Expeditionary Medicine Administration

Chapter 2HM2 Alcazar

Reports are a required aspect of HM work, the reports are found in NAVMED P-117

Management of the reports, forms is covered in the BUMEDINST 5210.9- Forms and Reports Management Program

Reports

Report to the OOD- Reported by the SMDR (Senior Medical Department Rep) Who is usually an Medical/ Dental officer or an IDC. Items reported are sever injuries, items that might affect the health if the crew, damaged/ lost equipment. Names of Pts in serious conditions are reported to the CO and OOD, along with information needed to notify the next of kin.A Memorandum for Record- IAW the SECNAVINST 5216.5 Department of the Navy Correspondence Manual. Notates information that would be of legal/ historical importance, EX serious injury/death of a pt. Pt refusing treatment or are non compliant.

Kinds of reports

Sick call Log- is maintained IN SAMS on the ship, contains the date, time, name, rate, division, and complaint and treatment. This report is made daily to the COTraining log- Documented in SAMS, include date, time, how long it lasted, who the training was given to, and the # of attendees broken down.Potable Water- daily residual Chlorine/Bromine levels and weekly bacteriological testing documentation maintained IAW NAVMED P5010 chapter 6. Recorded in SAMS Environmental Management Mode

Kinds of logs

SAMS- Shipboard Non-Tactical Automatic Data Process(SNAP) Automated Medical System- Admin tool that tracks Medical/Dental Readiness, also tracts supply, Prev Med inspections, medical training, report/receive Radiation DataMRRS- Medical Readiness Reporting system Admin tool used to track readiness of every AD or Reserve sailor or marine. Internet based. SAMS and MRRS are able to share data between

each other by the Central Data Repository (CDR) and Defense Enrollment Eligibility Reporting System (DEERS)

SAMS/MRRS

Used to record, report and evaluate maintenance requirements. To plan schedule and control planned maintenance.

OPNAVINST 4790.4 Ships Maintenance and materials management systems, is the guidance for the program, this tells how to use the PMS planned maintenance system.

The Work Center PMS manual is maintained in the work space neat the weekly PMS schedule. This schedule tells the periodicity and what’s required for the checks. This is a minimum standard to keep equipment operational.

Navy Maintenance and Material Management System 3M

Permanent Directive- used to establish policy, delegate authority and assign mission function or taskTemporary Directive- usually issued as a notice, to announce changes, such as promotion/education opportunities and change of commands.Notice- lasts no longer than a yearChange Transmittals- used to issue changes to instructions and notices, Each describes the nature of the change and how to complete it. Filed in front of the instruction with the most recent on topCorrespondence – Standard Navy letter instructions found in SECNAVINST 5216.5- Department of the Navy Correspondence Manual

Directive Issuance System- OPNAVINST 5215.17

Instructions are filed in numerical sequence according to the Standard Subject Identification Code (SSIC)

If they are classified then they are stored separately, and placed in a safe IAW SECNAV

M 5510.36 Department of the Navy Information security Program If a correspondence does not have an SSIC from the

originator then upon receipt it will be assigned oneRecords Management Program SECNAVINST 5210.8 Tells how to retain records and dispose of those that are expired

Filing

A method of identifying the subject for all Navy/Marine letters, messages, forms, directives.

Divided into primary, secondary and tertiary groups

1000- Military Personnel2000- Telecommunication3000- Operations & Readiness4000- Logistics5000-Gen Admin& management6000- Medicine/ Dentistry 7000- Financial mang.8000- Ordnance material9000- Ships Design & material10000- Gen. Material11000- Facilities/ Activities Ashore12000- Civilian Personnel13000- Aeronautical/ Astronautical Material16000- Coast Guard missions

SECNAVINST 5210.11 Standard Subject Identification Code

Individual Medical Readiness (IMR) has six Elements Individual Medical Equipment Immunizations Readiness Laboratory Studies Deployment limiting Conditions- Limited Duty, Physical

Evaluation Board, Medical Evaluation Board Periodic Health Assessment (PHA)-used to correct IMR

deficiencies Dental Readiness- Class 3&4 non deployable

SECNAVINST 6120.3 Periodic health Assessment for Individual Medical Readiness Outline the regulations

Operational medical& Dental Readiness

FMF Consists of Marine Logistics Group (MLG) marine divisions, brigades and Aircraft wings.

BAS- direct support to company and platoon HMs, consists of 65Hms and 2 medical officers depending on the size. Dental detachments are attached to provide care for 1-3 level dental care.

Combat personnel- medical and initial first aid, evacuation

Support personnel- surgical/ medical aid to those who need it and are unable to evacuated.

Medical Battalion- attached to MLG. Missions are Combat collection, Emergency Treatment, Temporary hospitalization, Specialized surgery, and Evacuation

Medical/ Dental support to the Fleet Marine Force

Transportable, provide support during intense combat/ long term low intensity

Expeditionary Medical Facilities – 500 beds Fleet hosp. used in operation longer than 60

days with moderately sophisticated, the chain of command is similar to a MTF Command Staff, 5 directorate, Nursing services, Medical services, Surgical services, Ancillary, and Admin services

Fleet Hospital

Work with the Seabees, there are 8 NMBC home ported in Gulfport MS and Port Hueneme CA.

