DOD Needs a Plan To Make Military Health System Genesis Work Better for Users, Watchdog Says

April 22, 2024 | By David Roza

A government watchdog urged the Department of Defense to set concrete goals for improving user satisfaction with military health system (MHS) Genesis, the widely-maligned program meant to modernize and streamline the military’s electronic health record (EHR) networks.

Without goals and a plan to achieve them, the Defense Department “will be limited in its ability to objectively measure progress, plan for improvements, and ensure that the system optimally meets the users’ needs,” wrote the Government Accountability Office in a report published April 18.

Indeed, while the 2023 user satisfaction survey shows improvement over past years, it paints a grim picture overall as users still prefer older DOD or private section systems.

Only 39 percent of MHS Genesis users agreed that the system enabled patient-centered care: a four percent improvement over 2022. That lags well behind the 56 percent of users who felt the same way about legacy EHR systems, and the 46 percent of respondents who use the private sector version of MHS Genesis.

Likewise, just 20 percent of MHS Genesis users agreed that the system was efficient, 21 percent said it had a fast response time, and 29 percent said it helped deliver high quality care. By comparison, legacy system users scored 36 percent, 31 percent, and 46 percent in the same categories, while private sector users scored 32 percent, 40 percent, and 50 percent.

The findings confirm a wide-held frustration with MHS Genesis, which has been plagued by glitches since it first rolled out in 2017. These include cybersecurity vulnerabilities, network latency, lengthy issue resolution processes, inadequate staff training, and delayed upgrades, the Congressional Research Service wrote in 2019. About 90 percent of survey respondents found inaccurate or incomplete patient health care information, which delayed access to health care, the Defense Department Inspector General wrote in 2022.

Some also say the system is too aggressive, flagging recruits with minor health conditions and preventing them from joining the service. It also slows down the medical review process: MHS Genesis connects to most civilian health information exchange networks to get a closer look at a recruit’s history, but that history is often incomplete, which draws out the timeline, the Defense Department Inspector General wrote in 2023.

“Prior to MHS Genesis onboarding, it was at least half, if not a third of the time to medically assess someone,” Brig. Gen. Christopher Amrhein, the head of the Air Force Recruiting Service, said in February. “If we can continue to work that piece, I think we can garner a great number of folks to join our Air and Space Forces.”

Lawmakers are worried too: at a hearing in December, Sen. Elizabeth Warren (D-Mass.), chair of the Senate Armed Services subcommittee on personnel, said she was concerned MHS Genesis was delaying the recruiting process and raising issues over applicants with manageable or long-healed injuries. At the hearing, Maj. Gen. William Bowers, head of the Marine Corps Recruiting Command, said the Pentagon had “recently set up a task force to look at the challenges of implementation” that was due to finish in February. A Pentagon spokesperson did not immediately respond when asked for a status update on the task force.

Future Moves

With more than 171,000 users around the world, MHS Genesis is here to stay, which is why the Department of Defense needs goals for improving user experience and a plan to achieve them, GAO argued. Those goals and plans have not yet been established, because the department “focused its priorities on deploying the system to all sites and ensuring patient safety,” officials told the GAO.

The Defense Department partially concurred with GAO’s recommendation to establish MHS Genesis user satisfaction targets and work towards meeting them. After the deployment phase ended earlier this year, “we are transitioning to an optimization phase of the program to enhance the end user experience,” the department wrote.

But one area of MHS Genesis is still so bad that the GAO recommended the Pentagon find an alternative. The dental module, Dentrix, has had problems since it started in 2018, and it still can’t support a growing number of users, GAO found. The program office said the Dentrix vendor had “systemic inability to deliver fundamental capability on schedule and on budget,” but as of November, there were no dates, estimates, or plans for finding an alternative.

“Until the program office identifies an alternative approach to resolving the Dentrix issue, MHS Genesis will not provide critical functionality to dentists who are treating service members and other DOD beneficiaries,” GAO wrote.

The Defense Department partially concurred with GAO’s recommendation, saying it was currently conducting an analysis of alternatives to “explore new solutions.”

First AI Dogfights Focus on Safety, Building for CCA Applications

April 21, 2024 | By John A. Tirpak

The first live-fly dogfights between an artificial-intelligence-flown jet and human pilots took place last fall, the U.S. Air Force and the Defense Advanced Research Projects Agency revealed April 19. Ongoing testing of the capability will help inform the development of Collaborative Combat Aircraft, of which the USAF expects to field more than a thousand in the next decade.

