Billet Cuts Affecting Military Medical Facilities and Patients, Lawmaker Says

Billet Cuts Affecting Military Medical Facilities and Patients, Lawmaker Says
A sailor provides the COVID-19 vaccine to a Federal Fire Emergency Services staff member on Dec. 29, 2020, at Navy Medicine Readiness and Training Command Bremerton, Wash. The Naval Hospital Bremerton staff has been reduced by 100 billets, a lawmaker said, causing some problems for beneficiaries. (Photo by Douglas H. Stutz/Navy)

This article by Karen Jowers originally appeared on Military Times, the nation's largest independent newsroom dedicated to covering the military and veteran community.


Military beneficiaries are beginning to feel the effects of the personnel cuts in military medical facilities, a lawmaker told a panel of witnesses who are the top military medical officials.


And defense medical officials said they are “revalidating” their assumptions made before the pandemic for medical personnel requirements at each location, as well as the capacity of local civilian networks to take care of additional patients.


“I know the realignment is not only affecting the military hospital in my region, but is affecting many other districts across the country as well,” said Rep. Derek Kilmer, D-Wash., whose district includes Naval Hospital Bremerton. Hospital staff has been reduced by about 100 billets over the past year, he said. “When hospital staff leave, either because they retire or move to another installation, their positions are no longer being filled.”


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Kilmer referred to DoD’s plans, announced in 2019, to cut about 18,000 military medical billets throughout the services, as part of health care reform, moving those billets to operational forces. An estimated 190,000 retirees, family members and some active duty family members would be moved out of military treatment facilities.


Because of the cut of about 100 billets at the Bremerton hospital, Kilmer said, “unfortunately, we’ve seen some of these changes come at the expense of improving health care outcomes for the folks that I represent, including veterans and active duty military and their families. We’ve seen them lose access to quality care, so I’m concerned about the ability of local civilian providers to adequately cover the gaps in care.


“For example, a [retiree] living in Kitsap County in my district could be forced at times to drive over two hours to receive treatment in Seattle.”


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Kilmer asked the senior medical leaders what steps are taken before reforms are fully implemented to ensure that service members and their families have uninterrupted access to quality health care providers.


Defense and service officials are “revalidating” their manning plans for each location that were made before the pandemic, said Army Lt. Gen. Ronald Place, director of the Defense Health Agency. The results of that effort are being reviewed by defense and service officials, and should be provided to Congress sometime this summer, he said, in testimony before the defense subcommittee of the House Appropriations Committee.


“In the meantime, my responsibility, my requirement, is to make sure that care can be delivered, whether that care is on site, on the installation in our facilities, or in the network,” Place said. “If we can’t manage it in the network, then not reduce it within what’s happening on the installation.”


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Following a pandemic-induced pause last year, the Defense Department resumed its massive health transformation efforts that include reorganizing and reducing the military services’ medical billets to focus more on the operational forces. That transformation also includes moving the management of military treatment facilities worldwide from the control of the military services, to the authority and responsibility of DHA.


Kilmer asked for more insight into the analysis that’s being conducted, and what consideration is being made to the availability of care and the proximity of care in the local community. “And what consideration is made to the impact that this will have on our service members? Because frankly the sense from folks in our area is that there isn’t adequate sensitivity to those issues,” he said.


“I’m sorry folks feel that way,” Place said. “Certainly our intention is for all those considerations to be taken into account. One of the challenges we have to work through is the super sub-specialization of care in America, and in some locations of relatively rural America, as you mention, it takes some time to get from Whidbey Island or from Bremerton to Seattle where super specialty care is delivered.


“But there’s not enough requirement for it in the greater Bremerton area or the greater Whidbey Island area. So how do you balance the service members and family members who are stationed there using the Exceptional Family Member program as well as delivering primary and specialty care in those locations? That’s the balance we have to work through. …”


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