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ANNUAL REPORT OF THE SURGEON GENERAL UNITED STATES ARMY Fiscal Year 1958

Annual Report of the Surgeon General United States Army Fiscal Year 1958

MEDICAL SUPPLY AND EQUIPMENT

Medical-Dental Division, Army Stock Fund

Operations of the Medical-Dental Division, Army Stock Fund, focused primarily during the year upon adjusting to its new status as a retail establishment as provided under the single manager system which became effective on 31 March 1957 when CONUS Army medical depot inventories valued at 143.9 million dollars were transferred to the Navy (the single manager). Under this new arrangement, whereby the Navy is the wholesaler, the Army Medical Service procures the greater portion of its supplies and equipment from the Military Medical Supply Agency, the operating activity of the single manager. Thus, in effect, the Army Medical Service is now operating in


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a manner somewhat similar to that of a retail store in a chainstore organization.

The Army Medical Service was allotted 23 million dollars for obligation purposes in the apportionment program for fiscal year 1958. During the first half of the fiscal year, expenditures were limited to 45

percent of the annual program. The limitation resulted from the establishment of expenditure controls by the Department of Defense. This caused some curtailment in obligations during the first 6-month

period, since collections had to exceed disbursements. The limitation, however, was lifted after 1 January 1958, and obligations increased to a level that made it possible to obligate approximately all of the 23 million dollars by 30 June.

Medical Materiel Mission Reserve

AR 711-822, Stock Control, dated 1 August 1957, authorized retention at all CONUS medical installations and activities as well as selected oversea commands of medical supplies and equipment essential for emergency hospital requirements. This reserve constitutes an in-place stockage of inventory necessary to allow immediate operation within authorized bed capacities (table 12).

TABLE 12.- Dollar-value status of medical materiel mission reserve

 

Location

Requirements1

Assets

Deficiencies

CONUS class I stations

$19,521,829

$  9,723,445

$  9,798,384

CONUS class II stations

$  3,695,358

$  2,105,257

$  1,590,101

Oversea commands

$     360,589

$       72,147

$     288,442

    

Total

$23,577,776

$11,900,849

$11,676,927

1Requirement is limited to installation storage capacities.

Major Assembly Rebuilding Program

During fiscal year 1957, the U.S. Army, Europe, Branch Office, Medical-Dental Division, Army Stock Fund, capitalized approximately 7 million dollars in TOE assemblies for the purpose of reconstitution

and rebuilding. All of these had been assembled originally at the Louisville Medical Depot during the period 1950-52 and were considered functionally incomplete. Initial computations by USAREUR,


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based on disassembly of three 1,000-bed general hospital assemblages, disclosed that the assemblies were approximately 30 percent incomplete, due to deterioration and obsolescence. Funds in the amount of 1 million dollars were approved within the Medical-Dental Division, Army Stock Fund, fiscal year 1958 apportionment for the rebuilding project. Authority has also been obtained to retain these TOE assemblies in the stock fund as a portion of the USAREUR in-place reserves.

Emergency Medical Care of Nuclear Casualties

Since August 1956, a Department of Defense ad hoc committee, including representatives of the Army Medical Service, has been engaged in developing policies for planning, budgeting, and storing at all stations and bases such items of medical materiel as are considered essential for emergency medical treatment of military casualties resulting from a nuclear attack. The committee prepared two lists of items which were approved and published in DOD Directive 3110.2, dated 21 February 1957. The first list included items essential in phase I, the immediate postattack period when only self-care or buddy-type care would be available. The second list contains items of supplies for phase II, when some professional aid may be furnished under field conditions.

During the early part of fiscal year 1958, the Secretary of Defense directed the three military medical services to compute their requirements for submission to the Military Medical Supply Agency. The gross requirements computed by the Army Medical Service are approximately $11,000,000, and, with the application of known assets, the net requirement is estimated to be $8,620,000, which was included in the fiscal year 1958 Medical-Dental Division, Army Stock Fund budget. This amount, however, was not approved by the Deputy Chief of Staff for Logistics in the fiscal year 1958 funding program. He did establish a tentative estimate of 2.7 million dollars for inclusion in the fiscal year 1959 program.

Military Assistance Program

In November 1957, The Surgeon General requested, by memorandum to the Deputy Chief of Staff for Logistics, that action be taken to transfer the medical portion of the MAP (Military Assistance Program) from the Army to the Navy. This request was made because the single-manager assignment for medical materiel to the Navy left The Surgeon General with practically no control over MAP deliveries. In January 1958, the Deputy Chief of Staff for Logistics advised The Surgeon General that the requested transfer was not desirable from


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the standpoint of either the Army or the Navy and that if the problems of delayed delivery, billing, and reporting could not be resolved with the single manager, the Deputy Chief of Staff for Logistics would request assistance from the Department of the Army.