The AI was loaded aboard the Air Force’s X-62 VISTA (Variable Stability In-flight Simulator Test Aircraft), a highly modified F-16 research aircraft, and flew multiple dogfight engagements against stock F-16s flown by human pilots, according to Lt. Col. Ryan Hefron, program manager for DARPA’s Air Combat Evolution (ACE) project, and Col. James Valpiani, commandant of the Air Force Test Pilot School, who spoke to reporters in a teleconference about the effort.

Hefron declined to divulge the outcome of the initial dogfights, citing classification.

The ACE program has been underway for four years, he said, and the AI was trained not by feeding it hundreds of pilot engagement reports but by allowing the program to teach itself dogfighting by running “billions” of simulations about how to maneuver the aircraft given a wide range of demands, conditions and mission rules of engagement. The AI algorithms started non-dogfight flight tests on VISTA in late 2022, accomplishing 21 such missions before the dogfight phase. During the run-up, the two-seat VISTA had two pilots on board, switching between various AI agents to evaluate their performance. But Hefron said they never had to take control away from the AI.

The AI was first verified in computer simulations. There, Hefron said, the AI consistently prevailed against human pilots. But the simulations didn’t include rules on how “not to break the airplane” by overloading its structural limits. That was added before the live-fly elements were begun.

In the exhaustive virtual engagements over several years, the AI was “rewarded”—a computing term for something akin to emphasis—when it did the right thing and corrected when it did the wrong thing. Valpiani said that only when simulations showed it was routinely safe did the action move to life-fly engagements.

The key to the effort so far has been operating safely, in order to give pilots confidence that the AI can be trusted to function as expected, Hefron said.

Air Force Secretary Frank Kendall will soon fly in the VISTA to see firsthand how the experiments work.

In the dogfights, VISTA built up to full-on dogfighting by first flying defensively, then gradually being put more on the offense, often coming within 2,000 feet of a human opponent and flying at Mach 2. Flight test school students had a major hand in designing the tests, Valpiani said.

Valpiani and Hefron said a variety of dogfight situations were tested, including head-to-head engagements, and engagements where the dogfight started with one aircraft already in a disadvantaged position.

Gen. Mark D. Kelly, the recently-retired former head of Air Combat Command, had been cautious in recent years about human-machine teaming for air combat, insisting that before the Air Force plunges headlong into acquiring thousands of CCAs, fighter pilots who would collaborate with them must be completely satisfied that they can be trusted and are safe to fly with or the pilots would resist the technology.

Dogfighting is “inherently very dangerous,” Valpiani said, citing dozens of midair collisions in the F-16 and F/A-18 communities over the last few decades. It’s one of the “most difficult” aerial skills to master, he noted. That’s why the prime consideration in the “crawl-walk-run” effort has been on safety.

The autonomy builds on efforts such as the F-16’s Collision Avoidance System, he said, in which programs onboard the fighter will take control and steer clear of an impending air or ground crash if the pilot is not doing so. The system has saved a number of lives.

But air combat is much more complex than flying point-to-point or simply avoiding hazards, Valpiani noted, calling it the most stressing “challenge case” for an AI because it is such a dynamic activity, happening at high speed.

Lessons learned so far include how to quickly adapt the AI agent and load it into the aircraft, “plane-side” with laptops, or sometimes after takeoff. More such tests are contemplated and will pick up pace as the Air Force simultaneously launches the CCA development program with a contract to two or three companies later this year.

Top Lawmakers Want 15 Percent Pay Raise for Enlisted Troops

April 19, 2024 | By David Roza

A bipartisan law co-sponsored by the leaders of the House Armed Services Committee would boost pay by 15 percent for junior enlisted troops and seek to improve several quality of life issues.

The bill to improve U.S. military service members’ quality of life will form a fundamental part of the Fiscal Year 2025 National Defense Authorization Act, the annual law that funds most of the military. The bipartisan bill, Service Member Quality of Life Improvement Act, was introduced a week after the House Armed Services Committee published its Quality of Life report, an investigation of long-running concerns, including child care shortages, insufficient housing allowance, dilapidated barracks, and long wait times for medical appointments.

The report made a list of recommendations to help solve those issues, and HASC members vowed to write them into the 2025 NDAA. Although Congress is struggling to balance a range of competing modernization priorities as the military prepares for a possible conflict with China, lawmakers say a top priority for defense legislation is quality of life.

“We’re going to find the room in that bill to do this,” HASC Chairman Rep. Mike Rogers (R-Ala.) said last week. “We’re going to have complications. I’m not going to argue that we won’t. But it won’t be because of this, it’s because of a whole spectrum of threats and platforms and issues. But this is going to be done.”

