1. NJ HOSA Leadership Conference
US Public Health Service (PHS) Commissioned Corps & The PHS in US Coast Guard Medicine
CDR Esan O. Simon
MD, MBA, FS, USPHS
NJ HOSA Leadership Conference
March 19 – 20, 2011
Sewell, NJ

2. Outline I. Speaker Background II. PHS Commission Corps
III. Mission & Organization of the PHS
IV. History of the Corps
V. PHS in the U.S. Coast Guard
VI. U.S. Coast Guard Operations
VII. Health Professions Scholarships

3. I. Speaker Background A. Education -College: Harvard University ’94
-Medical School: Emory University ’98
-Internship: Pediatrics ‘99 (Naval Medical Center Portsmouth, VA)
-Flight Surgery: Naval Aerospace Medicine Institute ’00
-Residency: Mayo Clinic Family Medicine ‘10

4. I. Speaker Background B. Professional Experience
Flight Surgeon: CVW3 (Virginia Beach, VA) ’00 – ’02
Flight Surgeon: NASC (Pensacola, FL)
’02 – ’04
Flight Surgeon: USCG Air Station Elizabeth City (Elizabeth City, NC) ‘04 – ’07
Regional Practice Director: USCG Clinic (Cape May, NJ) ’10 – present

5. II. PHS Commissioned Corps
More than 6,000 full-time, highly qualified public health professionals.
Driven by a passion for public service.

6. II. PHS Commissioned Corps
Serve on the frontlines in the Nation's fight against disease and poor health conditions.
Leaders in Research- advancing public health science.

7. The Uniformed Services:
Army
Navy
Marines
Air Force
Armed Forces
Coast Guard
Uniformed Services
Military
PHS Commissioned Corps
NOAA Commissioned Corps

8. III. PHS Mission & Organization- Mission Statement
Protect, promote, and advance the health and safety of our Nation.
Rapid & Effective Response to Public Health Needs
Leadership & Excellence in Public Health Practices
Advancement of Public Health Science

9. III. PHS Mission & Organization
CORE MISSIONS
Provide urgently needed public health and clinical expertise in response to large-scale local, regional, and national public health emergencies and disasters
Work with other nations and international agencies to address global health challenges
Conduct and support cutting-edge research for the prevention, treatment, and elimination of disease, health disparities, and injury

10. III. PHS Mission & Organization
CORE VALUES
Provide essential public health and health care services to underserved and disadvantaged populations
Prevent and control injury and the spread of disease
Ensure that the Nation's food supply, drinking water, drugs, medical devices, and environment are safe

11. III. PHS Mission & Organization (Core Values, cont.)
Demonstrates a commitment to public health through compassionate actions and stewardship of time, resources, and talents
Provides vision and purpose in public health through inspiration, dedication, and loyalty.
Service
Leadership
Exemplifies uncompromising ethical conduct and maintains the highest standards or responsibility and accountability
Integrity
Excellence
Exhibits superior performance and continues improvement in knowledge and expertise

12. IV. History of PHS
John Adams, 2nd president of the United States, signed the Relief of Sick and Disabled Seamen Act.
Congress extended the Act to cover every officer and sailor in the U.S. Navy leading to the creation of a network of local Marine Hospitals along major waterways.
1870 – Marine Hospital Service administration was centralized with its headquarters in Washington, DC, under the position of supervising surgeon (later Surgeon General).
President Adams signs the Relief of Sick and Disabled Seamen Act on 16 July 1798.

13. IV. History of PHS
John Maynard Woodworth, the first supervising surgeon, adopted a military model. Woodworth instituted examinations for applicants, put physicians in uniforms, and created a cadre of mobile, career-service physicians who can be assigned to various marine hospitals.
Congress enacted the National Quarantine Act to prevent the introduction of contagious and infectious diseases into the US.
The Marine Hospital Service was tasked to administer immunizations programs and control epidemic diseases (i.e. smallpox, yellow fever, and cholera).

