4A0X1 Newsletter

“In Demand and Indispensable”

Spring 2011 Edition
Message from the CFM
In This Issue
The 4A0 Career Field is scheduled to conduct a Utilization
 Message from CFM and Training Workshop (U&TW) in San Antonio TX the week
of 16-20 May 2011. The purpose of a U&TW is for senior
 Messages from Associate Career enlisted leaders of our career-field to get together, review and
Field Managers update the current Career Field Education and Training Plan
(CFETP), instructional courses, career development courses
- TRICARE
(CDCs) for both 5 and 7 skill level, and other training initiatives
- Schoolhouse News
across the career-field. In other words, we will be looking at
- FHI 4A0 training from cradle to grave.
- IM/IT
- Health Benefits The last 4A0 U&TW was in 2006 and since then many of
- PRP our 4A0 work processes have changed significantly. This work-
shop will be especially challenging because we will need to not
 Editorial
only update the CFETP to reflect current tasks but look into the
 Around the Command future to try to determine what changes need to be made to best
prepare 4A0 personnel for the roles they'll be filling anywhere
Upcoming Events: from 2-5 years from now. CMSgt Jason A. Wagner
Appointing Information Systems 4A0X1 Career Field Manager
As 4A0s, we perform an incredibly broad set of duties and
hands-on Training Course can be assigned to any number of sections to include TOPA, RMO, Systems, Readiness, AE, Medi-
15—18 Mar 2011, Falls Church, VA cal Home, Specialty Clinics, etc. Since it will be impossible to review and update our CFETP with
all of these diverse duty requirements in just 5 days, we realize that a fair amount of pre-work must
Integrated Disability Evaluation be done before the actual workshop begins.
System (IDES) Implementation
WE NEED YOUR EXPERTISE AND LEADERSHIP SKILLS!
Conference (Phase 3)
May 2011, Location TBD Part of this pre-work consists of breaking the Specialty Training Standard (STS) of the CFETP
into 10 separate sections/teams comprised of 5 members each of Subject Matter Experts (SMEs)
PRP Training who will review and propose updates to the U&TW. We are in the process of soliciting 4A0s (A1C
11—15 Apr 2011, Wright-Patterson through SMSgt) to be nominated as members of these teams. If you are a 4A0 Superstar and are
interested in being a team member, let your MTF 4A0 Functional then 4A0 MAJCOM know NLT
AFB, OH
Friday 11 Mar 11. NOTE: This team work will not entail a TDY but team work will be done via e-
mail, video teleconference, phone, etc to review and recommend updates.
4A0X1 Utilization & Training
Workshop We will make final team selection from the names submitted as well as select one team mentor/
16—20 May 2011, San Antonio, TX facilitator (CMSgt or SMSgt) for each team not later than Friday, 18 Mar 11. Team inputs will be
due back not later than 22 Apr 11. Individual team member nominees must not be on TDY or
extended leave (more than 2 days) from mid March through 22 Apr 11 to ensure availability to con-
_______________________________ tribute to the team‘s end product. This is a great opportunity to make a difference in charting the
future of our career field so please don‘t hesitate to throw your name in and volunteer.

AVAILABLE TEAMS TO BE NOMINATED TO WORK ON:

Correction to last newsletter: The re-
cipient of the 2010 Space Coast Chief’s
Group College Scholarship, TSgt David
Kolcun is stationed at Patrick AFB, FL.
Interested in contributing to future
4A0X1 newsletters? Forward your
articles, pictures, short stories, etc to:
1 GEN 4A DUTIES (SECTIONS 1-8) 6 SYSTEMS (SECTION 45)
2 CLINIC DUTIES (SECTION 9-14) 7 READINESS (SECTION 46)
3 TOPA (SECTIONS 15– 36) 8 CSS/PERS ADMIN (SECTION 47)
4 TOPA INPATIENT (SECTIONS 22—24 AND 9 PATIENT MOVEMENT (AF 797)
35)
5 RMO (SECTIONS 37– 44) 10 PRP (PROPOSED AF 797)

matthew.morris.2@us.af.mil

Congratulations to our 2010 Chief
Master Sergeant Selectees
Samuel B. Hess
Christopher M. Lantagne
Cindy K. Rainey
David F. Craig
Vincent P. Iapichino, Jr.
Julie M. Lyn
Did You Know About…
THE IMPORTANCE OF MILITARY
RECORDS ACCURACY
As with most things in the military,
accuracy of records is of the utmost
importance and can and will drive the
direction of you future. In
accordance with AFI 36-2110, para-
graph 2.1., "Assignments are influenced entities in the private sector. That being said, I feel it is equally important that we ―educate‖ our
by all of these requirements collec-
tively. When necessary, in the
national interests or the best interests of prepare for the 4A0X1 Utilization and Training Workshop later in the year, know that I and my fel-
the AF, waivers, exceptions
and/or deviations from policies and
procedures in this instruction may
be authorized by proper authority."
Additionally, AFI 36-2110 paragraph,
2.32.2.2.2., also states that "Each
enlisted Airman is individually respon-
sible for the currency and
accuracy of his or her assignment pref-
erences/records in vMPF. When a
change in status occurs, for example,
marriage, completion of a PCS, and
so on, Airmen should update their
preferences accordingly. Outdated
preferences or no preferences on file
will not be the basis for release of an
enlisted Airman from an assignment
for which selected", this data
is important to all members in the
United States Air Force and includes
AFSC's and SEI in which you are quali-
fied to hold.
Provided courtesy of SMSgt Lisa Finuff
TRICARE
CMSgt Wesley Hardin
Superintendent, 60 MDSS, Travis AFB
.
Greetings from sunny California! It is truly an exciting time to
be a part of the Military Health System. I am sure most of you
have received some sort of update or feedback from your local
leadership that attended the 2011 MHS Conference. I was unable
to attend in person but I capitalized on technology and attended
―virtually‖ - viewing segments of the conference on-line and
taking notes for further study and discussion. It truly was the
place to be! (I even saw some of our 4A0s enjoying the festivi-
ties.) Dr. Jonathan Woodson‘s, Assistant Secretary of Defense
for Health Affairs & Director of TRICARE Management Activ-
ity, delivered a quite inspiring speech. I was very encouraged by
the presentations from each of the service‘s SG leadership – it
was apparent to me that we are ―marching to the same drum beat‖
and heading in the right direction to deliver ―Exceptional Customer Service‖. Quite a bit of time
was dedicated to what‘s being referred to as the Quadruple Aim (QA): Readiness, Population
Health, a Positive Patient Experience, and Cost. Dr. Woodson reaffirmed the importance of our
focus on the QA as well as his commitment to the welfare and care of our patient population. Essen-
tially, the QA focuses on what is most important to us all – the patient. I would like to touch briefly
on the Positive Patient Experience aim which includes Patient and Family centered Care, Access,
and Satisfaction as they relate to the 4A0 community. As the role of the 4A0‘s continues to evolve
– we must continue to seek more efficient ways of doing business while leveraging our resources
and expertise for the greater good of the enterprise. Senior enlisted leaders within the 4A0 commu-
nity must continue to ―groom their replacements‖ by encouraging peers and subordinates alike to
venture into new (and sometimes uncomfortable) opportunities for further growth and development.
How do we get there from her? Glad you asked that question – simply stated ―Training‖ – formal as
well as informal. The training is out there – let‘s continue to tap into those existing training arteries
to position our personnel for success! As TRICARE continues to evolve, our 4A0s must evolve
with it – staying on top of the game will prove to be mutually beneficial to the customers as well as
to the staff. Recall, TRICARE transcends our traditional boundaries – reaching into the civilian
healthcare arena; it only stands to reason that TRICARE is being looked at closely by healthcare
4A0s in the area of transferable skills – being ever so mindful that what we do in uniform can be
transferred into the private sector. Simply stated, we need to keep our heads in the game! As we
low Associate CFMs are ―All In‖ - committed to developing the best training tools and programs
possible to ―grow the next generation of 4As.‖ In closing, I would be remiss if I did not give a shout
out to our stellar METC staff as they continue to plant the seeds of our future force. Until next time,
―Keep it real.‖ I am honored to serve in this capacity. Thanks for doing what you do!
School House News
SMSgt Edward Vottero
Air Force Service Lead, Patient Administration Program
The vision known as the Medical Education and Training Campus
(METC), Fort Sam Houston, TX has now become a Department
of Defense reality. On 27 Oct 10, the Patient Administration Pro-
gram, Health Services Management Apprentice Course embarked
on an endeavor to develop the first generation of Airman and Sol-
diers trained in a Tri-service medical training platform. The mis-
sion of the METC, ―Produce the world‘s finest, Medics, Corps-
men and Technicians supporting our Nation‘s ability to engage
globally‖ was enacted in full force as the first iteration of Army
68G, Patient Administration Specialists and Air Force 4A0,
Health Services Management Apprentice were forged from a con-
solidated curriculum with a goal to fully encompass the philoso-
phy of joint interoperability. The class of 20101027 was com-
prised of 75 future leaders, all sharing the passion to support and
defend our great nation. Although the course lengths within the program differ (Army – 6 weeks, 3
days; Air Force 7 weeks, 1 day) we shared 4 weeks of consolidated training. In the early days of the
course the air was filled with a looming cloud of intensity, apprehension and curiosity. As training
progressed, the students rapidly began developing a rapport, the emotions quickly dissipated and an