The committee seems to have taken a step in that direction by writing several of the report’s recommendations into the bedrock of the 2025 NDAA.

“Service members should never have to worry about making ends meet, putting food on the table, or affording housing,” Rogers said in a release April 18. “Improving the quality of life for our service members and their families is my number one priority—we’re going to get this done.”

“This year’s bill leaves no doubt that the heart of America’s defense will get the recognition and resources they need and deserve,” Smith, the ranking member of the HASC who co-sponsored the bill, said in the release.

The first provision of the bill is to reform rates of monthly basic pay for troops ranked E-1 through E-4. For example, enlisted troops at the rank of E-3 with two years or fewer in service currently make $2,377.50 a month. Under the new bill, they would make $2,733.90 a month, a 15 percent increase. The raise is meant to keep pace with increasing wages for civilian low-income jobs, which have risen faster than higher-income earnings, leaving junior enlisted troops relatively shortchanged.

“This will restore real value to basic pay,” the Quality of Life Panel report said.

Beyond a pay raise, the bill would also evaluate the rates of basic allowance for subsistence and cost of living allowance; expand income eligibility for basic needs allowance from 150 percent to 200 percent of federal poverty guidelines; and appropriate $1.2 billion for upping the basic allowance for housing from 95 percent to 100 percent of the calculated rate for military housing areas.

The bill would also aim to pay child development center (CDC) workers more; make every service cover 100 percent of child care fees for the first child of a staff member at a CDC and reduce fees for additional children; fully fund requests for financial assistance to eligible civilian child care and youth program providers; and require a regular briefing from the Office of the Secretary of Defense on the state of child care waitlists, capacity at CDCs, and efforts to shorten those waitlists.

For housing, the 2025 NDAA would require each service provide increased transparency on how it spends money on barracks sustainment, restoration, and modernization. It would also require developing criteria for digital facilities management systems that would enable better tracking of building health and maintenance plans. The services would also have to explore leasing property to address the shortage of unaccompanied housing and conduct an independent assessment of how to fix that shortage.

To improve access to health care, the bill would waive referral requirements for Active-duty service members seeking help with physical therapy, nutrition, audiology, optometry, podiatry, and several areas of women’s health care. Staffing shortages across the military health system contribute to long wait times for medical appointments, and the bill requires an annual survey and reports on what strategies work to retain military medical providers.

About one in five military spouses are unemployed. To address that, the 2025 NDAA would extend the Defense Department’s authority to help state governments create interstate compacts so that spouses in licensed professions can work in other states more easily. That authority expires Sept. 30, the end of the fiscal year, under the current law, though the new bill does not specify an end date for its extension.

Beyond interstate compacts, the 2025 NDAA would also direct the Defense Department to help military spouses find paid fellowships in various industries and expand eligibility for child care for military spouses seeking employment from 90 days to at least 180 days.

Not all of the recommendations from the Quality of Life Panel report made it into the bill, but the panel’s ranking member, Rep. Chrissy Houlahan (D-Penn.), said it would still help.

“I look forward to its monumental impact on our service members and their families,” she said.

Thomas C. Reed, Secretary of the Air Force Under Ford and Carter, Dies at 89

April 19, 2024 | By John A. Tirpak

Thomas C. Reed, the 11th Secretary of the Air Force and the first to have served in uniform in the Air Force uniform, died Feb. 11, at 89. He led the service under presidents Gerald Ford and Jimmy Carter, was head of the National Reconnaissance Office, and also served as a national security advisor to President Ronald Reagan.

Reed entered the Air Force in 1956 through the ROTC at Cornell University, N.Y., where he was first in his academic class—receiving a bachelor’s in mechanical engineering—and commander of the cadet corps.

On Active-duty, he was the project officer for the Minuteman Re-Entry Vehicle System. After earning a master’s in electrical engineering from the University of Southern California, he worked on thermonuclear weapon physics at the Lawrence Radiation Laboratory, first in uniform and then as a civilian, and was a consultant there until 1967.

In 1962, he formed the Supercon, Ltd. company, which produced superconducting alloys. Soon after, while still with Supercon, he formed Quaker Hill Development Corp., a real estate firm in California and Colorado.

Reed managed Ronald Reagan’s second successful campaign for governor of California and was a senior member of Richard Nixon’s re-election campaign.

In 1973, he was appointed assistant to Secretary of Defense James Schlesinger, recruiting talent for the DOD and troubleshooting procurement issues. Soon after, he was named head of Telecommunications and Command and Control Systems for the Defense Department in 1974.

Nominated by Ford, Reed became the 11th Secretary of the Air Force on Jan. 2, 1976, and served in that role—in which he was also the director of the NRO—for 15 months, departing April 6, 1977, at the beginning of the Carter presidency.

