INTRODUCTION
The United States military maintains superior readiness and is the best-trained and best-equipped fighting force in the world. Advanced weapons give U.S. armed forces tremendous advantages, but U.S. national security ultimately relies on the quality and commitment of the men and women who serve in uniform and of the civilian employees who support them. That is why the Department of Defense continues to place the highest priority on recruiting, training, developing, and supporting U.S. service members and the civilian workforce.
FORCE STRUCTURE AND MANPOWER LEVELS
The Department has been extremely successful in accomplishing its two overarching drawdown goals: to maintain a high state of readiness and to treat people fairly. Principal features of the drawdown strategy include synchronization of personnel reductions and unit inactivations to maintain readiness, strategic evaluation of workforce needs, caring for individuals, and the pacing of reductions to access the numbers of new recruits required to maintain the needed mix of experience, grade, and skills.
Military reductions continued as planned in FY 1995. These included an Air Force reduction of 26,000, an Army reduction of almost 33,000, and a Navy reduction of more than 34,000. Consequently, at the end of FY 1995, the Air Force had completed 91 percent of its drawdown, the Army 95 percent, and the Navy 79 percent. The Marine Corps achieved its drawdown strength objective at the end of FY 1994.
The success with which these significant reductions have been made can be attributed to the Department's strategy to maintain a close linkage between force structure and personnel management programs. For example, a rapid achievement of the force structure outlined in the Defense Bottom-Up Review required significant congressional cooperation and support for temporary separation incentive programs, approved early retirement authorizations, transitional assistance, and relief from statutory constraints. These programs have allowed orderly downsizing with due consideration of the human dynamics involved in such a massive undertaking. Minimizing involuntary separations remains central to the Department's plans; the vast majority of the reductions have been accomplished through voluntary measures, a tremendous accomplishment in the context of an all-volunteer force. This has resulted in a right-sized force providing challenging career opportunities and one that is cost-efficient and sustainable.
Civilian downsizing has also been successful. Since FY 1989, the Department has reduced the civilian workforce by approximately 24 percent or 269,000 civilians; more than 53,000 of these reductions occurred in FY 1995. The Department continues to pursue a civilian drawdown strategy that calls for cumulative reductions in the civilian workforce between FY 1989-2001 of approximately 35 percent. Minimizing involuntary separations by promoting voluntary incentives is also a key feature of the civilian drawdown strategy. Consequently, fewer than 10 percent of civilian reductions in the past two years were through involuntary separations, which are so costly in morale, productivity, time, and money. To achieve this result, the Department used a variety of tools provided by Congress, including hiring freezes, the Priority Placement Program, separation incentives, out-placement assistance, and collaborative ventures with the Department of Labor and the Office of Personnel Management.
RECRUITING HIGH QUALITY PEOPLE
A steady flow of new recruits is essential to maintain a personnel force with the proper distribution of skills, and to ensure the balance of age and experience that supports the attainment of readiness. Each Service must enlist and appoint enough people each year to sustain the force and ensure seasoned and capable leaders for the future. DoD annually must recruit about 200,000 youth to join the full-time, active duty armed forces, along with approximately 150,000 for the Selected Reserve. The Department estimates that over the next three years, non-prior service accession missions for the active force will increase more than 15 percent above current levels.
DoD values recruits with a high school diploma because years of research and experience show that those with a high school diploma are more likely to complete their initial three years of service. About 80 percent of recruits who receive a high school diploma will complete their first three years; yet only about 50 percent of those who failed to complete high school will make it. Those holding an alternative credential, such as a general equivalency diploma (GED), fall between these extremes. Over the past two years, more than 95 percent of all active duty recruits held a high school diploma, compared to the 75 percent of American youth, ages 18 to 23.
A separate indicator of quality is aptitude. All recruits take a written enlistment test, called the ASVAB (Armed Services Vocational Aptitude Battery). One component of that test is the Armed Forces Qualification Test, or AFQT, which measures math and verbal skills. Those who score at or above the 50th percentile on the AFQT are in Categories I-IIIA. DoD values these higher-aptitude recruits because their training and job performance are superior to those in the lower (below the 50th percentile) categories. Research shows a strong correlation between AFQT scores and on-the-job performance, as measured by hands-on performance tests (speed and accuracy of performing job-related tasks) across the range of occupations. Over 70 percent of recent recruits score above the 50th percentile of the nationally representative samples of 18-23 year olds.
Higher levels of recruit quality -- a traditional high school diploma which predicts perseverance, and higher aptitude which indicates performance potential -- serve to reduce attrition while increasing individual performance. In 1993, the Department established benchmarks, or floors, to sustain recruit quality. The figure above displays the recent success against those floors (90 percent high school diploma graduates; 60 percent top-half aptitude (Category I-IIIA)).
