Thursday, June 08, 2006

Failing the Aggie Test

Like other elements within DOD, the Air Force is struggling with budget shortfalls and accompanying personnel cutbacks. At least 40,000 enlisted personnel, officers and civilians will be trimmed from the ranks over the next four years, to achieve required savings and help fund weapons upgrades.

In military circles, it’s called a Reduction in Force (RIF) and most of us have lived through one or more. The Air Force has already announced plans to involuntarily separate several hundred junior officers by the end of the current fiscal year, and more cuts may be on the way. A senior officer told me the other day that he expects that 20,000 additional personnel will be eventually eliminated, on top of the 40,000 currently projected. The ramifications of these cutbacks will be felt for years to come; today’s airmen and lieutenants are tomorrow’s Chief Master Sergeants and Colonels. In other words, we may face an experience gap in the future, thanks to personnel decisions being made today.

If the service is facing tough times in terms of manning and personnel—and it is—perhaps someone can explain the logic of this Air Force decision, outlined in a recent press release:

6/7/2006 - WASHINGTON (AFPN) -- Some previously restricted Airmen now may be assigned permanently or on temporary duty to any stateside base with a medical facility or to certain overseas bases with a medical facility because of recent changes to Air Force Instruction 41-210, “Patient Administration Functions,” and the initiation of a Stratified Assignment Limitation Code C.

Airmen diagnosed with medical conditions that are potentially disqualifying from continued military service undergo a medical evaluation board. Many are not discharged, but are returned to duty with an Assignment Limitation Code-C, or ALC-C. The code is issued by the Air Force Personnel Center's Medical Standards Branch in the Medical Service Officer Management Division.

This code restricts permanent and TDY assignments to areas where appropriate medical care is available to the member. The intent of the ALC-C is to protect members from being placed in an environment where adequate medical care is not available.

Under the Stratified Assignment Limitation Code C program, Airmen placed on Code C restriction now fall into one of three stratification levels:

C1: Airmen permanently and TDY assignment-eligible to global Department of Defense installations with medical treatment facilities. Generally, approvals are for conditions that are stable and found as a result of a medical review and not likely to worsen suddenly.

C2: Airmen permanently and TDY assignment-eligible to CONUS installations. They could also be deployable or assignable to overseas bases or non-fixed facilities if appropriate care is available. This is generally approved for temporary or mild conditions requiring follow-up but clinically inactive and managed without frequent visits or unique medication regimen or prescriptions.

C3: Airmen who are TDY non-deployable and assignment-limited to a specific installation based on medical need and availability of care. Approval authority is the Medical Standards Branch. The member’s commander may request waivers to send a member on deployment or permanent assignment in support of unit operations.

“Airmen with certain conditions, such as mild asthma, may now be eligible for permanent or TDY assignments to locations never before possible," said Lt. Col. (Dr.) Lane Wall, Air Force Medical Operations Agency in Washington, D.C.

Asthma accounts for the highest number of Airmen restricted from assignments.

“Roughly 2,000 Airmen with asthma could be affected by the change,” Colonel Wall said. “These Airmen with asthma may deploy to places such as Germany and Japan.”

Assignment or deployment to these locations will depend on the availability of primary care physicians to manage the disease-associated routine medication issues, and assurance that additional care is available should the Airman’s condition worsen.

“All Airmen going through the medical review process will be assigned using the new stratification levels,” Colonel Wall said. “Airmen who are already on Code C will be assigned the new stratification levels during their next scheduled update or when they’re selected for a permanent or TDY deployment assignment.”

In other words, the Air Force is kicking 40,000 healthy folks to the curb, while bending over backwards to retain 2,000 airmen, NCOs and officers whose health conditions prevent them from deploying to a combat zone. Perhaps I’m a bit unschooled in the finer points of military medicine and personnel assignments, but this one simply flunks the Aggie test.