As Secretary, Reed worked to keep the multinational F-16 program on track and deflected budgetary efforts to derail the F-15 and A-10 fighter programs. He said he saw much of his job as keeping programs alive during the budget austerity following the Vietnam War. During his tenure, the Air Force experimented with the first stealth aircraft.

Reed served as a member of the Defense Science Board from 1977 to 1983 and as a member of the Strategic Air Command’s scientific advisory group from 1981-1983.

With the election of Ronald Reagan in 1980, Reed was appointed to the newly-created Commission on Strategic Forces, which recommended renewed investment in the strategic forces, to include the M-X—later “Peacekeeper”—missile and endorsed continuing the B-1 bomber program. Reagan also appointed Reed as his Special Assistant for National Security Affairs, but he resigned the post in March 1983 when he became the subject of an investigation into insider trading. He was found not guilty in a 1985 trial resulting from that investigation.

He returned to his business interests, developing a ski resort in Colorado and a successful winery in Sonoma, Calif., but continued in various national security advisory positions. In the 1990s, after the collapse of the Soviet Union, Reed played a role in returning nuclear weapons in Ukraine to Russia—a move that has sparked renewed debate after Russia’s invasion of Ukraine.

Reed was also a prolific and eclectic author.

In the early 2000s, Reed wrote “At the Abyss: An Insider’s History of the Cold War, which recounted his involvement with nuclear weapons at Livermore up through his advisory time at the Reagan White House. A second book, “The Nuclear Express: A Political History of the Bomb and its Proliferation,”co-authored with Danny Stillman, technical intelligence chief at the Los Alamos National Laboratory, contended that China deliberately spread nuclear weapons technology to third-world countries in the 1980s. Reed also wrote a spy thriller, released in 2012, titled “The Tehran Triangle,” about Iranian nuclear terrorism.

PHOTOS: 12 B-2s Conduct Massive Fly-Off, Elephant Walk

April 19, 2024 | By Unshin Lee Harpley

The Air Force carried out the largest B-2 Spirit fly-off in recent history when 12 aircraft—the majority of the nation’s stealth bombers—took off one by one on April 15 from Whiteman Air Force Base, Mo.

The event also created a massive elephant walk as the aircraft taxied to and took off from the base’s lone runway.

“Visual displays of power can serve as a reminder to potential adversaries of the overwhelming air power that the B-2 can bring to bear,” a spokesman for the 509th Bomb Wing, which operates the Air Force’s combat B-2 fleet, told Air & Space Forces Magazine.

B-2 Spirit stealth bombers assigned to the 509th Bomb Wing taxi on the runway at Whiteman Air Force Base, Mo., April 15, 2024. Team Whiteman executed a mass fly-off of 12 B-2s to cap off the annual Spirit Vigilance exercise. U.S. Air Force photo by Airman 1st Class Hailey Farrell

The mass gathering of the iconic flying wing aircraft was a capstone of Air Force Global Strike Command’s annual Spirit Vigilance readiness exercise, spanning from April 8 to April 12. The last mass fly-off of B-2s saw eight bombers take off from the base during the 2022 iteration of the exercise.

“Exercises are both critical to our readiness and a powerful tool to demonstrate to the world that the B-2 is a credible and reliable strategic deterrent,” Col. Keith Butler, 509th Bomb Wing commander said in a release.

Col. Geoffrey Steeves, the 509th Operations Group commander, further highlighted the bomber’s unique capabilities as part of the nation’s nuclear triad of nuclear-capable B-2s and B-52s bombers, land-based Minuteman III intercontinental ballistic missiles, and Ohio-class submarines. The air and land legs both fall under AFGSC.

“As the world’s most strategic aircraft, the B-2 has an outsized effect on great power competition,” Steeves said in the release. “The B-2 is the only aircraft on the planet that combines stealth, payload, and long-range strike.”

The display of the service’s bombers is also a reminder of the stealth bomber capabilities following months of fleet-wide stand-down after two separate accidents involving two Spirits at Whiteman. In September 2021, a B-2 was involved in an incident after an issue with the landing gear, followed by another accident in December 2022. Both bombers were damaged in the incidents, which prompted a months-long safety stand-down of the fleet until May 2023 after the 2022 mishap. The service officials said that despite the pause in flight, the B-2s could deploy if ordered during that period.

