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PUBLIC HEALTH SERVICE AT HOME AND ABROAD: Public Health Preparedness Across Disciplines and Uniformed Services

Posted on: Thursday, 23 December 2004, 03:01 CST

The mission of a Public Health Service officer is to promote, protect, and advance the health of the nation, while being ready to respond to emergencies and public health issues. As 2005 approaches, we have the opportunity to reflect on a year of distinguished accomplishments by the Public Health Service's (PHS) Commissioned Corps and Inactive Reserve Corps.

The nation's health is constantly threatened-whether the threats are man-made, such as terrorism, or are naturally occurring, such as weather emergencies or new and re-emerging diseases. As such, we must continue to take an "allhazards" approach in emergency preparedness, and be ready to prevent, mitigate, and respond to any public health emergency.

CAPT Charles Craft, treating Mongolian refugee in Zanyn Und, Mongolia.

INVESTMENT AND COMMITMENT

While the Public Health Service Commissioned Corps and Inactive Reserve Corps have often risen to meet challenges of a public health system that has been stretched too far for too long, President George W. Bush and Health and Human Services secretary Tommy G. Thompson have led the way through their commitment to strengthen our nation's public health infrastructure. This began with a series of unprecedented investments in federal disaster response plans, laboratory and hospital preparedness, surge capacity, and continues with efforts across public health. As members of the PHS, all of us are leaders in this great army of compassion.

PHS officers are on the front lines of the war on terrorism with our brothers and sisters in the other uniformed services. On a daily basis, PHS officers care for the nation's soldiers, sailors, airmen, and their brave families, as well as the entire United States population. PHS officers fill gaps left by medical professionals who are serving abroad. They also build the public health's infrastructure that identifies, mitigates, and controls weapons of mass destruction that can be used by our enemies to attack America. In addition, PHS officers are assisting in the reconstruction of wartorn countries.

This year, a record number of PHS commissioned and inactive Reserve officers were deployed to assist Americans in time of need after natural disasters.

Not since September 11, 2001, have so many of the nation's citizens desperately needed the help of the PHS. As health leaders in our communities, we have also continued to spread our mission to the general public about disease prevention and eliminatinghealthdisparities. On behalf of President Bush and secretary Thompson, I thank all of these officers for their sacrifices to help communities and people in need.

In 2005, we look forward to new and renewed partnerships across Active and Reserve communities. The PHS and the Office of the Surgeon General will continue to focus on many important topics, including improving health literacy, preventing youth violence, ensuring corrections and community health, increasing healthy indoor environments, preventing child maltreatment, and addressing global health issues. Each topic requires dedicated and engaged partners.

Never before has there been such an intersection of public health and public preparedness. The continued threat of biological, chemical, and other weapons of mass destruction causing cataclysmic civilian casualties has motivated the Department of Health and Human Services (DHHS) to collaborate with our federal partners and local communities to combine the disciplines of medicine and the uniformed services.

CAPT Robert Rowe, providing dental care at Mescalero Indian Reservation, N. M.

As part of the White House's Freedom Corps program, DHHS continues to work with federal partners and state agencies to facilitate the development of Medical Reserve Corps (MRC) units in communities across the country (see page 63, "The Medical Reserve Corps: Get Involved and Help Your Community".

The MRC national program office, which is housed within the Office of the Surgeon General, facilitates the establishment and implementation of MRC units nationwide and functions as a clearinghouse for community information and best practices. Its role is to help communities achieve their local visions for public health and emergency preparedness and response. There are currently more than 30,000 civilian volunteers in 223 MRC units in 46 states, the District of Columbia, and the U.S. Virgin Islands.

INACTIVE RESERVE COMPONENT

In order to assure a surge capacity for DHHS to respond to public health emergencies and domestic terror, secretary Thompson has tasked the assistant secretary for health and me to explore ways to strengthen and expand our Inactive Reserve Corps (IRC).

The Secretary is committed to expanding our Reserve as a readily available source of officers should we be required to respond to public health emergencies and other urgent requirements that exceed our active duty capacities. In 2003, the Secretary created the Office of Reserve Affairs (ORA), within the Office of the Surgeon General, which was quickly tasked with Reserve recruitment and training as well as reviewing and implementing policy changes to improve management of this asset.

The strength of the Inactive Reserve has declined from 8,000 officers in 1989 to 5,000 officers in 1998 and further to approximately 2,000 officers in 2004. The PHS IRC is composed of physicians, nurses, allied health providers, and medical and epidemiological scientists who have served fewer than 20 years active duty and inactivated their commissions. As such they can only be voluntarily called back to active duty on short tours unless the president, by executive order, militarizes the PHS Commissioned Corps.

I am pleased to report on the progress we have made in developing the PHS IRC. In recognition of the need to provide training and create incentives, such as Reserve retirement credit and drilling points, DHHS has proposed the creation of a PHS Select Reserve, which is now part of the transformation of the Commissioned Corps legislative package recently reviewed by OMB.

This tremendous asset of clinical and technological skill sets could provide critical surge capacity to the DHHS missions in Centers for Disease Control and Prevention (CDC), theNational Institutes of Health (NIH), and the Food and Drug Administration (FDA) in the event of a national emergency; release of toxins in our environment; or an outbreak of undiagnosed illness among our population.

