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ANNUAL REPORT THE SURGEON GENERAL UNITED STATES ARMY Fiscal Year 1959

Annual Report the Surgeon General United States Army Fiscal Year 1959

MEDICAL SUPPLY AND EQUIPMENT

Supply Distribution Under Single Manager System

At the beginning of the fiscal year, the Army Medical Service was responsible for providing administrative support to the single manager distribution system for medical materiel by the operation of two of the three major distribution points. The Louisville Medical Depot, Louisville, Ky., and the Medical Supply Section, Sharpe General Depot, Lathrop, Calif., were responsible for the central and western geographic areas, respectively. In addition, the Medical Supply Section, Schenectady General Depot, Schenectady, N.Y., was assigned a limited primary stock point for the northeastern areas of the United States. With the closing of two Air Force depots during the year, the Louisville Medical Depot assumed responsibility for a greater distribution mission, and, on 1 October 1958, the Medical Supply Section, Atlanta General Depot, Atlanta, Ga., was assigned a primary stock point distribution mission for the southeastern States. The geographic areas assigned to depots in the distribution system provide for the distribution



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tion of medical materiel to all military installations within the areas and to designated oversea commands.

Medical Materiel Program for Nuclear Casualties

The distribution of supplies for the emergency care of nuclear casualties was initiated during the fiscal year. Although plans and requirements for this program have been in development since August 1956, fiscal year 1959 was the first year in which funds were made available for procurement and distribution of the supplies to posts, camps, and stations. A total of $2,900,000 was allotted from the Army Stock Fund and from appropriated funds for the distribution of 3,139 Phase I and 156 Phase II sets to CONUS stations. Packing and packaging procedures were also developed during the year for the Phase I set which is positioned with each 100 personnel and contains quantities of 26 different medical items for self-aid and buddy-type care during the immediate postattack period.

The Phase I supplies are functionally packaged in nine cartons, including two general supply or master packs, one pack for treating fractures, two for burns, and four for wounds. None of the packages exceed 40 pounds; each can be carried by an individual. The nine cartons are overpacked in a large carton mounted on a skid and appropriately marked for easy identification. Phase II sets, consisting of 75 different medical items in quantities sufficient for first aid treatment of 1,000 casualties for a 20-day period, are issued to hospital facilities in bulk for storage. It is anticipated that $4 million will be made available to provide for further distribution of the emergency supplies both within CONUS and to oversea commands during fiscal year 1960 and that the distribution will be completed in fiscal year 1961.

Reconstitution of Assemblages

The rehabilitation and repacking of nine field hospital assemblages in the possession of STRAC (Strategic Army Corps) units was completed during the fiscal year by the Louisville Medical Depot. In addition to the replacement of obsolete, outworn, and damaged equipment, the assemblages were packaged in lightweight portable and reusable containers to reduce substantially both the weight and size and thereby increase the mobility of the packaged assembly. The balance of six field hospital assemblages will be reconstituted during the ensuing fiscal year. The reconstitution of the field hospital assembly is the primary step in the program to modernize and to provide greater


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Contents of Emergency Medical Kit


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mobility for all types of hospital assemblages held by STRAF (Strategic Army Forces) units in CONUS.

Fabrication of Spectacles

Since the establishment of the Air Force as a separate service, the optical laboratories operated by the Army Medical Service have had the mission of fabricating spectacles for the Army and Air Force in CONUS and in support of oversea commands. With the discontinuance of the optical laboratory at the Naval Supply Center, Oakland, Calif., on 1 July 1958, as the result of a study made under the auspices of the Department of Defense, the fabrication of spectacles for the Navy in the western area of the United States was added to the mission of the Medical Supply Section, Sharpe General Depot. During this fiscal year, 491,185 pairs of spectacles were fabricated by the two Army Medical Service laboratories at the U.S. Army Medical Optical and Maintenance Activity at St. Louis, Mo., and the Medical Supply Section, Sharpe General Depot. Of these, 48.9 percent were for the Army, 46.1 percent for the Air Force, and 5 percent for the Navy.

