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This paragraph implements QSTAG 291. FM 8-55 CHAPTER 6 HEALTH SERVICE LOGISTICS Section I. MISSION, POLICIES, AND RESPONSIBILITIES 6-1. Health Service Logistics Mission a. Health service logistics is managed solely by the AMEDD. This gives the surgeon the ability to influence and control the resources needed ta save lives. The health service logistics mission parallels and supports the surgeon’s HSS mission, and in turn, the commander’s mission. The health service logistics mission is to provide support where and when it is required in the fastest, most inexpensive, and most practical way possible. Health service logistics includes– • Class VIII medical supplies (medical materiel to include medical peculiar repair parts used to sustain the HSS system). • Optical fabrication. Ž Medical equipment mainte- nance. Ž Blood storage and distribution. See Chapter 8 for a discussion on blood manage- ment. • New technology like oxygen generation, resuscitative fluids production, blood substitutes, and frozen blood. b. The successful operation of the health service logistics system is directly dependent upon– • Integration with the whole HSS effort. • Supervision by appropriate com- mand surgeons. • Anticipatory and proactive sup- port rather than reactive support. c. Field Manual 8-10 discusses the specific characteristics which set the Class VIII system apart from other classes of supply. One such characteristic is the special protection afforded by the Geneva Conventions. 6-2. Interface of Medical Materiel Pro- cedures Under the International Standardization Agreement The United States, United Kingdom, Australia, and Canadian Forces have agreed to accept each nation’s medical materiel procedures so that they interface within their national supply systems. The need for cross-supply may occur whenever multinational forces are present in a TO. a. Use of cross-supply procedures can occur in some or all of the following areas: (1) Requisitioning from depots. (2) Return of materiel to depots. (3) Acknowledgment of issue and receipt. (4) Receipt and due-out transaction procedures. (5) Serviceability classification. 6-1
Transcript of HEALTH SERVICE LOGISTICS - GlobalSecurity.org · HEALTH SERVICE LOGISTICS Section I. MISSION,...
This paragraph implements QSTAG 291.
FM 8-55
CHAPTER 6
HEALTH SERVICE LOGISTICS
Section I. MISSION, POLICIES, AND RESPONSIBILITIES
6-1. Health Service Logistics Mission
a. Health service logistics is managedsolely by the AMEDD. This gives the surgeon theability to influence and control the resources neededta save lives. The health service logistics missionparallels and supports the surgeon’s HSS mission,and in turn, the commander’s mission. The healthservice logistics mission is to provide support whereand when it is required in the fastest, mostinexpensive, and most practical way possible.Health service logistics includes–
• Class VIII medical supplies(medical materiel to include medical peculiar repairparts used to sustain the HSS system).
• Optical fabrication.
Ž Medical equipment mainte-nance.
Ž Blood storage and distribution.See Chapter 8 for a discussion on blood manage-ment.
• New technology like oxygengeneration, resuscitative fluids production, bloodsubstitutes, and frozen blood.
b. The successful operation of the healthservice logistics system is directly dependentupon–
• Integration with the whole HSSeffort.
• Supervision by appropriate com-mand surgeons.
• Anticipatory and proactive sup-port rather than reactive support.
c. Field Manual 8-10 discusses thespecific characteristics which set the Class VIIIsystem apart from other classes of supply. Onesuch characteristic is the special protection affordedby the Geneva Conventions.
6-2. Interface of Medical Materiel Pro-cedures Under the InternationalStandardization Agreement
The United States, United Kingdom, Australia,and Canadian Forces have agreed to accept eachnation’s medical materiel procedures so that theyinterface within their national supply systems.The need for cross-supply may occur whenevermultinational forces are present in a TO.
a. Use of cross-supply procedures canoccur in some or all of the following areas:
(1) Requisitioning from depots.
(2) Return of materiel to depots.
(3) Acknowledgment of issue andreceipt.
(4) Receipt and due-out transactionprocedures.
(5) Serviceability classification.
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(6) Repair and maintenance (withinthe health service logistics systems).
b. A health service logistics liaison willbe established within the TO health service logisticssystem—
• To assist in establishing thisinterface.
• To develop specific cross-supplyprocedures.
• To provide other logistics as-sistance as required.
The Army component surgeon’s office in conjunctionwith the Theater Medical Materiel ManagementCenter (TMMMC) will perform this function.
6-3. Policy and Responsibility
The TA commander is responsible for thedevelopment of supplies for TA forces and, whenapplicable, for Navy, Air Force, Marines, alliedforces, and CA activities. The Army componentcommander must be prepared to provide medicalsupply, medical equipment maintenance, opticalfabrication, and blood support as the singleintegrated medical logistics manager (SIMLM) ina TO. On the special staff of the TA commander isthe TA surgeon. Normally, the MEDCOM com-mander or the senior medical commander in the
COMMZ functions as the TA surgeon. In thatcapacity, he—
• Provides medical staff advice to thecommander and to other staff members in thedevelopment of the TA health service logisticssystem.
Ensures that an adequate health ser-Žvice logistics system exists to meet the needs of theService.
• Recommends policy and states prior-ities.
• Plans and supervises technical inspec-tions of the system.
Ž Determines TA requirements formedical equipment and supplies.
Ž Exercises staff supervision over therequisitions, procurement, storage, maintenance,distribution, and documentation of Class VIIIsupplies and equipment.
• Provides support to other militaryServices and to civilian communities, as required.(The HSS for military operations is normallyprovided on an area basis and must be coordinatedwith the component Service. Requirements tosupport civilian communities are developed incoordination with the Deputy Chief of Staff forHost-Nation Activities.)
Section II THE HEALTH SERVICE LOGISTICS INFORMATIONMANAGEMENT SYSTEM
6-4. Medical Logistics Subsystems and wartime. The three subsystems listed belowprovide the TAMMIS medical logistics capa-
The TAMMIS includes medical logistics bilities—(MEDLOG) subsystems designed to provide sup-port for field (TOE) medical units in peacetime Ž MEDSUP-TAMMIS medical supply.
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• MEDMNT-TAMMIS medical main-tenance.
• MEDASM-TAMMIS medical assem-blage management.
6-5. Theater Army Medical ManagementInformation System, Medical Supply
a. The TAMMIS MEDSUP Systemautomates the comprehensive management andrequisitioning of medical materiel (Class VIII)required to support all medical units.
b. The MEDSUP system provides theuser with automated capabilities in the followingareas:
(1) Customer processing which en-ables the user to process customer requests.
(2) Requisitioning, receiving, anddue-in items. This enables the user—
• To prepare and send req-uisitions to the supply support activity (SSA).
• To receive and process sta-tus and materiel receipts from the SSA.
(3) Maintaining local stocks, qualitycontrol, and reporting which enables the user—
• To manage stockage itemsand their levels.
• To maintain stocktions.
• To conduct physicaltories.
loca-
inven-
• To accomplish quality con-trol and destruction actions.
Ž To produce the reportsroutinely required in the management of a medicalsupply account.
(4) Calling up national stock num-bers, due in/out data, or transaction historiesenabling the user to access a broad range ofmanagement data and permitting decision making.
(5) System setup/maintenance pro-cedures allowing the user to build and update the-
Ž Supported customer file.
• Supporting activity file.
• Environmental data file.
• Local description data.
• Processing default data.
Ž Processing control data.
This capability also allows the user to performsystem file maintenance.
(6) Reviewing exceptions referredto manager allowing the user—
Ž To view the total numberof exception records that require manager action.
Ž To identify exceptions thatare over 2 days old.
The system generates four types of exceptionrecords: due-in status, demand, receipt, and re-plenishment.
(7) User designed reports allowingthe user to create, modify, delete, and print reportsof own design.
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6-6. Theater Army Medical ManagementInformation System, Medical Main-tenance System
a. The TAMMIS MEDMNT systemsupports the scheduled maintenance and repair ofmedical equipment essential for treating patients.
b. The MEDMNT system provides theuser with automated capabilities in the followingareas:
(1) Unit equipment file which al-lows the user to maintain maintenance records onsupported medical equipment.
(2) Work order processing whichallows the user to schedule, assign, update,complete, and report MEDMNT work orders andto track the status of equipment supported byMEDMNT personnel.
(3) Supply management which al-lows the unit to maintain stockage of the repairparts required to support the maintenance mission.This capability also allows the maintenance unit tointerface with the supply system to request andreceive materiels and maintain status on ordereditems.
(4) Periodic processing and report-ing which provides a monthly maintenanceperformance report to be used by local managementand/or higher commands.
(5) Command and control reportingwhich provides command interest informationconcerning scheduled and unscheduled main-tenance. It also provides the commander with up-to-the-minute status of all readiness significantitems of medical equipment.
(6) Maintenance system setup pro-cedures which define the local environment used
to control system processing by identifying sup-porting activities, supported customers, andprocessing default data.
6-7. Theater Army Medical ManagementInformation System, Medical Assem-blage Management System
a. The TAMMIS MEDASM system isused to establish management visibility of unitassemblage components within medical assem-blages.
b. The MEDASM system provides theuser with automated capabilities in the followingareas:
(1) Assemblage management pro-cess which includes a grouping of individualprocesses which are used to accomplish itemmanagement, allowance management, and qualitycontrol management, The result of the collectivemanagement of these individual areas allowsaccurate predictions of unit readiness based onasset availability.
(2) Request, receipt, and due-inmanagement which includes separate processeswhich expedite ordering of shortage items, placingof orders on the correct supply source, recordingreceipts, and managing aged orders for requireditems.
(3) System setup procedures in-cludes a group of processes which define theoperating environment to the MEDASM system.These procedures describe the parent unit, itssupported assemblages, sources of supply support,and routine ordering processes.
(4) User designed reports allow theuser to create, modify, delete, and print reports ofhis own design.
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SECTION III. THE HEALTH SERVICE LOGISTICS CONTINUUM
6-8. Request Flow in the Theater
a. Requests for medical materiel flowfrom Echelons I, II, and III HSS units to themedical battalion, logistics (forward) for issue.
(1) The combat lifesaver requestsClass VIII supplies from the BAS. The aid stationis responsible for having sufficient stock to resupplythe combat lifesaver. Combat lifesavers in nondi-visional units obtain Class VIII from the nearestmedical unit capable of supporting them.
(2) The combat medic requestssupplies from the BAS. This action is not a formalrequest so it can be oral or written. The requestsare delivered to the BAS by whatever means areavailable. Usually this will be accomplished by thedriver or the medic in the ambulance returning tothe BAS with patients. Commonality of suppliesbetween the combat medic and the ambulanceequipment set may allow the ambulance crew tofill the combat medic’s request from on-board stock.The ambulance crew can then replenish its stackupon returning to the BAS. Resupply to thecombat medic can be by line item or by resupplypackages.
