1 INSTITUTE FOR DEFENSE ANALYSES Medical Requirements and Deployments Brandon Gould June 2013 Approved for public release; distribution unlimited. IDA Document NS D-4919 Log: H INSTITUTE FOR DEFENSE ANALYSES 4850 Mark Center Drive Alexandria, Virginia
2 The Institute for Defense Analyses is a non-profit corporation that operates three federally funded research and development centers to provide objective analyses of national security issues, particularly those requiring scientific and technical expertise, and conduct related research on other national challenges. About this Publication The views, opinions, and findings should not be construed as representing the official position of either the Department of Defense or the sponsoring organization. Copyright Notice 2013 Institute for Defense Analyses, 4850 Mark Center Drive, Alexandria, Virginia (703)
3 INSTITUTE FOR DEFENSE ANALYSES IDA Document NS D-4919 Medical Requirements and Deployments Brandon Gould
5 Medical Requirements and Deployments Brandon Gould 2013 WEAI Conference
6 Briefing Outline Introduction Total Medical Requirements and Lessons Learned Military Essentiality of Medical Requirements Specialty Mix of Medical Force Conclusion
7 Motivation: Medical Cost Growth Budget pressure is increasing and medical costs are one of the largest (and fastest growing) components of the defense budget. Controlling medical costs (level and growth) requires addressing causes: Demand, e.g., benefit design and total force mix decisions. Supply, e.g., the efficiency with which care is delivered. Total medical force management is an element of improving the efficiency of care delivery. $ Billions Unified Medical Program Budget Direct Care Purchased Care Military Construction Military Personnel MERHCF Accrual Fund Source: TRICARE Evaluation Reports (multiple years)
8 Background: The FY 2011 Medical Force Service Active Duty End Strength Guard/Reserve End Strength Civilian End Strength Mil. + Civ. Medical Force Army 52,400 48,715 27, ,343 Navy 34,886 11,713 7,444 54,043 Air Force 31,894 19,064 3,981 54,939 Total 119,180 79,492 38, ,325 Military medical force composed of active, Guard, reserves, civilians, and contractors (contractors not included in table). Manpower mix should depend on the mission the manpower performs: Military Essential: Defined in DoD Instruction (f). Inherently Governmental, Non-Military Essential: Defined by FAIR Act and Inherently Governmental/Commercial Activity inventory. Commercial Activity: Not inherently governmental, subject to public-private competitive sourcing.
9 Introduction: Military Medical Personnel in the Total Force Active Duty O4-O6 End Strength 17,761, 20% 69,418, 80% Medical End Strength Non-Medical End Strength Cost of Average Billet BY13$K $500 $400 $300 $200 $100 $0 Army Average Full Manpower Costs by Corps Medical Dental Nurse Medical Services Military Manpower Civilian Manpower Enlisted Full cost of medical manpower excludes Transients, Patients, Prisoners, and Holdees, which would increase divergence from civilian manpower Military medical personnel constitute a large and costly portion of the total force Military personnel are generally more expensive than civilian personnel Military officers in some corps consume Defense Officer Personnel Management Act (DOPMA)-constrained end strength Requirements for some medical capabilities are generated separately from line requirements
10 Dual Missions of the Military Health System OPERATIONAL MISSION BENEFICIARY MISSION Organic Medical Capability Military Treatment Facilities In-Theater Hospitals Military Medical Personnel w/ Dual Assignments Purchased Private Care Trauma Surgery Anesthesiology Demand for Specialties Pediatrics Obstetrics
11 Military Medical Manpower Issues Changes in warfighting and medicine have influenced the practice of military medicine. Are these changes reflected in medical requirements? Independent studies have estimated military essential requirements below Service-reported requirements. Is the medical force aligned with and utilized according to military essentiality guidance? The medical force has total force mix challenges. Service reported data during Iraq/Afghanistan show mismatch between active duty forces and requirements. Do these imbalances persist in today s medical force? Medical Specialty Imbalances Readiness Requirement FY 2004 End Strength EndStr Req. Pediatrics Obstetrics Anesthesiology General Surgery Note: FY04 requirement for fully trained providers. Total requirements, including training, transients, prisoners, etc., were Pediatrics 484, Obstetrics 351, Anesthesiology 444, and General Surgery ,000 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 Total Medical Requirements Army Navy Air Force 2004 Service Req. Est MRR Req. Est data from the Medical Readiness Review 2004 data from Service medical sizing models
12 Data Sources Medical Requirements Data Service-reported sizing model estimates from 2004 and 2011/12 Medical Readiness Review (MRR) requirement estimates from 2006 Medical end strength for from Defense Manpower Data Center s (DMDC) Health Manpower Personnel Data System (HMPDS) Individual deployments to named contingencies from DMDC s Contingency Tracking System (CTS) ( ) Interviews with Service representatives on lessons learned during Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF).