And I’m not the only one concerned by this trend. A retired Air Force E-9, a former senior enlisted advisor (and one of the truly great Chiefs to ever wear the uniform) believes that medical restrictions have become a dodge for airmen who want to avoid deployments to combat zones or other undesirable locations. He remembers one case where a string of senior NCOs suddenly developed medical problems to avoid an assignment to a small base in northern Italy. With airmen now pulling duty at such garden spots as Bagram, Balad and Baghdad, I’m sure this trend has only accelerated.

The solution is painfully obvious. If these airmen aren’t healthy enough for duty in Iraq or Afghanistan, why should they be retained for assignments stateside, or at overseas locations with “adequate” medical facilities. If their problems are chronic or long-term, convene a medical board, and give them early retirement or involuntary separation. Then, fill their spot with a healthy airman who would be otherwise forced out by personnel reductions.

There’s nothing wrong with the Air Force making an occasional exception for personnel with medical conditions that limit deployments. But the number of airmen currently on the Code C program is entirely too high, and members of the “Profile Corps” are sending other airmen downrange for a second, third or fourth tour in the sandbox. Get rid of some of these medical goldbricks and you’ll see an immediate improvement across the board. Faced with an early exit from the Air Force, some of the Code C’rs will suddenly find their health improved; there will be less work for the admin troops, medical folks and commanders (who now spend too much time on medical restriction issues), and fully-qualified airmen will get more of a break from combat deployments.

It’s time for the Air Force to get serious about this issue. Or, as Chief Buddy would say, flush early and often.


JoeC said...

Whatever happened to "stop hiring", or "natural attrition"? Is re-enlistment/retention THAT high they couldn't meet their goals in the required timeframe? Or maybe even "slow promotion" that discourages retention? That was one of the reasons I left the service in the late '70s at the end of the Vietnam era. the AF RIF'd my brother at 4 years during the same timeframe. I wonder if the Disabilities Act and the legal system prevent medical separations, after all, they'd be medically handicapped and of course their condition worsened due to their during their service so the U.S. (that's us) would be on the hook for their disability payments for a loooooooong time?

cold pizza said...

The cuts are usually AFSC related as certain specialties are phased out or cut back (like personnel-3S0X1). The AF is trying to reduce the shaft of the spear (support/services) and focus on the tippy point (toys).

As a MSgt, 3S071, I was diagnosed with asthma in '03 as I prepped for deployment and I elected to retire. I know there are some folks with Code C who can stay in, serve stateside and provide a valuable pool of experience. I also know that asthma comes in lots of flavors and mine hasn't interfered with my life since my retirement last year. There was no reason, in my mind, why I couldn't deploy.

Bottom line, the AF has reasons determined by the Manpower office to rationalize cuts. There also reasons to let Code C folks deploy. It may not seem to make sense on the surface, but Manpower issues are ALWAYS complex and after 20+ years in Personnel, I pretty much knew details of every career field--except for how Finance worked and what magic hat Manpower had to pull it's numbers from. After 21 years of AF sponsored chaos, change and pain, the company I work for now is a welcomed vacation. -CP

Epador said...

Another sore point!

I agree it is a problem, bigger perhaps than you note. The Reserves are particularly a big problem, with folks attempting to blame long standing pre-existing problems on some episode that occurred in their 2 week annual stint - but that's another topic.

One main problem with Asthma is that even if you are well controlled at home, when you are in 140 degree, dusty heat (or primitive cold and wet), your chances of de-compensating are higher. Plus, the whole issue of what happens when you are exposed to smoke and fumes ( hey, that happens in combat, doesn't it?) or when you have to wear a "gas mask" and can't give yourself a dose of inhaler, ought to be NO BRAINERS!

I saw folks with cancer getting chemo, or post kidney transplant, deployed to Germany!

It was very frustrating as a military physician to try to do a good job on a medical board and have politics over rule your recommendations time and time again. Or be deployed and have to send back folks that should never have arrived, depleting the deployed work force and necessitating someone out of cycle coming in to replace the fellow that someone else tried to "be nice" to and keep them in for a year or two more...