(3) The forward deployed BASS of adivision request their Class VIII from the medicalcompany of a forward support battalion (FSB).
NOTE
While the medical company of the FSBcan be used as a medical supply point,the limited manpower resources (oneMOS 76J, medical supply specialist) ofthe medical supply section within themedical company limits the amount ofsupplies that can be handled.
(4) The division medical supplyofficer (DMSO) should anticipate requirements forthe combat lifesaver, combat medic, and BASallowing resupply PUSH packages to be forwardedto the maneuver battalion’s trains area (preferredmethod). These packages should be small enoughthat they can be easily handled by one person.
(5) The medical platoon leader canenhance the resupply to the combat medics byforward locating materiel at patient collectingpoints using ambulances whenever possible. Thismethod assumes a proactive standpoint on thepart of the medical platoon leader in anticipatingrequirements to push supplies forward via ambu-lances returning to collecting points, assuming theavailability of manpower. Ambulances shouldnever go forward empty as it only takes a fewminutes to place a box of Ringer’s lactate solutionor a couple of resupply packages into the back of anambulance.
NOTE
The DMSO, in conjunction with theDMOC and the medical battalion,logistics (forward), plans for precon-figured packages. This ensures thatthe user receives what he needs andeliminates waste of medical and trans-portation resources.
(6) Medical companies of maneu-ver divisions request their Class VIII from theDMSO, The DMSO has the responsibility to pro-vide medical supply support to all units within thedivision area. Requests may come by messagewith returning ambulances (ground or air), byland line, or through radio nets within the division,
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(7) The DMSO requisitions ClassVIII supplies from the medical battalion, logistics(forward). However, the medical battalion, logis-tics (forward) is responsible for anticipatingrequirements and pushing preconfigured resupplypackages forward.
(8) Corps hospitals request ClassVIII supplies from the medical battalion, logistics(forward).
(9) The medical battalion, logistics(forward) pushes resupply packages to Echelons Iand II units and surgical squads/teams/detach-ments in the division. This battalion manages lineitem replenishment requests when the tacticalsituation permits.
b. Echelons above corps units requestClass VIII from the medical battalion, logistics(rear). This unit will build preconfigured resupplypackages based on the medical battalion’s, logistics(forward) mission. It will PULL or PUSH resupplypackages based on requirements.
c. The medical battalion, logistics (rear)either issues the item from stock or passes therequisitions for Class VIII through the TMMMC toa CONUS source. The TMMMC serves as themanagement interface with CONUS-based ClassVIII national inventory control points (NICPs) andservice item control centers (SICCs). Figure 6-1illustrates the requisition flow in the TO.
c.
d. Replenishment requests for medicalbattalion, logistics (forward/rear) stocks follow thesame procedure described above. The medicalbattalion, logistics (forward) handles resupplypackages and throughput from CONUS. Themedical battalion, logistics (rear) builds resupplypackages primarily for Echelon I and II units andmanages line-item replenishment requests forEchelon IV units.
6-9. Supply Flow in the Theater
a. Requests that are passed to CONUSsources from the medical battalion, logistics (rear)for those items that cannot be filled with on-handstock for the medical battalion, logistics (forward)are normally filled via throughput. They areshipped from CONUS through the theater airhead/port directly to the requisitioning medical bat-talion, logistics with those designated for medicalbattalion, logistics (forward) not normally trans-shipped through a medical battalion, logistics (rear).Ultimately the materiel is forwarded to thesupported corps and COMMZ medical units viaCOMMZ/corps transportation assets. See Figure6-2 for an illustration of Class VIII supply flow ina TO. Figure 6-3 illustrates asset visibility andsupply request management of a two-corps, six-division theater.
b. Medical materiel for the division willflow to the DMSO. Shipment of Class VIII into thedivision is coordinated with the corps MCC (CMCC)and division MCC (DMCC), Emergency resupplywill be accomplished by air ambulance.
Resupply of the medical companies ofthe heavy or the light division is by the DMSO.The DMSO has the responsibility to provide medicalsupply support to all units within the divisionarea. The preferred method for resupply is throughunit distribution using division transportationassets. The DMOC has responsibility to plan theuse of division transportation assets in coordinationwith the DMCC. Backhaul, using ground or airambulances, is used in emergency situations asbackup to move the medical supplies forward tothe forward support medical companies in thebrigade support area. From this point, medicalsupplies are carried forward using ambulances(air and ground) or other vehicles that are goingforward to the BASS.
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Figure 6-1. Requisition flow.
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Figure 6-2. Supply (issue) flow.
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Figure 6-3. Asset visibility and supply request management of a two-corps, six-division theater.
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Section IV. HEALTH SERVICE LOGISTICS THEATER REQUIREMENTS
6-10. General Requirements for a Devel-oping or Mature Theater
a. The intense management of allaspects of health service logistics within a devel-oping or mature theater is essential. It requiresorganic command and control to provide overalloperational standardization, maintenance, andlogistical support. Continuous logistics planning isrequired since requirements may change as thetheater matures.
b. Analysis of past data and projectedlogistics requirements to support Army operationsreveals a significant increase in the consumptionof Class VIII materiel. Conservative estimateshave raised the 0.35 pounds per man per day to 1.9pounds per man per day, five times that experiencedduring World War II and the Korean Conflict. Theincrease in Class VIII supplies for soldiers is basedon the expanded use of lifesaving resuscitativefluids and medical oxygen in the forward areas ofthe battlefield.
c. Health service logistics units will bemodular in design with the flexibility, mobility,and capability to assemble, produce, process, move,and issue that amount of health service materiel tomeet the operational objective of continuousoperations. The medical battalion, logistics(forward) can echelon a platoon to the AO early. Asthe platoon cannot stand alone, it must be attachedto a command and control unit. Health servicelogistic activities are described in Section XII ofthis chapter. Resupply, follow-on resupply,resupply/throughput, and throughput will beeffected as follows:
(1) During the initial phases of con-flict, resupply will be effected from war reservestockpiles. These stocks are intended to fill thevoid created by the lag in establishing the functionalpipeline from CONUS, or other sources outside the
theater. They are not intended for initial basicload. Units must deploy with their basic loadsbecause health service logistics units are latedeploying CSS units that carry resupply loads—NOT INITIAL SUPPLY. Units that deploy withouttheir basic loads impair the theater resupplymission by depleting stocks projected for resupply.
(2) In the case of a developing (con-tingency) theater, resupply will be effected viainitial preplanned supply support. The US ArmyMedical Materiel Agency (USAMMA) developsrecommended lists for different scenarios.
(3) Follow-on resupply beyond warreserve stockpiles will also be included in initialpreplanned supply support. Initial preplannedsupply support will be identified in logistical plansto ensure continued resupply until normal requi-sitioning procedures are established. Medicalresupply planning has to consider existing in-theater capabilities as well as deploying organ-izations tasked with a supply support mission.
(4) Resupply/throughput will nor-mally be limited to Echelon III and IV HSS units,that is, to the medical logistics battalion or themajor medical unit. Under certain conditions,resupply/throughput may be required directly tothe division.
(5) Throughput of medical supplieswill continue for the duration of the conflict. Thesemedical supplies will be delivered by supportingcorps or theater transportation assets directly tothe medical battalion, logistics (forward) or medicalbattalion, logistics (rear).
6-11. Developing Theater Requirements
a. In the initial stages of a developingtheater, arriving medical units, to include medical
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battalions, logistics, will operate from their pre-planned basic loads and from any existing pre-positioned war reserve stockpiles. To deploy withthe necessary Class VIII materiel, the plannermust possess a detailed understanding of eachcontingency plan and the type and number of unitsto be supported.
b. Health service logistics planning foran initial period of operations may be based onmedical module (MEDMOD) resupply sets such astrauma and sick call sets, resupply by unit type(REBUT) computations, and recommendedstockage lists developed for the DMSO in theheavy and the light divisions and for hospitals.Preconfigured sets contain a specific number ofClass VIII consumable days of supply. Durableand nonexpendable items must be requestedseparately. Planners will review operationalrequirements and add or delete items from sets asnecessary. Preconfigured packages will predom-inately consist of high-consumption items.
(1) The preconfigured set conceptis not restricted to standardized sets. It can applyto locally assembled collections of supplies in antic-ipation of unique contingency requirements, Thisconcept is influenced by the projected usage ratesand casualty estimates or the mission assigned. Itcan be as simple as a box of Ringer’s lactatesolution taped together with a box of starter sets.
d.
(2) Preconfigured packages can besent automatically by supply support activities atprearranged intervals (PUSH) or can be called forwhen needed (PULL). The key to using precon-figured sets succeessfully is planning, coordinating,more planning, and more coordinating.
(3) During initial planning whenusing resupply sets, an analysis of the climate andterrain, local acquisition, and throughput distri-bution should be made. This is necessary to ensurethat the resupply sets are supplemented with itemsrequired at the specific geographic location.
Climate and terrain. Spe-cial requirements may exist for operations in desert,
Žmountain, jungle, or arctic conditions. Resupplysets, as normally configured, may not address allof a unit’s needs under the above conditions. Theymay contain more than is required. Too much iswasteful of critical materiel and transportationresources and ties up the resupply pipeline.Therefore, close coordination with the appropriatestaff is required to determine if specific itemsrequire addition, deletion, or quantity adjustment.
• Local acquisition. It maybe possible to obtain commitments from host nationsregarding specific items that will reduce supportrequired from CONUS and/or reduce theaterstockage requirements. Any medical items requiredto support operational requirements may beconsidered for host nation support pending thecommand surgeon’s approval.
c . Preplanning should include coor-dination with all supporting health serviceactivities.
When the logistics pipeline is es-tablished, line item requisitioning supports thetheater.
6-12. Mature Theater Requirements
a. In-theater medical units and de-ploying medical units sustain their operationswith unit basic loads and are resupplied fromwar reserve stockpiles. As the theater matures,levels of supply are established and normalreplenishment based on demands will replacereliance on deployment loads and theater warreserves. Resupply to the theater is preplannedand defined in appropriate logistical plans. Thispreplanned resupply includes shortfalls coexistingwar reserves, follow-on resupply and buildup toapproved theater stockage levels, and combat lossreplacements.
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b. In-theater medical battalions, logis- requisitioning procedures. As corps are added totics (forward or rear) operate from stockpiles of the theater, additional support units arrive andwar reserves and receive resupply from CONUS the health service logistics system expands tovia preplanned supply increments or normal support changing requirements.
