News & Information - The Mercury - September 2009 Mercury

by Jerry Harben
U.S. Army Medical Command

A planned reorganization of Medical Command, to become provisionally effective in October, will align regional medical commands (RMC) with TRICARE regions while improving readiness and support for the Army Force Generation cycle of deployments and resets.
Regional dental commands also will realign to match the regional medical commands.

In a separate reorganization initiative, the public health functions of Veterinary Command and the Center for Health Promotion and Preventive Medicine will combine into a new Public Health Command.

 “We are reorganizing around three CONUS-based regional medical commands, down from four, that are going to align with the TRICARE regions to provide health care in a seamless way with our TRICARE partners,” said MEDCOM Commander LTG Eric B. Schoomaker at the MEDCOM Medical Symposium in San Antonio, Texas.

“Increasingly, that is a problem for our Reserve and National Guard colleagues, who are out in the white space away from our installations where they can get care within our direct-care system. If we’re going to make this effective for them, and for our own people as we increasingly have to put care downtown, it’s because we are partnered very closely with our managed-care support contractors in the TRICARE regions,” Schoomaker continued.

In addition to TRICARE alignment, each region will contain a corps headquarters, and health-care assets will be better aligned with beneficiary populations.
Each regional medical command will have a deputy commander who is responsible for a readiness cell.

“This will help coordinate and collaborate with the ARFORGEN [Army Force Generation] cycle,” said MAJ Greg Canty in the health-care operations office at the Office of The Surgeon General. “Right now we don’t have a central hub for readiness.”

“All of the tasks within that region within all the camps, posts and stations that are supporting this Army at war, are going to be the responsibility of that readiness cell and deputy commander, who will be assisted by the director of readiness who is dual-hatted as the regional dental commander,” Schoomaker said. 

Structure and staffing for RMC headquarters will be standardized. It is not yet known whether this will result in more personnel at those headquarters, said Canty.

“I do not want the restructuring process to create any undue anxiety or concern for MEDCOM personnel,” Schoomaker wrote in a letter to commanders late last year. “I am committed to ensuring current members of our team are held free from any adverse impact as a result of this initiative.”

The consolidation of VETCOM and CHPPM is expected to increase focus on health promotion and create a single accountable agent for public health and veterinary issues.

“We get all public health officers within the command thinking of themselves as supporting public health efforts,” said Schoomaker. “We have veterinary officers, enlisted Soldiers and civilian professionals who are truly public health officers and experts in zoonotic disease, but I also have public health nurses, preventive medicine officers and others at CHPPM who are doing some of the same as well as practitioners in our hospitals and clinics who are engaged in prevention.”

Level I and Level II veterinary and preventive medicine missions will be realigned to medical treatment facilities, so installation public health services will be controlled by the local MTF commander.

“So we are going to create a single public health command and regional public health commands that work very collaboratively with the medical commands. At the installation we are going to assign a single accountable agent again so the director of health services and MTF commander is responsible for public health within that installation,” Schoomaker continued.

“We are going to turn more attention to scientific approaches to risky behaviors and how to interrupt those behaviors, so we can turn the tide away from disease and injury and keep more of our people healthy,” he added.

After a year of provisional status, the new regions are expected to be permanently realigned in October 2010. The Public Health Command will become provisional in October, have initial operational capacity by October 2010 and be fully operational by October 2011.

From the September 2009 Mercury, an Army Medical Department publication.