the us army public health command initiative transforming public health services for the us army-...

The US Army Public Health Command Initiative:

Transforming Public Health Services for the Army

John J. RestaDirector – Army Institute of Public Health

UNCLASSIFIED

29 October 2010

http://phc.amedd.army.mil

Briefing Outline

• Key Facts

• Change in Focus

• Strategic View of Army Public Health

• U.S. Army Public Health Command• CONOPS• Strategy Map• Integration Opportunities• FOC Operating Picture• FOC Location

• Breadth of Knowledge

• Questions

PURPOSE: To provide an informational briefing on the US Army Public Health Command Initiative.

John Resta/MCHB-IP/[email protected] Slide 2UNCLASSIFIED

• Smoking - Percent of adults 18 years of age and over who currently smoke cigarettes: 21% (2006)

• Alcohol Use - Percent of current drinkers who had five or more drinks on at least one day in the past year: 20% (2006)

• Overweight Prevalence - Percent of non-institutionalized adults age 20 years and over who are obese: 32%

• Health Insurance Coverage - Persons under age 65– Number uninsured at the time of interview: 43.6 million

(2008) – Percent uninsured at the time of interview: 17% (2008) – Percent with private insurance at the time of interview:

65% (2008)

US Health Indicators Key Facts


Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


TOBESAHOL

DoD spends an estimated $2.1 billion per year for medical care associated with TOBESAHOL. (Tobacco, Obesity and Alcohol)


Change in Focus

• “Health Care System” to a “System of Care”• AMEDD Balanced Scorecard Metrics

– HEDIS Measures for Preventative Health Screening

– ORYX Measures for preventative disease management

– Reducing Workplace Injuries in MTFs– Healthy Population 2010 goals for

overweight and obesity for family members and retirees

– HPV vaccinations for AD and FM Females (70% by FY 11)

– Emerging initiatives include improved tobacco use reduction campaigns, alcohol use reduction, enhanced employee wellness efforts and improved childhood immunization efforts.

• Public Health Command


Enhancing Health, Wellness and Optimizing Public Health Support to the Army and DoD

Direct Medical & Dental Care

IMCOMServices

Preventive Medicine

Veterinary Services

gratelth Surveillance, k Assessment, ease and Injury vention and trol

Integrate Community

Health Promotionand Wellness

Public Health Command = Accountable and Responsible AgentPublic Health Command = Accountable and Responsible Agent

Synchronized Public Health

Services

Strategic View of Public Health

ONOPSnd VETCOM integrate C

CHPPM Subordinate integrate into PHC

der the C2 of the PHC

ve C2 of installation missions

oversight of level I-III missions through

have enterprise nd monitoring the level I-II VETSVC.

authority infers a level g, advising,

n and collaboration execute oversight

This slide depicts

functional areas MEDCOM

RMCsRMCsRMCsRMCsRMCs

PHC

RPHCRPHCRPHCRPHCPHCRegions

MTFMTFMTFMTFMTF

vel of PH Servicesmmand Level (V)

l (V)L l (III d IV)

Red

Lt Blue

G ld

PHCDistrict

PHCDistrict

PHCDistrict

PHCDistrict

PHCDistrict

Installation PVNTMEDInstallation Installation

Installation PVNTMEDInstallation Installation

PHCIPH

PHC DoD MWD (VS) Center

Oversight (PH Missions)

RMCs oversee I-II VETSVCs; PHC oversees I-III PVNTMED

Revised CONOPS

Coordinate / Collaborate(PH Missions)

Coordinate / Collaborate(PH Missions)

Monitor (PH Missions)

CS 1.0 nimized Diseases & Injuries of Military Significance

CS 2.0Enhanced Health & Well‐

Being

CS 3.0 Optimized Public Health Programs and Practices

IP 6.0 Ensure Effective Public Health Oversight

LG 16.0 Improve Knowledge Management

APHC Strategy Map Alignment to AMEDD BSC September 2010

Maximize Value in Health Services

Synchronize Public Health Build the Team Balance Innovation with

StandardizationOptimize Communication and

Knowledge Management

Feedba

ck Adjusts Resou

rcing Decisions

LG 14.0 Maximize & Sustain Workforce Competencies

IP 9.0 Integrate Delivery of Health Promotion and Wellness Services

IP 11.0 Enhance Characterization and Analysis of Health Status and Threats

IP 10.0 Minimize Risk from Occupational & Environmental Health Hazards

IP 13.0 Develop and Enhance Relationships with Key Partners

IP 8.0 Improve Disease & Injury Surveillance and Control

P 5.0 Finalize Public Health Command

Transition Process

IP 7.0 Ensure Safe DoD Food and Water

World‐Class Provider of Public Health Services across DA and DoD.

