(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Table of Contents
Volume I – Justification of O&M Estimates for Fiscal Year (FY) 2016
Exhibit PBA-19
Page No.
Introductory Statement............................................ 1
Exhibit O-1
Operation and Maintenance Funding................................ 11
Exhibit OP-32
Summary of Price and Program Growth - Summary.................... 13
Exhibit PB-31R
Personnel Summary................................................ 17
Physicians' Comparability Allowance Worksheet.................... 19
Exhibit PB-31D
Summary of Funding Increases and Decreases....................... 21
Exhibit OP-5/OP-32
In-House Care.................................................... 25
Private Sector Care.............................................. 49
Consolidated Health Support...................................... 63
Information Management........................................... 87
Management Activities........................................... 110
Education and Training.......................................... 124
Base Operations/Communications.................................. 140
Facilities Sustainment, Restoration, and Modernization.......... 160
Exhibit PB-11
Cost of Medical Activities...................................... 172
Exhibit PB-11A
Personnel Summary............................................... 180
Exhibit PB-11B
Medical Workload Data - DHP Summary............................. 186
Exhibit PB-15
Advisory and Assistance Services................................ 194
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Table of Contents
Exhibit PB-22
Major DoD Headquarters Activities............................... 196
Exhibit OP-34
Appropriated Fund Support for MWR Activities.................... 198
Exhibit PB-28
Summary of Funds Budgeted for Environmental Projects............ 200
Section II - Procurement
Exhibit P-1
Procurement Program............................................. 204
Exhibit P-40
Procurement Budget Item Justification........................... 208
Section III - Research, Development, Test, and Evaluation (RDT&E)
Exhibit R-1
RDT&E Programs.................................................. 216
Exhibit R-2
RDT&E Justification.............................................217
Exhibit OCO O-1
Overseas Contingency Operations (OCO) Summary of Operations..... 544
Exhibit OCO OP-5
Overseas Contingency Operations (OCO) Operation
and Maintenance
Exhibit OCO OP-32
Detail......................................... 546
Overseas Contingency Operations (OCO) Summary of Price and Program
Growth.......................................................... 554
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement
($ in Millions)
Appropriation Summary:
Operation & Maintenance4
RDT&E
Procurement
Total, DHP
MERHCF Receipts5
Total Health Care Costs
($ Dollars in
FY 20141
Price
Actuals
Growth
Program
Growth
FY 20152
Estimate
Price
Growth
Program
Growth
FY 20163
Estimate
30,219.2
871.7
­1,078.9
30,012.0
863.6
14.3
30,889.9
1,710.3
30.8
­10.5
1,730.6
29.4
­779.9
980.1
705.8
16.4
­413.8
308.4
8.2
56.7
373.3
32,635.3
918.9
-1,503.2
32,051.0
901.2
-708.9
32,243.3
8,766.3
9,126.1
9,486.2
41,401.6
41,177.1
41,729.5
1/
FY 2014 actuals includes $715.484 million for OCO.
FY 2015 estimate excludes $300.531 million for OCO.
3/ FY 2016 request excludes $272.704 million for OCO.
4/ The Department of Defense transferred O&M funding of $117.9 million in FY 2014 and will transfer $117.1 million in FY 2015 and $120.4
million in FY 2016 to the Joint Department of Defense – Department of Veterans Affairs Medical Facility Demonstration Fund established
by section 1704 of Public Law 111­84 (National Defense Authorization Act for FY 2010). Additionally, the Department transferred $15
million of O&M funding in FY 2014 and will transfer the same amount in FY 2015 to the DoD­VA Health Care Joint Incentive Fund (JIF) as
required by Section 8111 of Title 38 of the United States Code (USC) and Section 721 of Public Law 107­314 (National Defense
Authorization Act for 2003). Pending congressional action on extending the JIF through FY 2016, $15 million will be transferred to
the JIF.
5/ Reflects DoD Medicare­Eligible Retiree Health Care Fund (MERHCF) O&M Receipts for FY 2014, FY 2015, and FY 2016.
2/
Exhibit PBA­19, Appropriation Highlights
DHP­1
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement
Description of Operations Financed:
The medical mission of the Department of Defense (DoD) is to enhance DoD and our Nation’s security by
providing health support for the full range of military operations and sustaining the health of all those
entrusted to our care. The Defense Health Program (DHP) Operation and Maintenance (O&M) appropriation
funding provides for worldwide medical and dental services to active forces and other eligible
beneficiaries, veterinary services, occupational and industrial health care, specialized services for the
training of medical personnel, and medical command headquarters. Included are costs associated with the
delivery of the TRICARE benefit which provides for the health care of eligible active duty family members,
retired members and their family members, and the eligible surviving family members of deceased active duty
and retired members. The FY 2016 budget request of $30,889.9 million includes realistic cost growth for
health care services either provided in the Military Treatment Facilities (MTFs) or purchased from the
private sector through the managed care support contracts, and for pharmaceuticals. This budget includes
funding for continued support of Traumatic Brain Injury and Psychological Health (TBI/PH) and Wounded, Ill
and Injured (WII) requirements. It complies with the Congressional mandate related to support of Centers
of Excellence (COE) and Department of Defense’s initiative for operations efficiencies, including savings
from the consolidation of like services to shared services and for proposed military healthcare reform
initiatives. Operation and Maintenance (O&M) funding is divided into seven major areas: In­House Care,
Private Sector Care, Information Management, Education and Training, Management Activities, Consolidated
Health Support, and Base Operations. The DoD Medicare Eligible Retiree Health Care Fund (MERHCF) is an
accrual fund to pay for DoD’s share of applicable Direct Care and Private Sector Care operation and
maintenance health care costs for Medicare­eligible retirees, retiree family members and survivors.