Procurement

Although the wholesale stocks of standard items of medical supplies and equipment in CONUS depots are purchased by the Military Medical Supply Agency under the direction of the single manager for medical materiel (the Secretary of the Navy), The Surgeon General retains the responsibility for a number of purchasing and contracting functions. During this fiscal year, the purchasing and contracting officers in the Office of The Surgeon General and AMEDS class II installations and activities contracted for supplies and services totaling $107,956,544 in 69,636 procurement actions. The expenditures were made for the operation of the Dependents' Medical Care Program, for research and development activities, for the purchase of nonstandard items, and for the procurement of supplies and services required for hospital operations. These expenditures were as follows:

Activity:          

Actions

Dollar value

     Office for Dependents' Medical Care

264

$80,023,177

     AMEDS Research and Development Command   

502

$10,889,779

     AMEDS class II hospitals and miscellaneous units

68,870

$17,043,588

          Total

69,636

$107,956,544


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Classification of Supply Items

The Army Medical Service, in collaboration with the other medical services, continued its emphasis on the elimination of outmoded and nonessential items from the supply system. During the fiscal year, 701 items were reclassified as obsolete or were deleted from the supply system through action taken by the Army Medical Service Technical Committee and the Armed Services Medical Materiel Coordination Committee. The reclassification actions have not limited the introduction of new items required by advances in the military practice of medicine as evidenced by the fact that 284 of these items were classified as standard during the year. Included in the newly standardized category were such items as an automatic cartridge needle atropine injector, a dried form of smallpox vaccine, a lightweight halftank respirator for use in transporting patients, a screening-type audiometer, and a moulage set with simulated wounds for training in first aid and emergency medical treatment.

Medical-Dental Division, Army Stock Fund

The Medical-Dental Division, Army Stock Fund, manages the inventories at 22 class I and 7 class II CONUS installations and activities and at 6 oversea commands. The average total value of these inventories during fiscal year 1959 was approximately $40 million, with purchases of $26 million and sales of $24.4 million. At the outset of the fiscal year, the division received obligatory authority for $26.9 million, but this amount was subsequently adjusted to $26 million as the result of a revised forecast of sales.

The availability of funds was affected by an increase, averaging 2 percent in the price listing of all standard items of medical supply, that became effective, on 1 July 1958, based on price changes authorized by the single manager for medical materiel.

In an effort to improve the status of mobilization readiness, actions were initiated to procure materiel and equipment in the amount of $2 million for the Medical Materiel Program for Nuclear Casualties, $300,000 for the Theater Reserve Number I program, and $1,300,000 for the reconstitution of mobilization reserve medical assemblies in USAREUR.

The following changes in procedure and organization were made during the year to improve management:

1. Stock fund and financial inventory accounting analyses were consolidated within one organizational element within OTSG to insure compatability of data.


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2.  A detailed supply operating program was prescribed for branch offices (the 29 CONUS installations and activities and 6 oversea commands) to support budget estimates, apportionment requests, and allotments.

3.  Branch offices were delegated authority to obligate funds on an annual basis in order to provide flexibility in procurement as dictated by consumer demands.

4.  Optimum utilization of equipment was assured in order to reduce hospital operating costs.

5.  The program for reconstituting and modernizing TOE medical assemblies in the mobilization reserve in USAREUR was continued.

Reconstitution of Major Medical Assemblies in U.S. Army, Europe

The reconstitution of the major medical assemblies in USAREUR began in fiscal year 1958 when obligational authority in the amount of $1 million was provided by the Army Stock Fund. Although au­thority to obligate $1.3 million to continue this program was provided for fiscal year 1959, the Bureau of the Budget placed a restriction on its use by indicating that the funds could not be obligated without being fully and specifically reimbursed from operations and maintenance appropriations. The funding restriction caused a delay of several months in the disassembly and reassembly process, and it was not until October 1958 that The Surgeon General was given the Stock Fund obligational authority to continue the purchase of replacement ma­teriel and equipment. The Department of the Army has taken the position that the Bureau of the Budget restriction is not based on a legal interpretation of Department of Defense regulations applicable to the Army Stock Fund operations. Although the reconstitution program has continued, the reimbursement problem has not been resolved.

Mutual Security Program

The Surgeon General retains the responsibility for the programming and reporting of deliveries made of medical supplies and equipment to foreign governments under the military assistance phase of the Mutual Security Program. The fiscal year 1959 program was valued at $9.2 million with requisitions totaling more than $8 million having been received. The shipments of medical materiel made to recipient governments during the year were valued in excess of $10.7 million and were primarily applicable to requisitions submitted for previous year programs.

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