Challenges in a Changing Recruiting Environment
In recent years, American youth have shown declining interest in joining the military. Results from the 1995 Youth Attitude Tracking Study (YATS), however, show propensity was slightly higher than in 1994; 28 percent of 16-21 year-old men expressed positive propensity for at least one active duty Service, up from 26 percent in 1994. The Department remains concerned, however, because of the great demand placed on recruiters. According to the most recent recruiter survey, recruiter morale is down and stress is up -- most recruiters now work at least 60-hour weeks. Fortunately, Congress has authorized an increase of up to $100 monthly in recruiter special duty assignment pay, something recruiters surely have earned.
Over the past several years, enlistment propensity declined as the Services experienced serious cuts in recruiting resources. In FY 1994-95, recruitment advertising was increased, and the 1995 YATS results indicate a slight increase in propensity. Continued investment in recruiting and advertising resources is required, however, to assure that the pool of young men and women interested in the military will be available to meet Service personnel requirements in the future.
Congress increased the Department's advertising budget for FY 1995 and 1996 to help ensure American youth are acquainted with opportunities in the armed forces. In spite of U.S. armed forces downsizing, American youth need to receive the message the military remains not only one of the nation's largest employers, but also one of its best!
National Service and Recruiting Programs
The Department explored the impact of National Service on military recruiting and concluded that the two programs can coexist successfully because the National Service program's size is modest, and the value of its benefits is lower in comparison with enlistment benefits offered by the military. Therefore, DoD believes both programs are correctly sized and structured. Anecdotal evidence suggests some National Service programs may even benefit recruitment marginally. The Navy and Americorps-affiliated Seaborne Conservation Corps, for instance, introduces high school dropouts to a military style of life and requires they earn a high school GED. Seven of the 42 members in the first graduating class enlisted in the armed services -- which they could not have done without the GED and may not have been inspired to do without the experience provided by the Seaborne Conservation Corps.
RECRUITING -- AN ESSENTIAL PRIORITY IN DOD
Because recruiting is vital to readiness, the Deputy Secretary of Defense established the Senior Panel on Recruiting in April 1994 to provide oversight at the highest levels of the Department. The standing panel is chaired by the Deputy Secretary of Defense and includes the Secretaries of the military departments and the Chairman of the Joint Chiefs of Staff; this group continues to meet regularly to review the status of recruiting. This panel deals quickly and effectively with any emerging problems.
DoD has focused on three major recruiting initiatives.
| Table III-1 | |
| Recruiting Challenges and Responses | |
|---|---|
| Issue | Current Efforts |
| Health Care | In August 1994, the Department addressed the issue of TRICARE Prime for members and their dependents in areas outside the normal areas of coverage. Other initiatives tentatively under review include waiving CHAMPUS deductibles and co-payments, providing a Health Care Management Program, and giving recruiters a medical debit card to guarantee payment to health care providers. |
| Housing | Many recruiters -- particularly those stationed in higher cost areas -- are inadequately reimbursed for housing costs; therefore, the Department now is evaluating the feasibility of establishing a leased-family housing program that would help those recruiters. |
| Child Care | The Department is reviewing the possibility to expand and use child care spaces in other government programs. This includes negotiating with the General Services Administration to obtain spaces for military members at 102 government-owned and leased locations nationwide. |
| Pay | DoD will implement authority to increase Special Duty Assignment Pay (SDAP) for recruiters from $275 to $375 per month. |
| Table III-2 | ||||||
| Quality and Numbers of Enlisted Accessions -- Active(Numbers in Thousands) | ||||||
|---|---|---|---|---|---|---|
| FY 1995 Quality Indices | Accessions [a] (in thousands) | |||||
| Component/Service | Percent High School Diploma Graduates | Percent Above Average Aptitude AFQT I-IIIA | FY 1995 Objectives | FY 1995 Actual | FY 1996 Planned [b] | FY 1997Planned [b] |
| Army | 96 | 69 | 62.9 | 62.9 | 68.0 | 90.7 |
| Navy | 95 | 66 | 48.6 | 48.6 | 57.0 | 57.2 |
| Marine Corps | 96 | 66 | 33.2 | 33.2 | 33.8 | 36.2 |
| Air Force | 99 | 84 | 30.9 | 31.0 | 30.7 | 30.3 |
| TOTAL | 96 | 71 | 174.8 | 175.8 | 189.5 | 214.4 |
| [a] Includes prior service accessions. [b] Based on Service Recruiting Production Reports and DoD FY 1997 Budget Estimates. | ||||||
| Table III-3 | ||||||
| Quality and Numbers of Enlisted Accessions -- Selected Reserve (Numbers in Thousands) | ||||||
|---|---|---|---|---|---|---|
| FY 1995 Quality Indices Non-Prior Service | Total Accessions Non-Prior and Prior Service (in thousands) | |||||
| Component/Service | Percent High School Diploma Graduates | Percent Above Average Aptitude AFQT I-IIIA | FY 1995 Objective [a] | FY 1995 Actual [a] | FY 1996 Planned [b] | FY 1997 Planned [b] |
| Army National Guard | 82 | 54 | 60.6 | 56.7 | 68.6 | 64.1 |