CDC facts: (AD Only—since 1 Oct 10)
5—Level
Average EOC score = 76%
First time failures = 11%
Second time failures = < 3%
7— Level
Average EOC score—82%
First time failures = 15%
Second time failures = 0%
Education Level -
BA/BS or higher by Grade
SrA &
below 1,226 36 <3%
SSgt 824 52 6%
TSgt 463 83 18%
MSgt 298 84 28%
SMSgt 52 30 58%
CMSgt 21 17 81%
2011 CSAF Reading List
Partners in Command: George Marshall
and Dwight Eisenhower by Mark Perry.
Perry is a military, intelligence, and foreign
policy analyst as well as a coordinator of
Conflicts Forum, an international political
advocacy organization. His absorbing
account follows the alliance between two
men who must be credited with a substan-
tial role in winning World War II in Europe
as well as laying the foundation for post-
war foreign policy as the cold war
commenced. Alliance is the key word here,
since Marshall and Eisenhower never be-
came close friends. Both men disdained
pomp and formality.
Descent into Chaos: The United States and
the Failure of Nation Building in Pakistan,
Afghanistan, and Central Asia by Ahmed
Rashid. Long overshadowed by the Iraq
War, the ongoing turmoil in Afghanistan
and Central Asia finally receives a search-
ing retrospective as Rashid (Taliban) sur-
veys the region to reveal a thicket of omi-
nous threats and lost opportunities—in
Pakistan, a rickety dictatorship colludes
with militants, and Afghanistan's weak
government is besieged by warlords, an
exploding drug economy and a powerful
Taliban insurgency. The author blames the
unwillingness of American policymakers to
shoulder the burden of nation building.
environment of learning was soon revealed. We began each academic day by assembling in our
newly constructed classrooms and recited both the Soldier‘s and Airman‘s Creed. The difficulty of
adjustment was not held with the students as they had no idea how training was delivered in the past.
The challenge of change and transition rested squarely on the shoulders of the instructor staff. The
first iteration of the class delivered my staff into an abyss of the unknown. It wasn‘t as though we
didn‘t know how to handle the task at hand, consequently the crux of the issue was how our actions
would impact our Battle Buddies, and whether or not we properly acknowledged and recognized the
Army‘s customs and courtesies. Ultimately, through many hot washes and AARs, we synergized
our efforts and fostered an atmosphere which embraced our service specific traditions and molded a
deliberate, relevant and effective academic delivery system.
The efforts of the Patient Administration Program Team culminated with the historic ―First
Graduation‖ of a consolidated course at the METC. We were honored as our CFM, CMSgt Jason
Wagner, was the guest speaker for the inaugural event. Although the Army and Air Force do not
graduate on the same day, ―jointness‖ resonated throughout the auditorium as we were joined by the
Dean for Academic Affairs Army COL Larry Hanson; the Associate Dean of the Instruction Deliv-
ery Division, Navy CAPT Peggy Westerbeck; the Command Chief Master Sergeant of the METC,
CMSgt Kevin Lambing; the Commander, Deputy Commander and Superintendent of the 882d
Training Group, Col Lista Benson Col Herbert Scott and CMSgt Dave Montano; the Squadron
Commander, 382d Training Squadron, Lt Col Patricia Welch and a host of other personnel repre-
senting the Army, Navy and Air Force. Although I can‘t capture all of the emotions, challenges and
successes we encountered during the first iteration of the course in this article, I can offer the follow-
ing image…an image solidifying the vision statement of the METC, ―Become a National Strategic
Asset!‖
Career Development Course Production Process
MSgt Jason Caszatt & MSgt Jaime Capps
As Career Development Course (CDC) writers, we often receive questions in regards to the pro-
duction process or just exactly how CDCs are developed. In this short article, we will cover this
inquiry by discussing the production process and those responsible for publishing the course.
The production process is a consolidated effort with the Career Field Manager (CFM), MAJCOM
Functional Managers (MFMs), Subject Matter Experts, Training Managers, CDC Writers, and
finally Air University. It starts months in advance when the CFM establishes a delivery date, also
known as ―customer need date.‖ The need date sets a target for CDC distribution and availability for
promotion testing. The CFM works with an AETC Training Manager from the 882 TRG to conduct
a Utilization and Training Workshop (U&TW). AFSC MAJCOM Functional Managers attend the
U&TW, during which time training standards are created/validated for 3, 5, and 7 skill-level require-
ments. After completion of the U&TW and approval of both the conference minutes and Career
Field Education and Training Plan (CFETP), the career field CDC Writers creates a production plan.
The production plan is used by both the CDC Writers and Air University as a timeline to meet the
required delivery date and it also acts as a contract between the two entities. Using the CFETP,
CDC Writers work with Subject Matter Experts to gather data on each topic in the Specialty Train-
ing Standard. The approximate number of days from research to publication for a five volume
course is 300 days; for example, each volume takes 30-60 days to write with constant interaction
with Air University who require 120 days to finalize and print.
Cont.
 As you can see, there are numerous experts with a great deal of experience involved in the assembly of a career development course.
Pending the U&TW, we anticipate going into production sometime in late spring with an estimated availability date of early next summer.

