Security Assistance; and Logistics - Federation of American Scientists

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Client CommentsCommander, MNF-I concurred, adding that the MNF-I Surgeon General had gainedtentative approval from the Iraqi Minister of Health to initiate mentoring programs forIraqi physicians, nurses, and health care administrators.Our ResponseCommander, MNF-I comments were partially responsive. The MNF-I response appearsto focus on mentoring Iraqi civilian health care professionals rather than Iraqi Armyhealth care personnel and does not mention using medical expertise that may be availablein Coalition forces. While mentoring Iraqi civilian health care professionals is animportant component of the development of the Iraqi health care delivery system, theintent of this recommendation is to address mentoring and advising needs within the IraqiArmy. MNF-I should leverage the extensive military medical expertise currentlyavailable in coalition units by developing partnering agreements with Coalition units foradvising and mentoring. Such efforts must be in support of a comprehensive,synchronized, multi-year medical mentoring plan as described in our summary responseat Recommendation 20.c. on page 146. Therefore, we request that MNF-I provideadditional comments in response to the final report identifying specific plans or initiativesundertaken or considered for mentoring Iraqi Army health care professionals by makinguse of the medical expertise resident in Coalition forces.19.b.(2) We recommend that the Commander, Multi-National Force-Iraq develop andimplement partnering agreements between co-located Coalition and Iraqi Army units inwhich Iraqi personnel are provided routine and emergency care on a reimbursable basis(this is discussed in more detail in Observation 23).Client CommentsCommander, MNF-I non-concurred with the recommendation, stating that routine carefor Iraqi personnel was prohibited by Title X. Further, the Commander reported thatthere were no implementing instructions available, nor medical units equipped or staffedto bill for services rendered. MNF-I reported that U.S. medical resources in Iraq hadbeen operating from a locally approved exception to policy for non-Coalition Forcemedical care.Our ResponseCommander, MNF-I comments were not responsive to the intent of the recommendation.DoD Instruction 6015.23, “Delivery of Healthcare at Military Treatment Facilities:Foreign Service Care; Third-Party Collection; Beneficiary Counseling and AssistanceCoordinators,” October 30, 2002, implements policy, assigns responsibilities, andprescribes procedures on provision of care in military treatment facilities. MNF-I shoulddevelop a local exception to policy to provide the routine and emergency care which isbeing provided on a reimbursable basis and submit a formal exception to policy requestto the Assistant Secretary of Defense for Health Affairs (ASD(HA)) to allow for thatcare. Subsequently, MNF-I should provide input to the ASD(HA) so that DoDI 6015.23can be updated to support MNF-I requirements in Iraq. During our visit, we identified132
two medical personnel who were already trained and equipped to implement a theaterwide reimbursement policy within the current scope of their duties. Our response atRecommendation 23 on page 167 provides additional detail about reimbursement forcare.We request that MNF-I reconsider its position on the recommendation and providecomments to the final report.19.c.(1) We recommend that the Commander, Multi-National Security TransitionCommand-Iraq advise and assist the Ministry of Defense in developing andimplementing a comprehensive, synchronized, integrated, multi-year Iraqi plan thatidentifies overall strategies, doctrines, and end-states to develop a sustainable Iraqi Armyhealth care delivery system. This plan should include, at a minimum, facilityconstruction, logistical support, external medical mentoring, and civilian partnerships forstaffing and management.Client CommentsCommander, MNSTC-I concurred, noting that MNSTC-I was engaged with the MoDSGO and Directorate of Military Medical Services in both near-term and long-termplanning. He reported that current ongoing planning efforts with the MoD SGO includedsuch issues as major facility construction, logistics support, external medical monitoring,and civilian partnerships for staffing and management.Our ResponseCommander, MNSTC-I comments were partially responsive. MNSTC-I is to becommended for its proactive engagement efforts with the MoD SGO, identifying multiplesources for medical supplies, and developing civilian partnerships. Those efforts shouldbe incorporated into a long-term plan that includes milestones and desired end states sothat those early successes can be continued and built upon as MNSTC-I Health Affairsteam members rotate. Additionally, resource gaps, including required manpower andexpertise, should be identified and promptly elevated to MNF-I and USCENTCOM forexpedited action, so that progress is maintained. We request that MNSTC-I provideadditional comments in response to the final report identifying specific actions to developand implement a comprehensive, multi-year plan for developing a sustainable Iraqi Armyhealth care delivery system.133
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INSPECTOR GENERALDEPARTMENT OF DEFE
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Report No. SPO-2009-002 (Project No
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Report No. SPO-2009-002 (Project No
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Table of ContentsExecutive SummaryR
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IntroductionBackgroundThe DoD Offic
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Appendix A discusses the scope and
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letter to clarify that DoD Instruct
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USCENTCOM guidance for its area of
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1. Describe the mission, roles, and
