[Senate Hearing 118-]
[From the U.S. Government Publishing Office]
DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2023
----------
U.S. Senate,
Subcommittee of the Committee on Appropriations,
Washington, DC.
NONDEPARTMENTAL WITNESSES
[Clerk's note.--The subcommittee was unable to hold
hearings on nondepartmental witnesses. The statements and
letters of those submitting written testimony are as follows:]
Prepared Statement of the American Psychological Association
The American Psychological Association (APA) is the largest
scientific and professional organization representing psychology in the
U.S., numbering over 135,000 researchers, educators, clinicians,
consultants and students. For decades, psychologists have played vital
roles within the Department of Defense (DoD), as providers of clinical
services to military personnel and their families, and as scientific
researchers investigating mission-targeted issues, such as counter-
terrorism, Post-Traumatic Stress Disorder (PTSD), and Traumatic Brain
Injury (TBI).
The performance of psychologists in training and performance in the
field remains an essential part of the readiness. Psychologists play
key roles in the development and deployment of programs such as the
Army Resilience Directorate Training Support program that emphasizes
the value of mental readiness. Teaching servicemembers and civilians
the value of cognitive capability, emotional capability, and
interpersonal/social capabilities show the real value of psychological
science.
Today, psychologists continue to bring unique and critical
expertise that is essential to meeting the needs of the military and
its personnel.
APA urges Congress to provide the following funding levels for
programs within the Department of Defense (DoD) in FY23.
defense science & technology (s&t) program
In addition to providing essential clinical services to our
military service members and their families, psychological scientists
within DoD conduct cutting-edge, mission-specific research critical to
our National defense. Psychological scientists address a broad range of
important issues and problems vital to our National defense, including
expertise in conflict prevention and resolution; promoting non-
discriminatory and evidence-based recruitment and retention; modeling
behavior of individuals and groups; as well as understanding and
optimizing cognitive functioning, perceptual awareness, complex
decision-making, stress resilience, and human- systems interactions.
Within DoD, the majority of behavioral, cognitive and social
science is funded through the Army Research Institute for the
Behavioral and Social Sciences (ARI) and Army Research Laboratory
(ARL); the Office of Naval Research (ONR); and the Air Force Research
Laboratory (AFRL), with additional, smaller human systems research
programs funded through the Office of the Secretary of Defense (OSD)
and the Defense Advanced Research Projects Agency (DARPA).
The military service laboratories provide a stable, mission-
oriented focus for behavioral and social science, conducting and
sponsoring basic (6.1), applied/exploratory development (6.2) and
advanced development (6.3) research. All of the services fund human-
related research in the broad categories of personnel, training and
leader development; warfighter protection, sustainment and physical
performance; and system interfaces and cognitive processing.
DoD funding for psychological research has supported a number of
major medical advancements, including the use of Virtual Reality (VR)
as a clinical, evidence-based tool to address the assessment,
prevention, and treatment of PTSD. Bravemind, for example, is a virtual
Iraq/Afghanistan exposure therapy tool that is currently used in
approximately 100 sites around the U.S., including VA hospitals,
military bases and university centers. While traditional prolonged
exposure therapy for PTSD involves the gradual reliving of a traumatic
event in the patient's imagination under a clinician's care, Bravemind
allows clinicians to gradually immerse patients into virtual combat
scenarios that reflect their specific traumatic experiences in a
controlled, stepwise fashion. Clinicians are then able monitor the
intensity of the patients' stress responses through brain imaging and
psychophysiological assessment techniques. Literature has shown that
patients with PTSD who were unresponsive to traditional prolonged
exposure therapy using their imaginations often responded successfully
to VR therapy using Bravemind.
Continued support for this research is essential to improving
mental and behavioral health outcomes for our Nation's veterans and
servicemembers.
APA joins the Coalition for National Security Research (CNSR) in
urging Congress to increase FY23 Defense S&T funding consistent with
recommendations of the National Defense Strategy Commission.
minerva research initiative
Launched in 2008, the Minerva Research Initiative is the
Department's signature social science basic research program that funds
university-led teams which conduct social science research in areas of
strategic importance to U.S. national security policy. Minerva provides
critical access to expertise to help the military better understand how
social, cultural, behavioral, and political forces impact security and
stability in regions significant to America's interests abroad. Across
the behavioral and social sciences, approximately 10 percent of all
Minerva grants have been awarded to support psychological science.
Recent Minerva-supported psychological research includes, Bio-Markers
and Counter-Messages: Measuring Individual Differences in the Influence
of Extremist Propaganda and Counter-Messages (2017) and Autonomy
Refugee Psychology and Its Potential for Refugee Radicalization (2016).
Research like this provides the DoD with unique insights that help
shape national security policies and better position the U.S. in a
complex global environment.
The Minerva Research Initiative, funded primarily from the Basic
Research Initiative PE, received renewed support after the fiscal
Year2022 budget request called for dramatic cuts. The fiscal Year2023
budget request supports roughly the level appropriated in fiscal
Year2022 ($17 million). Minerva serves as DOD's flagship social science
program that funds university-led teams to conduct social science
research on areas of strategic importance to U.S. national security
policy including efforts related to great power competition and near-
peer competition that can deter conflict or enhance understanding of
adversaries' environments to promote DoD success in potential
conflicts.
APA joins CNSR in urging Congress to restore Defense-Wide funding
for Minerva and increase its overall budget to $17 million in FY23.
artificial intelligence (ai)
Psychological research from all disciplines of psychology has
supported advancements in AI since its inception, including cognitive,
personality, social, neuropsychology, developmental, clinical, and
experimental psychology. Each discipline of the field provides a unique
perspective and contribution to the ongoing development of AI. APA
urges continued investments in AI research, including effective methods
for human-AI collaboration. Human/AI cooperation is one area which
illustrates the unique contributions of psychological science. As
experts in human behavior, psychologists work to examine how subtle
behaviors that are vital to cognitive processes and action, such as eye
contact, apply in the context of human-AI interaction, such as
autonomous vehicles and social robotics.
APA strongly urges continued support for the National Security
Commission on Artificial Intelligence, which is charged by Congress to
examine AI through the lens of national competitiveness, the means to
sustain technological advantage, trends in international cooperation
and competitiveness, ways to foster greater investment in basic and
advanced research, workforce and training, potential risks of military
use, ethical concerns, establishment of data standards, and the future
evolution of AI.
APA urges Congress to prioritize funding aligned with the
recommendations outlined by the Commission's 2019 Interim Report, which
identifies five fundamental lines of effort that are necessary to
preserve U.S. advantages, including:
(1) invest in AI research and development;
(2) apply AI to national security missions;
(3) train and recuit AI talent;
(4) protect and build upon U.S. technology advantages; and
(5) marshal global AI cooperation.
defense health programs and medical research
In order to maintain a strong military, it is imperative that
Congress continues to prioritize the health, including mental and
behavioral health, of our Nation's servicemembers. While suicide and
suicidal ideation continues to be a major concern for all veterans,
servicemembers, and their families, those living in rural communities
with limited access to care remain particularly at risk.
Increased funding for telehealth services within the DoD system is
critical to ensuring this population receives the evidence-based mental
and behavioral health care they need.
APA urges Congress to provide robust funding for the Defense Health
Agency (DHA), including increased funding for telehealth services
within the DoD system.
APA also encourages Congress to expand the Defense Suicide
Prevention Office's (DSPO) efforts to address military suicide
prevention. Using the REACH-VET model, REACH-MIL would analyze existing
data from health records of members of the military serving on active
duty to identify members who are at a statistically elevated risk for
suicide in order to provide preemptive care and support for
servicemembers before they have or express suicidal thoughts to
clinicians.
Within the DSPO, we urge Congress to provide funding for REACH-MIL,
a pilot program on suicide prevention in the military health care
system based on the predictive analytics suicide prevention program
REACH-VET within the Department of Veterans Affairs (VA).
congressionally directed medical research programs (cdmrp)
CNSR supports robust funding for investments in critical medical
research at DoD. This includes the CDMRP, which supports research to
understand, prevent, diagnose, and treat diseases and medical issues
that are prevalent and specifically impact service members, veterans,
and their families. These programs address diseases such as epilepsy,
spinal cord injuries, Alzheimer's, Gulf War Illness, Traumatic Brain
Injury, Posttraumatic Stress Disorder, and psychological health, among
many other critical issues.
CDMRP funds high-risk, high-impact research that is complementary
but not duplicative of efforts at other agencies such as the National
Institutes of Health (NIH). In fact, the National Academies has
assessed that CDMRPs appropriately coordinate research priorities with
other funding agencies and have an effective review and selection
process for awarding funds not dissimilar to the process used by
NIH.\1\
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\1\ https://www.nap.edu/catalog/23652/evaluation-of-the-
congressionally-directed-medical-research-programs-review-process.
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With NIH only being able to fund approximately 19 percent of
proposals it receives,\2\ CDMRPs play an important role in ensuring
that military-relevant innovative biomedical research is conducted.
However, in fiscal Year2020, these programs proved highly competitive
as CDMRP programs had an average success rate of just 13 percent--more
than 6,600 proposals unfunded.\3\ An increase in funding is
particularly vital this year to mitigate the impact of the recent spike
of inflation on the purchasing power of individual CDMRP programs,
particularly those programs that have been flat funded for several
years.
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\2\ https://nexus.od.nih.gov/all/2022/03/07/fy-2021-by-the-numbers-
extramural-grant-investments-in-research/.
\3\ https://cdmrp.army.mil/pubs/annreports/2021annrep/
2021annreport.pdf.
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APA joins the Defense Health Research Consortium (DHRC) in urging
Congress to increase funding for the Congressionally Directed Medical
Research Programs by five percent plus inflation FY23.
[This statement was submitted by Katherine B. McGuire, Chief
Advocacy Officer, American Psychological Association Services, Inc.]
