Commissioned Corps BULLETIN

U.S. Department of Health and Human Services

Vol. XVIII, No. 11 November 2004

Surgeon General's Column

In October, Secretary Thompson and I this office. It identifies the relevant sci- health. With healthy nutrition, physical launched the first-ever Surgeon Gen- entific data, rigorously evaluates and activity every day, and regular medical eral’s Report on bone health and osteo- summarizes the evidence, and deter- check-ups and screenings, Americans of porosis. I want to ask each of you to use mines conclusions. It is a starting point all ages can have strong bones and live the information in the Report and in the for even more concentrated national ac- longer, healthier lives. And if it’s diag- corresponding public education mate- tion to understand, prevent, diagnose, nosed in time, osteoporosis can be treated rials to help improve the bone health and treat bone diseases. with new drugs that help prevent bone of all Americans. Please see http:// loss and rebuild bone before life-threat- www.hhs.gov/surgeongeneral/library/ Scope ening fractures occur. We need to com- bonehealth for a wealth of information. The risks associated with poor bone municate these facts to all Americans. Secretary Thompson and I were health are high. By 2020, half of all Improving Health Literacy joined at the launch by the editors of American citizens older than 50 will be the Report, Dr. Joan McGowan of the at risk for fractures from osteoporosis We need to close the gap between what National Institutes of Health’s Na- and low bone mass if no immediate ac- health professionals know about bone tion is taken by individuals at risk, tional Institute of Arthritis and Mus- health, and what most Americans under- health care professionals, health sys- culoskeletal and Skin Diseases, Dr. stand. I am working hard to improve tems, and policymakers. Ten million Lawrence Raisz of the University of Americans’ health literacy—the ability of Americans over the age of 50 have os- Connecticut Health Center, and CAPT an individual to access, understand, and teoporosis, the most common bone dis- Allan Noonan of the Office of the Sur- use health-related information and serv- ease, and another 34 million are at risk geon General. We are truly grateful for for developing osteoporosis. Each year, ices to make appropriate health decisions. their leadership. I also want to thank roughly 1.5 million people suffer a bone the hundreds of dedicated scientists, We have developed a companion piece fracture related to osteoporosis and ap- clinicians, advocates, and public health to the Report for non-scientists who may proximately 20 percent of senior citizens not be interested in reading the 400-page professionals who helped us gather and who suffer a hip fracture die within a analyze the best scientific data avail- year of the fracture. (Continued on page 2) able, and develop recommendations to promote better bone health. These numbers alone are enough to raise concern. But let’s also consider the IN THIS ISSUE . . . The following is an excerpt from the financial burden of bone disease. Caring remarks I gave at the launch. Moving Toward a New Automated for bone fractures from osteoporosis costs Commissioned Corps Personnel America at least $18 billion a year in and Payroll System ...... 3 direct medical costs. LAUNCH OF “BONE HEALTH AND Corps Officers Attend MMCBC OSTEOPOROSIS: A REPORT OF THE Thirty years ago, when I was a young Course ...... 4 SURGEON GENERAL” medical student, we all believed that COSTEP Deadline Dates ...... 7 October 14, 2004, Hubert H. Humphrey weak bones and osteoporosis were a natu- TSP Open Season ...... 7 Building, Washington, D.C. ral part of aging. Today we know that we can do a lot to prevent bone disease. Office of Force Readiness and Thank you for being here today to help Deployment ...... 8 us launch the first-ever Surgeon “Osteoporosis isn’t just your Corps Officers Deploy to Indian General’s Report on bone health and os- grandmother’s disease.” Country ...... 9 teoporosis. This report on bone health Corps Officers Deploy with U.S. and osteoporosis follows in the tradition The good news is that you are never Department of State ...... 10 of Reports from my 16 predecessors in too old or too young to improve your bone

Commissioned Corps Published as part of the Commissioned Corps Personnel Manual for Public Health Service Commissioned Director, OCCO Corps officers. Forward news of Service-wide or special interest to Office of Commissioned Corps Operations, CAPT Denise S. Canton BULLETIN 1101 Wootton Parkway, Suite 100, Rockville, MD 20852, Phone: 240-453-6084, E-mail: [email protected]. Editor, Mrs. Virginia Kapusnick Page 2 Commissioned Corps Bulletin Vol. XVIII, No. 11 November 2004

Surgeon General's Column

(Continued from page 1) full Report. This little magazine is a multiple fractures, or patients who take We are asking everyone to join to- plain-language guide to help people un- medications or have a disease that can gether to promote bone health by in- derstand what the report says and what lead to bone loss. Health care profes- creasing awareness, promoting lifestyle it means to them. We call it the People’s sionals should recommend bone density changes, and defining and implement- Piece. It answers the most commonly tests for women over the age of 65 and ing treatment options for people of all asked questions about how to develop for any man or woman who suffers even ages. Everyone has a role to play in im- and maintain healthy bones. The a minor fracture after the age of 50. proving bone health. Let’s get started People’s Piece is available via a toll free by taking action today in homes, health number (1-866-718-BONE) and on our However, individuals and health care care settings, and communities across Web site at www.surgeongeneral.gov. professionals acting alone will not our Nation. Remember, you are never make a long-term, sustainable differ- too old or too young to improve your Recommendations ence. A coordinated public health ap- bone health. proach that brings together public- and If we can spread three simple recom- private-sector stakeholders is the most VADM Richard H. Carmona mendations about bone health, we can promising strategy. Surgeon General save lives, reduce suffering, and avoid billions of dollars in future health care costs. PHS Officers Attend American Red Cross Emergency • First, get the recommended amounts of calcium and vitamin D. High levels Response Course of calcium can be found in milk, leafy green vegetables, soybeans, yogurt, The Fort Defiance Indian Hospital The 45-hour course provided eight of- and cheese. Vitamin D is produced in sponsored an American Red Cross (ARC) ficers with ARC Emergency Response the skin by exposure to the sun and is Emergency Response Course in Septem- and CPR/AED – Professional Rescuer found in fortified milk and other foods. ber 2004. Public Health Service Commis- cards, and Emergency Oxygen Admin- For individuals who are not getting sioned Corps officers delighted their in- istration and Bloodborne Pathogens enough calcium and vitamin D in structor, Mr. Jim Stephens of First2Aid, cards from the American Safety and their diet, supplements may be help- with a 100 percent pass rate. Health Institute. ful. The average adult under age 50 needs about 1,000 mg of calcium per day and 200 International Units of Vitamin D.

