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1 Navy Medicine Program Elements Operations Finance Audit Readiness Training Symposium June 2012.

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Presentation on theme: "1 Navy Medicine Program Elements Operations Finance Audit Readiness Training Symposium June 2012."— Presentation transcript:

1 1 Navy Medicine Program Elements Operations Finance Audit Readiness Training Symposium June 2012

2 2 Context / Purpose / Outcome The current fiscal environment is very tight and program requirements continue to be highly scrutinized Starting this fiscal year, funds are being issued and managed at the Program Element (PE) level Context Purpose Outcome Enhance stakeholder understanding of the allowable and expected expenses within Navy Medicine PEs Better position Navy to reduce the risk of receiving reductions Not executing as planned puts Navy Medicine funds at-risk (EBP) Exposes Navy Medicine to potential Congressional reductions Further enhance Navy Medicine’s ability to effectively execute and budget at the Program Element level Continue to identify ways we can work together to improve our funding-execution accuracy

3 3 Agenda Background Overview –Program Element Description –Program Element Structure BAG-PE Overview –Definitions and Examples Effective Execution Monitoring

4 4 What is a Program Element? The Program Element is a primary data element in the OSD Defense Program and generally represents aggregations of organizational entities and resources related thereto. They are the building blocks of the programming and budgeting system and may be aggregated and reaggregated in a variety of ways. Program Elements are the link between Budget Execution and the Future Years Defense Program Each Program Element may or may not consist of forces, manpower, and dollars, depending on the definition of the element

5 5 Program Element Coding Symbology The structure of the PE can change over time. Currently, the PE (8 digits long) consists of 4 components: Positions Major Force Planning Code Positions OSD PE Serial Number Positions Special PE Group Sequence Position 8 - Program Sponsoring Organization (Navy - 'N'). MFP CodeMFP Description 01Strategic Forces 02General Purpose Forces 03Command, Control, Communications and Intelligence 04Mobility Forces 05Guard and Reserve Forces 06Research & Development 07Central Supply and Maintenance 08Training, Medical and Other General Personnel Activities 09Administration and Associated Activities 10Support of Other Nations 11Special Operations Forces PE Breakdown: N

6 6 Navy Medicine’s BAG-PE Structure Within Navy Medicine DHP, the PEs can be aggregated to form Budget Activity Groups (BAGs)

7 7 BAG-PE Overview

8 8 BAG 1: In House Care PEs BAG 1 provides for the delivery of patient care in the Continental United States (CONUS) and Outside the Continental United Status (OCONUS). This program includes the following: Care in DoD Medical Centers, Hospitals and Clinics – Resources medical care in CONUS and OCONUS facilities which are staffed and equipped to provide inpatient and outpatient care for both surgical and non- surgical conditions for MHS beneficiaries Dental Care – Resources dental care and services in CONUS and OCONUS for authorized personnel through the operation of hospital departments of dentistry, installation dental clinics an Regional Dental Activities Pharmaceuticals – Resources pharmaceuticals specifically identified and measurable to the provision of pharmacy services in CONUS and OCONUS facilities Also includes staffing to provide medical and dental care in medical facilities which provide the full range of inpatient and ambulatory medical and dental care services. Also includes medical center laboratories, alcohol treatment facilities, clinical investigation activities, facility on-the-job training programs and federal sharing arrangements Def Med Ctrs, Stn Hsps & Clns – CONUS Pharmaceuticals – CONUS Dental Care Activities – CONUS Def Md Ctrs, Stn Hsps & Md Clns – OCONUS Pharmaceuticals – OCONUS Dental Care Activities - OCONUS OverviewProgram Elements

9 9 BAG 1 – – Defense Medical Centers, Stations Hospitals and Medical Clinics - CONUS Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Resources devoted to the provision of health care in DoD-owned and operated CONUS facilities which are staffed, and equipped to provide inpatient care for both surgical and nonsurgical conditions and/or outpatient care for non-hospital type patients. Includes medical centers, station hospitals, medical clinics, subordinate aid stations, resource sharing and resource support agreements, federal sharing agreements, medical center laboratories which are integral to these facilities, alcohol abuse treatment programs conducted at these facilities, clinical investigations activities conducted at these activities, and staff support for on-the-job training and education programs conducted at these facilities. Excludes supplemental care costs specifically identified and measurable to health care services received in a non-defense facility as a result of a referral for authorized beneficiaries of the military services. Excludes resources associated with the operation of management headquarters for regional lead agents, dental clinics, tactical medical units (see appropriate elements in Programs 2 and 5) and other health care resources devoted exclusively to teaching (see appropriate elements in this program). Examples FOR CONUS FACILITIES: Medical Provider Contracts for the MTFs (Inpatient, Ambulatory, Outpatient) Civilian Personnel Costs for Medical Providers for the MTFs (Inpatient, Ambulatory, Outpatient) Expense Equipment (<$250K) Clinical Investigation Programs Patient Travel Consumables – Medical and Surgical Supplies

10 10 BAG 1 – – Pharmaceuticals in Defense Medical Centers, Station Hospitals and Medical Clinics - CONUS Includes pharmaceuticals specifically identified and measurable to provision of Pharmacy Services in DoD owned and operated CONUS facilities. Excludes manpower authorizations, support equipment and other cost directly associated with the production and operation of DoD owned and operated facilities. This Program Element is designed to specifically collect Pharmaceuticals. It will include all prescription supply items used in the direct patient care by hospitals, dental clinics, veterinary clinics and other clinics such as Occupational Health Clinics. These items include all Federal Supply Class (FSC) 6505, intravenous (IV) fluids, immunizations, food supplements that require a prescription and are dispensed directly to the patient, and (FSC) 6540 items such as chemistry strips, glucose strips, urine test strips, when dispensed to the patient and other applicable items from other Federal Supply Classes. Examples Pharmaceuticals (drugs) only, including immunizations at CONUS Facilities