13 Briefing Outline Introduction Total Medical Requirements and Lessons Learned Military Essentiality of Medical Requirements Specialty Mix of Medical Force Conclusion
14 Changes to Warfighting and Medicine from Service Interviews Warfighting and medical practice have changed. Decentralized, mobile battlefield drives a smaller medical footprint with more rapid evacuation of casualties. The range of care delivered in theater is reduced and medicine is more specialized. This has implications for medical force requirements. Total requirement goes down as less care is performed in theater. Specialty substitution opportunities decline as medical platforms become smaller with less redundancy potentially increasing requirements for some specific specialties. Changes in the requirements and end strength data are consistent with these implications. Systematic decline in underages across all Services. Increase in Army requirements for deployable medical enlisted personnel in line units. Decrease in Army requirements for deployable medical officers. Navy transitioning away from general physicians to an all-specialist force. Large requirements decreases in general physicians/nurses for Army and Air Force (other than aviation medicine).
15 Total Medical Requirements 2004 and 2011 Service 2004 Req. 2011/12 Req. % Change 2004 End Strength 2011 End Strength % Change Air Force 30,802 25,175-18% 34,756 31, % Army 44,004 50, % 46,679 52, % Navy 32,169 41, % 36,997 34, % Total 106, ,585 +9% 118, , % Air Force requirements and end strength decline, consistent with expectations. Army requirements grow, primarily due to two factors: Increased deployable enlisted requirements (~4,000). Increased non-deployable officer requirements (~3,000). Army determines deployable medical requirements with line requirements in the Total Army Analysis process. Non-deployable requirements are determined separately. Navy s substantial requirements increase is the outlier.
16 Briefing Outline Introduction Total Medical Requirements and Lessons Learned Military Essentiality of Medical Requirements Specialty Mix of Medical Force Conclusion
17 Military Essentiality Introduction DoD Instruction (DoDI) requires a military billet be justified by: Military-unique knowledge or skills Statutory, executive order, or treaty requirement Command and control, risk mitigation, or esprit de corps duties Wartime assignment, rotation base, or career development demands Unusual working conditions or costs not conducive to civilian employment All other manpower shall be designated civilian if inherently governmental/critical, or, if not, least-cost civilian or contractor performance
18 Elements of the Military Medical Requirement Wartime Requirement Deployable Medical Requirement Casualty Reception, R&D, Command & Control, etc. Day-to-Day Requirement Outside Continental US Military Treatment Facilities Isolated Continental US Military Treatment Facilities Medical Staff Billets Sustainment Requirement Graduate Medical Education Students and Trainers Transients, Patients, Prisoners, and Holdees 2004 Service-Estimated Requirements Service Wartime Requirement Day-to-Day Requirement Sustainment Requirement Total Requirement Air Force Army Navy 15,959 28,456 22,494 13,639 6,720 19,602 4,044 8,828 3,404 30,610 44,004 31,169 How well do the elements of the medical requirement align with the military essentiality criteria?
19 Medical Deployments and Military Essentiality Deployments of medical personnel serve as a proxy for utilization of the medical force. What fraction of the medical force deploys in support of contingencies? How frequently are medical personnel deployed? How long are medical deployments? Where do medical personnel deploy to? Comparison of medical deployments to deployments of non-medical personnel, specialties, and corps provides insight on the military essentiality of medical force elements.
20 Average Annual Share of Force Deployed by Specialty Army Specialties Air Force Specialties Navy Specialties Count of Specialties Count of Specialties Count of Specialties More More More Number of Deployments per Year Number of Deployments per Year Number of Deployments per Year Medical Non-Medical Medical Non-Medical Medical Non-Medical Medical specialties have fewer deployments per year than non-medical specialties. Divergence between Army medical and non-medical specialties is greater than other Services, driven by higher non-medical deployment rates in the Army than in other Services. Medical deployment rates are similar across the Services.
21 Army Medical Deployments Compared to Other Groups Average Share of Years with Deployment Officers Enlisted General Officers & Executives Medical Dental Nursing Medical-Related Corps Scientists & Professionals Medical Enlisted Medical Service Administrators Functional Support & Administration Other Technical & Allied Specialists Electronic Equipment Repairers Communications & Intelligence Specialists Tactical Operations Officers Supply, Procurement, and Allied Officers Intelligence Officers Service & Supply Handlers Engineering & Maintenance Officers Electrical/Mechanical Equipment Repairers Infantry, Gun Crews, and Seamanship Specialists Craftsmen Medical corps are among the least-deploying corps in the Army.