______
Prepared Statement of the American Urological Association
The American Urological Association, the premier organization for
urologists worldwide with over 15,000 urologists across the United
States, thanks Chairman Tester, Ranking Member Shelby, and fellow
members of the committee for the opportunity to provide written
testimony on the health needs of our military and veterans, including
bladder cancer. Our testimony will outline the importance of combatting
bladder cancer to our Nation's military and veteran population.
Specifically, we respectfully request an $8 million line item within
the Congressionally Directed Medical Research Program (CDMRP) for
bladder cancer to stabilize the field and fund groundbreaking science
that can finally bend the survival rate of bladder cancer in the right
direction.
Bladder cancer is the fourth most commonly diagnosed cancer in U.S.
military and veteran populations, and the sixth most commonly diagnosed
cancer in Americans. Additionally, it is estimated that approximately
81,180 Americans, will be diagnosed with bladder cancer in 2022. While
survival rates for many other cancers have increased, the 5-year
survival rate for bladder cancer has not improved in more than 30
years. Congress has previously provided funding for bladder cancer
research through the DoD's Peer Reviewed Cancer Research Program
(PRCRP). Despite the support to date for innovative and competitive
bladder cancer research, there remains an urgent need to make
investments that will improve the outcomes for this deadly cancer. A
dedicated funding line will help attract researchers to this field by
demonstrating a sustained commitment to this work.
The American Urological Association represents the interests of
urologists across the United States. We understand that new tools,
treatments, and techniques are necessary to ensure that a bladder
cancer diagnosis has good long-term outcomes. Yet time and again,
research dollars go to other, higher profile cancers. Highlighting
bladder cancer's importance to our military community by including a
line item will ensure that the research field remains strong and that
more research applications are funded moving forward.
Our membership has seen first-hand what bladder cancer can do to a
patient. For example, one bladder cancer patient is a 71 year-old
veteran of the Vietnam war living in Maryland with high risk non-muscle
invasive bladder cancer. Like many patients, he was unfamiliar with
bladder cancer when he began to have blood in his urine several years
ago. When told that bladder cancer was the fourth most common cancer
among men in the United States, he and his wife were shocked. We
treated him with intravesical BCG, the standard treatment for this type
of bladder cancer. BCG is also a relatively ineffective vaccine for
tuberculosis. Unfortunately, soon after treatment his cancer recurred.
At that point, his options were either a radical cystectomy, surgery to
remove his bladder necessitating urinary tract reconstruction, or a
second-line therapy. With few FDA approved therapies available, the
patient chose an experimental clinical trial involving intravesical
gemcitabine and docetaxel therapies. He has responded well thus far on
this second line therapy.
This case highlights the critical need of more funding to further
research and scientific understanding of bladder cancer, a disease
which is particularly prevalent among veterans. From this one example,
it is clear that there is a gap in patient awareness about bladder
cancer and a lack of treatments available for patients who recur after
BCG. We know that second-line therapies are lacking and identifying
novel therapies that avoid major surgery is a prominent focus of
research efforts. It is clear more must be done, and that our men and
women will directly benefit from advancements against bladder cancer.
The relevance to U.S. veterans is clear: many veterans were exposed
to high levels of ``rainbow herbicides,'' including Agent Blue and
Agent Orange which are both recognized as highly toxic. In the National
Defense Authorization Act for Fiscal Year 2021, Congress directed the
addition of bladder cancer to the Department of Veteran's Affairs list
of presumptive diseases linked to Agent Orange exposure. This addition
came after the National Academy of Medicine included bladder cancer on
its list of ``suggestive evidence of association'' with Agent Orange
exposure. Additionally, researchers are just learning that there may be
a significant link between exposure to burn puts and bladder cancer,
which must be further explored. By establishing an $8 million Bladder
Cancer Research Program in fiscal Year2023, we can ensure that bladder
cancer research and the well-being of bladder cancer patients,
particularly service members and veterans, is a national priority.
We thank you for your time and attention to this urgent health
priority for our military and veteran population.
______
Prepared Statement of the Bladder Cancer Advocacy Network
The Bladder Cancer Advocacy Network (BCAN), the only national
patient advocacy organization devoted to advancing bladder cancer
research and supporting the more than 700,000 Americans with this
common cancer, thanks Chairman Tester, Ranking Member Shelby, and
fellow members of the committee for the opportunity to provide written
testimony on the health needs of our military and veterans, including
bladder cancer.
Our testimony will outline the importance of combatting bladder
cancer to our Nation's military and veteran population. Specifically,
we respectfully request an $8 million line item within the
Congressionally Directed Medical Research Program (CDMRP) for bladder
cancer to stabilize the field and fund groundbreaking science that can
finally bend the survival rate of bladder cancer in the right
direction.
Bladder cancer is the fourth most commonly diagnosed cancer in the
U.S. military and veteran populations, and the sixth most commonly
diagnosed cancer in Americans. Additionally, it is estimated that
approximately 81,180 Americans, will be diagnosed with bladder cancer
in 2022. While survival rates for many other cancers have increased,
the 5-year survival rate for bladder cancer has not improved in more
than 30 years.
Congress has previously provided funding for bladder cancer
research through the DoD's Peer Reviewed Cancer Research Program
(PRCRP). Despite the support to date for innovative and competitive
bladder cancer research, there remains an urgent need to make
investments that will improve the outcomes for this deadly cancer. A
dedicated funding line will help attract researchers to this field by
demonstrating a sustained commitment to this work.
As a national patient advocacy organization, BCAN is eager to see
new tools, treatments, and techniques developed that are necessary to
ensure that a bladder cancer diagnosis has good long-term outcomes. Yet
time and again, research dollars go to other, higher profile cancers.
Highlighting bladder cancer's importance to our military community by
including a line item will ensure that the research field remains
strong and that more research applications are funded moving forward.
The relevance to U.S. veterans is clear: many veterans were exposed to
high levels of ``rainbow herbicides,'' including Agent Blue and Agent
Orange which are both recognized as highly toxic. In the National
Defense Authorization Act for fiscal year 2021, Congress directed the
addition of bladder cancer to the Department of Veteran's Affairs list
of presumptive diseases linked to Agent Orange exposure. This addition
came after the National Academy of Medicine included bladder cancer on
its list of ``suggestive evidence of association'' with Agent Orange
exposure.
Additionally, researchers are just learning that there may be a
significant link between exposure to burn pits and bladder cancer,
which must be further explored. By establishing an $8 million Bladder
Cancer Research Program in fiscal year 2023 in the CDMRP, we can ensure
that bladder cancer research and the well-being of bladder cancer
patients, particularly service members and veterans, is a national
priority. We thank you for your time and attention to this urgent
health priority for our military and veteran population and stand ready
to answer any questions you may have.
______
Prepared Statement of the Coalition for National Security Research
Dear Chairman Tester and Ranking Member Shelby, and distinguished
Members of the subcommittee, thank you for the opportunity to submit
outside witness testimony as you begin crafting the fiscal year 2023
Defense Appropriations bill. The Coalition for National Security
Research (CNSR) (https://cnsr4research.org/) is a broad-based alliance
of more than 100 members from industry, academia, scientific and
professional associations, and non-profits conducting vital scientific
research to create new and improve existing technologies and
capabilities to support the U.S. Department of Defense's (DoD)
operations.
Investments in basic and applied scientific research, development,
test and evaluation of new technologies and equipment are necessary so
forces will have the systems and equipment for tomorrow's challenges.
With approximately 70 percent of Research, Development, Test and
Evaluation (RDT&E) conducted extramurally,\1\ DoD relies on its
partners such as CNSR members to perform the RDT&E that will provide
the Department the technologies and capabilities it needs to secure our
National security. For example, with Russia and other adversaries
rising on the world stage and seeking potential avenues to attack U.S.
systems and infrastructure, defense funding for cybersecurity is
critical to ensure our energy and national security. Further, if the
United States military is to maintain its technological advantage
during the great power competition, it is imperative that we make
robust investments in the Defense Science and Technology (S&T)
enterprise, including strengthening the future defense workforce.
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\1\ https://ncses.nsf.gov/pubs/nsf22323.
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fiscal year 2022 budget request for the defense s&t program
The Biden-Harris Interim National Security Strategic Guidance
States that the United States will double down on science and
technology investments and support cutting-edge technologies and
capabilities that will advance our military and national security in
the future.\2\ Unfortunately, the fiscal year 2023 budget fails to meet
the commitment in the Interim National Security Strategic Guidance and
request the appropriate resources to implement the NDS.
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\2\ https://www.whitehouse.gov/briefing-room/statements-releases/
2021/03/03/interim-national-security-strategic-guidance/.
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While the budget requests the largest RDT&E top line ever, it
simultaneously calls for cutting Defense S&T funding within the larger
portfolio by 13 percent or more than $2.4 billion. The budget also
requests cutting defense basic research, the type of research that
makes discoveries to enable future technologies and military
capabilities, by 14 percent or more than $387 million. With China
investing three times more annually in R&D than the U.S. and likely to
be the world's top R&D performer in the near future,\3\ now is not the
time to cut funding for the DoD's primary programs that create new
technologies and capabilities--as well as to help train the next
generation defense workforce--to ensure the U.S. military maintains its
global dominance.
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\3\ https://ncses.nsf.gov/pubs/nsb20203.
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The fiscal year 2023 budget proposes more than just cutting the
Defense S&T program below fiscal year 2022 Congressionally enacted
levels, it proposes to cut certain research programs below levels
requested in the fiscal year 2022 budget request. More specifically,
DoD requested fewer resources compared to its last budget request for
key basic research programs at the Army, Navy, and Defense Threat
Reduction Agency (DTRA). This de-emphasis on supporting the kind of
research that maintains our technological and strategic advantage over
adversaries developing advanced capabilities puts the military at a
competitive disadvantage. Condoning this proposed budget will have many
negative, sustained implications for our National security in the
short-term and long-term.