| Army Reserve | 95 | 75 | 47.7 | 48.1 | 50.7 | 47.7 |
| Naval Reserve | NA [c] | NA [c] | 13.6 | 13.7 | 17.2 | 16.8 |
| Marine Corps Reserve | 98 | 77 | 9.6 | 9.9 | 10.2 | 10.5 |
| Air National Guard | 94 | 76 | 8.4 | 8.4 | 8.7 | 8.4 |
| Air Force Reserve | 94 | 78 | 8.8 | 8.5 | 6.9 | 8.7 |
| TOTAL | 90 | 67 | 148.7 | 145.2 | 162.3 | 154.2 |
| [a] Based on Service Component Recruiting Production Reports. [b] FY 1997 DoD Budget Estimates. [c] Naval Reserve accessed only prior service recruits in FY 1995. | ||||||
Recruiting for the Selected Reserve
With the increased reliance on the Reserve Components, continued manning by quality prior service and non-prior service recruits remains a priority. During recent years, the Department has experienced considerable success in recruiting for the reserve forces. Since 1991, the number of new recruits into the Reserve Components with high school diplomas has increased by 10 percent, and new recruits in the upper half of the Armed Forces Qualification Test categories has grown by 10 percent. There are, however, current and future dynamics that will make it increasingly difficult to maintain robust reserve force strength levels in the coming years. The perceptions caused by downsizing, reduced budgets, and inactivating local units all continue to give the public the impression the Reserves are no longer hiring, or that the Reserves are not a viable employment opportunity. Additionally, the approaching completion of the drawdown of the active forces will mean fewer service members entering the prior service pool for Selected Reserve membership, thus increasing the need for non-prior service recruiting. To meet this challenge, increased advertising budgets and more recruiters are needed to achieve outyear missions, especially after the Reserve Component downsizing abates and accession missions increase.
The Assistant Secretary of Defense for Reserve Affairs convened a Reserve Component Recruiting and Retention Task Force to analyze the current state of supporting programs and to explore new and innovative ways to meet the mission. Prime among the topics this task force will explore is the utilization of the Selected Reserve Incentive Program, a series of bonuses for enlistment and reenlistment. The task force will also focus on intensifying retention efforts to reduce unprogrammed losses in the Selected Reserve that occur prior to reenlistment windows.
Full-Time Support to the Reserve Components
Full-time support personnel provide increasingly critical assistance in administering, recruiting, retaining, instructing, and training the Guard and Reserve. The full-time support program grew rapidly during the past two decades as the reliance on Reserve components in the Total Force increased. As the Total Force decreases in size, so will the full-time support program. However, the Department is working hard to ensure the full-time support force remains large enough to provide a trained and ready force supported by well-maintained state-of-the-art equipment. Table III-4 shows current and planned full-time support strengths.
Full-time support personnel provide the backbone of Guard and Reserve readiness. Additional missions and reliance will be placed on the Reserve components. With the multiplicity of demands being placed on part-time soldiers, it is imperative the effective use of the limited training time available to them be maximized. Full-time support personnel ensure training is planned, organized, and conducted with properly maintained equipment.
| Table III-4 | ||||
| Full-Time Support Personnel *(End Strength) | ||||
|---|---|---|---|---|
| FY 1995 Actual | FY 1996 Planned | FY 1997 Planned | FY 1998 Planned | |
| Army National Guard | 49,180 | 49,854 | 49,504 | 48,714 |
| Army Reserve | 20,916 | 20,843 | 20,918 | 20,647 |
| Naval Reserve | 24,947 | 25,714 | 25,364 | 25,205 |
| Marine Corps Reserve | 6,669 | 6,609 | 6,685 | 6,685 |
| Air National Guard | 36,090 | 36,058 | 35,260 | 35,870 |
| Air Force Reserve | 16,920 | 17,122 | 16,736 | 16,421 |
| TOTAL | 154,722 | 156,200 | 154,467 | 153,542 |
| * Includes Active Guard and Reserve, military technicians, Active component, and civil service personnel. | ||||
TREATING PEOPLE FAIRLY
Supporting Service Members
Good quality of life, including adequate compensation, is an important component of medium-term readiness. Toward that end, the President announced a $25 billion increase in defense spending, about half of which was designated for quality of life improvements. Those funds are targeted at three areas: compensation, married and bachelor housing, and family and community support.
Pay/Compensation Issues
In order to attract, motivate, and retain quality people, the armed forces must provide a standard of living for its members that can compete with the private sector into the 21st century. If it does not, the Services cannot continue to recruit and retain high quality people in this nation's all-volunteer force. President Clinton has committed to support the full military pay raises authorized by law through the end of the decade -- an unprecedented commitment. The Department of Defense has implemented a cost of living allowance in areas of the continental United States where local costs (excluding housing, which is a separate allowance) exceed national average living costs by 9 percent or more. This program is now helping 30,000 military families that are assigned to high-cost areas. The Department is also moving to reduce the excessive absorption of housing costs now being experienced by those in uniform.
