enduring family
    program requirements while developing the fiscal year 2010 budget, and
    placed the increases in the fiscal year 2010 and future base budgets.
        Admiral Ferguson. fiscal year 2012 funding for Navy Fleet and
    Family Support Programs is in the base budget and not contingent on
    war-time funding. War-time funding of family programs is limited to
    support of forward-deployed active duty members in Africa and Southwest
    Asia.
        General Milstead. Yes, these enduring increases for family programs
    have been added to the baseline budget for fiscal year 2012.
        General Jones. Out-year funding requests include spend plans for
    Airman & Family Readiness (A&FR) Programs. To align services and
    resources that support and enhance mission and family readiness
    appropriately, all A&FR efforts are geared toward resource and service
    provision that enhance stability of members, making them war-ready and
    confident that the needs of their families are met. War-time funding
    would provide program enhancements.

                      yellow ribbon reintegration program
        24. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, many of our witnesses this year have testified
    about the importance of the Yellow Ribbon Reintegration Program (YRRP)
    which is funded in the President's budget request for fiscal year 2012
    at nearly $250 million. In last week's Personnel Subcommittee hearing,
    Assistant Secretary McCarthy voiced his strong support for continuation
    of this program, yet we have since learned that it may not be included
    in next year's budget request. Do you agree that the YRRP is an
    important resource for servicemembers and their families returning from
    deployment?
        Secretary Lamont. Yes, the reintegration our servicemembers and
    their families experience has second and third order repercussions in
    nearly all aspects of their military and civilian lives. Servicemembers
    and their families must understand how to access the support network
    that is available to them. Reintegration is as significant as any other
    part of the deployment cycle and must be resourced as such. The YRRP
    has been refined through lessons learned over a decade of hard
    deployments. It is imperative to identify the most effective and
    efficient models, institutionalize them in much the same way as we
    institutionalize the other areas of the deployment experience.
        Secretary Garcia. Yes, YRRP is very important and has been
    successful in providing transitional support services for
    servicemembers and their families. Though the majority of focus falls
    on post-deployment services, YRRP supports the military family through
    all phases of deployment, including but not limited to pre-deployment,
    deployment, demobilization, and post-deployment and reconstitution
    phases. It's designed to provide the operational reservist with as
    equitable levels of support as possible to what we provide to our
    Active Component personnel.
        Secretary Ginsberg. Yes. Today airmen are deployed abroad to
    numerous locations around the globe. Operations tempo in the deployed
    environment remains high and the rate of operations at home is higher
    than ever as airmen, both deployed in-place and in-between deployments
    dutifully perform their missions while balancing their home life.
    Support to airmen (whether they are Active Duty, Air National Guard or
    Air Force Reserve), civilians, and their families, is more critical now
    than at any point in the history of the U.S. Air Force.
        The YRRP provides for the physical, emotional, and cognitive well-
    being of airmen and families.
        The importance of the YRRP cannot be overstated. The goal is to
    provide servicemembers and their families with a delivery structure
    ensuring a continuum of care, with specific emphasis on the Deployment
    Cycle Support (DCS) so they are better prepared and sustained
    throughout the entire deployment cycle. The National Guard YRRP
    provides sufficient information, services, referral and proactive
    outreach opportunities for servicemembers and their families. The
    National Guard recognizes that each servicemember and family is part of
    a support structure and a network of protection that helps them cope
    and even thrive in the face of life's challenges.
        If YRRP is not funded or not fully funded for fiscal year 2012, ARC
    servicemembers and their families will be put at a disadvantage for
    receiving information and resources throughout the deployment cycle.
    Before this program was created, many ARC servicemembers and their
    families received partial information before and after deploying. This
    increased stress level places undue burden on them, which affected both
    their home and professional lives. There is no other funding stream or
    program like this available to ARC members. Cutting this would be a
    detriment to the Air National Guard and the Air Force Reserve.

        25. Senator Graham. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg what would replace it if budget cuts forced its
    cancellation in future years?
        Secretary Lamont. The YRRP is one of several programs that provide
    an important service to our soldiers. Some of the other programs are
    Strong Bonds, Army Strong Community Centers, Employer Partnership of
    the Armed Forces, Transitional Health Care and RC Soldier Medical
    Support.
        Secretary Garcia. It would be most unfortunate if YRRP were to be
    cancelled. However, were that to be the situation, the Department of
    the Navy would continue to provide its Returning Warrior Workshop
    program designed to reduce combat stress and other personal issues
    associated with a servicemember's deployment. These workshops are made
    available to the servicemember, their spouse, or if unmarried,
    significant other or close family member.
        Secretary Ginsberg. There is no replacement for the YRRP. It is a
    DOD-wide effort, mandated in Public Law 110-181, section 582. Before
    the onset of the National Guard YRRP, substantial funding and resources
    were not available to assist Air National Guard (ANG) servicemembers
    and their families throughout the entire deployment cycle. ANG
    servicemembers received counseling sessions by the ANG Airmen and
    Family Readiness Program Managers (A&FRPMs) that may or may not have
    included their families. These A&FRPMs provided Family Program
    counseling and information on each ANG installation. Despite the one-
    deep position, A&FRPMs manage as many programs as their active duty
    counterparts; therefore, not allowing the opportunity to provide the
    same level of service provided by YRRP.
        The YRRP has made a difference in the lives of thousands of
    servicemembers and their families with informational events and
    activities to facilitate access to services supporting their health and
    well-being throughout the deployment cycle. If the YRRP is not
    supported with appropriate funding, servicemembers and their families
    would be at a disadvantage on receiving information and resources.
    Continuing support from Congress, the Military Departments, the
    National Guard and Reserve, Federal agencies, nongovernmental agencies,
    and State and local partners will ensure our National Guard and Reserve
    servicemembers and their families remain strong and ready!
        The Air Force Reserve has always taken great pride in the level and
    quality of support and services provided for airmen and families. YRRP
    provides a one stop shop for military members and their families
    through all phases of the deployment cycle with information, services,
    referral, and proactive outreach programs.
        Many of the programs mentioned exist and with future budget cuts
    will require leaders to identify and prioritize where the needs are
    greatest to ensure the wisest use of critical financial resources while
    focusing toward meeting the needs of the Air Force Community.
        The work of strengthening the Air Force family and building a
    stronger Air Force community will continue. It is a priority because it
    is the right thing to do for our airmen and the smart thing to do to
    ensure America's Air Force accomplishes its mission and continues to be
    the world's best air, space, and cyber force.

                        suicide in the guard and reserve
        26. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, our committee has overseen a significant
    expansion of resources and programs by the Services in recent years to
    prevent suicide. I know that none of us is yet satisfied with our
    results. Recently we have seen reports of rising numbers of suicide in
    the Reserve components, and that is the focus of my questions today. We
    all agree that the Reserve components, including the National Guard,
    will continue to be operational assets of the armed forces, is that
    correct?
        General Bostick. Yes, over the past 15 years our military has
    become increasingly reliant on the Reserve components including the
    National Guard to perform title 10 missions. Although the operational
    tempo is expected to be less intense than it has been, the National
    Guard is uniquely suited to fulfill both military support to domestic
    civil authorities as well as integrating with Active and service
    Reserve components to perform full spectrum operations.
        Admiral Ferguson. Yes, the Navy Reserve will continue to be a vital
    operational asset of Navy's Total Force.
        General Milstead. That is correct. The Marine Corps is developing
    our concept of how to employ the Reserves as an operational force after
    current contingency operations have concluded.
        General Jones. The Reserve Component (RC) will continue to be an
    operational asset. There is significant capability in the RC, and in
    some cases the preponderance of key capabilities are in the RC. The AF
    has also embraced the concept of ``Total Force'' with very close
    integration of the Active (AC) and Reserve components. The AF uses
    various organizational constructs to augment and integrate the RC to
    ensure operations are seamless when called upon. With the Total Force
    construct and capacity within the RC, the RC will remain an operational
    asset for the foreseeable future.
        We know of no evidence that supports a link between the operational
    demands of the ARC and ARC suicides. The Army's 2010 Health Promotion,
    Risk Reduction and Suicide Prevention report found no direct
    correlation between military suicides and deployments. Rather, the
    report identified a correlation of suicide with high-risk behaviors and
    increased life stressors. In the Air National Guard (ANG), data also
    shows no direct correlation with deployments, though with the complex
    issue of suicide, it is difficult to know how much each factor and life
    event impacts someone's eventual decision to take their own life. The
    ANG sees a need to help airmen improve their protective factors,
    deployed or not.

        27. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the majority of suicides reported in
    Reserve components are carried out by servicemembers who have never
    deployed, is that correct?
        General Bostick. Yes, in general the Reserve components deployment
    profile of suicide deaths is different from the active duty deployment
    profile, and the majority of Reserve component soldiers have not
    deployed. However, this difference is consistent with overall
    deployment profile of the Army Reserve and Army National Guard where
    less than 50 percent of the force has a deployment history.
        In 2010, 79 of the 145 (54 percent) confirmed and pending (final
    medical examiner determination) suicide deaths for those who were not
    serving on active duty at the time of their death had no deployment
    history. Thus far in 2011, 24 of 48 (50 percent) of the confirmed and
    pending suicide deaths for non-active duty soldiers had no deployment
    history.
        Eight of the 16 (50 percent) Reserve component soldiers who died of
    suicide while on active duty in 2010 had no deployment history, and in
    2011 two of the four (50 percent) soldiers had no deployment history.
        Admiral Ferguson. The vast majority of Navy Reserve suicide victims
    have deployed. Of the seven Navy Reserve sailors who died by suicide in
    2010 and year to date 2011, one had never deployed, two had deployed
    within 2 years of their deaths, the remaining four had deployed earlier
    in their career.
        General Milstead. According to our records, suicides by Reserve
    Component Marines do not significantly vary between those with and
    those without a history of deployment. On 1 Jan 2009, DOD began
    requiring the reporting of suicides by members of the Select Reserve
    (SELRES) who were not on active duty or in a drilling status. From 1
    Jan 2009 to 31 Mar 2011, there were 20 suicides by SELRES marines not
    on active duty or drilling. Ten of those had no history of deployment
    and 10 had a history of deployment. From 1 Jan 2002 to 31 Mar 2011,
    there were 18 suicides by SELRES Marines on active duty or drilling.
    Eight of those had no history of deployment and 10 had a history of
    deployment.
        General Jones. The answer to this question depends on what is coded
    as a deployment. Analysis of the available data revealed that 67
    percent of the reservists and 60 percent of ANG members who committed
    suicide had not served on orders in support of a contingency.

