Changes Aim to Strengthen Military Health System

By Cheryl Pellerin
American Forces Press Service

WASHINGTON, March 2, 2012 – A proposed new governance structure will make the military health system more effective and produce savings, and the system’s 9.8 million beneficiaries worldwide will never miss an appointment, the Pentagon’s top health affairs official said.

In a Feb. 24 interview with the Pentagon Channel and American Forces Press service, Dr. Jonathan Woodson, assistant secretary of defense for health affairs and director of the TRICARE Management Activity, discussed three governance reforms under way for the military health system.

Woodson, a vascular surgeon, said it’s been a transformative decade for the nation and the Defense Department.

“Our defense health program budget was about $19 billion in 2001, [and] this year’s budget is about $53 billion,” he said. “So we clearly need to not only focus on accessing quality care, but [also on] producing value for the amount of money we’re spending on health care.”

As the health care budget grows and the Defense Department’s top-line budget shrinks, Woodson added, “a natural tension is created in terms of being able to train, man and equip the force, yet provide for quality health care.” He said everything possible must be done to reduce costs in the military health care system before adjusting fees for medical services.

The effort began in June, Woodson said, when then-Deputy Defense Secretary William J. Lynn III established an internal task force to review the military health system’s governance. The task force reported back in September, evaluating health system governance options as well as options for the governance of multiservice medical markets and of the national capital region’s health system.

Based on the report and on consultations with the services’ top civilian and military leaders, the chairman of the Joint Chiefs of Staff and other senior Defense Department officials, the current deputy defense secretary, Ashton B. Carter, now has directed that three reforms be instituted in the military health system.

One involves creating a defense health agency to take on the functions of the TRICARE Management Activity and assume responsibility for implementing shared services across the system. TRICARE is the civilian care component of the military health system.

“One of the things we looked at is whether new MHS governance could produce greater efficiencies and savings,” Woodson said. The main structure being proposed, called the Defense Health Agency, “looks to do a better job administering what we call shared services,” he added.

“Right now we have essentially three administrative structures -- the Army, Navy and Air Force -- that run health services,” the Defense Department’s top doctor explained. “The thought is that we would combine functions that are common to the services, and thereby produce savings.”

He cited health information technology as an example, noting that it is extraordinarily costly and is common to all of the services. “There [is] no reason why the services should develop their own products,” Woodson said. “This can be done in a shared fashion and produce savings.” Other common areas, he added, are medical education for physicians, nurses, medics and pharmacists, and medical logistics.

Another proposed reform will establish market managers for multiservice medical markets, except for the national capital region. The managers’ enhanced authorities will allow them to create and sustain a cost-effective, coordinated and high-quality health care system, Woodson said.

The third reform involves transferring responsibility for running military treatment facilities in and around Washington, D.C. -- including Walter Reed National Military Medical Center in Maryland and Fort Belvoir Community Hospital in Virginia -- to a national capital region directorate within the new Defense Health Agency.

Carter also is establishing a planning team, Woodson said, with leadership nominated by the undersecretary of defense for personnel and readiness and Joint Chiefs Chairman Army Gen. Martin E. Dempsey, to ensure timely implementation of the governance plan after it’s reviewed -- first by the Government Accountability Office and then by Congress.

Each organization has more than 100 days to review the proposal, so changes in the medical system’s governance, if approved, probably would not be instituted until early next year, Woodson said.

“The whole idea is to look forward,” he said, “understanding that we need to bend the curve of the health care budget to look at a governance structure that makes us more effective, more agile and adds value to the services and their ability to deliver high-quality care.”

Newest MH-60R Squadron Established Aboard NASNI

By Mass Communication Specialist 3rd Class Shawnte Bryan, Navy Public Affairs Support Element West

SAN DIEGO (NNS) -- The "Blue Hawks" of Helicopter Maritime Strike Squadron (HSM) 78, the fourth of six HSM squadrons established, held its commissioning ceremony aboard Naval Air Station North Island, March 1.

"The significance of this establishment ceremony is to introduce to our Navy, the public, and soon those across the globe that the HSM community's newest MH-60R Carrier Air Wing squadron has arrived," said Capt. Jeffrey W. Hughes, commander of Helicopter Maritime Strike Wing Pacific. "We are meeting a significant milestone in its progression to becoming the primary and premiere aviation sea control asset."

After months of training its pilots and maintenance crew while acquiring all of their equipment and preparing for maintenance inspections, the crewmembers were able to enjoy the benefits of being the first members of the HSM-78 squadron.

"It's a rare occasion and a great day when a new squadron is commissioned in the Navy, " said HSM-78 first Commanding Officer Cmdr. William Bucey. "And it's a very unique opportunity to stand up a squadron, I am honored."

"I am loving the fact that I get to be a plankowner," said Aviation Machinist's Mate 1st Class Marvin Journet. "I've been in the Navy for 15 years and this is my first time being a plankowner."

