ICYMI: At First Hearing of Armed Services Personnel Subcommittee, Warren Highlights Priorities for 2024 NDAA
ICYMI: At First Hearing of Armed Services Personnel Subcommittee, Warren Highlights Priorities for 2024 NDAA
Washington, D.C. – Today, chairing her first hearing of the Senate Armed Services Subcommittee on Personnel, Senator Elizabeth Warren (D-Mass.) highlighted the importance of providing adequate child care to military families, addressing existing failures in the Junior Reserve Officers’ Training Corps, and putting pressure on DoD to exercise its authority to waive civilian medical debt.
Senator Warren asked Gil Cisneros, Under Secretary of Defense for Personnel and Readiness, about how DoD’s can help increase supply in its excellent child care programs and improve pay to better hire and retain child care workers. In addition, she asked Assistant Secretaries of the Army, Navy, and Air Force about their inadequate oversight of the Junior Reserve Officers’ Training Corps (JROTC) program.
In September Senators Warren, Gillibrand, Hirono, and Blumenthal opened an investigation into the JROTC program’s failure to protect students from sexual misconduct. In written testimony Under Secretary of Defense Cisneros said DoD would enhance oversight of the program by standardizing background investigations, standardizing memorandums of agreement between the services and the schools, requiring instructors to acknowledge prohibited activities as well as take a Title IX compliance course, and revise its policies for notifying the services about allegations against JROTC instructors.
The Assistant Secretaries confirmed that there is no report to annually track allegations of sexual assault and no surveys for students to anonymously report these incidents. Assistant Secretary of the Army for Manpower and Reserve Affairs Agnes Schaefer said the Army is planning to include incidents of sexual harassment and assault in its annual reports in the future. Following reports that students were forced to participate in JROTC, the Assistant Secretaries supported taking steps to make sure students are only in the program voluntarily.
She also secured a commitment from Dr. Lester Martinez-Lopez, Assistant Secretary of Defense for Health Affairs, to present a plan within four weeks for implementation of FY 2021 NDAA provisions that authorize DoD to waive medical debt incurred at military treatment facilities.
Transcripts and videos from three rounds of Senator Warren’s questions and closing remarks below:
Transcript: Hearing to receive testimony on military and civilian
personnel programs in the Department of Defense in review of the Defense
Authorization Request for Fiscal Year 2024 and the Future Years Defense Program
U.S. Senate Committee on Armed Services, Subcommittee on Personnel
Remarks from U.S. Senator Elizabeth Warren
Wednesday, March 15, 2023
Round 1 of Questions below and video HERE:
Senator Elizabeth Warren: All across this country, families need high-quality, affordable child care in order to show up at their jobs or go to school. Military families are no exception on this. In fact, because of non-standard work hours, sudden changes, significant deployments, the need for child care among our military families can be even greater.
That’s why our military has long recognized that child care is essential to supporting service members’ ability to protect our country. DoD runs the largest employer-sponsored child care program in the United States.
Military and non-military families should all have access to high-quality, reliable care, which is why I based my bill for a universal child care system on the DoD model. But, the DoD child care system still faces its own challenges – a top one being finding enough workers to care for eligible children.
Secretary Cisneros, workforce shortages have been a major problem in the child care industry for years now, and of course it’s been made even worse since the pandemic. Are military child development centers facing this issue as well?
The Honorable Gil Cisneros, Under Secretary of Defense for Personnel and Readiness: Thank you for that question, Senator and thank you for your support on the child care efforts, not only in the military, but throughout the nation. You are correct in stating that there is a national child care provider shortage in the country and we are feeling that as well. Since the pandemic, we have had trouble – difficulties trying to hire more child care workers to work in our child development centers. Last year we were able to raise the salary – the minimum wage –
Senator Warren: We’re going to talk about the money in just a minute, but you do have a problem. Let’s start there. And I just want to make sure I get this on the record – what it means for military families when they don’t have access to the child care that they need? Can you just say a word about that?
Under Secretary Cisneros: Well, ma’am, it does create difficulties. We, as you stated, see child care as part of our readiness. We want our servicemembers to be able not to worry – to have the ability to drop their child off for child care at a child development center or using one of the options that we have available to them – really relieve some stress from them and allows them to focus on their mission and performing their tasks.
