rutstein retirement sends shock waves throughout the commissioned

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FROM THE EXECUTIVE DIRECTOR continued... The points made by Dr. Koh are contained in the “Executive Summary” slides made available to all Corps officers on the CCMIS website and announced in an email to the Corps just as our telephone call was ending at 4:35PM on the 12th. For those unable to access the password protected CCMIS webpage, we have posted the briefing notes on the COA website. Dr. Koh reported on the Office of Management and Budget (OMB) tasking for a management review, the process and players he directed to conduct that review, and the “findings” and 46 recommendations developed by the review. The findings concluded by the review validate COA’s concerns expressed to Dr. Koh during that first meeting with him in March, 2009. The management review found a decentralized and complex organizational structure; operations spread across three different chains of command (actually more if you include the opdivs and agencies); fragmented and inconsistent enforcement of policies; “suboptimal” customer satisfaction; and more. Dr. Koh told me that he was taking immediate steps to address the key items. Among these first steps are streamlining the Corps’ administrative structure from 20 to 10 offices; unifying policy and operations under a single point of accountability (realigning OCCFM back under OSG); and establishing an advisory board to assist the ASH in Corps oversight. Anticipated outcomes include cost savings, more effective and efficient management for the Corps, and increased customer satisfaction. That’s all good news. The other news was that while these significant changes were to begin immediately, they are not expected to be complete until the spring of next year. That said, the recommended changes are complex and will take time to implement. VADM Benjamin echoed Dr. Koh’s comments and voiced her “complete agreement” with him. I began my comments by thanking Dr. Koh and VADM Benjamin for the courtesy extended to COA by the call. I remarked that COA would certainly agree with the major issues identified as things stood on March 23rd – the day the PPACA became law; but on that day there would have been only three issues. Subsequent actions to impose a “pause” on calls-to-duty have, in COA’s view, propelled that issue to the top of the list. I asked about the relationship of the “pause” to the management review; the reasons for the “pause”, and the steps necessary to have it lifted. Dr. Koh assured me that everyone in DHHS, from the top down, is working as hard as possible on getting the “pause” lifted and has been from the beginning. But my questions went mostly unanswered – topics for a future meeting. There was a suggestion that since the PPACA required all new accessions to be commissioned as Regular Corps officers – effective immediately upon the bill becoming law on March 23rd – and that the required processes (DHHS submission of names to the White House for formal nomination to and confirmation by the Senate on a regular and recurring basis) did not exist, that this might somehow have caused the “pause.” I pointed out that the language in the PPACA regarding the Corps was unchanged in the almost year long process of congressional committee hearings. That language was publicly available and, in fact, was provided by me personally to DHHS on at least two occasions last year with a request to review and advise of any problems with implementation. No obstacles to implementation were identified. There may be inherent challenges in formulating plans and policies without legislation actually in place; but it is difficult to understand why such procedures are not in place almost seven months after the fact. My next question was related to the “pause” issue and had to do with reports from among the 450+ officers who have been commissioned since March 23rd, but whose commissions required special presidential authority. Many of these new officers have asked COA to look into their eligibility for promotions in the next cycle. Apparently, some officers have been told that because of their special status they will not be able to qualify for promotions for which they would otherwise be eligible. The Surgeon General promised to inquire into the situation and get back to me. COA supports the planned reorganization aimed at streamlining Corps management and focusing the chainof-command and accountability. But I cautioned against over-enthusiastic and optimistic expectations of savings and improved efficiencies. The focus must be on improved effectiveness and efficiency first and on cost savings second. I asked Dr. Koh to provide more detail on the planned Commissioned Corps Advisory Board that will report to him. I was concerned that the idea was to simply replace the functions performed by OCCFM in the ASH’s office with yet another bureaucratic layer. He assured me that