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2017 Year in Review: A look at inspiring individuals who help shape the MHS

Staff Sgt. Matthew Crabtree, a medic with the 285th Medical Company (Area Support) and a registered nurse, performs a medical assessment on an infant less than one month old Oct. 27, 2017, in Jayuya, Puerto Rico. Military medical personnel were critical to disaster response related to hurricanes Harvey, Irma, and Maria. (Ohio National Guard photo by Sgt. Joanna Bradshaw) Staff Sgt. Matthew Crabtree, a medic with the 285th Medical Company (Area Support) and a registered nurse, performs a medical assessment on an infant less than one month old Oct. 27, 2017, in Jayuya, Puerto Rico. Military medical personnel were critical to disaster response related to hurricanes Harvey, Irma, and Maria. (Ohio National Guard photo by Sgt. Joanna Bradshaw)

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Mental Health Care | Humanitarian Assistance and Disaster Relief | Research and Innovation

Members of the Military Health System family, spread across the country and overseas, have made a mark on the MHS this year. Here are few of these influential highlights:

Veterans. They trained with infantry soldiers, carrying first aid kits instead of weapons. They dodged bullets to tend to wounded soldiers, sometimes with whatever supplies they could find. And even in the midst of thick combat, they remained steadily focused on their mission of saving lives. They were the combat medics of World War II.

Known as “band-aid bandits” to their comrades, Pfc. Edwin Pepping and Staff Sgt. Albert Mampre were attached to Easy Company, 2nd Battalion of the 506th Infantry Regiment, 101st Airborne Division also known as the “Band of Brothers.” Seventy-three years ago, the U.S. took part in the invasion of Normandy, which would ultimately be the turning point of the war in Europe.

“A sense of humor is really what saved us,” said Pepping, who said the biggest lesson he learned as a medic was to duck. Veterans Day shed light on two more heroes of military medicine, platoon medic Charles Shay, who also hit the beach at Normandy, and Col. Pat Upah, who saw the Tet Offensive through the eyes of the combat soldiers she treated in Vietnam.

Advocates. Retired Army Gen. Carter Ham commanded a multinational brigade in Mosul during the early days of the Iraq War. “I was a brigadier general, so it wasn’t like I was out on combat patrol,” Ham said of those 13 months. Still, he witnessed the horrific aftermath of a suicide bomber’s attack on the forward operating base dining hall, which killed and wounded almost 90 U.S. and Iraqi soldiers and civilian contractors. And a few months after returning to the United States, he contacted a chaplain for emotional support after finally realizing “something’s not right with me. Something’s out of whack.” Learn more about service members reaching out for emotional support (or options available to them).

Providers. Military nurses are part of a versatile group of well-trained and well-educated professional leaders who take care of the people around them, both at home and on the front lines. During National Nurses Week, the Military Health System highlighted the diverse places our nurses serve.

“Being a nurse in the military is ever-changing and you have to be willing to adapt at all times,” said Army Capt. Christine Kampas, a brigade combat team nurse who served as the lead medical adviser at a regional hospital in southern Afghanistan. “It keeps you on your toes.”

Navy Capt. Michele Kane has spent 30 years as a nurse, researcher, and inspiring leader who became the first Navy nurse to earn a Ph.D. from the Uniformed Services University of the Health Sciences. Kane was a key player in executing Project SERVE (or Student’s Education Related to the Veteran Experience), which teaches nursing students how to care for wounded warriors returning to their local communities.

Brig. Gen. Theresa Prince, a civilian nurse practitioner and Air National Guard assistant to the Air Force Nurse Corps chief, is one of 9,000 nurses serving in the reserve components. “Many reserve nurses work in highly skilled jobs throughout the week and then maintain a lot of those skills [in their reserve position], so they’re truly experts in both of their jobs,” said Prince. Patients reap the benefits of these highly skilled health care professionals who bring the best of the military and civilian systems to their work.

Researchers. For more than 17 million people in the United States living with severe eczema – a condition that results in dry, itchy rashes and disqualifies many from military service – the mystery behind its cause may be all too familiar. Thanks to researchers at the Uniformed Services University of Health Sciences and National Institutes of Health, certain eczema patients may understand more about their condition.

“Studying these … disorders, especially when we can define the disease based on a single mutation, is incredibly informative because you can learn a lot,” said Andrew Snow, assistant professor in the department of pharmacology and molecular therapeutics at USU.

First responders. U.S. Coast Guard mobile medical units assisted with hurricane relief efforts in Florida and Puerto Rico in the weeks following Hurricane Irma and Hurricane Maria. Cmdr. Donald Kuhl loaded up a truck with a trailer containing his pop-up medical clinic and bed for what would be the next few weeks in Florida. Lt. Cmdr. Jacklyn Finocchio boarded a military flight to Puerto Rico and, upon arrival, had to figure out where to report despite a lack of cellphone service. “We were just waiting for our chance to help out those we knew needed it,” said Finocchio, a Public Health Service pharmacy officer and mobile medical unit leader.

For Army Master Sgt. Dean Dawson, the opportunity to serve in hurricane relief efforts presented itself after a planned flight to Las Vegas with his wife was cancelled by the approach of Hurricane Harvey. Instead, Dawson drove 350 miles to Houston where he helped distribute food and water in the hard-hit area. 

