Army Combat Developments and the Laboratory SAFMLS 2010

1. Army Combat Developments and the LaboratorySAFMLS 2010 COL Richard Gonzales Laboratory/Blood Bank Combat Developer

2. Outline • What is Combat Developments • What does a Combat Developer do? • What have I done for you lately? • What can you do? • Force Design Update: Medical Detachment Blood Support • How to reach me.

3. Regulations

4. Title 10 of the United States Code Outlines the role of Armed Forces in the United States Code. It provides the legal basis for the roles, missions and organization of each of the services as well as the United States Department of Defense. Each of the five subtitles deals with a separate aspect or component of the armed services.

5. CHAPTER 305—THE ARMY STAFF, 3036, Chiefs of Branches As a Commanding General, TSG provides advice and assistance to the Chief of Staff, Army (CSA) and to the Secretary of the Army (SECARMY) on all health care matters pertaining to the U.S. Army and its military health care system. He or she is responsible for development, policy direction, organization and overall management of an integrated Army-wide health service system and is the medical materiel developer for the Army. These duties include formulating policy regulations on health service support, health hazard assessment and the establishment of health standards. TSG is assisted by a Deputy Surgeon General.

6. Army Regulation 40–60 MEDICAL SERVICES POLICIES AND PROCEDURES FOR THE ACQUISITION OF MEDICAL MATERIEL Headquarters Department of the Army Washington, DC 15 March 1983 Para 1-8g: The materiel developer, combat developer, trainer, tester, and logistician will coordinate all formal documents and decision processes generated during the MEDMAP with the Office of The Surgeon General (OTSG) before their submission to- (1) Department of the Army (DA). (2) MACOMs. (3) Other external agencies and activities.

7. Army Regulation 40–60 Para 2–2. The Surgeon General (TSG). TSG, as the medical materiel developer for the Army, will a. Have the overall responsibility for the research, development, test, and evaluation (RDTE) and acquisition of medical materiel and related items. b. Delegate the authority for carrying out this responsibility to agencies primarily responsible for specific events within the materiel acquisition process. c. Coordinate the rationalization, standardization, and interoperability (RSI) considerations both with other Services as well as the North Atlantic Treaty Organization (NATO) and the American, British, Canadian, and Australian (ABCA) Armies throughout the medical materiel acquisition process. d. Review and approve all requirements documents authenticated by the- (1) Combat developer (AHS) and materiel developer (USAMRDC), or (2) Combat developer (AHS) and mission assignee agency (USAMMA) for NDIs and medical equipment sets (MESs). e. Submit requirements documents for major programs, designated acquisition programs, and DA IPR programs to HQDA for approval

8. Army Regulation 40–60 2–6 a. Commanding General, US Army Health Services Command (CG, HSC). CG, HSC, as the combat, doctrine, and training developer for the AMEDD, will Delegate authority to the AHS to carry out the responsibilities of combat developer, trainer, and operational or user tester for field medical materiel. (These activities will be performed within guidelines set by CG, TRADOC and Army health standards established by TSG. Details of this working relationship will be reflected in a memorandum of agreement between CG, TRADOC and CG, HSC.)

9. TRADOC Regulation 71-20 6 October 2009 Prescribes responsibilities and policy for the development of warfighting concepts, the conduct of experiments, and the determination of capability requirements. This regulation also prescribes responsibilities and policy for the implementation of the Joint Capabilities Integration and Development System (JCIDS), its execution, and how the U.S. Army Training and Doctrine Command (TRADOC) adheres to the Defense Acquisition System.