22 Air Force Medical Deployments Compared to Other Groups 0.5 Average Share of Years with Deployment Dental Officers Enlisted Medical Service Medical Enlisted Scientists & Professionals Medical-Related Corps General Officers & Executives Nursing Medical Engineering & Maintenance Officers Functional Support & Administration Administrators Electronic Equipment Repairers Supply, Procurement, and Allied Officers Electrical/Mechanical Equipment Repairers Intelligence Officers Communications & Intelligence Specialists Other Technical & Allied Specialists Tactical Operations Officers Craftsmen Service & Supply Handlers Infantry, Gun Crews, and Seamanship Specialists Medical corps are among the least-deploying corps in the Air Force.
23 Navy Medical Deployments Compared to Other Groups 0.5 Average Share of Years with Deployment General Officers & Executives Officers Enlisted Nursing Dental Medical Medical-Related Corps Scientists & Professionals Medical Service Administrators Medical Enlisted Supply, Procurement, and Allied Officers Engineering & Maintenance Officers Functional Support & Administration Intelligence Officers Other Technical & Allied Specialists Tactical Operations Officers Electronic Equipment Repairers Communications & Intelligence Specialists Service & Supply Handlers Craftsmen Electrical/Mechanical Equipment Repairers Infantry, Gun Crews, and Seamanship Specialists Medical corps are among the least-deploying corps in the Navy.
24 Deployment Experiences for Medical and Non-Medical Individuals 100% 80% 60% 40% 20% 0% 100% 80% 60% 40% 20% 0% Number of Deployments for Army Personnel 5% 6% 12% 11% 10% 21% 16% 28% 31% 20% 30% 28% 55% 54% 42% 31% Enlisted Officer Enlisted Officer Medical Medical Non-Medical Non-Medical Zero Deployments 1 Deployment 2 Deployments 3+ Deployments Number of Deployments for Air Force Personnel 5% 9% 5% 8% 13% 16% 23% 24% 13% 13% 24% 22% 64% 63% 51% 49% Enlisted Officer Enlisted Officer Medical Medical Non-Medical Non-Medical Zero Deployments 1 Deployment 2 Deployments 3+ Deployments 100% 80% 60% 40% 20% 0% Number of Deployments for Navy Personnel 7% 3% 7% 12% 10% 12% 15% 25% 15% 23% 27% 25% 58% 65% 49% 48% Enlisted Officer Enlisted Officer Medical Medical Non-Medical Non-Medical Zero Deployments 1 Deployment 2 Deployments 3+ Deployments Adding Marines to Navy does not significantly alter distribution Medical personnel are significantly less likely to experience deployment than non-medical personnel Medical personnel are less likely to experience repeat deployments than non-medical personnel Misalignment of specialty requirements and end strength likely has not caused force stress
25 Average Deployment Length by Service Army Average Deployment Length Navy Average Deployment Length Enlisted Officer Enlisted Officer Medical Non-Medical Medical Non-Medical Air Force Average Deployment Length Enlisted Officer Medical Non-Medical Army medical and non-medical deployments are similar in length and longer than the other Services Air Force personnel have the shortest deployment lengths; medical deployments are slightly longer Is joint sourcing an explanation? Navy medical deployments are longer than non-medical This difference diminishes when including Marine Corps deployments
26 Locations for Medical & Non-Medical Deployments Army CTS Deployments by Country Navy CTS Deployments by Country 100% 80% 60% 40% 0% 3% 0% 2% 18% 21% 19% 24% 82% 76% 81% 74% 100% 80% 60% 40% 1% 2% 2% 1% 2% 3% 2% 3% 49% 58% 79% 75% 20% 0% Enlisted Officer Enlisted Officer 20% 0% 48% 39% 15% 19% Enlisted Officer Enlisted Officer Medical Medical Non-Medical Non-Medical Medical Medical Non-Medical Non-Medical Iraq/Afghanistan Combat Support Area Green Zone Unknown Iraq/Afghanistan Combat Support Area Green Zone Unknown 100% 80% 60% 40% 20% 0% Air Force CTS Deployments by Country 14% 13% 0% 29% 0% 31% 0% 41% 0% 27% 51% 40% 45% 43% 36% 29% Enlisted Officer Enlisted Officer Medical Medical Non-Medical Non-Medical Iraq/Afghanistan Combat Support Area Green Zone Unknown Army medical deployment locations mirror non-medical deployment locations Iraq/Afghanistan provide a greater share of Air Force and Navy medical deployments than non-medical deployments Air Force medical locations provide evidence of joint sourcing (e.g., Balad, Bagram) Joint sourcing and medical deployments for Marines deployments explain Navy locations
27 Briefing Outline Introduction Total Medical Requirements and Lessons Learned Military Essentiality of Medical Requirements Specialty Mix of Medical Force Conclusion
28 Active Duty Specialty Underages (2004/11) Services report fewer underages against operational requirements. In general, requirements have decreased for wartime specialties and end strength for these same specialties has increased. Service Total Specialties 2004/2011 Underage* Specialties 2004 Underage* Specialties 2011 Personnel* Shortfall 2004 Personnel* Shortfall 2011 Army 90/ ,720 3,661 Navy 92/ ,601 4,404 Air Force 91/ ,762 1,905 * Underage defined as end strength greater than 20% below requirement. Army underages decreased 1.6% due to two offsetting trends. Large decrease in deployable requirements for 2004 underage specialties. Large increase in non-deployable requirements for new 2011 underage specialties. Navy increased end strength in 2004 underage specialties (+15%) despite overall end strength decreases. Requirements for 2012 underages have grown by 64% over Air Force underages cut in half due to large increases in underage specialty end strength (+222%) despite overall end strength decreases.