The DHP appropriation also funds the Research, Development, Test and Evaluation (RDT&E)
program for medical Information Management/Information Technology (IM/IT), research to
reduce medical capability gaps, and support to both Continental United States (CONUS)
and Outside the Continental United States (OCONUS) medical laboratory facilities.
The DHP appropriation Procurement program funds acquisition of capital equipment in MTFs
and other selected health care activities which include equipment for initial outfitting
of newly constructed, expanded, or modernized health care facilities; equipment for
modernization and replacement of uneconomically reparable items; equipment supporting
programs such as pollution control, clinical investigation, and
Exhibit PBA­19, Appropriation Highlights
DHP­2
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement
occupational/environmental health; and Military Health System (MHS) information
technology (IT) requirements.
Narrative Explanation of FY 2015 and FY 2016 Operation and Maintenance (O&M) Changes:
The DHP O&M funding reflects an overall increase of $877.9 million between FY 2015 and FY 2016, consisting
of $863.6 million in price growth and a net program increase of $14.3 million. Program increases include:
 $1,215.0 million for reversal of FY 2015 One­Time Congressional Adjustments.
 $63.0 million for Enterprise­Wide Information Technology Sustainment and Investments.
 $60.5 million for increase in Facilities Sustainment, Restoration and Modernization (FSRM) to normalize
the annual investment profile to meet a more consistent risk mitigation and acquisition management
strategy.
 $28.1 million to support the Joint Electronic Health Record data sharing and interoperability between
Department of Defense and Department of Veterans Affairs
 $22.7 million for one more civilian paid day.
 $11.6 million for support of military­relevant programs for Combating Antibiotic Resistant Bacteria
(CARB) in support of the President’s Countering Biological Threats and promoting the Global Health
Security Agenda (GHSA).
 $10.1 million for increased Initial Outfitting and Transition requirements for MILCON and Facilities
Replacement and Modernization projects.
 $6.9 million for support of the Secretary of Defense's direction to shape a properly sized and highly
capable civilian workforce.
 $6.0 million for continued Temporary Disability Retirement List (TDRL) legal support to expedite service
member medical status determinations.
 $5.2 million realigned from RDT&E to support operations at the Pacific­Based Joint Information
Technology Center (PJITC).
 $0.8 million for start­up costs to support to the Defense Health Agency Shared Services initiative.
Program decreases include:
 $806.8 million for reduced Private Sector Care and Direct Care requirements due to a reduced beneficiary
population.
Exhibit PBA­19, Appropriation Highlights
DHP­3
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement










$222.0 million for enactment of the FY 2015 National Defense Authorization Act and proposed FY 2016
Health Benefit Reform proposals.
$197.1 million in Shared Services Savings (these are net savings to include initial investment
requirements).
$101.1 million for decreased requirements associated with Traumatic Brain Injury/Psychological Health
(TBI/PH) and Wounded, Ill, and Injured (WII) requirements due to a 26% decrease in redeployments which
has resulted in a decrease in associated workload.
$49.2 million for reduced Integrated Disability Evaluation System (IDES) requirements.
$18.5 million for Department directed 20% management headquarters reductions.
$8.3 million for reduced audit contract responsibilities realigned to OSD Comptroller.
$7.9 million for education and training resources for support of healthcare services and operations.
$2.4 million for Defense Health Agency employee assistance program, Navy Medical advanced life support
and other administrative activities transferred to non­Defense Health Program organizations.
$1.3 million for decreased Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) training.
$1.0 million for Defense Financial Accounting Services (DFAS) rate reduction.
Continuing in FY 2016, the Department projects $120.4 million, should transfer to the Joint Department of
Defense (DoD) ­ Department of Veterans Affairs (VA) Medical Facility Demonstration Fund established by
section 1704 of Public Law 111­84, (National Defense Authorization Act for FY 2010). This fund combines
the resources of DoD and VA to operate the first totally integrated Federal Health Care Facility in the
country by the total integration of the North Chicago VA Medical Center and the Navy Health Clinic Great
Lakes. Authority for this program is extended to September 30, 2016.
Pending Congressional action to extend the DoD­VA Health Care Joint Incentive Fund (JIF) the Department
will transfer $15 million to the JIF in FY 2016. Authority for the JIF, established by Section 8111, Title
38, of the United States Code (USC) and Section 721 of Public Law 107­314(National Defense Authorization
Act for 2003) expires on September 30, 2015. This fund combines the resources of the DoD and VA to
implement, fund, and evaluate creative coordination and sharing initiatives at the facility, intraregional,
and nationwide levels.
