United States Public Health Service

1. United States Public Health Service “Protecting, promoting, and advancing the health and safety of the Nation”

2. Who are We? U.S. Public Health Service: • Highly-trained and mobile health professionals • The nation’s foremost health service • A principle component of the Department of Health and Human Services • One of the Seven Uniformed Services

3. Seven Uniformed Services of the U.S.

4. The Department of Health and Human Services (DHHS)

5. USPHS Part of the Department of Health and Human Services • Led by the Surgeon General • Dual Personnel System • 60,000 employees total • > 6,000 Commissioned Corps Officers & growing

6. RADM Boris Lushniak, MD, MPH http://www.surgeongeneral.gov/about/biographies/biosg.html Acting Surgeon General of the United States

7. RADM Scott Giberson, RPh, MPH Acting Deputy Surgeon General of the United States http://www.surgeongeneral.gov/about/biographies/biodeputy.html

8. Mission To protect, promote, and advance the health and safety of the Nation through: • rapid and effective response to public health needs • leadership and excellence in public health practices • advancement of public health science

9. Our Origins • 1798 Creation of PHS to provide for care and relief of sick and injured merchant seaman • 1870 Reorganization to create a Marine Hospital Service • 1889 Formalized by Congress as the Commissioned Corps • 1912 Renamed Public Health Service because of broadening responsibilities • 1939 Became part of the Federal Security Agency • 1980 Became part of the Department of Health and Human Services

10. PHS Seal • Fouled Anchor = seaman in distress • Caduceus (winged wand with 2 serpents intertwined) • Associated with the Greek god Mercury, used to symbolize trade or commerce (hence, PHS’ relationship with merchant seaman and maritime industry)

11. PHS Flag • Evolved out of the quarantine flag used by the Service on quarantine vessels and stations • Blue and yellow colors of the PHS represent its roots in maritime and quarantine activities

12. Where are we located? • Almost anywhere and everywhere in the United States • Whether you prefer urban or rural, east, west, north, or south - we have a location for you

13. Duty Locations Coast to Coast Arizona Washington Washington DC New Mexico South Dakota

14. Where do PHS Pharmacists Work? • Indian Health Service (IHS) • Food and Drug Administration (FDA) • Bureau of Prisons (BOP) • National Institutes of Health (NIH) • United States Coast Guard (USCG) • Immigration and Customs Enforcement (ICE) • Center for Medicare and Medicaid Services (CMS)

15. Where do PHS Pharmacists Work? • Agency for Healthcare Research and Quality (AHRQ) • Centers for Disease Control and Prevention (CDC) • Department of Defense Tricare Management Activity (DOD TMA) • Health Resources and Services Administration (HRSA) • Program Support Center (PSC) • Office of the Secretary (OS) • Substance Abuse and Mental Health Services Administration (SAMHSA)

16. Indian Health Service • IHS Mission: To raise the physical, mental, social and spiritual health of American Indians and Alaska Natives • IHS Serves 2 million people from 565 Federally recognized tribes and their descendants • Provides comprehensive healthcare services including preventive, curative, rehabilitative, and environmental • Most IHS facilities are west of the Mississippi River • Northern Plains States • Southwest • Pacific Northwest • Alaska http://www.ihs.gov

17. U.S. Coast Guard • Component of the Department of Homeland Security • One of the seven Uniformed Services, and is the smallest of the five armed services • Headquarters in Washington, DC • Opportunities throughout the US • New Jersey Massachusetts • Washington North Carolina • Florida Connecticut • Alabama Washington DC • California Virginia • Alaska http://www.uscg.mil

18. U.S. Food and Drug Administration • FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of: • Human and veterinary drugs • Biological products • Medical devices • National food supply • Cosmetics • Products that emit radiation

19. U.S. Food and Drug Administration • FDA regulates manufacturing, marketing and distribution of tobacco products • FDA monitors the manufacture, import, transport, storage, and sale of about $1 trillion worth of products each year http://www.fda.gov

20. Federal Bureau of Prisons • The health care mission of the BOP: To deliver medically necessary health care to inmates effectively in accordance with proven standards of care without compromising public safety concerns inherent to the Bureau’s overall mission. • Operates a system of Federal penitentiaries across the country • Settings range from small infirmaries to 500 bed tertiary care hospitals

21. Federal Bureau of Prisons • Inmates are designated a level of care according to their overall health • Care Level (CL) I – Healthy or simple chronic care • CL II – Stable, chronic care • CL III – Unstable, complex chronic care • CL IV – Medical Center, often requires daily nursing care http://www.bop.gov

22. Mission: to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability National Institutes of Health

23. National Institutes of Health • Federal focal point for medical research in the U.S. • More than 80% of NIH’s budget goes to over 3,000 universities and research institutions. • The NIH Clinical Center in Bethesda, MD is the largest hospital in the world totally dedicated to clinical research. http://www.nih.gov

24. Centers for Disease Control and Prevention • CDC employs more than 15,000 employees, in more than 50 countries and in 168 occupational categories • Primary function is to conduct and support public health activities in the United States

25. Centers for Disease Control and Prevention • CDC works in conjunction with local, state, and national partners to improve the public’s health, with particular focus on: • Providing support to local and state health departments • Improving global health • Decreasing leading causes of death • Strengthening surveillance and epidemiology • Reforming health policies http://www.cdc.gov

26. Substance Abuse and Mental Health Services Administration (SAMHSA) • Mission – to reduce the impact of substance abuse and mental illness on America’s communities • SAMHSA includesfour centers • Center for Mental HealthServices • Center forSubstance Abuse Prevention • Center forSubstance Abuse Treatment • Center forBehavioralHealthStatistics and Quality • Centers workwith and supportStates, Territories, Tribes, communities, and local organizationstoaccomplishthemissionthrough 8 strategicinitiatives http://www.samhsa.gov/