The Department continues to aggressively work initiatives to improve the military compensation system through a unified legislative and budgeting process. As a result, the Department submitted the following legislative initiatives, through the Office of Management and Budget; these were enacted as part of the FY 1996 National Defense Authorization Act:
These improvements directly and measurably assist members of the armed forces and their families. Moreover, these investments constitute a sound means of preserving high levels of personnel readiness.
Promotions
The Services have worked hard to provide reasonably consistent promotion opportunities in order to meet requirements, ensure a balanced personnel force structure, and provide a meaningful opportunity for all service members. There is a common misconception that promotions have been frozen because of the drawdown, but that is simply not the case. Promotions have remained generally steady during the drawdown. Last year, the Services promoted over 110,000 soldiers, sailors, airmen, and marines into the top five enlisted grades (E5-E9). There has been only a slight increase in the average promotion time for some grades and skills. Officer promotion opportunity also has held steady, generally remaining within 5 percent of the levels before the drawdown began. For the future, the Department expects promotion points will improve and promotion opportunity will remain steady.
Force Stability
As the Services complete their downsizing, the focus shifts to the task of stabilizing the force. Any drawdown of the size that has been achieved, even one carefully and successfully managed, will cause turbulence -- it is an inevitable by-product of change. Therefore, DoD is now taking steps to return a sense of stability to the armed forces.
One of the most important elements of this effort is Secretary Perry's Quality of Life Initiative (see Quality of Life chapter for a complete discussion of this initiative). Less quantifiable factors also contribute to a stable environment for service members. These include visible and challenging career opportunities, healthy military communities, the satisfaction of reasonable expectations for the future, and the availability of a military career for those who perform well. Compensation, housing, and family support, the central points of the initiative, are keys to creating the sense of stability.
Finally, personnel tempo (PERSTEMPO), the amount of time service members spend away from their home base, is an important component of force stability. PERSTEMPO has increased somewhat since the end of the Cold War, particularly for the Army and Air Force, as DoD has reduced forces stationed overseas. The Navy and Marine Corps, though more accustomed to routine deployments, have also seen some increase in PERSTEMPO. If this rate were to become too high, it could have a negative effect on the stability of the force. But, while there are certain specific units and military specialties which have been used repeatedly, DoD believes the current PERSTEMPO of the force as a whole is sustainable. PERSTEMPO has been historically high for the Services and has increased since the end of the Cold War. Despite the increase in PERSTEMPO, overall morale, retention, and readiness remain high. This is due, in part, to the fact that service members have always derived a sense of purpose and satisfaction from the opportunity to perform the functions for which they joined the military. However, there are some indications that high PERSTEMPO in certain units has a negative impact on the quality of life of members. For the small number of units subjected to a high deployment rate, DoD is now taking steps to alleviate that strain, including increased use of the Reserve Component. (See Readiness chapter for a full discussion of PERSTEMPO initiatives.)
Separation and Transition
While the number of separations in the remainder of the 1990s is expected to be somewhat lower than in the prior decade, substantial numbers will continue to leave the military each year for a variety of reasons. Throughout the 1990s, the military services will separate between 250,000 and 300,000 active duty personnel annually. Even after the drawdown, separations will average 250,000 per year.
Military personnel have certain advantages in the job marketplace; they are, on average, better trained, educated, and disciplined than their civilian counterparts. However, they also have three distinct disadvantages in seeking and securing civilian employment:
On a per capita basis, unemployment costs to DoD have been significantly reduced as a result of efforts to provide job assistance and pre-separation counseling through the established Transition Program. Since the beginning of the all-volunteer force, DoD policy has recognized that a positive quality of life in the nation's armed forces is a vital element of defense capability. Its commitment to treat people right has helped attract the best people to serve in the nation's defense. Transition support and services are a vital part of treating members right, even as they prepare to leave military service and embark upon new careers. This common sense approach to military separation is essential for the well-being of all military members. For more information on transition support to service members, see the chapter on Quality of Life.
Equal Opportunity
Equal opportunity is a military necessity. It provides today's all-volunteer force access to the widest possible pool of qualified men and women; it allows the military to train and assign people according to the needs of the Service; and it guarantees service men and women that they will be judged by their performance and will be protected from discrimination and sexual harassment.
Discrimination, sexual harassment, and disparate treatment jeopardize combat readiness by weakening interpersonal bonds, fomenting distrust, eroding unit cohesion, and threatening good order and discipline. An organizational climate poisoned by bias sets member against member and undermines institutional allegiance. Quality of life in the armed forces is supported by comprehensive and reliable systems for addressing human relations issues and for investigating and resolving discrimination complaints. Such systems provide a visible symbol of organizational commitment to equality and fair treatment, education and training, counseling support, and assistance to complainants when equal opportunity violations occur.
Department of Defense policy clearly proscribes discrimination and sexual harassment. DoD strives to ensure it is an organization where every individual is able to contribute to his or her fullest potential in an atmosphere of respect and dignity. Furthermore, the Department, of necessity, is building a force which reflects the diversity of the nation.