11 11 BAG 1 – – Dental Care Activities - CONUS Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Resources specifically identifiable and measurable to the provision of dental care and services in CONUS to authorized personnel through the operation of hospital departments of dentistry and installation dental clinics, and the operation of Regional Dental Activities. Excludes the provision of dental services by units organic to Operating Forces units and dental units operating in an active combat zone. Examples FOR CONUS FACILITIES: Dental Care Provider Contracts for the MTFs (Inpatient, Ambulatory, Outpatient) Civilian Personnel Costs for Dental Care Providers for the MTFs (Inpatient, Ambulatory, Outpatient) Expense Equipment (<$250K) Consumables – Medical and Surgical Supplies used for dental care

12 12 BAG 1 – – Defense Medical Centers, Station Hospitals and Medical Clinics - OCONUS Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Resources devoted to the provision of health care in DoD-owned and operated OCONUS facilities which are staffed, and equipped to provide inpatient care for both surgical and nonsurgical conditions and/or outpatient care for non-hospital type patients. Includes medical centers, station hospitals, medical clinics, subordinate aid stations, resource sharing and resource support agreements, federal sharing agreements, medical center laboratories which are integral to these facilities, alcohol abuse treatment programs conducted at these facilities, clinical investigations activities conducted at these activities, and staff support for on-the- job training and education programs conducted at these facilities. Excludes supplemental care costs specifically identified and measurable to health care services received in a non-defense facility as a result of a referral for authorized beneficiaries of the military services. Excludes resources for dental clinics, tactical medical units (see appropriate elements in Programs 2 and 5) and other health care resources devoted exclusively to teaching (see appropriate elements in this program). Examples FOR OCONUS FACILITIES: Medical Provider Contracts for the MTFs (Inpatient, Ambulatory, Outpatient) Civilian Personnel Costs for Medical Providers for the MTFs (Inpatient, Ambulatory, Outpatient) Expense Equipment (<$250K) Clinical Investigation Programs Patient Travel Consumables – Medical and Surgical Supplies

13 13 BAG 1 – – Pharmaceuticals in Defense Medical Centers, Station Hospitals and Medical Clinics - OCONUS Includes pharmaceuticals specifically identified and measurable to provision of Pharmacy Services in DoD owned and operated OCONUS facilities. Excludes manpower authorizations, support equipment and other cost directly associated with the production and operation of DoD owned and operated facilities. This Program Element is designed to specifically collect Pharmaceuticals. It will include all prescription supply items used in the direct patient care by hospitals, dental clinics, veterinary clinics and other clinics such as Occupational Health Clinics. These items include all Federal Supply Class (FSC) 6505, intravenous (IV) fluids, immunizations, food supplements that require a prescription and are dispensed directly to the \patient, and (FSC) 6540 items such as chemistry strips, glucose strips, urine test strips, when dispensed to the patient and other applicable items from other Federal Supply Classes. Examples Pharmaceuticals (drugs) only, including immunizations at OCONUS Facilities

14 14 BAG 3: Consolidated Health Support BAG 3 provides health care program support for special mission activities and regional lead agents. Included are programs for manufacturing spectacles for active duty members, delivering specialized environmental health services consisting epidemiology, medical entomology, drinking water safety, monitoring hazardous waste disposal, food and facility sanitation, wellness/health promotion and education, health surveillance, community health nursing and medical intelligence to all shore facilities; collecting, processing, analyzing, and proper disposition of the remains of deceased for whom the Navy is responsible; staffing equipping, and maintaining Child Development Centers and Family Day Care Homes – Examining Activities – Health Care – Mil Public Hlth/Occ Health – Other Health Activities – Mil Unique Rqmts – Other Med – Health Care – Joint Pathology Center OverviewProgram Elements

15 15 BAG 3 – – Examining Activities Support Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Resources devoted to administering physical examinations and performing evaluations of medical suitability. Also includes resources at the Armed Forces Examination and Entrance Stations (AFEES) devoted to the Defense Medical Review Board. Excludes Service recruiting headquarters, career counselors assigned to AFEES, and mental/vocational testing performed by recruiting personnel (see "Recruiting Activities" – PE ); mental/vocational testing performed at reception centers (see "Personnel Processing Activities" - PE ); mental/vocational testing performed by recruit training centers (see "Recruit Training Units" - PE ; and "Defense Medical Centers, Station Hospitals, and Medical Clinics." Examples Normally, this Program Element is executed by Army, DHP We received funding in FY 09 which was a pass-through to MMSO for the Disability Evaluation System (Wounded, Ill, and Injured)