Narrative Explanation of FY 2015 and FY 2016 Research Development Test & Evaluation (RDT&E) Changes:
The DHP RDT&E Program reflects a net decrease of $750.5 million between FY 2015 and FY 2016. This includes
price growth of $29.4 million and a net program decrease of $779.9 million. Program increases include:
Exhibit PBA­19, Appropriation Highlights
DHP­4
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement



$347.0 million in additional funding for the DoD Healthcare Management System Modernization (DHMSM) in
order to support requirements review/finalization, configuration, integration and testing efforts.
$11.0 million realignment from the integrated Electronic Health Record (iEHR) Program Element (PE) to
support the newly established DoD Medical Information Exchange & Interoperability (DMIX) PE initiative.
$12.0 million for phased requirements based on the United States Army Medical Research Institute of
Infectious Diseases (USAMRIID) phase I safety certifications for Beneficial Occupancy Date (BOD).
Program decreases include:
 $1,076.1 million due to the reversal of FY 2015 one­time Congressional adds to the Defense Health
Program RDT&E appropriation.
 $60.8 million reduction to Integrated Electronic Health Record (iEHR) due to approved funding profile
adjustments provided in departmental fiscal guidance for the integrated Electronic Health Record
(iEHR)/Defense Medical Information Exchange (DMIX).
 $5.2 million is realigned to O&M for proper execution of operations support activities at the Pacific
Based Joint Information Technology Center – Maui (PJITC­Maui).
 $4.9 million in IO&T requirements associated with the military construction of the new US Army Medical
Research Institute of Chemical Defense (USAMRICD) which is nearing completion.
 $2.9 million in various smaller enhancements/realignments(these are net of increases and decreases).
Narrative Explanation of FY 2015 and FY 2016 Procurement Changes:
The DHP Procurement Program has a net increase of $64.9 million between FY 2015 and FY 2016.
of $8.2 million in price growth and increased program growth of $56.7 million.
This consists
Program increases include:


$29.4 million to support the Composite Health Care System (CHCS) and Armed Forced Health Longitudinal
Technology Application (AHLTA) sustainment activities required until the modernized electronic health
record reaches full operational capability.
$22.8 million restoral of Budget Control Act (BCA) reductions for replacement and modernization of
critical healthcare equipment.
Exhibit PBA­19, Appropriation Highlights
DHP­5
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement




$10.0 million increase for AHLTA End User Devices (EUDs).
$7.5 million associated with the start of planned Health Artifact and Image Management Solution (HAIMS)
refresh activities.
$5.4 million for infrastructure technology refresh supporting the Medical Community of Interest
(MEDCOI).
$2.8 million associated with implementation of Enterprise Blood Management System ­ Donor module.
Program decreases include:




$16.0 million transfer to the Defense Information Systems Agency (DISA) to support the build­out of four
(4) additional Non­Classified Internet Protocol Routers (NIPR) Joint Regional Security Stack (JRSS),
upgrade to the Defense Information Systems Network (DISN), and the build­out of the Joint Management
Suite (JMS).
$2.1 million for a one­time Procurement increase for Health Information Technology Portfolio
Rationalization in FY 2015.
$1.7 million for Theater Medical Information Program ­ Joint (TMIP­J) Increment 2 obtaining a full
deployment decision. Remaining Procurement will transition to the Operational Medicine project for
train the trainer activities.
$1.4 million reduction associated with revised cost and schedule for iEHR/Defense Medical Information
Exchange (DMIX).
President’s Management Plan – Performance Metrics Requirements:
The DHP continues to refine existing performance measures and develop specific criterion
to determine and measure outputs/outcomes as compared with initial goals. Over the past
year the DHP continues the transition to the Quadruple Aim that is focused on a balanced
approach to overall performance to include not only production but outcome measures
related to medical readiness, a healthy population, positive patient experiences and
responsible management of health care costs.
Exhibit PBA­19, Appropriation Highlights
DHP­6
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement
• Individual Medical Readiness ­ This measure provides operational commanders,
Military Department leaders and primary care managers the ability to monitor the
medical readiness status of their personnel, ensuring a healthy and fit fighting
force medically ready to deploy. This represents the best­available indicator of
the medical readiness of the Total Force, Active Components and Reserve Components
prior to deployment.
• Beneficiary Satisfaction with Health Plan – An increase in the satisfaction with the
Health Plan indicates that actions being taken are improving the overall functioning
of the plan from the beneficiary perspective. Improvements represent positive
patient experiences with the health care benefit and services they receive through
the system. The goal is to improve overall satisfaction level to that of civilian
plans using a standard survey instrument.