We continue to welcome feedback from all members of the career field and encourage everyone to coordinate inquiries through their MTF
and MAJCOM Functional Manager. If a CDC inquiry is submitted, please use the following template.
CDC Inquiry Format:
1. CDC Volume and Title
2. Date and Edit Code (located on the back cover of each volume)
3. Paragraph Number and Page Number
4. URE Question Number
5. Detailed Description of the Error

If an error is noted on the EOC test, coordinate your inquiry with the Testing Control Officer and complete the necessary documentation to
challenge the question.

HSMA Sponsorship: Do you remember arriving at your first duty station and being nervous about the people you were about to meet and
the job you were going to do? You may have had the following questions, ―Where do I work? How will I get to know all these people? What
is this new town or city like?‖ Not only were you moving to a new city, state or country but you were also new to the military lifestyle. Good
thing you had a sponsor to answer your questions and ease the transition… or did you?

The Health Services Management Apprentice (HSMA) Course has a sponsor process in place to connect Non-Prior Service students with
their first base. Speaking to a sponsor is a vital first step in making a smooth transition from technical school to permanent party status.
Many of the students who attend the HSMA Course have questions and concerns that require individual attention from a point of contact at
their gaining base. The best way for sponsors to contact Airmen is to email TSgt Tracy Anderson at tracy.anderson@metc.mil or TSgt Linda
Brown linda.l.brown3@metc.mil or call the HSMA course at Commercial @ 210-808-2088 or DSN 420– 2088/20838. Please be aware that
students in the HSMA Course are not allowed to carry or use cell phones during the duty day. When calling the HSMA course, leave a de-
tailed message with your rank and name, the name of the Airman you are trying to reach, your base, and a DSN call back number.

Each Airman that graduates with a sponsor is sure to have a better understanding of their gaining unit as well as their base. Having some-
one to ease the anxiety of an Airman leaving to technical school is a very important job. It is believed that a successful career can be
launched by having a good welcoming experience.

Family Health Initiative

CMSgt David Gilmore, Group Superintendent, 95th MDG
4A0 Associate CFM for FHI

NEWS FLASH: AFI 44-171, Patient Centered Medical Home and Family Health Operations was
signed by LtGen Green on 18 January 2011 officially enacting the Air Force governing directive for
the Family Health Initiative (FHI). Health Service Managers (HSMs) have distinct roles in Family
Health; reception and office manager responsibilities.

As your associate career field manager for FHI and writer of this article, my goals are simple: to en-
sure we all have a good understanding of the purpose of FHI and discuss how 4A0 are utilized in Family
Health. For clarity, Patient Centered Medical Home and Family Health Initiative are synonymous terms.

Much effort has gone into ensuring the success of FHI dating back to 2007 when the model was de-
signed. The goal was to create an enjoyable and productive practice environment that promotes and de-
livers quality, evidence-based care to our patient populations. Additionally, the model wanted to retain
staff, recruit new ones, deliver a greater spectrum of care for our population by improving the team sup-
port staff and promote prevention. The model includes one health services manager (HSMs) with addi-
tional HSMs earned when the clinic earns at least 10 providers. Most MTFs may decide to utilize the one
HSM authorization in a receptionist capacity. We would recommend looking at opportunities to purchase a second HSM that will provide
your Family Health clinic with both a receptionist and an office manager. At this time, this decision is entirely up to the MDF executive
team. So, I hope you will agree, 4A0s do have a role in the success of Family Health. The following excerpt is from AFI 44-117, section
1.1. and discusses the purpose of Family Health Operations.

Purpose for Family Health Operations (FHO)

1.1.1. Deliver highest quality, evidence-based, patient-centered care to enrolled patients through team-oriented processes, good access, high
continuity, communications, prevention, education and coordinated management of disease. Employ this approach to ensure operational
readiness and operational health of military members.
1.1.2. Create an innovative, rewarding and productive practice environment that attracts and retains highly qualified, top performing medical
professionals.
1.1.2.1. Utilize to maximum effect the skills of all team members with each team led by a physician.
Cont.
1.1.2.2. Emphasize continuous improvement of team processes centered around the principles of the Patient Centered Medical Home
(PCMH).
1.1.2.3. Integrate technological tools into team processes to enhance communications with patients and provide agile tracking of health
parameters for individual patients and across the team‘s population of patients.
1.1.2.4. Assure clinical currency and readiness for members of the team.‖

What stands out as 4A0 competencies or value in the ―Purpose of Family Health Operations?‖ Team orientated processes, good access,
skills of all team members, continuous improvement, technological tools, agile tracking of health parameters and readiness are all attributes
we bring to the fight. These tasks and more offer our career field a great opportunity to add value towards advancing team effectiveness and
ultimately the health of our patients. We must take this opportunity seriously!

Before, we discuss the role and tasks HSMs accomplish in FHO, it‘s important to know we report to the group practice manager (GPM).
Also, as office managers we have the opportunity in some cases to fill the GPM role. Therefore, the following excerpt from AFI 44-117,
details the role of the GPM in support of our office managers.

―1.3.12.7. Ensures training of the medical office manager is accomplished. If organized in the same rating chain, GPM will also supervise
and rate the medical office manager.
1.3.12.7.1. One 4A0 is earned in the model for all enrolled facilities but an additional 4A0 is earned for more than 10 providers. MTFs can
utilize them as front desk receptionists (see duty description in 1.4.6.1.) or as office managers (see duty description in 1.4.6.2.) as they see fit.
1.3.12.8. Supervised and rated by the SGH or Chief GPM.‖

Our career field manager, CMSgt Wagner, other 4A0 leaders and senior MSCs have spent a lot of effort ensuring the tasks our HSMs will
perform are value-added to our patients, the FHI teams and for themselves. The tasks are process oriented and focused on building reception
and office management as a 4A0 core competency. Additionally, much work continues with updating the military job descriptions and
civilian core documents with a major goal of upgrading them to attract and retain the best receptionists and office managers. The following
excerpt from AFI 44-117, details the tasks our HSM will accomplish as receptionists and office managers.