16 16 BAG 3 – – Military Public / Occupational Health Includes Military Public Health manpower authorizations, supplies, permits, certification and licensure fees, peculiar and support equipment, and the associated costs specifically identified and measurable to: management, direction, operation, training and conduct of preventive medicine disease prevention and control, consisting of: epidemiology; medical entomology; drinking water safety; monitoring hazardous waste disposal; food and facility sanitation; wellness/health promotion and education; health surveillance; community health nursing; medical intelligence; disease and climatic illness and injury surveillance, diagnosis and control. Includes training requirements; review and preparation of program documents; site and epidemiological studies; standard setting; laboratory analysis; examination; and data evaluations related to the medical aspects of preventive medicine. Also includes preparation and readiness training of military personnel in assessment, treatment and prevention of medical threats, both general and specific, within theaters of operation. Includes Occupational Health manpower authorizations, supplies, permits, certification and licensure fees, peculiar and support equipment, and the associated costs specifically identified and measurable to: assess workplace health hazards and risks; survey health and illness in employee population; track employee occupational exposures to physical, chemical, and biological stresses (vibration, noise, and radiation, etc.); develop preventive measures to reduce toxic and radiological exposures and health risks; recommend prevention measures; train/educate commanders, supervisors and employees to avoid risks and health hazards; train/educate commanders supervisors and employees in healthy work practices; collect and disseminate occupational illness surveillance data; investigate exposures to blood or other potentially infectious materials; perform health hazard assessment of new material and weapon systems; provide medical support to chemical, biological and nuclear surety programs; and conduct epidemiological studies in occupational diseases. Includes resources associated with the operation of separately organized occupational health clinics providing medical care to DoD civilian employees, the Army Hygiene Agency, Navy Environmental Health Center, Navy Environmental and Preventive Medicine Units, Navy Disease Vector Ecology and Control Centers, hearing conservation programs, and Epidemiological Flights and Laboratories. Excludes activities assigned under Environmental Compliance (0X0XX56); Veterinary Medicine; and Immunizations under Defense Medical Centers, Station Hospitals and Medical Clinics. Examples Industrial Hygiene Occupational Medicine Consolidated Industrial Hygiene Laboratories Environmental and Preventive Medicine Units Health Promotion and Wellness Navy Central HIV Program Global Emerging and Infectious Disease Surveillance (GEIS) Psychological Health – Resilience Promotion, Surveillance Screening

17 17 BAG 3 – – Other Health Activities Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Organizations and functions that support the provision of health care for Military Health Service System beneficiaries to include activities such as management headquarters for regional lead agents, central medical laboratories, medical service squadrons, AMEED Field Procurement Offices, the Health Services Data Systems Agency, Navy Healthcare Support Offices, public affairs, and family advocacy among others. Excludes tactical medical units (including dental activities) other than described above; Armed Forces Institute of Pathology and Aeromedical Evacuation resources; Armed Forces Examination and Entrance Stations (see Examining Activities element); recovery, preparation, transportation, and internment of deceased military personnel; veterinary services; and functions which are integral to medical center/station hospital/clinic/dispensary operations. Excludes activities that provide support to the unique health care mission required by virtue of the military mission and not generally analogous to services provided under a civilian health benefit plan. (See PE definition for Military Unique Requirements - Other Medical). Starting in FY 2013, resources for the Federal Health Care Center (FHCC) North Chicago are realigned to this functional area. Examples Regional Commands (Navy Medicine East, Navy Medicine West, Navy Medicine Support Command) Coordinated Care Operations (Referral Management) at Medical Treatment Facilities Patient Administration Quality of Care Review Healthcare Analysis and Studies Medical Logistics Public Affairs Psychological Health – Transition and Coordinated Care

18 18 BAG 3 – – Military Unique Requirements – Other Medical Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Military medical unique functions and activities that have a relationship to the size of the military population supported and are not included in any other program elements. Includes, but not limited to, resources to fund activities such as: Office of the Special Assistant for Gulf War Illnesses (OSAGWI), Physiological Training Units, the Defense Medical Standardization Board, Drug Abuse Detection Labs (except those funded by direct transfer from the OSD Drug Interdiction and Counter-Drug Activities Account in PE set), Military Blood Program Agency, Optical Repair and Fabrication Laboratories, the Air Force Armstrong Laboratory, Health Facilities Offices, Medical Logistics Offices, Medical Support Offices, Medical Wartime Hospital Integration Office; Army Medical Material Activities, Plans Operations and Training, Walter Reed Army Institute of Research; and the Navy Medical Logistics Command. Excludes functions and activities included in the definition for PE set Other Health Activities. Examples Naval Ophthalmic Support and Training Activity (NOSTRA), as well as Optical Fabrication support at medical treatment facilities Blood Donor Centers and Laboratories Humanitarian Support Disaster Relief (CONUS/OCONUS) Support to line missions, as requested by Navy and Other Services Physiological training units Readiness logistics support Operational medicine Repatriated Prisoner of War (RPOW) program Anti-terrorism Consequence Management

19 19 BAG 3 – – Joint Pathology Center Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identifiable and measurable to the following: Includes operation and maintenance of the JPC as authorized under the National Defense Authorization Act 2008 Section 722. Includes expenses incurred in the conduct of the JPC´s assigned missions: JPC shall function as the reference center in pathology for the Federal Government; provide diagnostic pathology consultation services in medicine, dentistry, and veterinary sciences; provide pathology education, to include graduate medical education (residency and fellowship programs), and continuing medical education; provide diagnostic pathology research; provide maintenance, continued modernization, and utilization of the Tissue Repository. Resources in this PE are strictly for support of DoD assigned missions and will not be commingled with other resources. Examples Manpower, equipment, facilities, and associated operation and maintenance of the Joint Pathology Center; funded by JTF-CAPMED. (18P2) JPC is jointly funded by Navy, DHP (18P2) and Army, DHP (18P1) O&M Military Unique former AFIP functions belong to either Army, DHP or TMA-Operations

