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Senate Hearings Before the Committee on Appropriations

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Senate Hearings Before the Committee on Appropriations S. HRG. 111–122 Senate Hearings Before the Committee on Appropriations Department of Defense Appropriations Fiscal Year 2010 111th CONGRESS, FIRST SESSION H.R. 3326 DEPARTMENT OF DEFENSE NONDEPARTMENTAL WITNESSES Department of Defense Appropriations, 2010 (H.R. 3326) S. HRG. 111–122 DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010 HEARINGS BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE ONE HUNDRED ELEVENTH CONGRESS FIRST SESSION ON H.R. 3326 AN ACT MAKING APPROPRIATIONS FOR THE DEPARTMENT OF DEFENSE FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2010, AND FOR OTHER PURPOSES Department of Defense Nondepartmental Witnesses Printed for the use of the Committee on Appropriations ( Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html U.S. GOVERNMENT PRINTING OFFICE 48–290 PDF WASHINGTON : 2009 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 COMMITTEE ON APPROPRIATIONS DANIEL K. INOUYE, Hawaii, Chairman ROBERT C. BYRD, West Virginia THAD COCHRAN, Mississippi PATRICK J. LEAHY, Vermont CHRISTOPHER S. BOND, Missouri TOM HARKIN, Iowa MITCH MCCONNELL, Kentucky BARBARA A. MIKULSKI, Maryland RICHARD C. SHELBY, Alabama HERB KOHL, Wisconsin JUDD GREGG, New Hampshire PATTY MURRAY, Washington ROBERT F. BENNETT, Utah BYRON L. DORGAN, North Dakota KAY BAILEY HUTCHISON, Texas DIANNE FEINSTEIN, California SAM BROWNBACK, Kansas RICHARD J. DURBIN, Illinois LAMAR ALEXANDER, Tennessee TIM JOHNSON, South Dakota SUSAN COLLINS, Maine MARY L. LANDRIEU, Louisiana GEORGE V. VOINOVICH, Ohio JACK REED, Rhode Island LISA MURKOWSKI, Alaska FRANK R. LAUTENBERG, New Jersey BEN NELSON, Nebraska MARK PRYOR, Arkansas JON TESTER, Montana ARLEN SPECTER, Pennsylvania CHARLES J. HOUY, Staff Director BRUCE EVANS, Minority Staff Director SUBCOMMITTEE ON DEFENSE DANIEL K. INOUYE, Hawaii, Chairman ROBERT C. BYRD, West Virginia THAD COCHRAN, Mississippi PATRICK J. LEAHY, Vermont CHRISTOPHER S. BOND, Missouri TOM HARKIN, Iowa MITCH MCCONNELL, Kentucky BYRON L. DORGAN, North Dakota RICHARD C. SHELBY, Alabama RICHARD J. DURBIN, Illinois JUDD GREGG, New Hampshire DIANNE FEINSTEIN, California KAY BAILEY HUTCHISON, Texas BARBARA A. MIKULSKI, Maryland ROBERT F. BENNETT, Utah HERB KOHL, Wisconsin SAM BROWNBACK, Kansas PATTY MURRAY, Washington ARLEN SPECTER, Pennsylvania Professional Staff CHARLES J. HOUY NICOLE DI RESTA KATE FITZPATRICK KATY HAGAN KATE KAUFER ELLEN MALDONADO ERIK RAVEN GARY REESE BETSY SCHMID BRIDGET ZARATE STEWART HOLMES (Minority) ALYCIA FARRELL (Minority) BRIAN POTTS (Minority) BRIAN WILSON (Minority) Administrative Support RENAN SNOWDEN (II) CONTENTS WEDNESDAY, MARCH 18, 2009 Page Department of Defense: Medical Health Programs .............................................. 1 WEDNESDAY, MARCH 25, 2009 Department of Defense: National Guard ................................................................................................. 117 Reserves ............................................................................................................ 171 TUESDAY, MAY 12, 2009 Department of Defense: Department of the Army: Office of the Secretary ........ 235 TUESDAY, JUNE 2, 2009 Department of Defense: Department of the Navy: Office of the Secretary ......... 279 THURSDAY, JUNE 4, 2009 Department of Defense: Department of the Air Force: Office of the Secretary .. 349 TUESDAY, JUNE 9, 2009 Department of Defense: Office of the Secretary .................................................... 399 THURSDAY, JUNE 18, 2009 Nondepartmental Witnesses ................................................................................... 469 (III) DEPARTMENT OF DEFENSE APPROPRIATIONS FOR FISCAL YEAR 2010 WEDNESDAY, MARCH 18, 2009 U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10:30 a.m., in room SD–192, Dirksen Senate Office Building, Hon. Daniel K. Inouye (chairman) pre- siding. Present: Senators Inouye, Murray, Cochran, and Bennett. DEPARTMENT OF DEFENSE MEDICAL HEALTH PROGRAMS STATEMENT OF LIEUTENANT GENERAL ERIC B. SCHOOMAKER, M.D., Ph.D., SURGEON GENERAL, U.S. ARMY MEDICAL COMMAND OPENING STATEMENT OF SENATOR DANIEL K. INOUYE Chairman INOUYE. I’d like to welcome all of the witnesses today as we review the Department of Defense (DOD) medical programs. There’ll be two panels this morning. First we’ll hear from the serv- ice surgeon generals: General Eric Schoomaker, Vice Admiral Adam Robinson, Jr., General James Roudebush. Then we’ll hear from our chiefs of the Nurse Corps: General Patricia Horoho, Rear Admiral Christine M. Bruzek-Kohler, and General Kimberly Siniscalchi. Did I get it correct? I’d like to welcome back all of the three surgeon generals to our subcommittee once again. I look forward to continuing our work to- gether to ensure the future of our military medical programs and personnel. As you may have noted, this is the first defense hearing that the subcommittee will be holding this year. We