Page 112 - JSOM Fall 2022

To the Editor:

e would like to thank N. L. Boyer, et al. [“Casualty Evac­ professionals. Unlike the DoD’s non­tactical care delivery
Wuation (CASEVAC) Platform Review and Case Series of organizations, COCOM’s do not have organic credentialing
US Military Enroute Critical Care Team With Contract Per­ entities to investigate and conduct prime verification to ensure
sonnel Recovery Services in an Austere Environment,” Volume the quality of contracted medical practitioners.
21, Edition 4/Winter 2021] for their recent article on con­
tracted personnel recovery services, highlighting the capabil­ Lastly, North Atlantic Treaty Organization (NATO) doctrine
ities of and lessons learned while utilizing civilian contracted specifically discusses the potential use of contracted medical
air medevac in the US Africa Command (USAFRICOM) area care in Allied Joint Publication­4.10–Allied Joint Doctrine for
of operations. We agree with the authors that contracted air Medical Support. Troop contributing nations may provide
MEDEVAC can provide our US forces in economy of force contracted medical resources as part of a NATO mission. US
missions or remote geographic regions with essential capa­ forces must be prepared to integrate these resources if they are
bilities. However, as the authors described, using contractors the framework nation or lead nation in charge of health ser­
for medical care and evacuation is not without challenges. We vices during a NATO mission. This would include integrating
propose that, in addition to the operational level challenges contracted capabilities into the health system in an expedition­
of ground force familiarization described by the authors, ary environment. As medical capabilities supporting Special
there are also several enterprise­level challenges that hinder Operations above Role 1 are predominantly provided by non­
the ability to fully integrate contracted medical support into SOF organizations except for very specific units, the current
the US expeditionary health system. While using contracted lack of US medical contracting policy and support to expedi­
capabilities should not be the primary plan for providing expe­ tionary forces is a direct risk to mission.
ditionary health services, the ability to quickly and effectively
resource and integrate contracted health capabilities into our We appreciate the authors bringing the important topic
expeditionary system expands the decision space. Specifically, of contracted medical care to the attention of this journal’s
it expands the decision space for our nonmedical and medical readership, and we hope these additional points contribute
leaders when faced with missions that cannot be sourced by to realizing the full opportunity of contracted expeditionary
military medical teams. medicine for our SOF.
2LT A.J. Steinlage*
Nonmedical contracting officers operating in the Combatant MD Candidate, Class of 2024
Commands (COCOM) lack the training and expertise in writ­ Uniformed Services University, Bethesda MD
ing and managing medical contracts, such as air MEDEVAC
and other personal services contracts. This expertise currently COL Ramey Wilson
resides in the Department of Defense’s (DoD) care delivery or­ Medical Corps, US Army
ganizations focused on nontactical care. As these specialized Deputy Director, Military Internal Medicine
types of contracts to provide medical capabilities to expedi­ Uniformed Services University, Bethesda, MD
tionary forces are still in their infancy, there are no standard­
ized “off­the­shelf” contracting vehicles for expeditionary *Correspondence to arnold.steinlage@usuhs.edu
contracted medical capabilities. Instead of leveraging the ex­
pertise of our medical system that commonly contracts care in Disclaimer
the US and abroad to support nonexpeditionary care, individ­ The opinions and assertions contained herein are those of the
ual combatant commands or organizations, like Special Op­ authors and do not reflect those of the Uniformed Services
erations Command Africa (SOCAFRICA), are left to develop University or the Department of Defense.
their own solutions and statements of work. This can lead to
different standards and decreased efficiencies.
Keywords: CASEVAC; critical care team; personnel recovery;
One such example with significant implications in terms of USAFRICOM; MEDEVAC; contractors; medical care; evacua-
care quality is the lack of policy or guidance on who is re­ tion POSTER RESEARCH AWARD
sponsible for credentialing oversight of contracted medical

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