        28. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, we have been inconsistent in our tracking
    of suicide, mental health care, and follow-up medical care for members
    of the Reserve components who have deployed, especially those in the
    Individual Ready Reserve, is correct?
        General Bostick. Significant effort is being made to track the
    suicide deaths of soldiers who are assigned to the Individual Ready
    Reserve. However, the Army relies on the family to notify the Army of
    the death. Because those assigned to the Individual Ready Reserve have
    chosen to not become members of an Army Reserve unit, they do not have
    the same leadership oversight that is provided to member of the Army
    Reserves in troop units.
        Admiral Ferguson. The Reserve component (RC) uses the same suicide
    tracking system (DOD suicide event report) system as the Active
    component (AC). They also have suicide prevention coordinators at each
    Navy Operational Support Center (NOSC) who conduct the same peer-to-
    peer prevention training provided to the AC. The Deployment Health
    Assessment (DHA) process is also in place in the RC, in addition to
    required annual Periodic Health Assessments (PHA) which are tracked in
    the same data base as the AC. The NDAA for Fiscal Year 2010 added a
    mental health assessment requirement that we are currently integrating
    into the DHA process to be assessed as part of pre-deployment (PDA),
    immediate post-deployment (PDHA) and later post-deployment--3 to 6
    months following return (PDHRA). These are performed by primary care
    providers, either as group events or partially on-line, with follow-up
    at a Reserve Health Readiness Program (RHRP) center within 50 miles of
    the reservist's residence. The PDHA process does track individuals who
    have deployed and are no longer on active duty. Selected Reserve
    personnel are tracked for suicides in the same manner as the AC. There
    is no consistent tracking of deaths or specific suicide prevention
    outreach for members of the individual Ready Reserve (IRR), who have no
    unit affiliation.
        Additionally the Reserve Psychological Health Outreach Program
    (PHOP) teams--five to six full-time licensed mental health providers,
    are embedded within each geographic Navy Reserve Region to help
    commands, their families and to help RC personnel meet their care
    needs. This support includes manning a 24/7 watch bill. They provide
    screening, find local affordable resources, make referrals, and follow-
    up to ensure that the care was effective. They are also charged with
    contacting all returning personnel and attend unit events to provide
    training and assessment. They have helped many find appropriate care
    for medical and mental health needs by connecting them with available
    and accessible Federal and State programs as well as with local
    programs and services.
        Members who had mobilized and were subsequently transferred to the
    IRR are still required to complete the PDHRA requirements which include
    psychological/mental health screenings. Navy has identified 316 IRR
    members who are due for this post-deployment evaluative tool. Navy's
    contracted PDHRA administrator, Logistics Health, Inc., is currently
    conducting call center events designed to drive PDHRA completion for
    this group of sailors. As of 1 June, three members have been referred
    to the VA for additional care as a result of this initiative.
        For our wounded personnel, Navy works closely with the Department
    of Veterans Affairs to provide transitional support for case management
    of medical and nonmedical care recipients. Navy's Safe Harbor program
    supports nonmedical case management for wounded, and seriously ill and
    injured sailors.
        General Milstead. The Reserve component (RC) uses the same suicide
    tracking system as the Active component (AC). The Deployment Health
    Assessment (DHA) process is also in place in the RC, in addition to the
    required annual Periodic Health Assessments (PHA). Reserve personnel
    affiliated as SELRES are tracked for suicides in the same manner as the
    AC. There is no consistent tracking of deaths or specific suicide
    prevention outreach for Individual Ready Reserve (IRR), who have no
    unit affiliation.
        Members who had mobilized and were subsequently transferred to the
    Individual Ready Reserve are still required to complete the PDHRA
    requirements which include psychological/mental health screenings.
        For our wounded personnel, the Marine Corps works closely with the
    Department of Veterans Affairs to provide transitional support for case
    management of medical and non-medical care recipients. The Marine
    Corps' Wounded Warrior Regiment supports non-medical case management of
    our seriously wounded, ill, and injured sailors.
        General Jones. Tracking of participating ARC members is consistent
    and reliable.
        Tracking of mental health care and follow-up medical care for AFR
    members who have deployed is tracked two ways. Servicemembers, with an
    identified need, who have received medical services through the
    military healthcare system (to include official referrals to non-
    military providers), are tracked using the same process as Active Duty.
    Second, AFR members who return to civilian status, and receive
    healthcare outside of the military system and not through TRICARE, are
    required to report that care to their respective Reserve medical unit
    (RMU). Reports may be made while in any status and include completion
    of well-known screening instruments (e.g., PHA and DD forms 2795, 2796,
    and 2900).
        Active Guard members (i.e., Title 10 and Title 32) are also
    monitored by multiple means. The new Wing Directors of Psychological
    Health (DPH) work closely with the ANG medical units in providing
    referral and case management when pre- and post-deployment assessments
    reveal mental health concerns. A primary goal of this program is to
    help ANG members, regardless of the genesis of the mental health issue,
    navigate the mental health system and follow through with care.
    Continuity of post-deployment medical care is addressed by the Medical
    Continuation process, wherein members are kept on Active Duty orders
    with full pay and benefits in order to continue care for deployment
    related conditions. An enhancement planned for the Medical Continuation
    program is the institution of a case management structure to ensure
    members are assisted throughout the medical care process.
        When an ANG member becomes an Individual Ready reservist, they fall
    under the Air Force Reserve Center and are not tracked by the Guard.
    Currently AFR does not track suicides, mental health care or follow-up
    medical care of members in the IRR because we don't typically mobilize
    AFR members out of the IRR. Since 2001, we have not mobilized any of
    our AFR members from the IRR.

