[House Hearing, 115 Congress]
[From the U.S. Government Publishing Office]
EXAMINATION OF REPORTS ON THE ``EL FARO'' MARINE CASUALTY AND COAST
GUARD'S ELECTRONIC HEALTH RECORDS
=======================================================================
(115-34)
HEARING
BEFORE THE
SUBCOMMITTEE ON
COAST GUARD AND MARITIME TRANSPORTATION
OF THE
COMMITTEE ON
TRANSPORTATION AND INFRASTRUCTURE
HOUSE OF REPRESENTATIVES
ONE HUNDRED FIFTEENTH CONGRESS
SECOND SESSION
__________
JANUARY 30, 2018
__________
Printed for the use of the
Committee on Transportation and Infrastructure
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Available online at: https://www.govinfo.gov/committee/house-
transportation?path=/browsecommittee/chamber/house/committee/
transportation
______
U.S. GOVERNMENT PUBLISHING OFFICE
30-345 PDF WASHINGTON : 2018
COMMITTEE ON TRANSPORTATION AND INFRASTRUCTURE
BILL SHUSTER, Pennsylvania, Chairman
DON YOUNG, Alaska PETER A. DeFAZIO, Oregon
JOHN J. DUNCAN, Jr., Tennessee, ELEANOR HOLMES NORTON, District of
Vice Chair Columbia
FRANK A. LoBIONDO, New Jersey JERROLD NADLER, New York
SAM GRAVES, Missouri EDDIE BERNICE JOHNSON, Texas
DUNCAN HUNTER, California ELIJAH E. CUMMINGS, Maryland
ERIC A. ``RICK'' CRAWFORD, Arkansas RICK LARSEN, Washington
LOU BARLETTA, Pennsylvania MICHAEL E. CAPUANO, Massachusetts
BLAKE FARENTHOLD, Texas GRACE F. NAPOLITANO, California
BOB GIBBS, Ohio DANIEL LIPINSKI, Illinois
DANIEL WEBSTER, Florida STEVE COHEN, Tennessee
JEFF DENHAM, California ALBIO SIRES, New Jersey
THOMAS MASSIE, Kentucky JOHN GARAMENDI, California
MARK MEADOWS, North Carolina HENRY C. ``HANK'' JOHNSON, Jr.,
SCOTT PERRY, Pennsylvania Georgia
RODNEY DAVIS, Illinois ANDRE CARSON, Indiana
MARK SANFORD, South Carolina RICHARD M. NOLAN, Minnesota
ROB WOODALL, Georgia DINA TITUS, Nevada
TODD ROKITA, Indiana SEAN PATRICK MALONEY, New York
JOHN KATKO, New York ELIZABETH H. ESTY, Connecticut,
BRIAN BABIN, Texas Vice Ranking Member
GARRET GRAVES, Louisiana LOIS FRANKEL, Florida
BARBARA COMSTOCK, Virginia CHERI BUSTOS, Illinois
DAVID ROUZER, North Carolina JARED HUFFMAN, California
MIKE BOST, Illinois JULIA BROWNLEY, California
RANDY K. WEBER, Sr., Texas FREDERICA S. WILSON, Florida
DOUG LaMALFA, California DONALD M. PAYNE, Jr., New Jersey
BRUCE WESTERMAN, Arkansas ALAN S. LOWENTHAL, California
LLOYD SMUCKER, Pennsylvania BRENDA L. LAWRENCE, Michigan
PAUL MITCHELL, Michigan MARK DeSAULNIER, California
JOHN J. FASO, New York
A. DREW FERGUSON IV, Georgia
BRIAN J. MAST, Florida
JASON LEWIS, Minnesota
------
Subcommittee on Coast Guard and Maritime Transportation
DUNCAN HUNTER, California, Chairman
DON YOUNG, Alaska JOHN GARAMENDI, California
FRANK A. LoBIONDO, New Jersey ELIJAH E. CUMMINGS, Maryland
GARRET GRAVES, Louisiana RICK LARSEN, Washington
DAVID ROUZER, North Carolina JARED HUFFMAN, California
RANDY K. WEBER, Sr., Texas ALAN S. LOWENTHAL, California
BRIAN J. MAST, Florida ELEANOR HOLMES NORTON, District of
JASON LEWIS, Minnesota, Vice Chair Columbia
BILL SHUSTER, Pennsylvania (Ex PETER A. DeFAZIO, Oregon (Ex
Officio) Officio)
CONTENTS
Page
Summary of Subject Matter........................................ v
TESTIMONY
Panel 1
Rear Admiral John P. Nadeau, Assistant Commandant for Prevention
Policy, U.S. Coast Guard....................................... 4
Hon. Earl F. Weener, Ph.D., Board Member, National Transportation
Safety Board, accompanied by Brian Curtis, Director, Office of
Marine Safety, National Transportation Safety Board............ 4
Panel 2
Rear Admiral Erica Schwartz, Director of Health, Safety, and
Work-Life, U.S. Coast Guard.................................... 19
Rear Admiral Michael J. Haycock, Assistant Commandant for
Acquisition and Chief Acquisition Officer, U.S. Coast Guard.... 19
David A. Powner, Director of Information Technology Management
Issues, U.S. Government Accountability Office.................. 19
PREPARED STATEMENTS SUBMITTED BY MEMBERS OF CONGRESS
Hon. John Garamendi of California................................ 30
PREPARED STATEMENTS SUBMITTED BY WITNESSES
Rear Admiral John P. Nadeau, Assistant Commandant for Prevention
Policy, U.S. Coast Guard....................................... 33
Hon. Earl F. Weener, Ph.D., Board Member, National Transportation
Safety Board, accompanied by Brian Curtis, Director, Office of
Marine Safety, National Transportation Safety Board............ 52
Rear Admiral Erica Schwartz, Director of Health, Safety, and
Work-Life, U.S. Coast Guard \1\
Rear Admiral Michael J. Haycock, Assistant Commandant for
Acquisition and Chief Acquisition Officer, U.S. Coast Guard \1\
David A. Powner, Director of Information Technology Management
Issues, U.S. Government Accountability Office.................. 66
SUBMISSIONS FOR THE RECORD
U.S. Coast Guard, responses to questions for the record from Hon.
John Garamendi, a Representative in Congress from the State of
California..................................................... 36
Hon. Earl F. Weener, Ph.D., Board Member, National Transportation
Safety Board, responses to questions for the record from Hon.
John Garamendi, a Representative in Congress from the State of
California..................................................... 62
David A. Powner, Director of Information Technology Management
Issues, U.S. Government Accountability Office, responses to
questions for the record from Hon. John Garamendi, a
Representative in Congress from the State of California........ 81
----------
\1\ RADM Schwartz and RADM Haycock did not submit written statements
for the record.
Reports referenced in the Summary of Subject Matter on pages v-x:
Coast Guard Marine Board of Investigation Recommendations \2\ 86
Action by the Commandant, U.S. Coast Guard, December 19,
2017, ``Steam Ship El Faro (O.N. 561732) Sinking and Loss
of the Vessel with 33 Persons Missing and Presumed Deceased
Northeast of Acklins and Crooked Island, Bahamas, on
October 1, 2015''.......................................... 92
National Transportation Safety Board Recommendations \3\..... 123
----------
\2\ This is an excerpt from the 199-page U.S. Coast Guard Marine Board
report entitled, ``Steam Ship El Faro (O.N. 561732) Sinking and Loss of
the Vessel with 33 Persons Missing and Presumed Deceased Northeast of
Acklins and Crooked Island, Bahamas, on October 1, 2015'' and available
online at https://media.defense.gov/2017/Oct/01/2001820187/-1/-1/0/
FINAL%20PDF%20ROI%2024%20SEP%2017.PDF.
\3\ This is an excerpt from the 282-page National Transportation Safety
Board report entitled, ``Sinking of U.S. Cargo Vessel SS El Faro,
Atlantic Ocean, Northeast of Acklins and Crooked Island, Bahamas,
October 1, 2015'' adopted December 12, 2017, NTSB/MAR-17/01, PB2018-
100342 and available online at https://www.ntsb.gov/investigations/
AccidentReports/Reports/MAR1701.pdf.
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EXAMINATION OF REPORTS ON THE ``EL FARO'' MARINE CASUALTY AND COAST
GUARD'S ELECTRONIC HEALTH RECORDS
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TUESDAY, JANUARY 30, 2018
House of Representatives,
Subcommittee on Coast Guard and Maritime
Transportation,
Committee on Transportation and Infrastructure,
Washington, DC.
The subcommittee met, pursuant to call, at 10 a.m., in room
2167, Rayburn House Office Building, Hon. Duncan Hunter
(Chairman of the subcommittee) presiding.
Mr. Hunter. Good morning. The subcommittee will come to
order.
The subcommittee is convening today to examine the fatal
sinking of the U.S.-flagged cargo ship, SS El Faro and, on a
second panel, the Coast Guard's failed efforts to implement an
electronic health record system.
On October 1, 2015, the 790-foot U.S.-flagged cargo ship SS
El Faro sank in the Atlantic Ocean about 40 nautical miles
northeast of Acklins and Crooked Island, Bahamas. An unusual
storm path, reliance on outdated weather reports, and failure
to implement proper bridge resource management techniques
resulted in El Faro sailing almost directly into Hurricane
Joaquin, a category 4 storm with an estimated sustained wind
speed of 115 knots.
The loss of the U.S.-flagged cargo vessel El Faro, along
with its 33-member crew, ranks as one of the worst maritime
disasters in U.S. history and resulted in the highest death
toll from a U.S. commercial vessel sinking in almost 40 years.
The last comparable U.S. maritime disaster was the sinking
of the U.S. bulk carrier Marine Electric off the coast of
Virginia in February 1983, in which all but 3 of the 34 persons
aboard lost their lives. The Coast Guard instituted major
changes following that tragedy to improve safety and prevent
similar events from occurring in the future.