CNSR urges Congress to reject cuts requested in the fiscal Year2023
budget for the Defense S&T program and increase funding by at least 6
percent over fiscal Year2022 consistent with the recommendations from
the National Defense Strategy Commission; \4\ DSB; \5\ National
Security Commission on Artificial Intelligence (NSCAI); \6\ National
Academies; \7\ Center for a New American Security (CNAS); \8\ House
Armed Services Committee's Future of Defense Task Force; \9\ Council on
Competitiveness; \10\ and American Academy of Arts and Sciences.\11\
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\4\ https://www.usip.org/sites/default/files/2018-11/providing-for-
the-common-defense.pdf.
\5\ http://www.dtic.mil/dtic/tr/fulltext/u2/a403874.pdf.
\6\ https://www.nscai.gov/wp-content/uploads/2021/03/Full-Report-
Digital-1.pdf.
\7\ https://www.nap.edu/catalog/11463/rising-above-the-gathering-
storm-energizing-and-employing-america-for.
\8\ https://www.cnas.org/publications/commentary/sharpening-the-u-
s-militarys-edge-critical-steps-for-the-next-administration.
\9\ https://armedservices.house.gov/--cache/files/2/6/26129500-
d208-47ba-a9f7-25a8f82828b0/6D5C75605DE8DDF0013712923B4388D7.future-of-
defense-task-force-report.pdf.
\10\ https://www.compete.org/reports/all/202.
\11\ https://www.amacad.org/sites/default/files/publication/
resources/Perils-of-Complacency_Full-Report_1.pdf.
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defense basic research pe recommendations
For decades, the defense basic research programs have provided the
scientific breakthroughs to give the warfighter the weapons and
infrastructure needed to succeed. Capabilities that help ensure our
National security--such as advances in hypersonics testing, various
quantum technologies, semiconductors critical to defense radar systems,
solar cell efficiency, laser technologies, stealth capabilities, night
vision, GPS, sonar, radar, precision munitions, biosensors, and near-
real-time delivery of battlefield information--all derive from defense
basic research.
We offer the following recommendations for the key defense basic
research PEs that serve as the foundation of the defense innovation
pipeline necessary to maintaining the U.S. military's global
technological superiority.
[$ in Thousands]
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FY22 CNSR FY23
Agency--RDT&E Program Element (PE) FY22 BR Enacted FY23 PBR Request
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Army................................ Defense Research $297,241 $368,751 $279,328 $392,455
Sciences.
Army................................ University Research $66,981 $91,241 $70,775 $97,500
Initiatives.
Army................................ University and $94,003 $126,267 $100,909 $134,888
Industry Research
Centers.
Army................................ Cyber Collaborative $5,067 $5,067 $5,355 $5,371
Research Alliance.
Army................................ Artificial $10,183 $15,183 $10,456 $16,094
Intelligence and
Machine Learning
Basic Research.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Navy................................ University Research $117,448 $153,505 $116,816 $185,392
Initiatives.
Navy................................ Defense Research $484,421 $523,324 $499,116 $554,826
Sciences.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Air Force........................... Defense Research $328,303 $353,303 $375,325 $375,325
Sciences.
Air Force........................... University Research $162,403 $187,403 $171,192 $198,647
Initiatives.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Defense-Wide........................ DTRA Basic Research $11,828 $11,828 $11,584 $12,538
Initiatives.
Defense-Wide........................ Basic Research $39,828 $76,702 $62,836 $81,438
Initiatives.
Defense-Wide........................ National Defense $112,195 $144,841 $132,347 $153,907
Education Program.
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university research initiatives
The fiscal Year2023 budget request would cut University Research
Initiatives (URIs) across the military services and defense-wide. Given
that universities and colleges perform the majority (55 percent) of
DoD-funded basic research,\12\ the type of research that creates
paradigm shifts in DoD's technological capabilities, cutting URIs this
significantly will not only harm defense innovation efforts, but also
workforce development since basic research funding often attracts the
most creative minds in fields of critical interest to DoD.\13\
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\12\ https://ncses.nsf.gov/pubs/nsf21329.
\13\ https://dsb.cto.mil/reports/2010s/BasicResearch.pdf.
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A program within URIs, the Multidisciplinary University Research
Initiative (MURI), regularly produces revolutionary military
technologies and has become an essential skunkworks for creating
innovation.\14\ Unfortunately, the fiscal year 2023 budget request
would require cuts to MURIs at levels below fiscal year 2005, adjusted
for inflation. This will only exacerbate the fact that the program is
already dramatically underfunded. According to DoD, the MURI program
received 298 proposals in fiscal year 2021 but was only able to make 36
awards--leaving 262 proposals unfunded, including proposals with
potentially game-changing research projects due to a lack of
appropriations. Not funding potentially revolutionary defense
scientific research will hurt our ability to maintain global military
technological superiority.
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\14\ https://www.ida.org/idamedia/Corporate/Files/Publications/
IDA.../STD/D-5361.pdf.
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The situation is similar for the Defense University Research
Instrumentation Program (DURIP), which provides infrastructure and
equipment support to build universities' capacity to conduct defense-
relevant research. The fiscal year 2023 budget request would also cut
funding for DURIP. According to DoD, the DURIP program received 742
proposals in fiscal year 2021 but was only able to make 244 awards--
leaving a staggering 498 proposals unfunded due to a lack of
appropriations. If universities and colleges do not have the
infrastructure and equipment necessary to do unique defense research,
the DoD will potentially lose its biggest source of support for
developing new capabilities.
minerva research initiative
The Minerva Research Initiative is DoD's signature social science
basic research program that funds university-led teams to address
problems of strategic importance to U.S. national security. As noted by
DoD officials, because many national security challenges are driven by
complex social dynamics, Minerva is an important source of new ideas to
better understand social, behavioral, cultural, and political
considerations that are inherent to our security and stability. The
fiscal year 2023 budget request supports roughly the level appropriated
in fiscal year 2022 ($17 million).
This represents critical, renewed support will enable Minerva to
conduct research that is aligned with and critical to carrying out the
NDS in support of Department-wide priorities. Recently funded Minerva
projects, such as ``Russian Disinformation and Propaganda Campaigns''
and ``Empirical Analysis for Meeting Great Power Challenges'' have
given DoD unique insights that help shape future national security
policies and better position the warfighter to navigate a complex
global environment. Despite this exciting support, Minerva is another
underfunded defense basic research program. According to DoD, in fiscal
year 2021, Minerva received 220 applications but only funded 17--at
least 10 projects were determined to be worthy of funding but were not
funded due to a lack of appropriations.
defense applied research pe recommendations
Basic scientific research is just the first step in creating new or
improving existing military technologies. Researchers, scientists, and
engineers must apply the fundamental knowledge learned from basic
research to solve complex military problems and develop the systems and
components for potential solutions. To that end, we propose to
highlight the success of the Defense-Wide Manufacturing Science &
Technology PE, which the fiscal year 2023 budget requests provides a
mere $1 million increase compared to fiscal year 2022 enacted levels.
This PE provides DoD's contributions to the Manufacturing USA
Institutes that help move discoveries from the Nation's universities
and research laboratories to the defense industrial base while
strengthening the U.S. workforce. For example, DoD-funded institutes
have demonstrated enhanced heat exchange capabilities for additive
manufacturing, addressed cybersecurity supply chain issues, reduced
weight of armor for military ground vehicles, and developed a first-of-
its-kind advanced functional fiber to enable underwater
communications.\15\ In fiscal year 2020, the Manufacturing USA
Institutes conducted more than 500 major applied research and
development projects of high priority to broad industry sectors. In
addition, the network had more than 70,000 workers and students
participate in education and workforce development activities. The
Manufacturing USA Network is an exemplary program supporting
implementation of the NDS to enhance the domestic manufacturing and the
defense industrial base. In order to ensure that discoveries made
through basic research are translated into practical military
technologies and capabilities, we offer the following recommendations
for our priority applied research PEs.
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\15\ https://www.nist.gov/publications/manufacturing-usa-20192020-
highlights-report.
[$ in Thousands]
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Program Element
Agency--RDT&E (PE) CNSR FY23 Request
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Army......................... Lethality General Support
Technology.
Army......................... Soldier General Support
Lethality
Technology.
Army......................... Ground General Support
Technology.
Army......................... Next Generation General Support
Combat Vehicle
Technology.
Army......................... High General Support
Performance
Computing
Modernization.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Navy......................... Marine Corps General Support
Land Force
Technology.
Navy......................... Common Picture General Support
Applied
Research.
Navy......................... Warfighter General Support
Sustainment
Applied
Research.
Navy......................... Electromagnetic General Support
Systems
Applied
Research.
Navy......................... Ocean General Support
Warfighting
Environmental
Applied
Research.
Navy......................... Future Naval General Support
Capabilities
Applied
Research.
Navy......................... Manufacturing General Support
Technology
Program.
Navy......................... Advanced General Support
Undersea
Prototyping.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Air Force.................... Materials...... General Support
Air Force.................... Human General Support
Effectiveness
Applied
Research.
Air Force.................... Aerospace General Support
Sensors.
Air Force.................... Directed Energy General Support
Technology.
Air Force.................... Dominant General Support
Information
Sciences and
Methods.
Air Force.................... High Energy General Support
Laser Research.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
Defense-Wide................. Cyber Security General Support
Research.
Defense-Wide................. Defense-Wide General Support
Manufacturing
S&T Program.
------------------------------------------------------------------------
defense advanced research projects agency (darpa) recommendations
DARPA's ability to create truly revolutionary new capabilities is
well documented. AI, microelectronics, speech recognition, touchscreen
displays, unmanned aerial vehicles, and advanced wireless capabilities
all stem from DARPA-funded research. DARPA has worked with the academic
community to create the Internet, computer chips critical to AI
systems, self-driving cars, stealth technologies, metamaterials, and
neuro-prosthetics. More recently, DARPA's research was partially
responsible for developing RNA-based vaccines, which have been critical
in the global response to COVID-19.\16\ It is safe to say that the
world would be a different place without DARPA-enabled research. CNSR
strongly supports robust funding for DARPA. Consistent with the fiscal
year 2023 budget request, we recommend a funding level of $4.1 billion
for DARPA to continue supporting game-changing scientific research.
