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Hearing of the Military Personnel Subcommittee of the House Armed Services Committee - Status of the Implementation of the Army's Medical Action Plan and Other Services' Support for Wounded Service Members


Location: Washington, DC


REP. JOHN KLINE (R-MN): Thank you, Madame Chair.

Thank you, gentlemen, for being with us today.

Admiral Robinson, could you tell us what your working relationship is -- not your personal relationship, but your working relationship is with Colonel Boyle? How does that work?

ADM. ROBINSON: With Colonel Boyle, who is the Marine Corps liaison at Bethesda?

REP. KLINE: No, sir. I'm sorry. He's the CO of the Wounded Warrior Regiment. We've been talking about how the Army does that. I'm just trying to see how the Navy and the Marine Corps does that.

ADM. ROBINSON: Okay. The Wounded Warrior Regiment at Camp Lejeune or at Pendleton?

REP. KLINE: Admiral, there's one Wounded Warrior Regiment, and it has tie-ins on each coast. I'm just -- I guess what I'm hearing is we're not very well plugged in there between the Navy surgeon general and the Marines' Wounded Warrior Regiment. But the Army -- you seem to be (on one hat ?) here.

General Schoomaker talked about the installations are providing the funding that comes under Installations Command for the barracks and so forth. But it looks like your Wounded Warrior program in the Army falls under you. Is that right, General Schoomaker? And with the Navy, you have a safe-harbor program that treats 250 or so sailors a year. That falls under you, Admiral?

ADM. ROBINSON: No, that falls under the Chief of Naval Personnel.

REP. KLINE: Okay. So for neither the wounded sailors or Marines, you don't have any direct connection with that follow-on program, that outpatient program, that mentoring and caring-for program that we're hearing about in the Army? Is that what I'm hearing from you?

ADM. ROBINSON: Well, other than building the initial health care in the institutions, then doing the medical case management and the non-medical case management, going through the continuum of care and transitioning them to the appropriate facility, such as the VA poly- trauma or wherever they need to be, and then, when ready, getting them back as close as they can to their home units, Lejeune or Pendleton, or wherever that may be, and we do that through the Wounded Warrior program. I think that we have a very good hook-up.

The fact that Colonel Boyle, who I do know, and who does have the regiment, and the fact that we have one at Lejeune and at Pendleton that I don't have daily cognizance over, doesn't mean that Chris Hunter at Balboa, who's the commander of the medical center at Balboa, and that Mark Colson (sp), who's my commander of the naval hospital at Camp Lejeune, aren't talking with them --


ADM. ROBINSON: -- and from my three years at Bethesda as the commander, the (AC-MAC ?) and the CMC and the sergeant major of the Marine Corps and the Wounded Warrior Marine liaison that was there were a daily occurrence, are hooked into the multidisciplinary team that I spoke about. So those people are people that I've lived with on a day-to-day basis for the last --

REP. KLINE: Okay, thank you, Admiral. I'm a little bit concerned. Maybe it's fine. And I would suggest, Madame Chair, that if we're going to look at this Wounded Warrior, you know, continuing care issue, that it would probably be helpful to have the Marines' Wounded Warrior regiment, since that is an up-and-running organization that is connected, and the admiral is explaining some of how that's connected, but I'd like to explore that a little deeper. And I can do it on my own. Perhaps as a subcommittee we ought to do that; we ought to take a look at that.

ADM. ROBINSON: Well, the deputy medical officer of the Marine Corps, Mike Anderson, who is sitting behind me, is here. The medical officer of the Marine Corps is Admiral Bill Roberts, who couldn't be here today. But that connection exists, and it exists on a daily basis. And it has for a long time, and it will in the future.

REP. KLINE: Okay. It's not the same relationship, though, as what they have in the Army. And I would just --

ADM. ROBINSON: No, it isn't the same relationship for a number of reasons, not the least of which is we don't have quite as many people involved in terms of wounded. But the relationship is a little different in terms of philosophy of how we manage the care.

REP. KLINE: Exactly. And this is not meant as a criticism. I'm trying to understand how it works. And so we'll have to -- I'd like to explore that a little bit separately, because we have a different model here. There are a lot of similarities. The Marines are assigning officers and staff non-commissioned officers and barracks in a model very much like what the Army is doing, I think. Cadre members are back here in the audience.

But in the Army's case, it falls under the surgeon general of the Army; I understand all one uniform. And in the Navy/Marine Corps case, it's a little bit different. And I'd just like to understand how that works. That's all I'm suggesting.

I've got some other questions, Madame Chair, having to do -- sort of an unrelated matter. And I'll wait for the second round. I yield back.


REP. JOHN KLINE (R-MN): Yes. Thank you, Madame Chair. I'm going to switch directions quite a bit here. We as a nation, you as the surgeons-general have been placing a lot of emphasis on traumatic brain injury and PTSD and some of the stresses that are -- have been associated with the combat in Iraq and Afghanistan, the nature of the weapons that -- all of those things, and I think that's very appropriate. I know the members of this committee have also spent a lot of time looking at those issues.

But still, we have -- over 80 percent of our injuries are extremity injuries. I think 82 percent was the last number I saw. A lot of cases of legs particular but legs and arms, and we are putting some resources into that. I was talking to General Roudebush beforehand. I know there's some peer reviewed sort of joint effort going on between civilian orthopedic efforts and military to make sure that we're doing the best that we can for these wounded warriors where so many of them have these wounds, and we've seen tremendous examples of -- in fact, we had in this hearing I think a couple years ago -- we had a Marine and an airman who had artificial legs and they were in uniform and looking great and proud and the Marine had just come back in fact from his second tour in Iraq and that tour he served with that artificial leg. But my question is have we let that emphasis on TBI and PTSD pull us away from this orthopedic effort and should we look at putting some more emphasis and resources into that effort, and I'll just throw it out for any of you who have a comment there.


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