Statement of Chairwoman Susan Davis

Military Personnel Subcommittee

Department of Defense Medical Centers of Excellence

“Today the Military Personnel Subcommittee meets to receive testimony on the progress of medical Defense Centers of Excellence (DCoE). Three years ago, as different types of casualties than had been initially anticipated mounted, Congress realized that the Department of Defense had to do a better job preventing, diagnosing, mitigating, treatment, and rehabilitating these injuries.

“One of these injuries, traumatic brain injury, or TBI, was somewhat new for the military, and in truth for medicine in general. Advances in both protective armor and battlefield medicine were savings lives that would have been lost in previously wars. The knowledge and expertise to deal with TBI were not resident anywhere, so as has been the case in previous wars, the Department of Defense would need to be at the leading edge of medical research. Another injury, post traumatic stress disorder, or PTSD, was better known, but the clinical expertise to deal with it was more resident in the Department of Veterans Affairs.

“After many years of relative peace followed by an intense period of conflict, the medical research and development functions of the Department of Defense found themselves inundated with requirements. The military medical establishment has made great, heroic even, improvements to trauma care during this conflict, but more remains to be done, both for initial battlefield treatment and long-term rehabilitation. This is why these medical centers of excellence are so important. And why our frustration is so pronounced with the excessive amount of time it has taken to get these centers up and running.

“The first appropriation for this purpose was made almost three years ago. Several months after that the House and Senate Armed Services Committees included a requirement to establish centers of excellence in TBI, PTSD, and vision in the National Defense Authorization Act for 2008. Today, only two of these are in actually operation, combined by the department as the Defense Center of Excellence.

“Little apparent progress has been made in establishing the Vision Center of Excellence, nor as far as we can tell, with either the Hearing Center of Excellence or the Traumatic Extremity Injuries and Amputations Center of Excellence required by the National Defense Authorization Act for 2009.

“So, clearly, we are concerned about the department’s slow pace in developing such an important function. However, excessive delays are not our only issue.

“The center that has been established, the Defense Center of Excellence, while having achieved some notable small-scale successes, has not inspired great confidence or enthusiasm thus far. The great hope that it would serve as an information clearinghouse has not yet materialized. The desire that the center become the preeminent catalogue of what research has been done, what is being done, and what needs to be done has not been realized.

“Part of this is no doubt due to the fact that the DCoE has had to create, or more accurately recreate, all of the administrative infrastructure and processes required to oversee medical research on such a monumental scale. However, the center has also made some serious management missteps that call into question its ability to properly administer such a large and important function. We will look forward to hearing how the department plans to improve this organization going forward so that it can realize the goals set for it by Congress.

“Today we will hear from the senior medical leadership of the Department of Defense. Dr. Charles Rice is the President of the Uniformed Services University of Health Sciences, and is currently performing the Duties of the Assistant Secretary of Defense for Health Affairs. In this role, Dr. Rice directly oversees the Defense Center of Excellence, as well as the establishment of the other centers of excellence.

“We are also fortunate to have with us the service surgeons-general, Lieutenant General Eric Schoomaker from the Army, Vice Admiral Adam Robinson from the Navy, and Lieutenant General Bruce Green from the Air Force, to describe how well the current centers supports the requirements of their services. Gentlemen, welcome. General Green, this is not the first time that you have appeared before our panel, but it is the first time since your promotion to Surgeon General of the Air Force, so welcome.

“Throughout our conversations today, it should go without saying that all of us, both members of the legislative and executive branches, are committed to providing the best care possible to our wounded warriors. It is not hyperbole to say that our Military Health System has made previously impossible feats routine.

“This is a testament to the commitment displayed on a daily basis by everyone who is associated the Military Health System. We must all do our part to make sure this trend continues.”

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