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Status of Implementation of Recomme
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Management Comments to Recommendati
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. Performing a 10 percent sample in
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94 personnel). The proposed JMD als
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MiTTs. Between February 15 and Marc
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Part II - Arms, Ammunition, and Exp
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Observation 1. Assistance to the Mi
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5, March 25, 2008, 12 addresses DoD
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MNSTC-I personnel made on-the-spot
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1.a. We recommend that the Commande
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Observation 2. Assistance to the Mi
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and procedures for receipt, process
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MNSTC-I and Iraqi military personne
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captured weapons, or if it permanen
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SAO manning has increased approxima
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End-Use Monitoring Compliance PlanT
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Observation 4. Accountability of Ni
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• Corrective actions implemented
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Observation 5. Multi-National Secur
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Observation 6. Multi-National Secur
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elationships with ISF personnel. In
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Originally, personnel filling the n
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FMS shipments to Iraq will sharply
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Client CommentsThe Assistant Secret
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Ministry of Defense and Iraqi Army
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uild 3 rd and 4 th Line maintenance
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Observation 8. Use of Iraq Security
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The Iraqi Government has progressiv
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Observation 9. Request for Forces f
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Page 104 and 105: The MoD provided an increased alloc
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Page 134 and 135: developing the IAMP IT network to p
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Page 139 and 140: Observation 19. Iraqi Army Heath Ca
Page 141 and 142: MNC—I had not fully identified th
Page 143 and 144: civilian patients. U.S. military me
Page 145: those deficiencies are many, but th
Page 149 and 150: Our ResponseCommander, MNSTC-I comm
Page 151 and 152: Observation 20. Multi-National Forc
Page 153 and 154: While some Iraqi Army mentoring and
Page 155 and 156: eporting. A Medical Operational Rea
Page 157 and 158: Client CommentsCommander, MNF-I con
Page 159 and 160: numbers of billets on the MNF-I JMD
Page 161: MNF-I as U.S. forces are right-size
Page 164 and 165: The Military Health System Strategi
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Page 168 and 169: objective will also impact Iraqi ca
Page 170 and 171: 21.a.(2) We recommend that the Comm
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Page 178 and 179: Client CommentsCommander, MNSTC-I c
Page 180 and 181: guidance on stability operations th
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Page 187 and 188: Appendix B. Summary of Prior Covera
Page 189 and 190: Appendix C. GlossaryThis appendix p
Page 191 and 192: Foreign Military Sales Trust Fund -
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• Officials assigned to the U.S.
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Appendix E. Status of Recommendatio
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RecommendationNumberG-3-aG-3-bRecom
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RecommendationNumberL-2-aL-2-bFOLLO
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Appendix F. Organizations Supportin
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Joint Contracting Command-Iraq/Afgh
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DoD 5100.76-M. DoD 5100.76-M, “Ph
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DoD 5105.38-M states that:…[T]itl
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USD (AT&L) Value Stream Analysis, A
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leader in health education, trainin
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Appendix H. Notional Division and B
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6. Medical Logistics Status (Author
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Combatant CommandsCommander, U.S. C
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Final ReportReferenceDraftRecommend
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Final ReportReferenceIncorporated a
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Final ReportReferenceRecommendation
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Commander, Multi-National Force-Ira
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Final ReportReferenceClick to add J
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Final ReportReferenceRecommendation
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Final ReportReferenceDraftRecommend
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Commander, Multi-National SecurityT
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Final ReportReferenceRenumbered toR
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Team MembersUnder the guidance of t
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