US Coast Guard Health Service Support

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US Coast GuardHealth Service SupportAPhA PHS
Session16 March 2007
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Mary Fong, RPhCAPT, USPHS Pharmacy Program
Coordinator/ConsultantOffice of Health
SafetyUSCG HeadquartersWashington, DC
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US Coast Guard

• USCG in the Armed Forces
• US Public Health Service
• History of the USCG
• Missions of the USCG
• Vessels/aircraft in the USCG
• Contingency Operations
• Contingency Medical Support
• Health Services Publications
• Summary

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The Uniformed Services

• Army Navy Marines Air Force
• Coast Guard
• Public Health Service (PHS)
• National Oceanographic and Atmospheric
  Administration (NOAA)

• Armed
  Forces
  
• DOC DHHS DHS DOD

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Coast Guard Forces

• 42,000 Active Duty
• 18,000 Selected Reservists
• 35,000 Auxiliarists
• 8,000 Civilian

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History of the U.S. Coast Guard

• Lighthouse Service-1716 (Treasury Dept. in 1789)
• Revenue Cutter Service-1790 (Treasury)
• Life-Saving Service-1848 (Treasury)
• Steamboat Inspection-1838 (Justice, Treasury,
  Commerce)
  
• Bureau of Navigation-1848 (Treasury)

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History of the USCG (cont.)

• United States Coast Guard formed in 1915
• Combined Revenue Cutter Svc Life-Saving Svc
• Bureau of Navigation Steamboat Inspection
  joined USCG in 1942
  
• Became part of Dept of Homeland Security 2003
• Served under Navy from 1917-19 and 1941-45
• Currently 60,000 active duty and reserve

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CG Command Structure

• Commandant (4-star)
• Vice Commandant, Chief of Staff, Headquarters
• Maintenance and Logistics Commands (MLCs)
• Atlantic and Pacific (3-star commands)
• Districts Nine 2-star commands
• Academy New London, CT
• Training Centers
• Cape May, Yorktown, Elizabeth City, Petaluma,
  Mobile
  

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History of CG and DoD

• CG is part of Dept of Homeland Security
• Function under Department of the Navy in time of
  war
  
• Last functioned as part of Navy in WWII
• Has Memorandum of Understanding with Navy
• CG had significant presence under DOT/DHS but
  alongside DoD
  
• Korea, Vietnam, Persian Gulf War, OIF
• Became part of Department of Homeland Security on
  1 Mar 03
  
• Retained all current missions
• Expect that Homeland Security missions will
  increase

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Coast Guard

• Military
• Maritime
• Multi-mission
• Authority on, over, under high seas and
  waterways under US jurisdiction
  
• CG is an agency of Department of Homeland
  Security
  

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Primary Coast GuardAir and Maritime Missions

• Humanitarian
• Search and Rescue
• (SAR)
• Law Enforcement
• Drug Interdiction
• Alien Migrant
• Interdiction Ops (AMIO)

• Port Security
• National Defense
• Ice Operations
• Aids to Navigation (ATON)
• Environmental
• Mishap Investigation
• Coast Guard Auxiliary

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Humanitarian

• Flood Relief
• Hurricane Relief

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Search and Rescue (SAR)

• Nationwide system of boats, aircraft, cutters,
  and rescue coordination centers
  
• 24 hour alert status
• Minimize loss of life, personal injury and
  property damage in U.S. waters and on the high
  seas
  
• May risk losing aircraft to save a life
• May not risk losing aircraft to save property
• May not risk losing a life to save a life

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Law Enforcement

• Fisheries
• Smuggling
• LEDETs/TACLETs aboard Navy vessels outside US
  territorial waters
  
• UN sanctions/embargo enforcement
• Drug interdiction

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Drug Interdiction

• Federal agency to limit smuggling of illicit
  substances into U.S.
  
