Military

Nursing Staff Shortages Disrupt Infusion Clinic Operations at Walter Reed

Staffing shortages continue to plague the U.S. military's flagship hospital in Bethesda, Maryland, leading to the disruption of services this month in the nephrology infusion clinic at Walter Reed National Military Medical Center.

A Walter Reed spokeswoman said Thursday that two nurses at the clinic, which provides infusion services for kidney, some gastroenterology and other department patients, went on emergency leave, forcing hospital leaders to shift staff from other areas of the hospital to support clinic operations.

Ricardo Reyes, a public affairs officer at Walter Reed, said no appointments were canceled and "all patients scheduled for this week have been rescheduled."

A patient said that late last week they were notified by staff that the clinic would be closed for two weeks and told to make alternate arrangements.

The patient said they were shifted to Fort Belvoir ^[2] Community Hospital, which also has a limited number of staff to support infusions and is a 90-minute drive during most times of the day from Walter Reed.

"We are working to make sure next week's scheduled patients are covered," Reyes said in an email to Military.com on Wednesday. "This is a temporary situation, and we expect to be back to normal operations later this month."

An April 2024 Defense Department report to Congress said that the facility was staffed at just 79% of its authorized number of personnel, with nurses having the lowest staffing rate at 68%.

To address the issue, the Defense Health Agency launched an effort with the medical commands of the military services to develop a Human Capital Distribution Plan, or HCDP, to determine the requirements at all medical and dental facilities to ensure that the facilities were adequately supported by military personnel as well as civilian and contract staff.

In its report to Congress on Walter Reed, Defense Health Agency officials said the HCDP would give the facility the means to fill its empty jobs.

"The HCDP ... will provide Military Health System leaders a way, and the means, to provide military and civil service authorizations filled by the right person, at the time they are needed, achieving great outcomes for our beneficiaries," the report stated.

The Defense Department awarded contracts worth up to $43 billion in May 2024 to 11 health care staffing companies to provide contract medical staff as well as support at military treatment facilities and other federal hospitals and clinics in the 50 states, District of Columbia, Puerto Rico and Guam.

According to the Defense Health Agency, under the agreements, known as the Medical Q-Coded Support and Services Next Generation contracts, the companies are to provide dental, nursing, physician and medical support staff to augment DoD civilian employees and military personnel at those hospitals and clinics.

Last year, Karen Ruedisueli, director of government relations for health affairs at the Military Officers Association of America, noted that staffing shortfalls at Walter Reed "could reverberate" across the military health system because not only is it considered a premier medical center, it is responsible for training the next generation of military doctors, with 53 graduate medical programs for the Army ^[3], Navy ^[4] and Air Force ^[5].

"MOAA supports the DoD's revised strategy to stabilize the military health system ^[6] and improve MTF [military treatment facilities] staffing so MHS [the military health system] can fulfill both readiness and beneficiary care missions," Ruedisueli wrote.

In an opinion piece published earlier this month ^[7], acting Assistant Secretary of Defense for Health Affairs Dr. Stephen Ferrara pledged to work with department leadership to ensure that the military health system has what it needs to serve patients and train physicians.

"Military medicine is a no-fail mission. I'm confident that our success will continue to reinforce the strength that sustains the peace. But should the peace be broken ... our preparation will ensure we break the Walker Dip streak," Ferrara wrote, referring to the decline in combat medical skills following the end of a period of war.

Walter Reed is undergoing a multiyear renovation and expansion project, with a new five-story, 533,000-square-foot facility that opened this spring to house operating rooms and ambulatory procedure rooms, women's health, the Mother Infant Care Center and Neonatal Intensive Care Unit, dentistry, and dozens of other clinics and services.

A new building, slated to open in 2028, will house optometry, patient transport, the American Red Cross and administrative offices, according to facility officials.

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Pentagon Encourages Troops to Join Immigration Enforcement, Border Security Job Training Program

Customs and Border Protection agent places concertina wire along the border

Defense Secretary Pete Hegseth has ordered the military to take steps to encourage troops to consider being part of the agencies that handle immigration enforcement and border security though a new policy unveiled Thursday.