SECTION V. HEALTH SERVICE LOGISTICS COMPUTATIONS
6-13. Computing Days of Supply
a. Computing the days of supply (DOS)is a key factor in supply planning. Levels of supplyexpress the quantity of supplies authorized to beon hand or on order in anticipation of demands.For most consumable medical materiel, the DOSconcept is normally employed to determine medicalmateriel and medical repair parts stockagerequirements.
b. The DOS method computes stockagerequirements for a given number of days based ona daily usage or demand rate. In addition tomedical materiel, the DOS method is usedthroughout the Army for other items that possessa short life, or that are critical, seasonal, orperishable. Successful use of the DOS conceptrequires demand history or the ability to forecastover the short run (6- to 12-month forecastingperiod).
c. Department of the Army Pamphlet(DA Pam) 710-2-2 contains specific details for DOScomputations. Other supply planning, estimating,and computational guidance is contained inFM 101-10-1/1 and FM 101-10-1/2. The appropriateDOS levels may vary; however, the planner mustkeep in mind the levels are situationally andoperationally dependent on the type of mission.
6-14. Theater Stockage Objective
Headquarters, DA, prescribes the DOS authorizedfor overseas armies. Days of supply are convertedto numerical quantities of items. These quantitiesconstitute the stockage objective; permit requi-
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sitioning, inventory control, and movementplanning; and form the basis of supply support.The theater stockage objective includes all requiredstocks except those in the hands of using units.The senior health service materiel officer in thetheater recommends the theater stockage objectiveto the theater surgeon. Routinely, the theaterstockage objective is 30 days at the medicalbattalion, logistics (rear) with 15 days stockageobjective at each supported corps (medicalbattalion, logistics [forward]). The senior healthservice materiel officer continuously monitors thetheater stockage objective and, if required,recommends that it be modified based on thesituation or operation. A pounds-per-day-per-manconsumption figure can be used for initial grossplanning for transportation and storage estimateswithin the theater. However, this is not a preciseplanning method.
6-15. Requisitioning Objective
A unit’s requisitioning objective (RO) consists ofseveral stockage levels added together. The RO isthe maximum quantity of an item that may be onhand or on order. The following formula is used tocalculate the RO:
RO=OL+OST+SL
where:
• OL=Operation level. The OL is the quantity of stock required to sustain opera-tions in the interval between receipt of a replen-ishment requisition and submission of anotherrequisition.
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• OST = Order ship time. TheOST is the quantity of stock required to sustainoperations between the time a replenishmentrequisition is submitted and the time the materielis received and posted to the stock record account.
Ž SL = Safety level. The SL is thequantity of stock on hand to sustain operations inthe event of demand rate increases or temporaryinterruptions to the supply pipeline. The SL forClass VIII will be determined by the appropriatecommand surgeon.
6-16. The Reorder Point
The reorder point (ROP) is the number of DOSexpressed as a quantity of stock which in all casesis less than the RO. A replenishment requisition
should be submitted whenever the quantity ofstock on hand and due in, less any due out, equalsor is less than the ROP. The following formula isused to calculate the ROP:
ROP = OST + SL
NOTE
Since the DOS concept is based ondemand history or forecasting or both,the planner must be careful whenestablishing levels for a changingsituation where usage or consumptionis likely to increase or decrease rapidly.In this case, an improperly establishedlevel could result in excess or zerobalances and poor supply economy.
Section VI. MEDICAL ASSEMBLAGES
6-17. Management
Medical assemblages are classified service unique(major) or multiservice (minor).
a. A service-unique (major) medicalassemblage is a grouping of medical and nonmedicalitems under a single stock number which ismanaged by the AMEDD and used primarily bythe Army. These assemblages are identified by theSets, Kits, and Outfits (SKO) National StockNumber and Title Only reflected in the Componentsof Sets, Kits, and Outfits printed in Volume II,Medical Sets, Kits, and Outfits of the DOD MedicalCatalog (microfiche version).
(1) Components are initially autho-rized and published in DA supply catalogs (SC)6545-8-XXX series and unit assemblage listings(UAL).
(2) Revisions to assemblage com-ponents are published annually in the DA Supply
Bulletin (SB) 8-75 series and are reflected in currentyear UAL.
b. A multiservice (minor) medical as-semblage is a grouping of medical and nonmedicalitems under a single stock number which ismanaged by the Defense Medical StandardizationBoard (DMSB) and used by multiple services.
(1) Components are published inthe DOD Medical Catalog (microfiche version),Volume H, Medical Sets, Kits, and Outfits.
(2) Revisions to assemblage com-ponents are published monthly in the DOD MedicalCatalog, Volume II, Medical Sets, Kits, and Outfits.
6-18. Procedures
a. Requisition. Authorized serviceunique medical assemblages are requisitionedaccording to procedures contained in AR 40-61.
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Authorized multiservice medical equipment setsare requisitioned through normal supportingClass VIII channels to the wholesale system.Equipment listed in the authorized column of theunits’ modified table of organization and equipment(MTOE) should be either on hand or on requisitionaccording to AR 710-2.
b. Accounting. Property records aremaintained for each authorized nonexpendableitem according to AR 710-2. A quality controlprogram must be established.
c. Maintenance. The commander of aunit issued a medical assembly is responsible forcontinuous maintenance and update of its com-ponents. To prevent loss of shelf-life items,commanders should ensure that stock rotation isaccomplished where this capability exists.Normally, potency dated items are not packedwith the assemblage but are maintained separatelyfor management purposes. United States MedicalMateriel Agency will furnish latest unit assembly
listings to commanders on request. These listingsreflect the latest assembly configurations asauthorized by The Surgeon General, Commandersshould ensure that all newly authorized assemblycomponents are promptly requisitioned. The officialcomponent listing of medical assemblages is listedin the supply catalog. Unit assemblage listingsare updated annually by USAMMA. If there is adiscrepancy between the supply catalog and theUAL, the UAL will be used since it contains themost current information. Detailed maintenanceand surveillance procedures for medical assem-blages are contained in TB Med 1 and TB 740-10.
NOTE
Service unique medical assemblages, ifissued to Reserve units, will not normallycontain components having a shelf lifeof 60 months or less. Reserve units mustbe prepared to requisition these items, ifrequired, on deployment.
Section VII. MEDICAL EQUIPMENT MAINTENANCE
6-19. Purpose a. Maintenance of an item includes—
The purpose of medical equipment maintenance isto assure that medical equipment is maintained ina mission-capable condition. Commanders at eachlevel are responsible for the successful accom-plishment of the maintenance requirements oftheir unit. In recent years, medical technology hasadvanced at a very rapid pace. As a result,maintenance actions required to support thesetechnological advances have become more complex.In many cases, proper care and maintenance nowrequire sophisticated test, measurement, anddiagnostic equipment (TMDE), and advancedschooling for maintenance personnel.
• Inspecting.
• Testing.
• Servicing.
• Classifying.
Ž Adjusting.
• Aligning.
Ž Repairing.
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Ž Rebuilding.
• Modifying.
b. The objectives of a maintenance pro-gram include—
(1) Prevention of equipment fail-ures by timely and adequate scheduled services(preventive maintenance checks and services[PMCS]).
(2) Early detection and correctionat the lowest level of repair capability or capacity.
(3) Minimizing requirements fornew equipment.
c. Maintenance planning must beconducted concurrently with supply planning, asthe two are closely related. An inadequatemaintenance program will impose inordinaterequirements on the supply system. A lack ofproper prescribed load list (PLL) managementcauses great increases in maintenance turnaroundtime when repair parts are not available.
6-20. Policy
a. Medical equipment maintenanceefforts are divided into two main areas:
(1) Scheduled periodic services.These services include-
• Preventive maintenancechecks and services.
• Electrical safety inspec-tions and tests.
• Calibration, verification,and certification (CVC).
Scheduled periodic services take precedence overall but emergency repairs. Preventive maintenancechecks and services, performed principally at theoperator level, are the heart of a maintenancesystem. Preventive maintenance is defined as thesystematic care, servicing, and inspecting ofequipment to maintain it in a standard serviceablecondition and to detect and correct minor faultsbefore they develop into major defects.
(2) Unscheduled repairs (remedialmaintenance). These repairs will be performedonly by or under the direct supervision of a healthservice maintenance technician or a medicalequipment repairer (MER). Unscheduled repairsof an item consist of inspecting, classifying, test-ing, servicing, and all related actions necessary toreturn the item to a fully serviceable state.Unscheduled repairs include necessary calibrationsand tests that are incidental to a repair action.
b. Medical equipment maintenance sup-port must be provided as far forward as possible.Ideally, equipment items should be diagnosed andrepaired on site if conditions permit, either byorganic MERs or by mobile support teams (MSTs)from the supporting medical battalion, logistics.This policy eliminates time-consuming evacuationprocedures and normally results in more rapidreturn of the equipment to the user. Considerationsfor employment of the forward support conceptinclude—
• Mission statement, to includemaintenance allocation charts.
Ž Availability of appropriateTMDE, tools, and repair parts.
• Requirements for special main-tenance skills or specialized procedures.
Ž Size and/or transportability ofthe item requiring maintenance services.
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6-21. Concepts • Specifically designated as suchby the manufacturer or other competent authority.
In addition to having a high degree of technologicalproficiency, maintenance managers must becapable of employing a variety of managementprinciples to ensure that the maximum servicepossible is available to supported unite. Techniquesof production scheduling, production control, work-flow analysis, and work area configuration mustbe analyzed and the best combination of theavailable resources selected to allow optimal use ofthe MER’s technical skills. The high technology,critical life support nature of many medicalequipment items requires a maximum managerialeffort to ensure that life-sustaining equipment isfully mission capable when needed. To this end,the following concepts should be considered formaintenance planning purposes:
a. Forward Support. In a TO, diagnosisand repair of an item as far forward as possible isessential. Ideally, equipment items should berepaired on site if conditions permit either byorganic MER’s or by MSTs from the appropriatemedical battalion, logistics. On-site repair reducestime-consuming and costly retrograde of equip-ment.
b. Evacuate. Selected end items and/orcomponents will be evacuated to the supportingmedical battalion, logistics when a lower echelonof maintenance cannot perform the requiredservices, or when conditions do not permit on-siterepairs. If within its capability, the supportingmedical battalion, logistics will repair the item andreturn it to the user. Items that cannot be repairedwill be further evacuated to a supporting activity.Uneconomically repairable items will be disposedof according to appropriate directives.
c. Discard. Certain items of medicalequipment are designed and engineered to employdiscardable “throw-away” components or modules.These components/modules should only be treatedas discard items when—
• It is more economical to discardthe items than to repair them.
Ž Repair times would significantlyaffect mission performance.