• Medical Cost Per Member Per Year – Annual Cost Growth – The medical cost per member
per year looks at the overall cost of the Prime enrollees for the DHP. This tracks
all costs related to care delivered to enrollees. The objective is to keep the rate
of cost growth for the treatment of TRICARE enrollees to a level at or below the
Civilian health care plans rate increases at the national level. Currently the
measure provides insight to issues regarding unit cost, utilization management, and
Purchased care management. The metric has been enhanced to properly account for
differences in population demographics and health care requirements of the enrolled
population. Since enrollment demographics can vary significantly by Service, and
across time, it is important to adjust the measure. For example, as increasing
numbers of older individuals enroll, the overall average medical expense per
enrollee would likely increase. Conversely, as younger, healthy active duty enroll,
the overall average would likely decrease. Through the use of adjustment factors, a
comparison across Services and across time is made more meaningful.
Exhibit PBA­19, Appropriation Highlights
DHP­7
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement
Output related measures that influence Medical Cost Per Member Per Year:

Inpatient Production Target (Medicare Severity Adjusted Relative Weighted
Products, referred to as MS­RWPs) – Achieving the production targets ensures
that the initial plan for allocation of personnel and resources are used
appropriately in the production of inpatient workload.

Outpatient Production Target (Relative Value Units, referred to as RVUs) –
Achieving the production targets ensures that the initial plans for allocation
of personnel and resources are used appropriately in the production of
outpatient workload.
Below is reporting for FY 2014 related to the prior performance measure goals. The next
reporting period will focus on the measures related to the Quadruple Aim, and two output
measures related to production plan targets. The overall success of each area measured is
discussed below along with information related to continuation of reporting in future
documents:

Individual Medical Readiness – The Military Health System achieved the goal for the
Total Force Medical Readiness for FY 2014 with a score of 86% compared to the goal
of 85%. This is the first time the MHS has reported this high of an overall
performance level for the measure, and will have to take significant steps to ensure
that performance can be sustained. This measure will continue to be reported in
support of the Quadruple Aim.

Beneficiary Satisfaction with Health Plan – Satisfaction with Health Care Plan performance for FY
2014 exceeded the goal of 57 percent for the fiscal year. Continuous increases in enrollment and
improvement in the score demonstrates real progress for the program with respect to satisfying our
beneficiaries. While progress on this metric demonstrates program success, changes to the number of
individuals covered by the TRICARE Prime benefit over the next couple of years may result in a
decreased overall satisfaction with the Health Plan. This measure will continue to be reported in
support of the Quadruple Aim.
Exhibit PBA­19, Appropriation Highlights
DHP­8
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Introductory Statement

Inpatient Production Target (MS­RWPs) – For the most recent reported monthly data for FY 2014, the
MHS produced 215 thousand MS­RWPs against a target of 214 thousand MS­RWPs slightly above the target.
These numbers are based on the records reported to date, and will increase slightly as all records
are completed. This measure will continue to be reported as an output measure for the DHP.

Outpatient Production Target (RVUs) – With an increased emphasis on paying for performance, the
system has seen a renewed focus on production of outpatient care. For FY 2014, the system produced
78 million relative value units versus a goal of 81 million relative value units. The MHS failed to
achieve the goal for the year, but expects continued improvements in the coming years. Approximately
25 percent of the shortage is related to procedure weight changes affecting inappropriate weighting
of workload for some non­credential providers that was corrected in FY2014, but included in the
baseline and target when developed last year. Additionally, the MHS was unable to continue some
contracts and may be experiencing some of the declined utilization from the implementation of Patient
Medical Homes earlier than expected. This measure will continue to be reported as an output measure
for the DHP.

Medical Cost Per Member Per Year – Annual Cost Growth – The Year to Date performance estimate for FY
2014 is 2.6% vs goal of 2.8%. While final claims data are still lagging, the system was able to
achieve the goal during the fiscal year. A significant reason for keeping the low growth rates is
related to the lack of salary inflation increases for Department civilian employees, as well very
limited inflationary growth for Military. Additionally, while utilization increased slightly, it
remains below the utilization growth rates experienced in the past. The MHS continues to see
improvements related to changes made with respect to the outpatient prospective payments in Purchased
Care and Patient Centered Medical Home within Direct Care. The expectation is that the improvements
should continue into FY 2015 where the measure will continue to be reported.