        29. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, continuity of health care can be a
    significant problem for members of the Guard and Reserve, is that
    correct?
        General Bostick. Yes, continuity of care is a complex issue for
    members of the Reserve components as they may be eligible for care from
    multiple sources. Reserve soldiers may be eligible for health care
    insurance from either TRICARE or non-TRICARE sources depending on where
    they are in the deployment life cycle. Additionally, their chosen
    civilian providers may or may not participate in TRICARE for which the
    soldier is eligible. Hence, continuity of both health care coverage and
    health care providers can be a significant problem for members of the
    Reserve Components throughout their deployment life cycle.
        Admiral Ferguson. Given the mobile nature of our military force and
    the fact that many Reserve component (RC) sailors reside outside of a
    Military Treatment Facility (MTF) catchment areas, continuity of care
    can be challenging. RC servicemembers transition between civilian
    healthcare providers and military providers over the course of their
    military service. However, Navy, in partnership with the entire MHS and
    the Department of Veterans Affairs (VA), is fully committed to ensuring
    the health and well-being of sailors as they make this transition.
    Continuity of care is maintained through a combination of the TRICARE
    benefit, Navy-specific outreach and entitlement programs, and the
    support and resources of the VA.
        From the time a RC sailor receives their early TRICARE eligibility
    entitlement, in advance of mobilization through actual demobilization,
    they receive the same level of care and access to services as any other
    member of the Active Force. Once demobilized, they maintain eligibility
    for TRICARE through the Transitional Assistance Management Program
    (TAMP) and may receive care at an MTF or through civilian providers.
    Following the 180-day TAMP eligibility period, these members may elect
    to purchase TRICARE Reserve Select, if they qualify through their
    Reserve affiliation. Those who do not qualify may elect to purchase the
    Continued Health Care Benefit Program. As these Reserve component
    servicemembers retire, they may elect to purchase TRICARE Retired
    Reserve coverage until age 60, when they become eligible for TRICARE
    retired benefits.
        The Reserve Component Medical Programs System is available to
    provide continued medical care and financial support for Reserve
    component members who incur or aggravate an injury, illness, or
    disease, in the course of their military duties. Members may be
    retained on active duty through the Medical Hold Program or they may
    receive a Line of Duty (LOD) Determination. The LOD allows them to
    receive care for that condition in a non-activated status. LOD care may
    be provided within an MTF catchment area or, in remote areas, through
    civilian providers, with authorization from the TRICARE Management
    Activity Military Medical Support Office (MMSO). Oversight of these
    Reserve Component members is maintained by their unit or Navy
    Operational Support Center, Navy Personnel Command, as well as an MTF
    or the MMSO. The program provides incapacitation pay in those instances
    in which a member's condition prevents them from working in their
    civilian occupation.
        The Deployment Health Assessment process is designed to reach out
    to Reserve Component members who have returned from deployment and
    demobilized. These members are assessed at established intervals from
    pre-deployment through up to 24 months post deployment, to evaluate
    both their physical and mental health.
        The Navy Bureau of Medicine and Surgery's PHOP teams, which are
    embedded within each Navy geographical Reserve Region, also assist
    commands, Reserve component members and their families. This can
    include helping with the LOD process when necessary, finding local
    resources, and obtaining other health care services when personnel do
    not have access to military medical benefits, or have limited, or no,
    health insurance. The PHOP teams can also provide screening, follow-up
    and referrals to Federal, State, local, and nongovernmental resources.
        Finally, the VA offers medical and psychological health services,
    including treatment for sexual assault, for RC servicemembers who have
    served in combat areas, whether they are still in the Reserves,
    separated or retired. Veteran Centers, with additional psychological
    and family support services, including marital counseling, are found in
    many local areas in which current and former Reserve component
    servicemembers reside.
        General Milstead. Given the more mobile nature of our military
    force and the fact that many of our reservists reside outside the
    catchment area of a Military Treatment Facility (MTF), continuity of
    care can be challenging. Reserve component members transition between
    their civilian healthcare providers and military providers over the
    course of their military service. However, the Department of the Navy,
    in partnership with the entire MHS and the Department of Veterans
    Affairs (VA), is fully committed to ensuring the health and well being
    of our servicemembers as they make this transition. Continuity of care
    is maintained through a combination of the TRICARE benefit, Navy-
    specific outreach and entitlement programs, as well as VA support and
    resources.
        From the time a reservists receives their early TRICARE eligibility
    entitlement in advance of mobilization through actual demobilization,
    they receive the same level of care and access to services as members
    of the Active Force. Once demobilized, they maintain eligibility for
    TRICARE through the Transitional Assistance Management Program (TAMP)
    and may receive care at an MTF or through civilian providers. Following
    the 180 day TAMP eligibility period, these members may elect to
    purchase TRICARE Reserve Select, if they qualify through their Reserve
    affiliation. For those who do not qualify, they may elect to purchase
    the Continued Health Care Benefit Program. As these same members
    retire, they may elect to purchase TRICARE Retired Reserve coverage
    until age 60, when they then become eligible for TRICARE retired
    benefits.
        The Reserve Component Medical Programs System is available to
    provide continued medical care and financial support for reservists who
    incur or aggravate an injury, illness or disease in the course of their
    military duties. Members may be retained on active duty through the
    Medical Hold Program or they may receive a Line of Duty (LOD)
    Determination. The LOD then allows them to receive care for that
    condition in a non-activated status. LOD care may be provided within an
    MTF catchment area or in remote areas through civilian providers.
        General Jones. Continuity of care can be a challenge in the Guard
    and Reserve due to many factors, including changes in status and
    geographic dispersement.
        The ANG is in the process of placing a Director of Psychological
    Health (DPH) in each Wing to promote and support the psychological
    health and continuity of care of servicemembers. The Wing DPHs work
    closely with the ANG medical units in providing referral and case
    management when pre- and post-deployment assessments reveal mental
    health concerns. Wing DPHs can work closely with their State DPH
    counterparts when additional support is required.
        Additionally, if a member chooses to participate in Tricare Reserve
    Select or has private health insurance, there should not be a problem
    with continuity of care.

        30. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, stigma and confidentiality in mental
    health are uniquely significant for servicemembers who live and work in
    small towns all over our country, is that correct?
        General Bostick. Stigma is a concern for those seeking behavioral
    health care across the entire Army community. Over the last few years,
    the Army has focused significant attention, with a great deal of
    success, at reducing soldier unwillingness to seek behavioral health
    support attributed to stigma. Behavioral health care utilization has
    increased across the Army. The Army established the Health Promotion,
    Risk Reduction and Suicide Prevention Task Force to further understand
    and mitigate the effects stigma has in extending care to the Army
    family.
        Admiral Ferguson. We are continuing to address such concerns for
    Reserve Component personnel, whether they reside and work in small
    towns or in communities with larger populations, through our suicide
    prevention and psychological health programs, including Operational
    Stress Control (OSC), which is integrated into the Navy career training
    continuum. DOD and Navy have made policy changes to support this
    development over the past few years, and to encourage sailors to seek
    help. We are fully committed to reducing the stigma associated with
    mental health care and to raising awareness within the Reserve
    community that there is confidentiality for mental health care,
    especially when self-initiated.
        General Milstead. We are not aware of any professional literature
    that addresses the significance of stigma and confidentiality rates in
    small towns versus more populated areas in America. However, we are
    continuing to address these concerns for Reserve Component personnel
    who may live and work in either small towns or in communities with
    larger populations through our suicide prevention and psychological
    health programs, including Operational Stress Control (OSC) which is
    integrated into the Marine career training continuum.
        DOD and the Marine Corps have made policy changes to support this
    development over the past few years and to encourage help-seeking by
    marines. We are fully committed to reducing the stigma associated with
    mental health care and to raising the awareness within the Reserve
    community that there is confidentiality for mental health care,
    especially when self-initiated.
        General Jones. There is some evidence to support this conclusion,
    likely due to the lack of anonymity in small towns.

        31. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, prevention programs that work in one State
    or community, may or may not be the right approach in another one--in
    other words, one-size-does-not-fit-all, is that correct?
        General Bostick. There are numerous studies that suggest there are
    ``universal'' aspects of suicide prevention programs. Resources such as
    the Suicide Prevention Resource Center (http://www.sprc.org/about--
    sprc/index.asp) acknowledge there are some cultural differences in how
    programs and services are provided (e.g., appropriate language, etc.).
    The observed differences in the effectiveness of a program has less to
    do with the differences in communities and is more influenced by the
    behavioral health condition the program is attempting to address (e.g.,
    a program targeted towards those with depression are less effective in
    helping someone who has a substance abuse problem).
        Admiral Ferguson. Many complex and individual pathways lead both
    toward and away from suicidal ideation and attempts. No single message,
    training, intervention, or approach will intercept everyone on a deadly
    path. Intuitively it makes sense that different populations would
    respond in a non-uniform manner to various intervention attempts, given
    cultural differences between communities. Lessons from research and
    years of program efforts have shown that multiple approaches working
    within a strategic framework are required to reduce suicide risk.
        Each of the Services has developed unique programs designed to fit
    their communities/cultures, including their respective Reserve
    Components. These programs are based on the best evidence available,
    including accepted professional models and best practices. Each Service
    takes many measures to prevent suicide, including: mandated annual
    peer-to-peer training; regular safety briefings; large-scale social
    marketing campaigns to encourage members to seek help and promote
    suicide prevention; and offer programs that include suicide prevention
    at accession points, schoolhouses, and at critical career decision
    points and milestones. Also inherent to all of the Services' programs
    is emphasis on the broader concepts of buddy care, leaving no one
    behind and bystander intervention.
        General Milstead. Suicide prevention relies primarily on Marine
    Corps leadership, regardless of location. Beginning at the non-
    commissioned officer level and extending up through the ranks, leaders
    prevent suicide by fostering individual and unit resilience,
    encouraging self-care and peer-intervention, and managing command
    climate in a way that encourages Marines to engage helping services
    early, before problems worsen to the point of suicide.
        General Jones. One size certainly does not fit all especially when
    it comes to the Reserve Components. ANG and AFR units are very unique
    based on their population, geographic diversity, economic
    circumstances, and a number of other critical factors. Because of this
    reality, the recent National Guard Bureau Warrior Care Initiative
    focused on researching and recommending a toolbox of resilience-
    building programs so that each State/Territory can choose the programs
    that best fit its unique needs. In this instance, all programs fit into
    the Comprehensive Soldier Fitness/Comprehensive Airman Fitness pillars
    of wellness. Thus, prevention programs do need to be tailored for their
    recipients, and can be based upon certain principles and guiding
    theories. Programs should provide some latitude for local factors (e.g.
    culture, resources, etc.) and demands of the wing missions, but should
    also be proven effective prior to widespread implementation.

        32. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, community involvement is essential for the
    Reserve components--even more so than the Active component, is that
    correct?
        General Bostick. Community involvement is equally important for all
    components. Many of the soldiers serving as recruiters and supporting
    Reserve component are stationed away from military installations and
    require the support of the local community. Many of the medical
    professionals return from deployments and return to work in community
    hospitals, where they are no longer around the soldiers with whom they
    deployed and on whom they learned to rely for support during that
    deployment. Reserve component soldiers also experience this sense of
    isolation when they return to their hometown and lack ``peer to peer''
    support. It is impossible to say if community support is more important
    for one component versus another.
        Admiral Ferguson. Yes, community involvement is essential for the
    Reserve Components. Reserve sailors typically have limited access to
    resources available on base and may only interact with members of their
    unit when drilling. On-line and telephone resources, such as the Navy
    help-line and Military OneSource, are available to all military
    servicemembers and their families. However, due to the distance between
    some RC sailors and face-to-face services, accessing available civilian
    community resources is important to their quality of life. Active
    component sailors are typically more rooted in the associated military
    community, while Reserve component sailors are more closely connected
    to their civilian communities, in part because they tend to relocate
    less frequently.
        Regarding suicide prevention, however, military involvement remains
    essential for Reserve sailors so they may benefit from all DOD
    resources designed to promote resiliency and prevent suicide, including
    effective peer-to-peer suicide prevention training. Our PHOP offers
    five counselors in each Navy Region responsible for reaching out to
    sailors returning from mobilization and for being readily available
    when leadership or shipmates sense a need for a sailor to speak with a
    professional.
        General Milstead. Community involvement is equally important to
    suicide prevention in the Reserve and Active components. A marine's
    community must recognize signs of distress, know where to turn for
    help, and be willing to assure that the marine gets the needed help.
        General Jones. Absolutely. Citizen airmen are more engrained in
    their communities. Traditional Guard members and reservist in
    particular spend much more time in their communities and at their
    civilian jobs than with their unit. The member and their families,
    although eligible for some military services, are often geographically
    separated from, or otherwise not exposed to, the unique aspects of an
    active duty lifestyle, which readily offers more assistance,
    accountability and oversight. Because of this, it is critical that
    leadership and policymakers begin to engage with the community in
    efforts to prevent suicide in airmen. This would help educate community
    providers and other community supporting agencies about the unique
    stressors faced by our Guard and Reserve members. Partnering with
    community initiatives in suicide prevention and educating agencies that
    assist citizen airmen about their unique stressors could prove to be
    helpful in reducing suicide rates. The ANG anticipates the newly-placed
    ANG Wing Directors of Psychological Health (WDPHs) will be instrumental
    in assisting with this effort. They are best able to impact the
    immediate community in which the wing is located.