A B-2 Spirit stealth bomber assigned to the 509th Bomb Wing taxis to the runway at Whiteman Air Force Base, Mo., April 15, 2024. Team Whiteman executed a mass fly-off of 12 B-2s to cap off the annual Spirit Vigilance exercise. U.S. Air Force photo by Airman 1st Class Hailey Farrell

Since then, the B-2 has been deployed to Europe for NATO-related missions, flying across the North Sea alongside the U.K.’s Royal Air Force fighters. The Spirit’s highly anticipated return was highlighted when a single B-2 soared through the skies of southern California for the Rose Bowl in January, reinstating the football game’s tradition after missing the flyover in 2023.

The B-2 jets entered service in the early 1990s as the Air Force’s first stealth bomber, and fewer than two dozen were produced. After a crash in 2008, the fleet was reduced to just 20 aircraft. Whiteman is the home base for the nation’s combat B-2s, though the service also typically has a test aircraft assigned to Edwards Air Force Base, Calif. The service has outlined plans to retire the fleet once the B-21 Raider, another flying wing produced by Northrup Grumman, enters service in substantial numbers in the 2030s.

Sticker Shock Drags Out USAF’s E-7 Negotiations with Boeing

April 18, 2024 | By John A. Tirpak

The Air Force hopes to nail down a deal with Boeing for the E-7 Wedgetail airborne early warning and battle management aircraft soon, but negotiations remain bogged down over what the service deems an unreasonably high price for the jet.

The Air Force won’t say what it thinks is a fair cost for the E-7, but in a hearing of the Senate Armed Services Committee this week, Sen. Markwayne Mullin (R-Okla.) said a figure of $2.5 billion per airplane is rumored, and neither Air Force Secretary Frank Kendall nor Chief of Staff Gen. David W. Allvin challenged that figure.

A congressional source said the figure came up in pre-testimony office visits and, again, was not refuted by Air Force officials. However, an Air Force official said the figure is “about” what’s being discussed for the engineering and manufacturing development program for the E-7 program.

An Air Force spokesperson said the $2.5 billion per jet figure is “inaccurate,” but declined to comment further.

The E-7s in question would be prototypes, and that cost would not necessarily correlate to the other 24 Wedgetails the Air Force plans to buy.

When asked about progress with the E-7 in the April 16 SASC hearing on the Department of the Air Force’s budget, Kendall said the Air Force is “still moving ahead with the E-7; it’s funded in the ’25 budget.” He added that production of one of the two developmental prototypes has been slipped “a year to the right.”

“The price that we got from the prime came in much higher than we had anticipated,” Kendall said. “We’ve been involved in negotiations trying to get it down. We have come much closer, but we’re not really at closure yet. So, we have some additional work to do there.”

In what Kendall said was an admittedly “optimistic” forecast, the Air Force would “hopefully … get to an agreement very shortly, and then we’ll be able to move on to the program. We’re still committed to the program, but we’ve got to have an affordable aircraft.”

The Air Force plans to buy 26 E-7s to replace the E-3 Airborne Warning and Control System aircraft, which now is more than 40 years old. Allvin said that because of obsolete parts, overall structural fatigue, engine maintenance issues, and age, the aircraft are “starting to divest themselves” and cannot continue to be upgraded. He lauded maintenance Airmen who manage to keep the aircraft flying despite the many mechanical issues.

Kendall said the E-3’s radar is obsolete, and because Chinese long-range missiles would target such key assets early on in a potential conflict, the E-3 and other critical assets like it “are not effective and would die very quickly.” The E-7, with its main active electronically scanned array radar, can operate further away from the heat of the fight, increasing its survivability.

Long-term, Kendall said, the airborne and ground moving-target mission will transition to satellites.

Asked why the E-7 is apparently so costly, Kendall said that it “would have to include all of our communication systems. So, there are a number of modifications from the original E-7, which is several years old, that have to be made to meet our requirements. That’s part of the problem with the cost.”

The E-7 was developed by the Royal Australian Air Force with Boeing, and has also been adopted by the U.K. Royal Air Force. The Republic of Korea Air Force and Turkish Air Force have also signed up to buy it, and NATO is considering the jet to replace its own E-3 fleet.

Mullin—whose state the E-3s are based and fixed at depot—insisted the 16 E-3s the Air Force will retain until the E-7 arrives are too few, adding that “quantity has a quality all its own” and that more aircraft can help blunt Chinese advances.

In response, Allvin retorted that “it’s only good if that quantity can survive. It’s only good if that quantity can be effective.”

Operating in a “highly contested environment, against a peer adversary … more quantities” of less advanced aircraft “might be left in the bottom of the Pacific Ocean,” he said.

The Air Force needs to “ensure that those crews can survive; they can execute their mission,” Allvin said. The proposed plan for the E-3 retains “enough for today” while investing in a more credible capability in the near term, he added.