29 Causes and Consequences of Specialty Underages Underages have been reduced from FY04 to FY11. Deployable requirements are now generally fully covered. Consistent with OEF/OIF lessons learned, underages concentrated in generalist or substitutable specialties. Low deployment levels suggest that underages caused minimal force stress during OIF and OEF. Through substitution, recruitment, and skill maintenance partnerships with civilian facilities, the Services appear to be managing their underages. Two causes of underages were identified by the Services: Insufficient beneficiary care workload to support the required personnel was the main cause of underages identified. A secondary factor cited was challenges to recruit/retain wartime specialties.
30 Active Duty Specialty Overages 2004/11 Services continue to report overages against many specialties. Overages are generally seen in beneficiary care specialties with little to no wartime requirement and are larger than can be explained by substitutions. Service Total Specialties 2004/2011 Overage* Specialties 2004 Overage* Specialties 2011 Personnel* Excess 2004 Personnel* Excess 2011 Army 90/ ,594 1,130 Navy 92/ , Air Force 91/ ,284 7,080 * Overage defined as end strength greater than 20% above requirement. Army overages go down, but that is driven by large (70%) increases in nondeployable requirements and small (17%) end strength declines. Navy has decreased end strength in 2004 overage specialties by 27% and increased requirements by 18%. Air Force increase in overages driven by both reduction in requirements and increases in end strength in specialties becoming overage specialties in 2011.
31 Causes and Consequences of Specialty Overages Overages remain a consistent problem with the medical force. A cause discussed in Service meetings is the lack of visibility into full cost of military personnel in total force decisions in beneficiary care mission. Local commanders and Military Departments only bear a fraction of the cost of military personnel, but bear most of the cost of civilians and contractors. Two additional factors discussed with the Services include: Constraints on the ability to manage the force such as: Legislative restrictions, e.g., conversion ban and mental health requirements. Policy restrictions, e.g., civilian personnel cap. Service choices in provision of beneficiary care, e.g., Air Force blueon-blue.
32 Briefing Outline Introduction Total Medical Requirements and Lessons Learned Military Essentiality of Medical Requirements Specialty Mix of Medical Force Conclusion
33 Conclusion on Military Medical Requirements Military medical requirements have partially incorporated lessons from OEF/OIF. Deployable requirements have fallen. Specialization has increased. Navy medicine is a significant outlier. Specialty mix is more aligned with operational requirements but significant overages remain. Large portions of medical requirements may not be military essential. Deployment levels uniformly low compared to other occupations. Some elements of the medical requirement may not be consistent with military essentiality guidance. Line participation in medical requirement generation may help to align the medical force with its military essential operational mission.
35 Explanations for Medical Deployment Levels Uniformly low deployment rates may be explained by: Joint sourcing and substitution smoothing deployment levels across high and low deploying specialties and services. Insufficient workload during deployments to maintain clinical skills constrains rotation of medical personnel. Negative recruitment and retention consequences from deployment may discourage greater utilization of medical assets. Large elements of medical requirements are not deployable
36 Army Medical Deployments Compared to Other Groups 0.3 Officers 0.25 Enlisted Number of Deployments per Year Dental Nursing Medical-Related Corps Medical Medical Service Medical Enlisted Scientists & Professionals Other Technical & Allied Specialists Functional Support & Administration Administrators Electronic Equipment Repairers Service & Supply Handlers Communications & Intelligence Specialists Engineering & Maintenance Officers Craftsmen Supply, Procurement, and Allied Officers Electrical/Mechanical Equipment Repairers Intelligence Officers General Officers & Executives Tactical Operations Officers Infantry, Gun Crews, and Seamanship Specialists Medical corps are among the least-deploying corps in the Army.