In May 1995, the Department transmitted to Congress the report of the Defense Equal Opportunity Council Task Force on Discrimination and Sexual Harassment. The report contained 48 recommendations for improvements in the Services' discrimination and sexual harassment prevention programs, including the establishment of Department-wide standards for discrimination complaints processing. In August 1995, publication of DoD Directive 1350.2, Department of Defense Military Equal Opportunity Program, implemented the report's recommendations.
The Department of Defense has carefully monitored the effects of the downsizing on minorities; in fact, Section 533 of Public Law 103-337 requires the Department to report on readiness factors by race and gender. This report is at Appendix G. The appendix also discusses the Department's review of the Services' discrimination complaint procedures and the improvements implemented to help ensure the fair and prompt resolution of identified transgressions.
IMPROVING FORCE MANAGEMENT
Future Officer Management
The Defense Officer Personnel Management Act (DOPMA) is the cornerstone of the Department's officer management system, and has served the Department, Services, and individual officers well for the past 15 years. Further, DOPMA, along with other special programs provided by Congress, gave the Department the flexibility to manage the drawdown of the officer force in a humane way, treating officers right, while maintaining readiness. Nonetheless, given the evolving force structure, changing roles and missions, and the substantially smaller size of the officer corps, the Department is reevaluating DOPMA and other elements of officer personnel management to ensure their viability into the 21st century. This is a long-term effort that will look at all elements of the officer life cycle from accession, through training, utilization, and promotion, to separation or retirement.
Improving Compensation
The law requires the President to conduct a complete review of the principles and concepts of the compensation systems for members of the uniformed services every four years. President Clinton signed a charter for the Eighth Quadrennial Review of Military Compensation (QRMC) in January 1995. Previous QRMCs focused on the existing system and how to improve its effectiveness; the Eighth QRMC is focusing on how to employ the military human resource management system strategically. The charter requires the Eighth QRMC to look well into the future and to develop a military compensation system that will attract, retain, and motivate the diverse work force of the 21st century. The Review is:
The Eighth QRMC is expected to complete its work in June 1996.
Status of Women in the Military
DACOWITS
Establishment of the Defense Advisory Committee on Women in the Services (DACOWITS) in 1951 was a major milestone for military women. DACOWITS is a civilian federal advisory committee of prominent citizens from across the nation, representing industry, education, and civic affairs. The committee serves to promote public acceptance of military service as a career field for women, and to advise the Secretary of Defense on policies relating to the utilization of women. DACOWITS has been particularly effective in improving opportunities and benefits for military women. In 1995, the DACOWITS Executive Committee visited the military in the Pacific, including Hawaii, Alaska, Korea, and Japan. The committee's trip was characterized by many of the installation commanders as one of the most successful in memory. The key to this success was the positive partnership formed between military leaders and the committee members. The committee conducted interviews with over 3,000 service women and men and included this feedback in their report to the Secretary of Defense.
NEW ROLES FOR SERVICE WOMEN
During the past two years, the Department of Defense has made major progress in removing impediments to the recruitment, training, and use of its service members. The Department's policy on the assignment of women has proceeded in three phases -- first with a focus on aviation, then on assignment to naval combatants and, finally, on ground assignments.
In April 1993, then-Secretary of Defense Les Aspin directed the Services to open up additional occupational specialties and assignments to women. In particular, women began to compete for assignments in aircraft that engage in combat. Secretary Aspin also directed the Secretary of the Navy to open more assignments for women on noncombatant vessels and to develop legislation to repeal the naval combatant exclusion law. One important qualification in the implementing memorandum was that women were not to be assigned to units that engage in direct combat on the ground. During this phase, nearly 42,000 new positions could be filled by either men or women.
Congress made the second phase possible in November 1993, when it repealed the naval combatant exclusion law. That change opened more than 136,000 new positions in the Navy to women. The November 1993 law also prohibited opening additional combat positions to women without congressional review.
The third phase began with Secretary Aspin's January 1994 policy memorandum which revoked the DoD Risk Rule and promulgated a definition of direct ground combat and an associated assignment rule. On July 28, 1994, Congress was notified that the DoD Risk Rule would be rescinded and the Services would open additional combat positions and career fields to women effective October 1, 1994. This guidance established the framework for the utilization of women under which the Department now operates. As a result of these initiatives, more than 80,000 new positions opened to women in the Army and Marine Corps, with the most prominent constraint on the assignment of women remaining in the area of direct ground combat. Under the current policy, women are eligible to be assigned to all positions for which they are qualified, except they shall be excluded from assignment to units below the brigade level whose primary mission is to engage in direct combat on the ground. Generally speaking, this means that armor, infantry, ranger, special forces, and field artillery battalions remain closed to women in the Army. In the Marine Corps, the infantry regiment and artillery, as well as tracked vehicle and combat engineer battalions, with their associated elements, remain closed to women.
