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CAPT Scott Gaustad, USPHS Therapist Chief Professional Officer

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1 CAPT Scott Gaustad, USPHS Therapist Chief Professional Officer
State of the Category 2014 CAPT Scott Gaustad, USPHS Therapist Chief Professional Officer

2 Category Day 2014 Welcome! 2014 USPHS Scientific and Training Symposium "Public Health Today: Prevention, Innovation, Progress.“ Thank you Category Day Organizing Committee Chair CDR Damien Avery Thank you CDR Tarri Randall and the TPAC Executive Committee. Distinguished guests

3 State of the Category We are… We practice… Our accomplishments…
Promotion… Readiness… What’s new…

4 State of the Category Nation’s Rehabilitation Professionals
Health Promotion and Disease Prevention Professionals Audiologists Occupational Therapists Physical Therapists Respiratory Therapists Speech-Language Pathologists 162 licensed professionals 12 Federal Agencies


6 In support of the PHS mission the Therapist Category:
“Public Health Today: Prevention, Innovation, Progress” Mission Statement: In support of the PHS mission the Therapist Category: ADVANCES the Nation's health through innovative and cutting edge research, policy design, and health science, IMPLEMENTS evidenced-based research into clinical practice for the health and wellness of the Nation's underserved populations, EDUCATES the Nation to facilitate and encourage the adoption of healthy lifestyles to prevent disease and disability, PROVIDES efficacious and progressive intervention for those with disability and disease to maximize function and improve quality of life, and RESPONDS to national and international Public Health needs with highly trained and skilled officers.

7 Prevention, Innovation, Progress
Prevention, Innovation, Progress.“Public Health Today”: Therapist Vision Statement: The Public Health Service Therapist Category will be a leader in in clinical and research rehabilitation science through: ENHANCING the Therapist Category’s leadership role in promoting the health and wellness of the Nation, EDUCATING public health leadership about the abilities of the Therapist Category on health promotion, disease prevention, wellness, rehabilitation and readiness response, PROMOTING Therapist Category professional development by enhancing their value in Public Health Service and the people we serve, ENCOURAGING advanced training, policy development, and research, ENGAGING in partnerships to meet public health challenges, and honoring the values, practices, and traditions of the Nation and the U.S. Public Health Service.

8 State of the Category Gender Diverse Female - 77 or 48%
American Indian or Alaskan Native - 16 or 10% Asian or Pacific Islander - 6 or 4% Black, not of Hispanic Origin – 10 or 6% Hispanic - 7 or 4% White, not of Hispanic Origin - 70 or 46% Unknown - 53 or 33%

9 The Corps by Category

10 The Corps by Agency SAMHSA 52 ATSDR 37 HRSA 192 IHS 2093 OS 172 ACF 8
JUSTICE 13 CDC 918 CMS 168 AHRQ 7 DOD TMA 254 USDA 20 NIH 296 INTERIOR 49 FDA 1033 PSC 35 DOD DOC 19 USAMRMC 1 BOP 880 EPA 63 DHS 337 USCG 155

11 We practice… Corps

ACF 1 5 8 AHRQ 2 3 7 (-1) ATSDR 20 6 37 (nc) BOP 62 7 196 16 390 157 13 37 (+2) 868 (+12) CDC 4 72 17 140 411 44 19 154 47 898 (+20) CMS 52 9 58 32 168(+13) DHS 75 202 18 337 DHS (CG) 53 57 155 DOC 10 19(+1) DOD 7 (nc) DOD/TMA 116 46 12 43 11 254(-21) EPA 15 34 63(-4) FDA 26 82 68 186 48 372 71 6(+1) 1033(+43) HRSA 86 5(-1) 192(-11) IHS 132 94 233 282 133 526 566 77 (+2) 2093(-1) INTER 22 49(+2) JUSTICE 13(nc) NIH 31 95 92 21 296(+1) OS 38 14 172(+5) PSC 35(-4) SAMHSA 50(+2) USAMRMC 1(nc) USDA 20(-1) Grand Total 280 (-18) (-1) 354 (-5) (-23) 1326 (+8) 851 1641 (+17) 1239 (+44) 350 (+16) 162 (+2) (-1) 6809(+44)

13 Therapist Category - Where We Practice:

14 Where We Practice… Region 10: AK, ID, OR, WA
Region 9: AZ, CA, HI, NV, AS, MIslands, Guam Region 8: CO, MT, ND, SD, UT, WY Region 7: IA, KS, MO, NE Region 6: AR, LA, NM, OK, TX Region 5: IL, IN, MI, MN, OH, WI Region 4: AL, FL, GA, KY, MS, NC, SC, TN Region 3: DC, DE, MD, PA, VA, WV Region 2: NY, NJ, PR, VI Region 1: CT, ME, MA, NH, RI, VT