37 Air Force Medical Deployments Compared to Other Groups 0.3 Officers Number of Deployments per Year Dental Enlisted Medical-Related Corps Scientists & Professionals Medical Service Medical Enlisted Medical Supply, Procurement, and Allied Officers General Officers & Executives Engineering & Maintenance Officers Administrators Nursing Functional Support & Administration Electronic Equipment Repairers Communications & Intelligence Specialists Electrical/Mechanical Equipment Repairers Intelligence Officers Other Technical & Allied Specialists Craftsmen Service & Supply Handlers Tactical Operations Officers Infantry, Gun Crews, and Seamanship Specialists Medical corps are among the least-deploying corps in the Air Force.
38 Navy Medical Deployments Compared to Other Groups 0.25 Officers 0.2 Enlisted Number of Deployments per Year Dental Nursing Medical Service Medical-Related Corps Medical Administrators Scientists & Professionals Engineering & Maintenance Officers Medical Enlisted Supply, Procurement, and Allied Officers Electronic Equipment Repairers General Officers & Executives Functional Support & Administration Intelligence Officers Service & Supply Handlers Communications & Intelligence Specialists Electrical/Mechanical Equipment Repairers Tactical Operations Officers Craftsmen Infantry, Gun Crews, and Seamanship Specialists Other Technical & Allied Specialists Medical corps are among the least-deploying corps in the Navy.
39 REPORT DOCUMENTATION PAGE Form Approved OMB No The public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports ( ), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 2. REPORT TYPE 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR'S ACRONYM(S) 11. SPONSOR/MONITOR'S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: a. REPORT b. ABSTRACT c. THIS PAGE 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON 19b. TELEPHONE NUMBER (Include area code) Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18
INSTITUTE FOR DEFENSE ANALYSES Potential Savings from Substituting Civilians for Military Personnel (Presentation) Stanley A. Horowitz May 2014 Approved for public release; distribution is unlimited. IDA
INSTITUTE FOR DEFENSE ANALYSES Defense Health Care Issues and Data John E. Whitley June 2013 Approved for public release; distribution is unlimited. IDA Document NS D-4958 Log: H 13-000944 Copy INSTITUTE
INSTITUTE FOR DEFENSE ANALYSES Staffing Cyber Operations (Presentation) Thomas H. Barth Stanley A. Horowitz Mark F. Kaye Linda Wu May 2015 Approved for public release; distribution is unlimited. IDA Document
The Military Health System How Might It Be Reorganized? Since the end of World War II, the issue of whether to create a unified military health system has arisen repeatedly. Some observers have suggested
Order Code RS22452 Updated 9, United States Military Casualty Statistics: Operation Iraqi Freedom and Operation Enduring Freedom Summary Hannah Fischer Information Research Specialist Knowledge Services
2011 Military Health System Conference Improving the Quality of Patient Care Utilizing Tracer Methodology Sharing The Quadruple Knowledge: Aim: Working Achieving Together, Breakthrough Achieving Performance
712CD 75 TH MORSS CD Cover Page If you would like your presentation included in the 75 th MORSS Final Report CD it must : 1. Be unclassified, approved for public release, distribution unlimited, and is
Report No. D-2011-092 July 25, 2011 Guam Medical Plans Do Not Ensure Active Duty Family Members Will Have Adequate Access To Dental Care Report Documentation Page Form Approved OMB No. 0704-0188 Public
Report No. DODIG-2012-097 May 31, 2012 Independent Auditor's Report on the Attestation of the Existence, Completeness, and Rights of the Department of the Navy's Aircraft Report Documentation Page Form
Veterans Affairs: Gray Area Retirees Issues and Related Legislation Douglas Reid Weimer Legislative Attorney June 21, 2010 Congressional Research Service CRS Report for Congress Prepared for Members and
