Review of the Development of Interagency Plans to Address Health Preparedness for and Readjustment of Veterans and Their Families After Future Deployments
President Clinton established the Presidential Advisory Committee on Gulf War Veterans' Illnesses on May 26, 1995, to ensure an independent, open and comprehensive examination of health concerns related to Gulf War service. The Committee issued its final report on December 31, 1996, documenting its review of the government's outreach, medical care and research, efforts to protect against and to assess exposure to chemical and biological weapons, and coordination activities pertinent to Gulf War veterans' illnesses. During the course of the Committee's deliberations, government efforts to address and to resolve veterans' concerns continued, consistent with respective agencies' missions to provide for the health and welfare of active, reserve, and retired service personnel and their dependents. The issuance of the Committee's recommendations provides valuable guidance to the Federal Government in reviewing policies and programs and developing a coordinated interagency plan for minimizing or preventing similar post-conflict health concerns in the future, to the extent possible.
Extensive public review and analysis of Gulf War veterans' illnesses and risk factors have identified a number of opportunities for government action aimed at minimizing or preventing future post-conflict health concerns. Ameliorating, avoiding or, ideally, preventing such health effects can be approached through a variety of means. These include improving service personnel's understanding of health risk information; enhancing government collection of health and exposure data; coordinating agency research programs; and improving the delivery of health care services to veterans and their families, as could be accomplished by establishing effective linkages between health information systems.
The Presidential Advisory Committee on Gulf War Veterans' Illnesses recommended that the National Science and Technology Council (NSTC) "develop an interagency plan to address health preparedness for and readjustment of veterans and their families after future conflicts and peacekeeping missions." This Presidential Review Directive responds to the Committee's recommendation. The Department of Defense, the Department of Health and Human Services, the Department of Veterans Affairs, the Office of Management and Budget, the National Security Council, the Office of Science and Technology Policy, the Joint Chiefs of Staff, and others as appropriate, are asked to review policies and programs and identify relevant actions that may be taken by the Federal Government to better safeguard those individuals who risk their lives to defend our Nation's interests. In accordance with the Advisory Committee's proposal, agency recommendations will form the basis for an NSTC report, which will be submitted for outside expert review.
Agency recommendations should address the following:
Health (e.g., stress prevention, treatment, research; medical surveillance adequacy, coordination; interventions for families);
Outreach and risk communication;
Record keeping (e.g., accountability, timeliness, cross-agency coordination, application of new technologies);
Research (e.g., adequacy, quality, coordination, dissemination of results);
Biological and chemical weapons preparedness and research;
Application of emerging technologies (e.g., telemedicine, technology transfer); and
International cooperation and coordination, especially on research and technology matters.
It is crucial that the lessons from the Gulf War experience be applied in improving protection of troops, responding to health concerns, and assisting veterans and their family members through difficult transitions. A comprehensive, coordinated set of interagency plans is necessary to build upon what we have learned and ensure that the burden borne by those who risk their lives and well-being to protect our country's interests is minimized.
Agency recommendations should be accommodated within and among the rest of each agency s budget priorities. Each agency must report on how it intends to accomplish these programs and policies within its budgetary allowances, subject to its resource constraints.
The report should be completed and approved by the NSTC by April 21, 1998. At that time, it will be submitted to the President's Committee of Advisors on Science and Technology (PCAST) and other national experts for review and comment. This process is expected to take approximately three months. Another three months are allocated for analysis and revision of the plan, after which it will be resubmitted to NSTC.
The NSTC may seek advice, in accordance with existing laws, from members of the PCAST, National Academy of Sciences, Institute of Medicine, and other appropriate representatives of industry, academia, the non-profit private sector, and State governments in preparing the report.
Agencies shall provide the NSTC with the administrative resources needed for agency review and preparation of the NSTC s report.