• Second, maintain a healthy weight and be physically active. That means at least 30 minutes a day for adults and 60 minutes a day for children, including weight-bearing activities to improve strength and balance.

• Third, take steps to minimize the risk of falls. Remove items that might cause tripping, improve light- ing, and get regular exercise to im- prove balance and coordination. Vision tests and other medical as- sessments are also important to make sure that impaired vision doesn’t lead to falls.

In the Report we also call upon health care professionals to help Ameri- cans maintain healthy bones by look- ing for ‘red flags’ that may indicate that (Pictured left to right) LT Ricardo Varela; CDR Tom Plummer; LCDR Mike Faz; LCDR Ricardo someone is at risk. These include people Murga; LCDR David Tibbs; LTJG Darlene Stephens; CDR Siona Willie; LT Malini Krishnan; who are under age 50 who have had Mr. Jim Stephens (Instructor, first2aid.com). November 2004 Vol. XVIII, No. 11 Commissioned Corps Bulletin Page 3

Moving Toward a New Automated Commissioned Corps Personnel and Payroll System Submitted by CAPT Barry Bragin, USPHS (Ret.)

This is the first in a series of articles and Human Services’ civilian personnel • The system will be implemented some designed to keep active-duty officers, re- processing for over 20 years as well as time in 2005. tirees, and annuitants aware of upcom- personnel and payroll systems employed • It will be fully Web-based and avail- ing IT changes planned for Public by the U.S. Coast Guard. able through the existing Commis- Health Service Commissioned Corps sioned Corps Management Informa- payroll processing. However, the time has come for a change. Not only is there considerable tion System home page. Over a quarter century ago, officers risk relying on such antiquated hardware • There will be a self-service module and civilians working for what was then technology, the human resources that that will allow recipients significant called CPOD (Commissioned Personnel have been maintaining the software and control of the distribution of their Operations Division) designed and running the production processes are ei- gross pay (W-4, State tax, allotments, implemented the Government’s first au- ther retired or contemplating retirement. net check to bank, etc.). tomated, integrated, personnel and pay- It is very hard to recruit young IT pro- roll system. Using cutting-edge technol- fessionals to an office with the job of • Leave management will be fully inte- ogy (something called a ‘minicomputer’ maintaining millions of lines of Wang grated and an online leave and earn- from Wang corporation) and new ad- COBOL code. ings statement will be available for vances in software design (capturing viewing and printing. data interactively on full-screen dis- Earlier this year, the Program Support plays), IT professionals and military Center began the procurement process In the months ahead I will keep you pay specialists combined their talents to find a vendor who could take on this posted as to the progress being made and to produce an effective and reliable sys- responsibility for the foreseeable future. how the new system will improve your tem that, with very slight modifica- Many companies expressed interest, pro- payroll support. If you have specific com- tions, is still churning out timely and posals were received and reviewed for ments, suggestions, or concerns, please accurate monthly payrolls and the technical merit and cost value, and in late send them to a specific e-mail account— myriad of related outputs (earnings September, CIA Corporation, partnering [email protected]—we have set up for statements, Federal and State taxes, with Lyceum Corporation, was awarded you to use. Every submission will get a banking and other financial transac- the contract. They are in the early stages reply and those that have general ap- tions, bonds, Thrift Savings Plan con- of requirements gathering and project plicability will be used for a FAQ fea- tributions, payments to charities, etc.). planning, but there are a few items that ture in future Commissioned Corps The design we came up with was used I can pass onto you even at this point in Bulletin articles. as the basis for the Department of Health the process:

Hispanic Officers Advisory Committee’s Call for Nominations for the Juan Carlos Finlay Award

The Juan Carlos Finlay Award was (1) leadership in their area of expertise an OPDIV or organization, the head of established by the Hispanic Officers Ad- as it pertains to Hispanic health the OPDIV or organization should sign, visory Committee (HOAC) to honor in- care issues; and only one nominee should be sub- dividuals, organizations, and groups who mitted by each. Endorsements are en- (2) accomplishments in Hispanic health through work performance and other couraged since they provide verification care development, management, activities have demonstrated leadership and support. Nominations are due by and/or improvement; and/or in the development of programs, meth- November 19, 2004. ods, or initiatives that improve health (3) organization and/or implementation To request a nomination packet or if services for Hispanics. This award was of activities/programs that signifi- you need additional information, please named after Juan Carlos Finlay (1833- cantly improve Hispanic access to contact: 1915), a Cuban physician and epidemi- health care and health care services. ologist who discovered that the mosquito Ms. Lisa Flach Nominations may be submitted by was the vector of “fiebre amarilla” or yel- HOAC Award Committee the Department’s Operating Divisions low fever. (OPDIVs) and regional offices, private 5600 Fishers Lane, Room 9A-27 Nominations for the Juan Carlos nonprofit groups, and others with spe- Rockville, MD 20857 Finlay Award should describe the specific cial knowledge of Hispanic health is- Phone: 301-443-8646 accomplishments of the candidate (indi- sues and programs. Each nomination E-mail: [email protected] vidual or organization) in one or more of must be signed by the individual mak- the following areas: ing the nomination, and in the case of Page 4 Commissioned Corps Bulletin Vol. XVIII, No. 11 November 2004