1.4.6. Health Services Management Personnel (4A0) or Civilian Equivalent (see roles and responsibilities in 1.3.12.7.1).
1.4.6.1. Front Desk Receptionist (Recommend GS or Contract).
1.4.6.1.1. Greets the patient.
1.4.6.1.2. Verifies patient identity and eligibility in Defense Eligibility Enrollment Reporting Systems (DEERS).
1.4.6.1.3. Checks in the patient and enters patient information into the Armed Forces Health Longitudinal Technology Application (AHLTA).
1.4.6.1.4. Obtains Third Party Collection Information.
1.4.6.1.5. Identifies patients on Personnel Reliability Program (PRP).
1.4.6.1.6. Verifies patient demographics and directs patient to update in DEERS if required. Will enter any new contact information
(minimum phone number) in the COMMENTS section of AHLTA. Note: Demographic information updated elsewhere in AHLTA will be
overwritten at next CHCS update with DEERS.
1.4.6.1.7. Determines from patient if visit is injury related; ensure AF Form 1488 is completed if visit is injury related.
1.4.6.1.8. Provides patient with any visit required paperwork and clinic instructions.
1.4.6.1.9. Routes patient to appropriate location for the visit.
1.4.6.1.10. Schedules follow-up visit for patient if required.
1.4.6.1.11. Tracks, or assists with tracking, diagnostic results/route to appropriate PCM/Specialist.
1.4.6.1.12. Assists Office Manager and GPM as needed.
1.4.6.1.13. Trains, as appropriate and assists Medical Technicians (4N0s) in the proper completion and maintenance of paperwork and
outpatient medical records.
1.4.6.1.14. Performs other patient administrative functions consistent with the 4A0 skill set as appropriate to the Family Health Clinic setting.
1.4.6.2. Medical Office Manager (recommend military 4A0 (minimum E-5) or GS equivalent (minimum GS-7))
1.4.6.2.1. Assists GPM with identifying and managing patient demand by utilizing historical workload data using tools such as Composite
Health Care System (CHCS) or Template Analysis Tool.
1.4.6.2.2. Assists GPM in developing and maintaining provider templates.
1.4.6.2.3. Inputs appointment templates/schedules into CHCS.
1.4.6.2.4. Coordinates patient referrals with Referral Management Center (RMC) if a referral is required. Obtain referral reports from RMC
when required and route to appropriate PCM. Note: T-cons to the ordering provider are the usual method by which RMC notifies providers of
results. The Office manager may have to obtain paper copies, or route the referral results to the PCM when he or she is not the ordering
provider.
1.4.6.2.5. Performs End of Day processing at the end of clinic each day.
1.4.6.2.6. Orders/restocks office supplies as required.
1.4.6.2.7. Coordinates required documentation with appropriate clinical and support functions.
1.4.6.2.8. Aids clinical staff in maintenance of preventive health databases for FHTs.
1.4.6.2.9. Contacts/schedules patients requiring preventive health visits in coordination with HCI.
1.4.6.2.10. Assists RMO in auditing Third Party Collections to ensure maximum MTF reimbursement.
1.4.6.2.11. Supervises, rates and ensures training of the Family Health Clinic front desk personnel. 1.4.6.2.12. Obtaining national Medical
Office Specialist Certificate within 12 months of assuming duties is highly encouraged.‖

Cont.
 I hope you noticed the organization of the duties for the receptionist is 90 percent patient focused and occur in a chronological manner.
This is by design with a focus on value-added work being paramount. The office manager duties are organized around preparing team data
sets (templates, schedules, RMC, end of day processing, etc.), efficiencies and performance measurements. To give our office manager legiti-
macy and value, we‘re also encouraging certification as a ―Medical Office Specialist‖ within 12 months of assuming this position.

In closing, Family Health and Patient Centered Medical Home is the AFMS family medicine platform and Health Services Managers do
have a valuable and distinct role. It‘s our responsibility to take this opportunity very seriously and to demonstrate through our competencies
our value to the health of our patients and the effectiveness of our health care teams. This will be my last article as the 4A0 Associate CFM
for Family Health. To that end, we‘re looking for a 4A0 leader to carry the torch for Family Health. If this opportunity interests you, please
send me or Chief Wagner an email.

On behalf of Chief Wagner, thank you for what you do every day for the AFMS, our patients and your team-mates. Chief Collie (one of
our previous CFMs) stated it well, ―4A0s are In Demand and Indispensable‖ to the AFMS mission. Good day Health Services Managers!!

Information Management/Information Technology IM/IT

MSgt William Barfknecht
Superintendent, Information Services Division
AFMOA/SGAI
4A0X1 Associate Career Field Manager for IM/IT

For those of us who have been in the career field for a long time, Medical Information Systems is an
always evolving flight, identifying those individuals who have this highly valued training. We get these
individuals trained and they would inevitably move to another office, PCS, or not work in systems again.

The Air Force finally recognized the need to identify those who had special training and experience to
maintain computers and networks. They did this by authorizing 4A0‘s to have a ―V‖ prefix. This had a
tremendous impact on our career field, but unfortunately the sole purpose of the ―V‖ code was to identify
those who had this special training for deployment purposes only. In order to obtain this prefix you had
to fill this position for two years and apply through the MAJCOM functional for approval. At most
MTF‘s there was only one V coded individual that was tasked to deploy once a year.

Through the years, the medical information system‘s mission has changed. We are now in fixed fa-
cilities with state-of-the-art equipment. The downfall with the V codes today is the number of members
with current IT experience. All of these past experiences have shown that, the best way to identify and manage systems experience is the use
of special experience identifiers (SEI). SEIs are established when identifying experience or training that is critical to the job, the personnel
assignment matches, and no other identification is appropriate or available. SEIs permit rapid identification of a resource already experi-
enced to meet unique circumstances, contingency requirements or management needs. They provide a means to track individuals and iden-
tify positions requiring or providing unique experience or training that otherwise would be lost. Currently, there are two SEIs 4A0s may use
to identify Systems experience. They are SEI 260 and 264, which are listed below. SEIs give us the ability and flexibility to effectively
management our folks who have systems experience without the radical changes caused by a shred.

Special Experience Identifier (SEI): DOD 8570 mandated each position that requires elevated rights on the network (normally our Sys-
tem Administrators/Client Support Administrators) be coded with an SEI 260: Requires an A+ certification as the mini-mum requirement.
SEI 264: Requires a Security + certification: anyone who has root level access to a server would require this certification. Individuals occu-
pying these positions must then accomplish the required certification. After certification, they must formally update their personnel record
via submission of an AF 2096, Classification/On-the-Job Training Action to add the SEI code to their military record.

FINAL THOUGHT: It is a privilege and honor to work in Systems. Everyone who walks through your door is your customer. Remember
to always start by telling the customer what you can do for them—not what you cannot do! Thank you for all you do to support the best
healthcare service in the world. william.barfknecht@us.af.mil or DSN: 969-9875.

Patient Administration Update

MSgt Kenneth Causie, AFMSA/SG3SA

AFI 41-210 Update: The title is changing from Patient Administration Functions to TRICARE Operations and Patient Administration
Functions. The instruction combines guidance from AFH 41-114, AFI 41-115, and AFI 41-210. Both AFH 41-114 and AFI 41-115 will be
rescinded following the publication of the new and improved AFI 41-210. The new 430+ page instruction has almost cleared AFMS func-
tional review. So far, our office has reviewed and approved 1,200 line-item content change recommendations from a total 1,500 recommen-
dations received. As soon as all remaining AF/SG offices have had a chance to review, I‘ll forward the draft to HQ AF/A1, SAF/AA, and
SAF/MR for final executive coordination. Barring no major coordination set-backs, the instruction should be ready for publication by the 1st
week of April.

Cont.
 Although several new sections regarding TRICARE operations have been added to the proposed instruction, much of the Access to Care
management topics, including clinic appointing and scheduling, PCM enrollment, and referral management will be published under a separate
100+ page instruction in the next few months. Just imagine if we left this information in AFI 41-210! If you‘re like me, thumbing through a
530+ page instruction looking for TOPA-related references could get a bit tedious.