Despite those efforts to improve safety, tragedy befell the
El Faro.
On October 31, 2015, a U.S. Navy vessel located the main
wreckage of El Faro and the vessel's voyage data recorder was
successfully recovered. It contained 26 hours of bridge audio
recordings and other critical navigation data that were used by
the Coast Guard and the NTSB investigators to understand the
causes of this horrible incident and develop recommendations to
prevent future tragedies.
The Coast Guard Marine Board of Investigation made 31
safety and 4 administrative recommendations to address the
causes of the El Faro's sinking. In December 2017, the
Commandant of the Coast Guard released his Final Action Memo on
the Marine Board's recommendation. The Commandant concurred
with 29 of 31 safety recommendations and 3 of 4 administrative
recommendations.
The National Transportation Safety Board launched an
investigation as soon as the sinking of El Faro was confirmed,
ultimately providing numerous recommendations for responsible
entities, including the Coast Guard, the International
Association of Classification Societies, and the owner of El
Faro.
The Nation relies on our merchant mariners and the U.S.-
flagged ships they sail. It is critical that policies are in
place and adopted as standard practice to ensure mariners'
safety. In order to do so, we must learn from the loss of the
El Faro. I look forward to discussing how this tragedy occurred
and what steps are being taken to prevent another such incident
from occurring.
Notwithstanding the importance and gravity of the El Faro
tragedy, on panel 2 we will examine the Coast Guard's apparent
inability to implement an electronic health record system to
manage data for its over 56,000 Coast Guard members and
retirees.
After wasting more than $66 million over a 5-year period,
the Coast Guard canceled its electronic health records effort,
referred to as the Integrated Health Information System
project.
The Service has nothing to show for the time and money
expended and finds itself in a worse position than before it
awarded the first contract almost 8 years ago.
Today the Coast Guard is still handling all medical
information using paper records, records that cannot be shared
with the Department of Defense or the Department of Veterans
Affairs system.
Following a subcommittee request to review Coast Guard
actions, the Government Accountability Office found that for
nearly the entire span of the project, the Coast Guard allowed
program managers to act without sufficient oversight by
acquisition professionals. Even when the Coast Guard
established its nonmajor acquisition process policies to
provide oversight for information technology acquisitions,
things like the Integrated Health Information System project,
they did not implement any oversight.
Despite chartering several oversight bodies for the
project, GAO found that the Coast Guard, ``could not provide
evidence that the boards had ever been active in overseeing the
project prior to its cancellation.''
Other than realizing they had been throwing away good money
for years, the Coast Guard still cannot provide a solid
explanation as to why it canceled the Integrated Health
Information System project.
The Coast Guard needs to show what it has learned and how
things have changed as it works to finally implement an
electronic health record system. We understand the Service is
following its acquisition policies for the current effort and
has conducted significant research which pointed to a
recommended solution of using an existing Federal agency
system. That is amazing.
After a 5-year epic failure, these are positive steps.
However, we need to hear more about the policies and procedures
that are now in place to prevent the waste of taxpayer money in
the future.
I look forward to discussing how this debacle occurred,
what steps the Coast Guard is taking to ensure nothing like
this can happen again, and where the Coast Guard is in the
process of finally acquiring an electronic health record
system.
I thank the witnesses for being here today, and I look
forward to hearing all the various testimony on the various
issues.
And I yield to Ranking Member Garamendi. You are
recognized.
Mr. Garamendi. I yield to----
Mr. Hunter. Yield to the ranking member of the full
committee, Mr. DeFazio.
Mr. DeFazio. Thank you, Mr. Chairman. And I thank the
ranking member for that. I have to run to a press event and
then I will be back.
First off, I am concerned that we are merging two totally
unrelated subjects here. Certainly, the acquisition failure is
important. Whether it merits a hearing or not, I am not sure,
but it certainly shouldn't be taking away from a focus on the
El Faro tragedy.
This was totally preventable. And I think there are a
number of factors and things that require the attention of the
subcommittee.
First off, there are real questions about the Coast Guard,
whether their budget is adequate to carry out this very, very
important function. I think it is not. I think we have spread
them too thin. And they are relying far too much on
classification societies without any substantial oversight of
those classification societies.
And from some in the industry, I understand there are
companies who do a good job and there are other companies, if
you pay them, they will certify your rust bucket as seaworthy.
Now, that is just not right, and that really requires some
scrutiny. It also requires us to question how we got to that
point, and what we can do to rectify that.
I think that the Coast Guard should have resources adequate
to, minimally, to oversee these classification societies.
Perhaps we need to have some sort of a system where we either
certify them or decertify them for U.S. certification.
Now, they can go to these nonexisting countries with these
registries and certify rust buckets. We can't control that, but
we can control whose certifications we accept here in the
United States of America, and that, I think, played a
substantial role in this.
Plus, real questions about, obviously, the management of
TOTE and the training that TOTE provided, the adequacy of the
lifesaving supplies on the ship, all the questions about when
the ship had a major conversion, why it wasn't considered a
major conversion, and, therefore, they didn't have to upgrade
things, what brought that about, which might have saved lives
in this case.
There is just a host of questions. And I hope we can really
drill down on that, and I hope we don't get distracted with the
second panel.
Thank you, Mr. Chairman.
Mr. Hunter. I thank the ranking member.
From I understand, too, it is hard to get committee time,
because we won't do in this full committee multiple
subcommittees at the same time. So we don't do freeways and
Coast Guard, which enables the ranking member and others to
attend, but we are out of days for stuff. So we are going to
focus for the first hour on the El Faro, or however long it
takes us, before we move on.
Mr. Garamendi, you are recognized for your opening
statement.
Mr. Garamendi. Let's get on with the hearing. Without
objection, my testimony will be in the record.
Mr. Hunter. Without objection, so ordered.
Mr. Garamendi. And I think I will just let it go at that,
with a couple of very brief statements.
It was 35 years ago that the Marine Board of Investigation
made a report about the faults of two systems in the maritime
safety programs. Here we are again, essentially the same report
being issued, this time on the El Faro situation.
The question is, why are we back with the same
recommendations to address the tragedy of the El Faro? Bottom
line is, why didn't we get it right in the last 35 years?
With that, my testimony, my written, will be in the record.
Mr. Hunter. I thank the gentleman.
And I ask unanimous consent that members not on the
subcommittee be permitted to sit with the subcommittee at
today's hearing and ask questions. Without objection, so
ordered.
On the first panel we will hear from Rear Admiral John
Nadeau, Assistant Commandant for Prevention Policy for the
United States Coast Guard, and the Honorable Earl Weener,
Member of the National Transportation Safety Board, accompanied
by Mr. Brian Curtis, Director of the Office of Marine Safety
for the NTSB.
Admiral Nadeau, you are recognized to give your statement,
and welcome back.
TESTIMONY OF REAR ADMIRAL JOHN P. NADEAU, ASSISTANT COMMANDANT
FOR PREVENTION POLICY, U.S. COAST GUARD; AND HON. EARL F.
WEENER, PH.D., BOARD MEMBER, NATIONAL TRANSPORTATION SAFETY
BOARD, ACCOMPANIED BY BRIAN CURTIS, DIRECTOR, OFFICE OF MARINE
SAFETY, NATIONAL TRANSPORTATION SAFETY BOARD
Admiral Nadeau. Good morning, Chairman Hunter, Ranking
Member Garamendi, distinguished members of the subcommittee. I
am honored to be here today.
Mr. Chairman, I want to especially thank you for your
leadership and enduring support to the Coast Guard.
On behalf of all the men and women in the Coast Guard, I
offer our deepest condolences to the families of the 33
mariners lost onboard El Faro.
As our Commandant noted in the Final Action Memo, the loss
of the El Faro and everyone aboard was a tragic and preventable
accident. This is a call to action for the entire maritime
community. The Commandant is committed to making improvements
within the Coast Guard and the maritime industry and has
directed me to do so.
The Marine Board of Investigation conducted an exhaustive
2-year investigation in full view of the public. While the
primary cause of the casualty was the decision to navigate El
Faro too close to the path of Hurricane Joaquin, there were
other contributing factors.
These include, one, the failure of TOTE Services,
Incorporated, to maintain an effective safety management
system; two, the failure of the ship's classification society,
ABS [American Bureau of Shipping], on multiple occasions to
uncover or otherwise resolve longstanding deficiencies that
adversely affected the safety and seaworthiness of vessels;
and, three, failure of the Coast Guard to properly oversee the
work conducted by ABS on our behalf.
To determine if these issues revealed in the El Faro
investigation are pervasive throughout the fleet, I directed a
team of senior marine inspectors to closely examine more ships
currently enrolled in the Alternate Compliance Program, or ACP.
We have found additional evidence of breakdowns in the safety
framework, and our findings confirm concerns raised in the
investigation about the material condition of several other
U.S.-flagged vessels.
All elements of the safety framework--the vessel owners and
operators, the class societies, and the Coast Guard--must all
improve.
The vessel owner is accountable for properly maintaining
and ensuring the safe operations of the vessel.
The class society plays a key role in ensuring safety by
providing thorough and accurate surveys and compelling
corrective actions when needed.
The Coast Guard is the final element in the safety
framework by verifying compliance with mandatory safety
standards.
As was noted in the Federal Register announcing the program
more than two decades ago, ACP was created in response to the
needs expressed by the U.S. maritime industry to reduce the
regulatory burden and alleviate duplication of effort between
the Coast Guard and class societies.
Since day one, the Coast Guard has committed to providing
oversight to ensure that vessels participating in ACP are
maintained and operated to the same level of safety as vessels
inspected by the Coast Guard under the traditional process.
