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A Modular Medical Logistics Force

Forward distribution teams help mitigate some of the supply distribution problems experienced during early Operation Iraqi Freedom rotations.

A modular force is a key aspect of the Army Chief of Staff’s vision and Strategic Planning Guidance for transforming the Army. The modular force model is based on brigade-sized elements that are more responsive than division-sized elements and can perform joint and expeditionary-type missions. Using modular units, Army planners can tailor force structure, reduce strategic lift requirements, and create flexible forces with specialized capabilities based on ever-changing mission requirements.

Throughout Operation Iraqi Freedom (OIF), medical logisticians have made significant progress toward meeting the Chief of Staff’s vision for a modular force. During the past two rotations, medical logistics units, through the concept of modular forward distribution teams, have addressed several major problems that occurred in OIF I.

OIF I Logistics Shortfalls

In OIF I, medical logistics units supported their customers largely through doctrinal supply point distribution, in which customers picked up supplies from their designated source of supply. Medical logisticians quickly realized that this system did not meet customer requirements or expectations adequately. Extended lines of communication and enemy threats created unique problems for supply point distribution. Medical logisticians also did not communicate medical distribution requirements
adequately to the distribution process owners. Therefore, the overall system was not responsive to customers’ needs.

Medical logisticians realized that some of these problems occurred because Army medical logistics systems operators were not skilled in using those systems, even when electronic communication systems were available. Likewise, many medical logistics Soldiers and leaders were not adequately trained for their mission. This training shortfall occurred primarily because garrison medical logistics supply operations, which are supported by medical prime vendors and door-to-door commercial transportation, are significantly different from deployment operations, which are characterized by extended lines of communication. Also, medical materiel requirements during peacetime are relatively low when compared to wartime requirements.

In short, many medical units and customers in OIF I were frustrated with the medical logistics system because it lacked responsive distribution, adequate automation support, and adequate Soldier and leader training to meet their needs and expectations.

Forward Distribution Teams

In OIF II, the 226th Medical Logistics Battalion (Forward) from Miesau, Germany, quickly addressed these problems by using a nondoctrinal modular concept of forward distribution teams (FDTs) to move materiel throughout Iraq using 13th Corps Support Command (COSCOM) trucks. The 226th’s FDTs were stand-alone entities that had all of the organizational equipment needed to operate outside of the battalion’s area of operations. They were small, four-Soldier operations that could deploy rapidly across the battlefield.

‘ New and Improved’ FDTs

In OIF 04–06, the goal of the 32d Medical Logistics Battalion (Forward), XVIII Airborne Corps, from Fort Bragg, North Carolina, was to improve the FDT concept and processes that were implemented by the 226th. (The Army adopted a new rotation-numbering system after OIF I and II.) To medical logisticians and maintainers, value is more than a box or a part; value also lies in personal service to the customer. With this in mind, the battalion divided its two-platoon distribution company into seven modular FDTs. These teams were paired with the 1st COSCOM distribution management teams and tasked to sustain geographic areas of responsibility in conjunction with the corps support group’s area of responsibility. Predeployment training conducted at Fort Bragg focused on the tasks the modular teams would perform independently to support customers.

The size and makeup of the teams were tailored to the number and type of supported units. Typical FDTs consisted of a noncommissioned officer in charge (NCOIC), two medical logistics technicians, and a medical maintenance technician. These four-Soldier teams supported 60 units (approximately 15,000 Soldiers). To meet mission requirements, the FDTs that supported level III healthcare facilities (those staffed to perform resuscitative, surgical, and postoperative care), large troop concentrations, and multiple outlying forward operating bases were augmented with additional medical logistics specialists with military occupational specialty (MOS) 91J and medical equipment repairers with MOS 91A.

A lieutenant and two FDTs supported the Multinational Division (MND) North Central and Multinational Force (MNF) Northwest. Another lieutenant and two FDTs supported the MND Baghdad and the Multinational Security Transition Command-Iraq. A third lieutenant and two FDTs supported the MND Southeast and MND Central South. These lieutenants planned and directed all medical logistics operations and provided situational awareness to the distribution company commander and the battalion support operations officer. They participated in corps support group operations meetings and hospital and medical coordination meetings, conducted mission analyses, and anticipated and fixed distribution and maintenance problems encountered in their areas of responsibility. The seventh FDT supported the MNF West in partnership with the Navy Medical Logistics Detachment.

Direct Shipments

To address continuing problems with supply point distribution, the 32d Medical Logistics Battalion used a direct distribution process. The battalion coordinated with supply sources in Qatar and Germany to have materiel flown directly to strategic air hubs and FDT locations. The FDTs made sure that materiel was received and secured, requisitions were closed out, and materiel was prepared for customer pickup or onward movement by ground. Having the FDTs available to receive and process materiel forward reduced the 10- to 15-day shipping time to 3 to 6 days. In 1 month, the use of direct shipments removed approximately 41 truckloads of cargo and at least 82 Soldiers from the dangerous roads of Iraq.

