Naval Medical Logistics Command Operational Forces Support Directorate

2. FOR OFFICIAL USE ONLY 2 What do I need to know about Class VIII when my team deploys? Theater Lead Agent for Medical Materials (TLAMM) Requisition Flow DMLSS Customer Assistance Module (DCAM) Connectivity Process Flow CENTCOM Operational Policy Overview MedPDB (Med/Surg Product Data Bank) JDF (Joint Deployment Formulary) Medical Air Bridge OEF 10.1-2 Challenges In-Theater

3. Class VIII Supplies Protected by Geneva Convention FOR OFFICIAL USE ONLY 3 Medical material and supplies are protected under the law of land warfare and the Geneva Conventions. However, when medical material and supplies are mixed with combat supplies, they lose the protection afforded by these covenants. Marking of medical material and supply storage areas with the red cross of the Geneva Conventions is a tactical decision to be made by the area commander. The Geneva Conventions and the law of land warfare prohibit the destruction of medical material and supplies that must be abandoned in a retrograde movement occasioned by enemy action or other tactical considerations. Medical material and supplies are protected under the law of land warfare and the Geneva Conventions. However, when medical material and supplies are mixed with combat supplies, they lose the protection afforded by these covenants. Marking of medical material and supply storage areas with the red cross of the Geneva Conventions is a tactical decision to be made by the area commander. The Geneva Conventions and the law of land warfare prohibit the destruction of medical material and supplies that must be abandoned in a retrograde movement occasioned by enemy action or other tactical considerations.

4. FOR OFFICIAL USE ONLY 4 Provide Class VIII medical equipment & supplies to the Marine Air-Ground Task Force (MAGTF). AMALs/ADALs are task organized to facilitate rapid deployment. In theater, MedLog�s Mission is a combination of AMAL assemblages and line item resupply. AMAL block re-supply is used to reinforce the FRSS/STPs in the AOR. 5 levels of health care Level 1=First aid/buddy aid (stabalization) Level 2=Initial resuscitative care (treatment) Level 3=Resuscitative care Level 4=Definitive care Level 5=Rehabilitative careProvide Class VIII medical equipment & supplies to the Marine Air-Ground Task Force (MAGTF). AMALs/ADALs are task organized to facilitate rapid deployment. In theater, MedLog�s Mission is a combination of AMAL assemblages and line item resupply. AMAL block re-supply is used to reinforce the FRSS/STPs in the AOR. 5 levels of health care Level 1=First aid/buddy aid (stabalization) Level 2=Initial resuscitative care (treatment) Level 3=Resuscitative care Level 4=Definitive care Level 5=Rehabilitative care

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6. FOR OFFICIAL USE ONLY 6 +As the Source of Supply, MedLog currently uses TEWLs out in-theater. +Currently in OEF, most using units are NOT connected to DCAM and are using spreadsheets to place orders. +Why is this occurring? A using unit has to have TMIP (Theater Medical Information Program) installed in their computer because DCAM is packaged within the TMIP program. Because of firewall issues within theater. Each base/fob has it�s own encrypted network (not like in the states). DCAM has to have a specific IP address generated by the TLAMM in order to be functional. CURRENT SITUATION IN OEF 10.1 -MedLog currently using DCAM, not TAMMIS. -TEWLs is used by the TLAMM, not SOS -MedLog uses the TEWLs portal for the following actions: +product research +track order status +input NIRs +The TEWLs portal does not allow you to: manage inventory or place orders. +As the Source of Supply, MedLog currently uses TEWLs out in-theater. +Currently in OEF, most using units are NOT connected to DCAM and are using spreadsheets to place orders. +Why is this occurring? A using unit has to have TMIP (Theater Medical Information Program) installed in their computer because DCAM is packaged within the TMIP program. Because of firewall issues within theater. Each base/fob has it�s own encrypted network (not like in the states). DCAM has to have a specific IP address generated by the TLAMM in order to be functional. CURRENT SITUATION IN OEF 10.1 -MedLog currently using DCAM, not TAMMIS. -TEWLs is used by the TLAMM, not SOS -MedLog uses the TEWLs portal for the following actions: +product research +track order status +input NIRs +The TEWLs portal does not allow you to: manage inventory or place orders.

