On July 1, 2008, per the 2005 Base Realignment and Closure law, several medical and dental functions of the 62d Medical Group were realigned to Madigan Army Medical Center and Western Regional Dental Command. At that time, the 62d Medical Squadron was established as a Limited Scope Inter Service Supported Medical Treatment Facility. Patient enrollment to the 62 MDS was limited to the 4,000 Air Force personnel on active duty orders assigned to Joint Base Lewis-McChord. Medical care for all other non-AD beneficiaries was transferred to MAMC’s health care system.
Since October 1, 2008, the 62 MDS has provided primary care and operational medicine services (including optometry) for nearly 4,000 enrolled active duty Air Force personnel assigned to JBLM. Obstetric and gynecologic care, mental health services, physical therapy, and ancillary support (i.e. laboratory, radiology, and pharmacy) are provided to active duty enrollees at the McChord Clinic location by the McChord Medical Clinic - a co-located clinic directly managed by the MAMC health care system. Most referrals for specialty care services are accepted by MAMC. A few are directed to the United Healthcare private sector network. The 62 MDS ensures that the medical and dental readiness requirements for Air Force personnel are met, and that personnel supporting the Prime Nuclear Airlift Forces are medically reliable. The 62 MDS deployment mission is limited. While it deploys few of its personnel, it is responsible for sustaining one of the highest deployment operations tempos in the Air Mobility Command.
Strategic Mission, Vision and Goals
Mission: Promote Quality Health to provide and sustain fit, resilient and ready forces.
Vision: Patient centered health services and mission readiness within a professional culture of dignity and respect.
The 62d Medical Squadron falls under the 62d Airlift Wing under 18th Air Force within Air Mobility Command, and operates on Joint Base Lewis-McChord as the Air Force ‘Airman’s Clinic’ in the same facility as the Army McChord Clinic that is a satellite Clinic of Madigan Army Medical Center. The Squadron is divided into four separate Flights: Operational Medicine, Bio-Medicine, Dental and Medical Support. The current manning is 64 active duty Air Force, seven Government Service, and 17 Contractors for total of 88 medical staff. The FY16 budget is approximately $1.5 million supporting staff and clinical operations. The Clinic offers 45,000 appointments supporting active duty, Air National Guard and Air Force Reserve Personnel. The annual relative value unit output is around 630,000 which saves approximately $21.5 million in outsourcing care costs.
Best Practices/Unique Activities
Within the Air Force Medical Service, the 62 MDS is a unique healthcare organization assigned to the 62d Airlift Wing. Since the BRAC transition, the organization has ensured the medical and dental readiness of 4,000 AF personnel of active duty orders while functioning as a Limited Scope military treatment facility. Many of the functions typically performed at an Air Force MTF and the care of non-active duty beneficiaries have been transferred to the Army (lead service) MTF on JBLM-MAMC Health Care System. As such, the 62 MDS partners with MAMC to optimize medical service delivery in a joint environment.
The 62 AW is the nation’s sole provider of PNAF support. As such, it is imperative that the Personnel Reliability Program at JBLM-McChord Field is implemented with no discrepancies. The actions of the 62 MDS’s Medical PRP team are critical to the success of this priority mission. In January 2015, the Medical Squadron had an NSSAV that revealed no deficiencies and numerous strengths to the program to include: Certification process, the positive working relationship with the Army, willingness from the PRP monitor and Lead CMA to refine the PRP processes, referral tracking for PRP members, and their record reviews and scenarios demonstrated 100% compliance. In March 2015, the Wing underwent a Nuclear Surety Inspection and received the highest possible rating with zero significant findings (other agencies/Sqs in the wing had deficiencies but medical had none). The 62 MDS PRP monitor was coined by the IG as an outstanding performer. The 62 MDS implemented the AFMAN and DoDM updates throughout the program to ensure safety and integrity of PNAF missions. The hard work and dedication of the 62 MDS PRP team was recognized when they were selected as the 2015 Air Mobility Command PRP Team of the Year. Additionally, the 62 MDS Medical PRP Monitor was selected as the 2015 Air Mobility Command PRP Technician of the Year for the second consecutive year.
The McChord Dental Clinic provides care for the Active Duty Air Force and ANG members assigned to JBLM. It is an Army asset and falls under the JBLM-US Army Dental Activity. The 62d Dental Flight is comprised of one ADAF Dental Officer and two ADAF Enlisted members. The ADAF presence maintains and promotes standard of care, readiness, and enforces Air Force unique requirements, such as PRP and rated personnel, for our active duty Air Force population. Great strides have been made in 2015 to increase Dental Readiness to 99.3% for our McChord ADAF population. This is the highest rate attained since the BRAC in 2008. Additionally, this year marks the addition of the 1st edition of the Army Clinical Practice Guidelines which has been created to improve and mirror standardized practice in all services to ensure the safe and high quality dental treatment that our patients deserve.
In 2015, the Bioenvironmental Engineering Element made significant progress by implementing several process improvements. The first major success was publishing an updated version of 62 AWI 48-148 Ionizing Radiation Safety which updated requirements driven by parent regulations including radioactive materials management, training, monitoring, and reporting requirements. A second improvement was the implementation of Defense Occupational and Environmental Health Readiness System guidance to electronically document and track occupational health hazards and controls. This included fully implementing the use of DOEHRS to track and document annual fit testing for all 62 AW members enrolled in the respiratory protection program.