Exhibit PBA­19, Appropriation Highlights
DHP­9
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Operation and Maintenance Funding
Total Obligational Authority
(Dollars in Thousands)
0130D
FY 20141/
Base + OCO
Defense Health Program
BUDGET ACTIVITY 01: OPERATION & MAINTENANCE
0130D
010
In­House Care
0130D
020
Private Sector Care
0130D
030
Consolidated Health Support
0130D
040
Information Management
0130D
050
Management Activities
0130D
060
Education and Training
0130D
070
Base Operations/Communications
TOTAL, BA 01: OPERATION & MAINTENANCE
BUDGET ACTIVITY 02: RDT&E
0130D
DEFENSE HEALTH PROGRAM
TOTAL, BA 02: RDT&E
BUDGET ACTIVITY 03: PROCUREMENT
0130D
DEFENSE HEALTH PROGRAM
TOTAL, BA 03:
1/ FY
(CSI)
2/ FY
3/ FY
FY 2015 Enacted2/
Base
OCO
Total
8,551,239 8,665,240 65,902 8,731,142 9,082,298 65,149 9,147,447
14,746,862 14,503,759 214,259 14,718,018 14,892,683 192,210 15,084,893
1,981,722 2,353,824 15,311 2,369,135 2,415,658
9,460 2,425,118
1,524,919 1,537,696
1,537,696 1,677,827
1,677,827
325,005
364,192
364,192
327,967
327,967
651,486
750,866 5,059
755,925
750,614
5,885
756,499
2,438,008 1,836,471
1,836,471 1,742,893
1,742,893
30,219,241 30,012,048 300,531 30,312,579 30,889,940 272,704 31,162,644
1,710,284 1,730,536
1,710,284 1,730,536
PROCUREMENT
FY 2016 Requested3/
Base
OCO
Total
705,764
705,764
308,413
308,413
0
0
1,730,536
1,730,536
980,101
980,101
0
0
980,101
980,101
0
0
308,413
308,413
373,287
373,287
0
0
373,287
373,287
Total Defense Health Program
32,635,289 32,050,997 300,531 32,351,528 32,243,328 272,704 32,516,032
2014 includes Overseas Contingency Operations (OCO) funding of 715.484M for O&M, Congressional Special Interests
of ­948.739M for O&M, 822.786M for RDT&E, and ­229.417M for Procurement
2015 includes CSI of ­1,001.261M for O&M, +1,076.115M for RDT&E
2016 reflects Requested amounts
Exhibit O­1, Funding by BA/AG/SAG (Budget Years)
DHP­11
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Price and Program Growth
Foreign
Currency
Rate Diff
FY 2014
Program
Price
Growth
Percent
Price
Growth
Program
Growth
Foreign
Currency
Rate Diff
FY 2015
Program
Price
Growth
Percent
Price
Growth
Program
Growth
FY 2016
Program
Civ Compensation
101 Exec, Gen’l & Spec Scheds
5,252,763
0
199 TOTAL CIV COMPENSATION
5,252,763
0
308 Travel of Persons
179,181
0
399 TOTAL TRAVEL
179,181
0
3,221
0
199
0
95
1.00%
52,529
574,871
5,880,163
0
1.23%
72,033
­178,474
5,773,722
52,529
574,871
5,880,163
0
72,033
-178,474
5,773,722
3,225
3,298
185,704
60
3,225
3,298
185,704
60
3,158
20,840
209,762
3,158
20,840
209,762
2.24%
72
2,404
5,697
0
­7.30%
2.01%
4
181
384
0
­7.29%
­416
785
6,066
­28
­220
0
1.05%
1
5,067
5,163
0
136
2.56%
132
­5,288
1,392
0
1.22%
17
784
2,193
7
0
3.47%
76
­33
2,236
46
46
0
­2.17%
­1
2
47
Travel
1.80%
1.70%
Supplies & Materials
401 DLA Energy (Fuel Products)
402 Service Fund Fuel
411 Army Supply
412 Navy Managed Supply, Matl
414 Air Force Consol Sust AG
(Supply)
416 GSA Supplies & Materials
0
0
0.00%
0
11,418
0
1.80%
205
1,549
13,172
188
1.70%
227
­86
13,501
417 Local Purch Supplies & Mat
11,442
0
1.79%
205
43,300
54,947
0
1.70%
934
186
56,067
422 DLA Mat Supply Chain (Medical)
19,400
0
­0.40%
­77
2,147
21,470
0
0.40%
499 TOTAL SUPPLIES & MATERIALS
47,167
0
427
55,478
103,072
188
502 Army Fund Equipment
4,984
0
1.26%
63
­4,487
560
0
503 Navy Fund Equipment
2,067
0
1.21%
25
­958
1,134
0
53,473
0
0.00%
0
­12,521
40,952
0
0.00%
9,210
0
0.69%
64
­5,173
4,101
0
1.00%
1.82%
1.70%
86
329
21,885
1,010
-4,325
99,945
0.00%
0
10
570
0.00%
0
21
1,155
0
788
41,740
41
­3,422
720
211
­1,630
11,018
252
-4,233
55,203
844
2,857
14,353
Equipment Purchases
505 Air Force Fund Equip
506 DLA Mat Supply Chain (Const &
Equip)
507 GSA Managed Equipment
599 TOTAL EQUIPMENT PURCHASES
4,459
0
74,193
0
22,144
0
81
7,897
12,437
0
233
-15,242
59,184
0
690
­12,182
10,652
0
DWCF Purchases
601 Army Industrial Operations
3.12%
7.92%
Exhibit OP­32, Summary of Price and Program Growth
DHP­13