New JOAG Membership and Executive Committee Selected

The Junior Officer Advisory Group • LCDR Nasser Mahmud – Pharmacist • LCDR Mark Agnello – Health Services (JOAG) recently held elections for the category, FDA category, OS Executive Committee for the 2004-2005 • LCDR Jeff Richardson – Therapy cat- • LCDR Janis Armendariz – Dietitian year. The JOAG advises to the Office of egory, Indian Health Service (IHS) category, FDA the Surgeon General, Chief Professional Officers (CPOs), and Professional Advi- • LCDR Joshua Schier – Medical cat- • LCDR Jackie Kennedy-Sullivan – sory Committees. The following officers egory, Centers for Disease Control and Nurse category, DoD/TMA were selected: Prevention (CDC) • LCDR Brenda Ross – Nurse category, • Vice-Chair: LCDR Janis Armendariz, • LCDR Geoff Wachs – Engineer cat- Program Support Center Dietitian category, Food and Drug Ad- egory, IHS • LCDR Bobby Villines – Environmen- ministration (FDA) • LT Jane Bleuel – Dental category, IHS tal Health category, IHS • Secretary: LCDR Jackie Kennedy- • LT Michelle Colledge – Health Serv- Sullivan, Nurse category, DoD/Tricare ices category, ATSDR • LCDR Allison Williams – Veterinary Management Agency (TMA) category, CDC • LT Ted Hall – Pharmacist category, • Chair-Elect: LT Claudine Samanic, IHS • LT Laura Longstaff – Nurse category, NIH Health Services category, National In- • LT Carrie Oyster – Environmental stitutes of Health (NIH) Health category, Office of the Secre- • LT Claudine Samanic – Health Serv- This year’s Chair is LT Michelle tary (OS) ices category, NIH Colledge, Health Services category, • LT Sheila Ryan – Pharmacist cat- • LT Nancy Tone- Nurse category, IHS Agency for Toxic Substances and Disease egory, FDA Registry (ATSDR). She served the previ- The JOAG Senior Advisor is CAPT ous year as the Chair-Elect. The returning members of JOAG are: John Steward – Environmental Health • CDR Robert Newman – Medical cat- category, CDC New voting members were also re- egory, CDC cently selected for the 2004-2006 term. Congratulations to the above officers! They have been endorsed by their respec- • LCDR Nelson Adekoya – Scientist cat- tive CPOs and agencies. They are: egory, CDC

PHS Officers Attend the Medical Management of Chemical and Biological Casualties Course at Fort Detrick and Aberdeen Proving Ground Submitted by LCDR Laura Pincock

From September 12 through 17, 2004, possibly as imminent as Ivan and poten- The MMCBC course is offered as ad- as Hurricane Ivan set its path for the tially just as deadly. vanced training for PHS officers through United States, nine U.S. Public Health We hear daily that terrorists are work- the Office of Force Readiness and Deploy- Service (PHS) Commissioned Corps of- ing to obtain chemical, biological, radiologi- ment (OFRD). Healthcare professionals ficers attended a U.S. Army Medical Re- cal, and nuclear weapons and that the and administrators from the Armed search Institute of Infectious Diseases threat of an attack on our homeland is very Forces, Uniformed Services, and the ci- (USAMRIID) / U.S. Army Medical Re- real. Whenever possible, preventing such vilian sector may apply. The course fo- search Institute of Chemical Defense an attack is the best defense. However, cuses on battlefield situations; however, (USAMRICD) training course for medi- when an attack has already occurred, our as demonstrated from our current world cal and public health professionals. We preparedness will make the difference be- situation, terrorists have made any lo- watched television for updates on Ivan tween a tragedy and an overwhelming di- cation a potential battlefield—from the in between didactic lectures, case discus- saster. Preparedness is important for a local post office, to government buildings, sions, laboratory exercises, and field ex- natural disaster such as a hurricane, and to embassies, to the World Trade Center. ercises. As the immediate threat of the it is absolutely imperative for a biological The medical management of chemical hurricane came upon our fellow Ameri- or chemical attack to prevent an escala- and biological casualties remains simi- cans, leaving wide areas of devastation tion or perpetuation of events. As PHS of- lar, regardless of where the attack occurs. with uncertainty, we watched with appre- ficers, we have the privilege of attending The first 3 days of the course at hension and a dawning understanding of courses to prepare for situations that were USAMRID comprise management of the looming public health crisis. As pub- not addressed in our professional educa- biological casualties. USAMRIID is lo- lic health officers, we had vowed to pro- tion programs. The Medical Management cated at Fort Detrick in Frederick, MD, tect the health of the American people. of Chemical and Biological Casualties and prior to 1969, was the home of the In our minds, Hurricane Ivan loomed (MMCBC) course offered by the U.S. Army U.S. Offensive Biological Warfare Pro- large, yet we were currently preparing is an excellent opportunity to gain knowl- gram. In 1969, the offensive program was for different threats to the United States, edge and experience in these situations. (Continued on page 5) November 2004 Vol. XVIII, No. 11 Commissioned Corps Bulletin Page 5

