The RAND Corporation recently published a groundbreaking report, Hidden Heroes America's Military Caregivers, which depicts the immense scope of military caregiver work in the United States as well as detailing the shortfalls of current veteran’s care policies and programs. The study distinguishes between healthcare providers and military caregivers, with the latter group assisting with activities related to daily living, rather than diagnosing or prescribing treatment. RAND estimates that 5.5 million military care givers support at least 3.8 million disabled veterans nationwide with roughly 20% of military caregivers assisting post-9/11 veterans. This article will provide a summary of the report’s key findings with respect to military caregivers and the efficacy military caregiver related of Government programs.
Blog
The National Defense Industrial Association (NDIA) recently hosted its 26th annual Special Operations/Low Intensity Conflict (SO/LIC) Symposium and Exhibition. The three day event hosted several notable speakers including: General Joseph L. Votel - Commander of US Special Operations Command (SOCOM), Lieutenant General Michael T. Flynn (Ret.) - former Director of the Defense Intelligence Agency, and Lieutenant General Marshall B. Webb, Commander - NATO Special Operations Headquarters. The event covered topics such as the challenges related to combating ISIL and a more assertive Russia, as well the increasing demand for Unmanned Aerial Vehicles (UAVs) and the growing desire for commercial off-the-shelf (COTS) technologies.
The threat posed by ISIL was at the centerpiece of many discussions between SO/LIC event speakers and panelists. General Votel stated that at least 19,000 foreign fighters have surged into Iraq and Syria from over 90 countries. Votel further added that SOCOM has been closely observing ISIL’s operations in North Africa. Similarly, Lieutenant General Flynn offered a stark appraisal of the threat posed by ISIL, and cautioned that the ongoing international effort to defeat the group would likely last decades.
Of all the measures outlined in the President’s latest state of the union address, the three measures below are the most likely to pass the Republican controlled Congress.
F/A-18F Super Hornets from Strike Fighter Squadron 22 operating from the USS Carl Vinson in support of Operation Inherent Resolve.
Image Credit: U.S. Navy photo by Petty Officer 2nd Class Scott Fenaroli
1. Authorization for the Use of Military Force (AUMF)
During his address, President Obama asked the Congress to pass an AUMF specific to combating ISIL in Iraq and Syria. The President has been in consultation with members of Congress with respect to a new AUMF since late December of 2014, and Speaker of the House John Bohner has indicated a vote will be held on the AUMF by spring of 2015 (Bennett, 2015). A point of contention between Congressional Republicans and Democrats in negotiating an AUMF is the level of discretion the bill will afford to the President, particularly the measures that would prohibit the deployment of ground troops.
The ISIL related AUMF will greatly augment the President’s legal justification for Operation Inherent Resolve, which has been previously justified by the nearly 14 year old AUMF passed after September 11th 2001. Since combat operations in late 2014, the US has launched over 1,800 airstrikes in both Syria and Iraq at a total cost of $1.2 billion.
The Department of Defense (DoD) is in the midst of selecting a vendor to overhaul its electronic health record (EHR) systems, which facilitate the transfer of information pertaining to patient’s medical history, conditions, prescriptions, and other data across multiple healthcare providers over time. The Healthcare Management Systems Modernization (DHMSM) program is projected to cost $11 billion through the year 2023. DHMSM will replace the DoD’s existing EHR system, the Armed Forces Health Longitudinal Technology Application (AHLTA), as well as elements of the Theater Medical Information Program-Joint (TIMP-J) and the inpatient Composite Health Care System. When DHMSM launches in 2017, it will become the largest EHR system in the United States, with more than 9.6 million patients associated with over 400 hospitals (Brewin, 2014).
Despite the relatively flat budget in recent years, the National Institutes of Health (NIH) is undergoing changes which will better equip the agency to collect and analyze large biomedical data sets. The cancelation of the NIH’s National Children’s Study (NCS) and the continued investment in the Big Data to Knowledge (BD2K) initiative is indicative of the agency’s efforts to adapt towards recent technological advancements in big data over older more conventional means of collecting biomedical data.