In a memo made public Thursday ^[1], Hegseth ordered the Pentagon to "prioritize and broadly advertise" opportunities troops who are nearing separation or retirement from the military have with either Customs and Border Protection or Immigration and Customs Enforcement as part of its SkillBridge program.

SkillBridge is a program that is intended to allow troops to take part in real-world job experience while in their final 180 days of military service. The idea behind the program is that it enables a smoother transition to civilian life and allows troops to be more competitive in their chosen industries or fields.

"Recognizing the importance of leveraging talent and furthering our commitment to work with DHS [Department of Homeland Security], the department is expanding opportunities for transitioning service members to support southern border activities," Hegseth wrote in his memo, which was signed two weeks ago.

While troops have long had access to SkillBridge opportunities with CBP and ICE, the new policy would give those agencies greater emphasis, and commanders are encouraged to approve requests to work with either agency "to the maximum extent possible."

SkillBridge is a training program with no explicit promise of a job after a service member gets out of the military, but there is also a broad understanding that it is meant to act as a gateway to a position with the chosen company or agency.

A defense official told Military.com on Thursday that the current training opportunities with DHS include jobs like paralegal, program management and intelligence research specialists. The official added that none of the training opportunities includes law enforcement at this time.

Top Pentagon spokesman Sean Parnell called the move "an exceptional opportunity to ensure the best of America can continue to serve and defend their country."

The move is just the latest push that Hegseth has made to enable the military to more closely support the Trump administration's growing emphasis on security on the southern border and deportations of people they claim to be in the country illegally.

Nearly two weeks ago, Parnell also announced that Hegseth signed a memo that allowed Pentagon civilians to be detailed to the Department of Homeland Security -- the agency that oversees both CBP and ICE -- to better support "border security efforts, as well as interior immigration enforcement."

The defense official said that, while the civilian effort is still being worked out with DHS, the military branches can begin prioritizing troops taking advantage of SkillBridge immediately.

The memos are now two moves the Trump administration has made to more closely integrate the military with law enforcement as a way to expedite the widespread removal of immigrants on American soil, a move deemed alarming by legal and military experts.

Mark Nevitt, an associate professor at Emory University School of Law, said it was "odd" that Hegseth would put this memo out and that it raises a multitude of questions as it relates to integrating the military with immigration enforcement.

"What capacity are they working through SkillBridge?" Nevitt said to Military.com in an interview Thursday. "Hopefully, there's some sort of deep, deep, deep thought being put into that. And if the military member is still on an active-duty status, you would hope that they're very limited in what they're doing with SkillBridge other than more observing."

The announced deployments ^[3] of the National Guard ^[4] and Marines to support Immigration and Customs Enforcement agents amid protests in Los Angeles this week mark another mixture of those two agencies. Active-duty military forces are not allowed to conduct law enforcement activities under the Posse Comitatus Act, but the Trump administration has worked to push those legal boundaries.

Although Guardsmen in Los Angeles have been pictured doing traditional law enforcement-related tasks, like carrying riot shields and securing perimeters behind police tape, U.S. Northern Command has claimed on social media that troops "are not conducting civilian law enforcement activities."

Nevitt said another recent trend is that National Guard units, such as those in Texas and Florida, have partnered under "287g" Immigration and Customs Enforcement agreements, which allow them to perform certain immigration officer-type actions while under state orders.

"SkillBridge is part of this larger integration, and there's just a strong, strong desire in this administration to use every tool at their disposal to enforce immigration law," Nevitt said.

Hegseth Won't Say He'd Follow Court Order on LA Troop Deployment

Secretary of Defense Pete Hegseth joined by Gen. Dan Caine

Defense Secretary Pete Hegseth refused to say Thursday whether he would follow a federal district court order if it rules that the Trump administration's troop deployments ^[1] to Los Angeles are illegal.

"What I can say is that we should not have local judges determining foreign policy or national security policy for the country," Hegseth said in response to a question from Rep. Ro Khanna, D-Calif., during a House Armed Services Committee hearing.