• Aviation and Vessel Operations
• Jurisdiction extends out of US territorial waters
  into high seas per UN Charter
  
• U.S. Navy-deemed act of war or piracy
• entering territorial waters foreign country
• high seas boarding of foreign vessel

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Alien Migrant Interdiction Operations (AMIO)

• Massive illegal migration of populations over
  water
  
• Haiti, Cuba
• Exposure to infectious disease
• Interdict in foreign ports if possible
• Return to country of origin or transfer to Navy
  in Guantanemo Bay, Cuba

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Ice Operations

• Polar Ice operations
• International Ice Patrol
• Since 1912 due to sinking of the Titanic
• Large Icebreakers with helo support
• Deploy for 6 month missions
• Domestic Ice Operations
• Facilitates transportation through ice-laden
  domestic shipping lanes
  
• Use Icebreaker Tugs, 1 large icebreaker

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Environmental ProtectionCG National Strike Teams

• Minimize damage caused by pollutants released in
  the coastal zone
  
• Reduce threats posed by potential spills of oil
  hazardous materials
  
• Assist in national and international pollution
  response planning
  
• Anthrax cleanup in Florida and DC
• Ricin cleanup in DC
• Expeditionary role w/DoD for HAZMAT/oil response,
  etc.

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Environmental ProtectionPort Safety

• Detection of oil/hazardous substance spills
• Safeguard ports/vessels/waterways/personnel from
  accidental damage, injury, or destruction
  
• Vessel/cargo inspection

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Mishap Investigation

• Investigation of all USCG aviation and vessel
  mishaps
  
• Investigation of civilian mishaps which occur on
  U.S. waterways
  
• Exxon Valdez
• Amtrak train crash in Mobile waterway
• TWA Flight 800
• Barge collision with I 40 bridge in Oklahoma

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Aids To Navigation (ATON)

• Maintenance of buoys in US coastal and shipping
  waterways
  
• Maintenance of 90 of US lighthouses-automated
  and manned
  
• LORAN stations

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Port Security and Safety Operations

• Marine Safety Offices
• Responsible for US and territories
• Interact with local and state law enforcement
• Increased Marine Security (MARSEC) in response to
  military out loads at certain ports
  
• Captain of the Port
• Marine Safety and Security Teams (MSSTs)
• Port Security Units (PSUs)
• 120 man units
• Security in foreign ports in DoD operations

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Captain of the Port (COTP)
Broad authorities to manage maritime safety
security at US ports Enforces International Nat
ional Regulatory standards Leads efforts with the
Harbor Safety Committee Industry Associations
Designated CG Incident Commander for Port Wide E
mergencies
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Marine Safety and Security Teams(MSSTs)

• Maritime SWAT teams for US ports
• Currently 12 teams (1st activated in summer
  2002). Project to have 16 teams total.
  
• Required to be deployable anywhere in US in 24
  hours
  
• 76-84 person teams
• 6 high performance boats with M-60 machine guns
  and M-16s/shotguns for personnel
  
• CBR operations capable

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Security Response Team (SRT)

• 1st activated for mission response June 2004
• Combines MSST Boat ops with Special Ops aviation
• Designed to use maritime insertion teams
• Maritime equivalent of FBI Hostage Rescue team
• Will have ready team for immediate deployment

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US Coast Guard Auxiliary

• Non-military Coast Guard civil function
• Must own at least 25 interest in a boat,
  aircraft or marine radio station
  
• 35,000 members
• Missions
• Vessel exams (Courtesy Marine Exam)
• Public education
• Operations (SAR)
• Fellowship

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National Defense Expeditionary

• Port/Littoral Security
• PSUs
• Patrol Boats
• Buoy Tenders
• Law Enforcement
• LEDET/TACLETs
• Cutter Ops
• Transport C-130
• Intelligence gathering
• Cutters, fixed and rotary wing assets
• SAR/MEDEVAC

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National Defense Homeland Security

• Cutter Ops
• - 378, 270, 210 Cutters, Ice
  Breakers-offshore support
  
• Patrol Boat Ops
• - 110 shore patrol boats port/littoral
• PSU/MSST/SRT Ops
• - Port/shore/offshore based security/response
• Buoy Tenders
• - Provide ATON support for navigable waterways
• Aviation Ops
• - C-130 transport
• - land-based fixed wing Intel/Search platforms
• - cutter-based rotary wing Intel/Search platforms

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CG Response Assets Afloat

• High endurance/Medium endurance cutters
• Ice Breakers
• Patrol Boats
• Small Boats
• Deployable Pursuit Boats
• Port Security Boats

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USCG Cutters 399 Ice Breaker
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USCG Cutters WHEC-378
Interdiction/law enforcement/defense operations
Platform/hanger on fantail to accommodate CG
helicopter
Weaponry 76 mm gun 2 x 25 mm guns 2 x 50 ca
liber machine guns Phalanx CIWS (Close-In-Weapon
System) SRBOC launchers (Chaff and Decoy system
)
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USCG Cutters 225 Buoy tender
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USCG Cutters 110 Patrol Boat
Law enforcement Interdiction Coastal defense
Weaponry 25 mm machine gun 2 x 50 caliber mac
hine guns