7. FOR OFFICIAL USE ONLY 7 CENTCOM Operational Policies ANNEX Q-PLANNING GUIDANCE, MEDICAL SERVICES - WHY IS IT IMPORTANT? Because it�s the document used by medical planners and provides guidance for medical services and is used for pre-deployment planning. Appendix 6= Medical Logistics CENTCOM MOD X - WHY IS IT IMPORTANT? Because it�s the guidance for individual unit deployment readiness in the CENTCOM AOR. U.S.C. Title 10-Armed Forces - WHY IS IT IMPORTANT? Because it states the appropriation authority and responsibility for the Armed Services. There are 5 subtitles. Subtitle C governs the Navy & Marine Corps. NAVCENT MEMO N007/097 dtd 20100221 - WHY IS IT IMPORTANT? Because it gives USAMMC-SWA the procurement authority to purchase Navy & Marine Corps equipment for AMAL assemblages. -NAVCENT Memo N007/097 dtd 20100221 Because this is the Memo that gives USAMMC-SWA the procurement authority as part of their delegation of authority to exercise OPCON and ADCON of U.S. Navy Forces in the AOR. This allows USAMMC-SWA to purchase equipment for the Marine Corps AMAL configurations that we utilize. This memo governs equipment acquisitions. -NAVCENT Memo N007/097 dtd 20100221 Because this is the Memo that gives USAMMC-SWA the procurement authority as part of their delegation of authority to exercise OPCON and ADCON of U.S. Navy Forces in the AOR. This allows USAMMC-SWA to purchase equipment for the Marine Corps AMAL configurations that we utilize. This memo governs equipment acquisitions.

8. FOR OFFICIAL USE ONLY 8 What is a FRAGO? FRAGO means �Fragmentation Order� - It is a planning document that outlines a specific mission or problem that must be resolved. It is formulated by HHQ�s Planners out in-theater and outlines the following: Task Organization Mission Execution FACTs about FRAGOs: FRAGOs are in-theater documents It is obtained on the high side (SIPR) Usually for a short fused, mission need Once FRAGOs are completed, turnaround time is expected within 48-72 hours Medical + Logistics are usually the last to know about FRAGOs Explain example in OIF 08.1. Explain example in OIF 08.1.

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10. FOR OFFICIAL USE ONLY 10 The Joint Deployment Formulary (JDF) is the recommended list of Pharmaceutical products to be used and ordered by Deployed Forces. This list is continually updated to ensure that specific product is still the standard of care and is available for use and ordering. Use of the Formulary has reduced the order, ship time, and back order for Deployed Forces. The full JDF list is available at the DMSB website: https://www.dmsb.mil/ +Why is the JDF important? -Because when you are deployed, you cannot order items outside of the formulary because the TLAMM will deny your order. There are also special circumstances, as well. +Antivenin and rabies example +Psychotropic medications example. These types of medications alters perceptions, mood, consciousness, and behaviors. +Examples include: -Pain control medications -Psychiatric Medications: anti-depressants or mood stabilizing drugs +Why is the JDF important? -Because when you are deployed, you cannot order items outside of the formulary because the TLAMM will deny your order. There are also special circumstances, as well. +Antivenin and rabies example +Psychotropic medications example. These types of medications alters perceptions, mood, consciousness, and behaviors. +Examples include: -Pain control medications -Psychiatric Medications: anti-depressants or mood stabilizing drugs

11. FOR OFFICIAL USE ONLY 11 The Medical Air Bridge expedites the delivery of high-priority medical materiel to Warfighters overseas. Medical materials shipped overseas within 24 hours. -Must pay a premium for this service (EXPENSIVE) There were two main reasons DLA Troop Support Medical Supply Chain developed the MAB: There were competing requirements for transportation resources (e.g. personnel, ammunition, and food versus medical supplies) often resulting in delays in the delivery of medical materiel. The need to provide expedited delivery service and in-transit visibility (ITV) of medical materiel so customers can track order progress. Medical Air Bridge OEF 9.1-2 Supply Pushes Global tasker to all MedLog�s to provide Class VIII medical supplies ISO OEF. 1st MedLog 40% 2nd MedLog 40% 3rd MedLog 20% OEF 9.1-2 Supply Pushes Global tasker to all MedLog�s to provide Class VIII medical supplies ISO OEF. 1st MedLog 40% 2nd MedLog 40% 3rd MedLog 20%

12. FOR OFFICIAL USE ONLY 12 OEF 10.1 & 10.2 Challenges In-theater  Warehouse fire TAMMIS & DCAM Installation and connectivity issues Ordering CBRN medications ATNAA & Diazepam Autoinjectors Doxycycline FDA not approving shelf life extension OIF Supply/Equipment Retrogrades OEF 9.1/2 Supply Pushes No E-docs machine (currently using POGs for Oxygen)

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