20 20 BAG 4: Information Management BAG 4 includes funding for non-centrally managed, medical information managements/information technology programs and operations. Includes medical support (dollars and manpower) for functional area applications; communications and computing infrastructure; information assurance and information security activities; long haul/wide area communications, office automation and video teleconferencing. These financial and manpower resources support the operation and maintenance of information management and information technology at Naval Medical Centers, Branch Medical Clinics, Navy Dental Centers, Branch Dental Clinics and Specialized Mission Activities located at or near Navy and Marine Corps stations and bases – Non-Central IM/IT – MHS Tri-Service IM/IT (Central) OverviewProgram Elements

21 21 BAG 4 – – Non-Central IM/IT Includes funding for non-centrally managed, Service Medical Information Management/Information Technology Programs. Includes Service Medical funded support (dollars and manpower) for Functional Area Applications (Tri-Service and Service-Unique); Communications Computing Infrastructure to include Information Assurance (IA), long haul/wide area and deployable tactical/shipboard communications, office automation and video- teleconferencing; and Related Technical Activities. Specifically excludes Base Communications and Voice Communications costs. Any funds received in the year of execution from the centrally managed IM/IT program should be executed in Program Element Central Information Management/Information Technology (IM/IT). Examples FAA – DENCAS (Dental Common Access System) C&CI – Network Management Service, Help Desk Support RTA – DINPACS (Digital Imaging-Picture Archive System and Comm), CEB Library ( Clinical Evidence Base) IAA – ATO’s (Authority to Operate), Risk Assessments & Annual Reviews

22 22 BAG 4 – – MHS Tri-Service IM/IT (Central) Includes funding to manage the Military Health System (MHS), centrally managed, Tri-Service information programs. The Tri-Service IM/IT program manages development of standardized information systems designed to meet Tri-Service functional requirements at all echelons of command in the medical functional area. More specifically, the Tri-Service IM/IT program defines, acquires/develops, maintains and oversees the design, enhancement, operation, acquisition, sustainment and management of information systems, related IT infrastructure and communications in support of the activities for the DoD MHS. The transfer of any Defense Health Program (DHP) funds that are programmed and budgeted as part of the central Program Execution Office (PEO) Information Management/Information Technology (IM/IT) program which need to be executed by DHP components (Army, Navy, Air Force) will be accomplished by Funding Authorization Documents (FADs). Examples Execution occurs in this PE only if funding is received from TMA in this PE

23 23 BAG 5: Management Activities BAG 5 finances the internal operation of navy medical headquarters. The headquarters unit direct overall health care programs involving medical contingency preparedness and peacetime delivery of health care to authorized beneficiaries of the Navy and Marine Corps. This management, exercised through one headquarters unit, ensures the delivery of medical and dental care and associated support services to the operating forces and shore establishments of the Navy and Marine Corps and the training of adequate numbers of health professionals and paramedical personnel for contingency and mobilization purposes – Management Activities (Components) OverviewProgram Elements

24 24 BAG 5 – – Management Activities (Components) Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following: Army: U.S. Army Medical Command (MEDCOM) Headquarters; Medical Material Agency. Navy: Bureau of Medicine and Surgery. Defense Agencies: Defense Medical Facilities Office (DMFO), which is a component of the Defense Medical Programs Activity. Excludes non- management headquarters resources (refer DoDD ). Examples Used only by Headquarters Operations (M85) Civilian personnel at BUMED serving in a Headquarters Management capacity for any of the Assistants Chiefs or the Surgeon General’s office Contracts which support Assistant Chief projects Mission (non-training) related BUMED travel Administrative office supplies

25 25 BAG 6: Education and Training BAG 6 is comprised of three primary categories that provide support for education and training opportunities for personnel within the Defense Health Program: Health Professions Scholarship Program – Resources required for the Armed Forces HPSP, FAP, HPLRP and other pre-commissioning professional scholarship programs. Uniformed Services University of the Health Sciences – Resources required for operation and maintenance of the USUHS. Other Education and Training – Resources required for specialized skill training and professional development education programs for health care personnel at Navy BUMED sponsored schools and training programs. Includes formal education programs for health care personnel at civilian academic institutions, civilian medical facilities and facilities of non-DoD governmental agencies. Professional development provides officer, enlisted and civilian medical personnel with the skills and knowledge required to perform highly technical health services jobs – Armed Forces Health Professions Scholarship Program – Other Education and Training OverviewProgram Elements

26 26 BAG 6 – – Armed Forces Health Professions Scholarship Program Includes costs specifically identified and measurable to the Armed Forces Health Professions Scholarship (HPSP), Financial Assistance Program (FAP), Nurse Candidate Program (NCP), and other pre-commissioning professional scholarship programs. Excludes manpower authorizations and administrative support costs for the above programs, other health acquisition programs, and the Airman`s Education Commissioning Program. Examples Only executed at Navy Medicine Professional Development Center (NMPDC) Full tuition and fees for medical, dental, undergraduate nursing students Reimbursement for books, equipment and supplies

27 27 BAG 6 – – Other Education and Training Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the conduct of specialized skill training and professional development education programs for health care personnel at:U.S. Army Medical Department Center and School, Bureau of Medicine and Surgery sponsored schools, School of Aerospace Medicine, Brooks AFB, Texas, School of Health Care Sciences, Sheppard AFB, Texas. Also includes other formal health care training courses in DoD institutions, except health care acquisition training. Includes such formal programs for health care personnel at civilian academic institutions, civilian medical facilities, and the facilities of non- DoD governmental agencies. The nonpersonnel costs of formal training will be funded by the service which is executive agent for the school or course. Active duty enlisted personnel undergoing initial skill training will be identified by appropriate trainee Resource Identification Codes (RIC’s). Interns, residents, fellows and all other active duty military personnel undergoing training in PCS status will be identified by appropriate student RIC’s. Excludes Continuing Medical Education (CME), flying training for flight surgeons (PE ); health professionals acquisition programs; pay and allowances and manpower authorization for reserve component personnel undergoing training (Program 5); and base operations and communications. Examples Attendance at American Medical Association (AMA) conference Expenses associated with the Education and Training Department (i.e. CIVPERS, supplies, etc.) Funding for courses sponsored by NMPDC (i.e. Patient Admin Course, Financial & Material Management Training Course )