Support Operations Section

The need soon became apparent for a modular ele-ment that could be plugged into the corps’ distribution process to coordinate FDT operations and synchronize the movement of medical materiel with other classes of supply. The 32d Medical Logistics Battalion reorganized its headquarters detachment to create a modular plug that was dubbed the support operations (SPO) section. The functional layout of the reorganized battalion headquarters shown on page 9 includes the mission-dictated SPO section and FDTs. Note the coordinated communication between the FDTs and the SPO, distribution operations, and direct support unit (DSU) operations sections.

The SPO section is staffed by a major with area of concentration (AOC) 70K, medical logistician; a first lieutenant with AOC 70B, health services administrative assistant; a sergeant first class with MOS 25U, signal support systems specialist; a sergeant first class and a staff sergeant with MOS 91J, medical logistics specialist; and a sergeant with MOS 92Y, unit supply specialist. The SPO section operates out of 1st COSCOM’s Corps Distribu-tion Command and represents medical logistics on a joint distribution board that synchronizes, prioritizes, and solves movement issues across Iraq. Including a SPO section in the headquarters is not a new concept; it is a part of the design of the future multifunctional medical battalion. However, because it was embedded in 1st COSCOM’s Corps Distribution Command and employed in wartime without a programmed force structure or fielding, the SPO section was unique.

Locating the SPO section in 1st COSCOM’s Corps Distribution Command and the FDTs in the corps support groups makes it possible to provide coordinated customer assistance and timely distribution of medical logistics. Together, these units maintain tactical visibility of main supply routes, attend meetings of the joint movements board, exchange information with commodity command and COSCOM customer liaison officers, coordinate ground and air movements, expedite critical movements for mass casualty events and other urgent medical needs, and monitor materiel in the truck lanes at the joint distribution center. The SPO section facilitates resolution of issues raised by customers and the FDTs and coordinates support to upcoming operations.

Automation Support

The FDTs facilitate medical materiel movement and area medical maintenance support. The teams provide the critical link among COSCOM materiel movers and the corps support groups, distribution op-erations, and customers. To do this, the team mem-bers have become knowledgeable of the systems used by cus-tomers, such as the Combat Automated Support Server-Medical (CASS–M), Theater Army Medical Management Information System (TAMMIS), and TAMMIS Customer Assistance Module (TCAM). They also are familiar with the logistics distribution process and have an understanding of customer re-quirements so that they can best support them. FDTs have proven effective in troubleshooting problems on site with automation, materiel movement, and forward medical maintenance support.

The FDT NCOIC oversees training and assists customers in the use of logistics automation, such as TAMMIS and TCAM, and works to resolve medical logistics problems. FDT Soldiers also help customers with technological challenges such as firewalls and problems encountered when using Very Small Aperture Terminals (VSATs) and navigating Internet Protocol, or IP, addresses. They also assist with maintaining intransit visibility and using the Defense Automatic Addressing System Center Inquiry system to track inbound class VIII shipments and validate input of customer information into the DSU’s warehouse. The Soldiers on the FDTs also provide customers technical guidance on installing logistics system components, setting up customer files, sending orders electronically, receiving status reports, processing receipts, reconciling orders, locating product substitutions, researching products, updating catalogs, processing excess supplies, and issuing and turning in materiel.

Medical maintenance technicians are critical members of the modular team. They provide medical maintenance expertise to customers in the FDT’s area of responsibility, assist with the use of the Unit Level Logistics System-Medical (ULLS–M), and repair forward medical equipment. They also coordinate with DSU operations to obtain opera-tional readiness float equipment and facilitate the retrograde of equipment and components for repair. Their forward presence and their ability to assist with repair of critical equipment, such as the computerized tomography (CT) scanners and medical oxygen generators, in remote areas of Iraq are a true success story.

Within 30 days of implementation of the modular FDT initiative, the forward maintenance technicians repaired more than 145 items of equipment and provided on-site assistance to 62 customers. The FDTs were able to repair equipment on site rather than evacuate it to another location, which saved a significant amount of time.

The 32d Medical Logistics Battalion found that a modular medical logistics force could provide more coordinated support and enhanced customer service. The tailored structure of the FDTs not only enabled operational flexibility but also matched available medical logistics capabilities with the customers’ automation, materiel, and maintenance requirements to provide fast and accurate service and support.

Lieutenant Colonel Mitchell E. Brew is the Commander of the 32d Medical Logistics Battalion (Forward) at Fort Bragg, North Carolina, which is currently deployed to Iraq. He holds a B.S. degree in business from the State University of New York at Buffalo, an M.S. degree from the University of Southern California, an M.B.A. degree from George Washington University, and an M.H.A. degree from Baylor University and is a Fellow in the Ameri-can College of Healthcare Executives. He is a graduate of the Army Command and General Staff College, the Logistics Executive Development Course, the Joint Medical Planner’s Course, the Army Force Management Course, the Medical Logistics Management Course, and the Army Medical Department Basic and Advanced Courses.

Captain Jason M. Fairbanks is the Commander of B Company, 32d Medical Logistics Battalion (Forward), at Fort Bragg, which is currently deployed in Iraq. He has a B.S. degree is wildlife biology from the University of Montana. He is a graduate of Army Medical Department Officer Basic Course, the Medical Logistics Management Course, and the Infantry Captains Career Course.