10. Organization Structure

12. Assistant Commander Force Integration & MCIC Director COL Timothy Jones Deputy Mr. Hershell Moody Combined Arms Center Liaison Officer at Fort Leavenworth LTC Paz Combined Arms Support Command Liaison Officer at Fort Lee CW3 Wendel Johnson Future Force Integration Directorate Liaison Officer at Fort Bliss MAJ Marion Jefferson Sr Enlisted Advisor SGM Ella LaLone Center for AMEDD Strategic Studies Borden Institute Directorate of Combat & Doctrine Development (DCDD) Medical Evacuation Proponent Directorate (MEPD) US Army Medical Department Board (AMEDDBD) Medical Capabilities Integration Center Total AMEDD System Management (TASM) / Knowledge Management

13. MCIC Mission Develop, coordinate and integrate Force Management, Force Development, Force Integration, Force Sustainment, and Force Modernization processes within the AMEDD, TRADOC, HQDA, and other Services and agencies in building the medical arm of tomorrow’s Army.

14. Chief Med NCO SGM Pena Clinical Consultant Dr. James Kirkpatrick Deputy, DCDD Mr. Tim Gordon Director, DCDD COL Larry Conway Concepts & Requirements Division COL William Layden Organization & Personnel Systems Division Mr. Charles Cahill Doctrine & Literature Division Ms. Cecily Price Directorate of Combat & Doctrine Development Medical Materiel & Systems Division COL Daniel Chapa Medical Information Systems Division LTC Daniel Kral

15. DCDD Mission Develop concepts, organizations, materiel, and doctrine for Force Health Protection (FHP) to the Army across the operational continuum. Identify operational and clinical capability and requirement solutions across the TRADOC doctrine, training, leader, organization, materiel, personnel, and facilities (DOTML-PF) domains.

16. Medical Information Systems Division

17. Division Chief LTC Daniel Kral Information Systems Branch Communication and Operational Architecture Branch Operational Architecture Branch Medical Information Systems Division

18. MISD Mission Responsible for AMEDD information systems/technology and communication requirements determination. Develop AMEDD operational and system architecture. Prioritize/integrate AMEDD IM/IT requirements into Army/DOD OA.

19. Medical Materiel & Systems Division

20. MMSD Mission Identify requirements and represent the user in the development of medical materiel, non-medical materiel and technologically advanced systems needed to support the Army and joint users on the battlefield. Develop and provide input to medical logistics doctrine and organizational structures to support emerging war fighter and Army logistics concepts

21. MMSD Vision We are committed to providing responsive and relevant support, serving as the Soldiers’ representative in the DOTMLPF process as it relates to medical logistics concepts, business processes, system enablers and equipment solutions; ensuring our Soldiers’ survivability and enhancing their ability to provide premier Health Service Support and Force Health Protection.

22. Medical Materiel and Systems Division Administrative Assistant Ms. Terry Rodriguez 221-2069

23. Log Concepts Branch Mission Statement Research emerging technologies, review literature and studies of medical-related ideas, equipment and programs for application within the AMEDD. Develop Army Concepts, Joint Concepts and best business practices for incorporation into Army doctrine, force structures and TTPs. MMSD What Does This Mean to you… • Single point of contact for medical equipment maintenance, technology research and developmental programs, as they relate to issues and concepts • Infusion of Medical Logistics Doctrine into Other Army and Joint Concepts and Processes

24. MMSD Logistics Concepts Projects • Army Medical Equipment Maintenance Program in a Joint Operational Environment • Tactical Power Generation & Distribution Requirements • Oxygen on the Battlefield • Power Generation & Hospital Layout Planning Tool (AutoDISE) • LOG C2 ICDT • Supply and Services and Materiel Management • Logistics Enterprise • Lead for Total Army Analysis & Force Design Updates • Medical Logistics Integrated Concept Team • Capability Needs Analysis • 670A/68A Maintenance MARC Study • Class VIII Planning Factors • Conducts Doctrine & Literature Reviews • Medical Logistics Company Force Design Update as necessary(FDU) • Joint Experimentation Learning Demands

25. Logistics Systems Branch Mission Statement To advance & develop medical and non-medical logistics concepts supporting current and future forces through development of innovative logistics processes. MMSD What Does This Mean to you… • Development of Medical Logistics Concepts and Processes • Logistics Automation Integration (Medical and Non-Medical)

