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Opening Remarks by Dr. William Winkenwerder, Jr.

To the House Committee on Veterans' Affairs Oversight and Investigations Subcommittee

July 9, 2003

Mr. Chairman, Members of the Subcommittee, thank you for the opportunity to appear before you today. With your permission, I would like to submit my written testimony for the record, and provide the Committee with brief, opening remarks.

Protecting the health of military personnel is a paramount concern of the Department of Defense and my office.

The Department's Force Health Protection strategy establishes a comprehensive approach to sustain the health of service members throughout their military career. We sustain their health with thorough medical examinations when service members enter the military, with periodic physical examinations, and with comprehensive medical care throughout their military service. Service members are protected against numerous health threats through immunizations, health promotion programs, health protection training such as safety training, including chem-bio protection, health threat countermeasures and physical and mental fitness programs.

Our deployment health program is an important element of our overall force health protection strategy. Since Congress established the requirement for deployment health assessments in 1997, DoD has made continuous improvements in the implementation and management of all aspects of our deployment health programs - pre-deployment, theater-based care, and our post-deployment process.

First, our pre-deployment processing begins 30 days prior to deployment. After large reserve mobilizations following September 11th, DoD expanded this process to include reserve component personnel activated for 30 days or more even if not deployed overseas.

The deployment process includes a health assessment, a medical record review, verification of a current serum sample collected within the previous 12 months, and health care provider review to ensure deployment-specific medical countermeasures have been completed. Blood serum samples are archived in the DoD Serum Repository - currently housing 30 million frozen samples on more than seven million service members.

We electronically archive each service member's pre and post-deployment health assessment in the Defense Medical Surveillance System. The Department of Defense has captured more than a million of these forms so far, and the completed documents are available to healthcare providers worldwide through our web-based program, TRICARE OnLine.

During deployment there is extensive medical and environmental surveillance. DoD routinely deploys preventive medicine, and forward laboratory teams. Electronic daily and weekly disease and non-battle injury reporting were implemented for Operation Iraqi Freedom, and a system of electronic medical record keeping was partially implemented. During Operation Iraqi Freedom, combat stress teams were also deployed to address specific service member concerns.

Our latest enhancements to the post-deployment health process, introduced in April of this year, added a requirement for health care providers to individually assess each service member; the introduction of a more comprehensive self-assessment; and the collection of blood samples within 30 days of return. All health issues detected during this screening process must be addressed by health care providers using the Post-Deployment Health Clinical Practice Guidelines used throughout DoD and the VA.

We are in the early stages of the redeployment process. It is much too early to establish definitive findings or conclusions, but we have established a rigorous quality assurance program and we are actively monitoring compliance.

Although I want to be cautious with any results reporting, thus far the Services report less than 10 percent of active duty personnel (and a slightly higher percentage of reservists) have identified medical or dental problems or mental health or exposure health concerns.

My office will continue to monitor service member health through the comprehensive medical surveillance systems we have in place. We have demonstrated that we are committed to continuous improvement, and where shortfalls occur, we will quickly remedy these issues.

In addition to our medical efforts, the Under Secretary of Defense for Personnel and Readiness has established a Joint Working Group on Mobilization and Deployment Accountability to address the issues of deployment personnel accountability and locations. Significant progress has been made, and this month, we will identify measures to further improve deployment accountability. The Army, Navy and Air Force will also identify the steps they are taking to improve the quality of location data. This initiative is essential for our own medical surveillance efforts.

Mr. Chairman, I again thank you for inviting me here today. I am pleased to accept your questions.