Today we remain committed to this goal and acknowledge we
must do better.
The U.S., like other flag states around the globe today,
now relies far more heavily on third parties than ever before.
In fact, the vast majority of the U.S. sealift fleet that DoD
relies on to transport America's soldiers, Marines, and their
equipment overseas, uses class societies for many of their
compliance activities.
Now, more than ever, we need to get this right. The Coast
Guard must and will restore the safety framework with robust
and thorough oversight and accountability.
I am taking a number of steps to do so. I will lead the
actions directed by the Commandant in response to this tragedy.
I am reforming our oversight program and directing changes to
the organization, the procedures, the policy, the training, and
the capture and management of key information.
These actions are needed to ensure accountability for the
maritime industry, the authorized class societies, and the
Coast Guard. The Coast Guard has the authority and the
competency needed to successfully accomplish this. As I pursue
these actions, I will be transparent and keep you all informed.
At the end of the day, this is about the lives of the men
and women who go to sea in support of the Nation's economic
prosperity, in support of our military readiness, and in
support of our national security.
I recently had the opportunity to visit the El Faro
Memorial in Jacksonville. I also met some of the mariners who
had once sailed on the El Faro and now mourn the loss of their
shipmates. It was a moving and humbling experience.
This tragedy has shined a spotlight on failures of the
safety framework. We must honor the 33 lost mariners with a
strong bias towards action.
The Coast Guard, after the vessel owner and the class
society, is the final element in the safety framework
responsible for ensuring compliance with mandated safety
standards. The Coast Guard must and will restore the safety
framework.
Again, thank you for your strong support of the Coast
Guard. Thank you for the opportunity to testify today. I ask my
written statement be entered into the record. I look forward to
your questions.
Mr. Hunter. Without objection. Thank you, Admiral.
Mr. Weener, you are recognized.
Mr. Weener. Good morning, Chairman Hunter, Ranking Member
Garamendi, and members of the subcommittee. Thank you for
inviting the NTSB to provide testimony today.
Mr. Hunter. Would you mind pulling the microphone a bit
closer to you? Thank you.
Mr. Weener. I am accompanied by Brian Curtis, the Director
of our Office of Marine Safety.
My testimony will discuss the NTSB's investigation into the
sinking of the cargo ship El Faro and the loss of all 33
crewmembers aboard.
The NTSB-led investigation and was a joint effort with the
United States Coast Guard. Four days after the sinking, the
NTSB, Coast Guard, and many other organizations began a
collaborative search of the ocean floor seeking the El Faro
wreckage and in an effort to locate and retrieve the ship's
voyage data recorder, or VDR.
Data recorders are important investigative tools critical
to many of our investigations. It took three missions to
recover the VDR. Analysis revealed significant data, including
26 hours of audio, which was crucial in determining the
probable cause of El Faro's sinking.
On September 29, 2015, at 9:48 p.m., the El Faro and its
crew departed Jacksonville, Florida, for San Juan, Puerto Rico.
Operated by TOTE Services, the U.S.-flagged ship was slated to
arrive in the early morning hours of October 2. However, rather
than routing around the approaching storm, the ship sailed
directly----
Mr. Hunter. Mr. Weener, I am sorry, there is wind going
through here and I have bad ears. Do you mind pulling that
thing really close, please, and speak louder if you could.
There is like wind blowing through here behind us. And I have
got artillery ears.
Mr. Weener. On September 29, 2015, at 9:48 p.m., the El
Faro and its crew departed Jacksonville, Florida, for San Juan,
Puerto Rico. Operated by TOTE Services, the U.S.-flagged ship
was slated to arrive in the early morning hours of October 2.
However, rather than routing around the approaching storm, the
ship sailed directly into the path of the hurricane and sank at
approximately 8 a.m. on October 1.
My written testimony provides more detail regarding what
happened during the voyage that led to the ship's being in
harm's way. For now, I will focus on major safety issues
identified in our report.
The NTSB's probable cause determination for this accident
included the captain's decisionmaking and actions, which put
the El Faro and its crew in peril. The captain did not divert
to safer routes to avoid Hurricane Joaquin, failing to heed
junior officers who suggested an alternate course was necessary
to avoid the hurricane.
We found that although the El Faro received sufficient
weather information to facilitate appropriate decisionmaking by
the captain regarding the vessel's route, the captain did not
use the most current weather information available to him.
In addition, the investigation revealed the captain's light
regard for the crew's suggestions and the crew's lack of
assertiveness in stating their concerns to the captain. The
NTSB found that the bridge crew did not use all available
resources, nor act effectively as a team to safely operate the
ship.
The El Faro, sailing on a collision course with Hurricane
Joaquin, was further imperiled by the failure to maintain the
ship's watertight integrity. Seawater entered a cargo hole
through an open scuttle. The resulting flooding caused
improperly secured automobiles to impact an inadequately
protected fire pump supplied by piping carrying seawater.
The damaged piping allowed seawater to flow unchecked into
the ship. This exacerbated other flooding causes, caused by
water entering through open, unsecured ventilation closures.
In addition, the TOTE safety management system was
inadequate. Its lack of oversight in critical aspects of safety
management denoted a weak safety culture in the company and
contributed to the sinking of the El Faro.
Finally, the captain's decisions to muster the crew and
abandon the ship were late and likely reduced the crew's chance
of survival. The severe weather, combined with El Faro's list,
made it unlikely that liferafts or lifeboats available on the
ship could be launched or boarded by crewmembers once in the
water. The lifeboats onboard would not have provided adequate
protection, even if they had been launched.
Coast Guard standards do not require older ships, such as
the El Faro, to adhere to the latest safety standards.
These are just a few of the issues identified out of a
total of 81 findings and 53 safety recommendations. As with all
investigations, our aim is to learn from this tragedy to
prevent similar events from occurring again. We believe that
the adoption of our recommendations will help improve safety
for current and future generations of mariners.
Thank you again for the opportunity to testify, and I am
happy to take your questions.
Mr. Hunter. Thank you, sir.
Mr. Curtis, you are recognized.
OK. You are just accompanying. So I will start out by
recognizing myself. Thank you very much for being here.
My question is pretty simple. If they would have closed the
hatches or the ventilation systems, right, so the water could
not get in, in the heightened sea states that they had, would
they have been OK, if their engines would not have failed and
they hadn't taken on water? Could they have sailed through?
Mr. Weener. I think our investigation showed that this was
a series of events, a chain of events that had it been
interrupted at any point, the chain would not have been
completed. So it started with a decision to not avoid the
hurricane. Once they got into heavy weather, they had a scuttle
that got flooding in one of the holes----
Mr. Hunter. When you say an open scuttle, what is that? Can
you tell the committee what that is?
Mr. Weener. That is a hatch going between decks that for
heavy weather should have been closed and locked, but it was
left open. So they got down-flooding with that. Basically,
there was a whole series of events.
Mr. Hunter. Mr. Curtis? Admiral?
Admiral Nadeau. Sir, I would add to that.
In the Coast Guard's perspective, I think it is difficult
to say. It is hard to simplify it to that level. It is a series
of events that go on, that chain of events that occurred, and I
think it would be very difficult for us to say with any degree
of certainty whether or not simply closing vents would have
prevented this casualty.
Mr. Hunter. What I am trying to get at is you have all of
these recommendations, right? And you can go through a ship or
an airplane or anything, military or civilian, and say, this
isn't up to code, or this is unsatisfactory, or we are going to
allow this to slide because of the age of the vessel or the
aircraft or whatever.
But what I am trying to get at is, if all of those things
were followed then the right decisions would have been made in
the first place and the chain of events would not have
happened.
But it is not like the ship broke in half because the weld
wasn't right or something or it passed an inspection where it
failed on the structure of the ship. It was decisionmaking and
not paying attention to detail that caused the initial stuff,
right?
I mean, the captain sailed into the hurricane, not around
it, and they had basically open hatches on the ship that
allowed water to get in, and then, boom, right? That is sort of
the really fast chain of events, I am guessing.
Is that correct, roughly?
Admiral Nadeau. Sir, our investigation concluded that it is
likely the material condition of the ship did contribute as
well and that the watertight fittings that would be relied upon
to prevent progressive flooding were not in the condition they
should have been maintained.
Mr. Hunter. Mr. Curtis.
Mr. Curtis. Certainly, as you point out, that was a
significant event in the series of events, having the hatch
open. And our report made recommendations to that very point to
hopefully prohibit it from happening in the future, with having
alarms and notifications if a hatch is left open, that it
should be closed.
But it was, as you said, a significant----
Mr. Hunter. To me, you had, when I was in Fallujah, you had
M1 Abrams tanks every now and then that would roll over into
ravines and the Marines would die. They would go over into
irrigation canals, right?
It wasn't anything wrong with the tank. They might have had
some things that weren't up to code, but it is wartime, but
there wasn't anything wrong with the tank, but they changed how
they drove around irrigation canals. And I would guess that
that is a lot of your recommendations that say, do this next
time, don't do that, right?
Mr. Curtis. Certainly in our report. Yes, sir.
Admiral Nadeau. Sir, I would only add, during this
investigation we went aboard the sister vessel, the El Yunque,
which was in similar service, similar build date, maintained by
the same company, and that ship ended up being scrapped after
we went onboard based on the material condition.
Mr. Hunter. And TOTE was in the process of rebuilding
these--or building the new class of these anyway, right, as
this happened.
[Admiral Nadeau nods.]
Mr. Hunter. This ship, the El Faro, was going to be pulled
out of the line, I would assume, in the next couple--or now,
right, if it had stayed afloat.
Admiral Nadeau. Sir, I believe the intent was to shift the
El Faro to the northwest so that it would go into trade back
and forth to Alaska while they were still working to deliver
the final two new containerships that were being built.
Mr. Hunter. Thank you.