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Transportable Port Security Boat
MSST/SRT/Port Security for DoD operations
Weaponry 50 Caliber machine gun (bow) 2 x M-6
0 machine guns (port/starboard)

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CG Response AssetsAviation

• Rotary Wing
• - HH-60 (Jayhawk)
• - HH-65 (Dolphin)
• - MH-68 (Hitron)
• Fixed Wing
• - HC-130
• - HU-25 (Falcon)
• UAVs (future)

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USCG Aircraft HC-130
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USCG Aircraft
HH-65 Dolphin
HH-60 Jayhawk
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HITRONMH-68

• Drug interdiction
• 50 caliber machine gun
• 7.62 mm machine gun
• Used to disable go-fast boats of drug smugglers

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Average Coast Guard Day

• Every eight minutes, conducts a SAR 180 per day
  (65,700 SAR missions per year)
  
• Every two hours a life is saved 12 lives per
  day (4380 lives per year)
  
• Aid 315 people/day save 2 million in property
• Seize 318 pounds of marijuana and 253 pounds of
  cocaine
  
• Interdict 112 illegal immigrants

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Medical Structure of the CG

• Health care professionals are PHS officers
• Physicians 60
• Dentists 55
• PAs/NPs 7 (additional 30 CG)
• Pharmacists 16
• Sanitarians/Environmental Health Officers 18
• Corpsmen 675 total
• Includes dental/pharmacy/x-ray techs
• 71 afloat IDTs/81 ashore IDTs

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USCG Pharmacists

• Managerial Billets                               
                                                    
                 Headquarters, Washington , DC -
  Pharmacy Program Coordinator/ Pharmacy Chief
  Maintenance Logistics Command, Atlantic in
  Norfolk , VA LANT Regional Pharmacy
  Consultant                                        
                                                    
               Maintenance Logistics Command,
  Pacific in Oakland , CA PAC Regional Pharmacy
  Consultant
• Field Billets                                    
                                                    
                         Kodiak, AK Seattle, WA
  Petaluma, CA Alameda, CA Mobile, AL Miami, FL
  Clearwater, FL Elizabeth City, NC Portsmouth,
  VA Washington, DC Cape May, NJ New London, CT
  and Cape Cod, MA.

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USCG National Defense Medical Support

• Port Security Unit 1 Physicians assistant, 2
  corpsmen (1 E-7), 120 personnel
  
• Cutters/Buoy tenders/MSSTs 1 independent duty
  corpsman, EMTs/Combat lifesaver equivalent
  
• Patrol Boats 1 EMT-B
• SRT TBD (proposed 1 Flight Surgeon, 5-6 HSs)
• Aircraft
• Fixed wing - no intrinsic medical support
• Rotary wing - 1 rescue swimmer (EMT-B)
  (medevac/SAR)

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Levels of Care

• Defined for CG in DoD operations
• JP 4.02 - Doctrine for Health Service Support in
  Joint Operations
  
• Level 1 - EMT/possible Corpsman
• Level 2 - Have no level 2 or above capabilities
• rely on DoD medical treatment capabilities
• rely on lifts of opportunity for evacuation

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US Coast GuardMilitary Medical Readiness

• HQ responsibilities
• Policy
• Information gathering/dissemination
• MLC responsibilities
• Deployment oversight
• Assistance with equipment /supplies/medical
  readiness immediately predeployment
  
• Unit responsibilities
• Aware of physical readiness deficiencies
• Aware of equipment/supply deficiencies

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USCG Health DoctrinePublications

• Medical pubs responsibility of Office of Health
• Operational deployment pubs per Operations or
  Logistics offices with input from Office of Health

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Joint Program Participation

• ASD (HA) Prevention, Safety Health Promotion
  Council (PSHPC) and committees
  
• Force Health Protection Committee (FHPC)
• Joint Preventive Medicine Policy Group (JPMPG)
• Armed Forces Epidemiology Board
• Anthrax Vaccine Immunization Program (AVIP)
• Smallpox Vaccine Program (SVP)
• Joint Health Services Doctrine Board
• Accession and Induction Standards WG
• Reserve Health Affairs WG
• Individual Medical Requirements WG
• JOMMC, HLSMEC, Joint Med Planners Courses

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Questions?