27. Health Resources and Services Administration • Mission: To improve health and achieve health equity through access to quality services, a skilled health workforce, and innovative programs • Vision: Healthy Communities, Healthy People • Goals: • Improve access to quality care and services • Strengthen the health workforce • Build healthy communities • Improve health equity • 6 bureaus, 13 offices and 1,860 people improving health care for the uninsured, people living with HIV, pregnant women, mothers, and children http://www.hrsa.gov

28. Immigration and Customs Enforcement Health Service Corps • Oversees lawful immigration to the United States • Core Values include Integrity, Respect, Ingenuity, and Vigilance • Headquartered in D.C. with opportunities throughout the US and territories, including: • New York • Florida • Texas • Arizona • California • Puerto Rico http://www.uscis.gov

29. Centers for Medicare & Medicaid Services • Mission: to assure health care security for beneficiaries • Vision: to open our programs to full partnership with the entire health community to improve quality and efficiency in an evolving health care system. • Goals: • To provide access to quality care • To provide services to beneficiaries • To provide program administration to run CMS programs http://www.cms.hhs.gov/home/aboutcms.asp

30. Sample Pharmacist Billets FDA: CDER/OSE Safety Evaluator • Reviewing and evaluating pre-market proposed proprietary drug and biological names and product characteristics to determine the likelihood of confusion with existing products in the marketplace • Reviewing, analyzing, and evaluating the medication error reports for pre-market and post-market drug and biological products which are submitted to the FDA or cited in the scientific literature • Serving as a scientific advisor on adverse reactions associated with drug and biological products and on the safety of drug and biological products within FDA

31. Sample Pharmacist Billets IHS: Assistant Chief Pharmacist (Inpatient) • Serving as a Clinical Pharmacist for the ICU & Residency Program Director at the Indian Health Service Phoenix Indian Medical Center (PIMC) • Directing and coordinating clinical and distributive pharmacy services at this 110-bed facility • Providing pharmacotherapy services and distributive pharmacy services for ICU patients • Developing and implementing medication use policies • Developing and coordinating the ASHP accredited Pharmacy Practice Residency Program at PIMC • Active member of the Pharmacy and Therapeutics Committee

32. Sample Pharmacist Billets HRSA: Branch Chief for the AIDS Drug Assistance Program (ADAP) • Leading a team responsible for monitoring established ADAPs to improve health care for individuals and families affected by HIV • Establishing ADAP priorities to respond to issues that impact planning and delivery of HIV care services • Developing strategies for delivering care for HIV/AIDS • Guiding grantees to use the most cost-effective methods to purchase medications

33. Sample Pharmacist Billets HRSA: Branch Chief for the AIDS Drug Assistance Program (ADAP) • Assisting grantees in making formulary decisions • Preparing budget forecasting reports • Developing on-site program reviews of compliance with ADAP mandates and regulations • Addressing medication distribution strategies in resource-poor countries

34. Sample Pharmacist Billets NIH: Head of the Protocol and Information Office • Coordination of the administrative portion of the development and implementation of oncology clinical trials to assure patient safety • Optimization of scientific objectives, regulatory compliance, and efficient use of resources • Acting as a project manager to develop software to improve the efficiency of oncology clinical trials at the National Cancer Institute (NCI) by leveraging technology

35. Sample Pharmacist Billets Learn more about pharmacist roles at: Pharmacists Learning and Networking Together (PLANT) http://www.usphs.gov/corpslinks/pharmacy/sc_comms_plant.aspx

36. Why did I choose to be a PHS Pharmacist?

37. Why did I choose to be a PHS Pharmacist? • Quality of practice • Opportunities for professional growth

38. Quality of Practice • Pharmacy Practice wherein you are included in the decision process with other professionals, helping to manage treatment, utilizing the patient's medical record, and counseling every patient about their drug therapy • Pharmacy Practice settings where you and other providers sit down as a team and talk about your patient's drug therapy

39. Opportunities for Professional Growth Different agencies/programs Benefits accompany officers when transferring agencies/programs

40. Opportunities for Professional Growth • National and International Impact • Emergency Preparedness • USPHS Commissioned Corps: America’s Health Responders

41. Office of Force Readiness and Deployment (OFRD) OFRD coordinates the deployment of USPHS Officers in response to: • National Emergencies • Public Health Emergencies • Urgent Public Needs • National Special Security Events

42. OFRD Pharmacist Opportunities • Special Needs Shelters • General Shelter Clinics • Mobile Medical Clinics/Pharmacies

43. OFRD Pharmacist Opportunities • Vaccination Teams • Temporary Hospitals

44. OFRD Pharmacist Opportunities • Pharmacist assistance at disaster stricken hospitals • Assisting foreign Ministry of Health departments to establish health care systems: • Thailand (2005) • Iraq (2004) • Haiti (2004)

45. OFRD Pharmacist Opportunities • Incident Regional Coordination Team (IRCT) • Operations, Planning, and Logistics • Team Leaders and Incident Commanders • Public Health Assessment and Inspection Teams • Liaisons • State Emergency Operations Center • Homeland Security incident Management Group

46. OFRD - Make a Difference Hurricanes – September 2004 World Trade Center Attacks – Sept 2001

47. National Special Security Events Officers have deployed to provide assistance during the President’s Inauguration.

48. Foreign Humanitarian Missions USPHS Officers deploy aboard US Navy ships in support of annual humanitarian assistance operations providing medical care to foreign nations.

49. Foreign Humanitarian Missions Nigeria – September 2010 USNS Comfort Cruise – Sept 2009

50. Domestic Humanitarian Missions USPHS partners with Non-profit Groups to provide free medical care to the underserved populations within the United States.