---------------------------------------------------------------------------
\16\ https://www.appropriations.senate.gov/imo/media/doc/
Tompkinspercent20Statementpercent
20Forpercent20Thepercent20Record.pdf.
---------------------------------------------------------------------------
Again, thank you for the opportunity to submit outside witness
testimony as you develop the fiscal year 2023 Defense Appropriations
bill. Please do not hesitate to contact us if we can be of any
assistance during the fiscal year 2023 appropriations process.
______
Prepared Statement of The HALO Trust and
Mines Advisory Group (MAG) America
As the world's largest humanitarian demining organizations, The
HALO Trust and Mines Advisory Group (MAG) America protect lives and
restore livelihoods for those threatened by explosive hazards. We
remove and destroy landmines, improvised explosive devices (IEDs) and
other explosive remnants of war and help secure weapons that could fall
into the hands of terrorist groups. For 20 years, HALO and MAG have
partnered with the U.S. Department of Defense's (DOD) Humanitarian
Demining Research and Development (HD R&D) Program in more than 10
countries and territories. This program, implemented by the U.S. Army,
specializes in developing and testing innovative technologies to detect
and clear landmines, unexploded ordnance (UXO), and IEDs. These
technologies increase the effectiveness, efficiency, and safety of
demining operations for military and humanitarian use--saving lives and
taxpayer money.
The HD R&D team designs technologies to respond to technical
challenges in the field, drawing from new commercial technology,
equipment currently in use by the DOD, and advanced sensor technology
available only through other DOD R&D programs. They then trial
prototypes in real field conditions through partnerships with the
Department of State's (DOS) humanitarian demining programs. During
field evaluations, operators provide feedback on the functionality and
effectiveness of the equipment. This allows HD R&D to modify and
improve the equipment and increase the U.S. technical capacity to
respond to explosive threats.
HD R&D produces four specific outcomes. First, the field evaluation
process collects data that helps to improve demining technologies used
by the U.S. Armed Forces and to support geographic combatant commands
in achieving humanitarian mine action objectives. Second, successfully
trialed equipment is used to train and equip explosive disposal units
of the U.S. military as well as allied militaries. By equipping partner
militaries to address their own explosive threats, U.S. soldiers are
more likely to remain out of harm's way. Third, HD R&D equipment saves
civilian lives from landmines, most frequently children, and amplifies
the impact of American assistance by increasing the amount of clearance
performed on DOS projects without increasing costs. Fourth, the HD R&D
program supports American jobs by utilizing American manufactured
machines and products when possible in their equipment development
process.
The HD R&D Program has a track record of success, having performed
nearly 250 operational field evaluations in 43 countries since 1995.
The program is responsible for developing advanced technology for the
Handheld Standoff Mine Detection System (HSTAMIDS), which combines
metal detection with ground penetrating radar, the rotary mine comb,
designed to efficiently excavate low metal content anti-vehicle mines,
and TRAXX, built to cut through hard-to-see tripwires and lift mines
from soil. Overall, HD R&D equipment has been used to clear more than
22,000 acres of land, and to destroy more than 396,300 mines and UXO.
As you know, HD R&D now receives funding from the following
account: Research, Development, Test & Evaluation, Army/Advanced
Component Development & Prototypes/PE: 0603920A/Program Title:
Humanitarian Demining. Due to strong bipartisan support, the program
received $19 million in Fiscal Year 2022. However, the FY23 President's
Budget proposes only $8.933 million for HD R&D, which would represent a
53 percent decrease from the previous year's appropriation, and the
lowest funding level in over 10 years. This proposed funding reduction
would substantially curtail the ability of the HD R&D program to
develop necessary demining equipment that would otherwise protect
members of the Armed Forces.
HD R&D equipment has created huge cost savings for humanitarian
demining programs managed by the State Department through increased
efficiencies. Through the deployment of HD R&D-developed HSTAMIDS
detectors, HALO's program in Zimbabwe estimates a cost savings of
approximately $16 million over the last 5 years and the program was
able to clear in 5 years what would have otherwise taken eight. The
Rebel Crusher, a mobile soil sifter and rock crusher used by MAG in
Lebanon and Iraq has allowed for mine clearance at a rate five times
faster than with a traditional demining team. Remote-controlled Robocut
machines, used to cut through tripwires in Ukraine, has accelerated
clearance rates by an estimated 400 percent. The Wirehound in
Afghanistan, used to identify hard-to-detect IED components, has
increased clearance by over 200 percent compared to traditional
methods. The FAE Mulcher, a vegetation clearing tool being used by MAG
in Cambodia, can clear 200 percent more area than a single deminer
using a handheld strimmer. Investing in resources for HD R&D will allow
humanitarian and military deminers to eliminate threats far more
quickly.
Innovative technology developed by HD R&D also protects deminers.
Advanced machines including the Mini MineWolf and the Medium MineWolf,
can operate remotely to physically destroy anti-personnel (AP) and
anti-tank (AT) landmines with no threat to demining personnel.
This program has a long list of unfunded projects it is waiting to
trial, including magnetic technology in Iraq, and HD R&D equipment will
also be essential to demining efforts in Ukraine, where technological
advancements could support the removal of removing anti-tank mines, and
clearing trenches and bunkers of explosives.
We appreciate the support this subcommittee has provided for this
valuable program, and urge the subcommittee to raise funding to a level
of $21 million in FY23 for HD R&D. This additional funding will improve
the ability of U.S. soldiers and our allies' ability to safely detect
and clear landmines, UXO, and IEDs. This funding is especially
important as new conflicts uncover new challenges in Ukraine and the
Middle East.
Thank you for your consideration of this request.
[This statement was submitted by Chris Whatley, Executive Director,
The HALO Trust (USA) and Jamie Franklin, Executive Director, Mines
Advisory Group (MAG) America.]
______
Prepared Statement of the Human Factors and Ergonomics Society
On behalf of the Human Factors and Ergonomics Society (HFES), we
are pleased to provide this written testimony to the Senate
subcommittee on Defense and Related Agencies for the official record.
HFES urges the subcommittee to provide robust funding levels for
Research, Development, Test, and Evaluation (RDT&E) at the Department
of Defense (DOD) in the fiscal year 2023 appropriations process.
Specifically, we urge the subcommittee to direct DOD to identify
opportunities across the services to transition human performance
research to defense RDT&E activities and acquisition programs to reduce
cost, strengthen force protection, reduce potential for re-engineering,
and enhance training.
HFES and its members believe strongly that investment in scientific
research serves as an important driver for innovation and the economy,
and for maintaining American global competitiveness. Accordingly, we
thank the subcommittee for its longtime recognition of the value of
scientific and engineering research, and its contribution to innovation
in the U.S.
the value of human factors and ergonomics science
HFES is a multidisciplinary, professional association with over
4,500 individual members worldwide, including psychologists,
scientists, engineers, and designers, all with a common interest in
designing safe and effective systems and equipment that maximize and
adapt to human capabilities.
For over 50 years, the U.S. Federal Government has funded
scientists and engineers to explore and better understand the
relationship between humans, technology, and the environment.
Originally stemming from urgent needs to improve the performance of
humans using complex systems such as aircraft during World War II, the
field of human factors and ergonomics (HF/E) works to develop safe,
effective, and practical human use of technology. HF/E does this by
developing scientific approaches for understanding this complex
interface, also known as ``human-systems integration.'' Today, HF/E is
applied to fields as diverse as transportation, architecture,
environmental design, consumer products, electronics and computers,
energy systems, medical devices, manufacturing, office automation,
organizational design and management, aging, farming, health, sports
and recreation, oil field operations, mining, forensics, and education.
With increasing reliance by Federal agencies and the private sector
on technology-aided decision-making, HF/E is vital to effectively
achieving our National objectives. While a large portion of HF/E
research exists at the intersection of science and practice-that is,
HF/E is often viewed more at the ``applied'' end of the science
continuum-the field also contributes to advancing ``fundamental''
scientific understanding of the interface between human decision-
making, engineering, design, technology, and the world around us. The
reach of HF/E is profound, touching nearly all aspects of human life
from the health care sector, to the ways we travel, to the hand-held
devices we use every day.
human factors and ergonomics at the department of defense
HFES strongly believes that Federal investments in DOD-funded
research will have a direct and positive impact on national security,
the economy, and the overall safety and well-being of Americans. For
this, HFES supports robust funding for DOD RDT&E programs, including
HF/E research programs across the Services to encourage further
advancements in technology and safety, among other areas.
With the creation of the Department of Defense Human Factors
Engineering Technical Group (DOD HFE TAG), DOD has demonstrated the
value it places on the inclusion of HF/E-related research and has
acknowledged the benefit of interagency collaboration, as it relates to
RDT&E in this field. DOD HFE TAG is comprised of technical
representatives from DOD, the National Aeronautical and Space
Association (NASA), the Federal Aviation Administration (FAA), the
Department of Homeland Security (DHS), and the Department of Veterans
Affairs (VA).
The scope of this working group is broad, making its benefits
diverse. The goals of DOD HFE TAG are to:
--Provide a mechanism for the timely exchange of technical
information in the development and application of human factors
engineering.
--Enhance coordination among government agencies involved in HF/E
technology research, development, and application.
--Assist in the preparation and coordination of tri-service
documents, and sponsor in-depth interaction, which aids in
identifying HF/E technical issues and technology gaps.
In addition, the American National Standards Institute recently
approved ANSI/HFES 400-2021, the Human Readiness Level Scale in System
Development Process. This standard, created by HFES, defines the nine
levels of the Human Readiness Level (HRL) scale and provides guidance
for their application in the context of systems engineering and human
systems integration processes. The HRL scale both complements and
supplements the existing Technology Readiness Level scale to evaluate,
track, and communicate the readiness of a technology or system for safe
and effective human use.