"The Blue Hawks will contribute unique and awesome capabilities to the geographic combat commanders in the Pacific and Central areas of responsibilities to provide necessary influence to global affairs via humanitarian assistance and disaster relief efforts or through kinetic striking power," Hughes said.

HSM-78 is currently assigned to Carrier Air Wing 17 and is scheduled to deploy aboard USS Carl Vinson (CVN 70) in 2014.

HSM-78 will consist of 280 crewmembers, both enlisted and officers, and 11 new MH-60R Seahawk Helicopters before their first deployment.

"I can say with absolute confidence that they will be ready," said Hughes.

Bucey said all of the other helicopter squadrons are going through the transition of changing from flying MH-60B helicopters to flying MH-60R model.

NHB Corpsman Recognized at American Red Cross 'Real Heroes' Event

By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs

BREMERTON, Wash. (NNS) -- A hospital corpsman from Naval Hospital Bremerton was recognized by the American Red Cross serving King and Kitsap Counties as their recipient of the 2011 Military award March 1.

Hospital Corpsman 1st Class Marvin Belanio was honored for his lifesaving efforts at rendering emergency first aid on an airline flight at the 13th Annual Real Heroes Breakfast that drew a packed crowd of civic and community leaders.

"I'm surprised and humbled by being recognized for doing something that any corpsman would have done in such a situation," said Belanio, leading petty officer for NHB's Bio Medical Repair division.

Belanio was returning last May to NHB from a fiscal logistics symposium in Maryland aboard a Delta Airlines flight. Just as he put his headphones on and began to relax for the five hour flight, he heard a thump on the plane's floor. Looking ahead a few rows, he spotted a gentleman lying on the floor. The fellow passenger had collapsed, and just as Belanio started towards the man, the flight crew was calling for assistance from a doctor, or anybody with medical experience. A quick look around confirmed to Belanio that he was the only one qualified to handle the situation.

"I might have actually felt more than heard the thump of the passenger falling. The gentleman fell face first and obviously medical assistance was immediately needed. When I reached him, I noticed he had a pallid color and wasn't breathing. There was commotion and flustered people around him. Some wanted to move him, but I quickly took charge. The last thing we wanted to do in such a situation is move anyone in such a condition because there could be some type of spine injury. Especially with the kind of force he had to incur landing the way he did."

"I didn't see the passenger go down but I did notice that HM1 Belanio jumped out of his seat right away to render assistance. It was 'corpsman up' and there he was. While everyone else was looking around for someone to step up, that's exactly what he did. He told the flight attendants, "I'm a Navy corpsman and I can help him," said Lt. j.g. Rachel Smith, NHB assistant department head for Materiel Management, who was also on the flight and sitting three rows behind Belanio.

Belanio assessed the patient and administered cardiopulmonary resuscitation (CPR) that resuscitated the passenger. "I did the 'look-listen-feel' and received no response. I started the CPR which got his breathing back," Belanio said.

For the remainder of the flight, Belanio continued to assess and monitor the passenger.

Upon arriving in Seattle, Belanio briefed the emergency responders waiting to take over, was personally thanked by the flight crew and passengers, and was later awarded a free flight and bottle of champagne from Delta Airlines.

"HM1 Belanio has experience in combat caring for Marines and Sailors. He's a stand-up guy who always does the right thing. He has earned the right to be called 'doc' by his Marines, which is the highest honor for a hospital corpsman. What he did on that flight to help just showed why he is a 'doc', said Smith.

"I really don't consider myself a hero, but my wife Michelle does tell our two-year old that 'daddy is a hero,' and it is pleasing that she thinks that. My parents are also very happy and proud," said Belanio, a Wash. native and 13-year Navy veteran, with a background in emergency care. Belanio has served two tours in Iraq with Marine units as well as taught trauma support courses such as Tactical Combat Casualty Care training.

"Basic life support is something all corpsmen know. It's what we do. I think that all of us in uniform who are making such sacrifices to care for others are the real heroes. A hero is just someone at the right place at the right time to make an effort to help when needed," said Belanio.

The American Red Cross Real Heroes Breakfast celebrates extraordinary acts of courage and compassion by Kitsap County and North Mason County heroes, with those honored being chosen from hundreds of applications by a selection committee. Each Real Hero from the greater Kitsap Peninsula had a special tribute for their respective acts of heroism which included such as areas as; Good Samaritan, Animal Rescue, Call to Action, Law Enforcement, Fire Rescue, Good Neighbor, Medical, Preparedness, Water Rescue and Military.

Face of Defense: Former POW Shares Reintegration Tips

By Bo Joyner
Air Force Reserve Command Public Affairs

SAN DIEGO, March 2, 2012 – Having spent more than five years in prisoner-of-war camps during the Vietnam War, Lee Ellis knows how difficult it is to reconnect with family and friends after a long military separation.

Ellis shared his experiences and tips for reintegration with about 450 Air Force reservists and their family members here during a Feb. 25-26 Yellow Ribbon event.