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Price and Program Growth
Foreign
Currency
Rate Diff
FY 2014
Program
611 Navy Surface Warfare Ctr
614 Space & Naval Warfare Center
0
Price
Growth
Price
Percent Growth
0
0.00%
0
Program
Growth
812
FY 2015
Program
812
Foreign
Currency
Rate Diff
Price
Growth
Percent
0
1.48%
Price
Growth
12
Program
Growth
4
FY 2016
Program
828
54,175
0
1.28%
693
­45,335
9,533
0
1.62%
154
­101
9,586
631 Navy Base Support (NFESC)
1,590
0
0.69%
11
4,731
6,332
0
11.20%
709
­5,673
1,368
633 DLA Document Services
1,505
0
5.65%
85
885
2,475
0
­2.14%
­53
­502
1,920
634 Navy Base Support (NAVFEC)
34,938
0
4.96%
1,733
11,513
48,184
0
­0.34%
­164
­10,338
37,682
635 Navy Base Support (NAVFEC
Other Support Services)
647 DISA Enterprise Computing
Centers
671 DISA DISN Subscription
Services (DSS)
675 DLA Disposition Services
17,057
0
1.30%
221
30,088
47,366
0
0.00%
0
15,122
62,488
85,612
0
­0.74%
­633
3,613
88,592
0
­10.01%
­8,868
10,437
90,161
16,475
0
1.90%
313
­5,394
11,394
0
­9.29%
­1,058
1,789
12,125
677 DISA Telecomm Svcs ­
Reimbursable
679 Cost Reimbursable Purchase
680 Building Maint Fund Purch
691 DFAS Financial Operations
(Army)
692 DFAS Financial Operations
(Navy)
693 DFAS Financial Operations (Air
Force)
696 DFAS Financial Operation
(Other Defense Agencies)
699 TOTAL DWCF PURCHASES
0
0
0.00%
0
3
3
0
0.00%
0
0
3
597
0
7.71%
46
3,263
3,906
0
1.97%
77
­14
3,969
0
0
0.00%
0
979
979
0
1.63%
16
5
1,000
0
0
0.00%
0
37,846
37,846
0
2.28%
863
1,102
39,811
16,667
0
­10.39%
­1,732
2,277
17,212
0
1.32%
227
­1,075
16,364
6,781
0
1.42%
96
­6,230
647
0
3.09%
20
­29
638
0
0
0.00%
0
0
0
0
0.00%
0
2,867
2,867
6,012
0
1.76%
106
­4,016
2,102
0
5.61%
118
­267
1,953
263,553
0
1,629
22,853
288,035
0
-7,103
16,184
297,116
Transportation
706 AMC Channel Passenger
30,405
0
1.80%
547
­30,952
0
0
0.00%
0
400
400
719 SDDC Cargo Ops­Port hndlg
627
0
­22.17%
­139
705
1,193
0
38.81%
463
­435
1,221
724 MSC Afloat Prepositioning DLA
201
0
2.99%
6
­207
0
0
0.00%
0
0
0
Exhibit OP­32, Summary of Price and Program Growth
DHP­14
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Price and Program Growth
771 Commercial Transport
799 TOTAL TRANSPORTATION
Foreign
Price
FY 2014
Currency
Growth
Price
Program
Rate Diff
Percent Growth
13,556
0
1.81%
245
Foreign
Currency
Rate Diff
Price
Growth
Percent
0
1.70%
Program
Growth
29,920
FY 2015
Program
43,721
659
-534
44,914
0
675
28,688
96,839
0
1.23%
Price
Growth
743
Program
Growth
2,285
FY 2016
Program
46,749
1,206
2,250
48,370
1,187
­241
97,785
44,789
0
901 Foreign National Indirect Hire
(FNIH)
902 Separation Liab (FNIH)
67,476
0
1.00%
4,899
0
1.02%
50
­50
4,899
0
1.25%
61
­61
4,899
912 Rental Payments to GSA (SLUC)
54,582
0
1.80%
982
­29,643
25,921
0
1.70%
441
­291
26,071
913 Purchased Utilities (Non­Fund)
205,853
0
1.80%
3,705
7,842
217,400
0
1.70%
3,694
32,672
253,766
914 Purchased Communications (Non­
Fund)
915 Rents (Non­GSA)
37,449
0
1.80%
674
22,248
60,371
0
1.70%
1,026
­708
60,689
43,467
0
1.80%
783
­7,281
36,969
0
1.70%
628
­1,643
35,954
Other Purchases
917 Postal Services (U.S.P.S)
3,455
0
1.79%
62
­232
3,285
0
1.70%
56
2
3,343
920 Supplies & Materials (Non­
Fund)
921 Printing & Reproduction
937,751
0
3.35%
31,371
­277,284
691,838
416
2.97%
20,553
48,211
761,018
23,536
0
1.81%
425
­2,847
21,114
0
1.70%
358
2,232
23,704
922 Equipment Maintenance By
Contract
923 Facilities Sust, Rest, & Mod
by Contract
924 Pharmaceutical Drugs
169,319
0
1.80%
3,048
­24,131
148,236
0
1.70%
2,520
19,602
170,358
602,063
0
1.80%
10,837
­99,650
513,250
246
1.70%
8,729
82,165
604,390
3,780,210
0
3.70% 139,867
41,302
3,961,379
0
3.70%
146,571
­457,023
3,650,927
497,610
0
3.19%
15,890
­135,188
378,312
49
3.17%
11,998
48,995
439,354
0
0
0.00%
0
40
40
0
2.50%
1
0
41
1,071
0
1.87%
20
1,247
2,338
0
1.71%
40
­1,335
1,043
925 Equipment Purchases (Non­Fund)
926 Other Overseas Purchases
930 Other Depot Maintenance (Non­
Fund)
932 Mgt Prof Support Svcs
225,572
0
1.80%
4,061
23,768