14. IV. History of PHS
Legislation formalized the Commissioned Corps as the uniformed services component of the Marine Hospital Service. Congress organized Corps officers along military lines, with titles and pay corresponding to Army and Navy grades.
“Marine Hospital Service” expanded to “Public Health and Marine Hospital Service” to reflect growing responsibilities.
The Service now managed state quarantines and the medical inspection of arriving immigrants, such as those landing at Ellis Island in New York

15. IV. History of PHS
“Public Health and Marine Hospital Service” was shortened to the “Public Health Service” (PHS) and their powers broadened by Congress- authorizing investigations into human diseases, sanitation, water supplies, and sewage disposal.
1930 and Commissioned Corps was expanded to include engineers, dentists, research scientists, nurses, and other health care specialists.

16. IV. History of PHS
1930 and Corps officers expanded to include engineers, dentists, research scientists, nurses, and other health care specialists, as well as physicians.

17. IV. History of PHS
2006 to Present-The Commissioned Corps continues to fulfill its mission to protect and promote the public health of our Nation. With more than 6,000 active-duty officers, the Corps is working both nationally and internationally to create a global world free of preventable disease, sickness, and suffering.

18. IV. History of PHS PHS Commissioned Corps Today:
Fills essential public health leadership and service roles in over 20 Federal Agencies and Programs.

19. IV. History of PHS- PHS Commissioned Corps Today
Physician (988)
Dentist (376)
Nurse (1405)
Pharmacist (1000)
Dietitian (92)
Engineer (404)
Environmental Health Officer (365)
Scientist (247)
Veterinarian (85)
Therapist (140)
Occupational, Physical, Speech, & Audiology
Health Services Officer (1010)
Physician Asst, Info Tech, Med Admin, Optometrist, Social Worker, Lab Tech, Health Admin, & Mental Health

20. V. PHS in the U.S. Coast Guard
I. Health Care Professionals
Physicians (60)
Dentists (60)
Pharmacists (16)
PA’s/NP’s (40 tot; 31 CG 9 PHS)
Physical Therapists (3)
Health Service Officers (8)
Environmental Health Officers(18)
Clinic Administrators (43)
II. Health Services Technicians (HS)- 738
-includes dental/pharmacy/XRAY techs

21. V. PHS in the U.S. Coast Guard
MEDICAL FACILITIES
35 Outpatient Clinics/7 Satellite Clinics (AAAHC Accredited)
6 Clinics co-located with MTFs (Honolulu, LA, San Diego, Charleston, Selfridge, Sacramento)
Clinics typically comprised of 2+ Medical Officers
Vibrant Aviation Medicine component
2 Clinics with low acuity inpatient capability
Coast Guard Academy
Coast Guard Training Center Cape May
62 Sick Bays afloat & 72+ Sick Bays ashore - staffed by IDHSs/HS (without MO at unit)

22. V. PHS in the U.S. Coast Guard
US COAST GUARD OFFICE OF HEALTH SERVICES MISSION
To provide health care to active duty and reserve members in support of Coast Guard missions
To ensure the medical and dental readiness of all Coast Guard members
To ensure the availability of quality, cost effective health care for all eligible beneficiaries

23. VI. U.S. Coast Guard Operations- Coast Guard Missions
Maritime Safety
Search and Rescue
Ice Operations
Marine Safety
Boating Safety
Homeland & Maritime Security
Port & Waterways Security
Drug Interdiction
Alien Migrant Interdiction
Law and Treaty Enforcement
Protection of Natural Resources
Marine Pollution Education, Prevention,
Response and Enforcement
Foreign Vessel Inspections
Living Marine Resources Protection
Marine and Environmental Science
Maritime Mobility
Aids to Navigation
Polar & Domestic Ice Breaking
Bridge Administration
Maritime Transportation
Humanitarian & Disaster Response
National Defense

24. VI. U.S. Coast Guard Operations
AN AVERAGE COAST GUARD DAY
Save 14 lives
Board 193 ships and boats
Assist 98 people in distress
Escort over 20 larger passenger vessels, military vessels and High Interest Vessels
Launch 164 aircraft missions, logging 317 hours
Service 135 aids-to-navigation and correct 23 aids-to-navigation discrepancies
Conduct 74 Search and Rescue Cases
Interdict and rescue 17 illegal migrants
Respond to 12 oil/chemical/HAZMAT spills
Seize over 1,000 lbs of illegal drugs valued at $12.9M
Complete 31 Port State Control safety and environmental exams on foreign vessels
ALL HAZARDS, ALL THREATS, ALWAYS READY: SEMPER PARATUS