HFES strongly believes that all DOD programs developing new
technologies should be required to report to the Department on the HRL
of their systems on an annual basis. The HRL should be reported for
each major component of new military systems, and should be used to
identify deficiencies and areas where additional attention to human-
system integration is warranted to reduce risks to program schedules,
human safety, and effectiveness. DOD's HRL scale should correspond to
the requirements set forth in ANSI/HFES 400-2021. By incorporating this
standard DOD will better understand if needed human-system integration
activities have been conducted before deploying new national security
systems and technologies.
Continuing to prioritize HF/E research at DOD, along with
incorporating the Department's use of the HRL system would undoubtedly
produce positive impacts on the safety and well-being of American
citizens.
conclusion
Given DOD's critical role in supporting fundamental research and
development across defense and engineering disciplines, HFES supports
robust funding levels for DOD RDT&E programs, especially those that
specifically fund human factors RDT&E activities, in fiscal Year2023 as
well as improvements to the inclusion of human systems integration in
acquisition programs. These investments fund important research
studies, enabling an evidence base, methodology, and measurements for
improving organizational function, performance, and design across
sectors and disciplines.
On behalf of the HFES, we would like to thank you for the
opportunity to provide this testimony. Please do not hesitate to
contact us should you have any questions about HFES or HF/E research.
HFES truly appreciates the subcommittee's long history of support for
scientific research and innovation.
[This statement was submitted by Christopher R. Reid, President and
Steven C. Kemp, CAE, Executive Director, Human Factors and Ergonomics
Society.]
______
Prepared Statement of the Joint Baltic American National Committee
Dear Chairman Tester, Ranking Member Shelby, and Members of the
subcommittee:
The Joint Baltic American National Committee, Inc. (JBANC),
representing the Baltic-American community, has worked closely with
Congress since 1961 to enhance United States policy towards Estonia,
Latvia, and Lithuania.
As the subcommittee considers appropriations for the fiscal year
2023, we remain very grateful for the unwavering and enduring support
that the United States has shown to the Baltic countries.
This week's NATO Summit in Madrid has only strengthened the
commitment of the United States and other allies to NATO's eastern
flank. On June 29, President Biden announced the following additional
long-term U.S. commitments to bolster European security with respect to
the Baltic region: enhancement of rotational deployments--which include
armored, aviation, air defense, and special operations forces--to
reinforce Baltic security, enhance interoperability, and demonstrate
the flexibility and combat readiness of U.S. forces. Furthermore, the
United States commits to maintaining a persistent, boots on the ground
presence in the region and will intensify training with our Baltic
allies to maintain combat-credible capabilities.
This support is extremely timely and is of great strategic
importance for Estonia, Latvia, and Lithuania, and sends an important
message of deterrence to Russia. U.S. security assistance remains
existentially critical for the Baltic countries in being able to defend
against escalating threats from Russia. The Baltic American community
is especially grateful for continued strong language on security
assistance to the Baltic countries' capability development in the draft
FY23 National Defense Authorization Act.
This year, S.3950, the bipartisan ``Baltic Defense and Deterrence
Act'' (BDDA) has been introduced to codify the Baltic Security
Initiative (BSI) into law, providing $250 million per fiscal year
(2023-2027) to strengthen the Baltic State's conventional military
capabilities, especially in reconnaissance, air defense, and maritime
domain awareness. This assistance comes at a critical time as Russia
continues to execute its illegal, brutal, and unprovoked invasion of
Ukraine and engages in increasing war-like rhetoric and actions against
our Eastern European allies. The bill will discourage further Russian
threats against NATO territory by demonstrating U.S. resolve for Baltic
security and providing credible military deterrence against Russian
military provocations along NATO's eastern borders. We urge the
subcommittee to support these levels for the Baltic countries.
The bill also supports enhanced U.S.-Baltic security and economic
ties. If enacted, it would provide $60 million per fiscal year (2023-
2027) to support the Baltic Security and Economic Enhancement
Initiative, which aims to mitigate economic coercion by Russia and
China, encourage new opportunities for foreign direct investment and
U.S. business ties, and bolster Baltic energy security needs.
We believe that this legislation is important to demonstrate to the
terrorist Kremlin regime that the Baltic region remains an important
U.S. national security interest. It will help emphasize the strong
connection between the Baltic countries and the United States,
particularly this year when the countries mark their 100 years of
diplomatic relations.
It bears repeating that every Estonian, Latvian and Lithuanian
knows that freedom cannot be taken for granted. Besides their ongoing
commitment to invest increasing amounts above 2 percent of GDP for
defense, the Baltic countries have been outstanding in delivering their
own stocks of weapons and materials to Ukraine to help that country
continue to defend itself.
Thank you for the opportunity to address the subcommittee, and for
your efforts on this important area in transatlantic security. We look
forward to working with you on this issue. If you or your staff have
any questions, please contact us.
[This statement was submitted by Karl Altau, Managing Director,
Joint Baltic American National Committee, Inc.]
______
Prepared Statement of Manufacturing Times Digital
On behalf of Manufacturing times Digital (MxD), the National Center
for Cybersecurity in Manufacturing, we are pleased to provide this
written testimony to Senate Appropriations subcommittee on Defense for
the official record.
MxD urges the subcommittee to provide at least an additional $6
million for CMMC \1\ Compliance for Cybersecurity in Manufacturing in
the fiscal year 2023 defense appropriations bill.\2\ It is essential
that the Nation prioritizes ensuring that small and medium-sized
manufacturers (SMMs) and enterprises (SMEs) are equipped with the
knowledge and tools to help them achieve and maintain Department of
Defense (DoD) CMMC compliance to protect sensitive national security
information throughout the defense industrial base and to maintain and
grow the number of suppliers within the defense industrial base.
---------------------------------------------------------------------------
\1\ Cybersecurity Maturity Model Certification. https://
www.acq.osd.mil/cmmc/index.html.
\2\ Program Element 0603680D8Z, Line 54, Defense Wide Manufacturing
Science and Technology Program.
---------------------------------------------------------------------------
Manufacturing Times Digital (MxD) is a DoD manufacturing innovation
institute focused on enhancing the global competitiveness of U.S.
manufacturing by developing and deploying advanced digital
manufacturing technologies, educating the present and future workforce,
and securing the U.S. supply base. MxD was launched in February 2014 as
the second national manufacturing innovation institute, a network known
as Manufacturing USA. Through our over 300 partnerships, which includes
the DoD, industry, academia, non-profit organizations, and other
government stakeholders, MxD integrates multiple digital technologies
and systems, helping manufacturers improve their operations and driving
systemic productivity improvements. Developing strong cybersecurity
practices among manufacturers only addresses part of the problem. For
the long term, MxD and its partners are focused on the development of a
U.S. workforce pipeline that can drive and support cybersecurity
hygiene in manufacturing.
mxd and the cybersecurity maturity model certification (cmmc)
MxD strongly believes that investment to help SMMs and SMEs reach
compliance with the CMMC framework is absolutely necessary to ensure
that they are not left behind when compliance is required for every
funding opportunity and contract receiver by October 2025. CMMC
framework of standards for cybersecurity practices across the Defense
Industrial Base (DIB), whose organizations contract with and support
the DoD. The goal of CMMC is to enhance the protection of national
security information, including Federal Contract Information (FCI) and
Controlled Unclassified Information (CUI), across the supply chain
through a standard assessment model and framework for compliance. The
CMMC program was developed in response to concerns about cyberattacks
against potentially vulnerable contractors and organizations that
support DoD.
Earlier this year, Deputy Secretary of Defense Kathleen Hicks
warned that over the last 10 years, the U.S. defense industrial base
lost more than 40 percent of its suppliers and that further attrition
is possible if that trend continues.\3\ Investment to ensure that
cybersecurity compliance does not become a barrier to entering or
remaining in the defense industrial base must be made now.
---------------------------------------------------------------------------
\3\ Pentagon worried about mergers, especially among hypersonic
weapons suppliers. https://www.defensenews.com/pentagon/2022/02/15/
pentagon-worried-about-mergers-especially-among-hypersonic-weapons-
suppliers/.
---------------------------------------------------------------------------
MxD, as the DoD-designated National Center for Cybersecurity in
Manufacturing (NCCM), is eager and equipped to help SMMs and SMEs not
only achieve appropriate CMMC status but also evaluate their current
cyber posture by identifying opportunities to improve upon their cyber
hygiene, and providing the appropriate tools to react to additional
requirements from DoD and the CMMC-AB. MxD respectively asks the
committee to consider funding a suite of resources for free to SMMs and
SMEs to help them comprehensively achieve and maintain all levels of
CMMC compliance. These will include:
--Webinars, videos, and other on-demand training content, vetted and
verified as CMMC-compliant to provide to manufacturers and DIB
entities within Illinois and beyond, including through
collaborative outreach efforts with organizations like the
Manufacturing Extension Partnerships and IMEC.
--Assessment tools to evaluate current cybersecurity posture and
identify security capabilities for hundreds of SMEs that
require improvements via a Plan of Action & Milestone document
resource and provide data to aggregate and understand the
changing picture of cybersecurity compliance within the DIB.
--Development and distribution of at least five new cybersecurity
roles, pathways, profiles, and training curriculum specific to
the cybersecurity needs of small businesses, expanding the
existing MxD Hiring Guide for Cybersecurity in Manufacturing.
--Recommended, MxD-approved lists of cybersecurity software and
products, such as VPNs, firewalls, server security suites,
endpoint protection, and more.
--Subscriptions to specialized MxD Cyber/NCCM content on the latest
developments in cybersecurity, cyber threats, and major issues
relevant to DIB manufacturing cybersecurity.