28 28 BAG 7: Base Operations/ Communications Base Operations (BASOPS) / Communications refers to the resources dedicated to the operation and maintenance of Defense Health Program (DHP) facilities. BASOPS provides for facilities and services at military medical activities (CONUS and OCONUS) supporting active duty combat forces, reserve and guard components, training, eligible beneficiaries. The program consists of eight components: Facility Restoration and Modernization Facility Sustainment Facilities Operations Base Communications Base Operations Support Environmental Visual Information Systems Demolition/Disposal of Excess Facilities – Facility Restoration and Modernization (CONUS) – Facility Sustainment (CONUS) – Facility Restoration and Modernization (OCONUS) – Facility Sustainment (OCONUS) – Environmental Conservation – Pollution Prevention – Environmental Compliance – Facilities Operations – Health Care (CONUS) – Visual Information Activities – Base Communications (CONUS) – Base Operations – Health Care (CONUS) – Facilities Operations – Health Care (OCONUS) – Base Communications (OCONUS) – Base Operations – Health Care (OCONUS) OverviewProgram Elements

29 29 BAG 7 – – Facility Restoration and Modernization (CONUS) Facilities Restoration and Modernization Health Care. Provides resources for improving an inventory of medical facilities and installations with a primary mission of health care. Restoration includes repair and replacement work to restore damaged facilities due to accident or failure attributable to inadequate sustainment, excessive age, or other causes. Modernization includes alteration of facilities to implement a new, higher standard (including regulatory changes), to accommodate new functions, or to replace building components that typically last more than 50 years (such as foundations and structural components). Restoration and modernization does not include recurring sustainment tasks or certain environmental measures (such as removal of asbestos and lead paint), which are funded elsewhere. Other tasks associated with facilities operations (such as custodial services, grass cutting, and the provision of central utilities) are also not included. Excludes Army and Air Force contingency hospitals, Navy fleet hospitals, and Navy fleet hospital storage facilities. Examples CONUS R2 Special Projects > $200K are managed by BUMED M41 (i.e. Restore Building Systems, Reconfigure Pharmacy, Replace Fire Alarm System) CO Approved CONUS R1 Special Projects = < $200K are managed by your local Facilities Department CONUS MILCON Studies managed by Ms. Sharon BUMED M4

30 30 BAG 7 – – Facility Restoration and Modernization (OCONUS) Facilities Restoration and Modernization Health Care. Provides resources for improving an inventory of medical facilities and installations with a primary mission of health care. Restoration includes repair and replacement work to restore damaged facilities due to accident or failure attributable to inadequate sustainment, excessive age, or other causes. Modernization includes alteration of facilities to implement a new, higher standard (including regulatory changes), to accommodate new functions, or to replace building components that typically last more than 50 years (such as foundations and structural components). Restoration and modernization does not include recurring sustainment tasks or certain environmental measures (such as removal of asbestos and lead paint), which are funded elsewhere. Other tasks associated with facilities operations (such as custodial services, grass cutting, and the provision of central utilities) are also not included. Excludes Army and Air Force contingency hospitals, Navy fleet hospitals, and Navy fleet hospital storage facilities. Examples OCONUS R2 Special Projects > $200K are managed by BUMED M41 (i.e. Restore Maternity Residence at Overseas MTF, Restore Fire Doors) CO Approved OCONUS R1 Special Projects =< $200K are managed by your local Facilities Department OCONUS MILCON Studies managed by Ms. Sharon BUMED M4

31 31 BAG 7 – – Facility Sustainment (CONUS) Facilities Sustainment - Health Care. Provides resources for maintenance and repair activities necessary to keep an inventory of medical facilities and installations with a primary mission of health care in good working order. It includes regularly scheduled adjustments and inspections, preventive maintenance tasks, and emergency response and service calls for minor repairs. It also includes major repairs or replacement of facility components (usually accomplished by contract) that are expected to occur periodically throughout the life cycle of facilities. This work includes regular roof replacement, refinishing of wall surfaces, repairing and replacement of heating and cooling systems, replacing tile and carpeting, and similar types of work. It does not include certain restoration, modernization, and environmental compliance costs which are funded elsewhere. Other tasks associated with facilities operations (such as custodial services, grass cutting, landscaping, waste disposal, and the provision of central utilities) are also not included. Excludes Army and Air Force contingency hospitals, Navy fleet hospitals, and Navy fleet hospital storage facilities. Examples Facility maintenance/emergency repair contracts to include utility distribution systems Annual boiler inspections CO approved sustainment M2 special projects =< $200K (i.e. replace roof, walls, tiles, carpet, HVAC and similar type of work) M41 managed sustainment M2 special projects > $200K CIVPERS in support facility sustainment CONUS Excludes: Custodial services, ground maintenance, waste disposal, and utilities which are included in Facility Operations PE Repair of structures that will last more than the expected life of the facility which is part of RM PE Non-Facility related equipment service/repair contracts managed by BIOMED Technicians

