Lawmakers Seek to Slow DoD's Efforts to Slash Medical Billets, Outsource Moves

Hospital Corpsman 3rd Class Malachi Henderson reports the status of a simulated patient to Lieutenant Elizabeth Cooper while Hospital Corpsman 3rd Class Daniel Campoblanco records the injuries during a mass casualty drill aboard the USS Bataan. (U.S. Navy/Mass Communication Specialist Seaman Apprentice Levi Decker)
Hospital Corpsman 3rd Class Malachi Henderson reports the status of a simulated patient to Lieutenant Elizabeth Cooper while Hospital Corpsman 3rd Class Daniel Campoblanco records the injuries during a mass casualty drill aboard the USS Bataan. (U.S. Navy/Mass Communication Specialist Seaman Apprentice Levi Decker)

The House Appropriations Committee moved to rein in the Defense Department as it plans to cut 18,000 military medical billets and proceeds with outsourcing its household goods management system.

The committee on Tuesday passed a fiscal 2020 defense spending bill that would withhold $250 million from the Defense Health Agency to pay for contractors or civilians to work in jobs in military hospitals now held by nearly 18,000 uniformed personnel whose positions will be eliminated or transferred to operational billets.

Rep. Pete Visclosky, D-Indiana, chairman of the committee's defense panel, said the Defense Department has thousands of unfilled medical billets it plans to eliminate in fiscal 2020 but also plans to cut the number of uniformed billets. The Pentagon has failed to respond "adequately" to the committee's questions on patient risk and access to care, he added.

A Defense Health Agency spokesman said Tuesday the billets belong to the individual services’ medical commands, not DHA.

"In its [fiscal 2020] request, the department requested a significant amount of money for the reorganization and proposed a major reduction in health care billets," Visclosky said. "Yet it could not answer basic questions about how the reorganization would affect service members and beneficiaries."

Given that extensive reports on changes to the military medical system are not expected to be delivered to Congress until late summer or fall, the committee decided to deny the request.

"Of particular concern to the committee were impacts to pediatrics, maternity care and mental health. The legislation halts the reorganization until those questions can be answered," Visclosky said.

According to the report accompanying the proposed bill, the Pentagon plans to eliminate all the uniformed positions in 2020, as opposed to a phased reduction, leaving the committee "displeased that medical readiness [of active-duty troops] appears to have been the only consideration ... and key [DoD] leaders are either unable or unprepared to articulate a comprehensive plan."

Under a restructuring of the military health system directed by Congress in the fiscal 2017 National Defense Authorization Act, the Pentagon is transferring management of all military health facilities to the Defense Health Agency, leaving the services' individual medical commands to focus on providing care to military troops.

Defense officials say that transferring the uniformed billets, which include physicians, dentists, nurses, corpsmen, medics and administrative staff, to civilian positions would allow the services to devote more military personnel to "improving lethality."

But in the bill report, committee members questioned this logic. "Prior to implementation, both medical readiness and health care benefits were intertwined. ... Under the model, there was no separation between benefits and readiness, and the services had a holistic picture of treating service members and their families," committee members wrote.

"The department has not ... provided a detailed mitigation plant that would not result in lowered availability of care to beneficiaries," they added.

The committee also has asked for more information on plans to close treatment facilities or eliminate health care services at select hospitals or clinics.

"Important questions remain about each aspect of the implementation, and the committee has been unsatisfied with the department's inadequate responses," they wrote.

The bill also contains provisions aimed at delaying the Pentagon's plans to turn the Defense Personal Property Program, or DP3, over to a single private company.

According to the report accompanying the bill, the House Appropriations Committee has concerns with U.S. Transportation Command (TRANSCOM) efforts to hand over management and oversight of military permanent change-of-station moves to a private entity.

"The committee has concerns about such an abrupt change ... and before any such transition may begin, the committee requires a better understanding of the possible outcomes such a decision could have on the lives of military families," committee members wrote.

If the bill passes in its current form, the DoD comptroller general would be required to provide a comprehensive study on the proposed privatization efforts to Congress no later than four months after the bill becomes law.

Even then, the secretary of defense could not issue a request for proposal, or RFP, or spend money for the DP3 program until 90 days after the DoD receives a draft of the study and provides a response.

Following reports of problems with companies that handle military moves, as well as breakage, loss and theft of personal effects and delays in pickups and arrivals, TRANSCOM decided to pursue an effort to hire a single company to handle the task.

In April, the command issued a draft RFP to hire a single company to manage the PCS moving system. The DoD expects to issue an RFP by June 21 and award the contract by Jan. 1, 2020.

The House bill would not stop the DoD from issuing the RFP because it will need to be reconciled with the Senate before it is passed and signed into law.

It is likely, however, to slow the effort to award a contract if approved as scheduled by Sept. 30, the end of the fiscal year.

The bill would provide $690.2 billion for the Defense Department -- $8 billion below President Donald Trump's budget request, but $15.8 billion above the fiscal 2019 DoD budget. The $690.2 billion includes $68.1 billion in Overseas Contingency Operations funds.

The bill would cover a 3.1% military pay raise and includes $70.7 million for child care, instructing the DoD to upgrade facilities and come up with "innovative ideas" to solve the shortage of quality child care services.

Under the legislation, active-duty end strength would be trimmed: The proposal supports 1,337,500 troops, 600 fewer than are currently serving and 2,000 fewer than the administration's request, drawn entirely from the Army.

It also would alter the number of personnel in the reserve component, trimming the Army Reserve and Army National Guard by 17,500 but bolstering the Air Force Reserve and Air National Guard by 700.

Editor’s Note: This article was amended on May 22 to clarify ownership of the unfilled medical billets slated to be eliminated in the coming year.

-- Patricia Kime can be reached at Follow her on Twitter at @patriciakime.

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