        33. Senator Graham. General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the YRRP is funded in fiscal year 2012,
    but may not be funded in fiscal year 2013. It's part of the solution
    but not the entire solution, is that correct?
        General Bostick. The YRRP is one of several programs that provide
    an important service to our soldiers. Some of the other programs
    include:

             Strong Bonds

                     The Strong Bonds mission is to increase
                    soldier and family readiness through relationship
                    education and skills training.
                     Strong Bonds helps single soldiers, couples,
                    and families thrive in the turbulence of the military
                    environment.

             Army Strong Community Centers

                     The Army Strong Community Center (ASCC)
                    program was established by the Army Reserve to support
                    military members and their families who live away from
                    the larger military installations where support is
                    readily available.
                     The ASCC aims to connect geographically
                    dispersed families with support resources in their own
                    community.
                     The ASCC is an information and referral office
                    dedicated to assisting and supporting servicemembers,
                    retirees, veterans, and family members.
                     The ASCC serves all branches of the military,
                    Active and Reserve.
                     There are currently three ASCC locations in
                    Rochester, NY; Brevard, NC; and Coraopolis, PA.

             Employer Partnership of the Armed Forces

                     The Employer Partnership (EP) is a key program
                    to help mitigate economic stress on Reserve component
                    soldiers.
                     EP was created as a way to provide America's
                    employers with a direct link to some of America's
                    finest employees--servicemembers and their families.
                     EP's partner with over 1,000 employers who
                    include 96 of the 2010 Forbes Fortune 500 Companies,
                    and the list is growing.
                     There are 500,000 jobs available online on the
                    EP website (employerparternship.org).
                     Nearly 4,000 soldiers, family members, wounded
                    warriors, and veterans have been hired through the
                    program.
                     EP launched a powerful new online job search
                    portal on Veterans Day 2010.

             Transitional Health Care Program

                     The Transitional Health Care Program provides
                    180 days of transitional health care benefits,
                    including psychological health care, to demobilized
                    Reserve soldiers and their families.
                     TRICARE Reserve Select (TRS) is a premium-
                    based health plan that qualified RC soldiers may
                    purchase; the monthly premium for TRS individual
                    coverage is $47.51, and the monthly premium for TRS
                    family coverage is $180.17.
                     Military OneSource. Military OneSource is an
                    information and referral clearinghouse that can guide
                    AR members to the right resources. Through Military
                    OneSource, the soldier and each family member has
                    access to up to 12 in-person counseling sessions with a
                    licensed counselor at no cost.

             RC Soldier Medical Support Center

                     Its purpose is to ensure continuity of care/VA
                    benefits by integrating and streamlining the medical
                    review process across all States and territories.

        Admiral Ferguson. Yes, that is correct. The YRRP is an invaluable
    program that benefits sailors in many ways. However, it is just one of
    a number of tools available to ensure returning reservists successfully
    and seamlessly reintegrate into their communities. Navy also
    administers a comprehensive and highly effective suicide prevention,
    intervention, and response program, to address the challenges and
    stressors with which Active and Reserve sailors contend, particularly
    upon returning from prolonged absences and assignments in combat zones.
        General Milstead. Reserve suicide prevention relies in part, but
    not entirely on the YRRP. The Marine Corps has several other programs
    focused on Reserve suicide prevention, to include:

             The Never Leave a Marine Behind suicide prevention and
            awareness education series trains Active and Reserve marines to
            recognize the warning signs for suicide, foster personal and
            unit resiliency, know where to go for behavioral health care,
            engage helping services early, and in the case of senior
            leaders, how to manage command climate to reduce the risk of
            suicide.
             The Operational Stress Control and Readiness (OSCAR)
            program is being implemented at the Battalion/Squadron level to
            train marines and medical and religious ministry personnel to
            prevent, identify, and manage stress problems as early as
            possible. OSCAR team members know their unit members and can
            quickly recognize any unusual changes. Since the Marines are
            familiar with their team members, it is more likely that
            marines will talk about their stress.
             The Marine Corps is currently piloting a 24-7 by-
            Marine-for-Marine counseling line, available to all Marines,
            whether Active, Reserve, or veteran, and their loved ones. The
            DSTRESS Line is being piloted in the Western U.S.
             The Marine Corps Behavioral Health Information Network
            (BHIN) is a web-based clearinghouse for the latest information
            and tools for Reserve and Active marines on prevention and
            other resources concerning behavioral health. These free
            educational materials are excellent tools that will assist
            units and installation support services in their efforts to
            educate the military community about building resiliency,
            recognizing reactions and determining the need for help.
             The PHOP provides psychological health professionals
            at six regional Marine Forces Reserve sites to screen and refer
            members for behavioral health services. Marines that are
            referred to the program can be screened for behavioral health
            issues, medically referred, and provided a road to recovery.
            Outreach specialists will follow each referred reservist
            through the resolution of that member's case, whether it is
            return to active Reserve status, or resolution through the DES.

        General Jones. The YRRP provides information, services and
    referrals to servicemembers and their families. While suicide
    prevention briefings, information and counseling referrals are made at
    YRRP events, it is not the entire answer to suicide prevention in part
    because YRRP focuses only on supporting members who have deployed and
    because the events are based on voluntary attendance. The majority of
    reservists requiring behavioral health support has never deployed and
    thus would not be eligible or even exposed to these YRRP programs.
        The Air National Guard continues efforts to create and help
    implement strategies for suicide prevention with the development of
    outreach programs such as the ANG Wingman Project, whose goal is to
    eliminate warfighter and family member suicide through human outreach,
    media and training. Chaplains, Military Family Life Consultants, DPHs,
    and Military OneSource are just some of the resources available for
    anyone considering suicide. Suicide prevention success is driven by the
    collective action of individuals and communities across the Nation.
                                     ______

                 Questions Submitted by Senator Saxby Chambliss
                        servicemembers civil relief act
        34. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the number of service men and women
    experiencing significant financial problems with their mortgage
    companies and banks is unfortunately well known. While the operational
    tempo of our Armed Forces will hopefully decrease following the
    withdrawal of our combat forces from Iraq, the OPTEMPO will likely
    still remain high and we will continue to rely on our Reserve
    components to meet operational requirements for the foreseeable future.
    With this in mind and if private lenders continue to violate or ignore
    the provisions of the Servicemembers Civil Relief Act (SCRA), what
    adjustments do you believe may be necessary to that SCRA to protect the
    interests of our service men and women?
        Secretary Lamont and General Bostick. The Servicemember's Civil
    Relief Act (SCRA) should be amended in two ways:

        (1)  The SCRA (codified at 50 U.S.C. App. Sec. Sec. 501-597b)
    should be amended to make it easier for the lending industry to
    properly apply the 6 percent interest rate cap. Section 527 requires
    the servicemember to provide the lender with a copy of his or her
    official orders to show the period for which the 6 percent interest
    rate cap should apply. These orders, however, can be difficult to
    understand and interpret.

        Section 535 defines military orders to include ``any notification .
    . . from the servicemember's commanding officer, with respect to the
    servicemember's current or future military duty status.'' This
    basically allows the commander to write a letter clearly stating when
    the servicemember is or will be on active duty. This definition,
    however, only applies to section 535, and not to the 6 percent interest
    rate cap section, which, as noted, still requires a copy of the more
    complicated official orders.
        If the definition of military orders found in section 535 were made
    applicable to the entire SCRA by moving it to section 511--the
    definition section, which is applicable to the entire Act--then the
    lending industry could more readily determine when a servicemember was
    eligible for the 6 percent interest rate cap.
        This amendment would also make it easier for the lending industry
    to determine when the interest rate applied to Reserve component
    servicemembers who had received orders but had not yet reported for
    active duty. The SCRA extends some of its protections and benefits
    (including the 6 percent interest rate cap) to those with orders even
    though they have not yet reported for duty. Determining when the orders
    were received can be complicated. But if servicemembers were allowed to
    provide a letter from their commander, the period of applicability
    could be stated clearly.

        (2)  The SCRA should be amended to extend mortgage foreclosure
    protections to all servicemembers' mortgages, not just those secured by
    pre-service obligations. Section 533 provides protections against the
    non-judicial sale, foreclosure, or seizure of the property secured by a
    mortgage obligation that originated before the period of the
    servicemember's active duty. This means a court must enter a valid
    order before the sale, foreclosure, or seizure of such property can
    take place, and such an order cannot be entered unless and until the
    creditor files a lawsuit against the servicemember, gets service of the
    suit on the servicemember, and the servicemember has an opportunity to
    come into court and seek relief from the foreclosure. If the property
    is secured by a mortgage obligation created after the period of active
    duty, then the SCRA does not provide these protections.