In many cases, the discard feature allows morerapid repair and return to operational status.Unserviceable “throw-away” items must be dis-posed of according to approved procedures.
d. Reparable Exchange. Reparableexchange will be used to the maximum extentpossible to enhance the "fix forward concept.Reparable exchange facilitates immediate replace-ment of defective modules and minimizesequipment downtime. Defective modules will beevacuated to supporting medical battalions,logistics, where an exchange for serviceablemodules will occur and repair of the defectivemodule will be made.
e. Cannibalization and Controlled Ex-change. Authority for employing cannibalizationand controlled exchange is contained in AR 40-61and AR 750-1.
(1) Cannibalization is the autho-rized removal, under specified conditions, of itemssuch as serviceable and unserviceable parts,components, and assemblies from uneconomicallyrepairable materiel authorized for disposal.Removed items may be reused immediately inrestoring one or more like items to a serviceablecondition, or held in storage by support activitiesas an alternate parts source.
(2) Controlled exchange is theauthorized removal, under specified conditions,of items such as serviceable parts and assembliesfrom unserviceable, economically repairablemateriel. Removed items are to be reused
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immediately in restoring a like item of materiel toa mission-capable condition.
f. Operational Readiness Float Pro-gram. The name and acronym OperationalReadiness Float (ORF) Program replaces the nameand acronym Medical Standby Equipment Program(MEDSTEP) found in earlier publications. Thechange is required so that the AMEDD’s termi-nology can be consistent with that used by theArmy at large. Operational readiness float assetsinclude items, components, or assemblies used toprovide supported activities with serviceable itemsin exchange for mission essential, economicallyrepairable items. Operational readiness float assetsare not intended to be used for equipment shortages,expansion of operational missions, or temporaryloan requirements. Operational readiness floatassets in the theater are located at medicalbattalions, logistics (forward and rear) and areused to satisfy requirements at all medical units inthe theater.
g. Alteration/Modification. Alteration/modification of medical equipment is authorizedonly under certain conditions which will beannounced inappropriate publications. Records ofsuch alterations and modifications must bemaintained. Army Regulations 40-61 and 750-10contain additional guidance on equipment alter-ation and modification procedures.
h. Repair Parts Management. Carefulselection and stockage of the correct quantity ofrepair parts are essential elements of any successfulmaintenance program. Field medical units areconcerned with four categories of repair parts:
•
•
(1) Prescribed load list (unit-levelmaintenance function includes a mandatory partslist [MPL]).
(2) Nonstocked repair parts (allmaintenance levels).
(3) Bench stock/common usageitems (all maintenance levels).
(4) Authorized stockage list (ASL)(DS maintenance function).
Army Regulation 40-61, AR 710-2, DA Pam 710-2-1, and DA Pam 710-2-2 contain a detailed discus-sion of requirements and criteria for managementof each of these categories of repair parts, A list ofMPLs for medical equipment is published in theTB 8-6500-MPL. On request, the USAMMA na-tional maintenance point (NMP) will constructand provide a recommended PLL based onequipment density for newly activated units andunits having changes in assigned equipment.
6-22. Levels of Medical Maintenance
There are four levels of maintenance.
a. Unit Maintenance, Level 1. Theintended purpose of unit maintenance (UM) is tosustain materiel readiness by performing scheduledservices, minor repairs, and replacement ofcomponents. Unit maintenance is performed byequipment operators, users, assigned MERs, and/or MSTs.
(1) The responsibilities of the equip-ment operator/user include–
Cleaning.
Preventive maintenancechecks and services according to AR 40-61.
Ž Replacement of operator-level components and accessories.
Ž Prompt reporting of equip-ment malfunction to the MER.
(2) The responsibilities of the MERinclude–
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and documenting UM.• Scheduling, performing,
Ž Electrical safety inspec-tions and tests.
• Calibration,and certification services.
• Performingmaintenance (remedial repair).
verification,
unscheduled
Ž Maintaining unit-level re-pair parts (PLL, MPL, bench stick).
• Maintaining a file of oper-ating and service literature for all assigned medicalequipment.
Ž Performing preissue tech-nical inspections on incoming medical equipmentand condition coding medical equipment to beturned in.
• Notifying support mainte-nance activities of requirements and/or evacuatingunserviceable equipment as appropriate to supportmaintenance activity.
b. Direct Support Maintenance, Level 2.The purpose of DS maintenance is to—
Ž Provide all authorized main-tenance functions that exceed the authority,capability, or capacity of UM.
• Provide UM to medical unitswithin the CZ without an organic capability.
• Repair Level 2 components and/or modules.
Ž Provide on site support to CZmedical units by means of MSTs.
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• Provide technical assistance tosupported units.
• Fabricate minor repair partswhen required to meet operational readinessrequirements.
• Notify the next higher main-tenance support level of requirements and/orevacuate unserviceable equipment to a highermaintenance level.
c. General Support Maintenance, Level 3.The purpose of GS maintenance is to—
• Provide all authorized repairfunctions that exceed the authority, capability, orcapacity of DS units.
• Provide UM to medical unitswithin the COMMZ without an organic capability.
• Repair GS-level componentsand/or modules.
• Provide on-site support toCOMMZ medical units by means of MSTs.
• Provide technical assistance tosupported units.
• Fabricate repair parts whenrequired.
Ž Notify the next higher main-tenance support level of requirements and/orevacuate unserviceable equipment to a highermaintenance level.
d. Depot Maintenance, Level 4. Thepurpose of depot maintenance is to—
• Provide overhaul and rebuild ofend items and components in support of thewholesale supply system and as repair and returnactions.
FM 8-55
Ž Perform special inspections,tests, and modification program actions.
• Perform maintenance servicesand functions for the wholesale supply system.
Ž Manufacture items and partswhen required.
• Provide end items, components,and repair parts through established programs insupport of both TOE and tables of distribution andallowances (TDA) medical units.
Ž Provide on-site MSTs on an “asrequired” basis.
6-23. Organization for Maintenance
a. In the CZ, the most forward providerof medical equipment services is the medical
equipment maintenance section of the main sup-port battalion (MSB) of the division. The MERs ofthis organization normally provide UM supportonly to divisional units, Also located in the CZ areCSHs and MASHs with organic MERs. As with theMERs in the division, the corps TOE hospitals willnormally provide UM support to their ownorganization and attached units. Area medicalequipment maintenance support for units withoutorganic MERs and DS maintenance, whenrequired, is provided by the medical equipmentmaintenance section of the medical battalion,logistics (forward).
b. In the COMMZ, in addition to themedical battalion, logistics (rear), there are FHsand GHs, each with organic MERs. As in the corps,MERs assigned to these organizations normallyprovide UM for their own organization and attachedunits. Area medical equipment maintenancesupport for units in the COMMZ without organicMERs and DS/GS maintenance is provided by themedical battalion, logistics (rear).
Section VIII. OPTICAL FABRICATION SUPPORT
6-24. Support Responsibilities
More than one-third of all active military person-nel require vision correction. Current supportagreements require the Army to provide opticalfabrication and repair services to the Air Force andthe Navy. Other support agreements may requireprovision of these services to others such as theCoast Guard, the Red Cross, EPW, and allies.
6-25. Organization for Optical Support
a. The most forward provider of opticalfabrication support capability of the CZ is theoptometry section of the medical company, MSB.The optometry section provides fabrication offinished prescription single vision lenses andspectacles and repair services.
b. Area optical support within the CZ orCOMMZ is provided by the optometry section ofthe medical battalion, area support.
c. For greater optical fabrication andresupply of the optical medical equipment sets,requisitions will be supported by the medicalbattalion, logistics (forward/rear).
6-26. Optical Fabrication Concept
Optical fabrication support is only for standardprescription eyewear. Prescription eyewear in-cludes standard spectacles, aviation spectacles,protective mask inserts, and similar optical devices,Detailed procedures for preparation and submis-sion of eyewear prescriptions are contained in
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AR 40-63. Contact lenses, to include ancillaryitems such as saline solution and cleaners, may berequired for stockage and issue to individuals,such as Apache and Comanche pilots, who areoperators of targeting devices which preclude theuse of regular spectacles.
6-27. Optical Supply Planning
Optical fabrication laboratory operating suppliesare those consumable items, components, and
ancillary supplies used in the fabrication ofprescription eyewear. The initial supply of con-sumable items incorporated in optical fabricationassemblages for medical TOE (nondivisional) units,except the medical battalion, logistics (forward),consists of those items required under averageconditions for a period of 10 days. Authorizationsfor individual items are listed in the SC 6545-8-CLseries. The initial allowance of consumable itemsfor the optical section of the medical battalion,logistics (forward) consists of those quantitiesrequired under average conditions for a period of15 days.
Section IX. CONSIDERATIONS IN HEALTH CARE LOGISTICS PLANNING
6-28. Planning Considerations
a. Adequate supplies, maintenance,transportation, and services are necessary for theHSS mission to be successful. Detailed planningprinciples are discussed in AR 40-61, Chapter 2 ofthis manual, FM 101-5, and FM 101-10-1/1 and1/2. Logistics planners must fully understandthese principles and must actively participate inthe planning process.
b. Due to the technical nature of thehealth service logistics system, coupled with thelikelihood of a rapidly changing battlefield, theplanner must develop creative and flexible plans.
c. The planner must–
• Have a comprehensive under–standing of the operational and tactical plans.Additional contingency missions beyond those forwhich a published plan exists may be assigned ona short- or no-notice basis.
• Have a thorough knowledge ofthe entire spectrum of the logistics system toinclude those organizations and activities respon-sible for specific aspects of support.
• Be aware of Joint Service sup-port agreements.
• Be aware of host-nation sup-port agreements.
d. The health service logistics plannerdetermines requirements for the–
(1) Types of medical suppliesneeded.
(2) Supply procedures to be fol-lowed.
(3) Stock levels to be maintained.
(4) Sizes and locations of the healthservice logistics installations needed.
(5) Medical equipment mainte-nance procedures.
(6) Optical fabrication procedures.
(7) Production of medical-qualityfluids.
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(8) Production of medical oxygen.
(9) Disposal of unserviceable USequipment and supplies.
(10) Disposition of captured medicalequipment and supplies.
e. These determinations are based onthe health service estimate of the situation andMETT-T.
6-29. Disposal Planning
a. Disposal instructions will be providedwhen medical materiel is determined to be unsafeor unsuitable for use by–
(1) The Surgeon General.
(2) US Army Medical MaterielAgency.
(3) Defense Personnel Support Cen-ter.
(4) Food and Drug Administration,or
(5) Some other competent author-ity.
b. Excess, unserviceable, or unidenti-fiable medical materiel must be disposed of inaccordance with ARs 40-5,40-61, 200-1; FMs 8-10and 27-10; and the SB 8-75 series if it is notauthorized for–
(1) Return to either a MEDLOGbattalion or a CONUS source.