IP 12.0 Ensure High Quality Veterinary Clinical Services

LG 15.0 Standardize & Document Command Business Practices

CS 4.0 Optimized Animal Care

Promote health and prevent disease, injury, and disability of Soldiers and military retirees, their Families, and DA Civilian employees; assure effective execution of full spectrum veterinary service for Army and DOD Veterinary missions.

CS 1.0, 2.0, 3.0 CS 1.0, 3.0 CS 1.0, 2.0, 3.0, 5.0 CS 4.0

to AMEDD Strategic shown in red

IP 7.0, 11.0, 12.0 IP 7.0 IP 7.0, 10.0 IP 7.0, 10.0

IP 7.0 IP 7.0, 10 .0 IP 7.0

IP 8.0, 9.0 CS 6.0 , IP 13.0, 14.0

ventive Medicine 40-5)

ease prevention and control

d preventive medicine

ironmental health

cupational health

alth surveillance

epidemiology

dier, family,

mmunity health,

health promotion

icology

oratory Services

alth risk assessment

alth Risk Communication

Veterinary Health Services(AR 40-3, AR 40-656,

AR 40-657, AR 40-905)

Veterinary Medical care for Government-Owned Animals

Zoonotic disease surveillance and control

Food safety and food defense quality assurance programs

Veterinary Medical care for Privately-Owned Animals

• Disease prevention andcontrol

• Field preventive medicine• Environmental health• Health surveillance and

epidemiology• Laboratory services• Health risk assessment

• Zoonotic diseasesurveillance and control

• Food safety and food defense quality assurance programs

Integration Opportunities

Emerging Programs• Army Wellness Centers• NAF One Fund• First Year Graduate Medical Education • Community Health Promotion Councils

C Organizational Structure

FOC

Command Level (HQ)

evel (V)ortfolio Managers

Lt Blue

Green

Red

ort Sam Houston, TX) (planned)UTE OF PUBLIC HEALTH (APG, MD)Y WORKING DOG CENTER TX)

(Landstuhl, Germany)rope (Kaiserslautern Military ermany)urope (Kaiserslautern, Germany)urope (Vicenza Italy)

PHCR‐PACIFIC (Tripler, HI) (planned)PHCD‐Central Pacific (Fort Shafter, HI)PHCD‐West Pacific (Apra Harbor, Guam)PHCD‐Korea (Yongsan, Korea)PHCD‐Japan (Camp Zama, Japan)

PHCR‐NORTH (Fort Belvoir, VA) (planned)PHCD‐Fort Knox (Fort Knox, KY)PHCD‐Fort Belvoir (Fort Belvoir, VA)PHCD‐Fort Bragg (Fort Bragg NC)

PHCR‐SOUTH (Fort Sam Houston, TX)PHCD‐Fort Hood (Fort Hood, TX)PHCD‐Fort Gordon (Fort Gordon, GA)PHCD‐Fort Bliss (Fort Bliss, TX) (pending analysis)

PHCR‐WEST (Joint Base Lewis‐McChord, WA)PHCD‐Joint Base Lewis‐McChord (Joint Base Lewis‐McChord, WA)PHCD‐San Diego (San Diego CA)

on System Specialist Animal Care Specialist

ogist

gist

onal Health Nurse

mist

cal Engineer

Officer

ngineer

Engineer

orker

mental Engineer

mental Law Attorney

ogist

Health Physicist

Safety and Occupational Health Specialist

Acoustical Engineer

Medical Laboratory Specialist

Fire Protection Engineer

Psychologist

Veterinarian

Sanitary Engineer

Wildlife Biologist

Epidemiologist

Physical Therapist

Industrial Hygienist

Chaplain

Optometrist

Community Health Nurse

Chemist

ErgonomistDental Officer

ar Medical Science Officer

Marine Biologist

Dietitian

Geologist

Environmental Scientist

Audiologist

Physicist

Breadth of Knowledge

The US Army Public Health Command Initiative:

Transforming Public Health Services for the Army

John J. RestaDirector – Army Institute of Public Health