Kendall said the E-3s “just don’t have the resilience or the capability. … We’ve really got to get to the next generation. So keeping airplanes around that are going to be ineffective and essentially very vulnerable to attack in the early stages of conflict … is not putting us in a better position.”

At the AFA Warfare Symposium in February, Air Force acquisition executive Andrew Hunter said he doesn’t find it “surprising” that Boeing is bargaining hard on the E-7, noting that “they’ve gotten into some contracts in the past”—like the KC-46 taker and T-7 trainer—where “it’s apparent that as they were bidding those, there was key information they were lacking.”

Boeing is more than $7 billion in the red on the KC-46, which is a fixed-price program, and is starting to incur significant losses on the fixed-price T-7, as well. Outgoing Boeing CEO David Calhoun has said the company is resolved to be “more disciplined” in how it bids government contracts.

Boeing is “trying to do their homework and not bid” if “they don’t understand the full scope of the work they’re going to be expected to perform,” Hunter said at the conference.

The sticking point in the negotiations is focused solely on the “prototype aircraft,” Hunter said. Once those are in the configuration the Air Force needs, it wants to “seamlessly transition into a production program under the major capability acquisition pathway.”

Hunter and other officials have said that nonrecurring engineering and cybersecurity are the big E-7 cost items that were not anticipated. Officials have also said the Air Force has offered to defer some capabilities to later upgrades in order to meet a rapid timetable and get the cost to where the service and Boeing can agree.

An Air Force official said in February that although there are other potential solutions to the Air Force’s airborne tracking and battle management requirement, “there isn’t any alternative … when you think about what it would take to match this.”

B-52 Bombers Make Rare Landing at Civilian Airport

April 18, 2024 | By Unshin Lee Harpley

Two B-52 bombers made a rare touchdown at a civilian airport earlier this month to practice landing at non-military airfields. The jets, operated by the 20th Bomb Squadron at Barksdale Air Force Base, La., landed at Chennault International Airport, La. on April 12. The airport is about 200 miles south of Barksdale, the home of the 2nd Bomb Wing and Air Force Global Strike Command, which oversees the service’s bombers.

“When it comes to nuclear war, all bets are off and we need to be prepared to adapt to the current situation,” squadron commander Lt. Col. Jared Patterson said in a release. “By demonstrating our ability to land at a civilian airfield, we’re demonstrating our ability to conduct operations.”

b-52 — Senior Airman Justin Whitehead, 2nd Aircraft Maintenance Squadron crew chief, Capt. Joshua Benard, 20th Bomb Squadron radar navigator, and Capt. Stephen O’Donnell, 20th Bomb Squadron electron warfare navigator, line up stairs to a B-52H Stratofortress as they prepare to load a drag chute at Chennault International Airport, La., April 12, 2024. (U.S. Air Force photo by Senior Airman Nicole Ledbetter)

The 159-foot-long B-52 requires runways that are long, wide, and strong enough to support its weight, and those are not always found at civilian airports. By landing and taking off from Chennault, the squadron proved it can “land a B-52 anywhere across the globe,” Patterson said.

“Landing B-52s at a civilian airport, like Chennault International Airport, forces Airmen to think differently,” Barksdale spokesperson Capt. Hunter Rininger told Air & Space Forces Magazine. Working at unfamiliar airfields “allows Airmen to practice operations … that are difficult to replicate within the sanctuary of a typical military airfield.”

A spokesperson for Air Force Global Strike Command told Air & Space Forces Magazine that the landing demonstrates Agile Combat Employment, a concept in which small teams of Airmen launch and recover aircraft at remote or austere airfields, then relocate to avoid being targeted by enemy missiles. It also underscored the importance of military-civilian cooperation, said Kevin Melton, executive director of Chennault International Airport.

“The 2nd BW and Chennault International Airport partnership is significant because it provides the wing an alternate location for training and operations,” said Melton.

A B-52H Stratofortress assigned to the 96th Bomb Squadron, Barksdale Air Force Base, La. lands at Chennault International Airport, La., as part of exercise Bayou Vigilance April 12, 2024. U.S. Air Force photo by Senior Airman Nicole Ledbetter

The landing marked the end of this year’s first iteration of the wing’s Bayou Vigilance exercise, which started on April 3. Held multiple times a year, the exercise gives bomber air and ground crews a chance to practice responding quickly to a crisis.

“This exercise demonstrated the 2nd Bomb Wing’s ability to rapidly mobilize airpower, stand up nuclear security operations when called upon, and execute the alert mission for an extended period of time,” Col. Michael Maginness, 2nd Bomb Wing commander, said in a release. “With every rep, the Wing is laying the groundwork for future capabilities.”