Public Health remained busy supporting AMC deployments and ensuring Team McChord maintained Individual Medical Readiness. In 2015, PH screened and cleared 826 active duty, Guard and Reserve personnel for deployment to multiple AORs with only one administrative discrepancy. Additionally, our deployment medicine clinic administered 3069 Deployment Related Health Assessments, 12.2% of all of AMC’s DRHA workload, referring 301 service members for additional care and support. Individual Medical Readiness is a top priority of the AFMS. The 62 MDS manages the program for the 62 AW, the 627th Air Base Group, and numerous AF tenant units at JBLM. Also, PH provided additional hands-on training with new commanders on ASIMS capability catapulting McChord to a #1 IMR rating in AMC for six months.
Population-Based Community Health/Outreach is the most efficient means for Air Force Health Promotion to influence Airmen health. In CY 2015, the AFMS along with JBLM faced difficult choices necessary in a fiscally constrained environment. As a result manning losses occurred through attrition as the HP community cuts to Registered Dietitian (RD) and Exercise Physiologists. The Health Promotion Coordinator was relocated from the McChord Field Fitness Center Annex to the 62 MDS Clinic and realigned under Public Health in order to support AFMS long-term goal for the MTF HP Staff to transition away from directly providing “top of the pyramid” clinical services and move toward influencing policies, environment, and social norms that support healthy behaviors (“bottom of the pyramid”). The HPC Orchestrated DoD Operation Kid Fit study; 1/4 bases selected/coordinated outreach w/4 clinics--drove 20% BMI decline for target group. The HPC executed $125,000 comprehensive airman fitness budget; appropriated Wing purchases--expanded resilience to 50,000 JBLM community members. In 2015 62 MDS Health Promotions launched Health Improvement Program; incorporated Vivo Fits /improved 150 members health habits--average decrease 8lbs/98% PT pass/85% increase to eight hours sleep.
Optometry developed a workplace eye injury protocol which identified different trends that were happening around base to deter injuries before they happen. We also created a Corneal Refractive Surgery program that instituted mass briefings to increase an Airman's opportunity to get corrective eye surgery. During a short notice special operations deployment, we expedited dozens of laser eye exams, working over 70 hours to ensure Operation FREEDOM'S SENTINEL could be a success. Coordinating with our Joint Base partners, an additional Optometrist was hired to take care of our dependents and retiree population.
ADAPT has extended prevention services by expanding to bi-monthly CC Calls (or roll-calls) - each unit visited at least once yearly, more if referrals are increasing or if there is a concerning issue (positive UAs, increased risky behaviors). We have employed our fantastic drunk driving simulator around the base whenever possible (wingman day, BX food court, etc.) in order to decrease DUI's and to increase awareness of drinking and driving risks/dangers. We have expanded our aftercare program by 200% to reduce risk of relapse in our members diagnosed with any substance use disorder and to offer more support. We have implemented additional services locally (here on McChord) so Air Force members don’t have to travel/attend courses on Ft. Lewis- reducing man hours for units.
The 62 MDS is proud of a number of clinical innovations geared toward increasing access to care, reducing urgent care utilization at other locations, and returning airmen to duty in a state of optimal health as effectively and efficiently as possible. Its patient-centered focus maximizes care coordination and facilitates medical evaluation processes, ultimately strengthening the Force by returning fit, experienced airmen to their units or enabling medical retirement when appropriate. In 2015, the IDES caseload doubled but the 62 MDS continued to bolster this program by implementing the DoD/Veterans Administration Integrated Disability Evaluation System to expedite the transition of medically retired members to VA care and receipt of medical benefits. The 62 MDS currently delivers these services at levels which significantly beat DoD standards. In addition, Also in 2015, the 62 MDS has further enhanced Secure Messaging technologies by utilizing MiCare, a web-based communication tool that allows the beneficiaries to communicate with their healthcare team. Relay Health is the company that provides the secure messaging service. MiCare is the brand name the Air Force is using to describe secure messaging. This initiative should empower enrollees to become more engaged participants in their care and allow the medical staff of the 62 MDS to deliver services in a timelier, efficient manner. The AFMS vision is for secure messaging to be utilized for all non-urgent communications in support of population health and quality of care.
During the past year, the 62 MDS has been a participant in the Puget Sound Military Healthcare System formally called the enhanced Multi Service Market. Through this integrated, regional consortium, the 62 MDS continues to collaborate in efforts to further enhance beneficiary health and control medical expense. The 62 MDS was part of the team which penned four Consortium Joint Services Team Charters, a $68,000 tele-health initiative and a 5-year Behavior Health Service network estimating almost $3 million in recaptured costs.
MTF Commanders Priorities and Challenges
The 62 MDS will continue to fulfill the healthcare needs of its active duty Air Force population while supporting the Department of Defense, Air Force, AMC, Defense Health Agency, PSMHS, AFMS, 62 AW, 627 ABG and numerous other constituent units within the context of an evolving joint base environment. Toward that end, the mission priorities of the 62 MDS are/will be:
Priorities are consistent with the Air Force Medical Service strategic goals of Readiness, Better Care, Better Health at the Best Value with the end state of Trusted Care, Anywhere.