As a result of the Department's actions since April 1993, women are now eligible to be assigned to some 260,000 additional military positions. About 80 percent of the jobs and more than 90 percent of the career fields in the armed forces can now be filled by the best qualified and available person, man or woman. This represents a major increase in the flexibility of the Services to maintain a high state of readiness. Reports from the field and fleet indicate that service women are carrying out their new roles with the same excellence and professionalism that has always characterized the performance of members of the United States armed forces.
HEALTH CARE
A crucial part of the nonpay benefits package and a key element of military quality of life is health care. The Department of Defense has a dual health care mission -- first, to ensure medical readiness, which includes both the health and vitality of service members and the capability to provide health care during military operations, to include the effective management of evacuation policy, and second, to provide care to members of the armed services and their families, retirees, and others entitled or eligible for DoD health care.
The military's health care mission is both vast and complex. There are 8.3 million beneficiaries eligible to receive health care from the Military Health Services System (MHSS). Direct care is delivered worldwide in 120 hospitals and numerous clinics. Care is also purchased from the civilian sector through the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) and through managed care support contracts implemented under the TRICARE program. Substantial resources are required to accomplish the DoD medical mission. The medical portion of the DoD FY 1996 appropriation is approximately $15.6 billion, or 6.3 percent of the entire defense budget.
Health Care Initiatives
TRICARE
During the past year, the Department began implementing the new managed health care initiative under the TRICARE program. This initiative is a regional, managed care program for members of the uniformed services and their families, survivors, and retired members and their families. It brings together the health care delivery systems of each of the Services and CHAMPUS in a cooperative and supportive effort to provide quality uniform health care benefits. It offers stable, comprehensive health care coverage, quality care, and improved beneficiary access to a variety of health care options while containing overall DoD health care costs.
Under TRICARE, eligible beneficiaries will have three choices for their health care delivery: (1) TRICARE Prime is an enrolled health maintenance organization option; (2) TRICARE Extra offers a preferred provider option with discounts; and (3) TRICARE Standard is a fee-for-service option which is the same as standard CHAMPUS. All active duty members will be enrolled in TRICARE Prime. All CHAMPUS eligible beneficiaries may choose among the three TRICARE options while Medicare eligible beneficiaries remain eligible for care in military medical treatment facilities on a space-available basis. Provider education and beneficiary marketing programs are an integral part of the regional TRICARE program.
The dramatic reduction of the U.S. military presence in Europe has required better systematic integration of health care planning and delivery among the Services. The Department, the Services, and personnel in Europe are all actively working to develop a comprehensive regional health care plan for all DoD beneficiaries residing in Europe. Many of the initiatives being developed in Europe also have merit for consideration in other overseas areas with sizable military populations, most notably in the Pacific.
OVERSEAS FAMILY MEMBER DENTAL CARE
The Department initiated an aggressive program to improve access to dental care for family members residing outside the United States. The Overseas Family Member Dental Program is a comprehensive, integrated plan tailored to each location and is an integral part of the TRICARE Europe Regional Health Plan. A sizable increase in dental resources has begun and will result in increasing access for family members. Phased implementation of the Overseas Family Member Dental Program has begun in Germany and northern Italy. Full worldwide implementation is planned for FY 1996. This initiative is already considered one of the single greatest quality of life improvements for family members overseas.
MEDICAL CARE FOR BENEFICIARIES IN BRAC AREAS
The approved BRAC lists (1988, 1991, 1993, and 1995) will result in the closure of 31 military hospitals and an additional number of health clinics in the continental United States. With strong congressional support for the Department to do more for beneficiary populations affected by base closures, planning and programs were enhanced to specifically address their needs. DoD eligible beneficiaries remaining in areas affected by BRAC actions will be provided with alternative health care delivery options after their local military treatment facility closes. The Department's actions to lessen the medical impact include transition health care programs, managed care initiatives, retail pharmacy networks, a mail service pharmacy demonstration, and meetings with beneficiaries at affected BRAC sites.
JOINT EFFORTS WITH THE DEPARTMENT OF VETERANS AFFAIRS
Within the past year, a very constructive relationship on health issues has evolved between the Assistant Secretary of Defense for Health Affairs and the Department of Veterans Affairs (VA) Under Secretary for Health. Last year, DoD and VA worked closely together to allow VA hospitals to participate in the TRICARE program. These efforts culminated in a memorandum of understanding that enables VA hospitals to become a part of the provider network under TRICARE. Further, the two agencies have laid out and committed themselves to a number of priority and mutually beneficial program areas.
GULF WAR VETERANS HEALTH ISSUES
The Department is strongly committed to dealing with the issue of potential adverse health effects that may have resulted from service during Operations Desert Shield and Desert Storm. To investigate the nature of their illnesses, DoD and the Department of Veterans Affairs each developed programs to provide medical examinations to Gulf War veterans. Established in June 1994, DoD's Comprehensive Clinical Evaluation Program (CCEP) provides in-depth medical evaluation for DoD beneficiaries who are experiencing illnesses which may be related to their service in the Persian Gulf. Spouses and children of Gulf War veterans may participate in the CCEP if they are eligible for DoD health care. As of early December 1995, there were 27,575 participants in the program, of which 20,796 had requested an examination and over 18,924 had finished the evaluation process. A report on 10,020 participants was completed and released in August 1995. Based on the experience at that time, the CCEP found no clinical evidence for a new syndrome or unique illness among Gulf War veterans. These results are consistent with conclusions of a National Institutes of Health Technology Assessment Workshop.