Capturing Referral/Consult Results in AHLTA. Over the last six months, our office has participated in numerous policy meetings and
discussions all focused on how to best capture or ―upload‖ TRICARE network referral/consultation results using the electronic health record
(EHR). We‘ve consulted with several AF/SG, AFMOA, and AFMSA stakeholders and subject matter experts from IM/IT, referral manage-
ment, records management, and legal backgrounds. From these policy discussions, two potential solutions have emerged: Use the AHLTA
Telephone Consultation (T-CON) function or Clinical Notes section to capture network referral results. Proponents for each process have
made good arguments. The T-CON solution offers a ―built-in‖ results-availability provider notification system with the ability for the pro-
vider to ―lock-in‖ the information with a read-receipt e-signature. Capturing referral results using the Clinical Notes method also offers se-
cure document protection. Plus, using Clinical Notes to capture network referral results also matches the Army‘s current EHR referral man-
agement process.

I‘m optimistic that by the time this newsletter is available, we will have reached a decision. Guidance will likely be released to the field
through an Interim Change to AFI 41-210.

Exception to Policy – Hand-Carrying Service Treatment Records (STR) to Korea. With the recent implementation of the 29 Nov 2010
Interim Change to AFI 41-210, Service Members assigned to sensitive duties positions (Personnel Reliability Program, Presidential Support,
White House Communications, etc.) and active Flight personnel are now required to hand-carry their STRs from the losing MTF to the gain-
ing MTF during a PCS reassignment. Medical and dental records belonging to Airmen not assigned to these special jobs are now mailed di-
rectly from the losing MTF to the gaining MTF.

Since the release of this updated STR custody guidance, however, senior HQ PACAF officials identified several potential patient safety
concerns associated with the new records management requirements. The PACAF Command Surgeon was concerned the medical and dental
records, if mailed from the losing MTF, would not be immediately available for Airmen ―PCSing‖ to Air Force installations within the Ko-
rean Peninsula by the time the Service Member physically arrived on station. Not having the complete medical record immediately available,
PACAF officials argued, could cause providers to overlook or miss significant medical issues that would otherwise be reasonably known had
they had the paper medical records.

To mitigate this potential patient safety issue, AFMOA and AFMSA records management officials are working with HQ PACAF represen-
tatives to modify the new records custody rules for Airmen PCSing to Kunsan and Osan Air Bases, or any associated unit of attachment.
Similarly to Airmen assigned to sensitive duties or active Flight positions, the expected change will require Airmen traveling, during a PCS
reassignment, to Air Force installations in Korea, to hand-carry their STRs from the losing MTF to the gaining MTF.

If not already approved and released to the field by the time this newsletter is published, official instructions will likely be released within
a few days in the form of a guidance memorandum attached to AFI 41-210.

PRP Update
TSgt Kimona Woodard, USAFE/A3NS

After months of frustration and anticipation DoD 5210.42R_AFMAN 10-3902, interim change 2 was
released 2 November 2010 and is now available on E-pubs for your reading pleasure. This change incor-
porated guidance from the memorandum published 16 July 2010, gave clarification for several defini-
tions, key terms, procedures and forms disposition.

AF PRP Training modules have been revised. The on-line PRP training modules to include AFMAN
interim change 2 and DoD interim change 1 instructions are now posted. In addition, AF PRP has re-
leased a new PRP Awareness training module. This instruction module provides an introduction to the AF
PRP and is geared towards personnel at non-nuclear installation/medical facilities desiring a general
knowledge of the PRP.

OSD is gearing up for a re-write to the DoD 5210.42R, Nuclear Weapons Personnel Reliability Pro-
gram (PRP), regulation. The Security Policy Verification Committee (SPVC), Nuclear Matters will host a
meeting with PRP Service Reps in February to discuss upcoming changes to the PRP Manual (DoD
5210.42). The revision will incorporate DoD interim change 1 and also look to re-align some of the cur-
rent DoD standards.

As Chief Wagner mentioned previously by e-mail, to fill the position as the Unit PRP Monitor, the individual must attend the Certification
PRP Course. The course will be centrally funded and will be administered through USAFSAM (held at Wright Patterson). More information
will be released as the dates of the course get closer. The future course dates will be in Apr, Aug, Oct 2011 and Feb, Apr, Aug, Nov 2012.

Did you know discrepancies are still being reported to MAJCOM‘s for PRP member‘s not hand carrying their medical and dental records.
Interim Change One (IC-1), AFI 41-210, Patient Administration Function states:
Cont.
 6.17.1.2.1. This section applies to any Service Member or Airman assigned (including Service Members who will be assigned to a sensitive
duties or active flight status position upon arrival to their next installation or organization), including but not limited to: Personnel Reliability
Program, Presidential Support Program, overseas U.S. embassy support, or any Airmen on active Flight Status (FLY) or a Service Member
assigned to a Flight position or those who maintain an active aeronautical rating. Airmen meeting these requirements, or any other Service
Member authorized by the MTF commander, are required to hand-carry their outpatient medical and dental treatment records (in a sealed en-
velope or package) from the losing or departure MTF to the arrival or gaining MTF; from the departure Reserve Component (RC) medical
unit to the arrival or gaining RC medical unit; or from any official location responsible for maintaining health records to the arrival or gaining
MTF, RC medical unit, or official duty assignment during a Permanent Change of Station, Permanent Change of Assignment, duty location re
-assignment or extended Temporary Duty (TDY) assignment (excluding deployment). Inbound PRP and active flight crew personnel must
hand-carry their medical records. If an Airman is not expected to perform the duties normally associated with his or her sensitive duties pro-
gram, flight, or aeronautical mission or position, or if sensitive duties program, flight status, operational program access or permission(s) has
been suspended or expected to be suspended during or at the next installation or organization duty assignment or during an extended TDY
period, only the identified MTF competent medical authority, or MTF Chief of Aerospace Medicine may authorize an individual to travel to
the gaining installation or TDY location without his or her outpatient medical or dental treatment records in hand. Please ensure members,
who are going to a PRP, PSP, and/or flying assignments are allowed to hand carry their medical records.

For more PRP information feel free to contact me at DSN 314 480-6856 or email kimona.woodard@ramstein.af.mil.

Editorial
(C)MSgt Samuel Hess
Superintendent, Information Systems Flight
Elmendorf AFB
Motivational speaker Blake Beattie once said ―Sail beyond the horizon; fly higher than you ever
thought possible; magnify your existence by helping others; be kind to people and animals of all shapes
and sizes; be true to what you value most; shine your light on the world; and be the person you were born
to be.‖ I feel this quote describes what people want to achieve in their personal and professional futures.

During my career as a 4A0X1, my mentors taught me many of these attributes. Maybe not in those
particular words, but I understood not to settle for anything short of the best. To this day I continue to
live by these lessons I learned and often reflect back on those personalities who shaped my growth.
Given the opportunity, I guarantee your past, current, and future supervisors will help shape who you are
and who you will become in the future. If you don‘t have a mentor, seek one out that you look up to and
who will challenge you to grow beyond your comfort zones to be the best you can be.

All of us had excuses for not getting back in school after High School. Some would say, ―Going back
to school is not for me,‖ or ―I don‘t have the time,‖ and others ―I‘m always deployed.‖ There are numerous ways to rationalize not going
back to school to pursue higher education. You make time for things that are important in your life. Education is that important. It is some-
thing that can never be taken away from you. It is the building block to your future, and the lack of higher education severely limits your po-
tential and opportunities down the road. I can‘t stress enough the importance of completing your education early in your career before in-
creased responsibilities make it more difficult to complete.