26. MMSD LOG Systems Projects • Medical Logistics Systems Concepts & Capabilities Requirements Management • Theater Medical Logistics Automation Systems Concept • Battle Command Sustainment Support System (BCS3) • Net-Enabled Command Capability (NECC) • Force XXI Battle Command Brigade and Below (FBCB2) • Logistics Decision Support System (LDSS) • Single Army Logistics Enterprise (SALE) • AIS Hardware (MC4) Requirements • Defense Medical Logistics Transformation • Medical Communication for Combat Casualty Care (MC4) • Defense Medical Logistics (DML) JIPT • Army Sustainment Systems & Enterprise Architecture Integration • Conducts Doctrine & Literature Reviews

27. Non-Medical Materiel Branch Mission Statement To represent the user through the combat development process for all non-medical materiel programs, doctrine, organizational structures, materiel fielding and acquisition programs. MMSD What Does This Mean to you… • Represent the user as the Combat Developer in the Materiel Development and Acquisition process • Describe the who, what, where, when, why, and how a piece of equipment is used by AMEDD Soldiers

28. MMSD Non-Medical Materiel Projects • Ground Evacuation Platforms • Mine Resistant Ambush Protected Ambulance (MRAP-A) • Medium Troop Transport System Ambulance (MTTS-A) • Stryker Medical Evacuation Vehicle (MEV) • Up-Armored HMMWV CASEVAC Kits • Joint Light Tactical Vehicle (JLTV) • Ground Combat Vehicle • Family of Medium Tactical Vehicles (FMTV) • Tracked Ambulance Modernization Program • M113 Replacement Program • Bradley Family of Vehicles • AMEV XM11 • AMTV • Treatment Vehicles • Striker • AMTV

29. MMSD Non-Medical Materiel Projects • Collective Protection Systems • Chemically and Biological Protected System (CBPS) • Chemically Protected DEPMEDS (CP DEPMEDS) • CSS Support Items • Blue Force Tracking and Sensors/Jammers • Materiel Handling Equipment (MHE) • Family of Medium Tactical Vehicle-Load Handling Systems (FMTV-LHS) • Medical Shelters Program • Containers for Medical Applications • Integrated Concept Team (ICT) participation • Evacuation • Combat Casualty Care (CCC) • C4I • Force Protection

30. MMSD Summary Projects & Initiatives • Future Medical Shelter Systems • Medical Shelter Requirements • Force Design Updates • Regulatory Guidance Reviews • Medical Equipment Maintenance Architecture • Combat Medical Equipment Maintenance Support Doctrine • Medical Logistics Organization Development • MED LOG ICT • Facility Design & Maintenance • Medical Materiel Executive Agency/DLA

31. MMSD Summary Projects & Initiatives • Joint Medical Logistics Transformation • Medical Logistics Automation Systems • Medical Logistics Concepts • Single Army Logistics Enterprise • Ground Evacuation Platforms • Collective Protection Systems • Materiel Handling Equipment • Trucks and trailers • Blue Force Tracking and Sensors • AHS support items

32. Organization and Personnel Systems Division (O&PSD)

33. Mission Develop, coordinate and integrate Force Management, Force Development, Force Integration, Force Sustainment, and Force Modernization processes within the AMEDD, TRADOC, HQDA, and other Services and agencies in building the medical arm of tomorrow’s Army. Functions Establish, review, analyze, revise, and document: - AMEDD organizations - Tables of Organization and Equipment (TOE) - Basis of Issue Plans (BOIP). - Design, develop, and implement Manpower Requirements Criteria (MARC) studies and staffing guides. - Design, develop, document, and coordinate the composition of medical assemblages. - Coordinate Force Structure and manage AMEDD participation in Total Army Analysis (TAA) process.