        Losing one's home to foreclosure almost inevitably leads to a
    cascade of financial complications. If it occurs while on active duty,
    these complications are no less painful and disruptive to mission
    accomplishment just because the obligation was created while on active
    duty, rather than prior to entering active duty.
        To ensure that servicemembers remain focused on the military
    mission, the mortgage foreclosure protection should be extended to
    cover all servicemembers' mortgage obligations, not just pre-service
    ones.
        Such expanded protection would also simplify the process for the
    lending industry. If such an amendment were adopted, the foreclosing
    creditor would only have to determine whether the servicemember is on
    active duty at the time of the proposed sale, foreclosure, or seizure
    (or was on active duty within the nine months preceding the sale,
    foreclosure, or seizure). The foreclosing creditor would not have to
    sort through a possible series of prior mobilizations to determine the
    status of the servicemember at the origination of the mortgage
    obligation.
        Secretary Garcia and Admiral Ferguson. DOD is currently evaluating
    the need for three amendments to the Servicemembers Civil Relief Act
    (SCRA) (50 U.S.C. App. Sec. Sec. 501-597b), which may warrant
    consideration by Congress:

             Amend the SCRA to ease eligibility determination and
            proper application of the 6 percent interest rate cap by the
            lending industry. Under section 527, a servicemember can secure
            an interest rate cap of 6 percent per year on all loans
            incurred before entering active duty if military service
            affects the member's ability to meet the obligation. To
            qualify, the member must provide the lender with a copy of
            official orders to show that he or she is on active duty.
            However, military orders can be difficult for lenders to
            interpret. Section 535 provides a broader definition of
            military orders to include ``any notification . . . from the
            servicemember's commanding officer, with respect to the
            servicemember's current or future military duty status.''
            Applying section 535 definition of ``military orders'' to the
            entire SCRA would allow lending institutions to more readily
            determine eligibility for SCRA protections, including the 6
            percent interest rate cap provision.
             Amend the SCRA to extend mortgage foreclosure
            protections to all servicemember mortgages, vice only those
            secured by pre-service obligations. Section 533 requires a
            valid court order before sale, foreclosure, or seizure of a
            servicemembers mortgage-secured property, but only if the
            mortgage obligation of the servicemember was created before the
            period of active duty began; consequently, servicemembers who
            incur mortgage obligations after commencing active duty are not
            protected. Expanding protections to all servicemembers would
            ease lending institution compliance by removing the burden of
            determining whether the debt was incurred pre-active duty or
            after entry on active duty. Providing foreclosure protections
            for all servicemembers would ensure court oversight, help
            servicemembers remain mission-focused knowing they have this
            judicial supervision, and help them avoid or mitigate financial
            complications that often follow a foreclosure.
             Increase penalty provisions for SCRA violations to
            enhance financial compliance with the act.

        Secretary Ginsberg and General Jones. We commend the Department of
    Justice for their recent investigations into violations of the SCRA.
    This Act is an important protection offered to our servicemembers,
    particularly those who are deployed, or have been deployed multiple
    times over the past 10 years. Enforcing this act greatly contributes to
    peace of mind many of our personnel appreciate when they are deployed
    for extended time periods. The recent examples of nationally known
    mortgage companies being held accountable for violating SCRA should
    sound a clarion call to the industry. Lenders must ensure
    servicemembers are not harmed by their lack of due diligence in meeting
    the requirements of SCRA and working with our servicemembers to avoid
    home foreclosures. SCRA makes clear that lender's responsibility to
    work with servicemembers is not negotiable. When a violation occurs,
    impacting the credit and financial status of any servicemember, the
    financial institution must take action to remedy negative consequences
    and ensure the servicemember's credit rating is restored to pre-
    foreclosure value.
        General Milstead. I do not currently foresee any necessary
    adjustments to the SCRA. The SCRA was completely rewritten in 2003 and
    substantially amended again in 2008. The SCRA currently offers
    expansive protections to servicemembers in the areas of default
    judgments, civil stay provisions, maximum interest rates (to include
    mortgages), eviction and foreclosure protection.

           uniformed services employment and reemployment rights act
        35. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the Uniformed Services Employment and
    Reemployment Rights Act (USERRA) protect millions of people, largely
    National Guard and Reserve members, as they transition between their
    Federal duties and civilian employment. USERRA is intended to eliminate
    or minimize civilian employment disadvantages resulting from service in
    the Reserve components and protect the rights of those members when
    they deploy. Since September 11, 2001, over 500,000 citizen soldiers
    have been mobilized to fight the war on terrorism. Many American
    soldiers have served more than one tour of duty and may be required to
    serve more. While some would argue that it is statistically reasonable
    for the number of employment discrimination complaints filed by service
    men and women during this time period to have increased--based on the
    number of deployments--the data needed to make such a judgment remains
    incomplete. Furthermore, data from a 2004 DOD survey showed that at
    least 72 percent of National Guard and Reserve members with USERRA
    problems never sought assistance for their problems, raising questions
    as to whether complaint numbers alone can fully explain USERRA
    compliance or employer support. Finally, the time it takes to process
    USERRA complaints, while somewhat improved, remains unacceptable when
    you are speaking in terms of whether or not a veteran and/or his family
    will lose their home due to a negligent or willfully mistaken
    foreclosure action. In light of these factors, do you see the need for
    any changes to USERRA to address these issues or provide additional
    protection to our Guard and Reserve members?
        Secretary Lamont and General Bostick. Yes, based on the heightened
    operations of the last 10 years and anecdotal evidence gathered by ESGR
    Volunteers and Ombudsman, USERRA should be reviewed. Aside from minor
    amendments, USERRA has not been holistically reviewed since 1994.
        Based on information from the ESGR office, USERRA complaints and
    inquiries have risen statistically since September 2001, but the number
    of cases requiring ESGR intervention represents less than 0.01 percent
    of all Reserve component members.
        There are also some indications of employer fatigue from 10 years
    of continuous mobilizations. To verify the impact on employers, ESGR is
    sponsoring two efforts:

        (1)  The ``2011 Department of Defense National Survey of
    Employers'' was sent to a cross-section of 80K civilian employers
    across America. The survey runs through July 6 with the results
    expected late in fiscal year 2011.
        (2)  As a companion piece to this survey, ESGR is sponsoring a
    study to examine the results of the survey and incorporate information
    gleaned from four regional focus groups of civilian employers. The
    focus groups will participate in questions formulated based on the
    survey results and used to provide meaningful narrative to a report
    summarizing both efforts. The collective efforts of these employer
    engagements should be available late in CY 11.

        Secretary Garcia and Admiral Ferguson. I currently do not see a
    need to amend the USERRA. We continue to monitor the effects of
    continued and persistent usage of the Reserve component on sailors,
    marines, and their families. The DON has found that engaged leadership
    throughout the chain of command and use of Employer Support of the
    Guard and Reserve (ESGR) representatives coupled with existing USERRA
    legislation meets the challenges faced by Reserve component sailors and
    marines.
        Secretary Ginsberg and General Jones. USERRA is crucial to protect
    the employment rights of our citizen airmen. We are not currently
    proposing changes to USERRA, but with the increased reliance on the
    National Guard and Reserve since September 11, it might be time for
    Department of Labor to reevaluate the authority. Regardless, the
    statute has served us well since its inception. Within the Air Force,
    we have experienced tremendous support from our civilian employers when
    we have asked our airmen to support their military commitments.
    Moreover, the Air Force has received a limited number of USERRA
    complaints. We believe this attests to the tremendous support our
    civilian employers extend to our citizen airmen while they are
    performing their military duties. The Air Reserve Components (ARC)
    conduct a number of ongoing employer out-reach programs to bring
    civilian employers into the fold of local Reserve component
    installations and provide them the opportunity to experience the
    military commitments of their employees. Additionally, through a number
    of ARC and Employer Support of Guard and Reserve (ESGR) awards
    programs, the Air Force recognizes the outstanding support of the
    employers to the military community. Finally, we provide relevant
    USERRA education to our citizen airmen on the benefits of this law to
    include points of contact should they experience concerns or issues. It
    should also be noted the ESGR has expanded its mission to provide a
    stronger advocate role for civilian employers by ``developing and
    promoting a culture in which all American employers support and value
    the military service of their employees''. The support of ESGR is a key
    component of maintaining good relations between our airmen and their
    employers.
        General Milstead. I currently do not see a need to amend the
    USERRA. We continue to monitor the effects of continued and persistent
    usage of the Reserve component on our marines and their families. The
    Marine Corps has found that engaged leadership throughout the chain of
    command and use of Employer Support of the Guard and Reserve (ESGR)
    representatives, coupled with existing USERRA legislation, meets the
    challenges faced by Reserve Component Marines.

                               reserve retirement
        36. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, the 2008 NDAA included a provision which I
    authored which authorized members of the Reserve component who perform
    Active Duty for significant periods in support of contingency
    operations to collect retired pay early. Feedback I have gotten on how
    this provision is affecting the troops so far has been very positive.
    What feedback have you received on this issue?
        Secretary Lamont and General Bostick. Overall, we have received
    positive feedback. Soldiers like the retirement as outlined in the NDAA
    2008. We believe that it has been a very positive incentive in support
    of contingency operations.
        Secretary Garcia and Admiral Ferguson. Feedback from the Reserve
    Force on the early collection of retired pay for the performance of
    Active Duty in support of contingency operations is uniformly positive.
        Secretary Ginsberg and General Jones. The Air Force has received
    overall positive feedback from the ARC regarding this statute change.
    The provision is not only an incentive to support volunteerism for
    contingency operations; it may also be viewed as a retention tool for
    the Reserve components.
        General Milstead. We have not received any negative feedback and
    believe the law has been successful in incentivizing and rewarding
    Reserve marines who mobilize in support of contingency operations.