Naval Mobile Construction Battalion

Healthcare Administration ProgramsChapter 3

HM2 Alcazar

Eligibility instruction NAVMEDCOMINST 6320.3 Enrollment in to DEERS happens by completing

Privilege Identification Card application- DD1172and the Uniform Services Identification card

DEERS verification conducted using CHCS is outlined in OPNAVINST 1750.2 Defense Enrollment Eligibility Reporting System

If a person shows up without an ID card but are in DEERS treatment will be issues and individual will be billed 30 after if an ID card has not been shown. Resources Management handbook NAVMED P-5020

Exceptions to eligibility Secretary of the Navy Designees Foreign Military Personnel

DEERS

Not enrolled in DEERS, member separated from the military, family member child is married, spouse is divorce, not entitled to the benefits of the former spouse

9 Eligibility over ridesDD 1172 the person has a copy or original DEERS enrollment formFamily members recently becoming eligible for treatment ie baby, adoptionNew ID card- previous 120 daysIneligible due to ID card expiration- if Deers say its no good as long as the person has a card that was issues up to 120 days priorEntering active duty status for 30 days or more- need a copy of ordersNewborns- 61st day they need to be on the members pg2 and enrolled in to tricare primeEmergency careSponsers duty station is outside the US or has an APO/FPO address.Survivors- the deceased sponsor remains in DEERS to allow care for the family members as survivors.

Ineligibility

An enhancement of Civilian Health and Medical Program of the Uniform Services (CHAMPUS) it is the health coverage for MTF/DTF. It shares in cost for civilian services.

DENTAL- AD for 30 days or longer are eligible for dental care, Tricare dental plan to dependents as long as 12 months left on ADDental exams, restoration of lost tooth, treatment of periodontal conditions, surgical procedgers, and replacement of missing teeth.

Tricare

CAT 1A- AD membersCAT 1B- members of the Reserve and National GuardCAT 2- family members of active duty, and family of a dead memberCAT 3- members of the Senior Reserve Officer Training CampCAT4- Retired members and their familyCAT 5- Civilian Employees of Federal gov.Cat 6- Everyone else.

Dental Priority

Uses various sources to evaluate the degree of excellence and to make improvements as needed for health care.

Joint Commissions and Medical Inspector General value Quality assurance, and the program derives form OPNAVINST 6320.7 Health care Quality Insurance Policies for Operating Forces.

BUMEDINST 6300.10 series Navy’s Health Care Relations Program, provides the guidelines for setting up the program in thee parts Internal External and Patient Relations.

Survey which help with the commands yearly QA check should be displayed at the front desk.

Quality Assurance ProgramBUMEDINST 6010.13

Patient Relations Program- help resolve Pt complaints IAW BUMEDINST 6300.10 , by enhancing communication between the Hospital and PT.Patient Contact Point- subset of the relations program, ensure a way of resolving issues before the PT has left. The point of contact will have there picture visible at the front desk/ reception area. Next to the picture the PT bill of rights will be displayed.

PT Relations & PT contact point programs

SECNAVINST 1752.3 and BUMEDINST 6230.70

It is designed to identify and monitor spouse/child abuse/neglect and sexual abuse in military families.

Managed by the Family Advocacy Rep

Family Advocacy Program

OPNAVINST 5350.4 Drug abuse “Zero Tolerance” Alcohol use “Responsible use” DAPAS are the commands primary Advisers

to all ETOH and Drug matter. They are responsible for screenings, prevention education, monitor aftercare, and preparing required reports

Drug and Alcohol Abuse Prevention and Control Program

OPNAVINST 6110.1 Testing required for all on a semi-annual

basis.Medical staff are responsible for: Providing assistance to BUPERSConducting lifestyle, fitness and obesity researchReviewing health status/ and waiversHelp make a exercise prescription.

Physical Readiness program

Informed Consent- requires the provider to provide the to with information they will need to know to make an knowledgeable choice. Who can consent-parents/ guardian for a childSpouse for and incompetent spouse.Laws of the state where the hospital is controls the rules of “Substitute Consent”Consent is valid as long there are no material changes between the date of consent and the date of a procedure. Implied/ written Consent

Legal Implications to medical care

Falls under Title 10 U.S.C 1102, Confidentiality of medical Quality Assurance records.

Incidents as submitted via a QCR to notify the events of an incident to the Risk Manager, Co and others who may be involved.

QCR are not allowed to be provided to people to assist in legal action.

The Risk management Program BUMEDINST 6010.21

Incident Report

Freedom of Information Act- reasonable request for information will be responded to with in 20 days of receipt of request does not include PII

Prviacy Act of 1974- the individual is allowed to:

Know what records are retianed on them, prvent a record that is on them to be used for other purposes with out their consent, have a copy made, make sue the information retained is correct.

Release of Information

Started in 1996- protects health information, and compliance with the military started 14APR2003, DODINST 6025.18

With this act MTF are allowed to release information to the Pt and the Secretary of the Department of health and human services

Information released for treatment, payment and helath care opperations.

Health Information portability and Accountability Act (HIPPA)

Posse Comitatis Act 1956 Makes it illegal for the military to enforce or assist in a federal/ state civil laws, there are exemptions.

No Pt under treatment will be released until medically sound to do so.

Non-AD Pt- when released from medical care the Hosp. has no control, authorities maybe notified of a discharge from care

AD Pt- the Co is allowed to turn Pt over with the proper paperwork. If local authorities desire the pt a warrant is needed and will have to consult the JAG before the release of the Pt.

Medical conditions and law enforcemtn

Enemy POW/ Detained Personnel- are eligible to all care

Non Federal Prisoners- only emergency care Military Prisoners- all care

Rape/Sexual assault-NCIS will investigate, it is medicals job to provide care IAW NAVMEDCOMINST 6310.3 management for Alleged or Suspected Sexual Assault and Rape Case

Pt Prisoners