PHS Officers Attend the Medical Management of Chemical and Biological Casualties Course at Fort Detrick and Aberdeen Proving Ground (Continued from page 4) terminated and subsequently, research limited to defensive medical and equip- concern themselves with the constant at USAMRIID has been limited to defen- ment countermeasures against chemical threat of an attack. One course instruc- sive measures. warfare agents. Both of the Army Medi- tor told stories about his recent deploy- cal Research Institutes realize that edu- ment in the Middle East when he wore The USAMRIID portion of the course cation in an important part of any de- the mask and full protective gear for provides didactic lectures covering the fensive program, and therefore offer the hours, even days, in the desert heat. He historical uses of biological weapons, and MMCBC course. slept wearing his gear. Upon hearing the current bacterial and toxin threats, about their experiences, our challenge of including prophylaxis, treatment, epide- The USAMRICD portion of the course completing several field exercises in full miology and surveillance, immunization/ provides didactic lectures covering the gear became more tolerable. After 6 days, antidotes, laboratory testing, and iden- historical uses of chemical weapons, and I left the program with an increased tification of these agents. Students par- the current chemical threats, including awareness of how to recognize an attack, ticipate in scenarios and case presenta- prevention, treatment, surveillance, an- activate the appropriate response per- tions covering the medical management tidotes, laboratory testing, and identifi- sonnel to investigate the event, treat ca- of these casualties in the field as well as cation of these agents. Students partici- sualties, and prevent the spread of dis- in health care facilities. Other topics that pate in field training exercises using ease. I would encourage all PHS officers are covered include the biological mission-oriented protective posture to broaden their personal and profes- weaponization of agents, likely scenarios (MOPP) and the components of the pro- sional preparedness by attending the for their use, the threat of food and water- tective chemical ensemble gear (M40 MMCBC course. borne terrorism, and the psychological mask and suit). One field training exer- aspects of biological warfare. Students cise has students practicing the prin- The OFRD will send PHS officers to tour the USAMRIID facilities and orient ciples of personal protection, triage, attend the MMCBC course. It is offered to the required equipment for a labora- treatment, and decontamination of eight times per year at Fort Detrick, MD, tory with biocontainment level (BL) 3 or chemical casualties while operating in a and Aberdeen Proving Ground, MD. Fur- 4 agents, such as the Ebola virus. Stu- contaminated environment. Students are ther information and course prerequi- dents also orient to the aeromedical iso- presented with the field management of sites for OFRD are available on the Web lation team and care unit where persons chemical casualties under various likely at http://ccrf.hhs.gov/ccrf/training.htm. are isolated after exposure to one of these scenarios. Additionally, students partici- Additional information about the pro- agents. pate in a laboratory exercise to evaluate gram is also available at the Army Medi- and treat a primate exposed to a stimu- The final 3 days of the course comprise cal Research Institute Web sites. lant nerve agent. management of chemical casualties. • USAMRICD: USAMRICD is located at Aberdeen Prov- For this officer, the knowledge and ex- https://ccc.apgea.army.mil/ ing Ground in Aberdeen, MD. The United perience gained at the MMCBC course States does not have an offensive chemi- created a renewed appreciation for our • USAMRIID: cal agent program; current research is uniformed officers overseas who must http://www.usamriid.army.mil/

The following nine U.S. Public Health Service Commissioned Corps officers were among the 45 attendees at the MMCBC course held in September 2004: CAPT David Forsythe (Nurse officer), CDR Steven Brockett (Dental officer), CDR David Frucht (Medical officer), CDR Calman Prussin (Medical officer), CDR Tejashri Purohit-Sheth (Medical officer), CDR Jeffrey Salvon-Harman (Medical officer), CDR Eric Wassermann (Medical officer), LCDR Laura Pincock (Pharmacist officer), and LT Daniel Nguyen (Pharmacist officer) Page 6 Commissioned Corps Bulletin Vol. XVIII, No. 11 November 2004

Commissioned Corps Awards Board

LCDR DEBRA GRECO, Food and Drug cartridge devices were causing patient The firm had knowledge of serious in- Administration (FDA), was awarded the blindness, blurred vision, and capsule juries attributed to the use of their Public Health Service Meritorious Serv- tears, which posed a significant safety Collamer intraocular lens and injectors, ice Medal for her achievements in con- and health risk to the public. but failed to report over 3,000 significant ducting a high profile inspection of a LCDR Greco’s inspectional thorough- adverse events of spontaneous rotation, manufacturer of Class III medical de- ness and persistence uncovered a seri- blurred vision, and blindness from do- vices. The firm manufactures and distrib- ous situation with processing, chemical mestic and international physicians. utes over one million intraocular lenses testing, and design of the firm’s lenses LCDR Greco discovered the firm made per year worldwide to physicians for im- that were being implanted in sensitive no efforts to withdraw from market these plantation. While conducting an indepen- and elderly patients. The Collamer in- devices or to notify 100,000 health care dent inspection at a contract laboratory traocular lens is made of a chemical sub- providers of known problems associated servicing the device manufacturer, LCDR stance called HEMA which causes severe with the Collamer lens. Greco discovered significant safety and allergic reactions in the eye and is con- LCDR Greco demonstrated exceptional effectiveness issues with the chemical sidered toxic to the body. LCDR Greco regulatory and problem solving skills in composition of the lens and its effect on thoroughly investigated the firm’s labo- conducting this inspection. Her initiative the body. LCDR Greco pursued her con- ratory methods and determined the toxic and dedication to her work and the cern at the medical device manufacturer substance in the lens had not been iden- agency was demonstrated throughout and discovered the firm’s Collamer in- tified fully and the associated risks had this complex and difficult inspection. The traocular lens and associated injector not been reported to FDA. (Continued on page 7)

Recent Calls to Active Duty

Title/Name Agency/OPDIV/Program Title/Name Agency/OPDIV/Program Title/Name Agency/OPDIV/Program MEDICAL Charles P. McGee HRSA Chandima B. Deegala IHS LIEUTENANT Batavia, NY Shiprock, NM Garth N. Graham OS LIEUTENANT J.G. Thang X. La IHS Zuni, NM Washington, DC Tiffany May G. Moore IHS Joan C. Han NIH Santa Fe, NM Ben J. Peacock IHS Bethesda, MD Crownpoint, NM ENGINEER William F. Pierce FDA DENTAL LIEUTENANT Rockville, MD LIEUTENANT COMMANDER Duane R. Hammond CDC Kendra C. Worthy FDA Ian M. Kott IHS Cincinnati, OH Rockville, MD Sitka, AK LIEUTENANT J.G. THERAPY LIEUTENANT Benjamin R. Chadwick IHS LIEUTENANT Margaret A. Facenda-McNeill DHS Manlius, NY Alicia R. Souvignier IHS Portsmouth, VA Shiprock, NM Paul K. Taylor IHS SCIENTIST Winnebago, NE LIEUTENANT HEALTH SERVICES Vincen G. Barnes IHS LIEUTENANT NURSE Belcourt, ND Michael J. Belgarde IHS LIEUTENANT COMMANDER Bemidji, MN ENVIRONMENTAL HEALTH Cheryl L. Peterson IHS Leah L. Ferrier IHS LIEUTENANT Phoenix, AZ Redlake, MN Christianna L. Zerbe CDC Glenn V. Janzen IHS LIEUTENANT Atlanta, GA Rachel C. Bodeen IHS Bemidji, MN Anchorage, AK LIEUTENANT J.G. Kimberly A. Kempisty IHS Christopher D. Dankmeyer IHS Darin L. Burns IHS Nespelem, WA Dillingham, AK Santa Fe, NM Kimberly B. McIntosh-Little OS Ramona D. Helms BOP PHARMACY Rockville, MD Butner, NC LIEUTENANT LIEUTENANT J.G. Christopher J. Howard NIH David E. Araojo FDA Julia H. Bryan HRSA Bethesda, MD Rockville, MD Bethesda, MD Aldrin J. Jaranilla NIH Aleta B. Bosley IHS Patricia M. Nickell IHS Parker, AZ Bethesda, MD Gallup, NM November 2004 Vol. XVIII, No. 11 Commissioned Corps Bulletin Page 7