Asked again by Khanna whether he would respect a court decision, Hegseth reiterated that, "What I'm saying is local district judges shouldn't make foreign policy for the United States."

When pressed later in the hearing by Rep. Sarah Elfreth, D-Md., specifically whether he would follow a Supreme Court ruling, Hegseth said, "We're not here to defy a Supreme Court ruling."

Hegseth's evasiveness on Khanna's questions was part of a pattern of dodging inquiries from Democrats on Thursday.

Among the topics where Hegseth did not provide direct answers: his disclosure of real-time attack plans on the unclassified messaging app Signal; whether he believes women are capable of "lethality," one of his favorite buzzwords; why he and the president have fired several top military officers; and whether it is Pentagon policy to be prepared to invade Greenland and Panama, as President Donald Trump has sometimes floated.

Thursday capped off a week of congressional testimony for Hegseth, who faced pointed questions ^[3] at each hearing ^[4] about the Trump administration's decision to deploy the National Guard ^[5] and Marines to Los Angeles to respond to protests against immigration raids.

Trump ordered about 4,000 National Guardsmen and 700 Marines to protect federal property and immigration officers from the protests, which have been punctuated by some violence but have been largely peaceful and confined to a few blocks in downtown LA.

The deployments were done over the objections of California Gov. Gavin Newsom, who quickly filed a lawsuit alleging Trump illegally usurped state authority.

The Justice Department, in a court filing Wednesday, called Newsom's lawsuit a "crass political stunt." A court hearing on the lawsuit was taking place Thursday afternoon.

The Trump administration has repeatedly violated court orders since taking office in January, particularly on cases related to immigration, one of the top issues he campaigned on.

Trump and other administration officials have sought to differentiate between lower court rulings, which they maintain have run amok and shouldn't dictate nationwide policy, and the Supreme Court, which they have said they would respect.

But the Trump administration has also ignored the Supreme Court.

After the Supreme Court ruled the Trump administration had to "facilitate" the return of a man wrongly deported to El Salvador, administration officials spent months claiming they couldn't bring him back and did not have to. The man was ultimately brought back to the United States last week and charged with transporting undocumented immigrants.

The Pentagon, though, has been following court orders, such as waiting until after the Supreme Court ruled in its favor to enforce the Trump administration's ban on transgender troops.

In response to Hegseth's comments at the hearing Thursday, Newsom posted on social media that "this is not normal."

Deep Workforce Cuts at VA, Pentagon Backed by Republican Spending Bills

Sondria Linford, 533rd Commodities Maintenance Squadron, stands at attention with her Airman Leadership School classmates at Hill Air Force Base, Utah.

House Republicans are on track to allow job cuts at the Pentagon and Department of Veterans Affairs ^[1] to proceed in the annual spending bills for each department.

The House Appropriations Committee's fiscal 2026 defense appropriations bill includes a cut to civilian personnel funds that Republicans said accounts for the Pentagon's plan to slash about 45,000 civilian jobs. The full committee is debating the bill Thursday after it was advanced out of the defense subcommittee earlier this week.

Meanwhile, at a full committee debate Tuesday night about the fiscal 2026 VA appropriations bill, Republicans rejected a Democratic amendment that would have pumped the brakes on the VA's plans to fire about 80,000 employees.

House Republicans are moving forward with the 2026 appropriations process even as the Trump administration has yet to provide Congress with its full, detailed budget request. Republicans have described the top-line dollar figures in their bills, which are based on the White House's so-called skinny budget request, as "interim."

In the defense appropriations bill, Republicans are proposing a total of $831.5 billion for the Pentagon, which is essentially flat compared to this year.

The White House also requested a flat budget for the Pentagon. But it argued that when its request is combined with a separate $150 billion defense budget boost working its way through Congress ^[3] right now, the defense budget will hit a record $1 trillion.

GOP defense hawks have fumed at that reasoning, arguing they crafted the $150 billion bill to be in addition to a regular $1 trillion defense budget. But House GOP appropriators are using the same reasoning as the White House in defending their proposal.