34. Division Chief Mr Charles Cahill Basis of Issue Plan (BOIP) & Table of Organization & Equipment (TOE) Branch Mrs. Laura Ashinhurst Medical Materiel Branch Mr. John Lisenbee Manpower Requirements Criteria (MARC) Branch Mr. Rick Dabbs Force Structure and Analysis Branch Ms Monica Talamantez Organization and Personnel Systems Division

35. Table of Organization & Equipment (TOE)/Basis of Issue Plan (BOIP) Branch • • As branch and specified proponent, AMEDDC&S is the combat developer and therefore, proponent for medical organizations. • • The TOE/BOIP Branch will develop: • ▪ Automated Unit Reference Sheets • ▪ Force Design Update (FDU) • ▪ Coordinate Pending Changes for TOE’s with U S Army Force Management Support Agency, (USAFMSA) Ft Belvoir • ▪ Approve Requirements Prior to Submission to Standardization, Analysis and Integration (SAI), Review Board, USAFMSA, Ft Leavenworth • ▪ Have Direct Influence on: • - Design Process • - FDU Process

36. Unit Reference Sheet (URS) • • Supports Concepts and Doctrinal Studies • • Depicts Proposed Organization • • Provides: • - Organization • - Mission • - Assignment • - Capabilities • - Basis of Allocation • - Personnel • - Major Equipment

37. Table of Organization and Equipment (TOE) • • Developed by U.S. Army Force Management Support Agency (USAFMSA) • ▪ Documents Minimum Mission Essential Wartime Personnel and • EquipmentREQUIREMENTS (MMEWR) to Perform Assigned Doctrinal • Mission • ▪ Used to Determine the Army’s Objective Force • ▪ An Organizational Model • Types of Documents • ▪ BASE TOE • ▪ Intermediate TOE • ▪ Objective TOE • ▪ Modified TOE

38. BASE TOE: • An organizational design based on doctrine and equipment currently available. It • is the least modernized level for a TOE and represents the lowest common • collection of personnel and equipment requirements. • Intermediate TOE: • An organizational design which applies one or more ICP’s to a BASE TOE to • produce a calculated enhanced capability. • These documents form the bridge between the BASE and Objective TOE’s and • provide the primary tool for programming, executing, standardizing, and • documenting the Force Structure during phased modernization. • Objective TOE: • Provides a fully modernized, doctrinally sound organizational design. • Along with developmental acquisition plans sets the goal for planning and • Programming of the Army’s Force Structure.

39. Modification Tables of Organization and Equipment (MTOE) • Modeled on the TOE, but reflects AUTHORIZATIONS. • Apply to a specific unit • Portray resources AUTHORIZED • May include geographic, unique requirements • Used for resource programming and distribution.

40. TOE = REQUIREMENTS MTOE = AUTHORIZATIONS

41. TOE Development and Approval Process 1 Day 35 Days TOE developer builds new TOE 4 Days 15 Days DIWG AOI Review • Chair • TOE developer • Proponent • TWVRMO • HRC • Other Agencies 1 Application of changes From AOI staffing. • Proponent • TWVRMO • HRC • Other • Developers DIWG preparation (TOE developer) 85 Days 3 4 2 TOE developer - cyclic rev of TOE (AL 4) 5 (AL 3) 5 Days 1 5 Days TOE developer electronically transmits TOE pkg for HQDA staffing/w copy to RDD and impacted proponents (AL 5) TOE developer appends DIWG changes at AL 5 _______________ RDD applies changes at AL 3 36 Days HQDA Staffing 8 6 7 1-30 Days 1 Day 1 Day 5 Days TOE Developer transmits approval to Proponent, OI, and RDD OI/TOE Developer resolve issues RDD Opns coords monthly approval IPR, COC, and brief. Dir of FM approves TOE. TOE developer coords to change PPC in RDS RDD publishes briefing matrix Approval 10 11 12 9 (PPC 2) Deferral Disapproval (AL 5) 224 - 253 Days New TOE 194 - 223 Days Cyclic Review

