January Message from the Assistant Secretary of Defense for Health Affairs

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MHS Team:

Happy New Year! I hope you had a restful holiday season and are back in the
swing of things. I fully expect that – like 2019 – 2020 will be a jam-packed
year for the MHS.

That starts, of course, with making progress on the reform efforts that
formed so much of our work in 2019. First is the consolidation of management
of Military Treatment Facilities. The Defense Health Agency is working with
all other elements of the system to stand up its headquarters and the market
construct that we will use to administer the MTFs under DHA. And we got an
assist from Congress, which as part of the National Defense Authorization
Act passed in December, included provisions that allow us the flexibility we
need to shift key civilian personnel in MTF management from the military
departments to DHA. We expect the first Transfer of Function-related
personnel moves to start in early February.

Second is the reexamination of our facilities footprint, a review directed
in Sec. 703 of the FY17 NDAA that asks the Department to assess MTFs to
determine if there are opportunities to resize any facilities that do not
offer a platform for maximizing ready medical capabilities. We expect that
our report outlining these plans will go to Congress within the next few
weeks, and we are prioritizing clear communications with key audiences –
especially patients and staff – to help all understand any changes and their

Third is our work to support the Military Departments’ implementation
efforts tied to their proposed repurposing of military medical billets.
Planning to implement these reductions while ensuring we meet our
obligations to patients and operational forces continued through 2019. In
that NDAA passed in December, Congress established new requirements that the
Military Departments and the Department of Defense must fulfill before
implementing these reductions, and Health Affairs, DHA and the Services are
working together to comply with this direction from Congress.

Congress included other important provisions in the NDAA with implications
for the MHS. You have probably already heard about the provision that
authorizes a new process for service members who want to file medical
malpractice claims. Health Affairs will work with the Military Departments
and DHA to develop the rules and procedures for such a process.

Related to our focus on readiness, at last month’s annual AMSUS conference I
announced that the Joint Staff Surgeon and Health Affairs had been tasked to
develop a Strategic Framework for Operational Medicine. This framework,
being developed with the Surgeons General, DHA, and the Uniformed Services
University, will provide a common goal for synchronizing DHA’s role in
health delivery with the Military Departments’ readiness and training
requirements. The goal is to better integrate the tremendous work happening
across the MHS to build and sustain the skills we need to support
operational requirements. This work gets to the heart of our system’s reason
for being and will be a focus throughout the year.

One constant in Health Affairs the last four years has been Dr. Terry
Adirim. Terry has helped the MHS navigate a host of challenging clinical,
policy, and organizational issues. For me personally, on every important
issue we’ve dealt with, she has provided invaluable counsel and support.
Terry is leaving us to take a position at the Florida Atlantic University
College of Medicine. FAU is immensely fortunate to have a physician of
Terry’s experience, skill, and dedication helping to shape the next
generation of medical professionals. The MHS’s loss is FAU’s gain. Please
join me in thanking Terry for her many contributions to our military medical


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