NDAA

Update on DHA Transition in June Message from the Principal Deputy Assistant Secretary of Defense for Health Affairs

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MHS Team,

As the Military Health System (MHS) has continued implementation of FY17 National Defense Authorization Act (NDAA) Section 702, we’ve revised our approach for transitioning administration and management of the Military Treatment Facilities (MTFs) from the Military Departments to the Defense Health Agency (DHA). Our original implementation framework required maintaining Military Department Headquarters and Intermediate Management Organization (IMO) MTF management responsibilities for an extended period of time to support those MTFs in geographic regions as we phased in MTF transfers to the DHA over several years. Recognizing this approach had several challenges in addressing civilian personnel changes, financial resources, and the Military Departments’ ability to focus on medical readiness, in May the MHS leadership team recommended a new transition framework to DOD and Military Department senior leadership. Our new framework has DHA assuming authority, direction, and control of all MTFs on October 1 of this year and DHA will oversee the MTFs through a Direct Support relationship from Military Department IMOs. The DHA will relieve the Military Departments of this support during a transition period during which responsibility for specific functional capabilities are fully transferred from the Military Departments to DHA under a controlled “hand off.” For the remainder of FY19, the DHA and the Military Departments will finalize and implement the necessary memoranda of agreement to formalize this Direct Support approach.

At the same time, our work to carry out FY17 NDAA Section 703 continues as we prepare to adjust the MHS infrastructure to better support operational readiness requirements. Over the past several months, OASD/Health Affairs-led teams have conducted site visits to dozens of facilities, assessing both “on base” health services and needs, as well as the capacity of nearby civilian networks. The goal is to complete a top-to-bottom review of MTF capacity to ensure we dedicate the right personnel and resources to meet readiness requirements and identify any insufficient network coverage for our 9.5 million beneficiaries. To date we’ve identified 73 MTFs that merit additional analysis, and we are working to provide a final report and recommendations to Congress later this summer.

The Department continues to assess the medical manpower requirements in support of the National Defense Strategy. The Military Medical Departments have put forward their recommendations for force changes based on operational requirements, manpower needed, and subsequent proposed manpower reductions. Health Affairs, the DHA, and the Military Departments continue to work closely together to implement the medical force changes to meet future operational requirements while ensuring the MHS continues to provide the highest quality health care services possible to our patients.

Amidst these major organizational changes, our colleagues across the MHS continue to support medical operational requirements and deliver outstanding medical care to service members, retirees and their families. Earlier this month I had the opportunity to see firsthand evolving capabilities of the MHS when we visited Nellis and Creech Air Force Bases, Nevada. The trip illustrated how greater integration of services between the Military Health System, VA and local health systems can strengthen readiness support to the combatant forces and the delivery of quality care to the entire beneficiary population. I had the honor to meet with several military unit commanders and their staffs including: The 99th Medical Operations Squadron (99th MDG) at the Mike O’Callaghan Military Medical Center; 66th Rescue Squadron; 57th/757th Aircraft Maintenance Squadron (AMXS); Creech Medical Clinic; and the 42d Attack Squadron (42 ATKS) and 42d Attack Squadron-Human Performance Team (HPT).  I toured the Reaper Operation Center (ROC) Orientation & Ground Control Station (GCS) where General Hogg, Air Force Surgeon General, and I had the rare opportunity to fly a Remotely Piloted Aircraft mission in the flight simulator.

Rounding out the time with the Air Force components was the opportunity to visit the University Medical Center (UMC) to learn about the benefits of the Nellis partnership with this leading Las Vegas provider. Through this partnership Air Force physicians, nurses and technicians are able to temporarily work and train at UMC of Southern Nevada to help ensure they stay current and maintain the highest levels of readiness.

Last month, Dr. Terry Rauch, Acting DASD Health Readiness Policy and Oversight and our Global Health Engagement team participated in the 43rd International Committee on Military Medicine World Congress in Basel, Switzerland. Since 1921, the ICMM has worked to strengthen cooperation between the health services of militaries worldwide. The United States is proud to be one of the founding members of the ICMM, and U.S. military medicine remains committed to this enduring partnership as we step into the Vice Chair role. That commitment is fully in keeping with one of the pillars of our National Defense Strategy, which calls for strengthening our existing global partnerships and seeking to work with new partners.

Back at the Pentagon, the Health Affairs team bid farewell to COL Jesse Ortel, CDR Tilford Clark and LCDR Kishla Askins. A special thanks to these exceptional staff members for their significant contributions and unwavering dedication to the Health Affairs team over the past years. I wish them all the best in their future endeavors. As they depart, we are pleased to hail the newest members to Health Affairs: COL Chris Warner, Military Deputy and Chief of Staff; LCDR Chris Barnes, Military Assistant; LT Ariel Campbell, Deputy Director for MHS Governance/Integration Officer; Dr. Jill Sterling, Program Director, Medical Quality Assurance and Clinical Quality Management Policy; and Dr. Richard Mooney, Director of Health Services Policy and Oversight. Welcome to the team!

Lastly, I’d like to recognize our MHS Communications Team for winning the prestigious Silver Anvil Award from the Public Relations Society of America, as well as the Hermes Creative Award for the Take Command campaign executed last year to inform TRICARE beneficiaries about the many changes to their benefit. Congratulations on this great achievement – a true testament to the MHS’s commitment to meeting the needs of our beneficiaries.

MOAA – Defense Bills: House and Senate Versions Compared

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Here’s an article that compares the House and Senate versions of the NDAA 20. Here are the two bullets most readers would care about:

  • A pay raise win. Summaries from leaders of both the House and Senate Armed Services Committees pledge that their final legislation will include a 3.1% military pay raise, which would align with the administration’s FY 2020 budget request and with MOAA efforts to sustain pay comparability with the private sector. While nothing’s settled until passage, this appears to be one of few issues that won’t be affected by ongoing debate – a key House member said as much at a recent news event.
  • Halfway on health care? While House Armed Services Committee (HASC) members included language that would put a stop to a proposal to cut up to 18,000 medical billets, the Senate Armed Services Committee (SASC) has not. House committee members shared MOAA’s concerns about the potential consequences of cutting roughly 20 percent of the military’s medical force. They included language requiring DoD to study the issue further and report back to Congress.

What the HASC Version of NDAA 20 Says About Medical Billet Cuts

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Here is a summary of the House Armed Service Committee’s (HASC’s) version of the FY20 National Defense Authorization Act (NDAA). The bullet point about medical billets says:

– Prohibits the Secretary of Defense and the Secretaries of the military departments from realigning or reducing military medical end strength until analyses are conducted on potential manpower realignments and the availability of health care services in the local area.