Commissioned Corps Awards Board REMINDER: (Continued from page 6) Thrift Savings Plan Open Center of Devices and Radiological injectors. Locally, the firm received a Health (CDRH) initiated actions against Warning Letter for Quality System Regu- Season— the firm resulting in a worldwide Prod- lation deviations and CDRH issued a October 15 uct Alert for HEMA lenses; the firm re- separate Warning Letter for significant through December called two different lens injectors sold in Bioresearch Monitoring deviations. 13 different countries; and CDRH with- 31, 2004 LCDR Greco exposed a significant pub- held the approval of the firm’s pre-mar- lic health threat thus preventing further keted application for a new lens made The Thrift Savings Plan (TSP) open deleterious effects on consumers. The from the same material. The firm was season is your chance to start or change outcome of this inspection was published required to report to FDA all 3,000 un- the amount of your contributions to your in the March 2004 issue of the “Medical reported adverse events relating to the account. Please see page 6 of the Octo- Device & Diagnostic Industry” magazine. Collamer intraocular lens and associated ber issue of the Commissioned Corps Bulletin for more information.

Deadline Dates and Information About COSTEP Applications for Fiscal Year 2005 Recent Deaths The deadline dates for submission of process for students, preceptors, and applications for the Junior Commis- agencies. DCCTCD staff will work with sioned Officer Student Training and Ex- agency representatives who make special Note: To report the death of a retired of- tern Program (COSTEP) and the Senior requests to submit/request applicants ficer or an annuitant to the Office of Com- COSTEP for Fiscal Year 2005 are as fol- after the deadlines, and will consider any missioned Corps Support Services lows: special cases forwarded for consideration (OCCSS), please phone 1-800-638-8744. by preceptors, on an exception basis. The The deaths of the following active-duty Junior COSTEP applications must deadlines listed above are intended to officer and retired officers were recently be postmarked: help maintain order and timeliness to the reported to OCCSS: process. • June 1 - September 30 for positions during the following January 1 - April Title/Name Date New Mailing Address as of 30 August 2004 MEDICAL • September 1 - December 31 for posi- CAPTAIN Applicants should mail their com- tions during the following May 1 - George F. Ellinger 09/21/04 pleted applications and references to the August 31 following address: NURSE • January 1 - April 30 for positions dur- Office of Commissioned Corps CAPTAIN ing the following September 1 - De- Operations Geraldine L. Ellis 09/23/04 cember 31 ATTN: Division of Commissioned ENGINEER Corps Assignments Senior COSTEP applications must be CAPTAIN postmarked: 1101 Wootton Parkway, Plaza Level, Terry R. Deen 09/21/04 Suite 100 • by December 31, 2004 for applicants Rockville, MD 20852 SCIENTIST entering senior status beginning the following August or after. Note: Some Note: If an applicant wants to confirm CAPTAIN flexibility is allowed at the request of that his/her application was received, James V. Smith 09/15/04 the agency. certified mail or a domestic delivery ser- ENVIRONMENTAL HEALTH vice (e.g, Federal Express, UPS, etc.) CAPTAIN Background should be used. Alice B. Frazer 10/05/04 Because the Junior and Senior Further Information Francis F. Reierson 08/30/04 COSTEP programs are important ways Ruth F. Richards 09/28/04 to make excellent students aware of op- Information about COSTEP is avail- portunities with the Public Health Serv- able at—www.usphs.gov—under the COMMANDER ice Commissioned Corps, the staff mem- ‘Students’ tab. For additional assistance, Barry M. Owens 10/05/04 please contact DCCTCD at 240-453- bers of the Division of Commissioned VETERINARY Corps Training and Career Development 6125, 240-453-6072, or toll free at 1-800- CAPTAIN (DCCTCD), Office of Commissioned 279-1605, and ask for a COSTEP repre- Corps Operations, are committed to con- sentative. Samuel Abramson 09/01/04 tinuing to create a flexible, workable Page 8 Commissioned Corps Bulletin Vol. XVIII, No. 11 November 2004