Senator Warren: So it’s a part of performing your mission and being able to concentrate on your tasks. Now, it takes a lot to recruit and retain quality staff for anything, but one significant issue is pay, which is where you started a minute ago. When was the last time you updated your pay scale for child care workers?
Under Secretary Cisneros: Well, last year ma’am we were able to raise —
Senator Warren: I’m not asking that. I’m saying when did you last update the pay scale for child care workers?
Under Secretary Cisneros: Well, raising the salaries on our child development workers last year when we raised the minimum wage was when we were able to –
Senator Warren: Okay. You got the minimum up, but I’m talking about the scale overall. Not everybody is down at minimum. I understand that the last time was 30 years ago. Does that sound about right?
Under Secretary Cisneros: It’s probably been a while since we looked at it, ma’am.
Senator Warren: And what is the highest level of pay a child care worker in the military system can receive under your 30-year-old scale?
Under Secretary Cisneros: From what I’ve been told, ma’am, I’ll allow Mr. Constable this question –
Senator Warren: Mr. Constable, you want to answer that one? I think that was known as a lateral pass.
Mr. Tom Constable, Acting Assistant Secretary of Defense for Manpower and Reserve Affairs: Chairwoman, thank you very much. The top of the scale is approximately $55,000 per year.
Senator Warren: Yeah, $55,000. That’s it. That’s the top. So, DoD runs a school system for military families, called DODEA, right? How does the pay scale for a DODEA teacher compare with DoD child care pay scales for people with similar credentials? Secretary Cisneros? Unless you want to call on Mr. Constable.
Under Secretary Cisneros: Well, ma’am they don’t really have similar credentials.
Senator Warren: Well the question I am asking is when you’ve got people with similar credentials – maybe I should ask it this way – what is the top pay for DODEA workers?
Under Secretary Cisneros: I’ll allow Mr. Constable to answer.
Senator Warren: Mr. Constable?
Acting Assistant Secretary Constable: The top pay is approximately $110,000 per year.
Senator Warren: So approximately $110,000. I think we understand the difference here. $55,000 vs. $110,000 for the very top. So if we had two workers with the same credentials—same education, same experience—and one was teaching 4-year-olds at a DoD child development center, they would only earn about half as much as one teaching 6-year-olds at a DODEA center. I just have to ask – do you think that makes any sense? And are you surprised to find out that you’re having trouble filling these spots?
Under Secretary Cisneros: Ma’am we know that – as you stated – we are having difficulty hiring these spots. It’s a national problem and I think being able to pay a competitive salary is part of that. It has to be there to get a solution to resolving this problem.
Senator Warren: So, that’s why we’re here today, to talk about this. Look, child care is infrastructure. We need roads and bridges to get to work. In the case of our military, sometimes you need an aircraft carrier or a cargo jet. But you also need a functioning child care center. If the federal government is serious about military readiness and national security, if it is serious about retaining families, then we need to invest more in child care workers and that means within DoD. It’s putting money into these workers. And we need to start by updating these pay scales and doing it now. Thirty years is too long to go between and it is a statement that we don’t care about those people. If we care about this system, we’ll update those pay scales. Thank you.
Round 2 of Questions below and video HERE:
Senator Elizabeth Warren: The U.S. military should have the best doctors in the entire world. In a crisis, these are the medical professionals who are on the front lines. But unlike doctors who are at a busy place like Mass General or Boston Medical Center, military doctors don’t have a constant stream of service members with serious injuries coming in the front door.
It’s a good thing that fewer service members are suffering serious injury, but it’s also a problem for the doctors because it means they get less practice stitching people up, setting broken bones, or doing emergency surgery to repair gunshot wounds.
One of the key ways military doctors and surgeons maintain their skills is by treating civilians at military treatment facilities, or MTFs.
Dr. Martinez-Lopez, how does DoD benefit from treating civilian patients?