In recent years, the strategic bombers have conducted more landings at other nations’ military airfields, broadening their presence around the globe.

New Bill Looks to Ease Military Child Care Shortage

April 18, 2024 | By David Roza

A new bipartisan law introduced April 18 promises to help ease the nationwide military child care shortage by allowing the Defense Department to create 12 partnerships with private and public child care centers on or near military bases. The hope is that those first-of-its-kind partnerships, along with new incentives and authorities to recruit and retain child care providers, will drive up capacity at those locations, where many families are stuck with monthslong waiting lists.

Introduced by Sens. Jeanne Shaheen (D-N.H.) and Joni Ernst (R-Iowa), the Expanding Child Care for Military Families Act comes a week after the House Armed Services Committee released a report investigating military quality-of-life issues, including child care.

“[A]ccessibility due to long waitlists, particularly for infant care, persists as a significant challenge and source of frustration for service members and their families,” the report said.

Both the military and civilian workforce suffer from a nationwide shortage of providers, which is felt even more acutely at remote military installations. The report cited wait times as long as six to seven months. To make things more difficult, military families move frequently and often work odd hours when most child care centers are closed. The Defense Department received funds to build 17 new child development centers (CDCs) since 2019, but many of those are not yet complete.

To hire new workers, the Defense Department is offering wages comparable to civilian employers, but the problem is those are still often not high enough, and many child care workers switch to retail industries, the report found. Still, some incentives are having an effect: the Air Force reported last year that direct-care staffing levels increased from 72 to 77 percent from 2022 to 2023 after the branch began providing complete child care fee waivers for the first child of staff at military CDCs, plus a 25 percent discount for additional children.

The Quality of Life Panel Report called for making those benefits universal across the services and cover up to 100 percent for additional children. It also called for paying military child care workers more; for quarterly briefs from the Defense Department on how it is addressing staffing shortages; and for a study on whether hiring authorities for child care workers can be improved.

The new bill seems to address several of those issues. Establishing partnerships with eligible providers should increase capacity, improve child care workforce development, and recruit and retain more providers. To sweeten the pot, the bill also calls for the military to provide certification and training opportunities at participating child care centers.

That kind of support could make a difference for Cora Hoppe, director of the nonprofit, New Hampshire-based Rochester Child Care Center. Hoppe told NBC News she had to lay off a quarter of her staff due to a tight budget and high operating costs.

“There’s no wiggle room. There’s absolutely none,” she said. “The DOD’s backing would be huge, because then it would allow us to build our capacity.”

Beyond local providers, the bill would also authorize the Defense Department to partner with national service agencies such as AmeriCorps to place volunteers at child care centers. It would also encourage the department to recruit and offer training for eligible military spouses.

Should the bill be passed, the pilot program would start no later than Jan. 1, 2026. After that, the Pentagon would have to report on the status of the program every year until the pilot ends on Dec. 31 2030—or longer if the pilot is extended.

“As a mom and a new grandma, I know it takes a village to raise a child and that our military members need high-quality, affordable child care for their young ones,” Ernst said in a statement. “By boosting training and recruitment efforts, this bipartisan bill will ensure military kids are safe and loved while their parents diligently train and prepare to protect our nation.”

Why a Civilian Defense Employee Died After a C-17 Test Flight Last Year

April 18, 2024 | By Unshin Lee Harpley

The Air Force blamed the death of a 33-year-old Missile Defense Agency civilian employee after a C-17 test flight in August on decompression sickness complicated by his underlying medical conditions, including obesity, hypertension, an enlarged heart, and cardiovascular disease, according to the results of an accident investigation board released April 12.

However, the report leaves several questions unanswered, such as how the employee was cleared for the flight, why medical specialists aboard did not recognize his symptoms, and why the test flight continued as planned, even after it was clear he was experiencing a medical emergency.

The C-17 took off from Joint Base Elmendorf-Richardson at about 10 a.m. on August 21, flying over the Pacific Ocean past the Aleutian Islands. The MDA employee was there to help test out a simulated high-altitude, medium range ballistic missile launch. Following procedure, the crew donned helmets and oxygen masks to start pre-breathing pure oxygen 30 minutes before the test to prevent decompression sickness.

At about 2 p.m., the crew opened the C-17 cargo doors, conducted the test, then closed the doors after about five minutes and repressurized the jet. But after the doors closed, the MDA employee began sweating excessively and making “motions of distress,” the report wrote. Crew members flagged down High Altitude Airdrop Mission Support (HAAMS) physiological technicians, who oversee crew safety on un-pressurized high altitude flights. Barely able to breath, the MDA employee used a whiteboard to communicate, but he could only scribble illegibly, the report said. He also indicated pain and a lack of mobility in his right arm.