15 Where we work… 13 5 8 2 9 27 5 38 28 27

16 We are… Corps Distribution by Corps and Category Therapist Category
(6/2/2014) Regular Active: 162 Regular Retired: 111 Reserve Retired: 11 284

17 We are… Corps Distribution by Rank – Corps

18 We are… (Therapist vs Corps, T-Grade)
Therapist Category Regular/RR Corps

19 We are… Therapist Distribution by Rank – Category (T-grade) 2014 data

20 We are… 2013 24 47 62 26 1 10 20 30 40 50 60 70 O-2 O-3 O-4 O-5 O-6 O-7

21 We are… (Therapist vs Corps)

22 We are… Information is only as good as that entered into online databases by officers.

23 Hail! Farewell! 2013-2014: 2013-2014: LT Lars Krusholm, PT - IHS
LT Michael Krok, PT - BOP LT Raul Leija, PT - BOP LT Melissa McGuinness, PT - IHS LT Kayla Meeks, PT - IHS LT John Burkart, AUD - IHS LT Peter Arroyo, OT - BOP LT Luis Millan, PT - IHS LTjg Catherine Kaminski, OT - BOP : RADM Penny Slade-Sawyer - OS CAPT Fran Oakley - NIH CAPT Georgia Johnson - CMS

24 Recruitment and Retention
Mentoring: The Therapist Category Mentoring program is designed to promote mentoring skills and to assist with the integration of officers and civilian therapists into the US Public Health Service. Junior levels of GS (5-7) and CO (O3 and below) are eligible to participate as mentorees. Eligible mentors are those persons at or above the GS-8 level for civil service or a rank of O4 for commissioned officers. Therapist Category: 162 officers (26 O-3 and below) - 68 mentors (42%) - 8 mentorees (5%)

25 Recruitment and Retention
Benefits of Mentoring: Enhance strategic business/professional initiatives Encourage retention Improve productivity Break down the "silo" mentality Elevate knowledge transfer Enhance professional development Link employees with valuable knowledge Internal experts for professional development Creating a mentoring culture, which promotes individual employee growth and development

26 Recruitment and Retention
Years of Service – 2014 Total = 162

27 Recruitment and Retention
Retirement Credit Years of Service – Total = 161 Year s of Service – Total = 162

28 Recruitment and Retention
2013 Data Most therapist officers with a rank of O4, 19 (18%) were in a billet grade of O5. The majority of officers with a rank of O5 reported either to be in a billet grade of O5, 22 (21%) or O6, 21 (20%).

29 Recruitment and Retention
2013 Data When asked if therapist officers serve in a non-traditional billet or multidisciplinary assignment, 29 answered “Yes” of which 11 officers were Physical Therapists and 9 were Occupational Therapists. Eighty-five (85) (75%) officers answered “No”, of which 67 were Physical Therapists and 9 were Occupational Therapists

30 Recruitment and Retention
2013 Data One officer whose billet grade was increased felt neutral about the change and the remaining 16 officers were satisfied with the change. Thirteen officers (17%) whose billet grade remained the same were also dissatisfied with their billet grade while 73% of officers whose grade didn’t change reported they were satisfied. In addition, four officers had their billet grade reduced but still reported being satisfied with their billet grade

31 Recruitment and Retention
2013 Data Factors leading therapist officers to consider early separation from the Commissioned Corps, comparing officers with <5 years of retirement credit to officers with >15 years of retirement credit. Factors leading therapist officers to consider early separation from the Commissioned Corps, comparing officers with 5-15 years of retirement credit to officers with >15 years of retirement credit.

32 Recruitment and Retention
2013 Data Therapist officer agreement with statements pertaining to specific features of Commissioned Corps services (N=115).