The Carl Levin and Howard P. McKeon National Defense Authorization Act (NDAA) for fiscal year (FY) 2015 passed the Senate Friday night by a bipartisan vote of 89-11, after the House passed the measure 300-119. The bill includes $495.9 billion for the Department of Defense’s (DoD) base budget, $63.7 billion overseas contingency operations (OCO) budget, and $17.9 billion for the Department of Energy related to maintaining the nation’s nuclear arsenal (Alexander, 2014). The FY 2015 NDAA also institutes a host of provisions related to curbing military benefits, creates a new DoD leadership position – the Under Secretary of Defense for Business Management and Information (USDBMI), and provides the Navy with billions in extra procurement funding.
The 2015 NDAA enacts measures to curtail rising DoD personnel costs, such as increasing co-pays related to prescription drugs by $3, decreasing pay raises to 1% - below the current rate of inflation, and prohibiting further wage raises for flag officers. Departing Chairman of the Senate Armed Services Committee Carl Levin expressed his concern that the spending caps imposed by sequestration, in conjunction with rising of personnel costs will erode military readiness.
The House Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies & the Subcommittee on Research and Technology recently held a joint hearing on the potential re-authorization of the Department of Homeland Security’s (DHS) Science and Technology (S&T) directorate. S&T’s objective is to develop new technologies for agencies under DHS such as the Transportation Security Administration, Coast Guard, Federal Emergency Management Agency, etc. to better protect the homeland from a wide variety of threats. Representatives from both committees were concerned on the level of redundant research programs within S&T’s $1.2 billion budget across DHS; Chairman Lamar Smith highlighted a government accountability office report which described S&T’s R&D management approach as “fragmented and overlapping.”
In fiscal year 2014 (FY14) the Defense Information Systems Agency (DISA) bought $8 billion worth of information technology and cyber products and services for the Department of Defense. During the DISA 2014 forecast to industry event, Major General (MG) Alan Lynn, Vice Director and Senior Procurement Executive at DISA, recently outlined his five main objectives with respect to ongoing and future procurement programs:
- Meet small business goals
- Increase competition
- Foster greater discipline in acquisition planning
- Leverage buying power via consolidation of like type items
- Review all procurements exceeding $10 million
With a net gain of at least seven seats in the Senate and the possibility of gaining another seat during the December runoff election in Louisiana, Republicans are expected to make several key Senate committee appointments in January, including:
- Sen. Richard Burr, R-NC for Chairman of the Intelligence Committee (current Chairwoman Dianne Feinstein, D-CA)
- Sen. Bob Corker, R-TN for Chairman of the Foreign Relations Committee (current Sen. Robert Menendez D-NJ)
- Sen. Jeff Sessions, R-Al for Chairman of the Budget Committee (current Chairwoman Sen. Patty Murray D-WA)
- Sen. Orrin Hatch, R-UT for Chairman of the Finance Committee (current Sen. Ron Wyden D-OR)
- Sen. James Inhofe, R-OK for Chairman of the Environment and Public Works Committee (SECWP)(current Chairwoman is Sen. Barbara Boxer D-CA)
- Sen. John McCain, R-AZ for Chairman of the Senate Armed Services Committee (SASC) from the current Sen. Carl Levin, D-MI
The Obama Administration has requested $1 billion in Department of Defense (DoD) reappropriations to augment efforts to contain the outbreak of Ebola in West Africa.
As of late October, the House Appropriations, House Armed Services, and Senate Armed Services committees have approved $750 million dollars in DoD reappropriations, which will come from the overseas contingency operations (OCO) budget, though the Senate Appropriations Committee (SAC) has yet to approve this request. Chairwoman Barbara Mikulski (D-Md.) announced the SAC will hold a hearing on Ebola reappropriations on November 6th, shortly after the midterm elections.