Dr. Lester Martinez-Lopez, Assistant Secretary of Defense for Health Affairs: Thank you very much Senator. That’s extremely important to us from the standpoint of readiness. We need to keep all the docs and nurses – it’s not just the docs – it’s a whole team that has to be sharp. By taking care of civilians, we do two things. One is the readiness piece, but also the good neighbor piece. Like if in San Antonio, there is an emergency and they show up at our doorsteps, we have the good neighbor responsibility to provide good care to them too. We need to – as you said – bring about more patients, especially trauma patients, than we – San Antonio is a perfect place where we do world-class burn care and also trauma care and also hopefully we never have to use those abroad, but if we do our team will be ready to deploy and do that right so –
Senator Warren: Right, so we want you to be sharp and we want you to have the chance to train as a team on an ongoing basis. We want you to be designated as trauma centers because your level is that high in terms of your practice. In other words, treating civilians, for the military to treat civilians is supposed to be a win-win. The civilian patient gets world-class care and the military doctors stay up to date on their skills sharp.
It’s not working out so well for the patients. Most of them are dropped off at the MTF in an ambulance because they need emergency treatment and the MTF is the best, closest option. Two-thirds of civilians who end up at an MTF for care don’t have any insurance.
The military treatment facility sticks these patients with massive bills, and if the cost isn’t waived, federal law requires aggressive debt collection, including garnishing patients’ wages or seizing tax refunds or even taking up to 15 percent of their Social Security check before it even reaches their pockets.
The good news is that DoD has the authority to waive these debts.
Dr. Martinez-Lopez, over the last five years, military treatment facilities treated almost 30,000 civilian emergency patients. For how many of those 30,000 patients did DoD exercise its authority to waive civilian medical debt, keeping in mind two-thirds of these folks don’t have insurance?
Dr. Martinez-Lopez: Ma’am, a very small number. I think 57.
Senator Warren: Fifty-seven. That’s exactly right. Fifty-seven times DoD waived medical debt out of 30,000 people who came in and incurred these debts. So DoD is actually waiving debt – I tried to work this out – in about 0.2% of the cases. Now, DoD claimed that their number is low because waiver authority was too narrow. The debt could only be waived if there was a “direct and compelling relationship to a priority DoD objective” – not just that someone can’t pay.
To address this problem, Representative Castro and I got an amendment into the 2021 NDAA – some of you remember this – to expand DoD’s authority to waive medical bills. Our changes clarified that if medical treatment for civilians will enhance military medical readiness overall and if the patient is unable to pay – DoD has legal authority just to tear up the bill.
Dr. Martinez-Lopez, how often has DoD exercised this expanded authority to waive costs for civilians when the treatment will enhance readiness and the patient is unable to pay?
Dr. Martinez-Lopez: Ma’am, I don’t know for sure, but I don’t think we’ve done many, if any.
Senator Warren: Yeah, so it’s kind of looking like zero right now. Look, DoD is dragging its feet while patients are toppling into financial ruin. The GAO also found DoD wasn’t telling patients that they had an option for relief as required by DoD’s own regulations – and they weren’t properly tracking people when they had or had not paid their bills.
Dr. Martinez-Lopez, on this new notion that we’re really going to start holding people accountable in this committee, can I have your commitment that you’re going to clean this up, start wiping out medical debts for civilians who shouldn’t have been hit with those devastating bills to begin with and you’re going to get back to me on this?
Dr. Martinez-Lopez: Senator, I don’t want to put more burden. My colleagues are in the same boat when patients have already been traumatized. That’s not what we’re in. I mean, what’s worse, they cannot even pay. So why do we want to keep adding insult to many of those – So we, thank you for this waiver, as I understand right now we’re stuck in the rulemaking of trying to figure out how I can expedite that rulemaking to get the solutions that you want and we want so I commit that I will work hard to get through that process in DoD and start affecting in a nice way the patients that we care for.
Senator Warren: I understand your heart is in the right place. I’m not quarreling with your heart. I’ve got to have your actions in the right place so I’m going to ask for the same thing that Senator Duckworth asked for. Can you get back to me in four weeks and at least lay out what the plan is to make certain that patients are fully informed about the opportunity to have their debts wiped out and what DoD’s plan is to implement what we all worked to put into the law in 2021?
Dr. Martinez-Lopez: I will get back to you ma’am.
Senator Warren: 4 weeks? Just to tell me what the plan is. I’m not even asking you for the final report. Just tell me what the plan is.