33 Accomplishments: Activities in 13-14 TPAC year Continuing activities
2016 PY Benchmarks review New TPAC Chair members/ sub/committee chairs APAN National Prevention Strategy Continued development of Direct Access Category Deployment Guideline Evolving Mentorship Program Strategic Growth Subcommittee business plan and career planning Call to Active Duty process/Appointment Board Academic Recruitment Project Continuing activities Retirement recognition Category, Responder Awards AMSUS – Rehab Program Journal Club Vacancy list – Recruitment Promotion preparation guide, credentials review guide Category roster and profile Web page Listserv PAC P&P and Model Charter implementation Fit for Duty – Fit for Life articles Mentoring! Promoting Physical Activity Guidelines

34 We’ve Accomplished…! Individual accomplishments – Awards PHS Awards
Commendation Medal Achievement Medals Crisis Response Service Award COA recognition AMSUS recognition (P.T. and O.T.) Agency and duty station recognition Directors awards, employee of the quarter, month National Recognition - AOTA Category awards - luncheon

35 We’ve Accomplished…! Individual accomplishments – training
Advanced degrees (DPT)/certificates Women’s Health, Vestibular Rehab Earned Board Specialties OCS, GCS, EMG/NCV, CWS, CLT, CSCS Participated in professional training professional conferences/CEUs, readiness and response, OBC, and MOC

36 We’ve Accomplished…! Service Clinical Programs
COA office, local and national Healthy lifestyles, health fairs, PT Month activities Community service Recruiting Expert on grant reviews CC Ensemble and Choir Clinical Programs EMG/NCV Bariatrics, diabetes Wound care, Spinal Cord Student education Journal Club Health and Wellness!

37 We’ve Accomplished…! Presentations Agency/Local Professional societies
2013 COF symposium CEU courses Publications The Hearing Journal Journal of the Acoustical Society of America Journal of the American Academy of Audiology Military Medicine (AMSUS) Physical and Occupational Therapy in Pediatrics American Journal of Occupational Therapy Pediatric Physical Therapy Journal of Orthopedic and Sports Physical Therapy Book chapters

38 We’ve Accomplished…! 2014 Category Awards:
William Fromherz Award: CAPT Michaele Smith Therapist of the Year: CDR Matthew Armentano Junior Officer of the Year: LT Chandra Preator Josef Hoog Award: CAPT David Byrne

39 Professional Development Promotion
Recognition Temporary Promotions (PY ’13) O-6, O-5, O-4 * 1 EPP Permanent Promotions (PY ’13) O-5, O-4, O-3

40 Professional Development Promotion

41 Professional Development Promotion

42 Professional Development Promotion

43 Professional Development Promotion

44 Professional Development Promotion - Precepts
1) Performance (40% of overall score) 2) Education, Training, and Professional Development (20% of overall score) 3) Career Progression and Potential (25% of overall score) 4) Characteristics of Career Officer & Service to the Corps (15% of overall score) 5) Response Readiness (0% of overall score, not scored by the promotion board). Response readiness is still an administrative check used for promotion. Officers who fail to meet and maintain basic readiness will not be promoted

45 Professional Development Promotion - Precepts
T-O4 Successful Average Performance

46 Professional Development Promotion - Precepts
T-O5 Successful Average Performance

47 Professional Development Promotion - Precepts
T-O6 Successful Average Officership

48 Professional Development Promotion Preparation
General feedback to all officers: Current and accurately formatted CVs are very important. Check Therapist Category for current year Promotion Benchmarks Use recommended CV format on website Awards Acknowledge post-graduate education and academic achievements Acknowledge and include post-graduate work in eOPF

49 Professional Development Promotion Preparation
General feedback to all officers: Career counseling encouraged but not required for any officer not promoted. Officers are free to choose who performs the counseling. Category career counseling by CPO or designee required for officers ranked in the lowest decile and lowest quartile X3 years. This must be documented in OPF. Officers ranked in lowest decile x3 years referred to retention review board. Officers not meeting readiness standards receive automatic not recommend and referred to review board.

50 Professional Development Promotion Preparation
General feedback to all officers Review your eOPF to see if you can EASILY locate information that addresses ALL promotion benchmarks. List the contact hours for continuing education Please consider the fax machine you are using Common issues included missing or out-of-date documents, 100% under the officer’s influence; CVs, Officer Statements, Continuing Education List. Verify that documents are complete, accurate, error free, and legible after they are faxed to the eOPF.

51 Professional Development Promotion Preparation
60 Comments on the score sheet provide insight into areas on which to focus to improve your performance/ scores for next year At least 2 board members must check box for strength/ suggestion to appear All free text comments appear

52 Professional Development Promotion Preparation
Readiness December 31 If ready – earn 0 points on readiness precept (PY-14) If not – automatic not recommend for promotion March 31 Part of administrative check along with licensure and other issues If ready – stay on rank order list If not – removed from rank order list, even if scored well enough by promotion board to be promoted

53 Strategic Growth/Development Promotion Preparation

54 Strategic Growth/Development Productivity
USPHS Provider Productivity benchmarks for Occupational and Physical Therapists: Occupational and Physical Therapy clinicians within the USPHS work in various practice settings and this document represents an initial attempt to establish productivity benchmarks. These benchmarks should be used to gauge and improve productivity and are not intended to represent an absolute standard for all providers. The benchmarks are established utilizing productivity data from the US Army and the private sector1,2. Unit of Measure: Provider productivity is measured utilizing relative value units (RVU’s). Two major components of the relative value unit are: personnel time associated with the activity other direct and appropriate indirect department resources used in providing the activity. 15 minutes has been established as the least increment of time for which a unit of service (e.g., evaluation, therapeutic, or patient educational activity) can occur The unit of service is a modality - Activity is used to establish the basic relative value unit of 1.0.

