1. Maturing the ANSF Training Mission for 2012 & Beyond 30 Jan 2012 CAPT Philip Blaine, MSC, USN The MHS: Healthcare to Health NMT-A / CSTC-A

2. Has no real or apparent conflicts of interest to report. Conflict of Interest Disclosure Philip J. Blaine, CAPT, MSC, USN, PharmD, MA

3. ANSF Healthcare Transition Obj “An interdependent, professionally led ANSF Health Function that generates & sustains sufficient police & army medical personnel, infrastructure, services & logistics capabilities, with accountable & effective health systems to support ANSF”

4. Lines of Effort  Training –Training Military Medical Competencies  Ministerial Development –Develop, Foster, and Mature Healthcare Administrative Systems and Processes

5. Lines of Effort  Institutional Development –Enact, Enforce, and Engage Accepted Healthcare Standards Across Regions –Institutionalize Afghan Led Training of Medical Competencies  Direct Provision of Healthcare Specific to Defenders of the Afghan Nation

6. ANSF Healthcare Transition Obj Conduct SAVs 1.2 An interdependent, professionally – led ANSF Health Function which generates and sustains sufficient police and army medical personnel, infrastructure, services and logistics capabilities, with accountable and effective health systems that support the ANSF Institutional Development HospitalsPreventive Medicine Medical Logistics Command & Control Direct Provision of Healthcare ANA / ANP Assessments MOD / MOI Formal Guidance Objective 2.5 Unit Validations Training Ministerial Development Routine SAVs Regional Medic Course Doctrine & Policies Validation Team Tiered Afghan Healthcare Stds CM-1A CM-1B CM-2A CM-2B CM-3 CM-4 AFAMS Field Sanitation Course

7. Validation Team Formation  Multidisciplinary Healthcare Team –Implement Tiered Afghan Healthcare Standards –Standardize Ministerial and Institutional Development Plan Measures (Capability Milestone [CM] Ratings) –Horizontally Integrate Efforts and Effects Across the Battle Space

8. Validation Team Formation Bio-Med Equip Tech Transition Activities, Validation of Clinical Standards, Increased Synergy Among Mentoring Efforts Med-Log, Facilities, and Bio-Med Equip Clinical Processes Executive Leadership Medical Validation Team Clinical Lead Clinician Nursing Lead Preventive Med Lead Prev Med Tech Pharmacy Lead Medical Logistics Medical Facilities Lead Bio Medical Equip Lead Security Lead Physical Therapy Lead Dental Lead Validation Team Drives Horizontal Integration Validation Team Drives Horizontal Integration Executive Leadership

9. ANSF Healthcare Advisors by 2014 ANSF Healthcare advisors 2014 Mentor Partner Advisor Partners: ISAF forces who live and operate together with their Afghan partners Limited Partners: Partnering at a lessened ratio but maintaining key enablers Advisors: Enhanced mentor teams that include those enablers that the ANSF cannot self-generate, but are essential to the completion of the mission, and force protection for the mentor personnel Mentors: Experienced teams that guide and advise their Afghan partners, influencing through enduring relationships 2010 20112012 2013 Glide path to ANSF Transition

10. Pre-Deployment Training  Wide Variation in Current Training –Range from 6/10/19/30/60 Days  Efforts to Refine the Curricula with Target of ~30 Days to Achieve Right Mix of Mentor/Advisor Training and Combat Skills

11. Pre-Deployment Training  Enhanced POI and Training –Will Never Be Enough to Prepare Many US Medical Personnel Mindset US Medical Personnel Commitment to Providing US Standard of Care Translates to a Commitment to Mentor/Advise to the Same Standard

12. Pre-Deployment Training  If “US Standard” is Not Met –Culture Shock –Anger –Frustration –Withdrawal –Get “Too Close” –Potential Long Term Mission Consequences

13. Way Forward  Improve Training Model –AT A MINIMUM Practice Scenarios Experienced in Theater Develop Skills to Address Situations Not Normally Encountered Ability to Anticipate the Disconnect and Process Ahead of Time Ability to Mitigate Culture Shock Up Front

14. Way Forward  Use Scenarios Developed From In Theater Engagements as Lessons Learned –Progressively Challenging Scenarios Progress from “Meet and Greet” to Complex Scenarios –Scenarios Developed From Actual Encounters Accountability, Clinical Competence & Healthcare System, Communication, Culture, Learning/Teaching, Management/Leadership

15. Training Common Components  Didactic Training Areas –Overview of Afghanistan –Afghan Tier One Standards of Care –Ministry of Public health (MoPH) Basic and Essential Health Care Packages –Working With Interpreters –Mentoring Approaches, Outcomes, End States –Medical Class VIII Logistical System

16. Summary  Mature and Integrate Validation Team  Integration of NTM-A/CSTC-A Campaign Plan –Long Range Goal to Integrated Afghan Led ANSF Healthcare Development with GIRoA & MoPH Plans  Surge in Efforts Toward Class VIII Logistics, Preventive Medicine, Patient Movement & C2  Press for Enhanced Pre-Deployment Training

17. ANSF Training Mission 2012 & Beyond Questions?