32 32 BAG 7 – – Facility Sustainment (OCONUS) Facilities Sustainment - Health Care. Provides resources for maintenance and repair activities necessary to keep an inventory of medical facilities and installations with a primary mission of health care in good working order. It includes regularly scheduled adjustments and inspections, preventive maintenance tasks, and emergency response and service calls for minor repairs. It also includes major repairs or replacement of facility components (usually accomplished by contract) that are expected to occur periodically throughout the life cycle of facilities. This work includes regular roof replacement, refinishing of wall surfaces, repairing and replacement of heating and cooling systems, replacing tile and carpeting, and similar types of work. It does not include certain restoration, modernization, and environmental compliance costs which are funded elsewhere. Other tasks associated with facilities operations (such as custodial services, grass cutting, landscaping, waste disposal, and the provision of central utilities) are also not included. Excludes Army and Air Force contingency hospitals, Navy fleet hospitals, and Navy fleet hospital storage facilities. Examples Facility maintenance/emergency repair contracts to include utility distribution systems Annual boiler inspections CO approved sustainment M2 special projects =< $200K (i.e. replace roof, walls, tiles, carpet, HVAC and similar type of work) M41 managed sustainment M2 special projects > $200K CIVPERS in support facility sustainment OCONUS Excludes: Custodial services, ground maintenance, waste disposal, and utilities which are included in Facility Operations PE Repair of structures that will last more than the expected life of the facility which is part of RM PE Non-Facility related equipment service/repair contracts managed by BIOMED Technicians

33 33 BAG 7 – – Environmental Conservation Conservation includes any action specifically required to protect or enhance natural and cultural resources, preserve access to improved and unimproved training areas, and make necessary repairs to minimize erosion and otherwise rehabilitate DoD lands and waters. This includes complying with federal, state and local codes such as the National Historic Preservation Act, Archaeological Resources Protection Act, Native American Graves Protection and Repatriation Act, Endangered Species Act, Federal Insecticide, Fungicide and Rodenticide Act (FIFRA), and the Sikes Act. Funds all costs associated with direct support of conservation activities, including: A. Studies and surveys to identify, inventory, and manage existing natural and cultural resources and evaluation of the resources so identified and inventoried; B. Management costs, including workyears devoted to natural and cultural activities and preparing natural and cultural resource management plans; C. Permits for use of natural and cultural resources; D. Certification of innovative technology for DoD applications; E. Design, construction, maintenance or repair costs specifically required to restore, improve or maintain natural or cultural resources; F. Supplies and equipment required to carry out applicable natural and cultural resources management activities; G. Appropriated funds attributable to fish, wildlife, agricultural outleasing and timber management activities. Excludes: A. Base Closure costs associated with these programs; B. Normal maintenance required for appearance, including landscaping; C. NEPA costs associated with facilities or weapons systems which are included in facility or weapon system costs; D. Activities funded in the DoD Working Capital Funds (DWCF), which are charged to the appropriate DWCF program elements. Examples Cultural /Historical Preservation Contract No activity is currently using this PE in 2012

34 34 BAG 7 – – Pollution Prevention Pollution prevention is any action that is designed to reduce or eliminate (rather than control or treat) the future impact that an operation may have on the environment (including impacts to the air, surface and ground waters, vegetation and soils) through the source reduction of pollutants, more efficient use of natural resources, recycling, and/or reduced emissions of toxic and other undesirable materials or wastes to the environment. Funds all costs associated with pollution prevention, including: A. Certification of innovative technology for DoD applications; B. Any laws, Executive Orders, or DoD policies that apply specifically to pollution prevention efforts; C. Initial acquisition of environmentally acceptable replacements for hazardous materials required to comply with pollution prevention standards; (excludes normal replacement of hazardous material with less hazardous materials); D. Installation level pollution prevention plans, assessments, equipment, and projects; E. Review and modification of standardized documents for the sole purpose of eliminating or reducing the use of toxic chemicals and/or hazardous materials; F. Cost of personnel and office operations directly involved with pollution prevention programs (including recycling programs); G. Any facilities construction costs or maintenance costs primarily required to meet pollution prevention goals; Excluding: A. Research and development efforts associated with pollution prevention, which are covered under specific R&D program elements; B. Normal infrastructure maintenance and repair to keep a system in good working order or system replacement as part of normal replacement cycles; C. Activities funded in the DoD Working Capital Funds (DWCF), which are charged to the appropriate DWCF program elements; D. Activities funded as part of a larger system acquisition program, which should be separately identified through cost accounting codes under the main system acquisition program element. For example, pollution prevention efforts included in the design of a new weapon system would be under the PE of the weapon system; E. Base closure costs associated with these programs; F. Activities funded within Family Housing program elements. Examples Only one activity is using this PE in FY-12