"Together, with the significant defense funding advancing through Congress as part of the reconciliation process, the FY26 bill will lift total defense spending over $1 trillion in the next fiscal year, representing a historic commitment to strengthening and modernizing America's national defense," Rep. Ken Calvert, R-Calif., chairman of the Appropriations Committee's defense subcommittee, said in a statement this week.

The funding in the House appropriations bill would go toward providing service members with a 3.8% pay raise ^[4] next year.

On the civilian side, though, the bill would endorse the hefty cuts being pushed by the so-called Department of Government Efficiency, or DOGE, the advisory agency previously led by billionaire Elon Musk before he left the White House, got into a public feud with the president, and then backed off the feud.

The bill would codify "both the department's cooperation with DOGE and streamlined functions and management improvements at the Pentagon," as well as cut "$3.6 billion and almost 45,000 civilian full-time equivalents to capture Workforce Acceleration and Recapitalization Initiative efforts," according to a GOP summary.

The Pentagon announced in March ^[5] that it was aiming to slash about 5% to 8% of its civilian workforce, or about 50,000 to 60,000 jobs.

While officials initially planned to achieve the cuts through a mix of hiring freezes, firings and resignations, they have increasingly relied on resignations as firings have run into lawsuits and other hurdles.

DOGE first offered a program to employees across the federal government in January, and the Pentagon reopened the deferred resignation offer ^[6] for its employees in April. The program allows government workers to leave their jobs while still getting paid until October, or risk getting fired later.

In written testimony this week ^[7], Defense Secretary Pete Hegseth said about 22,000 employees were approved for deferred resignation in January and noted the second window for deferred resignation in April without saying how many employees took the offer then. Service officials previously said they were poised ^[8] to lose thousands of employees after the April window.

Meanwhile, the VA is planning its own DOGE-inspired mass firings. Under a memo leaked earlier this year ^[9], the department is supposed to have more details on its plans to fire up to 83,000 employees this month and could start the firings by August.

The VA has signed an agreement with the Office of Personnel Management, essentially human resources for the federal government, to help with the firings, news outlet Government Executive reported this week ^[10].

The fiscal 2026 VA appropriations bill proposed by House Republicans does not address the VA firings one way or the other.

But Rep. Debbie Wasserman Schultz, D-Fla., ranking member of the Appropriations Committee's VA subcommittee, offered an amendment during Tuesday night's debate on the bill that would have blocked any "reduction in force," as such mass firings are formally called, unless Congress specifically approves it.

"There is absolutely no way that the secretary can achieve his goal without it having an impact on the health care provided to our veterans," Wasserman Schultz said at the committee meeting. "Does this administration really believe the arbitrary firing culture it is creating at the VA will make it an attractive place to work? No one wants to work at a place where the threat of being fired for no reason looms over their head every day."

The amendment was voted down along party lines, 27-34, with Republicans arguing it was unnecessary.

"The bill as written and the budget request does not include personnel cuts," said Rep. John Carter, R-Texas, the chairman of the committee's VA subcommittee. "VA has reinforced health care and benefits by safeguarding … mission-critical positions to ensure uninterrupted services."

While appropriators are ignoring potential staff cuts at the VA, they appear uneasy about other cuts at the department.

In the nonbinding report that accompanies the bill, lawmakers expressed concern that recent contract cancellations ^[11] at the VA have been done haphazardly and without congressional approval.

"The committee is concerned that the department canceled many contracts and purported to reprogram funding originally dedicated to these contracts without proper analysis on the impacts to the veteran community, or without transparency about which contracts were ended, or proper notification to Congress," said the report, which was released Tuesday night after the committee approved the bill. "If the department seeks to reprogram previously appropriated funding, congressional approval is required by law."

The report called on the VA to provide lawmakers with a list of all contracts canceled since January that includes "a detailed analysis of the decision-making process that led to the cancellations," as well as a list of where the funding from the canceled contracts was redirected to.

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