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DHA-PI 3200.01: Research and Development (R&D) Enterprise Activity (EA)

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This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (p): a. Establishes the Defense Health Agency’s (DHA) procedures for the Deputy Assistant Director (DAD), R&D to manage and execute, on behalf of the Assistant Secretary of Defense for Health Affairs (ASD(HA)), the portion of the Defense Health Program (DHP) Research, Development, Test, and Evaluation (RDT&E) appropriation assigned to it (referred to as the “DHP Science and Technology (S&T) Program)”. The DHP S&T Program includes Budget Activities (BAs) 6.1-6.3 and 6.6. The ASD(HA) provides policy, direction, and guidance to inform planning, programming, budgeting, and execution of the DHP RDT&E appropriation in accordance with statute, regulation, and policy in Reference (a). The DAD-R&D, and Component Acquisition Executive (CAE) manage and execute DHP RDT&E Program funds aligned to them on behalf of the ASD(HA). The CAE is responsible for managing BAs 6.4, 6.5, and 6.7 funding, as well as Procurement and Operations and Maintenance funding required to support DHP-funded Acquisition Programs, regardless of acquisition activity. b. Supports the Director, DHA, in developing appropriate DHA management models to maximize efficiencies in the management and execution of DHP RDT&E-funded activities carried out by the Combatant Commands (CCMDs), Services, Uniformed Services University of the Health Sciences (USU), Defense Agencies, and other DoD Components, as applicable. c. Codifies processes to confirm DHP RDT&E funds are applied towards medical priorities and aligned to ASD(HA) policy, direction, and guidance to develop and deliver innovative medical products and solutions that increase the readiness of the DoD medical mission in accordance with Reference (a). d. Supports the following objectives of the R&D EA: (1) Increasing the quantity, quality, and pace of medical research through improved programmatic organization, processes, and oversight. (2) Ensuring DHP RDT&E funded efforts align to ASD(HA) published program guidance that provides resourcing guidance and translates national, departmental, and Service priorities into specific program objectives. (3) Verifying alignment of DHP RDT&E funds to medical priorities and to ASD(HA) policy, direction, and guidance to ensure the development and delivery of medical materiel and knowledge solutions. (4) Facilitating coordination with the CCMDs, Services, USU, Defense Agencies, and other DoD Components, as applicable, to ensure DHP RDT&E funded activities address joint medical capability gaps, and avoid unnecessary duplication.

DHA IPM 18-019: Guidance for Service Implementation of Separation Mental Health Assessments

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This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (g): • Assigns responsibilities and provides instructions for implementing Reference (d), which requires an MHA for Service members prior to separation in accordance with References (e) through (g). • Is effective immediately; it will be incorporated into DHA-Procedural Instruction xxxx.xx, “Separation History and Physical Examination.” This DHA-IPM will expire effective 12 months from the date of issue.

DHA PI 6490.01: BH Treatment and Outcomes Monitoring

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This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (k): a. Establishes the Defense Health Agency’s (DHA) procedures for the collection and analysis of BH outcome data. b. Addresses how DoD will standardize BH outcome data collection to: assess variations in mental health and substance use care among in-garrison medical treatment facilities (MTFs) and clinics; assess the relationship of treatment protocols and practices to BH outcomes; and identify barriers to provider implementation of evidence-based clinical guidance approved by DoD. c. Designates the Army as the DoD lead Service for maintenance and sustainment of the Behavioral Health Data Portal (BHDP) in specialty care mental health and substance use clinics, referred to collectively as BH clinics, until BHDP functionality can be integrated with GENESIS or another electronic health record (EHR) system managed by DHA. d. Designates DHA Information Operations (J-6) as lead on transitioning BHDP functional requirements related to outcomes monitoring to future EHR data collection platforms and processes.

DoD Instruction 6010.22: National Disaster Medical System (NDMS)

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This instruction establishes policy for DoD participation in the NDMS, a joint federal, State, and local mutual aid response system, to provide a coordinated medical response, patient movement, and definitive patient care during a military health emergency, U.S. national emergency, or U.S. domestic disaster.

DoD Instruction 6490.10: Continuity of Behavioral Health Care for Transferring and Transitioning Service Members

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In accordance with the authority in Reference (a), this Instruction establishes policy for the Military Departments, assigns responsibilities, and prescribes guidelines for establishment of Military Department policy and procedures to ensure continuity of behavioral health (BH) care at the losing and gaining installations when Service members transition from one health care provider (HCP) to another when transferring to a new duty station or transitioning out of the Service.

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DoD Instruction 6490.15: Integration of Behavioral Health Personnel (BHP) Services Into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings

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DoD Instruction 6490.05: Maintenance of Psychological Health in Military Operations

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DoD Instruction 6490.12: Mental Health Assessments for Service Members Deployed in Connection with a Contingency Operation

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DoD Directive 5100.46, Foreign Disaster Relief, July 6, 2012

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DoD Support to Foreign Disaster Relief Handbook

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DoD Support to Foreign Disaster Relief Handbook

DoD Instruction 6490.08: Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Service Members

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This instruction provides guidance for balance between patient confidentiality rights and the commander’s right to know for operation and risk management decisions.

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DoD Instruction 6000.16: Military Health Support for Stability Operations

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This Instruction establishes policy, assigns responsibilities, and provides instructions for military health support of stability operations in accordance with the authority in Reference (a). Military health support for stability operations is hereafter referred to as medical stability operations (MSOs).

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