Programs were also developed at military Specialized Care Centers focusing on rehabilitation, restoration of function, and promotion of well-being. Ongoing related research efforts include reproductive health research, leishmaniasis (type of parasite) research, research on the effects of exposure to depleted uranium, and the possible effects of certain chemical compounds encountered in the Gulf War. The Department also launched an investigation team to look into incidents and exposure that might be related to illnesses experienced by Gulf War veterans.
TELEMEDICINE
Telemedicine uses high tech communications to allow doctors and other health care professionals to help patients in distant locations. Rapid advances in communications and related technologies continue to expand the usefulness of telemedicine. The Department is developing strategies to fully exploit the potential for telemedicine and move telemedicine and other new technologies into the mainstream of the military health care system. Today's provisional telemedicine links between deployed U.S. forces and military hospitals in the United States support diagnostic consultation and long-distance medical mentoring. In the future, DoD expects to save casualties who would have been among the killed in action in previous wars by projecting expert medical care forward on the battlefield.
Applications for telemedicine include trauma care, radiology, dentistry, pathology, surgery, dermatology, patient evacuation, infectious disease surveillance, and support of epidemiological field investigations. These technologies are expected to become much more widely applied in both military and civilian health care delivery, medical training and education, and medical research.
GLOBAL SURVEILLANCE SYSTEM
DoD has a strong national security interest in medical intelligence and global epidemiology. With an increase in the number of infectious diseases (both old and emerging), the Department believes a Global Surveillance System, which would identify and characterize infectious diseases and aid in their containment, will have great benefits for the international community, the U.S. population vulnerable to such diseases, and U.S. troops deployed outside the United States. The Assistant Secretary of Defense for Health Affairs, in conjunction with the Departments of State and Health and Human Services, the Agency for International Development, and other agencies, is working to develop and promote a vision for this system which would cover all geographic areas, coordinate with all participating nations and nongovernmental organizations, provide timely reporting, be capable of international rapid response to outbreaks, train infectious disease staff, expand research on disease diagnosis, prevention and control, and provide international data system and communications support.
Military Health Care Advisory Committee
This Committee, which includes members designated from outside DoD, functions as an external advisory body for developing MHSS policy and strategy. It advises the Secretary of Defense, the Deputy Secretary of Defense, the Under Secretary of Defense for Personnel and Readiness, the Assistant Secretary of Defense for Health Affairs, and the military departments on matters relating to military health care and other health related matters that are of special interest to the DoD. Facing important challenges, the Department is developing a strategic vision focusing on future-oriented solutions which consider the rapid changes occurring in the world. The goal is to improve the quality and efficiency of the military health services system and provide access to excellent medical services for all those entitled to DoD health care.
THE CIVILIAN WORKFORCE
Civilian Downsizing and Transition Assistance
Reducing the workforce while minimizing the impact on civilian employees has been one of the most difficult tasks facing the Department of Defense in recent years. DoD was largely successful in this effort through the innovative use of special personnel programs and incentives. To date, DoD has accounted for the overwhelming majority of cuts in the efforts to downsize the federal government. Since October 1989, DoD has reduced civilian employment by over 269,000. By September 1999, an additional 90,000 positions will be eliminated, with further reductions anticipated.
To achieve the necessary reductions with minimum workforce turbulence, DoD developed the Civilian Assistance and Re-Employment (CARE) Program in FY 1993. CARE capitalized on the existing Department of Defense Priority Placement Program (PPP); combined and enhanced reduction and transition assistance programs into one division; and sought flexibility from other federal agencies and Congress.
The Department's combined use of hiring constraints, Voluntary Early Retirement Authority, training initiatives, and the approaches mentioned above has resulted in minimal involuntary separations. DoD is now adding the Non-Federal Hiring Incentive, which Congress authorized in the FY 1995 National Defense Authorization Act, at all closing bases. This incentive will encourage private and public employers to hire DoD workers who are facing separation by providing payments of up to $10,000 per worker for retraining and relocation.
Civilian Training and Education
The Department is looking at more effective and cost-efficient ways to train, educate, and develop civilian employees. Last year, DoD launched an effort to develop a framework for civilian leader development that would provide a universal, comprehensive, and systematic program to enhance support of the changing national security objectives. The framework, called Growing the Gold, is built on the professional military education (PME) model. PME provides a sequential and progressive program of leadership education in basic, intermediate, and senior Service schools, as well as the National Defense University. The draft program seeks to increase civilian participation in those schools and to identify comparable opportunities. In a related effort, the Department is investigating the possibility of exporting to other critical functions the approach to career management used by the acquisition workforce. That approach calls for certification of employees based upon prescribed training, education, and assignments. These initiatives respond to the President's call for greater and smarter investment in human capital.