Mr. Garamendi, you are recognized.
Mr. Garamendi. I am not going to spend a lot of time
focusing on the mistakes made by the captain and the crew along
the way. Those are well documented in the report.
Going forward, the utility of the National Transportation
Safety Board report and the Coast Guard is really where I want
to focus here. How can we prevent this kind of accident from
occurring again?
So to the Coast Guard who has oversight of the safety of
ships and the associations that are specifically responsible
for reviewing a ship, what are you doing to assure us that the
various associations and organizations that review the safety
of ships is actually taking place and is robust enough to
assure that the ship is safe? Then there is a series of
questions about the competency of the men and women on the
ship.
So, first, what are you doing to assure us that the
organizations that review the safety of the ships actually do
their job?
Admiral Nadeau. Ranking Member Garamendi, for starters, we
want to see how pervasive these conditions were throughout the
fleet. So I have a team out visiting what we would view as the
high-risk vessels that are enrolled in ACP, based on their age,
based on their history, based on their casualties, et cetera.
And the findings indicate that it is not unique to the El Faro,
we have other ships out there that are in substandard
condition.
We have moved out to reform our oversight program. It
starts with governance and having the proper people in place
with the proper focus to call attention and hold others
accountable. That also involves having the right policy and
procedures in place, the right information management systems
to capture the data, collect it, and then engage with our third
parties and communicate to hold them accountable.
So it is an ongoing effort. It will take us a little time.
But we have launched and we are underway and committed to
rectifying the problems that we are finding.
Mr. Garamendi. Do you have a tracking system, a review
system in place, so that you know what is actually taking place
as you attempt to improve your oversight?
Admiral Nadeau. We have a--it is called MISLE, it is an
information management system we use for all of our marine
safety activities and others. It has not been able to capture
some of the information we want it to capture, so we are making
changes now to improve that system.
At this time it is difficult for our people in the field,
when they do find things, to properly incorporate it into MISLE
so we can roll up all that data, all that information, and then
engage with our third parties to talk to them about the
problems we are finding.
Changes are underway, so we will have that capability and
be able to make sure we have the information to engage with
them.
Mr. Garamendi. So there is a reporting system that has not
worked well in the past when your people in the field find
something is amiss. No reporting up the chain of command, and
then no action by the chain of command. Is that what has
happened in the past?
Admiral Nadeau. The procedures, the processes, the
training, and the information capture all need to be improved.
Mr. Garamendi. Well, we are towards the end of January
here, and I suppose you have a tracking system in place so that
you know that there are improvements underway?
Admiral Nadeau. We do, sir. We are working, have a team
assembled that is working on this, and we have moved out to
actually look at the ship.
So I guess there are a couple efforts. One, again, is in
the field, getting aboard the ships, and trying to call out
those requirements and raise the condition of those ships that
need it. And the second thing is to actually make structural
changes within our processes and our procedures and those tools
we use to better enable us to conduct the proper oversight.
Mr. Garamendi. All right. I was just talking to our
chairman and his staff. I am going to turn this back to the
chairman about a request for a matrix on exactly what you are
doing and timeframes.
Mr. Hunter. Which you have, which you are going to give us,
right?
Admiral Nadeau. I can do that for you, sir.
Mr. Hunter. We have already asked you for it.
Admiral Nadeau. OK.
Mr. Hunter. So somebody is working on it. Anybody here
working on it who would know when it would be given to us?
OK.
Mr. Garamendi. Well, let me just take it up here.
If you have a system in place to improve the review and
oversight not only of the work you--that the Coast Guard is
doing, but also of the various organizations to whom you have
assigned responsibility, this committee would like to have that
tracking system, that matrix, that reporting program, as to
exactly how you are tracking the safety programs, and then an
update, a report 6 months from now as to how it is going.
Can you do that?
Admiral Nadeau. Yes, sir.
Mr. Garamendi. Good. Thank you.
For the NTSB, with regard to the action in itself, you
report you have, I don't know, I am trying to add up the number
of at least 20 or 30 different recommendations. Do you ever go
back and follow up on your recommendations as to whether they
are actually done, Mr. Weener?
Mr. Weener. Yes, we do. We make these recommendations,
safety recommendations, to a variety of parties, but the
majority in this case have gone to the Coast Guard. We send
these recommendations off, we expect acknowledgment of receipt,
and then we track them from that point on.
We have some expectations of how long it is going to take
to get a response. But we constantly keep track of the
recommendations until such time as they are ``Closed
Acceptable,'' in some cases ``Closed Unacceptable,'' but we
track them all the way through.
Mr. Garamendi. So your recommendations came out more than a
month, almost 2 months ago now, the final version, I think that
is the date. And have you had any success or have you seen any
improvement, any action on your recommendations yet, some to
the Coast Guard, some to the shipowners?
Mr. Weener. At this point in time we would just expect to
be getting an acknowledgment that they have the recommendation.
At this point we would hope that they would give us some idea
of what their plan was and how long it was going to take.
Mr. Garamendi. Our role here with regard to the Coast Guard
is to make sure they are doing their task of maritime safety.
And for the NTSB, your work to report to us, Mr. Curtis, I
think this is your specific responsibility.
What is your timeframe on following up on the
recommendations, both to the shipping industry as well as to
the Coast Guard? We just asked the Coast Guard for their matrix
for review, and I am asking you for your matrix for review,
your timeframe, your schedule.
Mr. Curtis. Yes, sir. So as you said, the recommendations
would go out as the adoption date shortly after once they are
forwarded to the parties, and they have 90 days to make their
initial response to how they respond to the recommendation,
what they would do. And TOTE has implemented some changes to
those recommendations. There are about 10 recommendations to
TOTE.
But for all parties, whether they go to the Coast Guard,
TOTE, other agencies, NOAA, some to NOAA, they have 90 days for
the initial response. And then we have an office, Office of
Safety Recommendations, which corresponds directly with them on
an ongoing basis. And when they get a response back from those
recipients of the recommendations, specific ones are forwarded
back to our office to respond that we feel whether they are
appropriate or not.
And so we work through back to the Safety Recommendations
Office and ultimately back to the recipient of the
recommendation. So in this case there were 53 recommendations,
so we will be very active and proactive in working with the
Office of Safety Recommendations and the recipients.
Mr. Garamendi. It seems to me that the committee should be
aware of this response loop that you just described. I would
appreciate it if you could provide to the committee a
continuous update on the progress by both the Coast Guard and
the shipping industry in addressing the multiple
recommendations that you have made. When might you be able to
provide that update to us?
Mr. Curtis. Sir, we can provide that any time. I can work
with through Office of Government Affairs to work with your
folks to give you an update at any period you specify.
Certainly we are available at any time to give those updates.
Mr. Garamendi. I am going to yield back at this point, but
before I do, for me and my particular role here, the NTSB's
recommendations and the response of both the Coast Guard and
the shipping industry generally, written large, is really
important.
So I would appreciate it if the NTSB, towards the middle of
this coming year, like maybe June, report back to us on what
progress has been made, what outreach you have done to NTSB
with regard to the recommendations that you have made. They are
of no value unless somebody follows up on them. So I would
appreciate it, Mr. Curtis and Mr. Weener, if you would do that.
And similarly the Coast Guard with regard to all of the
recommendations and updating both with regard to the
recommendations as well as with regard to the improvements on
the oversight of the various organizations that do the safety
reviews.
And with that, I yield back. Thank you, Mr. Chairman.
Mr. Hunter. I thank the ranking member.
Quick question. Does every ship being built now have an
indicator for the hatch being closed, the hatches around the
ship, if they are below a certain----
Admiral Nadeau. There are standards in place for newer
ships that are being built, yes, sir.
Mr. Hunter. So that is in effect now? So all big ships
being built, cargo ships, have a little light with all the
hatches that says that they are closed or open?
Admiral Nadeau. They have indicators, as well as there is
flooding detection in the hold spaces to alert them if there is
water coming into that space. Yes, sir.
Mr. Hunter. Thank you.
I would like to yield to the ranking member, which we are
honored to have here with us.
Mr. DeFazio. Thanks, Mr. Chairman.
Well, I read a lot about this, and I really don't like
systems that foster preventable tragedies that take 33 lives.
Admiral, the Coast Guard subsequently looked at the sister
ship, El Yunque. What was the condition of that ship?
Admiral Nadeau. It was in substandard condition.
Mr. DeFazio. And so we can assume that El Faro was, as the
sister ship, in similar substandard condition?
Admiral Nadeau. The Coast Guard's Marine Board certainly
made that same conclusion, sir.
Mr. DeFazio. And was this boat certified by ABS?
Admiral Nadeau. Yes.
Mr. DeFazio. And what did they say about the boat? Did they
note deficiencies? How recent was their inspection? Isn't it
annual?
Admiral Nadeau. Yes, they would be on there every year, as
would the Coast Guard. I don't know when the last survey had
been. I don't recall on the El Yunque when the last survey was.
Certainly, we found things that should have been captured in
the course of the normal routine of surveys and Coast Guard
inspections.
Mr. DeFazio. So things were omitted.
Now, when is the last time that you are aware that one of
these alternative compliance folks told a company they had to
take a ship out of service and make very significant repairs or
just retire it, as they did El Yunque once you looked at it?
Admiral Nadeau. I am aware of others that have been in
similar condition that have had to come out of service. But I
would say probably--it is not frequent. It is not frequent.
Mr. DeFazio. Right. I mean, it is a competitive industry,
right? And so I hire you, I am hiring you to certify my rust
bucket, I would rather not hear about it, or you tell me about
it and then I am probably not going to hire you again, right? I
mean, if they aren't being adequately overseen.
What is the liability of the classification people in this
case? Is there potential liability for them? Are they being
sued because they overlooked things?