According to Bright Hub, the 2010 average cost of a Bachelors Degree in a US public school is about $28K. The Air Force offers the in-
credible benefit of paying 100% of the allowed cost of tuition for a recognized certification or a degree from a regionally accredited school.
Not only to have a Bachelors degree, Masters Degree or a PhD, but simply ―aspire‖ to sail beyond the horizon and fly higher than you ever
thought possible. Pursuing your education is an investment in your future as a leader; it develops your values, improves your perspective on a
host of issues, and gives you a greater appreciation for what you have the freedom to do in this great nation. Don‘t procrastinate; invest in
your future by starting with your CCAF.

Education is the foundation that leadership is built on through continued effort. For you Packer fans, Vince Lombardi once said, ―Good
leaders are made not born.‖ If you have the desire and willpower, you can develop into a more effective leader through a never ending proc-
ess of self-study, education, training, and experience. Our former AFCS General Ronald R. Fogleman once stated, ―Good leaders are people
who have a passion to succeed…If you are to be a good leader, you have to cultivate your skills in the arena of personal relations.‖ This im-
plies becoming a good leader does not mean just leading at work, but leading in your personal lives with family and community. Air Force
members are held to a higher standard and we truly want to ―magnify our existence‖ at work, within our families, and in the community. So,
I challenge each of you to ―believe‖ in yourselves, step out of your comfort zones, and take that journey to becoming or honing your leader-
ship qualities.

My last and most important point is to recognize what others have done for you to ―achieve‖ major milestones throughout your career and
to ―Pay It Forward.‖ You could do this by helping them reach their own career goals, clearing a road block out of their way so they can be
more effective, or being a wingman for them when they need one in the countless opportunities we encounter every day. Without our mentors
shedding light on the correct paths, I don‘t think any of us would be in this incredible Air Force. The way to make sure this happens is by
each of you being humble to what you have accomplished thus far and ensure you ―PAY IT FORWARD‖ to our future Air Force generation.

As we look to the future of the 4A0X1 career field, leave a legacy to leave things better than you found them and encourage everyone‘s
commitment to aspire, believe, and achieve. Start today by earning an education, becoming leaders in your personal and professional lives,
and ―paying it forward.‖
 Around the Commands

19th MDG, Little Rock AFB

SSgt Felicia Ochoa—AMC Expeditionary SrA Marqueta Blakey—19 MDG Airman of the 3rd
Medical Operations Airman of the Year, 2010 Qtr and Airman of the year, 2010

TSgt Jamie Richardson earned her

(M)Sgt Raymond Riley MSgt Supplemental CCAF Degree

8th MDG, Kunsan AB

8th FW Deputy Command, Col Hanlon presents the

Wing Pride of the Pack award to SSgt Misty Givens. 8th FW Commander, Col Dolan and Command Chief,
CMSgt Sanders congratulate Sergeant Givens on her
STEP promotion to Technical Sergeant. Way to go!
 319th MDG, Grandforks AFB

The 319th Medical Group celebrates 4A/MSC appre-

ciation week with a pizza party.

27th MDG, Cannon AFB

(S)Sgt Tawny Foreman was recently selected as the AF-

SOC Medical Readiness Airman of the Year, 2010. A;sp
we was recognized as an Outstanding Performer during
the ORI and coined the 27 Special Operations Wing Com-
mander. Wow!

A1C Stephanie Todaro was selected for SrA BTZ. Other

accomplishments include: AFSOC RMO Airman of the Yr,
AFSOC RMO Team of the Yr mbr, 27 Special Operations
Volunteer of the Qtr and 27 Special
Operations Medical Support Squadron Airman of the Yr, 2010.
SSgt Oscar Hernandez promotion ceremony.
 86th AES, Ramstein Air Base

SSgt Amber Prazak

86 AES Mission Support NCO of the Year, 2010

MSgt Catherine Gaco-Escalera

86 AES SNCO of the Year, 2010

628th MDG, Charleston AFB

A1C Nicholas Estrada is assigned

to the 628 Medical Support
Squadron, Charleston Air Force
Base as an Outpatient Records
technician. He was selected as the
628 MDG Medic of the Month, TSgt Paul Smitko
October 2010, based on his out-
standing dedication to duty and
86 AES NCO of the 4th Quarter, 2010
service to others. A1C Estrada
hails from Eau Clair, Wisconsin.
His main goal is to be a communi-
cation officer in the USAF. Some
of A1C Estrada‘s accomplish-
ments include:

- Proactively retiring 450 medical

records. He took the time to re-
search the process before action, double-checked the quality of each
record before shipping, and coordinated the final shipment to NPRC.

- Solving an inefficient, time-consuming records pull process. He

researched the CHCS manual to find a better method. His imple-
mentation of the batch-pull list process saved Outpatient Records 1.5
hours daily.

- Setting the fitness example. He finished fourth in the 8 Oct 10 SSgt Eugene Pamplona
Commander‘s Fit Challenge 5K run, enthusiastically played on the
86th AES Mission Support NCO of the 4th
MDG Volleyball Team, and ultimately scored a 94 on his PT test.
Quarter, 2010
366th MDG, Mountain Home AFB

SrA Shandrena Burney and SrA Lynn Amoroso graduated from ALS.
SrA Burney was also recognized as a distinguished Graduate.

78th MDG, Robins AFB

A1C Steven Rodriquez was the Nov 2010

Outpatient Records Superior Performer.
He also scored an excellent 96% on his
PT test. Airman Rodriguez has been in
10th MDG, USAF Academy the AF for around 1 1/2 years and calls
Philadelphia, PA home.

TSgt Paige Hanson was STEP

promoted to MSgt effective 30 Jan 11.
 71st MDG, Vance AFB

Left: MSgt Ashley Roney was promoted to

MSgt in Dec 10.

Right: MSgt Castro with CMSgt of the AF Chief Roy

who was the guest speaker at the wings annual awards
ceremony

Left: SSgt Nathaniel Parry and SSgt Marisol Manzo were

selected for retraining during the 2010 NCORP. SSgt
Parry is going into broadcasting and SSgt Manzo will be
going into Intel. Thanks to both for their
contributions to the 4A0 career field.

Right: Vance‘s 4A0 with CMSgt Marie

Potts, AETC CMEF
 436th MDG, Dover AFB

The 4As and MSCs from the 436th Medical Group jump started their 2010 4A/MSC Appreciation week with a
web conference hosted by Air Staff. The group of 4As and MSCs listened in as BG Miller and the 4A CFMs spoke
about the diversity and importance of the career fields and what the 4As and MSCs bring to the fight! The celebration
continued as the 436th Medical Support Squadron Commander, Lt Col Greg Cullison, thanked the MSCs and 4As for
their commitment and dedication in supporting the 436th Medical Group, and the entire 436th Airlift Wing. SMSgt
Kathleen Harrison, the 436th Medical Support Squadron Superintendent, emphasized the significant contributions the
4As and MSCs have made, and the momentous impact they‘ve had on the Group. The highlight of appreciation week
was, ―Teamwork at its Best‖. The week was a success; the team enjoyed a series of events to include an ice cream
social and bowling competition. The week concluded with hails and farewells.