Defense Partnership Council
Chartered in June 1994, the Defense Partnership Council (DPC) is composed of senior management officials from the Department, the Services, and key leaders from several major unions. The union officials who are part of the DPC represent approximately 1,700 bargaining units located throughout the world. The DPC has taken important steps in the process of transforming labor-management relations from the traditional adversarial mode to a cooperative model based on partnership and mutual respect. The Department has trained more than 23,000 management officials, union representatives, and employees in some aspect of partnership. In addition, the Office of the Assistant Secretary of Defense for Force Management Policy sponsored training for more than 500 managers and union officials; this training was jointly developed by DoD, several major unions, the Federal Labor Relations Authority, and the Federal Mediation and Conciliation Service.
The DPC is forging a more constructive relationship between labor and management by bringing together key officials with the ability to shape the labor-management climate in the Department. By discussing substantive issues face-to-face, the DPC members are breaking down old barriers of suspicion and mistrust. The partnership process highlights the many common interests shared by DoD organizations and DoD unions. In fact, projects initiated by the DPC were instrumental in fostering local labor-management relationships focused on supporting and enhancing DoD's national security mission and creating and maintaining high-performance workplaces that deliver the highest quality products and services to the American public at the lowest possible cost.
Civilian Personnel Regionalization and Systems Modernization
The Department is moving forward with its restructuring plan to regionalize civilian personnel services and develop a modern information system to support civilian personnel operations. With input from the military departments and defense agencies, the Department developed a regional service delivery model based on a number of successful prototypes implemented since 1986. The regionalization effort capitalizes on economies of scale by consolidating selected civilian personnel operations into Regional Service Centers and small Customer Support Units. Administrative processing operations and program management activities will be concentrated at the Regional Service Centers, while personnel operations requiring face-to-face customer interaction will remain at Customer Support Units.
Concurrent with regionalization, the Department is building on previous Corporate Information Management (CIM) efforts to modernize its civilian personnel data system. This modern approach will support regionalization with open systems-compliant hardware and software platforms and standard communications protocols over the Defense Information System Network. It will provide managers easy access to the data system through graphical user interfaces and implement other technological improvements. To reduce development time and resources and implement private sector best practices wherever possible, the Department has purchased a commercial off-the-shelf (COTS) human resource information system as the basis for the modern data system.
The Department's goal is to improve service quality while reducing resources. The current ratio of civilian personnel employees to employees serviced will greatly improve when the modernization effort reaches full implementation. The resultant resource reductions will meet or exceed the Department's National Performance Review streamlining targets. Economic analyses confirm that with proper investment, regionalization, and systems modernization are achievable and cost effective, and the benefits after full implementation will be substantial.
Consolidated Advisory Services to the Field
Field Advisory Service (FAS), a DoD program in the Defense Civilian Personnel Management Service, is the principal source of technical advice and guidance to defense organizations worldwide on civilian personnel management issues and questions. FAS provides interpretive advice on statute, regulation, policy, case law, and Comptroller General decisions in areas of benefits, entitlements, compensation, travel, classification, and labor relations. This DoD program provides service to 14,000 civilian personnel specialists worldwide, who in turn provide service to 848,000 DoD employees.
Establishing this program eliminated two layers of human resources management. At the same time, the number of personnel positions providing this support was reduced by 28 percent. Even as the Department saved money, though, it also improved service. Indeed, the Field Advisory Service has been able to answer 86 percent of the inquiries within one work day and 94 percent of the questions within three work days. The remaining questions required answers from sources outside the Department and they were tracked to ensure prompt response was provided to the field.
The FAS staff is comprised of a cadre of experts whose primary responsibility is to support the operating level personnel specialist. Guidance takes the form of reference guides and alerts which are available on a 24-hour basis through an automated fax-back system. The support is enhanced through regular issuance of a newsletter, 12-hour per day live-support, and 24-hour electronic access. In addition, use of modern technology (i.e., the Internet) keeps human resource specialists in the field up to date on issues affecting their functional areas. The Field Advisory Service program also serves as a direct conduit from the field personnel offices to the policy makers within DoD so concerns in the field can get a quick and serious hearing at the top levels. For example, a proposal to change the law providing in-lieu-of holidays for employees on compressed work schedules was written in direct response to concerns raised by the field.
CONCLUSION
The Department's primary personnel mission is to attract, develop, and retain the high quality service men and women and civilian employees who are essential to maintain a high state of warfighting readiness and to treat service members and civilian employees fairly. Service members of all grades will continue to receive high quality realistic training, exceptional educational opportunities, genuine equal opportunity, challenging worldwide assignments, and excellent advancement and leadership opportunities. The Department will continue to recruit the high quality personnel necessary to keep U.S. forces ready and to maintain the proper mix of junior, mid-career, and senior service members. In short, DoD will ensure the United States' armed forces remain the best in the world.