--Dedicated and vetted cybersecurity experts to facilitate tabletop
exercises providing validation and improvement opportunities to
SMMs with established security capabilities.
the value of cmmc compliance for smes and smms
With rapidly growing numbers of companies avoiding Federal
competitions because of onerous compliance requirements and a
corresponding glut cybersecurity information that requires specialized
knowledge for implementation that many companies do not possess, there
is no central clearinghouse for products, services, and resources
available to help SMMs achieve CMMC compliance. Without ample,
sophisticated, and accessible resources for CMMC compliance, the Nation
risks losing essential suppliers from the DIB because they do not want
to take on the burden and confusion of implementing CMMC requirements.
Given initial confusion during DoD's rollout of CMMC in 2020, the
simplification of its CMMC requirements in 2021 was a welcome change
for SMMs and SMEs. However, CMMC is still a burden to many businesses,
especially SMMs, who do not have resources or robust internal processes
for ensuring cybersecurity awareness and hygiene. While it's important
to ensure cybersecurity at every step of the supply chain, CMMC
requirements could limit future participation of SMMs and SMEs in the
DIB. That is why the implementation of a program proposed is crucial to
ensure that SMMs and SMEs continue to have a role in the future within
the DoD.
conclusion
Given MxD's role in supporting SMMs and SMEs across the country,
MxD respectfully requests the allocation of an additional $6 million of
funding for CMMC Compliance for Cybersecurity in Manufacturing within
the Defense-Wide Manufacturing Science and Technology Program to create
resources and tools to help them reach mandatory CMMC compliance.
On behalf of MxD, we would like to thank you for the opportunity to
provide this testimony. Please do not hesitate to contact us should you
have any questions. MxD truly appreciates the subcommittee's long
history of support of the USA Manufacturing Institutes and our work in
areas such as cyber, supply chains, 5G, and workforce development.
[This statement was submitted by Berardino Baratta, CEO, Federico
Sciammarella, President and CTO, and Jennifer Pilat, Vice President of
Strategy and Engagement, MxD.]
______
Prepared Statement of the National Congress of American Indians
On behalf of the National Congress of American Indians (NCAI),
thank you for this opportunity to provide testimony on fiscal year 2023
funding for the Department of Defense (DoD). DoD has a long and varied
history of relations with Tribal Nations and Tribal lands. Native
Americans' service in the military is disproportionately higher than
other groups' service. Yet, DoD operations have intersected and
impacted Tribal lands, creating a dichotomy of honor and service
alongside the destruction of cultural identity and resources. DoD also
administers government-wide programs critical to economic development
for Indian Country.
In 2018, the U.S. Commission on Civil Rights (USCCR) found that
Federal programs and services serving Indian Country continue to be
underfunded and Federal initiatives for Native Americans have regressed
in some ways.\1\ The USCCR report also States that many Native
Americans face unique challenges and harsh living conditions resulting
from the United States having removed their Tribal Nations to locations
without access to adequate resources and basic infrastructure upon
which their Tribal governments can foster thriving communities.\2\ In
its initial 2003 A Quiet Crisis report, the USCCR summarized the
funding shortfall to which Native Americans were subjected, stating
that, ``laws and policies are meaningless without resources to enforce
them. Resources are an important demonstration of the U.S. government's
commitment to its responsibilities, including the obligation to
preserve civil and other rights . . . [u]nder-funding violates the
basic tenets of the trust relationship between the [Federal] Government
and Native peoples and perpetuates a civil rights crisis in Indian
Country.'' \3\ Due to infringements on Tribal sovereign tax
jurisdiction, Tribal governments essentially have no tax base and are
currently unable to utilize traditional economic development tools-e.g.
tax abatements-to stimulate private sector investment. Instead, Tribal
Nations largely rely on economic development to generate the revenue
that other governments take for granted.
---------------------------------------------------------------------------
\1\ U.S. Commission on Civil Rights, Broken Promises: Continuing
Federal Funding Shortfall for Native Americans, 3-4, available at:
https://www.usccr.gov/files/pubs/2018/12-20-Broken-Promises.pdf,
accessed on: May 25, 2022.
\2\ Id. at 1.
\3\ Id. at 2.
---------------------------------------------------------------------------
Cross-referencing OMB Native American Crosscut data with
Appropriations Committee reports reveals that fiscal Year2022 spending
for Native American programs represents approximately 0.84 percent of
total regular budget authority, and approximately 0.01 percent of total
regular appropriations budget authority within this subcommittee's
jurisdiction. With Federal investment metrics such as these, it is no
surprise that Indian Country is in a State of catastrophe by national
standards.
Despite this chronic underinvestment, Indian Country is an
important economic contributor to national, State, and local
economies.\4\ Collectively, Tribal Nations comprise the 13 largest
employers in the United States, with Tribal businesses employing more
than 700,000 employees, providing economic opportunity for both Native
and non-Native workers.\5\ Evidence indicates that where Tribal Nations
are successful with economic development that poverty rates and other
health issues are lower, while educational outcomes and real per capita
income are higher.\6\ Further, revenue generated on Tribal lands
results in a spillover effect that supports local workforces and
generates tax revenue for surrounding communities.\7\ Ultimately,
prosperity for Indian Country increases market penetration across
sectors and productivity in the American labor market, as well as
improves outcomes associated with other Federal spending that maximize
value ratios of Federal input to desired output--in simple terms, good
governance.
---------------------------------------------------------------------------
\4\ Patrice H. Kunesh, Getting real about Indian Country--
surprising progress in the heartland, https://indiancountrytoday.com/
opinion/getting-real-about-indian-country-surprising-progress-in-the-
heartland, Accessed: April 6, 2022.
\5\ Id.
\6\ Id.
\7\ Id.
---------------------------------------------------------------------------
The Indian Financing Act Incentives Program, funded through the
annual Defense Appropriations law, provides funding for additional
compensation to Native-owned contractors or suppliers to promote
economic growth in Indian Country and fairness in government
contracting. In fiscal Year2022, the Indian Financing Act Incentives
Program received $25 million. Funding for the program has not received
an increase in the last 4 years, clearly indicating that the program
has lost purchasing power due to inflation. Similarly, American Indian
Procurement Technical Assistance Centers provide the training and
technical assistance necessary to enhance the successes of the Indian
Incentives Program; however, the program has similarly been flat-funded
at $4.5 million for the last four fiscal years. NCAI recommends that
Congress provide $50 million for the Indian Financing Act Incentives
Program and $5 million for American Indian Procurement Technical
Assistance Centers.
Past and current DOD operational and training activities have had
and continue to have an adverse effect on Tribal environmental health
and safety, economic, social and cultural welfare. The Native American
Lands Environmental Mitigation Program (NALEMP) addresses environmental
impacts on Indian lands from former DOD activities seeking maximum
Tribal participation through government-to-government consultation.
NALEMP addresses the impacts of hazardous materials, munitions debris,
unsafe buildings or structures, lead-based paint or asbestos, and
abandoned equipment. Unfortunately, the program has been flat-funded at
$12 million per year since 1993, losing more than half of its
purchasing power due to inflation. NCAI recommends that Congress
provide at least $25 million for the mitigation of ongoing
environmental impacts on Indian lands resulting from DOD activities.
conclusion
Our people have paid for every penny obligated to Indian Country
hundreds of times over by providing this nation with our land. In order
for this nation to uphold its promises to its people, it must first
uphold its promise to this land's First People. We expect to continue
to be treated as sovereign nations and with governmental parity. When
we work together, we can achieve so much. We must now continue down
that path of Nation-to-Nation growth-only then will all of our people
be able to fully flourish.
[This statement was submitted by Larry Wright, Jr., Director of
Leadership
Engagement and Interim CEO, National Congress of American Indians.]
______
Prepared Statement of the Neurofibromatosis Network
Thank you for the opportunity to submit testimony to the
subcommittee on the importance of continued funding for the Department
of Defense's Peer-reviewed Neurofibromatosis (NF) Research Program
(NFRP). NF is a terrible genetic disorder closely linked to many common
diseases widespread among the American population. The highly
successful Neurofibromatosis Research Program has shown tangible
results and direct military application with broad implications for the
general population.
On behalf of the Neurofibromatosis (NF) Network, a national
organization of NF advocacy groups, I speak on behalf of the 120,000
Americans who suffer from NF as well as the millions of Americans who
suffer from diseases and conditions linked to NF such as cancer, brain
tumors, heart disease, memory loss, bone abnormalities, deafness,
blindness, and psychosocial disabilities, such as autism and learning
disabilities. Thanks in large part to this subcommittee's strong
support, scientists have made enormous progress since the discovery of
the NF1 gene in 1990 resulting in clinical trials now being undertaken
by the NFRP.
In fiscal year 2023, we are requesting at least $25 million for the
Peer-reviewed Neurofibromatosis Research Program (NFRP). The NFRP is
now conducting clinical trials at nation-wide clinical trials centers
created by NFRP funding. These clinical trials involve drugs that have
already succeeded in eliminating tumors in humans and rescuing learning
deficits in mice. In addition, in March 2020, the Food and Drug
Administration approved the first ever drug, co-developed by NIH and
AstraZeneca, with seed money from the NFRP, for the treatment of
plexiform tumors in neurofibromatosis type 1 (NF1). Administrators of
the Army program have stated that the number of high-quality scientific
applications justify a much larger program. For these reasons, it is
imperative that we continue to invest in research if we are to advance
toward treatments and a cure for the numerous diseases associated with
NF.
what is neurofibromatosis (nf)?
NF is an unpredictable genetic disorder of the nervous system that
affects almost every organ system in the body. There are three types of
NF: NF1, which is more common, NF2, which initially involves tumors
causing deafness and balance problems, and Schwannomatosis, the
hallmark of which is severe pain. NF causes tumors to grow along nerves
including in the skin, just below the skin, and in the brain and spinal
cord. NF is the most common neurological disorder caused by a single
gene and affects more people than Cystic Fibrosis, hereditary Muscular
Dystrophy, Huntington's disease and Tay Sachs combined. It strikes
worldwide, without regard to gender, race or ethnicity. Approximately
50 percent of new NF cases result from a spontaneous mutation in an
individual's genes and 50 percent are inherited.