        37. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, how could Congress modify this provision
    to further incentivize and appropriately reward members of the Reserve
    components who deploy for significant periods of time?
        Secretary Lamont and General Bostick. Currently, a Reserve
    component soldier who retires prior to age 60 under the 2008 NDAA
    provision receives retired pay, but no other benefits, e.g. medical
    care. At age 60, the retired Reserve soldiers receive the remainder of
    their retirement benefits. This benefit was established in the NDAA for
    Fiscal Year 2008 and supports the expanded role of Reserve component
    soldiers.
        Secretary Garcia and Admiral Ferguson. Thank you for the
    opportunity to provide my thoughts on provisions that may further
    incentivize and reward members of the Reserve components. Remaining
    consistent with administration policy and established budget
    guidelines, I believe that Congress would be best served if DOD uses
    the standard authorization and budget process to request changes to
    existing authorities, if the Department determines that changes are
    needed.
        Secretary Ginsberg and General Jones. Our Reserve component has a
    longstanding heritage of selflessly supporting our national security,
    and we recognize the expanded role Air Force Reserve and Air National
    Guard airmen are fulfilling in accomplishing the mission. We are also
    keenly aware of the significant costs associated with incentives
    offered to our Reserve airmen and appreciate the generous support
    provided by legislative leadership. If after careful analysis it is
    determined a modificiation is needed to current Reserve benefits or
    entitlements, we will submit a proposal through the standard budget and
    authorization process.
        General Milstead. There are several potential ways the provision
    could be modified if it is determined that the Services need to amend
    the retirement structure for reservists who serve on Active Duty for
    significant periods of time. This is an issue for further study,
    including within the context of the recent military retirement reform
    review.

                               reserve retirement
        38. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, I understand that there is some confusion
    or lack of consistency regarding how the provision authorizing early
    receipt of retired pay is being interpreted within DOD. As the primary
    author of that provision, I would like to state my original intent for
    the record. First, my intent was to reward servicemembers who perform
    Active Duty for significant periods. We had to bind the provision
    somehow so we set the period during which members would be required to
    serve an aggregate of 90 days of duty to be the confines of a single
    fiscal year, fiscal year 2010, or fiscal year 2011, and so forth. The
    intent was not that a servicemember should be rewarded for any
    aggregate duty of 90 days that they served over their Reserve career.
    Second, my intent was to reward servicemembers who were activated,
    mobilized, deployed, or called to duty in support of a contingency
    operation. In my view this should include any duty, in the continental
    United States (CONUS) or outside the continental United States
    (OCONUS), which is related to a contingency operation or national
    emergency, regardless of the specific order type is utilized to call
    the member to duty. With that explanation, I would appreciate your
    feedback on how DOD is interpreting the current statute, what
    ambiguities you believe may exist in the language, and the extent to
    which the Services are interpreting the provision differently.
        Secretary Lamont and General Bostick. The Army follows the DOD
    interpretation of the NDAA for Fiscal Year 2008 provision that is based
    on the fiscal year restriction. I am unable to comment on how the other
    Services interpret the NDAA for Fiscal Year 2008 provision.
        Secretary Garcia and Admiral Ferguson. DOD implementing
    instructions limit accrual of 90-day aggregate increments to service
    performed during a fiscal year. Given this interpretation, with which
    Navy agrees, an inequity exists by not permitting credit toward
    otherwise qualifying 90-day periods of Active Duty that happen to cross
    fiscal years. There also appears to be ambiguity regarding the types of
    active duty orders for which credit may be awarded. For instance, it is
    unclear whether periods of operational support duty performed while on
    Annual Training under title 10, U.S.C., sections 10147 or 12301(b)
    qualify. Navy reservists provide significant operational support while
    on Annual Training; thereby, contributing to contingency operations in
    ways which warrant the awarding of credit towards the 90-day aggregate.
    My understanding is that some of the other Services may not be awarding
    credit for early receipt of retired pay for reservists on Annual
    Training orders.
        Secretary Ginsberg and General Jones. We believe DOD has
    interpreted and subsequently issued implementation guidance based on
    the intent you have identified. We further believe the current language
    is written as `generic' as it can in order to not constrain the
    department and services in implementation. Each of the services, are
    complying with the intent of acknowledging those called to duty in
    support of contingency operations. The OSD guidance is written in a
    manner to permit service secretaries latitude to establish service
    policy to implement the `full intent' of this provision in rewarding
    our servicemembers for their continued sacrifices. There does not
    appear to be any discrepancy in the interpretation and application of
    this law by ARPC between the two Air Force Reserve components.
        General Milstead. The Marine Corps adheres to the DOD policy,
    ``Service Credit for Reserve Retirement'' with the exception that,
    based on the clarifying language found in the NDAA for Fiscal Year
    2011, we no longer limit qualifying Active Duty to periods wholly
    served within the same fiscal year.

        39. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, what sort of clarity could Congress
    provide to eliminate some of the ambiguity and inconsistency between
    the Services in this area?
        Secretary Lamont and General Bostick. DOD Instructions that
    implement the 2008 NDAA provision provide clear guidance to the
    Services, so the Army requires no additional guidance.
        Secretary Garcia and Admiral Ferguson. To eliminate ambiguity and
    uncertainty, Congress could amend title 10, U.S.C., to eliminate the
    per-fiscal year calculation of days of certain Active Duty or active
    service used to reduce the minimum age at which a member of a Reserve
    component of the uniformed services may retire for non-regular service,
    as proposed in S. 3406, introduced in the 111th Congress. Such an
    amendment will codify the intent expressed in the Sense of Congress
    enacted in section 635 of the NDAA for Fiscal Year 2011, by expanding
    the authority to permit credit when an otherwise qualifying 90-day
    period of Active Duty or active service crosses between 2 fiscal years.
    Additionally, amending the language to clarify that all types of active
    duty orders are to be included in calculations for early receipt of
    non-regular retired pay under title 10, U.S.C., section 12731, would
    ensure greater consistency in awarding credit under this law.
        Secretary Ginsberg and General Jones. There does not appear to be
    any discrepancy in the interpretation and application of this law by
    ARPC between the two Air Force Reserve components.
        General Milstead. Given the clarification provided in the NDAA for
    Fiscal Year 2011, we are not aware that ambiguity and inconsistency
    currently exists between the Services.

        40. Senator Chambliss. Secretary Lamont, Secretary Garcia,
    Secretary Ginsberg, General Bostick, Admiral Ferguson, General
    Milstead, and General Jones, Senator Tester and I recently filed a bill
    which would change the requirement for the duty to be performed within
    ``any fiscal year'' and instead allow it to fall within ``any 2
    consecutive fiscal years.'' This would allow individuals who mobilize
    for 90 days to receive credit if the mobilization or deployment
    happened to span 2 fiscal years, which is often the case. I would
    appreciate your feedback on that proposed change and if you believe it
    might eliminate some of the confusion and inequity in the current
    provision.
        Secretary Lamont and General Bostick. The Army would support a bill
    that removes the fiscal year constraints imposed by the original law,
    and believes such a provision would eliminate the confusion and
    inequity resulting from the current law.
        Secretary Garcia and Admiral Ferguson. I greatly appreciate your
    commitment to reward members of the Reserve component who perform
    Active Duty in support of contingency operations. As written, however,
    the ``Reserve Retirement Deployment Credit Correction Act'' (S. 866)
    would establish eligibility for early receipt of non-regular retired
    pay credit for certain Reserve personnel who complete an aggregate of
    90 days Active Duty or active service which occurs across 2 fiscal
    years, which Navy supports, but would remove eligibility for reservists
    who currently qualify for early receipt of non-regular retired pay
    credit by completing 90-day increments of qualifying Active Duty or
    active service within a single fiscal year. We surmise that the latter
    is not intended and would clearly not be a desirable outcome of the
    legislation. As an alternative, Navy would support amendment of S. 866
    to adopt the language reflected in S. 3406, 111th Congress, which would
    retain credit for all those currently eligible, while expanding the
    authority to permit credit when an otherwise qualifying 90-day period
    of active duty or active service crosses between 2 fiscal years.
        Secretary Ginsberg and General Jones. The proposed change will have
    positive impact. A number of deployments cross fiscal years as the
    member is on site to support the mission requirement. Allowing for the
    duty to be performed within any 2 consecutive fiscal years will provide
    more Reserve component members the benefit of this provision. Finally,
    this action will support recruiting and retention in the Reserve
    components.
        General Milstead. Given the clarification provided in the NDAA for
    Fiscal Year 2011, we are not aware that ambiguity and inconsistency
    currently exists between the Services and do not believe an ``any 2
    consecutive fiscal years'' change is warranted.

                    navy chaplains performing gay marriages
        41. Senator Chambliss. Secretary Garcia, yesterday May 10th, the
    Navy suspended their decision to allow chaplains to perform same-sex
    unions. I applaud the Navy for that course of action. Regarding the
    Navy's initial decision--once Don't Ask Don't Tell policy is repealed--
    to authorize chaplains to perform same-sex marriages on military bases
    located in States that permit same-sex marriage or union, did the Navy
    seek a ruling from the Navy and/or DOD General Counsel regarding how
    the Navy's proposed policy may or may not conflict with the Defense of
    Marriage Act? If so, what ruling did the Navy and/or DOD General
    Counsel provide?
        Secretary Garcia. Prior to the issuance of that guidance, the
    Office of the Judge Advocate General of the Navy discussed the issue
    with the Offices of the Judge Advocates Generals of the Army, the Air
    Force, and the Office of the General Counsel of DOD. Navy's guidance
    was then developed and issued only after this discussion. Following the
    receipt of a letter from several Members of Congress questioning this
    guidance, the DOD General Counsel and the Navy General Counsel together
    personally decided that further legal review was warranted.

