Page 104 - JSOM Fall 2019

A more aggressive transformation to realign health and health and applied. The four HPO tenets put forward for SOF in this
care through integration and HPO is under way. In partic- article are noted next.
4,5
ular, realignment efforts have been occurring within Special
Operations Forces (SOF) communities as unit commanders Tenet 1: HPO Must Be Anchored in
are now looking toward programming that supports the spe- SOF Unit METL and Operator CTs
cific capabilities of their units. In contrast to the MHS delivery Although the military is often described in totalizing terms,
system, the US Special Operations Command (USSOCOM)’s even at the branch level, each career field represents subcul-
Preservation of the Force and Family (POTFF) program intro- tures within the diversity of multiple cultures existing in the
duced in 2012 provides a community-based, integrative, and US military. These subcultures are heavily shaped by each
proactive approach to delivering services that align with the unit’s METL and career field CTs. A METL is a critical list
diverse needs of SOF communities in the face of unparalleled of fundamental tasks for which a unit was designed. Similarly,

operational tempos. Initially a “top-down” approach, it con- CTs are a list of individual tasks an Operator must accom-
tinues to evolve within each Service’s community and is now plish as part of their occupational contributions to their unit’s
looked at by the DoD as the “model” to emulate for other METL. CTs also reflect those “honed” talents, capabilities,
embedded/organic assets. With its rapid growth and projected and skills that are forged upon entry into the military and key
expansion across USSOCOM and the DoD, however, there to the role within their profession. Unit METLs and Operator
is an increasing need for evidence to demonstrate/document CTs are not static and may change in response to combat oper-
“operational” return on investment and mission impact, as ations and mission demands. HPO understands and supports
10
current metrics remain disease based and operational return the prioritizing of diverse SOF communities by focusing on
on investment should be performance based. supporting each unit’s METLs and Operator’s CTs, while also
accounting for the priorities and needs of unique career fields.
With realignment under way and occurring across the “top” It is essential for all stakeholders involved in HPO efforts to
(DoD/Service level) and now “bottom” (Operator and unit directly collaborate with SOF leadership and their Opera-
communities), synchronization of HPO efforts is paramount tors to understand the diverse needs and subcultures of SOF
to successfully shift the culture toward supporting force sus- communities.
tainability and effectiveness. Thus far, the advancing works
of HPO has been presented strategically and more from a Tenet 1 can be understood as necessarily axiomatic if we con-
medically focused orientation. In this article, we present sider the following example. Within USSOCOM, the vari-
6–8
HPO from the “bottom-up” through an operational and sys- ous subcommunities and subcultures that make up the larger
tems-based lens, centered on SOF diversity and the optimiza- AFSOC community are diverse in their Operator’s CTs ( Table
tion and preservation of talents and capabilities related to SOF 1). Each Operator possesses unique capabilities and skill sets
unit METLs and Operator CTs. that are core to their operational readiness and lethality. For
the purpose of this article, lethality will be defined as the ability
HPO: Tactical/Operational Model of the SOF unit and Operator to maintain an optimal level
of performance at their METL and CTs. In Table 1, for in-
HPO is defined as the process of applying knowledge, skills, stance, optimizing and preserving the capabilities of each of
and emerging technologies to improve and preserve the capa- these Operators must be grounded in the CT of career field
bilities of SOF personnel to execute mission essential tasks. members, which are critical to their unit’s METL. 11–13 Without
HPO is at the heart of DoD’s paradigm shift: applying an in- considering unit METL, the risk of relying on a one-size-fits-all
tegrative and systems-based framework to a SOF Operator, approach to performance and health services is high—but one-
which mirrors other military “weapon systems” so it can ad- size-fits-all is not, and will never be, precise enough to address
dress capability gaps and improve the precision of Operator the specific needs and priorities of each individual community.
care. If we adopt this framework, however, we must move
beyond the current illness-based model of care and adopt or TABLE 1 Examples of AFSOC Operator and Core Task Diversity
create a more suitable structure and scope of practice. 3E8X1 Explosive 1C4X1 Tactical Air 1U Sensor
Ordnance Disposal CT Control Party CT Operator CT
In its original 2006 work, CHAMP and select community 3.2.1. Unexploded 6.4. Perform combat 7.1.1. Perform radio
members sought to identify a new structure to establish an ordnance recovery water survival communications
orientation focused on optimizing performance of Warfighter operations and crew interaction
mission essential tasks. Group consensus recognized a clearly 21.2. Remove fuse 10.5. Operate laser 8.6. Lost link
identified need for a capability-based and systems-oriented target designator procedures
approach that paralleled other military weapon systems. In (LTD)
3
addition, in 2009, HPO and the human weapon system para- 21.3. Disable electrical 12.10.5.1.3. React 9.2.3. Determine
to enemy contact
target orientation
components
digm were broadened to fit within the DoD Defense Acquisi-
tion Management System (DAMS) lifecyle framework. 9 25.1.3.3.4. Perform 12.10.8. Enter/clear 10.4.2. Coordinate/
disposal procedures
de-conflict airspace
a building
32.1. Perform 13.14. Perform call 10.5.4.5. Perform
HPO Tenets immediate 9-line for fire mission tactical analysis
medevac procedures
To continue the advancement of HPO along the lines just
noted, to merge/integrate “top-down” and “bottom-up” ef-
forts, and to ensure successful implementation within SOF Tenet 2: Performance Enhancement and
communities, HPO tenets are needed. Overall, the concept of Health Sustainment Are Not the Same Thing
HPO is based on unstated tenets or principles that should gen- HPO makes a distinction between performance enhancement
erally be acknowledged in order to be universally understood and health sustainment (Figure 1). Performance is defined as
102 | JSOM Volume 19, Edition 3 / Fall 2019