Dr. Martinez-Lopez: I will be glad to talk to your staff or yourself in four weeks.
Senator Warren: Okay, we got it.
Round 3 of Questions below and video HERE:
Senator Elizabeth Warren: The Junior Reserve Officers’ Training Corps, or the JROTC, is a DoD funded program for middle school and high school students that is designed to teach students the value of citizenship and public service. Schools hire and oversee the instructors and the military services vet, train, and pay part of the salaries for the instructors, who are retired service members.
DoD and the Department of Education share oversight for the program, but there are some pretty serious gaps in that oversight. A recent New York Times investigation found that at least 33 JROTC instructors have been criminally charged with sexual misconduct. I started my own investigation with Senators Blumenthal, Gillibrand, and Hirono in response to this alarming situation and found there were at least 114 allegations of abuse over the past decade.
When the services learned about these 114 cases, they did the right thing and suspended or fired the instructor. But I’m worried that we’re only seeing the tip of the iceberg.
Secretary Schaefer, the Army has the largest JROTC program of all the military services, so let me start by asking you. One of the main ways that we track whether we’re making progress on military sexual assault is an annual report. Is there any kind of formal annual reporting on instances of sexual assault and harassment in the JROTC program?
Ms. Agnes Schaefer, Assistant Secretary of the Army: Senator Warren, thank you for your question. This is an issue that deeply concerns me as well. My understanding is there is an annual report, but it has not had that tracking in it.
Senator Warren: The annual report I’m asking about is – is there a report tracking the incidences of sexual assault?
Assistant Secretary Schaefer: There is a report. It has not tracked sexual assault – up to this point, yet my office has directed it. Before I came in in December, my office directed that we include that in the report that exists.
Senator Warren: Okay, but you’re now trying to put this in? Okay, that’s good. That’s a good thing. Another tool recommended by experts for tracking this type of problem is a survey that allows individuals to anonymously report instances of sexual harassment or abuse. Does the Army have any kind of survey for JROTC?
Assistant Secretary Schaefer: I’m not aware of it, but I can look into it and I agree that that might be a good thing.
Senator Warren: I think you’ll find the answer is no on that. So let me ask the other services. Annual report, Secretary Parker?
Mr. Franklin Parker, Assistant Secretary of the Navy: Chairwoman Warren, no there is no annual report.
Senator Warren: No annual report. Secretary Wagner?
Mr. Alex Wagner, Assistant Secretary of the Air Force: Chairwoman, there is an annual report. It’s called the DEOCS for military folks and for DoD civilians. These are employees of schools. The JROTC instructors are school employees. The students are obviously students and so the optic of the military asking a survey of –
Senator Warren: I’m not asking that. What I’m asking is do you have an annual report that records how many people reported sexual assault against your folks who were in the JROTC program?
Assistant Secretary Wagner: The Air Force JROTC program tracks this extremely closely –
Senator Warren: So if I request that annual report you’ll get a copy of it and it will show me how many people reported incidences of sexual harassment or assault?
Assistant Secretary Wagner: I cannot say it’s a formal report –
Senator Warren: Well then it’s not a report.
Assistant Secretary Wagner: – What I can say is I’ve seen a list of every single incident and the disposition over the last five years.
Senator Warren: So the answer to my question about is there an annual report? Is that a yes or a no?
Assistant Secretary Wagner: We – as far as I’m aware – we don’t have an actual annual report, no.
Senator Warren: Alright, and do you do a survey? Secretary Parker?
Assistant Secretary Parker: No, we do not do a survey.
Assistant Secretary Wagner: Senator, we don’t do a survey, but we do provide a number of mechanisms for either parents or students to report incidents.
Senator Warren: Look, if you’re serious about sexual assault and sexual harassments, these are the two best tools that we know we have available. I’m asking the question: are the military services doing it? I’m hearing from Secretary Schaefer that she’s starting with the Army. I’m not hearing it from the Navy. I’m not hearing it from the Air Force and I’m asking all three of you, using the second tool and that is surveys, and I’m hearing the answer is no, no, and no.
No annual reporting – or just starting some annual reporting – and no surveys. In other words, there’s no real way for the DoD or the services to have the kind of information they need to exercise basic oversight. You’ve got to start with knowing what’s going on. And we know the problems with these surveys. We know that people underreport. We know they underreport formally. We know they underreport in surveys. We’ve got to at least start there.