42. Consolidated TOE Update (CTU) • Annual “Snapshot” of TOE records • Includes • HQDA approved documents • Documents at HQDA for approval • AURS • Related reference files • Distribution • HQDA • USAFMSA • MACOM’s

43. Basis of Issue Plan (BOIP) • Defined: A BOIP is a requirements document that states the planned placement of • quantities of new equipment and Associated Support Items Of Equipment and • Personnel (ASIOEP), as well as the reciprocal displacement of equipment and • personnel. Establishes the minimum wartime requirements, to include personnel, for • new or improved items of equipment for TOE organizations. • - Should include the institutional training base (AHS) • - BOIP Feeder data is prepared and submitted by the materiel developer • - BOIP developed by AMEDDC&S and Medical Team, USAFMSA - Belvoir • • Regulatory Guidance: • - AR 40-60, Policies and Procedures for the Acquisition of Medical Materiel (Mar 1983) • - AR 40-61, Medical Logistics Policies (Jan 2005) • - AR 71-32, Force Development and Documentation – Consolidated Policies • - DA Pam 700-60, Department of the Army Sets, Kits, Outfits, and Tools (SKOT) • • Required for equipment: • - costing more than $250,000 OR • - having significant maintenance requirements OR • - impacts Unit Status Report

44. BOIP Development and Approval Process 11 Days BOIP developer coord BOIP with: MACOM (TDA inputs) TWVRMO Proponent (CD) Personnel Proponent Other Developers TRADOC DCST TAPC BOIP Developer creates BOIP in coord w/SAID, other BOIP developers, SI, ARSTAF RDD Opns/ Developer Screen BOIPFD Materiel Developer Develops BOIPFD Standard or Complex 1 2 3 PPC 5 4 5* REJECT 45 Days 60 Days 1 - 30 Days 3 Days 20 Days 15 Days 36 Days Documentation Integration Work Group (DIWG). BOIP developer in coord w/SI prepares briefing slide. SAID recodes BOIP to PPC3 BOIP developer coord w/SI, finalizes BOIP pkg, and forwards to SAID BOIP developer electronically transmits BOIP pkg to HQDA with info cy to ADD and DAMO-FDF SI/BOIP Developer resolve issues. RDD Opns coords monthly approval IPR, COC, and briefing. Dir, FP approves BOIP. HQDA/SI coordination 9 8 AL 3 7 6 AL 4 10 1 Day 7 Days 1 Day STANDARD BOIP developer coordinates with SAID to change PPC in RDS BOIP developer transmits approval to Mat Dev, ADD, SI, and Proponent Approval TOTAL: 170 - 199 Days RDD publishes approval matrix. COMPLEX 11 12 13 TOTAL: 200-229 Days AL 2 Days = Calendar Days

45. Manpower Requirements Criteria (MARC) Branch MARC Defined: HQDA approved standards for determining Minimum Mission Essential Wartime Requirements forCombat Support (CS) and Combat Service Support (CSS) functions in TOE. Mission: To determine the Quantitative and Qualitative wartime manpower requirements needed for the performance of the defined medical function in a theater of operations at varying levels of work activity or services. Organizational Relationships: USAFMSA for coordination, review and approval MEDCOM & OTSG for staffing and/or coordination AMEDD Center and School for staffing and/or coordination Affected proponents