deliberately selected the medical programs as our inaugural topic to underscore the im- portance that this issue has to our subcommittee. Our surgeon gen- erals and the chiefs of the Nurse Corps have been called upon to share their insight on what is working and what is not working. Military medicine is a critical element in our defense strength. Our ability to care for our wounded soldiers on the modern battle- field is a testament both to the hard work and dedication of our men and women in uniform and to the application of the new tech- nology which is a hallmark of the U.S. armed forces, and so to our medical programs’ demonstrated commitment to provide for our servicemembers and their families, which is unsurpassed in any (1) 2 other military. It is a vital component in our military compensation package, one that is necessary to sustain the all-volunteer force, a force, I might add, which by all measurement is the finest in the world. This is a unique medical hearing because we have not received the details of the fiscal year 2010 DOD budget, nor have we re- ceived the remaining fiscal year 2009 supplemental request. While we may not be able to discuss detailed budget issues, we’ll focus on various medical personnel and medical technology issues facing the Department, our servicemembers and their families. On a personal note, when I was in the Army some time ago 4 percent of the men in my regiment were married, just 4 percent. I think that was about the average in the United States Army. Now 56 percent of the Army, 54 percent of the Navy, and 45 per- cent of the Marine Corps, and 59 percent of the Air Force are mar- ried. This completely alters the dynamic of the service I remember to the one you see today. Not only that, but the demographics of our servicemembers have drastically changed. We also have more than a few dual-service parents and couples, both of which deploy to theater. We’ve all read about the rising rates of suicide, divorce, sub- stance abuse in our military. This is not something that can only be addressed with the service member. This must be approached with the service member, their family, their fellow soldiers, sailors, marines, and airmen. The solutions are not one size fits all or one service fits all. Instead, all ideas must be on the table for everyone to consider. What works for the Army may not necessarily work for the Navy. In addition, we need to take a unified approach to medical re- search in areas directly tied to the warfighter that we are currently tackling and those that could be right around the corner. This co- ordinated approach should cross the entire Federal Government, utilizing the resources and expertise of the Department of Veterans Affairs, the National Institutes of Health, Department of Homeland Security, and the Substance Abuse and Mental Health Services Ad- ministration, just to name a few. The Department stands at a very pivotal juncture in its efforts to modernize the medical technology enterprise architecture. I’m certain each one of you can share a story or two about the various versions of the Department’s medical health records and how chal- lenging it can be, at the least. Now you are tasked to both mod- ernize the system and make it interoperable with the Veterans Ad- ministration (VA) to facilitate seamless transitions for our servicemembers and to enable joint DOD–VA locations to care for both veterans and servicemembers. These are not simple tasks and I know that there are many chal- lenges ahead. These are some of the issues we’ll face in the years ahead. We continue to hold this valuable hearing with the service surgeon generals and the chiefs of the Nurse Corps as an oppor- tunity to raise and address these and many other issues. I look forward to your statements and note that your full state- ments will be made part of the record. Before we proceed with witnesses, may I call upon the vice chair- man of the subcommittee, Senator Cochran. 3 STATEMENT OF SENATOR THAD COCHRAN Senator COCHRAN. Mr. Chairman, thank you very much. I’m pleased to join you in welcoming our two panels of witnesses today, the service surgeon generals and the chiefs of the Nurse Corps. We have an important duty to provide for the medical needs of our ac- tive, Guard, and Reserve personnel. The joint approach in man- aging the military medical programs has been very important in supporting our soldiers, sailors, airmen, and marines, especially during wartime. The men and women of the medical service corps deserve our thanks for their services they’ve provided and continue to provide. I’m pleased to join the chairman in being here to receive your testi- mony and working with you as we try to identify the priorities that need special attention in the funding cycle that we are approach- ing. Thank you very much. Chairman INOUYE. Thank you very much. I am especially pleased to have with us in the subcommittee this morning Senator Bennett of Utah. He’s our newest member. Wel- come, sir. Would you like to make a statement? Senator BENNETT.
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