253,401
0
1.70%
4,307
22,996
280,704
933 Studies, Analysis & Eval
40,143
0
1.80%
724
12,473
53,340
0
1.70%
907
­386
53,861
934 Engineering & Tech Svcs
12,474
0
1.80%
224
­12,200
498
0
1.61%
8
7,833
8,339
3,694
0
2.22%
82
­1,422
2,354
0
­7.31%
­172
278
2,460
937 Locally Purchased Fuel (Non­
Fund)
Exhibit OP­32, Summary of Price and Program Growth
DHP­15
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Price and Program Growth
955 Other Costs (Medical Care)
957 Other Costs (Land and
Structures)
959 Other Costs (Insurance
Claims/Indmnties)
960 Other Costs (Interest and
Dividends)
964 Other Costs (Subsistence and
Support of Persons)
986 Medical Care Contracts
Foreign
Price
FY 2014
Currency
Growth
Price
Program
Rate Diff
Percent Growth
712,135
0
4.44% 31,591
Program
Growth
­62,134
FY 2015
Program
681,592
Foreign
Price
Currency
Growth
Rate Diff
Percent
1,568
4.72%
Price
Growth
32,270
Program
Growth
20,510
FY 2016
Program
735,940
1,006,908
0
1.80%
18,124
­545,198
479,834
1,433
1.70%
8,182
­149,361
340,088
3
0
0.00%
0
­3
0
0
0.00%
0
0
0
1,429
0
1.82%
26
­103
1,352
0
1.70%
23
2
1,377
5,554
0
1.80%
100
­2,886
2,768
0
1.70%
47
1,004
3,819
13,847,985
0
3.70% 512,376
­658,467
13,701,894
2,135
3.70%
507,050
463,002
14,674,081
462,033
0
1.80%
8,317
­102,138
368,212
0
1.70%
6,261
­3,115
371,358
58,369
0
1.80%
1,051
­23,239
36,181
0
1.70%
615
2,327
39,123
989 Other Services
577,778
0
1.80%
10,401
140,182
728,361
565
1.70%
12,392
­27,780
713,538
990 IT Contract Support Services
973,984
0
1.80%
17,531
­12,517
978,998
0
1.70%
16,643
52,151
1,047,792
793
0
1.01%
8
­801
0
0
0.00%
0
0
0
TOTAL OTHER PURCHASES
24,357,595
0
813,005
-1,719,624
23,450,976
6,412
786,396
162,038
24,405,822
Total
30,219,241
0
871,707
-1,078,900
30,012,048
6,660
856,952
14,280
30,889,940
987 Other Intra­Govt Purch
988 Grants
998 Other Costs (SOCOM Only)
Exhibit OP­32, Summary of Price and Program Growth
DHP­16
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Civilian End Strength (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Memo: Reimbursable Civilians Included
Active Military Average Strength (A/S) (Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Memo: Reimbursable Civilians Included
Contractor FTEs (Total)
FY 2014
84,452
31,405
53,047
61,391
58,982
1,007
59,989
1,402
213
85,033
31,670
53,363
60,556
58,324
935
59,259
1,297
115
FY 2015
84,564
31,500
53,064
67,553
64,910
972
65,882
1,671
218
84,509
31,453
53,056
67,221
64,647
945
65,592
1,629
219
22,347
22,494
Change
FY 2016
FY 2015/2016
84,104
­460
31,396
­104
52,708
­356
66,264
­1,289
63,621
­1,289
972
0
64,593
­1,289
1,671
0
218
0
84,336
­173
31,449
­4
52,887
­169
65,012
­2,209
62,438
­2,209
945
0
63,383
­2,209
1,629
0
219
0
23,503
1,009
Personnel Summary Explanations
Note: Some numbers do not add due to rounding.
Exhibit PB­31R, Personnel Summary
DHP­17
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Physicians' Comparability Allowance Worksheet
Physicians’ Comparability Allowance (PCA) Worksheet
[Department: Component] MEDCOM: Army
Table 1
PY 2014
(Actual)
1) Number of Physicians Receiving PCAs
2) Number of Physicians with One-Year PCA Agreements
3) Number of Physicians with Multi-Year PCA Agreements
4) Average Annual PCA Physician Pay (without PCA payment)
5) Average Annual PCA Payment
Category I Clinical Position
Category II Research Position
6) Number of Physicians
Category III Occupational Health
Receiving PCAs by
Category IV-A Disability Evaluation
Category (non-add)
Category IV-B Health and Medical Admin.
*FY 2016 data will be approved during the FY 2017 Budget cycle.
7)
10
0
10
160052
34540
0
9
0
0
1
CY 2015
(Estimates)
10
0
10
160052
34540
0
9
0
0
1
BY 2016*
(Estimates)
10
0
10
160052
34540
0
9
0
0
1
If applicable, list and explain the necessity of any additional physician categories designated by your agency (for categories other than I
through IV-B). Provide the number of PCA agreements per additional category for the PY, CY and BY.
