HSHA-E       (350)                                                                                                                        26 November 1990

MEMORANDUM FOR SEE DISTRIBUTION

SUBJECT: Preliminary Lessons Learned Reports

1. Forwarded for your review are preliminary lessons learned reports from the 44th Medical Brigade and the 86th Evacuation Hospital, Fort Lee, VA.

2. Some of the observations in each of these reports are valid AMEDD lessons learned which should be reviewed, researched, and disseminated prior to follow-on units being deployed in support of Operation Desert Shield.

3. Please review both reports and provide the Directorate of Evaluation and Standardization (DOES) with input on issues you believe should be addressed as AMEDD lessons learned NLT 26 November 1990.

4. DOES POC is LTC Samuel K. Rock, XO17l/5574. FOR THE COMMANDANT:

2 Encls A KSON                            DAVID C. JACKSON

as                                              COLONEL, MS

 

DISTRIBUTION:

HSHA-T

HSHA-C

HSHA-D

HSHA-F

HSHA-P

HSHA-M

HSPE (PROF IS),

HSC HSOP, HSC


 

DEPARTMENT OF THE ARMY

 Headquarters 44th Medical Brigade (Rear) (Prov)

 Fort Bragg. North Carolina 28307-5000

AFVH-XA-CO                                                               26 September 1990

MEMORANDUM FOR SEE DISTRIBUTION

SUBJECT: Executive Summary -Operation Desert Shield Phase I

1. Operation Desert Shield has proven to be the single largest full-scale deployment for the 44th Medical Brigade in recent history. Beginning on or about, 6 August 1990, the Deployment Phase (Phase I) began. Every unit within the Brigade, (which will eventually Include numerous other active duty and reserve medical units) was placed on the exercise roster for deployment. In this unprecedented movement, many issues have surfaced which will serve as valuable lessons-learned should an undertaking of the magnitude of Operation Desert Shield occur In the future.

2. Issues of concern for the 44th Medical Brigade during Operation Desert Shield Phase I follow:

A. Echelons above Corps -

* ISSUE: Pregnant Soldiers

DISCUSSION: As part of the Army Contingency Corps, .the 44th Medical Brigade must be 100 percent deployable when needed. As Phase I began, a personnel shortage problem arose due, In part, to a number of pregnant soldiers within the Brigade. Since these soldiers are temporarily non-deployable and holding valid slots on unit manning rosters, units were not able to utilize 100 percent of their assigned strength for the exercise.

RECOMMENDATION: Submit request to PERSCOM to change

current regulations so as to' allow pregnant soldiers to be reassigned to non-deploying units (In the event of a national emergency) or place them on the Temporary Disability Retired List (TDRL) which will enable the losing unit to submit valid personnel requisitions for soldiers who are deployable.

* ISSUE: Blood Program Officer

.DISCUSSION: Blood Program Management is a critical area In the health care system. Currently, there Is no provision for a trained position for a Blood Program Officer In the Brigade.


AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield

RECOMMENDATION: With the criticality of blood Re-supply and management In the Area of Operations, a request will be made through the Office of the Surgeon General (OTSG) to FORSCOM to alter the MTOE to allow either a full time position or a PROFIS position to lend expertise to the Brigade in blood management.

* ISSUE: Filler System for Enlisted Personnel

DISCUSSION: The Professional Officer Filler System (PROFIS) has worked very well during Operation Desert Shield. However, there is not a system in place for providing fillers for critical enlisted MOS shortages In the event of a deployment. Most medical units are not authorized to carry personnel levels at the required strength and, therefore, require many fills on an as needed basis.  An enlisted  filler system for critical medical MOS personnel Is needed.

RECOMMENDATION: That the Office of the Surgeon

General develop an Enlisted Filler System that can meet the needs of MTOE medical units which do not maintain an ALO 1 level of fill of personnel.

* ISSUE: PROFIS Training In Soldier's Skills

DISCUSSION: The vast majority of Incoming PROFIS personnel have demonstrated a lack of training In basic soldier's skills that enable them to survive on the modern battlefield. Training In an NBC environment, weapons qualification and other areas, Is extremely Important to a soldier when faced with the possibility of needing these skills, as In Operation Desert Shield.

RECOMMENDATION: That Health Services Command develop a training and maintenance program In Common Task Skills for designated PROFIS personnel that will better enable them to survive on the battlefield. Additionally maintenance of these skills must be a regulatory requirement with the responsibility failing to HSC Commander.