"War damages you," Ellis, a retired Air Force colonel, told his audience. "It damages you mentally, emotionally, spiritually. Except for anger, I know I totally shut down emotionally while I was a POW. That works great during war, but it doesn't work when you get back home. You have to reconnect with your emotions when you get home."

Ellis said there were some challenges connecting with his family and friends until he was able to reconnect with his own emotions.

"I was not always easy to live with," he recalled. "I was controlling. I was hyper-vigilant. I was hyper-sensitive to criticism. And I was also dealing with feelings of guilt because a lot of my friends never made it home. It took a lot of time to get a handle on all of the things I was feeling and to reconnect with the people who were closest to me."

Ellis urged the reservists on hand, all of whom are either facing a deployment in the near future or are just returning from a deployment, to be patient when they begin the reintegration process.

"Don't expect perfection," he said. "It's going to take some time for things to be the same way they were before you left, but you will get there."

Ellis also encouraged the reservists and their family members to have a support system in place.

"The Navy SEALs have a saying that they never fight alone, and you shouldn't try to fight this battle alone," he said. "You need to have someone in your life you can tell anything to, someone who can help you deal with the emotions you are going to be feeling when you get home from your deployment or when your loved one gets home. And if you don't have someone like that, you need to know there are a lot of resources available right at your fingertips."

Like other Yellow Ribbon events held throughout the country each year, the event in San Diego was designed to let reservists and their family members know exactly what helping resources are at their disposal.

"Our main goal is to let our people know help is available and how to find it," said Mary Hill, the director of Air Force Reserve Command's Yellow Ribbon program. "We have chaplains, military family life consultants, psychological health advocates, [Veterans Administration] specialists and a host of other experts on hand at every Yellow Ribbon event to help reservists and their family members deal with any problems they may be experiencing.

"Things have changed quite a bit since Colonel Ellis came home from the Hanoi Hilton," she continued. "We're doing a lot more to try and take care of those who serve and those who support."

Ellis was 24 years old and flying his 53rd combat mission over enemy territory when his F-4C Phantom jet was taken down by enemy fire. He spent the next five-and-a-half years in various prisons, including the infamous Hanoi Hilton. He spent his first year in a 6 1/2-by-7-foot cell with three other prisoners, surviving on a diet of either pumpkin or cabbage soup and bread.

"We had a strategy for resistance based on the power of honor," Ellis said. That strategy, he said, revolved around being willing to take torture to resist, realizing that everyone can be broken, minimizing the enemy's net gain, bouncing back, and staying united through communications.

Ellis said he and his fellow POWs developed a tap code and a hand code so they could keep in touch with each other during long periods of separation.

"Communication was critical," he said. "Being able to communicate with the people in the adjoining cells helped us be more resilient and let us know we could get through most anything."

Ellis said another thing that helped tremendously during his confinement and in his reintegration into life back home was the fact that toward the end of his time as a POW he was moved into a large holding area with 55 other prisoners.

"During those last few months, the torture stopped, and we were grouped together," he said. "This gave us some time to decompress before we went home. Today, I don't think we get a lot of time to decompress, and it makes it a little harder to reintegrate into society."

After his return home from the Hanoi Hilton, Ellis went back to flying and assumed positions of leadership, including flying squadron commander. He was awarded two Silver Stars, the Legion of Merit, the Bronze Star with valor device, the Purple Heart and the POW Medal. He retired with 24 years of service.

Reservists who are facing a deployment or who have recently returned from a deployment are eligible to attend a Yellow Ribbon event. For more information, they should contact their unit's Yellow Ribbon representative.

USS San Antonio Earns "Battle E"

From Naval Surface Force Atlantic Public Affairs

NORFOLK, Va. (NNS) -- The officers and crew of USS San Antonio (LPD 17) were today presented with the Battle "Battle E" award by the commander of Amphibious Squadron (COMPHIBRON) 4.

"Everyone who believes that San Antonio is still broken and on the sidelines will now realize that we are not," said San Antonio Commanding Officer, Cmdr. Neil Koprowski. "We won the Battle E. We are back and ready to take on all missions."

San Antonio was recognized for superior performance over the past year, and for several significant achievements, displaying excellence in maritime warfare capabilities, engineering/survivability, command and control, and the type commander's Safety Award.

The Battle E award is based on a yearlong overall evaluation of San Antonio accomplishments during training exercises, various command inspections and nomination by their immediate superior in command COMPHIBRON 4.

"It's all of you that are making this ship succeed," said Capt. Peter Pagano, commander, COMPHIBRON 4, during a morning all-hands call aboard San Antonio. "It's the officers, chiefs and Sailors on this ship, down to the most junior seaman that will continue to do so through INSURV (Board of Inspection and Survey assessment scheduled to begin April 23). You all should be very proud to be San Antonio Sailors."

Eligibility for the award required a consistent day-to-day demonstration of excellence and superior achievement during all certifications and qualifications conducted following departure from the shipyard last year.

San Antonio may now display the big white letter "E" with the black shadow on its super structure along several other awards as a testament to the focus, teamwork, pride and ownership demonstrated throughout a rigorous maintenance and basic phase.