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Medical Equipment Concentration Sites: A Management Solution for Army Reserve Medical Equipment Repair and Training Needs

The author suggests medical equipment concentration sites as a possible solution to the Army Reserve’s deficiencies found by the Army Audit Agency.

The Army Reserve has a serious problem. It failed a 2008 audit, conducted by the Government Accountability Office and the Army Audit Agency, of its medical equipment maintenance program. The program’s failures were also the focus of a RAND Corporation study that was presented at the August 2009 FORSCOM (Army Forces Command) Combat Support Hospital (CSH) Conference. The study showed that most of the medical equipment sets in the Army Reserve are not mission capable.
The sustainment and maintenance of Reserve component medical equipment sets have taken a back seat to other priorities and have not received appropriate attention and funding. Moreover, the existing medical equipment sets are too large and cumbersome for units to maintain properly.

Operational Changes

It was also noted during the FORSCOM conference that, effective immediately, regional training sites-medical (RTS–MEDs) will no longer provide medical maintenance support to CSHs. However, they will provide support to small modification table of organization and equipment medical units that do not have organic military occupational specialty (MOS) 68A biomedical equipment technicians (BMETs).

Currently, medical logistics companies are tasked to provide medical maintenance support to CSHs that have insufficient or no BMETs assigned. This practice frees up RTS–MED BMETs to do a better job of supporting the collective training needs of Active and Reserve component units.

Potential Problems

Unfortunately, under the current system, Reserve component CSHs do not have a viable way to repair and maintain medical equipment without RTS–MED support. No training program is currently in place for BMET personnel to receive additional MOS training after they complete basic medical equipment training during advanced individual training.

Given these circumstances, it is clear that the current system for maintaining biomedical equipment in field units is inadequate. The Army Reserve must establish a system that will provide quality MOS training of BMETs. It also needs a system that will allow units to track, repair, maintain, and replace unserviceable medical equipment to meet medical equipment readiness requirements.

Basic Equipment Concentration Sites

To accomplish this, the U.S. Army Reserve Command (USARC) and the Army Medical Department should follow the RAND study recommendations and develop new medical basic equipment sets that are limited to the minimum amount of equipment that units need to conduct medical training at home station. Because of constraints on training and maintenance assets, basic equipment sets for the Army Reserve should not exceed 20 pieces of durable and nonexpendable medical items.

To best manage current and projected medical equipment repair and training requirements, the Army Reserve should adopt the Ordnance Corps’ model of area maintenance activities and equipment concentration sites for the maintenance and sustainment of medical equipment items that are not part of the proposed basic equipment sets. We could call these “medical equipment concentration sites.”

Using this model, the Army Reserve could establish four medical equipment concentration sites in the continental United States (two in the 807th Medical Deployment Support Command [MDSC] area of responsibility, at Ogden, Utah, and Seagoville, Texas, and two in the 3d MDSC area of responsibility, at Fort Dix, New Jersey, and Gulfport, Mississippi). Army Reserve medical units would store all existing medical equipment sets (minus the proposed bare bones basic equipment sets) at these medical equipment concentration sites.

Site Staffing Requirements

The two MDSCs would staff each medical equipment concentration site with four or five Active Guard/Reserve (AGR) medical maintenance personnel, three or four AGR medical logistics support personnel, three AGR materials-handling personnel, and three military technician administrative personnel. These spaces, intended to augment the units that conduct the medical equipment concentration site mission, would come from authorized full-time unit-support positions located in other Army Reserve medical logistics companies. Troop program unit (TPU) medical logistics personnel (MOS 68A and 68J, medical logistics specialist) would augment this full-time unit support staff on warrior training weekends and during extended combat training (formerly called annual training).

Most importantly, each medical equipment concentration site should include at least two BMET civilian contractors. These positions are key to the success of this support concept. Without civilian contractor support, the medical repair capabilities at medical equipment concentration sites will cease or become unsustainable when we mobilize the AGR or TPU logistics personnel assigned to conduct the medical equipment concentration site mission. The total annual cost for USARC to fund two full-time civilian contractors at each site would be an estimated $640,000 to $800,000 annually.

Site Facility Requirements

Each medical equipment concentration site facility should consist of at least 12,000 square feet of environmentally controlled warehouse space with shipping dock capabilities and an integrated medical maintenance shop designed and equipped to support the full scope of Army Reserve medical equipment. The medical equipment concentration site should have the necessary tools; test, measurement, and diagnostic equipment; materials-handling equipment; and medical repair parts to conduct proper maintenance operations.

These medical equipment concentration sites would enable the Army Reserve to provide Reserve component medical logistics personnel with quality mission-related MOS training opportunities during warrior training weekends and extended combat training. BMET personnel assigned to medical logistics companies that perform hands-on-training missions would also receive training opportunities while supporting customers.

USARC should fund and incorporate medical equipment concentration sites with full-time nondeployable civilian contract personnel, who are supported by AGR, military technician, and TPU medical logistics personnel. By doing this, medical maintenance readiness levels would improve dramatically, and units could focus less on maintenance and more on training requirements, especially during the critical train-up phase of the Army Force Generation cycle.

The contractor support option would provide continuity of service to nonmobilized Reserve component medical units when units with the medical equipment concentration site mission mobilize.

The medical equipment concentration site concept provides real training opportunities for all Reserve component medical logistics personnel, especially when the concept is used in conjunction with existing hands-on-training mission requirements. These benefits are worth the nominal added contract costs because the program will fix the medical equipment readiness problem and provide a way for the Army Reserve medical community to remain trained, ready, and relevant.

Lieutenant Colonel Paul Wakefield, USAR (Ret.), is a project management professional. He was the chief of the Force Development Office, 807th Medical Deployment Support Command, when he wrote this article. He holds a bachelor’s degree in Spanish from Weber State University and a master’s degree in administration and management from Lindenwood University.

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