3440.10 with Changes - Navy Medicine - U.S. Navy

BUMEDINST 3440.10
20 Nov 2008
3. BUMED-M3/5, in coordination with each NAVMEDREG commander and major parent
command, assigned tier designations for all fixed MTFs. BUMED M3/5 will conduct periodic
reviews of MTF tier designations to ensure applicability to the current Navy and Marine Corps
missions, to include such factors as Medical Readiness Review, Base Realignment and Closure
(BRAC) Commission, and Force Reshaping.
4. Reference (a) of this section establishes tiered response as a program standard for the “allhazards”
EM approach. This tiered response prioritizes resource allocation, financial
management, and capability requirements. Each tier equates to a defined capability level that
will provide the basis for organizing, training, and equipping resources.
5. MTFs are divided into four tiers representing (1) high, (2) medium, (3) low, and (4) minimal
response capabilities. MTF tiering is based on the following elements:
a. Installation prioritization per reference (g) of this section.
b. Support to power projection or strategic assets, per references (g) and (h) of this section.
c. Human capital.
d. Scope of response per reference (i) of this section.
e. Geographic (or potential) isolation from additional support capabilities (e.g., distance and
vulnerable transportation infrastructure such as bridges and tunnels).
6. The tier designation determines the type and number of MTF response elements required to
support the FHP EMP. Each specific element will be standardized across all Navy Medicine.
For example, a decontamination element at a Tier 3 MTF will be organized, trained, and
equipped to the same FHP EMP objectives as a decontamination element at a Tier 1 MTF.
However, the Tier 3 MTF will have a smaller decontamination element footprint than the Tier 1
MTF. See Table 1 for the minimum tiered MTF personnel requirements.
a. Personnel. Personnel will be task-organized into unit identification code (UIC)-based
capabilities areas (see Table 1). Designated active duty and civilian personnel located at an
MTF, independent of expeditionary wartime military augmentation platforms, must participate.
b. Training. All baseline didactic CBRNE training requirements will be met by the Navy
Knowledge Online-based CBRNE Emergency Medical Preparedness and Response Course
(EMPRC) as directed in reference (j) of this section. Additional practical application,
equipment, and training exercises (e.g., tabletop (TTX), command post exercises (CPX)/field
exercises (FE), and field training exercises (FTX)/full-scale exercises (FSE)) will contribute to
the training qualification standards.
5 Enclosure (1)