35 35 BAG 7 – – Environmental Compliance Environmental Compliance includes actions to achieve and maintain full and sustained compliance with federal, state, and local environmental laws and regulations, Executive Orders, host nation regulations and DoD policies. Applies to workyears, training, travel, supplies, permits, fees, support equipment, service, and facilities (if the primary purpose is to comply with environmental standards) and the associated costs specifically identified and measurable to environmental compliance. Funds all costs related to environmental compliance, including: A. Recurring costs of environmental program management, daily operations and services, permits, fees, certifications, studies, and licenses; civilian workyears; education and training of environmental programs; hazardous waste management and disposal; sampling, analysis, monitoring and surveys; supplies, equipment, and travel's. Nonrecurring costs of projects/services required to bring DoD into compliance with environmental standards or comply with a notice of violation (Class I); to prevent DoD from failing to meet impending environmental standards (Class II); or to enhance the environment beyond legal requirements (Class III);C. Pest management programs to meet FIFRA standards for pest management and pesticide storage, handling or use standards; D. Overseas cleanup, as well as overseas compliance, efforts; E. Certification of innovative technology for DoD applications;F. Health risk assessments of environmental pollution hazards; and G. Medical oversight of environmental compliance monitoring activities. Excluding: A. Efforts funded under Defense Environmental Restoration Account, Conservation, Pollution Prevention, BRAC or Occupational Health and Safety auspices; B. Research and Development efforts associated with compliance, which are covered under specific R&D program elements; C. Normal maintenance and repair to keep systems in working order, system replacement as part of normal replacement cycle; and normal installation operations (i.e. solid waste disposal including tipping fees, landfill operations, etc.); normal wastewater treatment plants, both domestic and industrial, which are appropriately included in base operations; D. Upgrade/alteration of an industrial process undertaken for other than environmental purposes; E. Environmental certification/licenses funded separately from mandatory requirements and training; F. Routine pest control applications required to preserve structural integrity, properly charged to RPM and health applications, such as, mosquito control. Examples Environmental Projects managed by Ms. Polly Kendall, BUMED (i.e. Waste Water Management/Water Quality Management/Mercury Abatement, etc) Hazardous Waste Disposal Contracts Pest Management storage Health Risk Assessments of environmental pollution hazards CIVPERS, Training, and Supplies in support of Environmental Compliance Programs Excludes: solid waste disposal and waste water treatment plant contracts which are included in Facility Operations PE

36 36 BAG 7 – – Facilities Operations – Health Care (CONUS) Operation of Utilities and Engineer Support for the Defense Health Program in CONUS. Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs of utility plant operations, purchased utilities, air conditioning and refrigeration, utility fuels, fire protection, crash rescue, snow removal and ice alleviation, entomological services, window glass replacement, elevator maintenance/inspection, custodial services, refuse collection and disposal, sewer and waste systems, rental of real property, facility engineering and public works management, other installation engineering services and other annual service requirements performed in-house or by contract. Examples Utility contracts to include gas, pest/weed control, water, electricity, heating, steam, air conditioning, and fuels Fire protection contracts Snow removal contracts Ground maintenance contracts Elevator maintenance/inspection contracts Custodial services contracts Refuse collection/disposal contracts (excluding hazardous waste) Sewer/waste systems contracts Rental of real property Facility Engineering/Public Works management contracts CIVPERS, Training, and Supplies in support of Facility Operations CONUS

37 37 BAG 7 – – Facilities Operations, Health Care (OCONUS) Operation of Utilities and Engineer Support for the Defense Health Program in OCONUS. Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs of utility plant operations, purchased utilities, air conditioning and refrigeration, utility fuels, fire protection, crash rescue, snow removal and ice alleviation, entomological services, window glass replacement, elevator maintenance/inspection, custodial services, refuse collection and disposal, sewer and waste systems, rental of real property, facility engineering and public works management, other installation engineering services and other annual service requirements performed in-house or by contract. Examples Utility contracts to include gas, pest/weed control, water, electricity, heating, steam, air conditioning, and fuels Fire protection contracts Snow removal contracts Ground maintenance contracts Elevator maintenance/inspection contracts Custodial services contracts Refuse collection/disposal contracts (excluding hazardous waste) Sewer/waste systems contracts Rental of real property Facility Engineering/Public Works management contracts CIVPERS, Training, and Supplies in support of Facility Operations OCONUS

38 38 BAG 7 – – Visual Information Activities Funds Visual Information programs, consisting of the following subsets: Visual information (VI) productions and services and VI support. Includes manpower authorizations and costs, travel, contractual services, procurement of supplies and materials, expense equipment, necessary facilities and the associated costs specifically identified, separable into "in-house" and "contract" portions, and measurable to the following medical functions, as appropriate: VI Productions and Services. Produce or acquire VI productions (i.e., slide and slide-sound sets, film strips, multi-media, video disc, audio productions, combination media), and motion media with sound. Includes resources for scripting, preproduction, production, postproduction, libraries, duplication, distribution, production project management, and other related and associated services. VI Support. Provide VI operational (combat and technical) documentation, still and motion picture photography, video, audio, radio and television closed circuit and broadcasting (not Armed Forces Radio and Television Service (AFRTS)) services, graphic art, VI records centers, VI records holding facilities, presentation support, repair and maintenance, video teleconferencing terminals, related and associated services, and their supervision. Joint Visual Information Services (JVIS). Resources to operate and maintain JVIS production, depository, and distribution activities assigned by OASD(PA), as a joint mission for DoD. Excludes VI management at command and component headquarters and OSD. Excludes technical documentation support not available from base VI services, integral to the mission of organizations supported, and identified in other program elements. VI equipment integral to technical documentation functions is also excluded. It does not include VI activities with discrete program elements such as: Armed Forces Radio and Television Service. Examples Productions and Services of multimedia, video discs, and audio contracts Combat and Technical documentation of still and motion photography contracts Joint Visual Information Services contract CIVPERS/travel/supplies in support of Visual Information Programs

39 39 BAG 7 – – Base Communications (CONUS) Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified in CONUS and measurable to the following: Army: Base communications resources in support of Army medical activities. Includes non-tactical, non-DCS base (post, camp and station) communications facilities, and equipment systems which provide local communications worldwide to installations/activities. Navy: Base-level communications for Navy health care facilities to include base telephones, industrial security networks, crash networks, and paging networks. Air Force: Base-level communications support for USAF hospitals and clinics to include base telephone systems (PBX or PABX), intrabase radio systems, wire communications services, official tolls, TWX usage and commercial refiles, Class B tolls and charges, other base-level commercial communications requirements, and CCTV systems. Excludes DCS switched network support (PE F and PE ); DCS long- haul telecommunications systems and circuits; and AFCS base telecommunication center operating and maintenance personnel (PE F). Examples Telephone, Pager, Cell phone Contracts Communication services contracts CIVPERS in support of Base Communications CONUS