* ISSUE: Insufficient Quantities of Weapons and Chemical Protective Gear. 

DISCUSSION: As part of the U.S. Army Contingency Corps, with the mission of going anywhere at any moment, the 44th Medical Brigade must be In a position to provide personal protection to all of Its personnel, to Include attached PROFIS, etc. Currently, there is not authorization to maintain sufficient numbers of weapons and chemical protective Items at the unit. This fact resulted In significant logistical problems In the acquisition of enough weapons and CPOG gear during rapid deployment, as in the case of Operation Desert Shield.

RECOMMENDATION: That Forces Command alter the MTOE of the 44th Medical Brigade to authorize an Increase In the number of weapons and chemical gear kept on-hand for contingency missions. This will eliminate this logistical problem In the event of an emergency, when there may not be enough time to provide these Items for the soldiers.

* ISSUE: Authorized Level of Organization (ALO) for Contingency Units

DISCUSSION: Medical units, particularly hospitals, within the XVIII Airborne Corps should be brought to ALO 1. Currently, all like units In the Active Army are authorized to be staffed and equipped at sub-ALO 1 levels. With the mission of the Contingency Corps, It Is Imperative that units with this no- notice, world-wide mission be staffed and equipped at full strength since there Is not sufficient time

AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield during a typical exercise to bring the unit up to required strength before deployment.

RECOMMENDATION: Request the upgrading of Authorized Levels of Organization for Contingency Corps units to ALO 1.

DISCUSSION: As part of the U.S. Army Contingency Corps, with the mission of going anywhere at any moment, the 44th Medical Brigade must be In a position to provide personal protection to all of Its personnel, to Include attached PROFIS, etc. Currently, there is not authorization to maintain sufficient numbers of weapons and chemical protective Items at the unit. This fact resulted In significant logistical problems In the acquisition of enough weapons and CPOG gear during rapid deployment, as in the case of Operation Desert Shield.

RECOMMENDATION: That Forces Command alter the MTOE of the 44th Medical Brigade to authorize an Increase In the number of weapons and chemical gear kept on-hand for contingency missions. This will eliminate this logistical problem In the event of an emergency, when there may not be enough time to provide these Items for the soldiers.

* ISSUE: On-Hand Contingency Supplies and Equipment

DISCUSSION: In light of the fact that Stocks of supplies, uniforms and equipment for Operation Desert Shield have been very difficult to procure' in adequate sizes and quantities, It would be more beneficial and efficient to provide contingency stocks of Items such as uniforms, for units based on their CAPSTONE alignment. Units cold store and maintain these Items at their home station which would enable the Immediate issue of necessary items to deploying soldier. The lack of such a program was evident when first echelon personnel deployed from Fort Bragg to Saudi Arabia without desert camouflage fatigues.

RECOMMENDATION: That units be Issued uniforms and equipment for local storage as would be required for their contingency under their CAPSTONE alignment.

* ISSUE: PROFIS Fillers Report to the Brigade In Various States of Readiness

DISCUSSION: PROFIS personnel arrived In the Brigade with all different types of luggage, uniforms, CTA-60, etc. Some had the required immunizations, some did not, some had orders, others didn't. There was no consistency in the preparation of the PROFIS personnel.

RECOMMENDATION:

a. That OTSG develop a supplement to the Regulation that provides MEDDAC/MEDCEN Commanders with checklists or requirements for PROF IS qualification, POR, equipment, training, etc., and mandates that Commanders ensure they comply.

b. As PROFIS personnel are identified through normal channels, Commanders of their deploying unit should write to them and explain the level of readiness that each must maintain, I.e. POR status, CTA-60, etc.

SUBJECT: Executive Summary -Desert Shield

* ISSUE: USER "C" Rating Does Not Equal Capabilities

DISCUSSION: The DA Form 2716, Unit Status Report Is designed to inform the Department of the Army officials of a unit's current war fighting capabilities. However, It lacks the ability to distinguish between mismatched MOS’s, non-deployable and other nuances that reflect a status due to sheer numbers, but do not accurately reflect the unit's true capabilities.

RECOMMENDATION: A request for an Improvement to the system must be Initiated at the command level and forwarded to DA.

B. Corps and Post level Issues

* ISSUE: Cumbersome POR Procedures

DISSCUSSION: POR procedures have continually been a main obstacle In the deployment process. It is often done piece- meal with long lines and poor information flow In relation to when, where and how to do things. A better system must be developed.

AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield

RECOMMENDATION: Streamline POR procedures by Implementing a manifest bar code system on color coded cards.

Issued cards would reflect current POR status on a semi-annual basis. POR processing should be made a part of "One-Stop" In- processing center.

* ISSUE: Computerizing the POR checklist on a Data Base

DISCUSSION: Much time was spent during the Initial, high pressure days In gathering information that could have already been computerized. Utilizing database capable of manipulating figures would have provided quick, accurate Information. This could be done particularly in the areas of supply requirements such as BDU sizes, boot sizes, CPOG sizes, etc. Other Items that could be added are family support group, addresses and notification rosters, blood types, single parent information, etc.

RECOMMENDATION: Acquire ADP equipment for company headquarters to use as a means for sourcing this data.

* ISSUE: Lack of Planning for XVIII Airborne Corps Sea Movement

DISCUSSION: While the XVIII Airborne Corps does well , with air movement operations, very little consideration Is given to sea movement requirements. This lack of emphasis was evident as sea deployment commenced. There was. no apparent method of prioritizing loads for the ships. As a result, unit equipment were split up and Integrity was lost. Essential pieces of equipment did not arrive In Saudi Arabia together, which prevented the use of most Items without the mutual support of the separated pieces.

RECOMMENDATION: Use the same deployment procedures as used at Green Ramp, I.e., deploy movements team with serial sequencing and load ship according to unit priorities.

* ISSUE: Rear Detachment Commander Legal Authority

DISCUSSION: At the onset of the exercise there was a Legal dilemma, In how UCMJ authority could be split between a Forward Commander and a Rear Commander. Legally, there cannot be two commanders for the same unit. Evidently, placing the term "Rear" "Provisional" behind the unit name for the rear detachment allows the Rear Detachment Commander to exercise UCMJ authority over Rear Detachment personnel.

AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield

RECOMMENDATION: Activate the use of the words

"(Rear)" "(Provisional)" at the end of all unit names so as to allow REAR DET CO to exercise UCMJ authority. Publish a Corps policy to clarify the Issue.

* ISSUE: Post Support Missions

DISCUSSION: There was no plan for the assumption of Post Support missions with regard to ground and air ambulance requirements upon the complete deployment of the Brigade. The 44th Medical Brigade does not have the assets to provide even command and control of reserve units who are called for these missions.

RECOMMENDATION: That XVIII Airborne Corps and the Director of Reserve Components develop a plan for continued post support upon the deployment of the entire 44th Medical Brigade.

* ISSUE: AVIM Support

DISCUSSION: In the beginning stages of Operation

Desert Shield, there was little guidance on which unit would provide AVIM support for Brigade air ambulance assets. This lack of information created some Initial logistical questions, which could have stalled operations.

RECOMMENDATION: That XVIII Airborne Corps provide early guidance on AVIM support for air assets.

C. COSCOM Level Issues -

* ISSUE: 1st COSCOM RSOP . DISCUSSION: The COSCOM Readiness SOP Is outdated and

was not used as It was designed. At a minimum, Information pertaining to the 44th Medical Brigade was missing, erroneous or questionable. The document is several years old. Initial airflow from COSCOM was not In accordance with any pre-planned RSOP packages.

RECOMMENDATION: That COSCOM update the COSCOM RSOP and then reeducate subordinate units on its contents. Once redeveloped, use the document.

* ISSUE: Distribution of Required Personal Gear

DISCUSSION: There was no plan for the distribution of desert BDUs, chemical protective over-garments, or flak vests. COSCOM left It’s units to fend for themselves on a first-come, first-served basis. This system Is not efficient. Units who deployed with the first airlift failed to obtain the necessary Items because the supply point could not prioritize Its customers, ISSD performed "fill or kill" operations and failed to reorder zero balance Items until It was too late for deploying units to get the Items needed,

RECOMMENDATION: That COSCOM draw these Items for the entire COSCOM and operate a central Issue operation for distribution, based on priority of flow of units; not first-come, first-served.

* ISSUE: Closure of Direct and General Support Units

DISCUSSION: There was no coordination between COSCOM and subordinate units as to schedules for closing direct support and general support units which service the 44th Medical Brigade. Units only discovered on the day of the closing that COSCOM DS/GS elements would no longer support them. There was no Information on where and how to pick items that came In on 0-1 priorities, nor was there Information on how to continue to order critical supplies and equipment.