Admiral Nadeau. That is a little bit outside my area of
expertise regarding the liability. I can reassure you that
certainly we recognize the importance of proper oversight over
all classification societies, all third parties that we entrust
to do our work, to help us. And we are committed, again, to
trying to rectify that.
Mr. DeFazio. Do you feel there is any conflict in your
mission here where you are both to facilitate and promote
seaborne commerce and at the same time you are supposed to
protect the life and safety of the mariners?
Many years ago, I offered an amendment in this committee
where the FAA had that dual mandate, and I asked, is that a
problem, and they said no.
Then we had a tragic, totally preventable airplane crash.
And after that came out, somehow my amendment got into the bill
without having been passed on either side of the Hill, because
people realized that this was a horrible problem for the FAA,
to be both promoting an industry which is very mature and
didn't need promotion and regulating safety, and I
substantially took away the promotional aspects.
Should we be moving the promotional aspects or mandate over
to Commerce? It seems a more logical place than the Coast
Guard.
Admiral Nadeau. I don't know that I find my role as
promotion. I think that we balance, we try and be practical and
apply common sense when we apply the standards that are either
developed by Congress or that industry has asked for. I think
we rely more on the safety side of things and we try and ensure
that there is a level playing field out there, that we equally
apply the regulations.
And I would offer also, sir, that we are not the only flag
in the world, the only country in the world that relies on
third parties. Virtually every flag state out there today
relies on these classification societies in some way, shape, or
form. It is just the way the system has evolved. But we need
proper oversight in order to ensure that all parties are doing
what they are responsible for doing.
Mr. DeFazio. Yeah. And what would constitute proper
oversight? I mean, in this case, let's just say had the Coast
Guard had adequate staff, El Faro was surveyed, deficiencies
were not noted. And if you had followed on with a comprehensive
inspection and found deficiencies that weren't noted, what
would be in consequences for that classification society?
Admiral Nadeau. Well, first off, we would have made sure
that the ship--should have made sure the ship is in proper
condition and does not have the problems that were found.
Secondly would be to have a scheme in place to make sure that
we do hold those class societies accountable.
So it starts at the basic level of getting onboard the ship
to observe the standards onboard the ship to see if they are
meeting the minimum standards.
Secondly, it is digging into the safety management system
aboard the ship and aboard that company that they have to make
sure that they have the proper systems in place to maintain the
ship.
And, thirdly, it is looking at the quality system in place
by those third parties to make sure that they have the proper
training, the proper procedures in place to make sure they
capture and resolve these things when they find them.
Mr. DeFazio. Is there any way to assess a penalty against
the classification society that does an inadequate survey that
endangers life and safety or to suspend their capability to do
alternate compliance?
Admiral Nadeau. I don't know that we would pursue the
penalty. I think probably the larger ramifications would be
either preventing them from doing that work on our behalf. They
all have a reputation they try and uphold. It is a competitive
business. They are generally pretty responsive when we ask them
to be. We need to make sure that we are on them, holding them
accountable, and ensuring they take the proper response.
Mr. DeFazio. I mean, it just all reminds me a little bit of
the junk bonds on Wall Street that caused the worst economic
collapse since the Great Depression where all of these bonds
were given very high ratings because it was well known if you
didn't give this junk high ratings, they wouldn't hire you to
give the junk high ratings, and you lose business. I don't see
how it is any different here.
Admiral Nadeau. Sir, I would say, here the difference is we
know how to do this work. I have asked myself over and over
again, how did this happen? We learned this lesson, yes, with
Marine Electric. Since then we have doubled down time and time
again, investing more and more in third parties, whether it is
through Congress or the industry asking us to push more and
more through the third parties.
And we have gone through changes in the Coast Guard where
we stood up sectors. We used to have marine safety offices
working for district M captains. Now we have sectors, which are
very powerful, allow us to do things we could never do before,
like we saw this summer in response to the hurricanes. But
along the way I think we have lost a little bit of our focus
and we are doubling down now to get that back.
Mr. DeFazio. And you have got adequate resources to do
that?
Admiral Nadeau. As always, you could do more if you had
more. But this is not strictly a capacity problem. There are
elements to training. If you just gave me another 1,000 marine
inspectors, it wouldn't solve this problem. This problem
involves training. This problem involves getting the right
information. This problem involves getting the right policy and
procedures in place.
Entry-level marine inspections is not what I am talking
about. I need to have a small corps--it is not a lot--a small
corps of people that can get out and are highly trained and
proficient and stay focused on this area until we get it right.
Mr. DeFazio. OK. All right. Thank you.
Thank you, Mr. Chairman.
Mr. Hunter. I thank the ranking member.
Does anybody else have any questions for this panel? Any of
my Republican colleagues? I will take that as a no.
I thank you very much for being here and talking with us on
this. And with that, we will move on to the next panel.
Mr. Garamendi. Mr. Chairman.
Mr. Hunter. Please.
Ms. Garamendi. Before we move on, we have a series of
questions that we would like to submit for the record. Many of
these have already been discussed here. Let me just review very
quickly and make sure that we cover what we want to cover.
I want to specifically ask Admiral Nadeau, the
recommendations from the NTSB, numerous as they are, I am just
going through them, I think there are 20 or 30 of them, have
you responded to those recommendations? Almost all of them are
specific to the Coast Guard.
Admiral Nadeau. Thank you for that question.
We look forward to getting the entire report so we can go
through them. We have seen the recommendations that were
published, I guess a summary notice when the hearing was held.
In looking at those, I can already tell, they are very
close to the recommendations we made in our own Marine Board
investigation, our own report. We had 36 recommendations. Many
of those are very, very similar to what is coming from the
NTSB.
So, yes, I think that we will respond. We have a process in
place to provide them feedback on each one of those, and we
will carefully assess their information, the report, and each
recommendation.
Mr. Garamendi. When will you have your initial review and
response to the recommendations?
Admiral Nadeau. As soon as we get the report--as soon as
the report is published, we will begin our review. And as I
indicated, I think there is a timeline, I don't think it is
laid out in our MOU, but there is a timeframe we meet. I don't
know if it is 30, 60 or 90 days. But we will certainly meet
that and do our best to meet the timeline that is established
in the procedures.
Ms. Garamendi. Mr. Curtis, when will it be finalized?
Mr. Curtis. The report will be out mid-February, the 15th,
and the recommendation letters right around that time.
Mr. Garamendi. So the 90-day response cycle, is that----
Mr. Curtis. The 90-day response cycle will start right
around mid-February, maybe a little earlier, but soon. But they
have been released in the abstract of the report.
Mr. Garamendi. OK. And presumably, I can't count, there are
53 specific recommendations. I lost count somewhere around 30.
We will be interested in hearing the response from the Coast
Guard.
Also, does the shipping company or companies also respond?
Mr. Curtis. Yes, it is the same process for all recipients
of NTSB recommendations, sir.
Mr. Garamendi. OK. We will await that. Thank you very much.
I yield back and thank you. And I do have specific
questions for the record.
Mr. Hunter. Without objection, we will give the gentleman
authority to submit questions for the record.
So we are looking for from the Coast Guard and from NTSB
the matrix that he is talking about earlier. I got those
confused. He would like the types of ships--and correct me, Mr.
Garamendi, if I am wrong--the types of ships that are like the
El Faro that you have been looking at now, the same year range,
I guess, that are out there.
I think that is what he is asking for, not the matrix of
recommendations and accomplishments, which is separate. So both
of those things. But we would like to see all of those ships
that you are out there looking at now, saying these could be at
risk.
In closing, I drive a 1997 Expedition. If you were to go
through the check list on my truck, there is probably a lot of
stuff on it that is not correct, like the middle seatbelt in
the back doesn't work, the airbag is out on the passenger side.
But if I take my seatbelt off, as a driver, when it is
pouring down rain and go driving on the freeway at 90 miles an
hour and crash it, you can look to all those things that
weren't up to code in my truck, but the reason that it crashed
and I died is because I drove it without my seatbelt in pouring
rain at 90 miles an hour.
In the end, you can make all the recommendations you want
to, but if you leave hatches open in high sea states and drive
into a hurricane, bad things could happen.
I think at the end of this that is what I am kind of taking
out of this, is all the structural issues, from the age of the
ship and classifications and giving the ship approval to set
sail, those are all good things, but if you drive at 90 miles
an hour in an old truck with no seatbelt on in pouring rain,
you might crash.
So with that, yes, sir, closing statement, it is all yours.
Admiral Nadeau. Sir, I could see why you draw that
conclusion. But I guess we looked a little further beyond this
particular incident, caused us to look at other vessels in the
fleet, and did cause us concern about their condition.
It is almost like your same old car. Some of our fleet--our
fleet is almost three times older than the average fleet
sailing around the world today. Just like your old car, those
are the ones likely to break down. Those are the ones that are
more difficult to maintain and may not start when I go out and
turn the key.
Our fleet is older than the average fleet. That presents
some challenges. And some of our fleet, particularly the
Military Sealift Command, where it is a Ready Reserve component
that kind of sits idle for long periods of time, that presents
challenges for us, sir.
We are working very closely with partners at Military
Sealift Command, Admiral Mewbourne, as well as MARAD Admiral
Buzby, to make sure that we pay proper attention to that.
Mr. Hunter. Thank you.
Mr. Garamendi is recognized.
Mr. Garamendi. Mr. Chairman, thank you for opening another
avenue here that I had neglected. I know we are running up
against the clock also.
There is the ship and all of the adequacies or inadequacies
of the ship itself. In this particular situation, as the
chairman was saying, the driver on the freeway made a serious
mistake.
Are the men and women who are responsible for the safe
operation of the ship, both from shore as well as on the ship
itself, are they adequately trained? Are they over a period of
time recertified? Are there questions that we should be raising
about the adequacy of the men and women responsible for the
ship itself? And is the Coast Guard also investigating that
piece?