NF can cause a myriad of devastating clinical problems including
nerve and brain tumors; disfiguring skin growths; inability to heal
after bone fracture, which may ultimately require amputation;
psychosocial disabilities, including autism and learning disabilities;
unmanageable chronic pain; deafness; blindness; cardiovascular defects;
vascular disease; and paralysis. NF gene mutations are also important
'drivers' of cancers in the lungs, liver, brain and breast.
nf's connection to the military
Neurofibromatosis (NF) has become a clinical 'model' for advancing
medical research. The genetic information learned from NF holds the key
to understanding a number of health issues that benefit the war
fighter, as well as the general population, including cancer, bone
fracture and repair, vascular disease, nerve regeneration, behavior and
psychosocial issues, and pain.
The Neurofibromatosis Research Program (NFRP) is providing critical
research that directly benefits the War Fighter including:
Bone Repair.--At least a quarter of children with NF1 have abnormal
bone growth in any part of the skeleton. In the legs, the long bones
are weak, prone to fracture and unable to heal properly; this can
require amputation at a young age. Adults with NF1 can have low bone
mineral density, placing them at risk of skeletal weakness and injury.
The NFRP is a strong supporter of NF1 bone defects research and as a
result this field has made significant progress in the past few years.
Bone fractures sustained by the war fighter and how to repair them is
of interest to the military. Research studies will identify new
information about understanding bone biology and repair and will pave
the way to new strategies to enhancing bone health and facilitating
repair.
Pain.--Severe and unmanageable pain is seen in all forms of NF,
particularly in schwannomatosis, and significantly impacts quality of
life. NF research has shown similarities between NF pain and phantom
limb pain. NFRP funding has been critical in supporting this. Chronic
pain, and how to treat it effectively, is one of the most poorly
understood areas of medicine but has very high relevance to those in
the military recovering from service-related injuries. NF Research in
this area could help identify new ways to target pain effectively with
the right drugs or therapies.
Vascular Disease.--NF1 elevates the risk of vascular disease
including aneurysm, stroke and vessel occlusive disease. NF1
predisposes patients to early cardiovascular disease, which is also the
leading cause of death among United States Veterans. NF research has
demonstrated that when treating affected NF mouse models with an
antioxidant medication it reduced vessel disease. Discoveries related
to cardiovascular disease in NF1 are likely to be more broadly
informative, including for veterans and active duty military personnel.
Psychosocial and Cognitive Disabilities.--In the last couple of
years, NFRP research has revealed common threads between NF1 learning
disabilities, autism and other related disabilities. Research being
done within the NF Clinical Trials Consortium, NFRP created clinical
centers, has led to important findings and expanded research in this
area. This research contributes to our broadening understanding of how
brain signaling can impact on behavior and psychosocial difficulties.
Members of the military returning from service can suffer from
psychological trauma and it is not easy to understand how this can be
effectively treated. As we learn more from the NF population about
psychosocial function, we will be able to shed light on this area for
the benefit of the military.
Nerve Tumors and Repair.--Nerves are the most common location for
tumor development amongpatients with NF1, NF2, and schwannomatosis.
Tumor growth alone, or treatments for the same, commonly cause nerve
injury and associated deficits. Identifying mechanisms to improve
nerverepair would benefit patients with NF, as well as advance the
science needed to better treat nerve injury common in warfighters.
dod' contribution to nf research
While other Federal agencies support medical research, the
Department of Defense (DoD) fills a special role by providing peer-
reviewed funding for innovative and rewarding medical research through
the Congressionally Directed Medical Research Program (CDMRP). CDMRP
research grants are awarded to researchers in every State in the
country through a competitive two-tier review process. These well-
executed and efficient programs, including the NFRP, demonstrate the
government's responsible stewardship of taxpayer dollars.
Recognizing NF's importance to both the military and to the general
population, Congress has given the NF Research Program strong
bipartisan support. From FY1996 through FY2022 funding for the NFRP has
amounted to $402.85 million, in addition to the original $8 million
appropriated in FY1992. In addition, between FY1996 and FY2020, 451
awards have been granted to researchers across the country.
The CDMRP funds innovative, groundbreaking research which would not
otherwise have been pursued, and has produced major advances in NF
research, including conducting clinical trials in a nation-wide
clinical trials infrastructure created by NFRP funding, development of
advanced animal models, and preclinical therapeutic experimentation.
Because of the enormous advances that have been made as a result of the
NFRP, research in NF has truly become one of the great success stories
in the current revolution in molecular genetics. In addition, the
program has brought new researchers into the field of NF. However,
despite this progress, Army officials administering the program have
indicated that they could easily fund more applications if funding were
available because of the high quality of the research applications
received.
In order to ensure maximum efficiency, the Army collaborates
closely with other Federal agencies that are involved in NF research,
such as the National Institutes of Health (NIH). Senior program staff
from the National Institute of Neurological Disorders and Stroke
(NINDS), for example, sit on the Army's NF Research Program Integration
Panel which sets the long-term vision and funding strategies for the
program. This assures the highest scientific standard for research
funding, efficiency and coordination while avoiding duplication or
overlapping of research efforts.
Thanks in large part to this subcommittee's support, scientists
have made enormous progress since the discovery of the NF1 gene. Major
advances in just the past few years have ushered in an exciting era of
clinical and translational research in NF with broad implications for
the general population. These recent advances have included:
--In March 2020 the Food and Drug Administration approved the first
ever drug, co-developed by NIH and AstraZeneca, with seed money
from the NFRP, for the treatment of plexiform tumors in
neurofibromatosis type 1 (NF1).
--Phase II and Phase III clinical trials involving new drug therapies
for both cancer, hearing tumors, vision tumors, bone graft and
cognitive disorders.
--Establishment of the Neurofibromatosis Clinical Trial Consortium
which includes an operation center and 25 clinical sites.
Allows for partnerships with well-established NF Centers,
pooling expertise and resources, quicker turn arounds of
scientific reviews and regulatory approvals, leveraged work
with pharmaceutical companies all towards the common goal of
new treatments and a cure for Neurofibromatosis.
--Successful elimination of tumors in NF1 and NF2 mice with the same
drug.
--Development of advanced mouse models showing human symptoms.
--Rescue of learning deficits in mice with an already existing well
known drug.
--Determination of the biochemical, molecular function of the NF
genes and gene products.
--Connection of NF to numerous diseases because of NF's impact on
many body functions.
fiscal year 2023 request
The highly successful NF Research Program has shown tangible
results and direct military application with broad implications for the
general population. The program has now advanced to the translational
and clinical research stages, which are the most promising, yet the
most expensive direction that NF research has taken. Therefore,
continued funding is needed to continue to build on the successes of
this program, and to fund this promising research thereby continuing
the enormous return on the taxpayers' investment.
We respectfully request that you include at least $25 million in
the Fiscal Year 2023 Department of Defense Appropriations bill for the
Peer-reviewed Neurofibromatosis Research Program. With this
subcommittee's continued support, we will prevail. Thank you for your
support.
[This statement was submitted by Kim Bischoff, Executive Director,
Neurofibromatosis Network.]
______
Prepared Statement of the Society of Gynecologic Oncology
The Society of Gynecologic Oncology (SGO) appreciates the
opportunity to provide outside witness testimony to the Senate
Committee on Appropriations subcommittee on Defense for the fiscal year
2023 defense appropriations bill. As you begin work on fiscal year 2023
appropriations, we respectfully request that you provide $50 million
for the Department of Defense (DoD) Ovarian Cancer Research Program and
establish a separate line-item program for endometrial cancer research
under the Congressionally Directed Medical Research Program (CDMRP)
with $10 million in initial appropriations.
The SGO is the premier medical specialty society for health care
professionals trained in the comprehensive management of gynecologic
cancers. The SGO's 2,000 members, who include physicians, nurses, and
other advanced practice providers, represent the entire oncology team
dedicated to the treatment and care of patients with gynecologic
cancers. The SGO's strategic goals include advancing the prevention,
early diagnosis, and treatment of gynecologic cancers by establishing
and promoting standards of excellence. Key priorities for the SGO are
to advocate for more equitable care for all patients and to support
research aimed at improving outcomes for diverse patient populations.
appropriate $50 million for the dod ovarian cancer research program
Ovarian cancer is the fifth leading cause of cancer-related death
in women and the deadliest of gynecologic cancers. More than 85 percent
of women are diagnosed in later stages because there is currently no
early detection test for ovarian cancer. Consequently, nearly 25
percent of women diagnosed with ovarian cancer will die within a year,
and less than 50 percent will survive 5 years. In the military,
gynecologic cancers represent 12 percent of all cancer identified in
women, and ovarian cancer is one of the most common diagnoses.\1\
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\1\ Leah L. Zullig, PhD, MPH, Karen M. Goldstein, MD, MSPH, Kellie
J. Sims, PhD, MS, Christina D. Williams, PhD, Michael Chang, MD, Dawn
Provenzale, MD, MHS, and Michael J. Kelley, MD5, J Womens Health
(Larchmt). 2019 Feb 1; 28(2): 268-275.
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The DoD Ovarian Cancer Research Program (OCRP) continues to support
high impact, innovative research that promotes readiness for military
members and their families, as well as the overall health of all
Americans. The OCRP not only supports research to address health
disparities and improve access to quality care and treatment for those
diagnosed with ovarian cancer, but it also aims to develop and improve
screening and diagnostic methods. The program has funded key studies
that have led to new discoveries and advancements in the treatment and
understanding of ovarian cancer, including the Food and Drug
Administration (FDA) approval of Rucaparib, an oral therapy for the
treatment of advanced ovarian cancer, and OVA1, a blood test combined
with imaging to identify patients at risk for malignant ovarian cancer.
To date, the OCRP has resulted in over 1,583 peer-reviewed publications
and 103 patent applications.