25. VI. U.S. Coast Guard Operations- Operational Platforms
CASA CN-235
HH-65 Dolphin
MH-68A Stingray
HH-60 Jayhawk
HC-130 Hercules

26. VI. U.S. Coast Guard Operations- Operational Platforms
Polar Icebreakers
Patrol Boat
National Security Cutter
Medium Endurance Cutter
High Endurance Cutter

27. VI. U.S. Coast Guard Operations- Operational Platforms
Motor Lifeboats
Utility Boats
Defender Class Response Boats
Port Security Patrol Boats

28. VI. U.S. Coast Guard Operations- Drug Interdiction

29. VI. U.S. Coast Guard Operations- Alien Migrant Interdiction

30. Boating Under the Influence (BUI) Rules of the Road
VI. U.S. Coast Guard Operations- General Maritime Law Enforcement
Boating Under the Influence (BUI)
Rules of the Road
Boating Regulations
Support of local Law Enforcement Agencies

31. VI. U.S. Coast Guard Operations- Search and Rescue
50,000 calls per year

32. VI. U.S. Coast Guard Operations- Search and Rescue
USCG H60 Jayhawk Helicopter
USCG Rescue Swimmer

33. Inspections of ships, especially foreign flagged ships
VI. U.S. Coast Guard Operations- Global Merchant Fleet
Inspections of ships, especially foreign flagged ships

34. VI. U.S. Coast Guard Operations- Fisheries Enforcement
Domestic Fisheries Enforcement
High Seas Drift Net Enforcement

35. VI. U.S. Coast GuardOperations- Marine Environmental Protection
Minimize oil spill damage
Oil Pollution Act of 1990 (OPA-90) – Exxon Valdez

36. VI. U.S. Coast Guard Operations- Aids to Navigation
-World’s largest ATON system
-Over 50,000 buoys, fixed markers, and lighthouses
-LORAN-C (‘10)

37. VI. U.S. Coast Guard Operations- Emergency Response
1999 Hospital center at Fort Dix, NJ, for Kosovo refugees
2001 Terrorist attacks
2001 Anthrax attacks
Tsunami and
Earthquake in
Indonesia
Hawaii

38. VI. U.S. Coast Guard Operations- Emergency Response
Hurricanes Katrina & Rita
>2500 Corps Officers, >1200 federal employees
Evacuation Triage
Federal Medical Shelters
Safe Drinking Water
Safe Food and Pharmaceuticals
Vaccinations (Td, Hep A, Influenza)
Waste Water Systems
Evaluated Hospitals, Shelters, Nursing Homes, Schools
Sick and abandoned animals
Comfort and assurance

39. VI. U.S. Coast Guard Operations- Emergency Response
Hurricane Gustav & Ike
6,000 officers placed on alert
800 officers deployed
Established 4 Federal Medical Shelters (LA & TX)
Disease surveillance, Environmental health assessments, & Food service site inspections (TX)

40. Emergency Response: Haitian Operations
2009
Haiti Earthquake
Coast Guard was the first of the US Forces on-scene in Port Au Prince
MEDEVAC > 120 critically injured
Evacuated ~ 936 American citizens

41. Emergency Response: Haitian Operations

42. Emergency Response: Haitian Operations

43. Emergency Response: Deepwater Horizon
2010 Deepwater Horizon Oil Spill
48,000+ personnel
10,000 Vessels of Opportunity
125 aircraft
1000+ organizations
USCG Response:
4,500 Coast Guard personnel deployed (~10% of Coast Guard workforce)
Assumed command & control immediately after the disaster occurred

44. Emergency Response: Deepwater Horizon
In situ burns
Beach cleanup

45. VII. Health Professions Scholarships
Government Options:
Income-Based Repayment & Public Service Forgiveness:
Public Service Fact Sheet:
Indian Health Service:
HRSA:
 National Health Service Corps
 State Obligations
Arizona:
List of Options & Programs:
Army:
Air Force:
Navy:

47. QUESTIONS?