(2) Redistribution within the the-ater, or
(3) Retention at the MTF.
c. Inadequate supply controls and pro-cedures often generate excess materiel. Logisticsmanagers must implement measures to ensurethat established levels are realistic and do notproduce unnecessary excesses. Often, newlyintroduced items by the health care provider mayrender existing stocks obsolete or items of secondchoice. In these cases, close coordination betweenthe logistics manager and the clinical staff on theuse of existing stocks and authorized substitutionswill eliminate or minimize creation of unnecessaryexcess from this source. Excess materiel at anylevel reduces mobility and increases accounting,storage, surveillance, and security requirements.Excess materiel must be reported to supportingmedical battalions, logistics (forward and rear) forredistribution.
d. Many pharmaceutical items requireadvanced technology and production techniques.Accordingly, these items may pose seriousenvironmental hazards if disposed of improperly.Other items of medical materiel maybe sensitive,pilferable, or subject to abuse and may also requirecontrolled disposal methods. Economicallyrecoverable precious metals constitute yet anothercategory of materiel requiring special disposaltechniques.
e.USAMMA SB 8-75-9 contain additional guidanceon disposal techniques for specific medical materiel.These techniques are developed in coordinationwith the US Army Environmental Hygiene Agen-cy. The US Government Environmental ProtectionAgency (EPA) and the Army EnvironmentalHygiene Agency have developed lists of hazardouspharmaceuticals and biological.
f. Disposal of medical materiel undercombat conditions may require additional planningand/or coordination with the MEDLOG battalion(s)and engineer units. Authorized means of disposal
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for medical materiel include, but are not limitedto–
• Disposal in an authorized incin-erator.
• Disposal in a sanitary landfill.
• Disposal in a hazardous wastelandfill.
Ž Disposal in a sanitary sewer.
• Disposal by chemical treatment.
g. In all cases, current directives mustbe consulted prior to disposal action. Thesedirectives must take into account restrictionsimposed by host nations and/or allied nations andUnited States and territorial governments.
•
6-30. Staff Relationships
a. The Health Service Logistics Officer.The health service logistics officer establishescommunications and directs necessary coordinationwith supported HSS logistical organizations of alluniformed services and other federal agencies forwhich the AMEDD has area support responsibility.
b. The Transportation Officer. Thehealth service logistics officer advises the trans-portation officer–
In the transportation and dockstorage of Class VIII materiel to preclude spoilageor deterioration in transit.
• In the supervision of the trans-portation of Class VIII.
c. The Engineer Officer.
(1) The health service logistics of-ficer should review plans with the engineer officerfor constructing facilities used for Class VIIIsupplies.
(2) The above step prevents po-tential problems resulting from improper con-struction.
d. The Civil Affairs Officer. The healthservice logistics officer advises the CA officer onClass VIII matters. He may be asked to furnishtechnical assistance or health service logisticspersonnel, or both, to that office to assist in thehumanitarian effort.
e. The Chemical Officer. The healthservice logistics officer requests assistance fromthe chemical officer in developing threat asses-sments. This coordination is needed to determinethe correct packaging and preservation method-ology to protect medical materiel.
Section X. THE HEALTH SERVICE LOGISTICS ESTIMATE
6-31. Developing the Estimate (2) Included along with the medicaland dental aspects in parts of paragraphs, or
a. The basic HSS estimate of thesituation discussed in Chapter 2 is used to develop (3) Presented as a separate append-specific information on health service logistics. age to the HSS estimate.This information can be–
b. The format shown in subsequent(1) Presented in a separate para- paragraphs includes the major points to be
graph. considered in arriving at a logical conclusion.
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c. The health service logistics plannershould adapt this format to his particular situation.He should omit those portions which do not apply,or expand those which require more detail.
d. The plans and operations division ofthe surgeon’s staff should not overlook the factthat the estimates and plans they prepare requiredefinite data relating to health service logistics.These data should be provided by the staff healthservice logistics officer, who should be furnishedsufficient information to guide him in preparingthe health service logistics portion of the estimateor the plan.
(3) Number of MTFs.
c. Characteristics of the Area of Oper-ations. The following should be included:
(1) Factors in the basic HSS esti-mate of the AO.
(2) Statements concerning the pop-ulation, health, and types of population in the AO.
(3) Detailed information concerningany disease which may pose a serious threat to thehealth of the command or other personnel in theAO and which may require specific Class VIIImateriel.
6-32. Missiond. Strengths to be Supported.
The health service logistics mission will paralleland support the surgeon’s mission, and in turn, thecommander’s mission. The unit’s mission must beclearly understood.
6-33. Situation and Considerations
The health service logistics situation may comprisea few or many elements. Some of the principal onesare as follows:
a. The Enemy Situation. List the enemycapabilities that might affect the ability of thehealth service logistics system to accomplish itsmission.
b. The Friendly Situation. The scope ofhealth services logistics support to be planned isdetermined to a great extent by the followingfactors:
(1) Casualty estimates (types andnumbers and evacuation policy).
(2) Age of population supported.
(1) Accurate data regarding thesupported population, to include personnel strengthof the Army, Navy, Air Force and Marines, allies,EPW, indigenous civilians, detained persons,civilian interns, and others, is required to determineClass VIII needed.
(a) Medical materiel andequipment. The Army is responsible for providingmedical care and treatment as stated in 6-33d(1)and may become responsible for providing medicalcare or assistance to displaced persons, and ref-ugees. In computing requirements for suppliesand equipment needed to perform this function,full use should be made of all available intelligencedata pertaining to estimates of the number ofindividuals for whom medical care must be providedand the incidence of disease among them. See FM8-10-8 for additional discussion.
(b) Supplies subject to capture.
1. The Geneva Con-vention precludes willful destruction of medicalmateriel; therefore, when the capture of medicalsupplies by enemy forces is imminent, medical
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materiel must not be purposefully destroyed. Whena commander, because of military necessity, hasdecided to abandon patients, sufficient andadequate medical personnel and materiel must beleft for the care of those abandoned patients.Under all other conditions, every attempt must bemade to evacuate all medical materiel andequipment. Those that cannot be evacuated shouldbe abandoned, but the abandonment of medicalsupplies is a command decision.
2. The destruction ofsupplies, other than medical, is also a commanddecision. Medical units should have an SOP for theevacuation and destruction of their own suppliesand equipment (other than medical) based oncommand priorities.
(c) Medical materiel andequipment captured from the enemy.
1. Medical materieland equipment captured from the enemy areconsidered to be neutral and protected propertyand are not to be intentionally destroyed. (Seediscussion in PM 8-10.) They are to be turned overto designated medical supply facilities. Adequatesamples of all captured materiel and equipmentmust be preserved and reported according to FM 8-10-8. In the event that large amounts of enemymedical materiel and equipment are captured, it isfrequently advisable to concentrate this materielin one or more medical materiel installations whereit may be examined for intelligence value andclassified. The materiel is segregated and that ofvalue is picked up in the theater if the designatedfacilities have the capability to store the supplies.
2. Since captured reed-ical personnel are familiar with their medicalmateriel, the captured items are especially valuablein the treatment of EPW. Only after their needshave been fully met may such supplies be used totreat others. If these supplies are unfit for use or
not needed, they may be abandoned for the enemy’suse. Under no circumstances will captured medicalsupplies be destroyed.
(2) Locations of personnel would beneeded to determine the most appropriate locationfor units in the CZ and or the COMMZ.
(a) The general locations ofmedical materiel activities are chosen along theproposed axis of advance, However, considerationmust be given to the—
• Strategic and tac-tical effort.
• Location of airfieldsand seaports.
Ž Major usable trans-portation facilities.
(b) W h e n s e l e c t i n g s p e c i f i clocations, however, one must consider such factorsas--
sion because of the threat.
stallations.
troops.
• Adequate disper-
Ž Defensibility of in-
• Local roads.
• Disposition of
Railsiding (situatedbeside a railroad track or right of way).
• Adequacy of localcommunication facilities.
• Existing buildingsand utilities.
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labor.• Availability of local
NOTE
Under the provisions of the GenevaConvention, medical stocks must bestored and distributed separately fromother classes of supply to be consideredprotected materiel. See FM 8-10 for adiscussion.
(c) Medical supply instal-lations should be near railheads, ports, airfields,and highways to minimize hauling. As trans-portation means are always at a premium, effieientmethods should be employed to minimizeunnecessary shipments, transshipments, andrehandling of medical supplies. So far as possible,shipments of medical supplies should beaccomplished in one move and as far forward aspossible. Movement of supplies through successivesupply installations should be avoided. Healthservice logistics organizations will provide supplysupport using unit distribution. Supply pointdistribution can be considered as an alternativemethod of supply.
(d) The availability of trans-portation assets, both organic and support units,must be analyzed. Many Class VIII items aresensitive and special transportation and/or storagerequirements exist, such as refrigeration, security,and flammable precautions. A sophisticated andresponsive transportation system may lessenrequirements for large safety levels and largestorage areas. Field Manual 55-1 contains addi-tional transportation planning guidance.
(e) Storage facilities forClass VIII supplies generally require 100-percentcovered storage. Consideration must be given toany special climatic conditions such as desert,
mountain, jungle, or arctic. Existing buildingsshould be used to the maximum extent possibleprovided they offer required security, refrigeration,flammable protection, and controlled humidityand temperature storage. Preservation andpacking procedures as prescribed in TB MED 1must be followed to the fullest extent practical.
1. Overall space re-quirements are determined from logisticalmanagement data and from experience factors forhandling medical supplies. Detailed spacerequirements should be based on specific assign-ments of support missions, supply levels to becarried, area and troops served, and types ofsupplies. Medical unit commanders and staffofficers should have an appreciation of storageproblems, particularly those pertaining to coveredstorage if they are to establish appropriate policiescovering storage of medical supplies. See TB 740-10 for additional guidance.
2. Maximum use ofstorage space is basic to economical supplyoperations, Such factors as accessibility of storedmedical supplies and maximum protection fromdeterioration, fire, weather, theft., rodents, andenemy action must be considered in ensuringefficient storage procedures.
(f) Accurate equipment den-sity data throughout the supported area is essentialto ensure adequate equipment repair capability.Equipment density data is also essential for medicalunit reconstitution planning. Equipment densitydata affects the ORF program.
(g) Conservation of suppliesand equipment should always be a matter of priorityconcern; however, under combat conditions, con-servation of medical supplies becomes particularlycritical. An austere environment requires thatclinicians practice supply discipline. They must beprepared to work with and be supported by genericsupplies. Lack of physician-preferred brands does
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not constitute a patient risk. A lack of supplydiscipline may contribute to a strained healthservice logistics system which constitutes a risk tothe patient. Unit assemblage listings must beupdated, maintained, and enforced. supplydiscipline must be a command priority. Cliniciansmust be familiar with their unit’s assembly listings.