In Remembrance of CAPT Derek Dunn Office of Force Readiness and Deployment

LCDR Nelson Adekoya dedicated his latest publication to the memory of the Current Responses in New York and Atlanta. In addition, late CAPT Derek Dunn. The manuscript PHS environmental health officers and • Orange Alert: Deployment to “Fatal Traumatic Brain Injury, West Vir- environmental engineers deployed to 12 Secretary’s Operation Center, Depart- ginia, 1989-1998,” was published in the Florida counties and Indian reservations. current issue of “Public Health Reports.” ment of Health and Human Services (HHS), through January 2004. The article used data from the National Dentists Deploy to Camp Lejeune Center for Health Statistics Multiple • Orange Alert: Secretary’s Emergency Cause of Death tapes to describe fatal Response Teams (SERT) On Call, In September 2004, the U.S. Marine cases of traumatic brain injury (TBI) through January 2004. Corps at Camp Lejeune was tasked with among West Virginia residents, and com- reconstituting the Second Marine Expe- • Dentists Deploy to Camp Lejeune, pared West Virginia’s annualized aver- ditionary Force for deployment back to October 2004 to February 2005. age TBI death rate with the rates of other Iraq. Beginning October 1, the facility States and with the rate among U.S. resi- • Haiti Mission with the Office of Glo- started receiving 27,000 Marines who dents for the same period. Main high- bal Health Affairs. will either be mobilizing or demobiliz- lights of the study include: ing—all of whom require dental clear- Recent Responses ance. The Dental Battalion has requested (a) Leading external causes of fatal TBI that PHS augment their depleted staff in West Virginia were firearm-re- • U.S. Forest Service Water System Sur- because 11 of their dentists are deployed. lated (39 percent), motor-vehicle-re- veys by environmental health officers This PHS deployment began in Octo- lated (34 percent), and fall-related and environmental engineers in Black ber 2004 and is scheduled to run until (10 percent); Hills Forest of South Dakota and the February 2005. At this time, 18 PHS El Dorado and Klamath Forest of Cali- (b) In West Virginia, firearm-related dentists have been identified to fill this fornia. TBI became the leading cause of TBI mission. These officers come from the fatalities in 1991, surpassing motor- • Hurricane Charley. Indian Health Service and the Bureau vehicle-related TBI; • Hurricane Frances. of Prisons.

(c) In West Virginia, 75 percent of fire- • Hurricane Ivan. On Call Responses arm-related TBI deaths were sui- • Hurricane Jeanne. cides; Recently, the Corps has been called upon to be in on-call status for a variety (d) West Virginia’s TBI death rate (23.6 Hurricanes Charley, Frances, Ivan, of high profile national security events. per 100,000) was higher than the and Jeanne For each event, teams were designated national rate (20.6 per 100,000); In the largest deployment for the Of- for the east coast, central U.S. or west (e) In 23 States, average TBI death fice of Force Readiness and Deployment coast, as needed. In addition, PHS offi- rates over the 10-year period were (OFRD) (formerly CCRF) since the ter- cers were on call to support an Incident higher than West Virginia’s death rorist attacks of 2001, over 600 Public Management Team in Washington, D.C. rates; and Health Service (PHS) Commissioned It is anticipated that this on-call status (f) In West Virginia, a 38 percent in- Corps officers responded to provide sup- will continue until after the Presidential crease occurred in the fall-related port to the citizens of Florida and Ala- Inauguration in January 2005. TBI death rate during the decade. bama in the wake of Hurricanes Char- ley, Frances, Ivan, and Jeanne. Deployed Policy Issues During 1989-1998, an average of officers were from every category of the 53,288 deaths among U.S. residents was PHS Commissioned Corps and repre- Please immediately review Manual associated with TBI. TBI reduction is a sented almost every Agency and Operat- Circular PHS No. 377, “Basic Level key objective of the Healthy People 2010 ing Division where officers are assigned. of Force Readiness Standards for the plan. Because of the significant poten- Commissioned Corps of the U.S. Pub- Officers deployed with the American tial for disability, Congress passed the lic Health Service,” and Commissioned Red Cross (ARC), the Federal Emergency Traumatic Brain Injury Act in 1996 (Pub- Corps Personnel Policy Memorandums Management Agency (FEMA), and HHS. 04-003, 04-006, and 05-002 at http:// lic Health Law 104-166) and the Act PHS officers served in a multitude of dcp.psc.gov/navigati.asp. mandates the surveillance of TBI to iden- roles and in a variety of locations such tify high-risk groups and the leading as ARC shelters; special needs shelters; Training causes of TBI. Public health, law enforce- Community Relation Teams; Florida and ment, and transportation safety profes- Alabama hospitals; the Secretary’s Emer- MMCBC: OFRD officers will be at- sionals can address these challenges by gency Response Team; Emergency Re- tending the U.S. Army Medical Re- implementing effective interventions sponse Teams in Florida and Alabama; search Institute of Infectious Disease’s based on a thorough assessment of the the FEMA Regional Operation Center; (USAMRIID) Medical Management of factors that influence health-related be- the FEMA Emergency Support Team; Chemical and Biological Casualties haviors. Data in this report can be used Disaster Field Offices in Florida, Puerto (MMCBC) course, October 31 - to develop targeted prevention programs Rico, and Alabama; State Health Depart- November 5. in West Virginia. ments; and Regional Operation Centers (Continued on page 9) November 2004 Vol. XVIII, No. 11 Commissioned Corps Bulletin Page 9

Office of Force Readiness Commissioned Corps Mental Health Providers and Deployment Deployed to Indian Country (Continued from page 8) Submitted by CDR David McIntyre