The LOGCAP III to LOGCAP IV Transition in Northern Afghanistan Contract Services Phase-in and Phase-out on a Grand Scale Lt. Col. Tommie J. Lucius, USA n Lt. Col. Mike Riley, USAF The U.S. military has
U.S. Military Casualty Statistics: Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom Hannah Fischer Information Research Specialist February 5, 2013 CRS Report for Congress Prepared
Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions,
White Space and Other Emerging Issues Conservation Conference 23 August 2004 Savannah, Georgia Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information
441 G St. N.W. Washington, DC 20548 June 22, 2015 The Honorable John McCain Chairman The Honorable Jack Reed Ranking Member Committee on Armed Services United States Senate Defense Logistics: Marine Corps
IMPROVING SPACE TRAINING A Career Model for FA40s By MAJ Robert A. Guerriero Training is the foundation that our professional Army is built upon. Starting in pre-commissioning training and continuing throughout
Department of Defense DIRECTIVE NUMBER 1100.4 February 12, 2005 USD(P&R) SUBJECT: Guidance for Manpower Management References: (a) DoD Directive 1100.4, "Guidance for Manpower Programs," August 20, 1954
Infantry Companies Need Intelligence Cells Submitted by Captain E.G. Koob Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated
Report No. D-2008-078 April 9, 2008 Training Requirements for U.S. Ground Forces Deploying in Support of Operation Iraqi Freedom Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting
Military to Civilian Conversion: Where Effectiveness Meets Efficiency EWS 2005 Subject Area Strategic Issues Military to Civilian Conversion: Where Effectiveness Meets Efficiency EWS Contemporary Issue
Panel 12 - Issues In Outsourcing Reuben S. Pitts III, NSWCDL Rueben.email@example.com Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is
Guest Editorial ITEA Journal 2010; 31: 309 312 Developmental Test and Evaluation Is Back Edward R. Greer Director, Developmental Test and Evaluation, Washington, D.C. W ith the Weapon Systems Acquisition
ASAP-X, Automated Safety Assessment Protocol - Explosives Mark Peterson Department of Defense Explosives Safety Board 14 July 2010 Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting
Cerberus Partnership with Industry Distribution authorized to Public Release Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated
Battle Captain Revisited Subject Area Training EWS 2006 Battle Captain Revisited Contemporary Issues Paper Submitted by Captain T. E. Mahar to Major S. D. Griffin, CG 11 December 2005 1 Report Documentation
Shadow 200 TUAV Schoolhouse Training Auto Launch Auto Recovery Accomplishing tomorrows training requirements today. Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for
Improving the Tank Scout Subject Area General EWS 2006 Improving the Tank Scout Contemporary Issues Paper Submitted by Captain R.L. Burton CG #3, FACADs: Majors A.L. Shaw and W.C. Stophel 7 February 2006
Joint Committee on Tactical Shelters Bi-Annual Meeting with Industry & Exhibition November 3, 2009 Darell Jones Team Leader Shelters and Collective Protection Team Combat Support Equipment 1 Report Documentation
MEMORANDUM Revised, August 12, 2010 Subject: Preliminary assessment of efficiency initiatives announced by Secretary of Defense Gates on August 9, 2010 From: Stephen Daggett, Specialist in Defense Policy
Fiscal Year 2011 Department of Homeland Security Assistance to States and Localities Shawn Reese Analyst in Emergency Management and Homeland Security Policy April 26, 2010 Congressional Research Service
Operational Energy: ENERGY FOR THE WARFIGHTER Office of the Assistant Secretary of Defense for Operational Energy Plans and Programs Mr. John D. Jennings 30 July 2012 UNCLASSIFIED DRAFT PREDECISIONAL FOR
Pittsburgh, PA 15213-3890 Mission Assurance Analysis Protocol (MAAP) Sponsored by the U.S. Department of Defense 2004 by Carnegie Mellon University page 1 Report Documentation Page Form Approved OMB No.