(h) With certain restrictions,specified items and categories of items of medicalsupply are authorized for procurement locallywithin the theater. Procurement of certain medicalsupplies from non-US sources in overseas areas isnot authorized unless specific prior approval of thecommand surgeon is obtained. Consideration inthe procurement of medical items from local sourcesshould include manufacturer technical know-how,sterilization techniques, raw material availability,and production capabilities. Because of the natureof most medical items (mainly drugs and surgicalinstruments), sound judgment must be exercised.The high standards established by the US Gov-ernment make it difficult to consider the use ofmanufacturers in many areas of the world as pos-sible sources of drug supplies. Drug standardsvary in different countries, and, therefore, foreigndrugs are used only in emergencies. In practice,locally procured materiel is identified and segre-gated from similar items of US manufacture.Quality control procedures must be followed asprescribed in TB 740-10, AR 40-61, and SB 8-75series.
(i) Time permitting, inven-tories will be conducted in accordance with ARs710-2 and 40-61. All effort should be made toreduce the occurrence of warehouse denials.Inventories tell what items are on hand, When itis not known that an item is available, then theitem is not on hand.
(j) Medical supply activitieswill be located in areas where maximum securityis provided. Such locations will be incorporatedinto rear operations plans for the CZ and COMMZ.
e. Health of Troops in the Command.(If applicable to this estimate.)
f. Assumptions. Assumptions neces-sary for completing the health service logisticsestimate should be considered.
g. Special Factors. The particularoperation being planned will have certain items ofspecial importance. These items should be listedand taken into consideration by the planner.
6-34. Analysis
a. Health Service Logistics PersonnelEstimate. A number of factors are involved inestimating the number and type of health servicelogistics personnel that will be required to supporta particular operation.
(1)
(2)
Distribution of MTFs.
Extent of local procurement.
b. Health Service Logistics Require-ments. The planner must estimate what therequirements will be for the situation. It is thennecessary to compare this with what is availablewithin troop ceilings.
6-35. Courses of Action
A careful comparison of the health service logis-tics requirements with the resources availableenables the health service logistics planner todetermine his major problems. This comparisonsubsequently enables him to develop all logicalCOA that will accomplish the mission. The COAare expressed in terms of what, when, where, how,and why.
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6-36. Evaluation and Comparison ofCourses of Action
a. Once COA have been enumeratedand described, it is necessary to analyze andcompare them to determine which one should beused. There are two steps in the process whichshould be followed:
(1) Determine and state thoseanticipated difficulties or difficulty patterns thatwill have an equal effect on the COA
(2) Evaluate each COA against eachsignificant difficulty or difficulty pattern todetermine strengths and weaknesses inherent ineach COA.
b. Having determined the specificstrengths and weaknesses inherent in each COA,the health service logistics planner must comparethe COAs to determine significant advantages anddisadvantages of each. He then decides whichCOA promises to be most successful inaccomplishing the mission with the least amountof problems.
6-37. Conclusions
After review and analysis of all possible COA, theplanner is able to make a number of possibleconclusions in relation to the mission to beaccomplished.
a. The mission can or cannot besupported based on preceding paragraphs of theestimate. If the mission cannot be supported, a fulljustification for inability to support must be given.
b. The preferred COA can be identifiedin terms of health service logistics support to beprovided.
c. The disadvantages of the COA notselected can be identified.
d. Deficiencies in the preferred COAmust be brought to the attention of the commander;deficiencies should be enumerated and brieflydiscussed.
Section XI. THE HEALTH SERVICE LOGISTICS PLAN
6-38. Developing the Plan 6-39. Format for the Health Service Logis-tics Plan
The health service logistics plan is a part of theHSS plan and is included in it or, if very detailed, a. General Supply. (Provide specialappended to it. It bears the same relationship to instructions applicable to medical units. )the health service logistics estimate that the HSSplan does to the HSS estimate. When approved, b. Medical Supply. (Provide specialit— procedures applicable to this operation.)
Becomes a directive to health service (1) Requirements.a.logistics officers in subordinate commands. (2) Procurement.
b. Serves as a guide to them in working (3) Storage.out the details of their particular functions withinhealth service logistics support of the command. (4) Distribution.
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(5) Transportation.
c . Medical Equipment MaintenanceSupport. (Include in separate subparagraphs thelocation, mission, hours of opening or closing ofMEDMNT, and/or optical repair teams, unlessthey are included as attachments to health servicelogistic units.)
d. Optical Support.
e. Medical Supply Installations. (Givethe locations, mission, hours of opening and closing,and troops supported for each health servicelogistics installation. An overlay may also be usedfor clarity.)
(1) Health service logistics unitsmust remain flexible to meet changing situations.A rapidly changing military situation may make itnecessary that alternative health service logisticsplans, procedures, and operations be formulated.In certain instances, it maybe advisable to establishduplicate records, especially when automatedprocedures are used, to serve as a backup system.Supply levels in the CZ must be kept to a minimumto allow for the mobility required to support arapidly changing battlefield. An inventorymanagement process is necessary for recording
supplies received and inventory control. Bycontrast, supply levels in the COMMZ will likelybe higher to support the entire depth of thebattlefield.
(2) The extent of the area for whichplans are made influences health service logisticstroop planning in several ways. A large number ofMTFs widely dispersed in the AO would requiremore health service logistics, for example, than ifthere were fewer and more centralized MTFs.
f. Policy Statements.
(1) A statement of the local pro-curement inspection policy.
(2) A statement of the capturedmedical supplies inspection policy.
(3) A statement of the N B C.contaminated Class VIII inspection policy.
g. Salvage of Medical Equipment andSupplies.
h. Civilian Medical Supplies.
i. Other Supply Matters.
Section XII. MAJOR HEALTH SERVICE LOGISTICS ACTIVITIES
6-40. Health Service Logistics in the Com- the division/separate brigade. The preferredbat Zone method of distributing Class VIII supplies within
the division is by unit distribution using divisionIn future conflicts, the DMSO may be the highest transportation assets coordinated through the MCClevel of health service logistics support in the and operations section of the MSB.theater. Resupply to the DMSO maybe sporadicduring the first 5 to 15 days of a conflict with a. The DMSO normally provides thislimited access to pre-positioned sticks. The DMSO support to divisional or brigade units only, unlessor the medical supply officer for the separate specifically tasked otherwise.brigade medical company provides medical supply,medical maintenance, and optical fabrication b. Although the division surgeon (withsupport to the organic medical companies within the assistance of the DMOC) plans for HSS, the
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DMSO executes health service logistics plans. Heexercises his responsibilities by—
• Procuring, receiving, storing,and issuing Class VIII supplies.
• Coordinating with the supportedelements to determine requirements for Class VIIImateriel and liquid blood and to determine whenthey should be shipped.
• Developing and maintainingauthorized stockage levels of contingency medicalsupplies. These levels should be based upontransportation and storage constraints, as well ascharacteristics of the AO.
• Managing the division’s healthservice logistics quality control program.
• Supervising the unit medicalequipment maintenance program.
• Monitoring the division medicalassemblage management program.
Ž Coordinating logistical planningfor the assembly, packing, and delivery of standardmedical supply sets and locally developed, unit-peculiar resupply bundles.
• Establishing and operating adivision Class VIII supply point.
c. The reconstitution duties of theDMSO include—
• Reconciling by brigade theshortages in each medical company and treatmentplatoon as reported by the commander, platoonleader, or the battalion headquarters element.
• Coordinating with the DMOCto determine and acquire the number of medicalassemblages required to ensure units maintainmedical readiness.
• Coordinating with the medicalbattalion, logistics (forward) to monitor the statusof requisitions for medical assemblages due in.
Ž Coordinating through theDMOC—
• With the DMCC formovement of bulk medical supplies or medicalassemblages from the DMSO to forward unitswhen backhaul would be inadequate. (The DMOCdirects quick fixes using available assets andcontrolled exchanges for medical equipment tomaximize the capability of returning trainedsoldiers to duty.)
Ž With the CMCC fordelivery of supplies from the MEDLOG battalionto the DMSO.
Ž To alert the appropriatecompany when modular systems are due to arrive,
• To distribute modular med-ical assemblages to the units based on guidancefrom the DMOC. (The DMSO coordinates with theDMCC, through the DMOC, for transportationassets to deliver modular medical assemblages tothe unit being reconstituted.)
• To prepare the criticalitems listing and consolidate the critical shortagesby brigade.
NOTE
Differences between health service logis-tics units discussed in FM 8-10, dated1 March 1991, and those discussed inthis chapter resulted from experiencegained during Operation Desert Storm/Desert Shield, Operation Provide Com-fort, and Total Army Analysis projections.
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6-41. The Medical Battalion, Logistics(Forward), TOE 08-485L0
a. Mission. The mission of this organ-ization is to provide Class VIII supplies, opticalfabrication, medical equipment maintenancesupport, and blood processing, storage, anddistribution to divisional and nondivisional unitsoperating in the corps. In a single corps theater,this organization must be prepared to function asthe SIMLM for the theater.
NOTE
AS OF THE PUBLICATION DATE OFTHIS MANUAL, FROZEN BLOODWAS NOT AN ASSIGNED MISSION.
b. Assignment. This unit is assigned tothe corps under the command and control of theMedical Brigade, TOE 08-442L00.
c. Concept of Operations. This unit isthe single point of contact for medical logisticssupport for the corps. It should be located nearmajor lines of communication (sea or air) to easetransportation requirements for incoming ship-ments and facilitate distribution of materiel. Themodular nature of this organization allows it to beincrementally introduced in the theater with thesupported forces. Forward support platoons of thedistribution company should be deployed early tocoordinate support to a DMSO and prepare toreceive pre-positioned stocks and resupply fromCONUS.
(1) Supply support. Levels of supplyat the medical battalion, logistics (forward) arekept to a minimum to permit relocation on arapidly changing battlefield. Replenishmentrequests from supported units that are not filledfrom on hand stock will be passed to the supporting
supply source. This supporting supply source maybe a medical battalion, Iogistics (rear) or the CONUSbase. Unit distribution using corps transportationassets will normally be used to move the medicalsupplies forward to the divisions, separate brigades,armored cavalry regiments (ACRs), and SpecialForces groups (SFGs).
(2) Medical equipment mainte-nance services. The medical battalion, logistics(forward) provides medical equipment maintenanceservices to supported units in the corps. It providesunit level maintenance to units in the corps withoutorganic medical equipment specialists. It providesDS maintenance to medical units in the corps.This level of maintenance is directed toward repairand return of equipment. Mobile support teamswill provide these services as far forward as thetactical situation permits. The medical battalion,logistics (forward) maintains a limited ORF ofcritical items.