LNO: OFRD will support the For the first time, the Surgeon Gen- fears and concerns. We were mindful that OASPHEP by identifying officers to be eral asked the Office of Force Readiness we were outsiders and listened carefully trained as Liaison officers for SERT. The and Deployment (OFRD) to activate of- before we could make any recommenda- next LNO (II)/SERT training will be held ficers to support the Indian Health Serv- tions that would be received. We attended in Washington, D.C., December 7 - 10. ice (IHS) in response to a suicide cluster a Pow-Wow held to honor the graduat- within Indian Country. On April 26, 2004, ing high school seniors of Crow Creek and Upcoming Training: Fiscal Year OFRD posted a request for mental health served food to Pow-Wow participants. We 2005 OFRD Training Courses will be providers to deploy to the Fort Thompson answered middle of the night crisis in- listed at http://ccrf.hhs.gov/ccrf/ IHS Hospital in South Dakota. During tervention calls and participated in training.htm as course offerings become the previous 5 months at Fort Thompson weekend EMS responses. We were also available. there had been a cluster of 5 completed welcomed into homes and were shown suicides and a report of over 60 suicide generous hospitality. We built a strong gestures or attempts within the same foundation within the community for time frame. other deployed officers to build upon Commissioned Corps throughout the summer. The purpose of the deployment was to Personnel Manual provide Fort Thompson IHS Hospital The officers to follow continued the with administrative guidance and clini- mission and provided expert support to NEW ISSUANCES cal consultative services. LT Linda Cox- the community and care providers. Each Ford (Bureau of Prisons (BOP)) and I, officer brought with him or her strong COMMISSIONED CDR Dave McIntyre (Division of Immi- clinical skills and a willingness to do CORPS gration Health Services (DIHS)), were whatever was asked of them. They dem- PERSONNEL the first deployed officers. Prior to our onstrated a true commitment to the POLICY arrival date, LT Cox-Ford and I commu- people of Crow Creek and to the OFRD MEMORANDUMS nicated via telephone with CDR Bernie mission. One of the most unique aspects (PMM) Long, Director of Field Health Opera- of the deployment was that each officer tions at Fort Thompson, to begin our plan PPM 04-007, brought his or her own special skills and of action. DATED gifts that were utilized by the mental OCTOBER 19, Upon arrival we were introduced to the health staff at Fort Thompson. Some of 2004 community by Ms. Nancy Miller, CEO, these added benefits included improving the hospital’s ability to capture addi- Subject: Duties and Responsibilities Fort Thompson IHS Hospital, and CDR tional dollars for mental health services Involving the Per Diem, Travel, and Long. During the first few days we trav- rendered, improving the mental health Transportation Allowance Committee. eled throughout the Crow Creek Sioux reservation and met with numerous case management process, providing people and agencies. The agencies in- needed psychological testing to children, PPM 05-001, DATED cluded the IHS hospital, all schools, designing school programs to address OCTOBER 14, 2004 tribal leadership, Emergency Medical teen behavior, and networking with psy- Subject: Authorization of Dental Officer Services (EMS), reservation police, social chiatric hospitals and the University of Multiyear Retention Bonus for Fiscal services, tribal court officers, alcohol/sub- South Dakota to improve access to care Year 2005. stance abuse treatment providers, men- for the American Indian community of tal health providers, and many other Crow Creek, to name a few. community organizations and care pro- PPM 05-002, DATED The Public Health Service (PHS) Com- viders. We helped develop a suicide re- OCTOBER 19, 2004 missioned Corps mental health officers sponse program to address the needs of Subject: Revision of Influenza Immuni- enjoyed this unique opportunity to prac- the community as well as conducted nu- zation Requirement Section 5.a.(2)(a) tice their skills in a different and excit- merous stress debriefings with commu- Manual Circular PHS No. 377, “Basic ing setting. The deployment required the nity members and workers. We were well Level of Force Readiness Standards for officers to be out and about most of their received and our guidance and services the Commissioned Corps of the U.S. Pub- days. They actively participated in many were appreciated. lic Health Service.” types of valuable and different activities The means by which we pursued the including doing home visits, visiting the purpose of the deployment were many. schools, talking with children and teens, Please note: The PPMs listed above can We learned about the history of Fort conducting suicide autopsies, working be accessed on the Commissioned Corps Thompson and the Crow Creek Sioux res- with teachers, meeting with tribal lead- Management Information System Web ervation. We made numerous home vis- ership, going on ambulance runs with the site—http://dcp.psc.gov—click on ‘Publi- its to family and friends of those who EMS staff, traveling the reservation with cations,’ ‘Commissioned Corps Personnel completed suicide. We gave the commu- tribal police officers, providing crisis Manual.’ nity the opportunity to express their (Continued on page 10)

Page 10 Commissioned Corps Bulletin Vol. XVIII, No. 11 November 2004

Commissioned Corps Mental Health Providers Deployed to Indian Country (Continued from page 9) interventions in the middle of the night, needs. They participated in our weekly Thanks to all of the PHS Corps men- consulting with the Director, Behavioral teleconferences and supported the mis- tal health professionals who participated Health Services for IHS, and meeting sion 110 percent. During the deployment, in the Fort Thompson IHS deployment. with some of the reservation elders. RADM Babb, Director of ORFD, joined They were: our weekly Fort Thompson teleconfer- This deployment provided the officers • CAPT Lawrence McMurtry (Office of ence. He offered his insights from his a firsthand experience of the daily chal- the Secretary) experience of working in Indian Coun- lenges faced by many of our PHS col- try. He communicated his strong commit- • CAPT Patricia Nye (IHS) leagues who work on rural American In- ment to this mission and gave thanks to dian reservations throughout our • CDR Stephen Formanski (BOP)) country. Observing the challenges of pro- all of the officers who volunteered to par- • CDR David McIntyre (DIHS/Health viding medical and mental health care ticipate in the deployment. CDR Resources and Services Administra- in rural America was a great experience Martinelli noted she had more than tion (HRSA)) and gave us all a deeper appreciation of enough volunteers for the deployment those officers who choose to work in such and was sorry that not all the officers • CDR Carlton Pyant (BOP) challenging environments. We also had who volunteered were able to participate. • LCDR Rhonda Koch (BOP) the opportunity to see the challenges and The deployment received only positive accomplishments of those living and • LCDR Torris Smith (Centers for Medi- feedback from the community at large as working on the reservation. We met care and Medicaid Services) well as from those working the front many strong, compassionate people on lines. There have been three serious sui- • LCDR Stacey Williams (USAMRMC) the reservation who were working hard cide attempts since the beginning of this to help the children of Fort Thompson. • LT Jeffrey Coady (HRSA) deployment, but there have been no ad- OFRD staff members, CDR Angela ditional suicide completions. Due to posi- • LT Linda Cox-Ford (BOP) Martinelli and LT John Mallos, had been tive response, this deployment was ex- • LT Dale Thompson (BOP) extremely helpful and responsive to our tended through September 2004.