        42. Senator Chambliss. Secretary Garcia, do you agree that,
    regardless of the Navy or the administration's views on the Defense of
    Marriage Act, that it is, in fact--law--and therefore should be
    followed until it is repealed or deemed unconstitutional?
        Secretary Garcia. Yes, the Navy will follow the law, including the
    Defense of Marriage Act, until such time as it ceases being the law.

                                women in combat
        43. Senator Chambliss. General Bostick, the Army's current policy
    for female soldiers allows women to serve in any officer or enlisted
    specialty or position except those in specialties, positions, or units
    (battalion or smaller) which are assigned a routine mission to engage
    in direct combat or which collocate routinely with units assigned a
    direct combat mission. I understand this policy is undergoing a routine
    review. I also understand that a military advisory commission known as
    the Military Leadership Diversity Commission recently released a report
    recommending that DOD create an equal playing field for women. At this
    time, do you personally support a change in the current Army policy in
    this area?
        General Bostick. I do personally support a change to current Army
    policy in this area at this time. The Army recently completed a routine
    cyclic review of its current assignment policy for female soldiers. As
    a result of this review, the Army is prepared to align its policy with
    that of DOD by adopting DOD terminology and definitions and by
    eliminating its collocation restriction. However, the Army does not
    intend to take action to change Army policy until after the
    comprehensive NDAA for Fiscal Year 2011 mandated review is completed,
    as this review may generate changes that extend well beyond the scope
    of our routine cyclic review. Any change in policy will increase
    further career opportunities for female soldiers and provide a larger
    pool of qualified soldiers.
        Women will continue to be assigned to units and positions that may
    necessitate combat actions within the scope of their restricted
    positioning--situations for which they are fully trained and equipped
    to respond.

                         reserve component integration
        44. Senator Chambliss. General Bostick, during a decade of
    sustained engagement in combat operations, the Reserve components of
    our Armed Forces have been transformed from a strategic force of last
    resort to an Operational Reserve Force that provides full-spectrum
    capability to the Nation. While DOD and the military Services have come
    a long way in realizing the vision of an Operational Reserve, more work
    needs to be done to fully implement this concept. In addition to the
    items you mention in your written statement, what additional steps are
    required to truly make the Reserve components the Operational Force of
    the future?
        General Bostick. As DOD continues to transform the National Guard
    and Reserves from a strategic to an operational force, a revised
    ``limited'' title 10 U.S.C. authority is needed to provide the
    Secretary of Defense and the Military Departments an authority for
    employing the Reserves and National Guard to support peace-time (non-
    emergency) force generation requirements. Such authority, would allow
    DOD components to program and budget for a greater use of the Reserves
    and National Guard to meet steady-state requirements within our base
    budget, such as theater security cooperation missions, rotational
    forces to Europe and/or Korea, and other force generation requirements
    that are longer than 29 days in duration. The President has requested
    that Congress consider amending 10 U.S.C., section 12304, to permit the
    use of the Reserve components for non-emergency requirements. We ask
    for your consideration of this request. Ideally, the Army would like an
    authority to permit the Secretary to begin programming and budgeting
    for involuntary use of the RC to perform missions vital to U.S.
    national interests at home and abroad as part of a flexible,
    accessible, cost effective Total Force.

                          force balance--civil affairs
        45. Senator Chambliss. General Bostick, in your written statement
    you note that ``the Reserve components make up 51 percent of the Army's
    manpower. Moreover, many of the capabilities that the combatant command
    would prefer to use in theater security cooperation activities do not
    exist in sufficient quantities in the Active component. For example,
    approximately 90 percent of the Army's Civil Affairs forces are in the
    USAR.'' Given that the majority of Civil Affairs personnel will
    continue to reside in the Army Reserve and continue to deploy primarily
    in support of conventional forces, why should Special Operations
    Command retain proponent responsibility for all Civil Affairs forces,
    Active and Reserve?
        General Bostick. Civil Affair Operations are a core activity of
    Special Operation Forces.

        46. Senator Chambliss. General Bostick, is Civil Affairs an Army or
    a Special Operations capability?
        General Bostick. Civil Affairs is an Army capability that is housed
    within U.S. Army Special Operations Command.

        47. Senator Chambliss. General Bostick, if the Army maintained
    proponent responsibility for Civil Affairs, how would you recommend
    better integration of the Active and Reserve Civil Affairs forces in
    support of the overall war effort?
        General Bostick. As the 2010 QDR noted, Civil Affairs forces serve
    as the vanguard of DOD's support to partner nations in the fields of
    rule of law, economic stability, governance, public health and welfare,
    infrastructure, and public education and information. The Army's
    current plan for Civil Affairs force modernization at U.S. Army John F.
    Kennedy Special Warfare Center and School is no longer tenable, given
    the recent decision by the Secretary of Defense to transfer proponent
    responsibility for U.S. Army Reserve (USAR) Civil Affairs forces from
    Commander, U.S. Special Operations Command (SOCOM) to the Department of
    the Army. The Commander, SOCOM is tasked with developing options for
    transferring proponent responsibilities for USAR Civil Affairs to the
    Department of the Army. The Army should establish a new force
    modernization and branch proponent for Civil Affairs within the U.S.
    Army Training and Doctrine Command that supports the Army's total
    force, with common standards between the Active and Reserve Forces.
                                     ______

                  Questions Submitted by Senator Susan Collins
                      yellow ribbon reintegration program
        48. Senator Collins. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, Reserve component members returning from combat to
    civilian communities are often geographically dispersed from military
    bases. The additional pressures of finding or resuming civilian
    employment and finding behavioral health support make it more difficult
    to provide them with an effective reintegration experience. The
    National Guard Bureau's YRRP and the Office of Secretary of Defense's
    Military and Family Life Counseling (MFLC) programs are designed to
    help assist these servicemembers and their families in making this
    transition. Do you have metrics that demonstrate whether or not these
    programs are meeting their objective?
        Secretary Lamont. The Defense Management Data Center (DMDC)
    conducted a web-based survey in fiscal year 2010. This survey, Status
    of Forces Survey of Reserve Component Members: Reunion and
    Reintegration, solicited input from 86,000 Reserve component members
    (31,815 responded). DMDC findings show respondents found YRRP to be
    very effective compared with other DOD programs with which they were
    familiar in the following areas: Overall effectiveness of reunion and
    reintegration support; Helpfulness of support services for members
    dealing with deployment related stress; Overall satisfaction with
    reunion and reintegration support; Helpfulness of support services for
    spouse or significant other dealing with deployment related stress; and
    Overall assessment of readjustment.
        The success of YRRP is largely predicated on the effectiveness of
    its events. It is for that reason Yellow Ribbon event planners are
    required to submit an After Action Report (AAR) following every Yellow
    Ribbon event. These AARs allow the National Guard and Reserve program
    leadership and the YRRP office to identify the needs and gauge the
    effectiveness of the program. Based on the reports from the Services,
    it is evident that YRRP is meeting the needs of its Service and family
    members and community partners.
        The National Guard will continue to work with The Yellow Ribbon
    Center for Excellence which is the analytical element of the YRRP to
    enhance and improve the development of data collection, analysis and
    distribution systems to provide best practices and measures of
    performance and effectiveness of YRRP.
        Although National Guard servicemembers and their families utilize
    MFLC programs offered within the States, the National Guard Bureau does
    not manage this program or track metrics that demonstrate their
    effectiveness.
        Secretary Garcia. The Navy and Marine Corps YRRPs have consistently
    received praise for its ability to smooth the process for reservists
    transitioning from mobilized service to the civilian sector. However,
    it remains voluntary and feedback is provided on a case-by-case basis.
    Exit surveys have been utilized which indicate a strong approval rating
    for both the workshop, as a whole and the material presented. In an
    effort to gain greater metrics, the Center for Naval Analysis (CNA) has
    been requested to conduct a comprehensive study of Navy's
    implementation of the YRRP. Reserve component members also are
    protected from the pressures of finding and resuming civilian
    employment by current laws such as the USERRA.
        There are metrics that demonstrate whether or not these programs
    meet their objective. OSD(P&R) coordinated an independent third party
    evaluation of the MFLC Program by Virginia Tech University. OSD(P&R)
    can provide the specific results of the evaluation as they apply to
    DOD.
        Secretary Ginsberg. In fiscal year 2011, YRRP will continue to
    build on its successes by pursuing a number of objectives including
    publishing the DOD Instruction and developing a plan to execute Joint
    events. These objectives and others will allow for the most efficient
    use of resources when conducting events.
        For fiscal year 2011, approximately 1,700 Yellow Ribbon Events are
    scheduled across the country. This level of commitment, in terms of
    fiscal resources and service provider support being spread thin,
    appears unsustainable based on feedback from YRRP Advisory Board, YRRP
    Conference attendees, and service providers. In addition, an increased
    emphasis on the role YRRP will play in terms of decreasing
    unemployment/underemployment must be addressed.
        YRRP continues to work diligently to enhance and improve the
    Program by finding new and innovative ways to communicate and deliver
    information to servicemembers and their families. In addition, the
    Program has also placed more emphasis on Service collaboration to
    better serve servicemembers and their families. These efforts provide
    the foundation for the Program's growth and achieving its mission to
    help, support, and ultimately increase the readiness of Service and
    family members throughout the deployment cycle.
        YRRP has made a difference in the lives of thousands of our
    soldiers, sailors, marines, airmen, and their families. Continuing
    support from Congress, the Military Departments, the National Guard and
    Reserve, Federal agencies, nongovernmental agencies, and State and
    local partners will ensure our National Guard and Reserve
    servicemembers and their families will remain strong and ready!