Written by: TSgt Takisha Ruffin/4A1 and SSgt Marita Rose Smartt/4A0
 88 MDG, Wright-Patterson AFB

SMSgt Darla Steetle was selected as the AFMC Out-

standing Health Plans Management SNCO of the
Year, 2010 and SrA Exume Serge was selected as the
AFMS Outstanding Health Plan Management Air-
man of the Year, 2010. Way to go!

The DD Form 2569 has gone Electronic

TSgt Stacy Massey, 88MDSS/SGSRT

Question: How many times a day does a front desk clerk have the following conversation?

Patient: ―Hello, I need to check in for my appointment‖

Front Desk Clerk: ―Do you have your yellow card?‖
Patient: ―No, it is in my other purse; No, it is in my other pair of pants; No, my spouse has it‖
Front Desk Clerk: ―No problem, but I need you to complete this form regarding Third Party Insurance‖
Patient: ―I just filled one out the last time I was here; this is ridiculous!‖
Front Desk Clerk: ―I understand Sir/Ma‘am, but I am required to verify your yellow card is current, or have you complete this form;
please complete the highlighted areas and sign the back, thank you.‖
Patient: ―I understand, but I am not happy with it.‖

Answer: Too Many!!!

Well let me be the first to inform you, help is on the way! Approximately, 2 years ago the Third Party Collection team, with the
help of AFSO21 here at Wright-Patterson AFB, put their thinking caps on, collaborated as a team, and created an electronic DD 2569
database. The team consisted of TPC staff (to include contractors), the UBO Manager, and a systems programmer.

The database was developed to be a one stop shop for information pertaining to the DD 2569; think of it as the Oracle of Third Party
Collections. Not only does the database populate demographic information by pulling from CHCS, it allows the clerk to scan and up-
load third party insurance information (i.e. insurance cards). With the use of this database there will no longer be a need to maintain
hard copies of the DD 2569 in the outpatient record or the TPC office. And, for you program managers the database also includes a
reports function allowing for real time metric snapshots.

Since the inception of the database here at the 88th MDG, reimbursements have soared! In Dec 2008, we were ranked ―worst‖ in
the AFMS concerning DD Form 2569 collections with a shameful compliance rate of 64%. By Aug 2009, our compliance rate had
increased to an astonishing 95%. Improving our compliance rate 31% in turn increased our reimbursements by $2.9M.

So what is my point; other than giving kudos to the 88th MDG TPC team. My point is: The database has been approved by Air
Staff and is currently going through the IT approval process and then will be deployed across the AFMS. Bottom-line: The days of the
hard copy DD form 2569 are limited.
 81st MDG, Keesler AFB

Who doesn‘t love the challenge of preparing our new Airmen for their final End of Course exam?
What would you do if you had 40 new Airmen to prepare for their CDC End of Course exam in a pe-
riod of one year? Welcome to the world of Outpatient Records at Keesler Air Force Base, MS. We
have found a way to overcome some challenges in shaping our future leaders and here is what we have
done. Work closely with your Unit Training Manager(s), it is pivotal to the program success. When
new 4A0 ascensions arrive to our section, their supervisor escorts them to the Education and Training
section to enroll them in their CDC‘s. Once the CDC‘s arrive, issue your Airman one volume at a time
and set a suspense of 30 days for them to complete the volume. Within those 30 days, follow-up with
them and keep abreast of their progress. Never forget to document the Airman‘s training progress into
AFTR. When a volume is completed, the supervisor conducts a review and administers a quiz. If any
questions are incorrect, a comprehensive review of those incorrect questions should be conducted. Do
not move on to the next volume until both the supervisor and Airman are comfortable with the material.
This process continues until all five volumes are completed.

Once all five volumes are completed, we prepare them for testing. Before establishing their EOC
test date, we administer a minimum of three pre-tests comprised of 100-130 questions. Our team of
TSgt Marissa Guzman
NCO supervisors created 5 different pre-tests to ensure questions are different every time. Each Air-
man must score a minimum of 70% on the first pre-test, score a minimum of 80% on the second test, and a 90% on the third pre-test. To
ensure we have fully prepared our Airman, there is one more important step in the process. A complete review of the Airman‘s AFTR record
is done by the Squadron Superintendent and the 4A0 Functional Manager, and if everything is good, they both sign the EOC request form and
are scheduled to take their End of Course Test. On average, the 4A0 Airmen at Keesler AFB have scored 10% above the Air Force average
on their End of Course exams. These results show that preparing our future 4A0 leaders involves many things in a big process. Most impor-
tantly, supervisor involvement is the key to the success of preparing our future 4A0 leaders.

22nd MDG, McConnell AFB

Top right: SrA Theresa Scherquist was

named the AFMS Outstanding Enlisted
Health Services Management Airman of the
Year, 2010

Bottom right: Ms. Diana Diaz was selected

as the AFMS Health Benefits Advisor of
the Year, 2010

Above left: SSgt Dare Oke completed

Security A+
certification with an awesome 880 of
900 possible point

Bottom left: Mr. Edward Hill also

scored and excellent score on his A+
certification
 95th MDG, Edwards Air Force Base

TSgt Bryan Horsey was the 95 MDG

NCO of the Year for 2010.

SSgt Corissa Santos and SSgt Tanya McClory are both re-
training due to NCORP. SSgt Santos is going into Intel and
SSgt McClory will become a Unit Training Manager. Best of
luck.

The rising 4A0 superstar SrA Saman-

tha Gonzalez was selected as both the
AFMC Health Services Management
Airman of the Year, 2010 and the
AFMS RMO Airman of the Year,
2010.
SrA Sean McClory was promoted via BTZ to SrA in 2010.
 59th MDW, Lackland AFB

Readiness Flight

Right: SrA Colleen Rock was recognized by the Health Services

Inspection Team chief for outstanding performance. Zero discrep-
ancies on her RSV program.

Over the last year, the men and women of the 59th Medical Wing Readiness Flight trained more that 3K San Antonio area
Airmen and deployed over 1K personnel to 33 geographic locations in support of both wartime and humanitarian operations.

In accordance with recent Base Realignment and Closure law changes, the 59th MDW now handles deployment for all medi-
cal assets assigned within Joint Base San Antonio. Due to this change, 64 percent of all Air Education and Training Command
deployment requirements are filled through this office. Additionally, the 59th MDW accepts and fills 18 percent of Air Force
medical Service taskings Air Force wide, while maintaining a less than .07 percent discrepancy rate.

The readiness team who makes all this happen consists of deployment operations, customer service, medical readiness train-
ing, and readiness resources. The deployment process is a collaborative one where the readiness team works intimately with
each group‘s deployment manager to prepare the Airmen for their deployment. This team ensures our Airmen are fully trained,
equipped and prepared to accomplish their mission whether into a war zone of on a humanitarian operation.

They orchestrated two major medical humanitarian relief missions in support of Haiti and Chile operations by assisting with
aggregation and deployment of 190 personnel from 14 bases ensuring first class medical care to millions of earthquake victims.

As part of the readiness training team, the medical readiness training instructors maintain the only full-time medical readiness
training site in the Air Force. This 12-acre, 15-facility field training site is where they provide instruction on topics such as
Chemical, Biological, Radiological, and nuclear Weapons or CBRN, Self Aid and Buddy Cre or SABC, Field Sanitation, and
Disease Prevention, just to name a few. They also taught the Hazardous Material Response First Receiver and Operations course
to ensure that the San Antonio military medical community is fully prepared to handle contaminated patients during homeland
defense emergencies.

