Today, U.S. Senator Deb Fischer (R-Neb.), a senior member of the Senate Armed Services Committee, questioned expert witnesses—including Former Director of the Defense Health Agency Lieutenant General Douglas Robb, Former Joint Staff Surgeon Major General Paul Friedrichs, and Professor of Surgery and retired Air Force Colonel Jeremy Cannon—on the critical role of the National Disaster Medical System (NDMS) in maintaining surge capacity during major conflicts. She also asked about the next steps for its ongoing pilot program.

Additionally, Senator Fischer questioned Dr. Friedrichs and Dr. Cannon about the benefits of Military Health System partnerships with academic institutions.

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Fischer Questions Expert Witnesses:

Senator Fischer: Thank you all for being here today. I really appreciate the information that you're giving us and also the concern you have with the direction that we aren't headed yet. In the NDAA for FY 2020, a pilot program was established to assess the National Disaster Medical System, the NDMS, and hopefully that it would increase not just capability but also capacity within that. In a conflict—you know, we've touched on that already—we have to be able to quickly disperse and absorb casualties throughout the United States. Dr. Friedrichs, why is it so important for the NDMS to maintain this surge capacity?

Dr. Friedrichs: Senator Fischer, first, thank you for the role that you and your colleagues from Nebraska played in championing this and highlighting this. It's important because the Military Health System does not have the capacity to care for every casualty coming back. We don't have the capacity to care for the people in peacetime right now. So, to think that somehow we can do this on our own is another mistaken belief. During the Cold War, we recognized that if our nation went to war, we would go to war together. And that we would do it with an integrated system, with the DoD, the Veterans Health Administration, and civilian partners. We must rejuvenate the NDMS, not let it continue to atrophy.

Senator Fischer: So, what's the next step in this pilot program?

Dr. Friedrichs: So the next step is to make this not a pilot program, but to reiterate that this is indeed the intent of Congress, that the NDMS is the framework in which we integrate our ability to deal with either surges in military patients or in the event of a natural disaster, surges in civilian patients. But that is the framework. A subset of that are the RESPTC Centers, which you're very familiar with, the Regional Emerging Special Pathogen Centers that are designed to take care of patients exposed to or infected with high consequence infectious diseases. And another subset of that is the trauma system that Dr. Cannon so nicely described. We need your help to articulate in law that we must work as a nation and as a team. We're short 300,000 nurses nationally. The projections are we will be short 130,000 doctors by 2035. There is no way that we can do this individually. We must do it together. And I urge you to codify the NDMS pilot and make that the intent moving forward.

Senator Fischer: Dr. Cannon, Dr. Robb, anything to add on that?

Dr. Cannon: Senator, I would just advocate for what my colleague General Friedrichs just said, but we need to put our foot on the gas. We don't have five years, 10 years, 20 years. We need the solution, really, now.

Senator Fischer: Dr. Robb?

Dr. Robb: Yeah, I concur with both their comments, and then going back, the fact that we dual purpose these assets, these expensive assets, to solve problems, both on the military and the civilian sector. But they're mutually synergistic. So absolutely, we need to press forward.

Senator Fischer: Thank you. Dr. Friedrichs, you mentioned the University of Nebraska Medical Center and working with an academic institution. Can you explain to the committee the benefits of those partnerships with academic institutions in particular, and what that can yield for the Military Health System?

Dr. Friedrichs: Thank you very much, Senator Fischer. So, the first benefit is we share and exchange information. The University of Nebraska has established, without a doubt, one of the premier programs for treating casualties or patients who are exposed to highly contagious infectious diseases, and they've got remarkable on-site training, which they built in partnership with the United States Air Force. This is a great example of a military-civilian partnership in which the exchange of ideas improves care, both for military and civilian patients. But the other thing that we can learn from our civilian partners is something that I offered to the committee to consider—the CHIP-IN Act, which was originally passed to allow for blending of funding to build new VA facilities, should be expanded to include the DoD. We cannot afford to keep building duplicative facilities. And the CHIP-IN Act was a great way to allow the blending of federal, state, local, and philanthropic funds so that we can most efficiently care for this diverse patient population. Again, I commend the University of Nebraska for the pioneering work that they've done in showing what a good military-civilian partnership looks like.

Senator Fischer: Thank you for the shout-out on the CHIP-IN Act. That bill was written in my office. So, thank you very much. Dr. Cannon, as a professor of surgery, do you have anything to add on that?

Dr. Cannon: I would just comment that these military-civilian partnership sites can be incredible assets for force generation, for building up that next generation, those future leaders in surgery and other combat relevant specialties. And these are epicenters of academic excellence where we can truly inspire that next generation.

Senator Fischer: Thank you. Thank you, Mr. Chairman.