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From the Reservation to the Medical Reserve Corps: One PHS Officer s Journey to a Career in Bioterrorism Prevention an

PHS History. 1798 - Marine Hospital Service established1889 - PHS Commissioned Corps officially established (along military lines) by Congress, with rank and pay similar to Navy1912 - Renamed Public Health Service. PHS Commissioned Corps One of the Seven Uniformed Services. PHS Mission . Protecting, promoting and advancing the health and safety of the nationThis mission is achieved through: rapid and effective response to public health needs leadership and excellence in public health practices the advancement of public health science.

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From the Reservation to the Medical Reserve Corps: One PHS Officer s Journey to a Career in Bioterrorism Prevention an

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    2. PHS History 1798 - Marine Hospital Service established 1889 - PHS Commissioned Corps officially established (along military lines) by Congress, with rank and pay similar to Navy 1912 - Renamed Public Health Service

    3. PHS Commissioned Corps One of the Seven Uniformed Services

    4. PHS Mission Protecting, promoting and advancing the health and safety of the nation This mission is achieved through: rapid and effective response to public health needs leadership and excellence in public health practices the advancement of public health science

    5. Surgeon General Priorities Overarching theme: Improve Health Literacy Increase Prevention Efforts Eliminate Health Disparities Enhance Public Health Preparedness

    6. HHS Agencies/OpDivs Agency for Healthcare Research and Quality (AHRQ) Agency for Toxic Substances and Disease Registry (ATSDR) Centers for Disease Control and Prevention (CDC) Food and Drug Administration (FDA) Health Resources and Services Administration (HRSA) Indian Health Service (IHS) National Institutes of Health (NIH) Office of the Secretary (OS) Substance Abuse and Mental Health Services Administration (SAMHSA)

    7. Non-HHS Agencies Department of Defense (DOD) Department of Homeland Security (DHS) Environmental Protection Agency (EPA) Federal Bureau of Prisons (BOP) National Oceanic and Atmospheric Administration National Park Service U.S. Agency for International Development (USAID) U.S. Coast Guard U.S. Department of Agriculture (USDA) U.S. Marshals Service

    8. Professional Categories Physician Nurse Pharmacist Dentist Veterinarian Engineer Scientist Environmental Health Officer Therapist Epidemiologist Mental Health Professional Others – Health Services Officers

    9. Eligibility Criteria U.S. citizenship < 44 years of age Qualifying degree from accredited University < 8 years prior service (active duty) Medically and physically fit

    10. Pay and Benefits Pay scale based on rank and time in service Some categories have special pays Non-taxable housing and subsistence allowances 30 days of paid leave per year (2.5 days per month) Sick leave granted as needed (no limitation) Non-contributory retirement (based on a 20-30 year career) Serviceman’s Group Life Insurance (up to $250,000 coverage) Full health care VA benefits (survivor and disability benefits, burial allowance, home loans, educational program, etc.) Base/Post privileges (commissary, exchange, officers’ club, etc.) Space available (Space-A) travel on U.S. military aircraft

    11. Student Opportunities Commissioned Officer Student Training and Extern Program (COSTEP) Junior Senior Internships Loan Repayment Program

    12. For more information about the Public Health Service: Website: www.usphs.gov Email: PHS@hhs.gov Telephone: 301-594-3360 or 1-800-279-1605

    13. My Career 1988-1994 – Indian Health Service Gallup, NM (Navajo) Rockville, MD (IHS Headquarters) Tuba City, AZ (Navajo) Fort Hall, ID (Shoshone-Bannock) Wanblee, SD (Pine Ridge Lakota/Sioux) 1994-1997 – Graduate School (UAB) + TDYs 1997-2000 – SAMHSA (St. Elizabeths Hospital) 2000-2003 – Office of Global Health Affairs 2003-present – Office of the Surgeon General Temporary Duty/Emergency Response Assignments

    14. Indian Health Service

    15. St. Elizabeths Hospital

    16. Special Assignment - USAID

    17. Operation Provide Refuge

    18. Montenegro November 1999 - USAID Consultation Needs assessment of the pharmaceutical supply situation Review Invoices Transparency? Need for Essential Drugs and Medical Supplies Many constraints – time, security, access

    20. HHS Office of the Secretary Office of Global Health Affairs

    21. Biotechnology Engagement Program (BTEP) Bioterrorism Prevention Public health is a national security issue What is the threat?