Admiral Nadeau. Yes. There were recommendations related to
training, both with respect to weather forecasting,
meteorology, and also with bridge resource management, and
other aspects that were highlighted here.
Mr. Garamendi. OK. Obviously, we are not going to be able
to question any of the personnel that were on the ship. But it
appears that there were mistakes made in the operation of the
ship, perhaps both from shore as well as from the ship itself
while at sea.
Does the NTSB or the Coast Guard have any concerns about
the adequacy of training of the personnel that are on American
ships that are currently on the oceans? Do we have any
recommendations for upgrade, for continuing classification, and
for review of their ability to properly conduct the ship?
Mr. Weener. The NTSB has recommendations related to
training and bridge resource management, both recurrent
training as well as initial training, for things like heavy
weather, for advanced meteorology, for deck crews. So that
aspect of training has also been included in their assessment
in our investigation.
Mr. Garamendi. My final point is that the ability and
capability of the men and women in charge of running the ship
has to be continually observed and with a high level of
assurance that they are competent and capable. In the NTSB
report, among your 53 recommendations, there are several that
speak to that issue. I would expect that in the responses, both
from the shipowner as well as from the Coast Guard, that this
will be an issue that will be taken up in the responses.
My concern goes beyond this particular company and the men
and women that are hired to operate the ships for this company,
but rather to the entire U.S. Fleet and the adequacy of the
training and the capability of the men and women that are
responsible. So I would like the Coast Guard to also pick up
that issue beyond just this one company.
With that I will yield back. Thank you.
Mr. Hunter. I thank the ranking member.
Just in closing, you had two Navy ships crash last year,
and it wasn't any mechanical anything. It was they took away,
the last couple years, they took away surface warfare officer
training, it became on-the-job training with a DVD. It used to
be a 6-month school up until, I don't know, 4 or 5 years ago.
They got rid of it. Training saves a lot of lives.
And looking through everything, it looks like this was poor
decisionmaking that exacerbated physical problems with the
ship. And I think that is what we take out of this and we will
keep drilling down.
If we could get those matrixes of the ships, right, that
you are looking at, so we can kind of see what is out there
right now, and then the recommendations and what has actually
been accomplished with those 53--52. The Commandant said, let's
go with it two out of the three, the admin recommendations, he
said, let's go with it. We would like to see what actions were
taken that match those recommendations.
And I think June 1. Is that too long? Could you get them
before that? We can get the ship matrix before that probably.
But as soon as you have it, we would like to see it.
Mr. Garamendi. June 1 is good.
Mr. Hunter. June 1 is good with the ranking member, so it
is good with me.
And with that, thank you all very much. And we will move on
to the next panel.
Lady and gentlemen, thanks for being here.
We will move on to the second panel. We will hear from Rear
Admiral Erica Schwartz, Director of Health, Safety, and Work-
life with the United States Coast Guard; Rear Admiral Michael
Haycock, Assistant Commandant for Acquisition and Chief
Acquisition Officer with the United States Coast Guard; and Mr.
David Powner, Director of Information Technology Management
Issues with the Government Accountability Office.
Admiral Schwartz, you are recognized.
TESTIMONY OF REAR ADMIRAL ERICA SCHWARTZ, DIRECTOR OF HEALTH,
SAFETY, AND WORK-LIFE, U.S. COAST GUARD; REAR ADMIRAL MICHAEL
J. HAYCOCK, ASSISTANT COMMANDANT FOR ACQUISITION AND CHIEF
ACQUISITION OFFICER, U.S. COAST GUARD; AND DAVID A. POWNER,
DIRECTOR OF INFORMATION TECHNOLOGY MANAGEMENT ISSUES, U.S.
GOVERNMENT ACCOUNTABILITY OFFICE
Admiral Schwartz. Chairman Hunter, Ranking Member
Garamendi, honorable members of the subcommittee, good morning
and thank you very much for your oversight and for your
continued strong support of the United States Coast Guard. I am
honored to testify before you today with my colleague, Rear
Admiral Haycock.
Let me state now, bottom line, upfront, we sincerely regret
what happened with the Integrated Health Information System, or
IHiS. The Coast Guard attempted to develop an electronic health
record that was ultimately unsuccessful.
What began as a project to develop a simple electronic
health record increased in scope and expanded into a much
larger concept, which added work-life and safety services.
While well intentioned, this project lacked appropriate
oversight and governance and resulted in a project that had
significant mission creep, untimely delays and increased cost.
Upon realizing that IHiS was not going to be completed in a
reasonable time, at a reasonable cost, the Coast Guard made the
decision to cancel IHiS.
We are incorporating lessons learned as we move forward
with our new electronic health record. Recognizing the
criticality of the new electronic health record, it has been
formally designed and designated with an acquisition with the
necessary and appropriate level of governance and oversight
that IHiS lacked.
As the program sponsor representative, it is my highest
priority to work alongside the chief acquisition officer, the
chief information officer, and other members on the governance
board to leverage lessons learned and to ensure that the best
choice that meets service requirements is acquired and
implemented as soon as possible.
Since our outdated electronic health record had significant
IT security concerns, we continued with just paper health
records.
As a physician, I know firsthand the risk of managing a
medical program based on paper health records. Whether it is
the challenges of scheduling an appointment, difficulty in
reading handwritten clinical notes, storing volumes of
information, or decreased productivity, the Coast Guard cannot
continue without an electronic health record system long term.
Our clinics and sick bays are managing with a paper health
record system, but this is not a permanent solution. We must
have an electronic health record system that is interoperable
with the DoD and one that allows our members to officially
transition to the Department of Veterans Affairs.
As the Coast Guard's chief medical officer, I oversee the
healthcare delivery and medical services for more than 48,000
members of the Nation's fifth armed service. I have a passion
for ensuring the Coast Guard has superior access to healthcare.
It is my duty and responsibility to ensure that our healthcare
system is able to serve our greatest asset, our people.
As we continue to pursue the very best electronic health
record solution for our members, the Coast Guard is thankful
for your interest and assistance on this important issue.
Supported by sustained internal governance and your continued
support, I am confident that the Coast Guard will implement the
finest electronic health record solution.
Thank you.
Mr. Hunter. Thank you, Admiral.
Admiral, you are recognized.
Admiral Haycock. Chairman Hunter, Ranking Member Garamendi,
good morning.
First, I would like to thank you for your continued support
of the Coast Guard and the guidance that you provide to our
military service. As my colleague has mentioned, the Coast
Guard recognizes the critical need to move to an electronic
health record system. And as the chief acquisition officer, I
appreciate the opportunity to discuss the improvements that we
have made over the last several years to apply disciplined
governance to these types of investments throughout our
Service.
As you are well aware, over the last 15 years or so, with
the tremendous assistance of this subcommittee, the Coast Guard
has undertaken significant efforts to improve the oversight and
the management of our major acquisitions, such as our vessels
and our aircraft.
Our acquisition framework is designed to constrain and
validate requirements to provide checks and balances and
provide continuous and effective oversight at all stages of the
acquisition life cycle. Until recently, we did not use the same
level of rigor to govern key decisions for our smaller
investments.
We have learned several lessons from our experience with
the Integrated Health Information System. The most important of
these lessons are related to oversight and program management.
Without the oversight and guidance normally provided to our
formal acquisition programs, well-meaning people were overcome
by the task at hand and that program simply outgrew their
capabilities. And as a result, we have made significant process
improvements to manage all sizes of acquisitions, including
nonmajor acquisitions.
To that end, the Coast Guard overhauled its processes of
our nonmajor programs. We established formal roles and
responsibilities and requirements in the same manner that we
use for major acquisition programs.
These new processes established a governance framework and
provided a roadmap for improving program execution and managing
risk. This framework leverages the expertise of our technical
authorities, including the chief information officer, to ensure
that nonmajor programs remain on track and key decisions
represent the priorities of all communities across the Coast
Guard.
Additionally, we recently instituted new processes to
identify candidates for formal acquisition management and
oversight which allows us to look out for those investments,
like IHiS, to prevent them from falling through the cracks.
We created an oversight council specifically to provide
oversight and governance for nonmajor programs. This provides
senior staff from across the Service a forum to regularly
assess performance, raise issues, and address concerns, and it
also ensures we have people with the right talents and skills
managing our programs.
Recognizing the continued urgent need to address our
healthcare record system, in 2016 the Coast Guard established a
formal nonmajor acquisition program to modernize the management
of healthcare acquisition for approximately 50,000 Active Duty
and Reserve members and improve the exchange of healthcare
information with the Department of Defense, the Department of
Veterans Affairs, and commercial care providers.
We initiated activities to explore several possible
alternatives and are in close contact with DoD and Department
of Veterans Affairs to ensure the new solution is interoperable
with their healthcare records systems.
Last year, we initiated market research to gather data on
cost, schedule, and performance capabilities, and potential
solutions currently available in the commercial marketplace. We
are evaluating the benefits and the risks associated with
several approaches and are developing the best procurement
strategy to expedite the acquisition.
The Coast Guard recognizes the urgency to support the
health of our most valuable asset--our people--and our current
governance framework ensures that we have the processes and
policies in place to oversee our current electronic healthcare
acquisition program.
We continue to incorporate the recommendations made as a
result of the invaluable oversight of this subcommittee and the
GAO. And I am committed, along with Admiral Schwartz, to the
expeditious and responsible delivery of a high-quality
electronic health record solution for our men and women in the
field.
Thank you again for the subcommittee's staunch support and
your oversight of Coast Guard programs and for the opportunity
to testify today. I look forward to answering your questions.
Mr. Hunter. Thank you, Admiral Haycock.
Now to Mr. Powner. You are recognized.