this is not the case; that the Advisory Board will be a senior executive group composed of many of the same officials convened to conduct the management review and may also include opdiv heads. The Advisory Board will function in just that capacity – providing advice to the ASH about the Corps – and not as yet another bureaucratic layer in the approval process. Dr. Koh concluded the call by once again stating his commitment to open communication with COA, encouraging me to call him directly whenever I had a question and that any requested meetings would be a priority for him. I remain impressed with, and convinced by Dr. Koh’s concern for and loyalty to the Corps. His dedication to improving transparency and communication as the Department moves forward to resolve Corps issues is exactly what is needed to reassure all officers of the Department’s strong support for their – and the Corps’ future. A future in which we all want to see an expanded, more effective, more efficient, more capable and more professional Corps as provided for in the PPACA. The timeline for all this does, however, leave much to be desired – a situation with which I expect the ASH would agree and which I am sure frustrates him as much as all of us. The longer the 14 commissioned officers association
Corps is frozen in place – the “pause”, no Ready Reserve, no Public Health Science Track, months still to go before reorganization is completed – the more ground is lost. Qualified candidates for a commission will lose hope and drift away; other programs and problems will take precedence. It is a sad fact that in today’s fast paced world, institutions that are not moving forward are actually moving backward We can only urge the ASH and the Surgeon General to do all in their power to accelerate the reorganization and implement the PPACA and pledge COA’s full support for those goals. At the same time, we counsel patience for our members and echo the words of RADM David Rutstein in his farewell message to the Corps; your job in this crisis, as commissioned officers in the Public Health Service, is to stand by your service to the country as a uniformed officer and not shrink from it. Coast Guard Study Contemplates Casting Off PHS Health Support In an example of the consequences of the “pause” in calls-to-duty for Corps officers, after years of speculation and discussion the U.S. Coast Guard decided to invest money in a formal study to evaluate the merits of establishing their own medical corps and severing their long-standing relationship with the PHS Commissioned Corps. Coast Guard has hired the consulting firm Harkcon to conduct the review and provide recommendations. I spent an hour with the Harkcon team a few weeks ago discussing the pros and cons of such a step. From my perspective the cons, especially for the Coast Guard, far outweigh the pros of standing up their own medical corps. Cost is the number one factor to consider, with career path development for such a small cadre running a close second. While it would be an unfortunate development for the Corps to lose this mission area, I don’t think the long term consequences for the PHS would be all that great. Join Me as a Club 159 Member! COA is working hard for our members’ and the Corps’ interests. Our affiliated Foundation is also working hard in a variety of ways to tell the Corps’ story and advocate for your interests. COF financial support also helps COA accomplish its mission. COA and COF share office space and the Foundation’s contributions to rent and other overhead expenses certainly benefit the Association. Foundation grants to COA can also help with other expenses. But in order to help, the Foundation must have the resources to do so. And that’s where COF (and by extension COA) needs your urgent help in these trying times. If every COA member donated just $159 to COF (about a dozen lattes), we would raise $1 million – the goal for COF’s capital campaign. So I ask you to join me and COF’s Development Director, Brian McSheffrey, and the COA Directors and COF Trustees in joining with us and becoming members of Club 159. If not now, when? If not you, who? If you have not already, please visit the COA or COF website and join Club 159 today. Help us help you. Yours Aye! october 2010 | Frontline 15
Page 1 and 2: COMMISSIONED OFFICERS ASSOCIATION V
Page 3 and 4: COA BRANCH PHS Officers Volunteer a
Page 5 and 6: COA Member Helps fellow Commissione
Page 7 and 8: LEGISLATIVE UPDATE continued... And
Page 9 and 10: Chair’s Corner Be a Mentor! Fifty
Page 11 and 12: welcome NEW MEMBERS LTJG Oladeji A.
Page 13: JOIN Club 159 Club 159 is a means t
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Page 19 and 20: Attention All COA Local Branches! T
Page 21 and 22: Senator Inouye Received PHS Flag fr
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rutstein retirement sends shock waves throughout the commissioned

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