        49. Senator Collins. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, what is the projected funding for the next 5 years
    for the YRRP and the Military and Family Counseling programs?
        Secretary Lamont. The Army National Guard (ARNG) uses the Army
    Community Services budget line for Base funding of all of their quality
    of life programs which include Yellow Ribbon, Family Programs, Survivor
    Outreach Services and Joint Staff. The Fiscal Year 2012 Operation/
    Maintenance (O&M) funding amount is $82.317 million; the Army is still
    working the numbers for the out years.
        The Air National Guard (ANG) funds their Yellow Ribbon program
    through Overseas Contingency Operations (OCO) funding. The fiscal year
    2012 funding includes both O&M at $17.4 million and Military Personnel
    (MILPERS) at $9.4 million for a total of $26.8 million. The Army is
    still working the numbers for the out years.
        National Guard servicemembers and their families utilize MFLC
    programs offered within their States. However, the National Guard
    Bureau does not manage funding for this program or track metrics that
    demonstrate their effectiveness.
        Secretary Garcia. The YRRP is currently funded through fiscal year
    2012. No additional funding has been sourced to support the program
    beyond fiscal year 2013.
        Secretary Ginsberg. YRRP currently remains adequately resourced to
    carry out the mission as mandated by law. The AFR fully supports the
    YRRP and will continue to work with the Service YRRP Managers,
    Liaisons, General Counsel, OSD Comptroller, and other OSD Offices to
    resolve issues that impact the ability to execute funds in support of
    servicemembers and their families. We anticipate funding for the next 5
    years of approximately $75 million.

        50. Senator Collins. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, do you believe you have adequate mental health and
    behavioral health personnel in the appropriate locations to reach all
    of the returning Reserve and National Guard servicemembers?
        Secretary Lamont. The U.S. Army Medical Command has sufficient
    behavioral health personnel to provide behavioral health screening to
    returning National Guard and Army Reserve soldiers. However, across the
    Army, we do not have sufficient numbers of behavioral health care
    providers in the appropriate locations to treat all of our returning
    soldiers with behavioral health care issues resulting from deployment.
    The Army is using numerous mechanisms, including bonuses, scholarships,
    and expansions in training programs, to recruit and retain both
    civilian and uniformed behavioral health providers.
        Secretary Garcia. We are committed to improving the psychological
    health, resiliency and well-being of all our sailors, marines, and
    their family members, both Active and Reserve component. Our priority
    remains ensuring that our personnel and their families have access to
    the providers, 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. We are also working hard to ensure that required
    civilian and contracted personnel positions are filled to meet the
    needs our personnel, regardless of location. Our programs are designed
    to make best use of our trained mental health personnel and resources
    including:

             Reserve  commands  have  trained  Combat/Operational
            Stress  Control  (C/OSC) caregivers and C/OSC training is
            conducted regularly in order to prevent suicide, sexual assault
            and family violence, and to normalize buddy-care and help-
            seeking behavior as early as possible. Like the Active
            component, these OSC concepts are integrated into all sailor
            and family programs in the RC, including alcohol awareness and
            SAPR--which also highlight the importance of bystander
            intervention. Together these efforts combine to create a
            culture of caring among shipmates, where seeking help for
            oneself or someone else in need is fast becoming the new social
            norm.
             These efforts are further supported by trained Suicide
            Prevention Coordinators within each Reserve Command who provide
            effective interactive peer-to-peer training as part of an
            ongoing social media campaign to de-stigmatize help-seeking.
             Reserve PHOP teams of five to six full-time licensed
            mental health providers are embedded within each geographic
            Navy Reserve Region or Marine Forces Reserve Region to help
            commands, reservists and their families, to meet their care
            needs. Each Region's team provides a 24/7 on-call service. They
            also contact every reservist returning from a combat
            deployment, and provide mental health screening, find local,
            affordable resources, make referrals and then follow-up to
            ensure that the care was effective. This program continues to
            help RC personnel with finding appropriate care for medical and
            mental health needs by connecting them with available and
            accessible state-of-the-art face to face, telephonic and web-
            based Federal and State programs, including those offered by
            TRICARE, Military OneSource, Military and Family Life
            Consultants serving in the Joint Family Support and Assistance
            Programs and the VA. PHOP teams conduct local Navy Operational
            Support Center (NOSC) visits at least annually and have
            participated in the YRRP Warrior and Family Support pre-
            deployment family readiness conferences and annual Periodic
            Health Assessments at NOSCs. They also receive referrals for
            assistance as a result of Post Deployment Health Assessments
            conducted by health care providers for reservists returning
            from deployments.
             Returning Warrior Workshops (RWWs), a 2-day weekend
            program designed specifically to support the successful
            reintegration of returning reservists and their families
            following mobilization are conducted within each Region usually
            each quarter. The PHOP teams serve as facilitators at these
            YRRP signature events which normalize the impact of combat
            stress, provide support and opportunities to assess mental
            health needs, destigmatize help-seeking, and provide resources
            for identified issues or concerns.
             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 RC personnel serving in areas with a high active
            duty fleet concentration.

        Secretary Ginsberg. ANG implemented the Psychological Health
    Program (PHP) during this fiscal year. The ANG PHP places licensed
    mental health professionals as DPHs into each wing to provide subject
    matter expertise on psychological health to wing commanders and to
    provide consultation, information, referral, and case management for
    airmen and their family members in need of assistance. Though the ANG
    does not provide treatment, these professionals help distressed airmen
    navigate the complex mental health system in order to obtain the help
    they need. They support airmen throughout the deployment cycle and are
    a resource when post-deployment assessments determine an airman is
    experiencing difficulties.
        The Wing DPHs work collaboratively with other wing helping
    agencies, such as Chaplains and Airman and Family Readiness Program
    Managers. Additionally, they partner with State DPHs, Joint Family
    Support Assistance Program Military and Family Life Consultants, and
    others who support Guard members and their families. Wing DPHs serve as
    consultants to medical personnel conducting pre- and post-deployment
    assessments of airmen, providing further screening, referral and case
    management as appropriate. Wing DPHs are involved in the YRRP to
    provide support for Guard members and their families throughout the
    deployment cycle.
        The Wing DPHs play a critical role in addressing the mental health
    needs of returning Reserve and National Guard servicemembers. However,
    the ANG would benefit from additional resources, as a single asset
    cannot possibly meet all needs. For example, as members of the Reserve
    component return from deployments, they undergo assessments at multiple
    locations, and changes in their Federal/State status. The ANG has begun
    to address this issue using the Deployment Resiliency Assessment.

        51. Senator Collins. Secretary Lamont, Secretary Garcia, and
    Secretary Ginsberg, if there are additional resources or programs that
    must be implemented to ensure the behavioral and mental health needs of
    reservists and guardsmen returning from war and their families are
    fully met, please describe those proposals.
        Secretary Lamont. Returning reservists and guardsmen are authorized
    extended care through the VA, TRICARE network, and direct care system
    as they transition from their combat experiences. However, they must be
    located near participating healthcare facilities or network providers
    to obtain such care. The Army is expanding a tele-behavioral health
    system that will greatly increase access for returning soldiers by
    enabling them to seek and receive care in remote locations. We are
    currently addressing the issues inherent in this expansion, with State
    licensure limitations of behavioral health professionals being one of
    the most critical challenges.
        Secretary Garcia. We maintain a culture of continuous improvement
    in critically evaluating our programs of support for all our sailors,
    marines, and their families. At the same time, the leadership within
    the Navy and Marine Corps is committed to eliminating any stigma
    associated with seeking care or assistance. We continue to make
    progress in providing better care, as well as seamless services and
    support to our personnel and their families and believe we have the
    resources necessary to meet our requirements moving forward.
        Secretary Ginsberg. Air Force Reserve proposes to adding wing-level
    personnel who will focus specifically on increasing access to services,
    improving the psychological health needs and resilience of AFR
    personnel and their families, and, when possible, mitigating the
    negative effects of community risk factors.
        The challenges of serving as a citizen airman are many. To attempt
    to meet this challenge, ANG implemented the PHP during this fiscal
    year. This program supports the force health protection of airmen by
    promoting resilience and psychological health. The ANG PHP places
    licensed mental health professionals as DPHs into each wing to provide
    subject matter expertise on psychological health to wing commanders and
    to provide consultation, information, referral, and case management for
    airmen and their family members in need of assistance. Though the ANG
    does not provide treatment, these professionals help distressed airmen
    navigate the complex mental health system in order to obtain the help
    they need. They also support the psychological health of wing members
    by providing psychoeducational presentations on topics such as post-
    traumatic stress, improving sleep, communication, and relationships.
        Mental health care of citizen airmen is complicated by geographic
    dispersal. Many members live in remote areas where access to care is
    limited. Continuing to expand funding for and availability of
    telehealth services, community mental health services and other
    population health efforts will be beneficial.
        Ongoing funding of the ANG PHP is essential. Funding is needed to
    continue the program beyond fiscal year 2012. The PHP is critical to
    ensuring the continuum or continuity of care for the Guard member.

        [Whereupon, at 2:59 p.m., the subcommittee adjourned.]