RECOMMENDATION: COSCOM establish a detailed plan for the phasing out of DSU’s and GSU’s and keep subordinate units Informed.

* ISSUE: Upgraded Requisition Priorities

AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield

DISCUSSION: COSCOM had published the word that all outstanding high priority requisitions would be automatically upgraded to 01 by COSCOM G4 In order to relieve the burden on the units In changing the requisitions themselves. However, COSCOM G4 did not know that this was to happen, so It didn't. Units ended up manually back-feeding requests on the upgraded priority once It was discovered that the automatic upgrades were not done. This lack of coordination within COSCOM put units three to four days behind In the requisition process. .

RECOMMENDATION: That COSCOM staff communicate among themselves. That units Initiate the upgrade of requisitions themselves.

* ISSUE: Vehicle Maintenance Contact Teams

DISCUSSION: Most mechanics' tool boxes and shop tools were packed early on In the plan to move to the sea port. This packing left very limited repair capabilities In the rear to sup- port equipment going later, or by air.

RECOMMENDATION: That COSCOM develop a mobile maintenance contact team to conduct last minute repairs on vehicles after the unit maintenance capability has deployed.

* ISSUE: Aviation Repair Parts System

DISCUSSION: The aviation repair parts system operates at a high level of Intensity on a dally basis. This made It difficult to relate the Increased need for parts for the 67th Med Det. prior to deployment. All required parts were not received,

to Include a controlled substitution of other units' aircraft until C+16.

RECOMMENDATION: Aviation PLL must be Increased and capability to carry PLL Increased. Also, the ability for the 67th Med Det to stock AIMI parts as part of the aviation PLL Is essential.

D. Brigade Level Issues-

* ISSUE: PROFIS Billeting and Transportation

DISCUSSION: As more and more PROFIS personnel arrived In the Brigade, we discovered that there was no plan to accept them with consolidated billeting and transportation. PROFIS were spread allover Fort Bragg and Fayetteville for billeting, which also caused a problem with transporting them as needed, due to a lack of vehicles within the Brigade.

RECOMMENDATION: Amend the Brigade RSOP to require the arrangement of billeting and transportation for all known Incoming PROFIS personnel. Planning can avoid some costly arrangements such as single rooms and single rental cars.

* ISSUE: POR Improvements

DISCUSSION: Preparation for Overseas Movement (POR) was disjointed, cumbersome and lacked planning, which resulted In long lines and 24-hour operations. With proper maintenance of soldiers' POR status, these problems could be minimized.

AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield

RECOMMENDATION: That the Brigade develop a POR checklist and packet to be used for each Soldier In the command. In sure subordinate units follow through with Implementation.

* ISSUE: Brigade RSOP

SUBJECT: Executive Summary -Desert Shield DISCUSSION: The Brigade did not initiate either the X-Hour sequence nor the N-Hour sequence during the entire exercise. Due to the failure to follow established plans, there were no Initial plans for par, POV parking, tasking relief, schools, TDY, reports, and map requests.

RECOMMENDATION: Update the Brigade RSOP and use It.

* ISSUE: 19t COSCOM Crisis Action Planning System

(CAPS)

DISCUSSION: The 1st COSCOM CAPS system dated 18 June 1990 is incorrect. It contains Information that is outdated. For example, it lists the 429th Ambulance Company as still having M1010 ambulances Instead of the M977 ambulances.

RECOMMENDATION: Ensure that changes are made In the COSCOM CAPS manual and that future revisions are staffed completely.

* ISSUE: CORPS "D" Packages

DISCUSSION: Some of the Brigade units do not have accurate configurations for the I r Corp9 "0" packages In relation to " fitting on the plane."

RECOMMENDATION: That units review and update their Corps ,. D" packages.

* ISSUE: Establish a Brigade Priority List

DISCUSSION: There was no apparent priority of load-out for Brigade units when the "100% Load-Out" directive was given. Every unit demanded limited resources, personnel, and time simultaneously.

RECOMMENDATION: The Brigade Staff should develop a Priority Action List (PAL) for the Commander's approval. The PAL would then govern the activities of supporting staff and unit activities to ensure that the Initial support went where It was deemed most necessary by the Brigade Commander.

* ISSUE: Early Deploying Advance Party (ADVON)

DISCUSSION: As units prepare to move to new locations, a well-informed, well-maintained ADVON with complete knowledge of its respective unit’s requirements for real estate, utilities (Including water and waste disposal), as well as other matters of Interest, Is vital to the smooth operation of unit movement. Additionally, this ADVON should be capable of assuming command of follow-on echelons of the unit until the normal command Is established. The ADVON should be a routine additional duty.

RECOMMENDATION: That each unit select and train ADVON parties that are capable of manipulating all aspects of the unit's requirements prior to unit arrival In an area of operations. ADVON party should train regularly to maintain necessary skills so that: there is little need for final training prior to actual deployment. ADVON must be completely self-supporting.

AFVH-XA-CO

SUBJECT: Executive Summary -Desert Shield

* ISSUE: Female Specific Items

DISCUSSION: There are few plans for providing Items essential to female soldiers. This Includes birth control, feminine hygiene products, protective masks (smaller sizes), and uniforms.

RECOMMENDATION: Identify and stock required Items.

* ISSUE: Maintenance Shortfalls and Spare Parts

DISCUSSION: When the mission was given to load-up, critical equipment was Identified as needing Immediate repair, some which were prime movers. We were given no priority In Support Maintenance facilities, no-where certain spare parts available for Organizational Maintenance activities. This resulted In dragging some non-operational equipment to port.

RECOMMENDATION:

a. Obtain local purchase authority to buy spare parts from the economy If they are not available In the system.

b. Obtain a COSCOM Directive that allows an Integration of prioritized vehicles by MSC (each MSC sends Its top priority vehicle).

c. Establish a system whereby Installations without deploying units can be queried for available parts.

* ISSUE: Storage of Basic Load of Class V In Unit Arms Rooms.

DISCUSSION: When deploying In echelons, a unit's class V Issue cannot be broken down at the ASP Into Individual basic load Increments.

RECOMMENDATION: The unit must draw Its entire basic load and then Issue It to Individuals. This ammo should be stored In the Arms Room and given out as required.

* ISSUE: Lack of Automation/Information Management Equipment within the Brigade

DISCUSSION: State of the art capabilities are required to execute routine and contingency operational missions. This capability Includes STU-III, facsimile, laptops and copiers. The current archaic mode of communication within the brigade needs upgrading.

RECOMMENDATION: Brigade MUST acquire modern means of communication.

* ISSUE: USAMMA Support

DISCUSSION: USAMMA requests were being filled on day two. This was outstanding support.

RECOMMENDATION: Command USAMMA.

* ISSUE: Families are demanding frequent and timely Information on their loved-ones forward-deployed.

DISCUSSION: As events unfold and are reported by the news media, families experience a heightened level of concern and demand more Information. Such a demand places an unrealistic burden on the skeletal rear detachment. However, this does not relieve the command from taking care of Its own.

RECOMMENDATION: That Brigade Headquarters obtain a recording telephone. This "hot line" will be operational 24 hours per day. The REAR DET CO will update the message daily, providing all the Information possible without violating security precautions.

* ISSUE: Rear Detachment Plan

DISCUSSION: A workable plan for the functioning Rear Detachment was devised after the exercise began. The first step was to Identify all Non-Deployable's and to designate a REAR DET Commander to assume command and control of all Brigade assets in the rear area. The REARDETCO assumes the responsibilities of: SDO/SDNCO duties, Emergency Operations Center (EOC) duties, accountability and safeguarding of all brigade property left behind (buildings, installation property, furnishings, etc.), all brigade staff functions, In-processing and deploying replacements, Brigade Family Support Group representative, and UCMJ actions for rear personnel. Only one officer was designated for the REARDET. All functions performed In the rear will be accomplished by the non-deploying personnel.

RECOMMENDATION: It Is too early to tell what the actual responsibilities for the REARDET will be, until all deploying parties are gone. So far, during Phase I, the plan seems to be adequate. Changes may be made to leave one physically capable and responsible NCO behind from each Battalion size element to assume responsibility for that unit, in order to assist the REARDETCO.

FOR THE COMMANDER:

                                        G.S. ROBINSON LTC,

     MS Chief of Staff

 

DISTRIBUTION:

Health Services Command (1)

Cdr, COSCOM (1)

Corps G-3 (1)

Corps Surgeon (1)

Office of the Surgeon General (1)

Health Care Operations Div (1)

Bde Cdr (1)


MEMORANDUM FOR LTC LARRY VERVACK, DOES, AHS FT. SAM HOUSTON TEXAS

SUBJECT: Desert Shield Lessons Learned

1. As promised, lessons learned so far. This by no means is an all inclusive list and I have my staff putting together other items that they encountered.

2. I am convinced that many of my frustrations were as a result of the post on which the unit happens to be located. I can't begin to explain what it is like being on an installation where the deployment for most is a spectator sport and they are more concerned with having briefing chart right than getting the job done. Of course everyone wants the able to put something about Desert Shield on the OER Support Form so there is lots of "help". Oh well, I guess that's why commanders get the big bucks.

3. As we move to other places and continue to learn more things, I will send more. It isn't often you get to participate in an Army wide ARTEP.

                                        H. J. CHRISTOPHER

                                        LTC, MSC

                                        Commanding

    


 

ISSUE: MOBILITY OF DEPMEDS-MILVANS

DISCUSSION: The number of MILVANS on the TOE do not adequately meet the needs of the unit too deploy all 400 beds of an evacuation hospital. This is especially true if the unit will be shipped by sea (the most likely scenario). Functional packing, coupled with the amount of equipment required dictates that additional MILVANS be obtained. In our particular case, we went from 29 to 45 to move the unit by sea. These 45 did not hold all unit equipment and some items still were required to go palletized.

RECOMMENDATION: The TOE of DEPMEDS facilities be modified to insure that there are sufficient MILVANS on the TOE to allow the unit to go square.

ISSUE: MOBILITY OF DEPMEDS-MILVANS

DISCUSSION: The Army MILVAN has different dimensions than the international standard for MILVANS. Army MILVANS are 8x8x20 while the ISO MILVAN is 8.5x8x20. All of the commercial MILVANS are not deployab1e. This further decreases the unit mobility and increases the reliance on outside transportation and material handling equipment.

RECOMMENDATION: R&D Command should explore the possibility of developing an adaptor so that dolly sets can be attached to and used with the current industry standard MILVAN.

ISSUE: MOVEMENT OF UNIT BY SEA

DISCUSSION: The current system allows no input from the unit commander to the port commander with regard to mission critical items to be loaded with the majority of the units equipment. In our case, the majority of the equipment was loaded onto one ship.

However, all of the ECUs, the power cables, and the Power Distribution Boxes were left. This created a situation where we then had to go to FORSCOM to obtain airflow to insure that the hospital could be made operational at the other end in a timely manner.

RECOMMENDATION: Change the authorization of MILVANS on the TOE to allow for splitting of these critical assets between several MILVANS to insure some capability gets loaded.

ISSUE: MOVEMENT OF UNIT BY SEA

DISCUSSION: Our port and the personnel operating the port did not provide us any type documentation acknowledging that they received the type equipment which we said they did. While you have the

ship manifest, there is no document for property accountability which shows that indeed, a unit took everything to port that they said they did.

RECOMMENDATION: Something as simple as a stamped copy of the load plan, acknowledging receipt by the Terminal Transfer unit at the port would keep the property accountability of major items of equipment intact.

ISSUE: MOVEMENT OF DEPMEDS

DISCUSSION: A total of 49 commercial flatbeds were required to move this unit to port. Given the early deployment of most of the Army transportation assets, this will be the requirement in the future. Commanders and installation transportation officers must plan for this in the future.

RECOMMENDATION: Commanders of DEPMEDS equipped must coordinate with the ITO to insure that they have an appreciation of how much "stuff" there is with the package.

ISSUE: AUEL

DISCUSSION: At the onset of the deployment the units AUEL was totally inadequate. It was used as the planning document by the ITO and the transportation requirements were grossly understated. This document should be a "living" document but because of its critical nature and the uses of it, it should be locked in as early as possible.

RECOMMENDATION: Insure that the units AUEL is reviewed at least quarterly and up dated as new major pieces of equipment are added.

ISSUE: UNIT MOVEMENTS

DISCUSSION: The availability of trained movements personnel is critical in the Corps level units. Without a Division Transportation Officer to consult you are forced to rely on the installation movements personnel. In my case that is one civilian and one SP4. While both of these personnel performed admirably, they were quickly overwhelmed when confronted with moving more than one unit moving to the port at the same time.

RECOMMENDATION:

a. AHS in conjunction with the Transportation School develop an exportable training package specifically geared to the movement considerations associated with DEPMEDS equipped hospitals to include blocking, bracing within MILVANS and ISOs, hazardous cargo requirements as it pertains to medical units etc.

b. Actively encourage AMEDD personnel to attend the unit movements courses offered at Ft. Eustis. One fully trained Officer is not enough.

ISSUE: PROFIS

DISCUSSION: Who is in charge. As the FORSCOM commander calling for my PROFIS I have had to deal with issues like funding of the TDY, changes to the roster at the 11th hour, substitutions made by consultants without informing the personnel community at HSC, conflicting guidance as to when to call the PROFIS (from the installation, FORSCOM and HSC) and whether they were deployable or not. All of these concerns must be addressed in advance. I realize that the system has never been tested to this extent, but it seems that to many people are making changes with no central point directing or blessing the changes. We were sent one officer who was sent home the next day as non deployable; personnel different than the name we have on the PROFIS roster showed up; personnel with many personnel actions pending were sent. etc. I am confident that many of the PROFIS fillers that I have are here as a result of being on the commanders of DCCS's bad boy or girl list.

RECOMMENDATION:

a. The current regulation is entirely to general. AR 601-142 must be expanded to detail all of the responsibilities with regard to PROFIS. It should be a "cookbook" that all concerned can go to for guidance. Current guidance is supplemented in a number of MACOM level regulations. It should be clearly outlined who funds what with regards to travel, Per Diem etc. A timeline should be developed to determine when the appropriate time to call for PROFIS.

b. There must be a time when the PROFIS roster is frozen and no changes are permitted without approval above the action officer level.

c. Hopefully, now that it has happened, in the future, the PROFIS roster and who is put on it will be taken more seriously by the action people within HSC and these situations can be thought out in a non crisis mode.

d. All levels of command in HSC must be made to account for who they send as PROFIS. Currently, no one seems to be excited about the problems which have been caused for the deploying commander. The standard response is that it is your problem now.

ISSUE: POR STATUS OF PROFIS

DISCUSSION: The POR status of most PROFIS personnel reporting to this unit was dismal at best. Each sending unit had a different way of sending information and sent different degrees of information, despite being informed what was required when the PROFIS was called up. This created additional problems for us in terms of lining up the post agencies at Ft. Lee to accomplish a proper POR for the deployment. The installation then stated that it was there responsibility to POR everyone who was leaving from Ft. Lee. Since many of the PROFIS personnel could not prove that they had already performed some function (i.e. Emergency Data Cards) they were required to prepare another. This lead to some minor confrontations between the Post agency and the PROFIS officer. Additionally, during the installation POR processing there were four personnel who were identified as having P-3 profiles and were deemed non deployable. The classic here is that the local MEDDAC declared an individual non deployable and then sent him to me as a PROFIS. It took excessive amounts of time from the unit operation to track down if there had been an MMRB conducted, if they were deployable etc. This unit had to conduct an "emergency MMRB" to get PROFIS personnel deployable. None of the dual military or single PROFIS personnel were able to prove that they had an approved dependent care plan as required by the POR regulation. This required massive expenditures of energy by the unit and post AG to clarify.

RECOMMENDATION: A standard packet must be developed within AR 601-142 which clearly spells out what needs to be brought to the gaining unit, what type records should be left etc. Right now it seems to be what ever the POT or C, Personnel at the sending MEDDAC feels that they need and the FORSCOM unit is left holding the problem. Consideration should be given to establishing a standard Army wide POR regulation which clearly spells out what should be in a POR packet so that all installations are the same.

ISSUE: PROFIS ENTITLEMENTS

DISCUSSION: Most losing units did not deal with issues like storage of household goods for single PROF IS personnel. Most were not made aware by their losing unit that they were entitled to. store their household goods at government expense. Once the PROFIS arrived, many hours were spent by the unit staff and the installation transportation trying to sort this out for them.

RECOMMENDATIONS: Losing units must insure that they are proactive with regard to PROFIS personnel being deployable totally.

ISSUE: Cut off of Supplies-All classes

DISCUSSION: At the onset of Desert Shield, all unit shortages were ordered on an 0-2 priority. This resulted in most of the unit shortages filled. However, once a unit has been shipped by sea, as we were, the supplies keep coming with no way to ship them, no way to pick them up etc. Coordination must be made early on to establish a cut off date when the unit will no longer accept supplies and the DOL must assume responsibility for forwarding these supplies to the unit once they are in country. This was not done at Ft. Lee and presented the unit with the situation of purchasing additional MILVANS and trying to get space with some other unit to get the supplies to the unit in country.

RECOMMENDATION: That Commanders coordinate early on to establish a cut off date with all supply support agencies regarding all outstanding requisitions. Unit document registers should be purged and all garrison type equipment cancelled to insure non mission items are not shipped to the AOR.