Commissioned Corps Officers Deploy with the U.S. Department of State to Provide Support for Hurricane Victims Submitted by CDR Jacinto Garrido

The Division of Immigration Health I immediately alerted a flight team of plies. Prior to departing for the airport, I Services’ (DIHS) Aviation Medicine Pro- five officers and tapped into our medical was advised to decrease my team to two gram provided staff to deploy with the facility (Krome Service Processing Cen- so that there would be more room for pas- U.S. Department of State to provide sup- ter) for immediate mission-specific sup- sengers being rescued. I then chose CDR port to those affected by Hurri- Abelardo Montalvo to continue cane Ivan. DIHS is an organiza- with me on the mission since he tion under the Bureau of Primary was a well-seasoned family prac- Health Care, Health Resources tice physician and we had worked and Services Administration. on difficult international deploy- DIHS supports the medical opera- ments in the past. Within 90 min- tions for Immigration and Cus- utes we were ready and were in toms Enforcement, Department of flight to conduct the rescue. During Homeland Security. the in-flight briefing we were in- On September 16, 2004, I re- formed of several medical cases and ceived a call from RADM Ronald were told to expect pandemonium Banks with a request from the As- at the airport in the Cayman Is- sistant Secretary of Health’s office lands, as it is the only port for re- to expeditiously assemble a medi- lief supplies and the only way off cal flight team to rescue American the island. We were told that people citizens stranded in the Cayman Is- were on the edge, displaying anger, lands after Hurricane Ivan devas- despair, and fear since there was tated the island. Apparently, during armed looting going on and no way the hurricane surge the entire is- out of the country because all com- land went under water, devastat- CDR Abelardo Montalvo assesses a patient as the young boy’s mercial flights were cancelled. ing most of their resources. mother looks on. (Continued on page 11) November 2004 Vol. XVIII, No. 11 Commissioned Corps Bulletin Page 11

Commissioned Corps Officers Deploy with the U.S. Department of State to Provide Support for Hurricane Victims (Continued from page 10)

As we began our final descent to the Cayman Islands, reality hit me. I wit- nessed the devastation caused by the hurricane, which gave me a flashback of when Hurricane Andrew devastated my hometown of Miami. At that point I felt that there would be a stampede towards the aircraft and I expected chaos. Before deplaning we teamed up with the Depart- ment of State staff and developed a plan to expedite the process. On arrival, the Department of State was tasked with identifying U.S. citizens and administratively processing them for the flight. We established a medical area and began to triage and clear Americans for fitness-to-travel. At first the crowd cheered as they saw the uniforms; they approached us and said “the marines are here to rescue us.” We quickly responded A view of the damage and destruction caused by the hurricane. that “No, we are the Public Health Serv- ice, and yes, you are being rescued.” At times the crowd got out of hand, pushing aside the injured and families with children. I found myself grabbing a bullhorn to help bring order. We encoun- tered many chronic medical conditions as well as injuries such as fractured ribs. Time was a factor since we had to fly out before the first sign of dusk due to the dev- astation of the tower and runway lights at the airport. When we finally all boarded the aircraft I noticed that people were calmer but still concerned, as they anx- iously looked out the airplane window hop- ing to see signs of our departure. During take-off the passengers cheered as we pre- pared to conduct our in-flight care. During the flight, the mood was happy and sad. CDR Montalvo attended to the acute cases such as fractured ribs and head trauma with infected lacerations. I proceeded to go through the cabin and do a complete sta- tus assessment on all of the passengers. CDR Abelardo Montalvo and CDR Jacinto Garrido prepare to depart Cayman Airport. Many were celebrating the rescue, ask- ing to take pictures with me, and the her and asked her why she was sad. She Once the airplane touched down at children were playing around. One pas- looked at me intensely and said that she Fort Lauderdale, all the passengers senger flagged me and said that she was lost everything that she owned and felt clapped and cheered. During deplaning hypoglycemic and was feeling dizzy. I hopeless. As she talked to me I felt a big I stood next to the air crew as the pas- quickly assessed her and gave her orange knot in my throat. I comforted her and sengers walked off the airplane. It was a juice and kept an eye on her. One case in said that I was once a victim of a bad great feeling to see their smiles, and, as particular caught my attention. It was a hurricane. I also told her that things al- a first, receive hugs and kisses. This is mother with two children who was pro- ways have a way of working out, and that unusual in my line of work as I normally fusely crying as she looked out the win- everything she needed to move-on was transport detainees under the custody of dow. Her children had not noticed and sitting right next to her. She smiled and Immigration and Customs Enforcement. were laughing and playing. I approached thanked me. I kept an eye on her as well. (Continued on page 12) Page 12 Commissioned Corps Bulletin Vol. XVIII, No. 11 November 2004

Commissioned Corps Retirements – October Officers Deploy with the U.S. Department of State to Title/Name Agency/OPDIV/Program Title/Name Agency/OPDIV/Program Provide Support for MEDICAL Marion G. Clower, Jr. FDA Hurricane Victims CAPTAIN John P. Lucas DOD Richard L. Ehrenberg CDC John M. Spaulding IHS (Continued from page 11) Richard D. Olson IHS VETERINARY The mission was a success. In sum- DENTAL CAPTAIN mary, we made two flights down to the COMMANDER Richard A. Salomon CDC Cayman Islands evacuating 254 Ameri- David R. Douglas HRSA PHARMACY cans, Canadians, and British nationals. CAPTAIN Among the conditions we found were: NURSE one individual with fractured ribs, four CAPTAIN Janet M. Jones FDA Michael N. Mericle IHS pregnant females in their second and Janet M. Jones NIH Yechiam Ostchega CDC third trimesters, six asthmatics, three THERAPY persons with hypothyroids, two epilep- LIEUTENANT COMMANDER CAPTAIN tics, among other conditions. Eric R. Heebner FDA Bonnie C. Thornton NIH It was a pleasure and an honor to rep- ENGINEER HEALTH SERVICES resent the U.S. Public Health Service CAPTAIN CAPTAIN (PHS) Commissioned Corps during this Alvin Chun EPA Edwin A. Knecht CDC humanitarian rescue of Americans Richard C. Oksness IHS Henry H. Knox FDA abroad. This opportunity gave PHS ex- Michael A. Lopatin CMS SCIENTIST posure with the U.S. Department of Joseph A. Zogby HRSA State and most importantly the Ameri- CAPTAIN COMMANDER can people. Melvyn R. Altman FDA William G. Brogdon CDC Glenn A. Hegamyer NIH

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