    22. Is it fact or fiction…

    23. Former Soviet Scientists Biopreparat had > 50,000 employees Decreased government support for scientific research in Russia/NIS “Requests for collaboration”

    25. Former Soviet Institutes Research institutes all over the Soviet Union Manufacturing R&D Collections of “bad bugs” Large sprawling campuses Un(der)-funded by Government Maintenance Utilities Equipment/supplies

    26. State Research Center for Virology and Biotechnology “Vector”

    27. State Research Center of Applied Microbiology “Obolensk”

    32. Goals: Non-proliferation: Keep former Soviet defense scientists and technicians employed in place Public Health: Apply scientific expertise towards public health needs in the region Sustainability: Train and mentor so that scientists may compete for “regular” funding

    33. Countries Involved Russia Republic of Georgia Kazakhstan Armenia Coming soon…Ukraine, Uzbekistan, Tajikistan Iraq? Libya?

    34. Results BT Prevention - Difficult to measure success 120 projects in portfolio >2000 former bioweapons scientists “engaged” Publications Presentations Patents

    35. Anthrax

    37. MRC Concept Developed

    38. State of the Union January 2002 President Bush calls for all Americans to offer volunteer service in their communities Formation of USA Freedom Corps and Citizen Corps announced

    40. To serve citizens and communities throughout the United States by establishing local teams of volunteers to strengthen the public health infrastructure and improve emergency preparedness Mission

    41. Status 255 MRC units in 47 states, the District of Columbia and the U.S. Virgin Islands Almost 40,000 volunteers: >5700 Physicians >450 Physician Assistants >700 Nurse Practitioners >9300 Registered Nurses >800 Licensed Practical Nurses >2100 Pharmacists >3100 Mental Health Professionals >1100 EMTs/Paramedics >450 Dentists >200 Veterinarians >400 Public Health Workers >3350 Other Medical >600 Other Public Health >9000 Other Non-medical/public health

    43. West Virginia MRCs Hancock County Marshall County Mid-Ohio Valley (MOV) Ohio County Pendleton County

    44. Health Departments Boards of Health Medical Centers/Hospitals Medical Societies Emergency Management Citizen Corps Councils Police/Fire Departments Volunteer Centers Faith Based Organizations American Red Cross Regional Planning Groups Medical Societies Non-Profit Community Organizations

    45. Health Departments Boards of Health Health Care Systems/Hospitals/Clinics Medical Retiree Groups Medical Examiners Offices Emergency Management Agencies Emergency Planning Committees Police and Fire Departments Community-Based Disaster Groups Healthcare Outreach Coalitions Retired and Senior Volunteer Programs Schools and Universities Emergency Medical Services Military Organizations/National Guard Neighborhood Associations City Attorney Offices Local Businesses/Corporations Metropolitan Medical Response System Coordinators CDC and HRSA Grant Coordinators SNS Coordinators Others…

    46. MRC Volunteers Local decision (based on needs) May include those in training, in active practice, or retired Medical and public health professionals Persons with no health experience who can help with communications, administration, logistics, and other essential functions

    47. MRC Activities Surgeon General’s Priorities for Public Health Increase Prevention Efforts Enhance Public Health Preparedness Eliminate Health Disparities Supporting Existing Community Resources Public Health Initiatives Emergency Preparedness and Response

    48. Supporting Existing Community Resources - Public Health

    49. Supporting Existing Community Resources - Emergency Preparedness and Response

    50. MRC Program Office Facilitate the formation, implementation, and sustainability of MRC teams in communities throughout the U.S. Coordinate mechanisms for information sharing Provide forums for discussions of “promising practices” and lessons learned

    51. MRC Program Goals Increase number of MRC units in communities across the U.S. Increase general awareness about the MRC program Provide technical assistance to communities Facilitate coordination, cooperation and information sharing among MRC units Facilitate coordination, cooperation and information sharing within HHS, among other Federal entities and with non-governmental organizations

    52. Increase Number Of MRC Units Targeted outreach “High-risk” areas Underserved areas

    53. Increase General Awareness Presentations Exhibit booth Brochure Articles Listserv Website

    54. Provide Technical Assistance MRC Technical Assistance Series MRC website: www.medicalreservecorps.gov Documents from MRC units Links to other resources TA Consultation MRCcontact@osophs.dhhs.gov (301) 443-4951

    55. Coordination Among MRC Units Coordinators State Regional MRC Message Board Meetings State Regional National

    56. Coordination and Information Sharing at National Level HHS OSG OPHEP HRSA CDC White House Homeland Security Council USA Freedom Corps DHS Citizen Corps (+ partners) MMRS NDMS VA DOD Non-governmental Groups ASTHO NACCHO NALBOH AMA ANA ASHP APHA AHA Many Others

    57. Contact Information: Robert J. Tosatto, RPh, MPH, MBA Commander, US Public Health Service Director, Medical Reserve Corps Program Office of the Surgeon General Room 18C-14, Parklawn Building 5600 Fishers Lane Rockville, MD  20857 Tel. (301) 443-2528 Fax (301) 480-1163 rtosatto@osophs.dhhs.gov www.medicalreservecorps.gov

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