40 40 BAG 7 – – Base Communications (OCONUS) Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified in OCONUS and measurable to the following: Army: Base communications resources in support of Army medical activities. Includes non-tactical, non-DCS base (post, camp and station) communications facilities, and equipment systems which provide local communications worldwide to installations/activities. Navy: Base-level communications for Navy health care facilities to include base telephones, industrial security networks, crash networks, and paging networks. Air Force: Base-level communications support for USAF hospitals and clinics to include base telephone systems (PBX or PABX), intrabase radio systems, wire communications services, official tolls, TWX usage and commercial refiles, Class B tolls and charges, other base-level commercial communications requirements, and CCTV systems. Excludes DCS switched network support (PE F and PE ); DCS long- haul telecommunications systems and circuits; and AFCS base telecommunication center operating and maintenance personnel (PE F). Examples Telephones, Pagers, Cell Phone Contracts Communication services contracts CIVPERS in support of Base Communications OCONUS

41 41 BAG 7 – – Base Operations (CONUS) Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following functional categories of effort at CONUS medical and dental facilities, Medical Centers, medical support activities, and medical installations. Administration: Installation Headquarters Administration and Command (including squadron level responsible for Base Operations), Installation Comptroller services, Installation ADP services, Installation Information Activities, Installation Legal Activities, Installation Civilian Personnel Administration, Installation Military Personnel Administration, Installation Printing and Reproduction, Installation Safety, Installation Management Analysis/Management Engineering. Retail Supply Operations: Installation Supply Activities, Installation Procurement Operations, Installation Storage Activities. Maintenance of Installation Equipment (includes maintenance of administrative aircraft, vehicles and equipment but excludes maintenance of tactical equipment, combat vehicles and mission aircraft.) Other Base Services: Installation Transportation Activities; Installation Training (excludes troop training and tactical exercises), Installation Physical Security and Police Activities, Laundry and Dry Cleaning (for troop support and other appropriated fund activities).Bachelor Housing Operations and Furnishings (management, housing assignment, care of quarters, provisions, care, preservation and maintenance of furnishing, etc.). Other Personnel Support: Installation Food Service, Social Actions, Community Services, Chaplains, Bands (excluding The Army Band and Division Bands), Morale, Welfare and Recreation. Excludes the following functional categories which are part of the standard definition of Base Operations Support, but are reported under separate PEs: Maintenance and Repair of Real Property, Real Property Services, Minor Construction, Base Commun. Examples Administrative HQ contracts Comptroller, ADP, Legal, Public Affairs, CIVPERS/MILPERS Administration, Printing/Reproduction, Safety services contracts Vehicle and equipment maintenance contracts Transportation Equipment Rentals, Physical Security, Laundry/Dry Cleaning contracts Bachelor Housing Operations maintenance contracts Food Service, Chaplains, MWR services contracts CIVPERS/travel/supplies in support of Base Operations CONUS

42 42 BAG 7 – – Base Operations (OCONUS) Includes manpower authorizations, peculiar and support equipment, necessary facilities and the associated costs specifically identified and measurable to the following functional categories of effort at OCONUS medical and dental facilities, Medical Centers, medical support activities, and medical installations. Administration: Installation Headquarters Administration and Command (including squadron level responsible for Base Operations), Installation Comptroller services, Installation ADP services, Installation Information Activities, Installation Legal Activities, Installation Civilian Personnel Administration, Installation Military Personnel Administration, Installation Printing and Reproduction, Installation Safety, Installation Management Analysis/Management Engineering. Retail Supply Operations: Installation Supply Activities, Installation Procurement Operations, Installation Storage Activities. Maintenance of Installation Equipment (includes maintenance of administrative aircraft, vehicles and equipment but excludes maintenance of tactical equipment, combat vehicles and mission aircraft.) Other Base Services: Installation Transportation Activities; Installation Training (excludes troop training and tactical exercises), Installation Physical Security and Police Activities, Laundry and Dry Cleaning (for troop support and other appropriated fund activities).Bachelor Housing Operations and Furnishings (management, housing assignment, care of quarters, provisions, care, preservation and maintenance of furnishing, etc.). Other Personnel Support: Installation Food Service, Social Actions, Community Services, Chaplains, Bands (excluding The Army Band and Division Bands), Morale, Welfare and Recreation. Excludes the following functional categories which are part of the standard definition of Base Operations Support, but are reported under separate PEs: Maintenance and Repair of Real Property, Real Property Services, Minor Construction, Base Commun. Examples Administrative HQ contracts Comptroller, ADP, Legal, CIVPERS/MILPERS Administration, Printing/Reproduction, Safety services contracts Vehicle and equipment maintenance contracts Transportation Equipment Rentals, Physical Security, Laundry/Dry Cleaning contracts Bachelor Housing Operations maintenance contracts Food Service, Chaplains, MWR services contracts CIVPERS/travel/supplies in support of Base Operations OCONUS

43 43 Effective Execution Monitoring Regular SMART reports using the major review criteria against PEs for each Activity in you AOR Track execution against plan and authority with variance explanations / corrective action plans prepared M83 will continue to conduct weekly Execution Reviews Data anomalies should be indentified early and explanations prepared at the first line Report issues through your chain of command

44 44 Questions


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