All of those symptoms indicate decompression sickness, investigation board president Brig. Gen. Derek Salmi noted in the report. Also known as “the bends,” decompression sickness is when changing air pressure forms nitrogen bubbles in the body that can pressure nerves, damage tissue, and block blood flow. The procedure for decompression sickness is to put the patient on pure oxygen, descend to normal air pressure, land immediately at the closest airfield, and, if necessary, put the patient in a hyperbaric oxygen therapy chamber.

But the HAAMS technicians failed to recognize the symptoms of decompression sickness and instead treated the patient for hyperventilation. They placed him on an emergency oxygen mask as the aircraft cabin altitude decreased below 10,000 feet, where oxygen masks are not required. One of the HAAMS technicians thought the employee was stable and removed his mask, but his right arm was “droopy,” he had difficult standing up and “looked like a guy that had been drinking all night,” according to a crew member.

The crew notified the pilot but said the MDA employee was in a stable condition, then moved him to the floor near the front of the aircraft. The flight deck trusted the HAAMS techs to care for the ill employee and provide updates, but it is unclear how often those updates were delivered, and the patient continued to slur his words, breath heavy, appear in pain, and look pale. The mission was planned for seven-hour duration, and the flight landed at 5:00 p.m. as originally scheduled without any indication of rushing to land.

The instructor pilot recalled feeling shocked at seeing the MDA employee’s condition for the first time, saying he “looked like he had a stroke,” and did not appear stable. Doctors at a nearby hospital said he needed a hyperbaric chamber, but the nearest one was in Seattle and air transport would not be available until the next morning.

Over the next 12 hours, the patient’s blood pressure dropped, and his lungs, liver, and kidneys failed. Despite the physicians’ best efforts, the employee went into cardiac arrest at 8:06 the next morning and was pronounced dead 26 minutes later.

Analysis

Salmi said the initial misdiagnosis “likely delayed available treatment measures such as continued oxygen use … as well as descent by the aircraft to a lower cabin altitude.” Another problem was the lack of follow-up care during the return flight “despite the persistent and significant symptoms” exhibited by the MDA employee.

Even so, the general said the employee’s case of decompression sickness, combined with his underlying conditions, was so severe that the outcome may have been the same. The report cited a history of hypertension, an enlarged heart, and blockage of the coronary arteries as contributing factors. How was an employee with such conditions allowed on the flight?

The MDA employee had a current Federal Aviation Administration Class III physical, “the simplest medical certificate for private, recreational, and student pilots to obtain,” according to Flying Magazine. He had been flying high-altitude test airdrop missions for a little over a year, and the August 21st sortie was his sixth such mission. In fact, he was considered “an expert in this mission set … and was actively instructing another MDA colleague as part of the mission.”

Even had he been in better shape, the employee may still have developed decompression sickness: Salmi wrote that recent medical studies found a 30 percent chance for anyone taking part in high-altitude operations to develop some symptoms, ranging from mild to severe. The Air Force did not respond before publication to a question of whether anyone was held accountable as a result of the report.

Earlier this month, the Air Force released an investigation into the death of a contractor who was killed last year when she walked into the moving propeller of an MQ-9 during ground tests. The death was blamed on a confluence of factors, including inadequate training, poor lighting, noisy conditions, and a rush to finish testing, all of which contributed to the victim’s loss of situational awareness while she took telemetry readings.

The deaths of the two civilians helped make fiscal year 2023 a difficult year for aviation accidents. Air Force Times reported two deaths, 10 aircraft destroyed, and 75 major non-combat aviation mishaps in total: a five-year high. Those mishaps occur as maintainers and aircrew try to meet mission requirements with a dwindling number of aging aircraft.

Meanwhile, the Air Force is recalculating its approach to risk as the service adopts agile combat employment (ACE), concept where small teams of Airmen launch and recover aircraft at remote or austere airfields, then relocate to avoid being targeted by enemy missiles. Many Airmen expect to carry out those operations without support and without connection to higher command. On April 2, the Air Force Safety Center unveiled a new plan to keep pace. Part of the plan is to use machine learning models to review safety data and provide better analysis for safety officers to improve their processes.

“Mishap reporting data is a lagging indicator and limited tool,” the center wrote in a release. “Our intent is to develop analytical tools to assist commanders with proactive risk reduction, mishap prevention, and maximized readiness.”