Navy Medical Flag Conference BUMED Headquarters 01 December 2008

1. Navy Medical Flag ConferenceBUMED Headquarters01 December 2008 J. Jerry LaCamera, M1 Deputy Chief BUMED, Dir. Total Force

2. MHS STRATEGIC PLAN Overarching Guidance SECNAV CNO &CMC 2009 • People • Agile Forces • Deployment Readiness • Effective Force Health Protection • Quality of Care • Patient & Family Centered Care • Performance Based Budgets • Research & Development Guidance NAVY MEDICENE’S STRATEGIC PLAN QDR

3. Manpower Transformational Period USMC Growth/OSCAR EMF UTC’s development Iraq to Afghanistan Focus on USMC Supt Adaptive Core & GWOT Mil-to-Civ Conversion Positions Restored as is Competing future demands 588 Restoral?? Human Capital Strategic Goal: Build and maintain unified joint manpower information management capabilities Manning Review Last ZBR done in 1980’s Last ER done in 1995 Navy RC ZBR underway Multiple Reqmts Models M-1 Challenges and Focus Ed & Training Medical Education &Training Campus (METC) – BRAC Consolid. Live Animals in Medical Education & Training • Joint Analysis Team Review MHS Human Capital Strategic Plan Simulation for Medical E&T • e.g. PULSE Personnel “Shaping” Personnel Inventories: • Specialty shorts/overages Special Pay Shortfalls: • ~$38M in FY 09 HPSP shortfall: • ~ $5.7M RPN in FY09 FY 09 Mental Health Incentives • Psychiatrists, Clinical Psych, Soc Worker, MHNP bonuses. • HPLRP eligible NSPS • Completion of 1st rating cycle • YG-1 Pay for Civ Resid. Title 38 Hybrid (VA Like)

4. BACK UP

5. Total: 7,545 DON MEDICAL RESERVE (SELRES) by Corps/Rate Total Labor Force: 66,419 (Medical and Non-Medical) DON Medical Workforce: FY08Total Force Break-out

6. Mil-to-Civ-to-MilProposed 4204 Glide Slope FY09-FY15 Execution Breakout by Corps by FY

7. I MEF II MEF III MEF CDR Psychiatrist LCDR Psychologist LCDR Psychologist LT Psychiatric MHN Practitioner LT Psychiatric MHN Practitioner LT Psychologist LT License Clinical Social Worker LT License Clinical Social Worker 1 - HM1 8485 4 - HM2 8485 4 - HM3 8485 CDR Psychiatrist LCDR Psychologist LCDR Psychologist LT Psychiatric MHN Practitioner LT Psychiatric MHN Practitioner LT Psychologist LT License Clinical Social Worker LT License Clinical Social Worker 1 - HM1 8485 4 - HM2 8485 4 - HM3 8485 CDR Psychiatrist LCDR Psychologist LCDR Psychologist LT Psychiatric MHN Practitioner LT Psychologist LT License Clinical Social Worker 1 - HM1 8485 2 - HM2 8485 4 - HM3 8485 MFR CDR Psychiatrist CDR Psychologist LT Psychiatric MHN Practitioner LT License Clinical Social Worker 1 - HM1 8485 3 - HM2 8485 OSCAR Teams at Division Pre-decisional Info TOTAL BUILD FOR DIVISION 4 CDR Psychiatrist 1 CDR Psychologist 6 LCDR Psychologist 6 LT Psychiatric MHN Practitioner (1973P) 6 LT License Clinical Social Worker 3 LT Psychologist 4 HM1 8485 13 HM2 8485 12 HM3 8485

8. OSCAR BUILD • All OSCAR billets will be organic to USMC at the MEF level. Total of 26 Officer/29 enlisted. • All organic OSCAR billets will be funded by reprogramming existing medical billets to this function. • APL Model estimates the number of BSO 18 Officer billets required to support the USMC OSCAR structure. (34 Officers)

9. Officer 6 General Surgeons (MC) 1 Orthopedic Surgeon (MC) 2 GMO (MC) 6 CC Nurses (NC) 3 Registered Prof Nurses (NC) 3 Physician Assistants (MSC) 1 POMI (MSC) 2 HCA (MSC) 1 Environmental Health Officer (MSC) 1 Dentist (DC) Enlisted 1 Surface IDC (8425) 15 HM Field Medical Tech (8404) 12 OR Tech (8483) 1 Preventive Med Tech (8432) BSO 27 Compensation Billets

10. OSCAR Requirement TBD* * BSO 18 reqmt as estimated by the APL Manpower Model. Model is still in development and currently only addresses Officer Specialty communities.

11. FY09 MH incentives Psychiatrist Incentives in FY09 CWSAB increased from $175K to $272K MSP increased 4 yr MSP from $33K/year to $43K/year ISP variable increased from $15K/yr to $20K/yr ASP, BCP, VSP Clinical Psychologist (must be licensed) Accession Bonus $60K 4yr, $37.5K 3yr Incentive Pay after completing Internship and licensure $5K Board Certification Pay $6K Retention Pay $20K 4yr, $15K 3 yr, $10K 2yr after completing training obligation or initial ADSO Clinical Social Workers (fully licensed) Accession Bonus $30K 4yr, $18.75K 3yr BCP Mental Health Nurse Practitioners and Psychiatric Nursing Accession Bonus $30K 4yr, $20K 3yr ISP - 4yr $20K, 3 yr $15K, 2yr $10K, 1 yr $5K BCP Health Professional Loan Repayment (HPLRP) All Mental Health Professionals are eligible for retention and accession HPLRP

12. Mental Health Gains and Losses

13. FY08/FY09 Medical Department Special Pays Projected FY09 budget $248M FY08 Expenditure $209M Actual FY09 control $213M $,000

14. HPSP Funding Shortfall • HPSP is critical to Medical Corps and Dental Corps • HPSP Tuition is funded by DHP • The stipend, ACDUTRA, and accession bonus funded by RPN • Navy is short $5.7M RPN in FY09 • $20K accession bonus implemented in late 2007. • DoD increased HPSP stipend from $1349 in FY-07 to $1907 per month in FY08 • Options if additional RPN funds not received • Access students and pay stipends until totally out of RPN funds. RPN funds will be exhausted by the third week of August 2009. • Stop recruiting when the RPN account runs out of funds for new students. There would need to be enough funds in reserve to continue full benefits for existing students. Navy would only be able to recruit approximately 55 HPSP MC, 75 DC, 30 MSC, and 54 NCP. • The HPSP RPN account is fully funded in 2010

15. Recruiting Accession Education Practice Proficiency Training Training Surge Developing Medical Capability Honing and Sustaining Medical Capability Bridging Care From Theater to Homeport Operational Medicine IAs Education A Medical Manpower StrategyThe Total Force Concept Ends Beneficiary Care Objective Readiness Mission Ways Means Clinics and Hospitals Fleet and Fleet Marines