The PHS Commissioned Officer Training Academy, (CAPTF. Behan, CDRs D. Taytor, M. Timmons, C. Wiseman, LT C. Oyster) conducted an Inactive Reserve Corps Basic Officer Training Course (BOTC) Augustt16-27in the Parklawn Building, Rockville, Maryland. The BOTC class was 26 commissioned officers. These officers traveled from 11 States. The class experienced classroom style presentations, uniform inspections, classroom instruction, saluting exercises, uniformed service protocols, the National Naval Medical Center Uniform Shop in Bethesda, QOA sessions, the Metro, individual pictures in uniform with US & PHS flags, a group picture, evening experiences in Bethesda, special presentations planned over additional days designed specifically for these IRC members, and a closing ceremony on Friday the 27th. The ceremony began at 2:00 p.m. with a class Procession, Presentation of Colors by the PHS Honor Corps (CAPTs C. Craft, V. Hrehorovich, M. Poler, S. Richards and LCDR M. Cillespie), National Anthem, 'Welcome Address' by CAPT Behan (Director, Commissioned Officer Training Academy), Class Invocation by CAPT t R. Ortega Jr., 'Class Reflections' by LTK. Lunney, Opening Remarks' by CAPT Sayers (Director, Office Reserve Affairs), and 'The Address' by RADM Kenneth P. Moritsugu (Deputy Surgeon General, OSG) followed by the graduation with the presentation of the BOTC Certificates. Bonds were formed, individual identities generated. The class was energetic and most positive. Class members shared experiences gained during very productive professional careers with some even started in uniform during WWII. All are very ready to serve the Nation as officers in the Inactive Reserve Corps of the USPHS Commissioned Corps.

The need for a Select Reserve can be seen by the more than 4,000 activation days served by IRC officers in FY04. To enhance the current cadre of Reservists, the ORA has conducted three training sessions for more than 80 IRC officers who came to Washington on a two-week activation to receive basic officer training, readiness training, and Reserve assignment orientation.

The fact that these 4,000 activation days and trainings were done on a completely voluntary basis indicates the commitment and dedication of these officers. With the addition of drilling points and retirement credit, the Reserve component could become the principal deployment asset of DHHS, with specialized Reserve units out of agencies like CDC.

In order to expand the ranks of the IRC, the ORA has begun to commission officers directly into the IRC. Some officers have been recruited out of civilian ranks, and many are coming from within DHHS channels.

Officer applicants who are seeking commissioning into a 20- or 30- year career track are now being considered for direct commissioning into the IRC. These newly comm\issioned Reservists can then be offered short-tour assignments, creating opportunities for agencies to not only fill short-term needs but to audition potential full- time staff. For example, when an agency determines that it wants an IRC officer on extended active duty, the agency can simply provide an activation request-as IRC officers are all fully commissioned and boarded.

The IRC is also involved in recruiting new officers. Each year, 400 to 1,000 students are enrolled in the PHS Commissioned Officer Student Training and Extern Program (COSTEP). Commissioned as Health Service Officers in the IRC, they serve short tours of 31 to 120 days in agencies that have sponsored them during summer and breaks in their training.

COSTEP students are given an opportunity to seek extended active duty after completing their qualifying degrees. They are retained in the IRC and then involuntarily terminated if they have not entered active duty within four years.

The value of the PHS IRC has also been recognized by the Department of Defense (DoD). Under a memorandum of understanding with the Army Office of the Surgeon General, PHS is deploying PHS Inactive Reservists on short tours to help staff Active Duty Army medical facilities.

PHS IRC officers in DoD assignments served more than 1,400 activation days during FY04. These have included a number of international and domestic assignments. Many of the officers have received Army recognition for their service. The success of this program is a credit to the IRC officers who volunteer, and to their Army sponsors who quickly integrate these officers into essential and meaningful service.

CLOSING

Reserve officers are a critical component of all our efforts. They have their own jobs, their own families, and their own responsibilities r in their homes and communities. Yet they volunteer their time to become trained and are ready to serve when called. They are often in difficult situations, and often in harm's way.

The selflessness and dedication that drive the Reserve officers of all the uniformed services represent the best of America - the best of our past, present, and future.

The nation asks much of these brave men and women, and we are truly grateful for their service. ROA

BY VADM RICHARD H. CARMONA, M.D., M.P.H., FACS

SURGEON GENERAL, U.S. PUBLIC HEALTH SERVICE

DEPARTMENT OF HEALTH AND HUMAN SERVICES

VADM Richard H. Carmona was sworn in as the 17th surgeon general of the United States Public Health Service on 6 August 2002.

Born and raised in New York City, Dr. Carmona dropped out of high school and enlisted in the U.S. Army in 1967. While enlisted he received his Army General Equivalency Diploma, joined the Army's Special Forces, ultimately becoming a combat-decorated Vietnam veteran, and began his career in medicine.

After leaving active duty, Dr. Carmona attended Bronx Community College of the City University of New York, where he earned his associate's degree. He later attended and graduated from the University of California, San Francisco, with a bachelor's degree (1977) and medical degree (1979). At the University of California Medical School, Dr. Carmona was awarded the prestigious gold-headed cane as the top graduate. He has also earned a master's of public health from the University of Arizona (1998).

Dr. Carmona has worked in various positions in the medical field including paramedic, physician's assistant, and registered nurse. Dr. Carmona completed a surgical residency at the University of California, San Francisco, and a National Institutes of Health- sponsored fellowship in trauma, burns and critical care. Dr. Carmona is a Fellow of the American College of Surgeons, and is also certified in correctional health care and in quality assurance.

Prior to being named Surgeon General, Dr. Carmona was the chairman of the State of Arizona Southern Regional Emergency Medical System, a professor of surgery, public health and family and community medicine at the University of Arizona, and the Pima County Sheriff's Department surgeon and deputy sheriff.

Dr. Carmona has also held progressive positions of responsibility as chief medical officer, hospital chief executive officer, public health officer, and finally chief executive officer of the Pima county health-care system. He has also served as a medical director of police and fire departments and is a fully qualified peace officer with expertise in special operations and emergency preparedness, including weapons of mass destruction.

Copyright Reserve Officers Association Dec 2004

Source: Officer, The

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