(3) Optical services. Optical fabri-cation requirements beyond the extremely limitedcapabilities of the main support medical companiesand the medical battalion, area support are providedby the medical battalion logistics (forward). Thisorganization provides spectacle frame repair,fabrication of prescription lenses and spectacles,and fabrication of protective mask inserts.
(4) Blood processing, storage, anddistribution. This organization receives, stores,packs for distribution, and distributes blood andblood products, A detailed discussion of the conceptof support is provided in Chapter 8.
d. Capabilities. This unit—
(1) Provides command and control,staff planning, supervision of operations, andadministration of assigned or attached unitsengaged in providing Class VIII supplies, opticalfabrication, medical equipment maintenance
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support, and blood processing, storage, anddistribution.
(2) Provides Class VIII supply basedon a consumption rate of 1.9 pounds per man perday, theater stockage objective of 30 days, and 15days of supply in each supported corps.
(3) Provides Class VIII supply,optical fabrication, and medical equipment main-tenance support, and blood processing, storage,and distribution to a maximum force of a two tothree division equivalent-size corps.
(4) Receives, classifies, and issuesup to 141.5 (maximum) short tons of Class VIIIsupplies per day. (This organization can support acorps force consisting of 74,470 soldiers based onits processing capability, consumption rate of 1.9pounds per man per day, and the theater stockageobjective. These factors may change based on anumber of variables. However, the actualmethodology explained in theremain the same.)
NOTE
notes, below, will
For example a corps force consisting of74,470 soldiers to be supported requires70.75 short tons per day (74,470 troopsX 1.9 pounds per man per day/ 2,000pounds [to arrive at short tons]) to beissued to the force. The medical battalionlogistics (forward) is required to receive70.75 short tons per day to replace thestack issued. The medical battalion,logistics (forward) would be at its limitto support the corps.
(5) Provides storage of up to 707.5short tons of Class VIII supplies based on anaverage order ship time of 5 days.
NOTE
Based on a 15-day stockage level in acorps with 5-days of that stockage levelbeing order ship time, the operating andsafety levels to be stored would be 10days. Using the data in the note above,the unit stores 707.5 short tons (70.75short tons per day X 10 days).
(6) Provides unit medical equip-ment maintenance for units without organiccapability and DS medical equipment maintenanceto corps and divisional medical units.
(7) Provides for blood processing,storage, and distribution within the corps.Distributes blood products to division medical units.
e. Basis of Allocation. One medicalbattalion, logistics (forward) is allocated per corpsor three division equivalent-size force. Oneadditional medical battalion logistics (forward) isallocated to support each additional increment of100,000 joint service population.
f. Organic Units. This organizationhas three organic units.
(1) Headquarters and Headquar-ters Detachment.
(2) Logistics Support Company(Forward).
(3) Distribution Company (For-ward).
See Figure 6-4 for an organizational diagram of themedical battalion, logistics (forward).
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Figure 6-4. Schematic of medical battalion, logistics (forward).
6-42. Headquarters and HeadquartersDetachment, Medical Battalion,Logistics (Forward), TOE 08-486L0
a. Mission. The mission of this unit is toprovide command and control and administrativeand logistics support to assigned and attachedunits.
b. Concept of Operations. This unit willusually be employed with the logistics supportcompany to plan and direct the execution of thehealth service logistics mission.
c. Capabilities. This unit—
(1) Provides command and control,staff planning, and supervision of operations andadministration of assigned or attached units.
(2) Provides unit maintenance fornonmedical equipment of assigned and attachedunits.
(3) Maintains a consolidated prop-erty book for assigned units.
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(4) Coordinates with corps trans-portation assets for the routine delivery of ClassVIII supplies.
(5) Coordinates with the medicalbattalion (evacuation) for transportation assets(aeromedical or ground ambulance) for theemergency delivery of Class VIII supplies.
d. Dependency. This unit is dependenton the Logistics Support Company, TOE 08-487L0,for food service.
e. Basis of Allocation. One unit isallocated per medical battalion, logistics (forward).See schematic of this unit in Figure 6-5.
6-43. Logistics Support Company, MedicalBattalion, Logistics (Forward), TOE08-487L0
a. Mission. The mission of this organ-ization is—
• To execute the planned supportof the corps in the areas of Class VIII supplies,
FM 8-55
Figure 6-5. Schematic of headquarters and headquarters detachment,medical battalion, logistics (forward).
optical fabrication, medical equipment main-tenance support, and blood processing, storageand distribution.
• To be prepared to support med-ical units of other Services in the corps area, asdirected.
b. Concept of Operations. This unitexecutes the medical logistics mission as directedby the headquarters element.
c. Capabilities. This unit—
(1) Receives, classifies, and issuesup to 119.5 short tons of Class VIII supplies per
(3) Receives and distributes preas-sembled modules (PUSH packages) for resupply insupport of divisional and nondivisional units in thesupported corps.
(4) Provides unit medical equip-ment maintenance for units without organiccapability and DS medical equipment maintenancethrough MSTs.
(5) Provides for blood processing,storage, and distribution within the corps. Distrib-utes blood products to division and nondivisionalmedical units.
(6) Provides optical lens fabrication.
FM 8-55
d. Dependency. This unit is dependent e. Basis of Allocation. One logisticson the Headquarters and Headquarters Detach- support company is allocated per one Medicalment, Medical Battalion, Logistics (Forward), TOE Battalion, Logistics (Forward), TOE 08-485L0.08-486L0, for UM on nonmedical equipment. See schematic of this unit in Figure 6-6.
Figure 6-6. Logistics support company,
6-44. Distribution Company, Medical Battal-ion, Logistics (Forward), TOE08-488L0
a. Mission. The mission of this organ-ization is to provide Class VIII support to divisionaland nondivisional medical units operating in thesupported operational area.
b. Concept of Operations. This unitemploys a company headquarters and organic
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medical battalion, logistics (forward).
forward support platoons to provide Class VIIIsupport on an area basis. This unit provides lim-ited Class VIII supply support for high volumeconsumables and facilitates the support of DMSOsand corps forces deployed in the division area ofoperations, This unit provides unit medicalequipment maintenance to units not otherwiseprovided support and has limited DS medicalequipment maintenance service for units withinits area.
FM 8-55
c. Capabilities. This unit—
(1) Receives, classifies, and issuesup to 22 short tons of Class VIII supplies per day(11 short tons per platoon).
(2) Provides storage for up to 22short tans of Class VIII supply (11 short tons perplatoon).
(3) Provides, through MSTs, unitmedical equipment maintenance to units nototherwise provided such support and limited DSmedical equipment maintenance on an area basis.
d. Dependency. This unit depends on—
(1) Headquarters and Headquar-ters Detachment, Medical Battalion, Logistics(Forward), TOE 08-486L0, for unit maintenanceon nonmedical equipment.
(2) Logistics Support Company,TOE 08-487L0, for food service, when collocated.Food service support must be coordinated for anelement operating independently.
e. Basis of Allocation. One distributioncompany is allocated per Medical Battalion,Logistics (Forward), TOE08-485L0. See schematicof distribution company in Figure 6-7.
Figure 6-7. Distribution company.
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6-45. The Medical Battalion, Logistics(Rear), TOE 08-696L0
a. Mission. The mission of this organ-ization is to provide Class VIII supplies, opticalfabrication, medical equipment maintenance sup-port, and blood processing, storage, and distributionto echelons above corps units and the medicalbattalions, logistics (forward) for nonthroughputrequirements. This organization must be preparedto function as the SIMLM for a joint theater.
b. Assignment. This unit is assigned toa MEDCOM, TOE 08-611L00.
Concept of Operations. The medicalbattalion, logistics (rear) is the single point ofcontact for medical logistics support for the theaterproviding support to both EAC units and medicalbattalions, logistics (forward). The medical bat-talion, logistics (rear) is normally located nearmajor lines of communication (sea or air) to easetransportation requirements for incomingshipments and facilitate distribution of materiel.
c .
(1) Supply support. Levels of supplyat the medical battalion, logistics (rear) are greaterto permit support of a rapidly changing battlefield.Replenishment requisitions from supported medicalbattalions, logistics (forward) that are not filledfrom on hand stock will normally be throughputfrom the CONUS base or other supporting supplysource bypassing the medical battalion, logistics(rear). Resupply for EAC units and requests frommedical battalion, logistics (forward) filled from onhand stock will normally be distributed on a unitdistribution basis using theater transportationassets.
(2) Medical equipment mainte-nance services. The medical battalion, logistics(rear) provides unit maintenance to those EACunits with medical equipment without organiccapability. It also provides DS maintenance toEAC units. This unit provides GS medical equip-
ment maintenance to the theater. Mobile supportteams will provide these services as far forward asthe tactical situation permits. The medical logistics(rear) battalion maintains an expanded ORF ofcritical items. Normally, an excessive maintenancebacklog at any unit, regardless of extent of repairsrequired, will be resolved by support from the nexthigher echelon, either by sending MSTs forward orby evacuation. In this regard, the medical battalion,logistics (rear) may expect to provide backupsupport to both the medical battalion, logistics(forward) and other EAC-supported units asrequired.
(3) Optical services. Optical fabri-cation requirements beyond the capabilities of themedical battalion, logistics (forward) and EACtreatment facilities are provided by the medicalbattalion, logistics (rear). This organizationprovides spectacle frame repair, fabrication ofprescription lenses and spectacles, and fabricationof protective mask inserts.
(4) Blood processing, storage, anddistribution. This organization receives, stores,packs for distribution and distributes blood andblood products.
d. Capabilities. This unit—
(1) Provides command and control,staff planning and supervision of operations, andadministration of assigned or attached unitsengaged in providing Class VIII supplies, opticalfabrication, medical equipment maintenancesupport, and blood processing, storage, anddistribution.
(2) Provides Class VIII supply basedon a consumption rate of 1.9 pounds per man perday; theater stockage objective of 30 days; and 15days of supply in each supported corps.
(3) Provides Class VIII supply, opti-cal fabrication medical equipment maintenance
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support, blood processing, storage, and distributionto a maximum force of a three corps equivalent-size force.
(4) Receives, classifies, and issuesup to 384.8 (maximum) short tons of Class VIIIsupplies per day. (This unit can support a forceconsisting of 202,500 soldiers.)
NOTE
For example a theater force consistingof 202,500 soldiers to be supportedrequires 192.4 short tons per day(202,500 X 1.9/ 2,000 pounds) to beissued to the force. The medical battalionlogistics (rear) is also required to receive192.4 short tans per day to replace thestock issued. The medical logisticsbattalion (rear) would be at its limit tosupport this theater.