Order Code RS21195 Updated April 8, 2004 Summary Evolutionary Acquisition an Spiral Development in Programs : Policy Issues for Congress Gary J. Pagliano and Ronald O'Rourke Specialists in National Defense
Opportunities to Streamline DOD s Milestone Review Process Cheryl K. Andrew, Assistant Director U.S. Government Accountability Office Acquisition and Sourcing Management Team May 2015 Page 1 Report Documentation
Report No. D-2007-112 July 23, 2007 World-Wide Satellite Systems Program Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated
SSgt, What LAR did you serve with? EWS 2005 Subject Area Warfighting SSgt, What LAR did you serve with? Submitted by Capt Mark C. Brown CG #15 To Majors Dixon and Duryea EWS 2005 Report Documentation Page
March 3, 2006 Acquisition Air Force Procurement of 60K Tunner Cargo Loader Contractor Logistics Support (D-2006-059) Department of Defense Office of Inspector General Quality Integrity Accountability Report
Product Manager Force Sustainment Systems Contingency Basing and Operational Energy Initiatives SUSTAINING WARFIGHTERS AWAY FROM HOME LTC(P) James E. Tuten Product Manager PM FSS Report Documentation Page
By Captain David L. Brewer A truck driver from the FSC provides security while his platoon changes a tire on an M870 semitrailer. In 2007, the United States Army Reserve completed its transformation to
Order Code RS22149 Updated August 17, 2007 Summary Exemptions from Environmental Law for the Department of Defense: Background and Issues for Congress David M. Bearden Specialist in Environmental Policy
The Need for a Common Aviation Command and Control System in the Marine Air Command and Control System Captain Michael Ahlstrom Expeditionary Warfare School, Contemporary Issue Paper Major Kelley, CG 13
Compliance MISSILE Assurance DEFENSE Oversight AGENCY at the Missile Defense Agency May 6, 2009 Mr. Ken Rock & Mr. Crate J. Spears Infrastructure and Environment Directorate Missile Defense Agency 0 Report
Revolutionary Logistics? Automatic Identification Technology EWS 2004 Subject Area Logistics REVOLUTIONARY LOGISTICS? AUTOMATIC IDENTIFICATION TECHNOLOGY A. I. T. Prepared for Expeditionary Warfare School
The 766th Explosive Hazards Coordination Cell Leads the Way Into Afghanistan By First Lieutenant Matthew D. Brady On today s resource-constrained, high-turnover, asymmetric battlefield, assessing the threats
ABSTRACT Life Support for Trauma and Transport (LSTAT) Patient Care Platform: Expanding Global Applications and Impact Matthew E. Hanson, Ph.D. Vice President Integrated Medical Systems, Inc. 1984 Obispo
Where Have You Gone MTO? EWS 2004 Subject Area Logistics Where Have You Gone MTO? Captain Brian M. Bell CG #7 LTC D. Major 1 Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden
Integrated Comprehensive Planning for Range Sustainability Steve Helfert DOD Liaison, Southwest Region, U.S. Fish and Wildlife Service Steve Bonner Community Planner, National Park Service Jan Larkin Range
U.S. Army Defense Ammunition Center DDESB Seminar Explosives Safety Training Mr. William S. Scott Distance Learning Manager (918) 420-8238/DSN 956-8238 firstname.lastname@example.org 13 July 2010 Report Documentation
The Landscape of the DoD Civilian Workforce Military Operations Research Society Personnel and National Security Workshop January 26, 2011 Bernard Jackson email@example.com Juan Amaral firstname.lastname@example.org
Report No. D-2010-058 May 14, 2010 Selected Controls for Information Assurance at the Defense Threat Reduction Agency Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for
Office of the Assistant Secretary of Defense (Homeland Defense and Americas Security Affairs) Don Lapham Director Domestic Preparedness Support Initiative 14 February 2012 Report Documentation Page Form
Biometrics in US Army Accessions Command LTC Joe Baird Mr. Rob Height Mr. Charles Dossett THERE S STRONG, AND THEN THERE S ARMY STRONG! 1-800-USA-ARMY goarmy.com Report Documentation Page Form Approved
Report No. DODIG-2013-124 Inspector General Department of Defense AUGUST 26, 2013 Report on Quality Control Review of the Grant Thornton, LLP, FY 2011 Single Audit of the Henry M. Jackson Foundation for
Aviation Logistics Officers: Combining Supply and Maintenance Responsibilities Captain WA Elliott Major E Cobham, CG6 5 January, 2009 Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting
2010 2011 Military Health System Conference Psychological Health Risk Adjusted Model for Staffing (PHRAMS) Sharing The Quadruple Knowledge: Aim: Working Achieving Together, Breakthrough Achieving Performance
AFRL-SA-WP-TP-2013-0003 USAF Hearing Conservation Program, DOEHRS Data Repository Annual Report: CY2012 Elizabeth McKenna, Maj, USAF Christina Waldrop, TSgt, USAF Eric Koenig September 2013 Distribution
Army Aviation and Missile Command (AMCOM) Corrosion Program Update Steven F. Carr Corrosion Program Manager Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection
DoD Executive Agent Office Office of the of the Assistant Assistant Secretary Secretary of the of Army the Army (Installations Installations, and Energy and Environment) Work Smarter Not Harder: Utilizing