Mr. Powner. Chairman Hunter, Ranking Member Garamendi,
thank you for inviting GAO to testify on the Coast Guard's
failed effort to acquire an electronic health record. This
morning I will provide details of what went wrong with the
acquisition and what needs to be done to manage this more
appropriately in the future. This lookback is important to make
sure that the Coast Guard corrects the management and
governance flaws that led to about $60 million being wasted.
This effort started in September 2010 and was to be a 5-
year project and cost about $14 million. Due to growing scope
and mismanagement, the cost grew to about $60 million before
the project was terminated in October 2015 with nothing to show
for it.
There is a long list of things that went wrong that are
laid out in great detail in the report we are releasing today.
The highlights are:
The project was behind schedule.
There were questions about whether the Coast Guard was
using appropriate funding sources to pay for it.
Expected system capabilities were not being delivered.
The system had limited security features, which is alarming
given the sensitivity of the data residing in these electronic
health records.
The Coast Guard wasn't completely following its own
processes to acquire a system. Examples include not involving
users of the system and not testing it adequately.
Executives who should have been involved were not, as
several governance boards were established to oversee this and
they were simply not active.
I would like to highlight the words ``not active.'' We at
GAO have reported on failed IT acquisitions over the years and
the message is usually that executive boards were not effective
or not involved enough, not ``not active.''
Finally, post-cancellation, no equipment or software was
delivered for reuse and the Coast Guard continued to pay
millions to vendors after the cancellation to satisfy
contractual commitments. In fact, our report highlights two
payments scheduled for next month that collectively total more
than $5 million. Yes, nearly 2\1/2\ years after cancellation,
we are still paying contractors.
Compounding the situation is the fact that 3 months after
the October 2015 cancellation, the Coast Guard decommissioned
its older existing legacy system because it was not complying
with international medical coding requirements. This left the
Coast Guard to predominantly use a paper process to maintain
health records.
To its credit, the Coast Guard is attempting to use some
DoD applications and workarounds to supplements its paper
process. But let's be clear, using paper is inefficient and
dangerous.
Coast Guard clinical staff reported major issues to us that
include problems with incomplete records, issues with tracking
medications, and challenges scheduling appointments.
The Coast Guard is planning a new electronic health record.
A request for information went out in April 2017, but the Coast
Guard has yet to determine its specific electronic health
record solution.
Moving forward, we have five recommendations for the Coast
Guard:
Number one, make sure managers and executives with the
right IT background are involved with this acquisition. Most
importantly, this includes the chief information officer.
Number two, executive governance needs to be active and
frequent. This governance needs to be driven by the CIO and the
witnesses here today.
Number three, project management disciplines need to be
carried out. This would include implementing the appropriate
cybersecurity measures and involving the user community
extensively, since business process change will be significant
to effectively deploy commercial products in this area.
Number four, the Coast Guard needs to consider adjustments
or tailoring of its processes it uses to manage what it calls
smaller or nonmajor acquisitions. Dollar thresholds alone
shouldn't drive the rigor and attention projects get. Mission
criticality should.
And finally, the Coast Guard needs to strongly consider the
EHR solution that DoD and the Department of Veterans Affairs
are pursuing.
Mr. Chairman, this concludes my statement. Thank you for
your oversight of this important acquisition.
Mr. Hunter. Thank you, Mr. Powner. And to the other
witnesses, thank you very much.
I guess let us go with what you were saying. What was your
last recommendation?
Mr. Powner. The last recommendation is you really need to
look at what DoD and Department of Veterans Affairs are doing.
I mean, we made a bold decision for VA to go with the solution
that DoD was using. And I understand competition in this
industry.
Mr. Hunter. But is the Coast Guard DoD? The Coast Guard is
a military service, right? Why wouldn't you go with DoD in the
first place? Why not be interchangable with DoD? Why not save
all that money and time and be efficient and use DoD's product?
Admirals.
Admiral Schwartz. The Coast Guard is looking with great
interest at what DoD is doing and what the Department of
Veterans Affairs is doing with regards to their new electronic
health record system.
Mr. Hunter. But why would you not use that?
Admiral Schwartz. So, sir, as a military service we
certainly are looking at what they are doing with respect to
the new MHS GENESIS product. And what we are doing is looking
at what their lessons learned are.
Mr. Hunter. But why would you not use that? Why would you
not use what DoD is already doing?
Admiral Schwartz. As part of the acquisition process, which
I will yield to my colleague here, we are looking at various
GOTS [Government off-the-shelf] and COTS [commercial off-the-
shelf] solutions.
Mr. Hunter. I understand that you are doing that. Why would
you not use DoD's solution?
Admiral Haycock. Mr. Chairman, I can't speak to something
that happened that long ago.
Mr. Hunter. No, now. Why would you not use DoD's solution
now?
Admiral Haycock. That is our----
Mr. Hunter. It is a waste of money and time going to look
at stuff when it exists right now. I don't think you would say
that the Navy is less complicated than the Coast Guard, right,
or the Army. It is a lot more complicated, and larger and more
spread out, and they are able to do it. So why wouldn't you
just use that?
Admiral Haycock. As you know, Mr. Chairman, when you start
getting into major acquisitions of great scope and complexity
there is discipline that we have to put in the process, and
that is what prevents us from getting into trouble.
We are going through that process. We have done an analysis
of alternatives, which is looking at what exists out there for
us to potential solutions.
One of those solutions is using a Federal service provider.
That is the solution that we would like to go for and that is
what we are working with the Department of Veterans Affairs and
DoD to make happen. We are in close conversation with them
informally on probably a weekly basis and meeting with them
formally on a monthly basis. We have been invited to be part of
their executive steering group and we are participating in
that.
So we are tracking down that direction, but we need to
follow the discipline of the acquisition process or we will end
up in messes like other programs have seen in the past for not
doing it.
That is when gives me great confidence on eHRA [electronic
health record acquisition] going forward, is that we have stood
it up as a formal acquisition program and it is getting that
discipline and the oversight. The very same people that oversee
all of our major acquisitions, like ships and aircraft and
such, they are providing the oversight for eHRa now, and that
includes the chief information officer and every stakeholder
and tech authority in the Coast Guard.
Mr. Hunter. OK. I would highly encourage you guys to do
what is easy and efficient and effective, especially when you
have got really big services with lots of money doing it for
you and you can just piggyback onto that.
Let me switch over. There is no code, there is no software,
there is no code and no machinery, right?
Admiral Schwartz. Sir, IHiS is considered a software as a
service product. And so what we did was we contracted with
various software companies and they produced, developed modules
for our safety program, for our health program, for our work-
life program. But because it is a software as a service, once
we stopped paying for those services we don't have a final
product to show.
Mr. Hunter. So you didn't have any intellectual property?
Admiral Schwartz. That is correct, sir.
Mr. Hunter. Whose decision was it to cancel it?
Admiral Haycock. I guess it was probably three-quarters of
the way through 2015 the Executive Oversight Committee, their
counsel was sought out by the project. The executives on that
team heard the brief, saw the risks involved, and recommended
that the Coast Guard, the Vice Commandant, cancel the program.
Mr. Hunter. I think it is very strange that there is
nothing, that you got $60 million and you literally got nothing
out of it.
Is that usual, Mr. Powner, I mean, to retain no
intellectual property?
Mr. Powner. You know, I think you can write contracts in a
way where you do maintain some of--I understand the software as
a service concept, but you can write that in a way that you
have some reusability.
If you have nothing, that might even be more of a reason to
go with what the Department of Veterans Affairs and DoD are
already doing, because if we don't have anything to reuse--I
agree with you on your comment about piggybacking on what is
already there. And they are ahead of the game, so you can look
at lessons learned and learn from that. That is what the
Department of Veterans Affairs is doing with DoD right now.
And there are lessons learned on the business processes and
the like. To me, that makes sense, to go that route, especially
given the fact that we have nothing.
Mr. Hunter. My last question is to stress this point. Is
there anything that makes coastguardsmen different from any
other servicemember besides what they do in their specialty? Is
there anything special about being in the Coast Guard that
would not allow you to be in the Department of Defense's health
record system?
Admiral Haycock. No, Mr. Chairman. We are a military
service, so our Active Duty coastguardsmen are just like all
the other Active Duty military.
I think some things that may play into it that make us a
little unique is the size of our Service. So infrastructure is
a little bit different, the types of patients that we see and
that the Department of Veterans Affairs sees might be a little
bit different. But for the most part there is nothing special
there.
Mr. Hunter. The Coast Guard has got a lot of missions that
do a lot of totally different things. And I think what you are
doing is complicating your own lives here. I mean, you can't
have a core competency of everything.
With that, I would like to yield to the ranking member. You
are recognized, Mr. Garamendi.
Mr. Garamendi. I think I have been through too many of
these. Electronic health records are now standard in virtually
every health system in the Nation. And every one of them have
made mistakes and in most every system the first effort failed.
But we have more than enough models in place so that this
should not have happened. But it did.
My real issue is, who was the contractor? I was looking
through the report and never a name of the contractor.
Admiral Schwartz. Sir, there were numerous contractors that
supported the IHiS effort.
Mr. Garamendi. Who are they?
Admiral Schwartz. Sir, I don't have a list of the
contractors with me today, but we certainly can make that list
available to you.
Mr. Garamendi. Somebody ought to be accountable here. We
are holding the Coast Guard accountable, but the contractor
also screwed up. I want to know who screwed up. Who is the
contractor that screwed up here?
Mr. Powner, do you know?
Mr. Powner. We can get you a list of the contractors who
were involved in that.
Mr. Garamendi. I am sorry, this whistling behind just wiped
you out. Could you say that again?
Mr. Powner. Yes, we can get you a list of the contractors
involved.
I think you bring up a good point. I have testified in
front of Congress on many failed acquisitions over the years.
