1. 1 N-9-89 Joint Maritime Medical Staff Course (JMARMEDS) NATO School – Oberammergau Germany 10 December 2012 Overall Classification Of This Presentation: NATO UNCLASSIFIED

2. PREVIOUS EXPERIENCE:  Fellow, American College of Healthcare Executives (ACHE)  Policy experience – as an Intern in the U.S. Chief of Naval Operations Medical Plans and Policy Branch (OPNAV N931D) from July 2010 – July 2011  Land operations – as the Medical Plans Officer for Task Force Medical – South, Afghanistan from September 2009 – April 2010  Maritime/Amphibious operations – as the Medical Plans Officer for the 31st U.S. Marine Expeditionary Unit (MEU) from April 2007 – July 2008 CURRENT POSITION:  CJ5 Plans Staff Officer and Medical Planner (PXX008)  Naval Striking and Support Forces NATO (SFN), PRT  Comm: +351-21-440- 4434//NCN: 529-4434  Mobile: +39-366-574-9989  NATO Unclassified: a.toler2@sfn.nato.int 2

3. 1. Overview of the NATO Operational Planning Process and the Comprehensive Operations Planning Directive (COPD) 2. Overview of NATO Medical Operations Planning Process 3

4. Part 1: Overview of the Reference/Source: Lieutenant Colonel Mehmet Salar, TUR-A NATO School – Joint Operations Department 4

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10. Simultaneous Planning Occurs From the Strategic to the Tactical Level 10

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22. Part 2: Overview of the Reference/Source: Colonel Toby Rowland GBR Army NATO HQ Supreme Allied Command Transformation Branch Head (Medical) 22

23. To support the mission, through conservation of manpower, preservation of life and minimization of residual physical and mental disabilities  How is this mission statement achieved…  Commensurate to force strength  Must deploy with forces tasked to support  Must be a robust and comprehensive capability  Reference: AJP-4.10 (A) 23

24. 1. Requires input from the medical staff at each point of the process 2. The Medical Operational Planning Process is continuously linked to the OPP 3. The output of Medical Planning delivered to the OPP is the Medical Support Plan Annex to the OPLAN 4. The Medical Plan needs to be coordinated on all levels  Reference: AJMedP-1 24

25. 1. Situation a)Health Risk Assessment b)Civil-Military Situation 2. Mission 3. Assumptions a)Estimated Casualty Rates 4. Execution a)Concept of Medical Support for each phase of the operation b)Scheme of Maneuver 5. Tasks and Responsibilities a)Per Afloat MTF b)MEDEVAC 6. Appendices 1.Medical Intelligence Report 2.Eligibility Matrix 3.Medical Report Formats What Should You Consider When Building Your Medical Support Plan? 25 Reference: AJMedP-1

26. NATO-UNCLASSIFIED NATO Standards of Medical Care NATO Medical Support is a national responsibility In practice it is increasingly a shared responsibility Treatment outcome must equate to best medical practice Standards need to be acceptable to all nations Continuum of Care from injury to home base Reference: MC 326/3, AJP-4.10(A), AMedP-11 (A)

27. NATO-UNCLASSIFIED NATO Medical Care Role System Standards of Medical Care are achieve through the Role System: –Role 1 medical support provides for routine primary health care, specialized first aid, triage, resuscitation and stabilization –Role 2 provides an intermediate capability for the reception and triage of casualties –Role 3 medical support is deployed hospitalization and the elements required to support it –Role 4 medical support provides the full spectrum of definitive medical care Specific maritime levels of healthcare will be defined by the Maritime Medical Planning presentation Reference: MC 326/3

28. NATO-UNCLASSIFIED MC 326/3MC 551 AJP-4.10 Medical Support AJMedP-1 Medical Planning AJMedP-2 Medical Evacuation AJMedP-3 Medical Intelligence AJMedP-4 Force Health Protection AJMedP-5 Medical C4I AJMedP-6 CivMilMed Interface AMedP-6 Med Aspects NBC AMedP-7 Med CBRN CONOPS AMedP-8 CRE CBRN AMedP-11 Maritime Med AMedP-16 Med Capabilities AMedP-17 Med Training Req AMedP-22 Trauma Care Training AMedP-14 Heat, Cold, Altitude AMedP-18 Water Potability AMedP-20 Waste Management AMedP-21 Health Surveillance AMedP-5 Multiling Phrasebook AMedP-12 Blood Brochure AMedP-13 Glossary Med Terms AMedP-19 Animal Care AMedP-3 Insect/Rodent Contr AMedP-23 Vaccination AMedP-24 Emergency Care Medical Policy Medical Keystone Doctrine Allied Joint Medical Doctrine Supporting Medical Doctrine NATO Medical Policy and Doctrine NATO Standardization Agency (NSA) Public Web Site: http://nsa.nato.int/nsa/

29. NATO-UNCLASSIFIED Medical Support Plan Considerations 1.NATO Standards of Medical Care 2.NATO Medical Role System 3.NATO Continuum of Care 4.NATO Medical Policy and Doctrine Now that you understand these considerations when building a Medical Support Plan Annex…Let’s go through basic medical planning steps! These Steps Will Occur During Phase 4 of the COPD Process

30. NATO-UNCLASSIFIED Step I – Initiation Joint Operations Planning Group (JOPG) Step I – Initiation Joint Operations Planning Group (JOPG) CHIEF JOPG CJ 5 PLANNERS CJ 2 PLANNERS CJ 1 CJ 2 CJ 4 CJ 6 CJ 3 CJ 9 LEGAD CC POLAD PIO MED CC CCs Cdr’sPlanningGuidance

31. NATO-UNCLASSIFIED Step II – Orientation Review of the Situation Step II – Orientation Review of the Situation Comprehensive Approach

32. NATO-UNCLASSIFIED Step III – Concept Development For development of the medical concept the medical planner has to take into account multiple factors. Some of them are: 1.Environment 2.Opposing Forces 3.Friendly Forces 4.Risk Assessment 5.Medical Logistics 6.Medical Capabilities The list of factors not complete, but gives you an idea…

33. NATO-UNCLASSIFIED Step III – Concept Development: Environment Environment  Geography  Weather / Climate  Health Risks & Threats  Civilian Population  Host Nation Resources  Other stakeholders  Geography  Weather / Climate  Health Risks & Threats  Civilian Population  Host Nation Resources  Other stakeholders

34. NATO-UNCLASSIFIED Step III – Concept Development: Medical Logistics Step III – Concept Development: Medical Logistics

35. NATO-UNCLASSIFIED  Summary of required capabilities and capacities  Medical Treatment Facilities  Evacuation Assets  Graphical Overlay: Concept of Medical Support  “Tentative Course of Action”  Summary of required capabilities and capacities  Medical Treatment Facilities  Evacuation Assets  Graphical Overlay: Concept of Medical Support  “Tentative Course of Action” Step III – Concept Development: Medical Capabilities Step III – Concept Development: Medical Capabilities

36. NATO-UNCLASSIFIED Step IV – Plan Development AConcept of OperationsLPsychological Operations BTask OrganizationMArms Control CForces and TasksNNuclear Operations DIntelligenceOInformation Operations ERules of EngagementPElectronic Warfare FMaritime OperationsQCIS GLand OperationsRLogistics HAir OperationsSMovements IAmphibious OperationsTEnvironmental Support JForce ProtectionUNBC Defence KSpecial OperationsQQ/ XX Medical

37. NATO-UNCLASSIFIED Step V – Plan Review

38. This Concludes The Lesson Overall Classification Of This Presentation: NATO UNCLASSIFIED 38