Social Science Research on Sensitive Topics and the Exemptions Caroline Miner Human Research Protections Consultant to the OUSD (Personnel and Readiness) DoD Training Day, 14 November 2006 1 Report Documentation
Order Code RS20643 Updated January 17, 2007 Summary Navy CVN-21 Aircraft Carrier Program: Background and Issues for Congress Ronald O Rourke Specialist in National Defense Foreign Affairs, Defense, and
Department of Defense DIRECTIVE NUMBER 6490.02E February 8, 2012 USD(P&R) SUBJECT: Comprehensive Health Surveillance References: See Enclosure 1 1. PURPOSE. This Directive: a. Reissues DoD Directive (DoDD)
Combat Service support MEU Commanders EWS 2005 Subject Area Logistics Contemporary Issues Paper EWS Submitted by K. D. Stevenson to Major B. T. Watson, CG 5 08 February 2005 Report Documentation Page Form
Make or Buy: Cost Impacts of Additive Manufacturing, 3D Laser Scanning Technology, and Collaborative Product Lifecycle Management on Ship Maintenance and Modernization David Ford Sandra Hom Thomas Housel
GAO United States Government Accountability Office Report to the Subcommittee on Readiness and Management Support, Committee on Armed Services, U.S. Senate July 2011 AIR FORCE WORKING CAPITAL FUND Budgeting
Report No. D-2009-049 February 9, 2009 Internal Controls Over the United States Marine Corps Military Equipment Baseline Valuation Effort Report Documentation Page Form Approved OMB No. 0704-0188 Public
Order Code RS20643 Updated December 5, 2007 Navy Ford (CVN-78) Class (CVN-21) Aircraft Carrier Program: Background and Issues for Congress Summary Ronald O Rourke Specialist in National Defense Foreign
Guest Editorial ITEA Journal 2009; 30: 3 6 Copyright 2009 by the International Test and Evaluation Association Test and Evaluation of Highly Complex Systems James J. Streilein, Ph.D. U.S. Army Test and
August 17, 2005 Financial Management Defense Departmental Reporting System Audited Financial Statements Report Map (D-2005-102) Department of Defense Office of the Inspector General Constitution of the
Wildland Fire Assistance Train personnel Form partnerships for prescribed burns State & regional data for fire management plans Develop agreements for DoD civilians to be reimbursed on NIFC fires if necessary
Naval Supply Systems Command Fleet Logistics Center, Puget Sound FLEET & INDUSTRIAL SUPPLY CENTER, PUGET SOUND Gold Coast Small Business Conference August 2012 Report Documentation Page Form Approved OMB
Report No. D-2011-RAM-004 November 29, 2010 American Recovery and Reinvestment Act Projects--Georgia Army National Guard Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden
STINFO COPY AFRL-HE-WP-TP-2007-0012 The Effects of Multimodal Collaboration Technology on Subjective Workload Profiles of Tactical Air Battle Management Teams Victor S. Finomore Benjamin A. Knott General
1 The Coalition Warfare Program (CWP) OUSD(AT&L)/International Cooperation Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated
Blue on Blue: Tracking Blue Forces Across the MAGTF EWS 2005 Subject Area WArfighting Blue on Blue: Tracking Blue Forces Across the MAGTF Contemporary Issue Paper Submitted by Captain D.R. Stengrim to:
Contractor s Progress Report (Technical and Financial) CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period June 1, 2014 to June 30, 2014 Submitted: 15 July 2014 Prepared
The Army Executes New Network Modernization Strategy Lt. Col. Carlos Wiley, USA Scott Newman Vivek Agnish S tarting in October 2012, the Army began to equip brigade combat teams that will deploy in 2013
Inside the Beltway ITEA Journal 2008; 29: 121 124 Copyright 2008 by the International Test and Evaluation Association Enhancing Operational Realism in Test & Evaluation Ernest Seglie, Ph.D. Office of the
DoD Scientific & Technical Information Program (STIP) 18 November 2008 Shari Pitts Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is
Order Code RS22631 March 26, 2007 Defense Acquisition: Use of Lead System Integrators (LSIs) Background, Oversight Issues, and Options for Congress Summary Valerie Bailey Grasso Analyst in National Defense
Report No. DODIG-2013-029 December 5, 2012 TRICARE Managed Care Support Contractor Program Integrity Units Met Contract Requirements Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting
Office of Inspector General Department of Defense FY 2012 FY 2017 Strategic Plan Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated
Small Business Innovation Research (SBIR) Program Wendy H. Schacht Specialist in Science and Technology Policy August 4, 2010 Congressional Research Service CRS Report for Congress Prepared for Members
Research to advance the Development of River Information Services (RIS) Technologies 1st interim report Reporting period 09/2014 09/2015 Approved for public release; distribution unlimited Contract number:
Making It Happen: Training Mechanized Infantry Companies Subject Area Training EWS 2006 MAKING IT HAPPEN: TRAINING MECHANIZED INFANTRY COMPANIES Final Draft SUBMITTED BY: Captain Mark W. Zanolli CG# 11,
COTS Impact to RM&S from an ISEA Perspective Robert Howard Land Attack System Engineering, Test & Evaluation Division Supportability Manager, Code L20 DISTRIBUTION STATEMENT A: APPROVED FOR PUBLIC RELEASE: