Thursday, April 17, 2008

Commander’s Column

The Joint Task Force National Capital Region⁄Medical (JTF CapMed) was Officially stood up on 1 October 2007 and will become Fully Operational Capable (FOC) on 30 September 2008. So what is a JTF and why would the Deputy Secretary of Defense (DEPSECDEF) establish one for the National Capital Region (NCR)?

A JTF is a force that is constituted jointly as designated by a JTF establishing authority such as the Secretary of Defense (SECDEF) or a Combatant Commander (COCOM) like Central Command in Iraq. A task force is a unit established to work on a specific limited objective. The term ‘‘Joint” implies the combination of more than one military service.

The SECDEF or COCOM has operational control for a ‘‘geographical area” {Joint Operational Area (JOA) like NCR} or a ‘‘functional” objective whose execution requires a joint military force integrated and in close coordination. The SECDEF has operational control (OPCON) of the units involved and gives day to day ‘‘tactical” control (TACON) of the forces involved to a JTF Commander (CJTF). TACON allows cross leveling of medical assets in the JOA to improve operations resulting in more efficient and effective use of scarce resources. CJTF CapMed has the responsibility for the delivery of world-class healthcare in the NCR and oversight of all medical BRAC Law changes in the JOA.

The Department of Defense is evaluating Joint⁄Unified Commands (J⁄UC) for military medicine. A J⁄UC has a broad continuing mission involving two or more Military Departments (Services). A J⁄UC has COCOM authority over its forces, which it usually exercises through subordinate Service or functional component commanders and⁄or sub-JTFs. In garrison a J⁄UC normally uses Service Component structures. Functional components are for specific joint operations. A combination can be better used for some missions.

A Service Component, like Navy Medicine National Capital Area, consists of all those Service’s units, organizations and installations in the JOA. Components are determined by their Service who have ‘‘administrative control” (ADCON) for their forces. Components are needed to perform Service responsibilities of an administrative and operational nature for the COCOMs and JTF Commanders. Unique to JTF CapMed from all other JTFs is the Commander’s direct supervision of the JTF Component Commanders in the JOA by direction of DEPSECDEF. Usually, Component Commanders answer to their Service Chiefs. This is ‘‘new ground” for JTFs and SECDEF.

The Military Health System (MHS) is piloting the concept of ‘‘functional” componencies as well. These are similarly composed of forces from two or more services focused on a particular operational mission. In a J⁄UC model a functional componency executes a jointly staffed mission where Service specificity has little effect or import. Two such commands meet this criteria, are part of BRAC and are under development for the MHS in Texas: Research and Development and basic Medical Education and Training (METC). This model is used when a jointly staffed mission would be difficult to do under Service Components or one Service. Unlike a JTF, the forces are placed OPCON to the J⁄UC Commander and the functional componency assumes the level of a Service Component to the SECDEF⁄COCOM. The Services play only a minor role with the administrative responsibilities for their people and resources. Special Operations (SOCOM) is more like this model.

So, some of you may be wondering what do the preceding paragraphs really say. This is a complex subject. It may take you reading it two or three times to understand a JTF structure and how we align. What this does mean to you is that we have a current state here at NNMC and are aligned with the Navy just as it has always been. But now we are working toward a future state of jointness and WRNMMC. Today, in your current state, your Chain of Command won’t change; I am still the Commander of the National Naval Medical Center, Bethesda and answer to BUMED. However, now as Commander NMNCA, I am also assigned to the JTF CapMed as the Navy Service Component. As a member of the JTF, I and all of you are in support of making this Command and base ready to be a world-class medical center. How WRNMMC will work is still not determined but it will come to exist in 2011.

These are momentous, changing times in military medicine and for us at NMMC. We are challenged to help find the best answers for healthcare in the region and possibly throughout military medicine. Our success will be measured by the effectiveness of our componency implementation of jointness and the practices, processes and procedures developed with the JTF, Services and our partners to enhance healthcare delivery in our JOA and successfully complete our BRAC requirements in building the nation’s state-of-the-art, world-class medical center and campus.

Commander sends,