For these reasons, the SGO is thankful that Congress provided $45
million for the DoD OCRP in fiscal year 2022, and we request that you
provide $50 million in fiscal year 2023 to preserve current and support
future investments in ovarian cancer research. This funding will help
to advance studies suspended by the COVID-19 pandemic and allow for the
pursuit of new research to improve the early diagnosis, treatment, and
survival rates from ovarian cancer.
support endometrial cancer research by creating a dedicated funding
line
Endometrial cancer is the most common gynecological cancer and the
fourth most common cancer in women. Endometrial cancer has increased in
the U.S from 40,000 to over 60,000 new cases in the past 10 years. The
Centers for Disease Control and Prevention reports that endometrial
cancer deaths have increased 21 percent since 1999.\2\ Its incidence
and mortality rates are continuing to rise, and the American Cancer
Society estimates that in 2022 there will be approximately 65,950 new
cases of endometrial cancer in this country and approximately 12,550
U.S. women will die from this disease.
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\2\ Henley SJ, Miller JW, Dowling NF, Benard VB, Richardson, LC.
Uterine cancer incidence and mortality--United States, 1999-2016. MMWR
Morb Mortal Wkly Rep 2018; 67(48): 1333-1338.
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Greater prevalence of key risk factors, such as obesity and shifts
in reproductive trends among women, including delayed childbirth and
having fewer children, are believed to be contributing to the increased
incidence of endometrial cancer. While other cancers have shown
improvements in the number of deaths over time, the National Cancer
Institute's Surveillance, Epidemiology and End Results Program shows a
worsening survival rate from endometrial cancer for 1996-2016.\3\
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\3\ National Cancer Institute. Surveillance, Epidemiology, and End
Results Program. Cancer Stat Facts: Uterine Cancer. Available at:
https://seer.cancer.gov/statfacts/html/corp.html. Last queried February
13, 2020.
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Further, endometrial cancer has a disparate impact on women of
color as the incidence rate for Black women surpassed that of White
women in 2007 and continues to increase each year.\4\ The incidence of
the more aggressive Type II cancers is dramatically higher for Black
women than for White women. Mortality rates and 5-year survival rates
are also much worse for Black women. The age-adjusted mortality among
Black women is approximately 84 percent higher.\5\
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\4\ Clarke MA, Devesa SS, Harvey SV, Wentzensen N. Hysterectomy-
corrected uterine corpus cancer incidence trends and differences in
relative survival reveal racial disparities and rising rates of
nonendometrioid cancers. J Clin Oncol 2019; 37(22): 1895-1908.
\5\ Ries LAG, Eisner MP, Kosary CL, eds, et al. SEER cancer
statistics review, 1973-1998. Bethesda, MD: National Cancer Institute;
2001. [Google Scholar]
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The Veterans Health Administration (VHA) is a high-volume provider
of cancer care and women are the fastest growing patient population
utilizing VHA services, growing from 159,810 in 2001 to over 550,000
today.\6\ In the U.S. military, there are over 213,000 women who
currently serve as active-duty personnel, accounting for 16 percent of
the total force, and Black women now constitute nearly one third of all
women in the U.S. armed forces.\7\ In 2010, the Journal of Women's
Health reported that among women treated in the VHA, gynecologic
cancers were 12 percent of all cancer identified in women in the VA
system. Among gynecological cancers, endometrial cancer was the most
diagnosed, followed by ovarian, cervical, and other gynecological
malignancies.\8\ Based on this data, the military population should
experience a similar increase in endometrial cancer rates as in the
general population.
---------------------------------------------------------------------------
\6\ https://www.womenshealth.va.gov/WOMENSHEALTH/
WomensHealthServices/healthcare_
about.asp.
\7\ Eileen Patten and Kim Parker, Women in the U.S. Military:
Growing Share, Distinctive Profile, Pew Research Center, 2011, http://
www.pewsocialtrends.org/2011/12/22/women-in-the-u-s-military-
growingshare-distinctive-profile/; Office of the Assistant Secretary of
Defense for Personnel and Readiness, Department of Defense, Population
Representation in the Military Services Annual Report, 2013.
\8\ Leah L. Zullig, PhD, MPH, Karen M. Goldstein, MD, MSPH, Kellie
J. Sims, PhD, MS, Christina D. Williams, PhD, Michael Chang, MD, Dawn
Provenzale, MD, MHS, and Michael J. Kelley, MD5, J Womens Health
(Larchmt). 2019 Feb 1; 28(2): 268-275.
---------------------------------------------------------------------------
The SGO believes the pace of discovery in endometrial cancer
research is inadequate given the poor progress in reversing endometrial
cancer incidence and mortality and the well-documented disparities in
endometrial cancer. A new DoD endometrial cancer research program will
advance endometrial cancer research by enhancing and sustaining the
pool of endometrial cancer scientists, reduce the risk of endometrial
cancer, and improve patient outcomes and survival rates for all women,
particularly women of color, impacted by the disease.
conclusion
Thank you again for the opportunity to submit testimony to the
Committee as you begin your work on the fiscal year 2023 appropriations
bills. We look forward to working with you to protect the health needs
of our military and veteran population.
______
Prepared Statement of the TriService Nursing Research Program
We are writing to ask you to consider an issue critical to military
health care in the FY23 NDAA budget: line-item funding in the DHP
budget and an increase to $12 million for the TriService Nursing
Research Program (TSNRP), a program that continues to have a positive
effect on servicemembers and the health care professionals that care
for them and their families.
TSNRP has a 30-year history of providing value-added research
conducted by PhD prepared active duty, reserve component and retired
military nurses on relevant healthcare issues that are important to
servicemembers and their families, as well as combat-related care not
replicated elsewhere in the DHA or civilian medicine. TSNRP is the
Nation's first and only Federal research program that supports military
nurses to conduct research on the reserve and active-duty populations
and translate that knowledge into evidence-based practices. Neither the
NIH/National Institute of Nursing Research nor the VA fund research on
this population.
Since its inception in 1992, TSNRP funding levels have remained
static; in the past two decades, funding remained at $6M annually.
TSNRP has been funded either through congressionally directed funding
or by DOD, through use of USUHS O&M dollars that are fungible and
movable to meet other needs. Though authorized in 10USC 2116, TSNRP has
an uncertain future should budget cuts force the elimination of this
valued research program as was the case in FY20. Without this program,
there is no dedicated funding stream for military nurse researchers to
continue the vital research that has saved lives and significantly
improved the care of our Nation's warfighters. It is time to place
TSNRP in its own line item in the budget to ensure its sustainability
and to raise the funding level so more studies by nurse researchers can
be funded. We need your support to increase funding for TSNRP ($12M)
and create a line item for it in the NDAA budget for FY23 and into the
24-26 FYDP.
Military nurses have been conducting research to improve force
readiness and patient care since the 1950s. With the financial support
of the TSNRP in the 1990s, military nursing research has expanded with
notable results. TSNRP also supports the dissertation research and
translation projects of military doctoral students in nursing schools
around the country to improve health and quality of life outcomes for
servicemembers and their families. TSNRP requires that funded
researchers provide mentorship to new researchers, ensuring knowledge
and skills are passed from year to year and along generations of
military researchers.
Select TSNRP Discoveries
--Home-based and field therapy with self-managed electrical
stimulation devices relieving both knee and back pain, helping
service members return to duty more quickly and maintain Force
Readiness.
--Specific ventilator settings result in better methods of weaning
patients from life support.
--CoQ10 supplements decrease brain cell injury, potentially
mitigating TBI.
--Powdered clotting agents stop hemorrhage in wounded soldiers,
saving lives after severe blood loss from injury on the
battlefield.
--Pocket devices allowing women on the battlefield to care for
personal and hygiene needs without embarrassment.
--Certain transport litters decrease the chance of skin ulcers in
wounded service members while in field situations and in
transport to fixed military facilities.
--Blood markers exist for genetic Vitamin D deficiency, and Vitamin D
supplements in this population improves bone health, reducing
stress fracture injuries that often occur during physically
demanding military training.
--Mental and ethical preparation and resilience training helps
service members function better mentally and emotionally in
combat, and upon returning home.
--Complementary treatment modalities such as acupressure can be done
in field settings.
--Soldiers who receive their care in Soldier Centered Medical Homes
recover and resume basic training more quickly than those who
receive care in a typical medical clinic.
--Better nurse staffing in military hospitals is associated with
fewer medication errors. Burnout in military nurses is linked
to low quality of patient care, job dissatisfaction and intent
to leave the job and/or the military. Ongoing TSNRP-funded
research during the pandemic will provide an update on the
military nurse workforce.
Select TSNRP Outcomes
--TSNRP research assisted families to cope with deployment; addressed
gaps in care for active-duty women; ameliorated long-term
effects of PTSD on family caregivers; improved the quality of
life for burn survivors; and improved patient safety.
--The TSNRP Women's Health Research Interest Group (WHRIG) recently
hosted the inaugural virtual Women in Combat Seminar, which
provided education to thousands of participants globally and
included topics such as operational performance, mission
readiness, and health and well-being.
--TSNRP has been the leader in evidence-based practice and
implementation science in the military healthcare system. The
program funds not only research, but also supports education
and guidance to implement the research. It aims to ensure that
nurses are using the most up-to-date practices to provide
beneficiaries the best care possible on the battlefield, in
transport, and in military facilities.
In summary, TSNRP funded research has been responsible for enhanced
injury resuscitation protocols, improved air-evacuation processes,
increased readiness of warfighters through bench science research,
behavioral and nutritional research, and widespread implementation of
evidence-based practices. One need only peruse the funded studies to
find sophisticated methodologies in a far-reaching array of research
from TSNRP funded scientists. For more about TSNRP, visit the website
at www.triservicenurse.org.
[This statement was submitted by MG (Ret) Margaret C. Wilmoth, U.S.
Army Reserve; BG (Ret) William Bester, U.S. Army; COL (Ret) Patricia A.
Patrician, U.S. Army; LTC (Ret) Deborah Kenny, U.S. Army; Maj. (Ret)
Linda Schwartz, U.S. Air Force.]