55 Readiness and Response
Readiness and Deployment Basic or 90% Exempt - 8 or 5% Not Qualified or 5% (March 31st) 35 or 22% (May 31st) n = 162 (last reported number) March 31, 2014 Basic +Exempt = 95% (1st – Copper!) May 31, 2014 Report: 78% 3/31/12

56 Readiness and Response
Extinct after 12/31/2014

57 Readiness and Response
Recent Deployments: Field-based training Mariana Islands - Saipan CHASM IHS

58 Transformation – Direct Access
Current Priorities Direct Access – continued implementation of DA. Retiree pay completed. Active duty pay transition ongoing. Now primary means to enter some readiness info, but be familiar with all data fields.

59 Professional Development Billets
Questions: personnel order in eOPF “change of assignment” receipt of “individual position number” DA number current Assignment and Assignment History Current assignment – DA position and billet equivalent grade Assignment History - DA Billet System Position Assignment Stated grade is the pay grade of the officer – not position

60 Professional Development Promotion: BCS
Number of Therapists at the time of BCS: 118 Number of O5 billets before BCS: 31 (26%) Number of O5 billets after BCS: (34%) Number of O6 billets before BCS: 37 (31%) Number of O6 billets after BCS: (29%) Total O5 & O6% before BCS: 58% Total O5 & O6% after BCS: 63% (+5%)

61 Professional Development Promotion: BCS
IHS: BOP: Total at time of BCS: 33 Before BCS Number of O5: 9 (27%) Number of O6: 6 (18%) Total % O5 and O6: 45 After BCS Number of O5: 10 (30%) Number of O6: 5 (15%) Total % O5 and O6: 45 (nc) Total at time of BCS: 63 Before BCS Number of O5: 16 (25%) Number of O6: 23 (37%) Total % O5 and O6: 62 After BCS Number of O5: 19 (30%) Number of O6: 21(33%) Total % O5 and O6: 63 (+2)

62 Professional Development Promotion: BCS

63 Information Management: New Policies
DCCPR Issuances Uniform Wear - ODU (January 1, 2015) Voluntary Retirement - CC384.02 Protected Communications - CCD Minimum GPA - PPM (2.5 to 2.8) Ready Reserve Officers - POM Amendment to Uniform Wear - PPM Uniforms and Appearance - CC412.01 2015 Promotion Benchmarks

64 Information Management: Policies in Development
DCCPR Issuances in process: Administrative and Disciplinary Actions Allotments Child Support/Alimony Garnishment Orders Consolidated Special Pays Deployment Readiness Details (Blanket) Domestic/Family Neglect; Violence, Abuse and Treatment Uniforms - Discipline APFT Equal Opportunity Force Management (Assimilation Program) Former Spouse Payments from Retired Pay Leave Physical Training Uniform Political Activities Promotions Directive Protected Communications Travel and Transportation Allowances

65 Health Care Reform Patient Protection and Affordable Care Act (ACA)
Sec Elimination Of Cap On Commissioned Corps. Sec Establishing A Ready Reserve Corps - pending Sec Commissioned Corps And Ready Reserve Sec United States Public Health Sciences Track – pending Wellness, Prevention and Chronic Care management is a priority

66 The future… Direct Access Active Duty Pay Health Care Reform
Review of CC operational components – Readiness CAD Process Five Pillars – 2016 Benchmarks National Prevention Strategy Best Practice Guidelines Standardized position descriptions Credentialing and Privileging ICD-10 Career Development/Career Progression mapping

67 Surgeon General Initiatives
Childhood Overweight and Obesity Prevention Initiative National Prevention Strategy Women’s Health Issues A Healthy and Fit Nation Walking Call to Action Stay Engaged…!


69 “The purpose of life is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience.” Eleanor Roosevelt

70 CAPT (Ret) John “Jack” Echternach
CAPT (Ret) Judith Bell Krotoski CAPT (Ret) Jonathan Spry “The most important thing in life is to live your life for something more important than your life.” Anonymous

71 August 16, 2014 – Vining, MN


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