This process happens every day on the year, the readiness mission never stops. It is because of the dedication and hard work
of the men and women of the readiness flight that the 59th MDW medics are the best trained, best equipped and best prepared
and stand ready to respond to any operation at home or abroad.

By: MSgt Robert Kimrey

 673rd MDG, Joint Base
Elmendorf-Richardson

TSgt Michelle Weaver won the Joint Base

Elmendorf-Richardson 673 ABW NCO of the
year award. Also in the photo are TSgt Frank
O‘Laughlin, SSgt Christopher Walthall,
(C)MSgt Samuel Hess, Capt Robert Traylor,
TSgt Jennifer Martin, MSgt Mireya
Calderafavela, TSgt Dawn Strickland, and
CMSgt John Gervais.

56th MDG, Luke AFB

4A/MSC Appreciation week events included a PT

Challenge and luncheon

Some deployed 4A0s from Luke include: SrA Pierce (WPAFB),

MSgt Washington (Luke), SrA Waseta (Luke), SMSgt Hoshaw
(Lackland), SrA Mateo (Travis), SSgt Vail (Luke AFB)
 MSgt Donaciano Salinas is second from left and SrA Cristina Preston second from right

Deployed 4AO members to Landstuhl Regional Medical Center (LRMC) in Germany are assigned as either Air Force Liai-
sons or in positions within LRMC's Patient Administration Division performing various in-garrison and deployment-related
functions. As team members of an Army Division of 90+ personnel, the various duties encompass those of a Level-2 trauma cen-
ter.

Of significant importance, is the recurring 2-week, 24-hour on-call rotation thru the Defense Medical Wounded Warrior Cen-
ter. Directly supporting OPERATIONS ENDURING FREEDOM and NEW DAWN, LRMC oversees medical care for approxi-
mately 30 incoming wounded warriors with various illnesses and injuries on a daily basis. After enduring a 6+ hour flight from
an aeromedical evacuation hub in either Balad, Iraq or Bagram, Afghanistan, warriors land at Ramstein Air Base and are trans-
ported via ambulance bus to LRMC. At their point of arrival, a group of approximately 40 well-trained Air Force, Army, and
Navy personnel wait to greet, offload, and care for them.

This seamless, well-oiled process runs to perfection four or five times a day. Regardless of participating personnel rank or
experience, the team "gets it right" every time. Every person assigned to the team plays a vital and important role in ensuring the
success and warm welcome of down range troops. This process knows no bounds; while serving on call, 4AO's can expect to be
called at any time, around the clock, to meet and care for incoming patients. By any other medical treatment facility standard,
this would be considered a "mass casualty." For LRMC, it's all in a day's work.

While not for the faint of heart, 4A's are directly exposed to the realities of war and the wounded warriors and their families
bravely facing an uncertain future as a result of their various battlefield injuries. Maintaining courage, patience, understanding,
and peer support enables 4A's to press forward through ongoing stress and mission complexities. This honorable and very hum-
bling assignment is an experience in and of itself. Should you have the chance to deploy to LRMC, take full advantage. This is
truly a once-in-a-lifetime opportunity to make a difference in a service member's life.

Written by: MSgt Donaciano Salinas

 36th MDG, Anderson AFB

Above: 2010 4A/MSC Appreciation Day Group SrA Sydney Bricker getting her stripes tack on after
being promoted to SrA below the zone

Below: SSgt Virna Garcia received the Team Andersen‘s

Best Award for her hard work and dedication in the RMO

28th MDG, Ellsworth AFB

Above: SSgt Bartlett, CMSgt Schrecengost, A1C Guyton, SrA Morgan, SSgt Tabor, A1C Thorn,
TSgt Davis, SSgt Matta, SSgt Spears, A1C Nicholson, SMSgt House BOTTOM: TSgt Baker, Lt Salle,
TSgt Schommer, MSgt Carnes, A1C Boose

Ellsworth 4A0s had an extremely busy year preparing for two inspections, many DV visits and the clinic's renovation. We've had many suc-
cesses over the year and I'd like to share our most recent achievements. First, MSgt Tricia Carnes was named ACC Medical Readiness
NCO of the Year along with SSgt Matta as the ACC Health Plan Management NCO of the Year and TSgt Kevin Davis as the ACC RMO
NCO of the Year. Additionally, our TOPA Team earned deserved recognition as the ACC Health Plan Management Team of the Year. Fi-
nally, TSgt Erlinda Schommer was just announced as the 28 th Medical Group's NCO of the Year. We had a great year and look forward to
the challenges and opportunities 2011 has in store for us.
 60th MDG, Travis AFB

Some MSCs and 4A‘s kick-off

SSgt Shelton Griffin shares his thoughts with the TOPA Flight appreciation week.
Commander, Lt Col Jason Buckner while SMSgt Dan Elliot looks on.

The Medical Readiness Flight earned the 60th

MDSS Team of the Year Award, 2010. TSgt Eden Macinnes is the
AMC Outstanding Global
Health NCO of the Year, 2010.

SSgt Michael Graham, 60 MDSS

NCO of the Year, 2010
 Chief Wesley Harding presents the
Travis Chief‘s Choice Award to SSgt
Tosha Bone. Sergeant Bone is the Unit
Deployment Manager at the 60th MDSS.

Deployed 4A0s

Anyone who has deployed will agree that deployment is a huge sacrifice of self, however, the rewards of helping our fellow soldiers, air-
men and marines are far greater. For any 4A0 who feels like he/she is ‗just‘ a 4A0 or was wondering what can a 4A0 possibly do on deploy-
ment, let me inform you that you are one of the most important components of a deployment team. Here at Balad, the process begins with
you! The Patient Admin section (commonly known as ―PAD‖), is the nerve center of the hospital. The PAD, operated 24/7 and staffed with
90% 4A0s, is where all critical communication occurs such as notification of helicopters (HELOS) with patients in route, aeromedical evacua-
tion missions, radio communications with command post, Joint Patient Movement Requirement Center (JPMRC), and all other key depart-
ments. Information gathered and packaged by PAD personnel is extremely vital as it travels as far as the Pentagon. A 4A0 is the first source
of support for an injured or ill soldier, airman, or marine. We meet and greet litter or ambulatory patients from HELOS on the HELO pad,
register patients into CHCS, coordinate paperwork in TRAC2ES to transport him/her to Germany, and secure patient valuables to name a few.
4A0s work efficiently and are depended on from the moment notification of a patient is received as every second is critical for patients‘ prog-
nosis. Patient registration is of utmost importance in order for patient to receive medication, undergo surgery, etc. TRAC2ES paperwork is
even more critical in order for patient to be flown out of theatre for extensive care.

Camaraderie is excellent here; everyone takes care of each other. I recently celebrated my birthday and was overwhelmed with love and
presents from my deployed family. I was even surprised to see that my was room decorated along with a present from my roommate! It is a
wonderful feeling working as a team in collaboration with Army personnel, doctors, nurses, and 4Ns, but it is more gratifying to know that as
a 4A we touch the lives of all who are cared for at the 332nd Medical Group, Joint Base Balad.

Written by: TSgt Suzan Atkins from Andrews AFB