And is there mismanagement on the Government side? Yes. But
there is also an obligation on the contractual side to work in
partnership on this, and we need more of that going forward,
clearly.
Mr. Garamendi. I am just willing to bet, without knowing
who they are, I will bet they have screwed up before and I will
bet we have hired the same folks that screwed up before to do
another screwup.
Yes, I would like to know the name of the companies that
failed to perform. That is the first issue.
The second issue was the question raised by the chairman,
Mr. Hunter, and that is, the Department of Defense is in the
process of developing an electronic medical record. And if I
recall correctly, they finally decided, out of a fit of wisdom,
that it would also be the same records that the Department of
Veterans Affairs used. In other words, they were transferrable
one to another.
That took about 10 years' fight between the two agencies,
but I guess somewhere along the line both decided that an
active member and reservist in the military, the Department of
Defense, might at some time in the future become a veteran and
that their medical records really ought to be available to the
Department of Veterans Affairs.
Does the Coast Guard also see the wisdom of this
transferability of the medical records from the Coast Guard to
the Department of Veterans Affairs? Are you taking that into
account?
Admiral Schwartz. Absolutely, sir. And just to be clear,
right now, even though we are on paper health records, we do
transfer our paper health records to the Department of Veterans
Affairs. It is through a system called the Health Artifact and
Image Management Solution, which is the same system DoD uses
right now. We digitize our paper health records when a member
leaves the Service, and that record is uploaded into HAIMS and
the Department of Veterans Affairs can extract the record from
HAIMS.
Mr. Garamendi. So at least you are thinking about it with
regard to paper. And you are going to do that with regard to
the electronics if and when you ever get there?
Admiral Schwartz. Absolutely, sir.
Mr. Garamendi. The chairman was pushing the point, I think
correctly, that you ought to be using the same system as the
Department of Defense. Are you contemplating doing that? It
wasn't quite clear to me in the responses, Admirals, that you
are or are not.
Admiral Haycock. The alternatives analysis is----
Mr. Garamendi. Please really speak loud, this whistling
behind us is most distracting.
Admiral Haycock. So the alternatives analysis that we
conducted, that is one of the preferred alternatives, and we
are working through the details to make that happen.
Mr. Garamendi. And when do you expect to make a decision?
Admiral Haycock. We are approaching Acquisition Decision
Event 2A/2B, which probably doesn't mean much. But we have a
major acquisition decision coming up here probably end of
February.
Mr. Garamendi. I know of several clinics in California that
have more than 50,000 lives in their clinics. They have
established electronic medical records. I mean, some of this
stuff is now off the shelf.
Mr. Powner, you have been at this a long time. You have
found more than enough problems. Your recommendations in your
report are rather general. Do you have specific
recommendations? And is one of those recommendations----
Mr. Powner. Yes. I would say the key recommendation, and I
have seen this, you can have the best project management on
these technology projects, but if you don't have executives
that are accountable and breathing down the neck of project
managers, that is what makes this stuff work, when you get
executives involved.
Example, the U.S. Census Bureau, OK? Now we are going to
spend $3 billion more on the Census Bureau. What happened?
Secretary Ross is now involved with the Census Bureau and they
set up adequate governance.
The Coast Guard has a governance process in their policies,
they just need to execute it. It starts with the admirals at
this table, with the CIO, with the CFO, and they need to drive
the delivery of this system.
Good governance, that is what actually works in Government,
when you have the executives accountable and pushing hard to
make sure we get deliveries, not only from the Government but
from contractors too. You sit down with contractors, you demand
the A team.
That is the stuff that has worked over the years, and I can
give you positive examples, too, where it has worked.
Mr. Garamendi. I agree entirely.
So, Admirals, are you engaged?
Admiral Haycock. Yes, Congressman. IHiS was kind of a
watershed event, shook our foundations. It really caused us to
kind of sit back on our heels and try to figure out what
happened.
IHiS did not have the appropriate executive oversight. That
is probably the biggest problem. There are other things that
complicate IHiS, but they all lead to this failed oversight on
our part.
So we have stood up a formal acquisition program for eHRa,
and it has the right executives providing the oversight.
Admiral Schwartz is a member of the EOC, the Executive
Oversight Committee, our CIO is, and a host of others that have
a stake in this.
So I assure you, we have the right executives breathing
down the neck.
Mr. Garamendi. You just described everybody is responsible
and therefore nobody is responsible. So which of the two of you
are responsible?
Admiral Haycock. I am responsible because I am the
acquisition officer.
Mr. Garamendi. Admiral Schwartz.
Admiral Schwartz. Sir, I am responsible for ensuring the
requirements document is delivered to our acquisition officer
to delineate what we need and what we want for an electronic
health record system.
Mr. Garamendi. Isn't that readily available from a dozen
different organizations that already have electronic medical
records?
Admiral Schwartz. We have completed the operational
requirements document. We delivered it to the hands of our
chief acquisition officer. And we are moving as quickly as we
can to get this EHR out in the field.
Mr. Garamendi. Have you consulted with Mr. Powner on his
recommendations?
Admiral Schwartz. Sir, we have read the GAO's draft report
and we have taken them absolutely to heart.
As Admiral Haycock mentioned, governance was a significant
issue with IHiS. IHiS was stovepiped in the medical program. We
did not involve the chief information officer. We did not
involve the chief acquisition officer.
No more. As we move forward, we have this cross-directorate
governance that includes the CIO, that includes the chief
acquisition officer and others on the governance board.
Mr. Garamendi. You have developed an AOA?
Admiral Haycock. An alternatives analysis, yes.
Mr. Garamendi. Have you developed one?
Admiral Haycock. We have.
Mr. Garamendi. Have you presented that to the committee,
us?
Admiral Haycock. I don't----
Mr. Garamendi. Well, why don't you do so? We have seen AOAs
on God knows how many things under Defense on the House Armed
Services Committee. I would love to see your AOA.
Mr. Powner, have you reviewed the AOAs?
Mr. Powner. No, I have not reviewed that in great detail.
Mr. Garamendi. Should you?
Mr. Powner. Yes. But I would say you could eliminate the
AOAs down to--as was mentioned here, this is a robust area when
you look at commercial products. So I don't know why we would
look at anything beyond commercial products.
And then I will narrow it further. Let's piggyback on DoD
and the Department of Veterans Affairs. Let's make it simple.
We are making it too complicated.
I understand we have to follow the process----
Mr. Garamendi. Admiral Schwartz, you heard what he said?
Admiral Schwartz. Sir, as the chief medical officer, I
absolutely would love to go with DoD and the Department of
Veterans Affairs. I have provided my requirements. We worked
very closely to look at what DoD was doing to ensure that the
operational requirements documents that we provided to the
acquisition officer was very similar to what the DoD system is.
Mr. Garamendi. I find it astounding that--I mean, this is
so--this is not complicated. There are commercial applications
out there. I know four clinics that in the last 3 years have
purchased off-the-shelf electronic medical records that also
allow them the opportunity to convert their previous paper
records to electronic records, all done. It is off the shelf.
And they have more lives than the Coast Guard has.
I guess one question is that the GAO comes in after there
is a screwup. It seems to me that there ought to be an
iterative process here.
Mr. Powner, you have got a lot more knowledge than either
of the two admirals here about these kinds of things. This has
been your life or at least you more recent life's work. Maybe
you ought to quit GAO and become a consultant. But stay where
you are, we need you there.
But it would seem to me that it would be worthwhile for the
Coast Guard to consult with the GAO and to learn from their
experiences. I know you have two different tasks.
Mr. Powner. If I can add. So we do some postmortems at GAO
on things that go wrong, but we also do a lot of work for the
Congress when acquisitions are in flight. And that is when it
is most effective, working alongside. We can still maintain our
independence and work alongside while acquisitions are in
flight to ensure that governance and project management,
contractor oversight, and all those things are occurring.
Mr. Garamendi. Well, given that, I have just requested an
AOA--or the AOA. I would appreciate your review of the AOA,
while it is in process. Postmortems are usually over dead and
troubled projects. We can avoid that, I think, by working
together here.
I yield back.
Mr. Hunter. I thank the gentleman.
One thing we looked at, and I don't know if you have heard
of this, Mr. Powner, but it is called the Distributed Common
Ground System, DCGS, for the Army. It is like $4 billion they
put into it.
It never worked. They had about 30 nice contractors that
all did modules and they could all plug and play theoretically,
but nothing. It didn't work, period.
And it was billions of dollars and it required the Chief of
Staff of the Army now, General Milley, to kind of do what you
are doing, Admiral Haycock, and taking a hard look at this, as
a four-star. Because when you are spending billions of dollars
or tens of millions of dollars for the Coast Guard, I mean, you
have to make sure you have it right, especially with software.
It would be nice to be a software contractor in town here.
I can do stuff for you and never give it to you and you will
pay me.
Mr. Garamendi. I want to know who the contractor was.
Mr. Hunter. I think it is absurd you are paying next month
for this, even though the whole thing is over. But what is in
the past is in the past. We don't want to beat on the Coast
Guard too much right now. You have got things straightened up.
And hopefully moving forward, Mr. Powner will have good things
to say.
And again, I am of the mind to make you get on DoD's thing
no matter what you think. We ought to just tell you to do it.
You don't need to be going off and doing your own thing when it
comes to healthcare.
I think that is not Mr. Garamendi and I or this committee
micromanaging. It is saying you guys don't get to go off on
your own and just use taxpayers' dollars because it is fun when
you have the Department of Defense doing it.
So I think that is something we ought to look at, is just
telling you what to do, especially in this case. I think that
would be a smart thing for us to look at and see if that is
even possible.
With that, thank you very much for being here. And
hopefully we get this straight.
With that, the hearing is adjourned.
[Whereupon, at 11:36 a.m., the subcommittee was adjourned.]
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