(5) Provides storage of up to 1725.5short tons of Class VIII supplies based on anaverage order ship time of 10 days.
NOTE
Based on a 15-day stockage level in acorps, a 30-day stockage level at theaterand 10 days of that stockage level beingorder ship time, the operating and safetylevels to be stored would be 20 days.Using the data in the note above, theunit stores 1725.5 short tons (192.4 shorttons per day X 20 days -[3 corps X 707.5short tons stored in each corps]).
(6) Provides unit medical equip-ment maintenance for EAC units without organiccapability and DS medical equipment maintenance
to EAC units and added support to corps medicalbattalions, logistics (forward).
(7) Provides GS medical equipmentmaintenance to the theater.
(8) Provides for blood processing,storage, and distribution within the EAC andadded support to corps medical battalions, logistics(forward).
e. Basis of Allocation. One medicalbattalion, logistics (rear) is allocated per theatersupported. One additional medical battalion,logistics (rear) is allocated to support eachadditional increment of 250,000 joint servicepopulation. See a schematic of the medical battal-ion, logistics (rear) in Figure 6-8.
f. Organic Units. This organizationhas three organic units.
(1) Headquarters and headquartersdetachment.
(rear).
6-46.
(2) Logistics support company
(3) Distribution company (rear).
Headquarters and HeadquartersDetachment, Medical Battalion,Logistics (Rear), TOE 08-686L0
a. Mission. The mission of this unit is toprovide command and control and administrativeand logistics support to assigned and attachedunits.
b. Concept of Operations. This unit willusually be employed with the logistics supportcompany to plan and direct the execution of thehealth service logistics mission.
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Figure 6-8. Medical battalion, logistics (rear).
c. Capabilities. This unit—
(1) Provides command and control,staff planning, supervision of operations, andadministration of assigned or attached units.
(2) Provides unit maintenance fornonmedical equipment of assigned and attachedunits.
(3) Maintains a consolidated prop-erty book for assigned units.
(4) Coordinates with theater trans-portation assets for the routine delivery of ClassVIII supplies.
(5) Coordinates with the medicalbattalion (evacuation) for transportation assets(aeromedical or ground ambulance) for theemergency delivery of Class VIII supplies.
d. Dependency. This unit is dependenton the Logistics Support Company, TOE 08-697L0,for food service.
e. Basis of Allocation. One HHD isassigned per medical battalion, logistics (rear).See schematic of the HHD in Figure 6-9.
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6-47. Logistics Support Company, MedicalBattalion, (Logistics) (Rear), TOE 08-697L0
a. Mission. The mission of this organ-ization is—
• To execute the planned supportof the theater in the areas of Class VIII supplies,optical fabrication, medical equipment main-tenance support, and blood processing, storageand distribution.
• To be prepared to support med-ical units of other Services in the theater area, asdirected.
b. Concept of Operations. This unitexecutes the medical logistics mission as directedby the headquarters element.
c. Capabilities. This organization—
(1) Receives, classifies, and issuesup to 351.8 short tans of Class VIII supplies perday.
(2) Provides storage for up to 1692.5short tons of Class VIII supply.
FM 8-55
Figure 6-9. Headquarters and headquarters detachment, medical battalion, logistics (rear).
(3) Receives, assembles, and distri-butes preplanned modules (PUSH packages) forresupply in support of corps and EAC units in thetheater.
(4) Provides optical lens fabrication.
(5) Provides unit medical equip-ment maintenance for EAC units without organiccapability and DS medical equipment maintenanceto EAC units and added support to corps medicalbattalions, logistics (forward).
(6) Provides GS medical equipmentmaintenance in the theater.
(7) Provides for blood processing,storage, and distribution within the EAC andadded support to corps medical battalions, logistics(forward).
(8) Provides food service supportfor the medical battalion, logistics (rear), TOE 08-695L0.
d. Dependency. This unit is dependenton the Headquarters and Headquarters Detach-ment, Medical Battalion, Logistics (Rear), TOE 08-696L0, for UM on nonmedical equipment.
e. Basis of Allocation. This unit isallocated on the basis of one per medical battalion,logistics (rear). The schematic of the logisticssupport company, medical battalion, logistics (rear)is in Figure 6-10.
6-43. Distribution Company, MedicalBattalion, Logistics (Rear), TOE 08-698L0
a. Mission. The mission of this organ-ization is to provide Class VIII supplies and medicalequipment maintenance support to EAC unitsoperating in the supported operational area.
b. Concept of Operations. This organ-ization employs a company headquarters andorganic forward support platoons to provide ClassVIII support on an area basis in the theater. Thisunit provides limited Class VIII supply support forhigh-volume consumables and facilitates thesupport of EAC units and corps forces in the areaof operations. This unit provides unit maintenanceto units not otherwise provided support and haslimited DS medical equipment maintenance servicefor units within its area of operations.
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Figure 6-10. Logistics support company, medical battalion, logistics (rear).
c. Capabilities. This unit—
(1) Receives, classifies, and issuesup to 33 short tons of Class VIII supplies per day(16.5 short tons per platoon).
(2) Provides storage for up to 33short tons of Class VIII supply (16.5 short tons perplatoon).
(3) Provides, through MSTs, unitmedical equipment maintenance to units not
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otherwise provided such support and limited DSmedical equipment maintenance on an area basis.
d. Dependency. This unit depends on—
(1) Headquarters and Headquar-ters Detachment, Medical Battalion, (Logistics)(Rear), TOE 08-696L0, for unit maintenance onorganic nonmedical equipment.
(2) Logistics Support Company,TOE 08-697L0, for food service, when collocated.
FM 8-55
Food service support must be coordinated for anelement operating independently.
e. Basis of Allocution. This unit isallocated on the basis of one per medical battalion,logistics (rear). See the distribution company’sorganizational diagram in Figure 6-11.
6-49. Theater Medical Materiel Manage-ment Center, TOE 08-897L0
a. Mission. The mission of this organ-ization is to provide centralized, theater-levelinventory management of Class VIII materiel,medical equipment maintenance, optical fabri-cation, and blood support to the theater.
b. Assignment. This unit is assigned tothe senior medical command and may be attached
to medical battalion, logistics (rear) for admin-istrative and logistics support.
c. Concept of Operations. The TMMMCprovides centralized control over the medicallogistics support of the theater. This unitcoordinates prioritization of scarce medical ma-teriel, medical maintenance, and optical fabricationassets in the theater.
d. Capabilities. This unit—
(1) Monitors the operation of healthservice logistics units in the theater which mayinclude joint forces if a SIMLM mission has beenassigned.
(2) Monitors the receipt and proces-sing of Class VIII requisitions from health servicelogistics units.
Figure 6-11. Distribution company, medical battalion, logistics (rear).
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(3) Reviews and analyzes demandsand computes theater requirements for Class VIIIsupplies, medical equipment, optical fabrication,medical equipment maintenance, and blood proces-sing, storage, and distribution.
(4) Monitors and evaluates the workload, capabilities, and asset position of the supportedmedical battalions, logistics (forward and rear)and recommends cross-leveling of work load or re-sources to achieve compatibility and maximumefficiency.
(5) Implements plans, procedures,and programs for medical materiel managementsystems.
(6) Provides medical materiel man-agement data and reports required by highertheater commands and services.
(7) Functions as the managementinterface with CONUS-base Class VIII NICPs andSICCs.
(8) Manages critical items and ana-lyzes production capabilities.
(9) Disseminates medical qualitycontrol information throughout the theater.
(10) Provides logistics assistance tomedical battalions, logistics (forward and rear).Much of this assistance will be provided on site atthe medical battalions, logistics to improve com-munications, automation, and transportationinterfaces.
(11) Provides logistics assistance toTOE hospitals within the theater to help improvelogistics support to and within the hospitals.
(12) Coordinates for the return totheater of medical evacuation equipment fromCONUS.
e. Dependency. This unit is dependenton the existing area support system to provide forthe exchange of information within the theaterand to CONUS. The communications exchangerequirements include but are not limited to highvolume data, voice, facsimile, and message traffic.This unit is dependent on the medical battalion,logistics (rear) for organizational maintenance onall organic equipment and the Logistics SupportCompany, TOE 08-697L0, for food service support,when collocated.
f. Basis of Allocation. This unit isallocated on the basis of one per theater supported.See the TMMMC’s organizational diagram inFigure 6-12.
6-50. The Medical Detachment (LogisticsSupport), TOE 06-909L0
a. Mission. The mission of this unit is toprovide Class VIII supply, optical fabrication, andmedical equipment maintenance augmentationcapability to a medical battalion, logistics (forwardor rear) where work load or special operations re-quire an increment of less than a battalion-sizeunit.
b. Assignment. This unit is attached toa medical battalion, logistics (forward), TOE 08-485L000, or a medical battalion logistics (rear),TOE 08-695L000.
c. Concept of Operations. This unitprovides a modular unit to incrementally increasethe capability of a medical battalion logistics. Thisunit may be deployed early in an operation tocoordinate support to a DMSO and prepare toreceive pre-positioned stocks and resupply fromCONUS.
d. Capabilities. This unit providesaugmentation to the unit of attachment for ClassVIII supplies, optical fabrication, and medicalequipment maintenance support.
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Figure 6-12. The Army theater medical management materiel center.
e. Basis of Allocation. This unit is allo- (3) One per 50,000 joint servicecated as follows: population in COMMZ.
(1) One per division, ACR, or sep- (4) One per medical battalion,arate brigade not supported by a medical battalion, logistics (forward) supporting a three-divisionlogistics (forward). corps.
(2) One per 25,000 Joint Service See the medical detachment, logistics support,population in CZ to include corps (rear). organizational diagram in Figure 6-13.
Figure 6-13. Medical detachment, logistics support.
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6-51.
Section XIII. PREVENTING MEDICAL EQUIPMENT SHORTFALLS
Aeromedical Evacuation Equipment 6-52. ProcedureShortfalls
The senior surgeon and logistics planner shouldrecommend to the theater commander theprocedures to be used to ensure that medicalequipment that leaves the TO during patientevacuation does not cause a critical shortfall inequipment availability. Prior planning forreplacement and adequate in-theater stockagelevels of these items is necessary.
The originating MTFs equipment travels with thepatient to the destination MTF. The equipment isthen returned to the TO equipment pool through aCONUS/OCONUS collection point. The CONUS/OCONUS collection point performs any necessarycleaning and maintenance. The TO equipmentpool redistributes the equipment based on requi-sitions from theater hospitals. This systemaddresses critical AE equipment such as ventilators,suction apparatus, and pulse oximeters using theSIMLM. Figure 6-14 depicts this procedure.
Figure 6-14. Medical equipment flow.
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