46. MARC Developers: • USAFMSA Fort Lee, Virginia – develops MARC for Combat Support and Combat Service Support Functions • AMEDDC&S - Develops MARC for all medical functions including medical requirements in non- medical TOEs SCOPE: AMEDD MARC Branch is responsible for 36 specific functional areas Food Insp Biomedical Combat Medic Ward Nursing PAD Hosp Lab Spt Ortho Serv Radiology Pharm Svc Vision Care CMS Hosp Med Sup OT/PT PM Med Trt SQD/TM Dental Serv MedLog Oper Room Mental Health Emerg Med Svc Resp Care Air Evac Vet Animal Care GYN Serv Litter Bearers Nutrition Care Podiatric Serv Urology Serv ENT Serv Off/Enl Nurs Supv Aviation Med Int Med Serv Hosp Surg Serv PT Holding Serv Ground Amb Spt Optical Fab These studies address requirements for: 25 Enlisted MOS’s; 2 WO MOS’s and 53 Officer AOC’s

47. Medical Materiel Branch • Mission • Draft and staff requirements documents; schedule and manage new builds, updates, and • modernization efforts for medical assemblages in coordination with DCDD clinical subject • matter experts in support of medical field treatment facilities, medical units, and both medical • and non-medical personnel performing a medical mission. • Regulatory Guidance: • - AR 71-32 – Force Development and Documentation – Consolidated Policies • - AR 40-60 – Policies and Procedures for the Acquisition of Medical Materiel • - DA Pam 700-60 – Department of the Army Sets, Kits, Outfits, and Special Tools • Charter: • - Improve delivery of medical care • - Reduce Force Health Protection foot print on battlefield • - Provide accurate mobility, power demand and survivability information • - Modernize existing medical equipment

48. Medical Materiel Branch • Guidelines: • • Assemblage build is based on Minimum Mission Essential Wartime Requirements to support combat operations for 72 hrs. • • Review is not a mechanism for altering unit mission, organization, or personnel strength. • • Medical Equipment end items • • Documentation of new medical equipment capabilities not previously present requires DOTMLPF analysis. • Functionaries: • • MMB AO lead – Meeting facilitator • • Clinical SME lead – Discussion leader (If necessary) • • DCDD SR Clinical Consultant – Clinical debate tie breaker. • • Clinical panelists – main body for input to update assemblage • • TOE/BOIP representative • • Other functional area SMEs - provide guidance and possible solutions and methods to meet Clinical panelists intent for • updating assemblage

49. Force Structure & Analysis Branch Mission Force Structure and Analysis Branch reviews, identifies and coordinates all Standard Requirements Code 08 organization Rules of Allocation (ROA) in conjunction with the Total Army Analysis (TAA) process, ensuring inclusion in future TAA processes. The FS&AB is the keeper of the official ROA and Card Catalog for medical echelon above brigade (EAB) TOE organizations in the U.S. Army. Functions • Coordinate and/or participate in meetings to discuss the need to update a ROA. • Meet with SMEs to discuss ideas for modeling, data collection, etc. • Ensures all allocation rules are justifiable to the Organizational Integrators (OIs). • Coordinate and/or participate in meetings to discuss the redesign/update of a unit. • Meet with SMEs to discuss ideas for redesign/update of unit. • Transfer of Master Force database to worksheet format and scrubbing worksheets to ensure data has transferred correctly. • Provide information regarding the status of a unit (activation, conversion, inactivation) to Combat Developers, Medical Planners, etc so that money will not be spent on equipping units that are going out of the force and units that are soon to activate or convert will be equipped. • Keep TOE branch informed on those SRCs that are going out of the system so that they can request they be rolled to history. • Review the FORGE output to ensure the ROAs are calculating correctly and working with the SME to also ensure the resulting requirements are correct.

50. Force Structure & Analysis Branch Functions (cont) • Update/maintain audit trail of ROAs and unit changes. • Provide Force Structure/TAA process briefs at all levels as required. • Obtains, reviews and applies Force Guidance (classified) to current TAA. • Ensure the Card Catalog contains the latest information regarding Section I, ROA’s, doctrine, and terminology as well as the number of required and resourced units. • Work unit requirement and resourcing issues with SMEs and OIs. • Develop and maintain crosswalk of SRCs to maintain audit trail of changes • Update/maintain file system of classified documents and prepare for annual inspection.