One of the biggest problems that has come to light in these investigations is also that some of the instructors who abused these students had done it before. For at least seven of the instructors that we know about who were eventually criminally charged, it turns out that students had already raised concerns with the school before the incident that got these instructors arrested.
So let me start there. Secretary Schaefer, if colleges fail to report public safety issues like sexual assault, the Department of Education can be fine them under the CLEARY Act or even strip them of all federal funding. There are serious consequences for failure to report. So let’s ask about DoD accountability. If schools fail to report or stop this behavior in JROTC programs, does DoD have any mechanism for saying you no longer get to operate a JROTC program?
Assistant Secretary Schaefer: My understanding is that it’s the responsibility of the schools to report any of these incidences.
Senator Warren: I know and I’m asking: when school falls down on that responsibility, if this were the Department of Education, the Department of Education actually has tools to use to say, you’re going to pay consequences if you fail to report because we understand, nobody wants to report this stuff and the schools that are responsible certainly don’t want to report this. So I’m asking, is there anything in the Army JROTC program that will tell a school, you fail to report there will be consequences.
Assistant Secretary Schaefer: Again, I’m not aware of that, but I can look into it for you and give you an answer.
Senator Warren: Okay. I'm going to take that as a no unless you tell me something different. Secretary Parker, how about the Navy?
Assistant Secretary Parker: I’m not aware that there’s a specific trigger for removing a school that –
Senator Warren: Okay, that is a no. Secretary Wagner?
Assistant Secretary Wagner: Senator, the memorandum of agreement between Air Force JROTC and each school has specific requirements for schools to report –
Senator Warren: I’m not asking about the requirements. I’m asking about whether there are consequences if the school just keeps its mouth shut.
Assistant Secretary Wagner: If the school violates and consistently violates the memorandum of agreement then the school would be decertified –
Senator Warren: Have you ever decertified a school?
Assistant Secretary Wagner: I’ll have to look into that for you.
Senator Warren: Okay, but you say you actually have a mechanism?
Assistant Secretary Wagner: We have a mechanism.
Senator Warren: Okay. So we’ve got this on sexual assault – very disturbing findings on sexual harassment. There’s one other thing I want to cover very briefly and that is, recent investigations have also found that dozens of schools have forced students to participate in the JROTC program against their will. Parents have to sign a permission slip for kids to go to the museum field trip – the notion that thousands of students are forced to participate in JROTC programs is out of line with the program’s values.
Secretary Schaefer, would the Army support requiring JROTC programs to certify that their units are made up only of students who have provided informed consent to participate?
Assistant Secretary Schaefer: Well, we certainly don’t condone forced enrollment of this and that may be an option that we could look into.
Senator Warren: So you would like to see perhaps a way to certify that that is the case?
Assistant Secretary Schaefer: Perhaps, yes.
Senator Warren: Secretary Parker, how would the Navy feel about that?
Assistant Secretary Parker: Senator Warren, I believe that is something we’d be willing to consider.
Senator Warren: Okay, and Secretary Wagner?
Assistant Secretary Wagner: Absolutely.
Senator Warren: Okay. Look, we have an all-volunteer force; we should have an all-volunteer JROTC. I think we should all be able to agree on that. If the military doesn’t step up and prevent these kinds of abuses, then you endanger our ability to continue programs that build our force for the future. This is your reputation on the line here, and I hope you’ll work with me to get some procedures in place and make this program a safe program for all of our kids.
Closing Remarks below and video HERE:
I want to thank all of our witnesses for their service. I want to thank you for testifying today. I also want to thank Jon Clark, Gary Leeling, Andy Scott, Sofia Kamali, Sean O’Keefe, Katie Magnus, and Brendan Gavin for their work putting together today’s hearing. I value your contributions and am looking forward to working with all of you.
Today’s hearing makes it clear that we still have a lot of work to do to offer our servicemembers, our extended military families and even our civilian employees and the civilians who interact with our military the very best. I look forward to working with Ranking Member Scott as we go forward on a bipartisan basis to do the very best for our people. Thank you all.
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