ISSUE: Chopping of Units to their Medical Headquarters

DISCUSSION: Medical units which are located on different installations than their next higher headquarters for deployment need to be chopped to them early in the deployment sequence. Many of the actions which were requested by 44th Med Bde or the 1st Med GRP had to be back door here. Many times I was called upon to justify a request or decision which was made based on input from the higher headquarters (medical). There is no legal basis for these type decisions. Often the guidance I was receiving from my higher headquarters at Ft. Lee and those who will be my higher headquarters in country was at odds.

RECOMMENDATION: Establish the trace early on, announce it and chop the units to that trace for all issues concerning the deployment.

ISSUE: Pregnancy

DISCUSSION: Many female soldiers have become pregnant since the announcement of the deployment. Some of these soldiers have blatantly stated they did it to become non deployable.

RECOMMENDATION: Changes to the appropriate regulations should be made so that female soldiers loose the option to remain on active duty if they are identified as pregnant once the unit has been alerted for deployment. Continuing to allow non-deployable soldiers to remain on active duty once a deployment situation arises at the same time the Army is being downsized is wrong. There is no special consideration given to the soldier whose wife is pregnant and these soldiers should not be given this out.

ISSUE: NON DEPLOYABILITY OF SOLDIERS

DISCUSSION: Many of the non deployable soldiers of this unit were made so based on profiles issued by the local MEDDAC. For the most part these profiles were issued once the deployment was announced. There seems to be no concern at the higher levels as to the ramifications of the profile upon the deploying unit. Elective surgeries must be stopped if the resulting profile will make the soldier non deployable. This is no way indicates that soldiers should be denied required medical treatment.

RECOMMENDATIONS: HSC should consider establishing a policy which requires that the Commander or DCCS approve all non emergency procedures which would make a soldier non deployable once a deployment is announced. The CG, HSC should then sensitize the MEDDAC Commanders to the sensitivity of this issue with deploying commanders and expect them to act accordingly.

ISSUES: Command and Control

DISCUSSION: Currently my higher headquarters is a TDA TRADOC brigade whose primary focus is on training, IAW the CG TRADOC- guidance. This has created many artificial layers of "help" between the deploying unit and the installation staff who have responsibility for the deployment. These layers of help play in the game when they have nothing else to do and issue guidance which is sometime contradictory to the guidance given by FORSCOM. This has been extremely frustrating during the entire operation.

RECOMMENDATION: FORSCOM should take a proactive role to insure, through an MOU with TRADOC, that FORSCOM units on non-FORSCOM installations belong to the garrison commander so that they each work for the same boss and issues involving the deployment are not filtered through people who are viewing the deployment as a spectator sport.

ISSUES: Outpatient Treatment

DISCUSSTON: An implied mission for any medical treatment facility is that of area medical support. It has been the experience of the unit on other exercises that outpatient treatment occupies much of the patient care hours spent. There is no provisions within the TOE to allow space for this activity. The unit is then left with two alternatives 1) run sick call etc out of the EMT area or 2) erect tent and establish and ad hoc out patient clinic in this area. In the overall structure of the unit, the added equipment would be negligible.

RECOMMENDATION: That the TOE be expanded to add an additional 8 section temper tent with two vestibules to accommodate an out patient clinic. While there are certainly other units with in the TOE structure, which have this mission, the addition of this equipment would increase the overall flexibility of corp level units.

ISSUE: ENLISTED FILLERS

DISCUSSION: Current the need for enlisted fillers is based on the overall C rating of the unit. Once a unit meets ALO there is no solid mechanism to identify continued critical enlisted fillers.

I my case I am excess some support type personnel and short in 91C and 91D. This presents a distorted picture of mission capability of the unit.

RECOMMENDATION: That DA identify specific MOS which are managed

By exception in terms of filler personnel. In my particular case I would like to see 91C and 91D be required to be filled to at least 100%. These are the bread and butter MOS of an evacuation hospital. All other shortages can be overcome.

ISSUE: Assignment of PROFIS Chief Nurse

DISCUSSION: Currently, the FORSCOM CN of the unit is a Major while the PROFIS CN is a LTC. The interposing of an entire new command structure within the unit seems counterproductive. While there will be no way around PROFIS MC Commanders, this should not happen within the Department of Nursing.

RECOMMENDATION: One of two options should be implemented; either the FORSCOM CN should be an LTC or the FORSCOM CN should remain the CN upon deployment and all PROFIS should be junior to the FORSCOM CN.