Unit Assembly Packaging Concept

A program to rehabilitate medical assemblages in the hands of field units was begun. Within priority, initial attention is being given to field hospitals. In addition to replacing deteriorated, obsolescent, and

obsolete items and equipping the assembly with components according to the latest approved list, a new packaging concept is being employed which embodies the maximum utilization of standard aluminum field chests, canvas-liner cases and rolls, or other lightweight, portable, reusable containers. This reduces substantially the weight and size of packaged assemblies. It also enables equipment to be opened for training or inspection and repackaged (by the field unit), thus maintaining it in constant readiness for immediate shipment or deployment.

Automatic Data Processing

An ADPS (automatic data processing system) test was conducted at the Louisville Medical Depot from 6 May to 30 September 1957. The equipment utilized was an IBM prototype model 305A (RAMAC). After a thorough evaluation of all phases of the test operation, approval was granted for installing a production model 305A. Installation has been completed, and the logistic functions of the Louisville Medical Depot pertaining to data processing are now performed by ADPS.

Maintenance of Medical Equipment

Maintenance capabilities of medical equipment were broadened considerably during the year, with the establishment of medical field maintenance shops at Brooke Army Medical Center and the Fitzsimons and Letterman Army Hospitals.

The ever-increasing complexity of electronic components in electromedical equipment necessitated a revision in the program of instruction in medical equipment maintenance. Two levels of maintenance

training are now provided for enlisted technicians, and a formal training program is provided for officers. The training, conducted at the U. S. Army Medical Optical and Maintenance Activity at St. Louis, Mo., consists of four courses. These are a basic course for enlisted


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personnel (18 weeks), an advanced course for noncommissioned officers and specialists (32 weeks), a new course for graduates of the advanced course on the operation and servicing of newly developed therapeutic and diagnostic equipment (6 weeks), and a course for staff maintenance officers and technical supervisors (21 weeks).

CONUS Depot Operations Study

At the request of the Deputy Chief of Staff for Logistics, The Surgeon General and chiefs of the other technical services established a working group to develop a plan for CONUS depots and their operations which would fulfill technical service responsibilities and requirements. As an additional requirement, the working group developed plans for supply and maintenance support in theaters of operations during war.

Supply Distribution Under Single-Manager System

Effective 1 July 1957, Army Medical Service installations and activities in CONUS and oversea commands revised their requisitioning procedures for medical supplies and equipment to conform to the distribution system established by the single manager for medical materiel. The Louisville Medical Depot, Louisville, Ky., and the Medical Section, Sharpe General Depot, Lathrop, Calif., are the distribution points for the central and western areas, respectively, in the new distribution pattern, while the Medical Section, Schenectady General Depot, Schenectady, N.Y., was assigned a reduced mission as a primary stock point in the eastern area. Single-manager distribution areas were established for the distribution of supplies to all military installations in assigned geographic areas and to designated oversea commands.

Army Medical Service Technical Committee

The Army Medical Service Technical Committee, comprised of the chiefs of the various divisions in the Office of the Surgeon General, determines which items of medical materiel will be adopted for use in the Army Medical Service, in CONUS as well as overseas, and which ones will be eliminated. Representatives of The Surgeon General also attend monthly meetings of similar committees of the other Army technical services to present the needs of the Army Medical Service for supply items that are the logistic responsibility of the other technical services.


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Department of Defense Directive 5160.23 reconstituted the Armed Services Medical Materiel Standardization Committee as the Armed Services Medical Materiel Coordination Committee. The Surgeons

General of the Army, Navy, and Air Force each designate one medical officer to serve on this joint committee and provide the additional personnel for staffing purposes. The committee receives from the three services lists of medical supply items which they suggest for triservice adoption and standardization. Those items which the committee approves are incorporated in the Armed Services Medical Stock List. The lists of Army items are furnished by the Army Medical Service Technical Committee. The joint committee submits the lists of approved items to the single manager for procurement. The committee also coordinates the activities of the Department of Defense blood program.

Standardization

The Army Medical Service continued its efforts, in collaboration with the single manager, the other medical services, and the other Army technical services, to simplify and reduce the number of medical supply items in Army use. The objective is to maintain at the lowest possible level the number of items required by the Army Medical Service.

Logistic Assignments

Considerable progress was made in the reassignment among Army technical services of logistic responsibility for Federal Supply Classification System items. The purpose is to transfer to the appropriate technical service the logistic responsibility for specific supply items to be furnished for use throughout the Army. The progress made in this program has tended to improve the Army's effectiveness in the field of supply.

Procurement

The purchasing and contracting offices of the Army Medical Service in CONUS expended $108,394,100 in procurement of supplies and services during the fiscal year. These expenditures involved 64,445 contractual actions. Of these, 444 with a dollar value of $87,423,880 represent the contracting activities of the Office for Dependents' Medical Care, and 625 amounting to $6,859,101 represent contracts negotiated with educational institutions, nonprofit organizations, and com-


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mercial research foundations in support of the research and development program.

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