N/A. All other categories are in PDPP.
8) Provide the maximum annual PCA amount paid to each category of physician in your agency and explain the reasoning for these amounts by
category.
Max PCA for Category II = $51,141; Category IVB = $30,671
9) Explain the recruitment and retention problem(s) for each category of physician in your agency
(this should demonstrate that a current need continues to persist).
(Please include any staffing data to support your explanation, such as number and duration of unfilled positions and
number of accessions and separations per fiscal year.)
PCA has negated all our retention problems. All our employees receiving PCA are multi-year agreements. PCA allows the
Command to craft compensation packages that are competitive with the local market points in the area.
DoD Physicians Comparability Allowance (PCA) Worksheet
DHP­19
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Physicians' Comparability Allowance Worksheet
10) Explain the degree to which recruitment and retention problems were alleviated in your agency through the use of PCAs in the prior fiscal
year.
(Please include any staffing data to support your explanation, such as number and duration of unfilled positions and
number of accessions and separations per fiscal year.) Because of the use of PCA we were able to retain our
current workforce. Without PCA our losses, other than normal attrition would have increased and impacted our
ability to accomplish our mission. PCA allows for competitive compensation packages. Furlough and the hiring
freeze had more impact on gains and losses.
11) Provide any additional information that may be useful in planning PCA staffing levels and amounts in your agency.
Because of PDPP PCA use has been reduced to a minimal level. Sequestration may also reduce use and
need for PCA if reductions in workforce and structure are mandated for FY 2015 and into the future.
DoD Physicians Comparability Allowance (PCA) Worksheet
DHP­20
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Funding Increases and Decreases
O&M (01)
FY 2015 President’s Budget Request
31,031,911
In­House Care
Private Sector Care
Consolidated Health Support
Information Management
Management Activities
Education and Training
Base Operations/Communications
RDT&E
Procurement
8,799,086
15,412,599
2,462,096
1,557,347
366,223
750,866
1,683,694
Budget Activity
RDT&E (02)
Procurement (03)
654,594
­1,019,863
­1,001,261
0
0
­18,602
1,075,942
1,076,115
FY 2015 Appropriated Amount
30,012,048
In­House Care
Private Sector Care
Consolidated Health Support
Information Management
Management Activities
Education and Training
Base Operations/Communications
RDT&E
Procurement
2. OCO and Other Supplemental Enacted
3. Fact­of­Life Changes
a) Functional Transfers
1. Transfers In
2. Transfers Out
b) Technical Adjustments
1. Increases
2. Decreases
c) Emergent Requirements
308,413
31,994,918
308,413
8,799,086
15,412,599
2,462,096
1,557,347
366,223
750,866
1,683,694
654,594
308,413
654,594
1. Congressional Adjustments
a) Distributed Adjustments
b) Undistributed Adjustments
c) Adjustments to Meet Congressional Intent
d) General Provisions
DHP Total
0
­173
0
0
0
56,079
74,854
0
0
­18,775
1,730,536
308,413
32,050,997
308,413
8,665,240
14,503,759
2,353,824
1,537,696
364,192
750,866
1,836,471
1,730,536
308,413
8,665,240
14,503,759
2,353,824
1,537,696
364,192
750,866
1,836,471
1,730,536
300,531
0
0
300,531
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Exhibit PB­31D, Summary of Increases and Decreases
DHP­21
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Funding Increases and Decreases
1.
2.
Program Increases
a) One­Time Costs
b) Program Growth
Program Reductions
a) One­Time Costs
b) Program Decreases
FY 2015 Baseline Funding
In­House Care
Private Sector Care
Consolidated Health Support
Information Management
Management Activities
Education and Training
Base Operations/Communications
RDT&E
Procurement
4. Reprogrammings
a) Increases
b) Decreases
5. Less: OCO and Other Supplemental Appropriations and Reprogrammings
(Items 2 and 4)
FY 2015 Normalized Current Estimate
In­House Care
Private Sector Care
Consolidated Health Support
Information Management
Management Activities
Education and Training
Base Operations/Communications
RDT&E
Procurement
6. Price Change
7. Functional Transfers
a) Transfers In
O&M (01)
0
0
0
0
0
0
30,312,579
Budget Activity
RDT&E (02)
Procurement (03)
0
0
0
0
0
0
0
0
0
0
0
0
1,730,536
DHP Total
0
0
0
0
0
0
308,413
32,351,528
308,413
8,731,142
14,718,018
2,369,135
1,537,696
364,192
755,925
1,836,471
1,730,536
308,413
8,731,142
14,718,018
2,369,135
1,537,696
364,192
755,925
1,836,471
1,730,536
0
0
0
0
0
0
0
0
0
0
0
0
­300,531
0
0
­300,531
30,012,048
1,730,536
308,413
32,050,997
308,413
8,665,240
14,503,759
2,353,824
1,537,696
364,192
750,866
1,836,471
1,730,536
308,413
8,665,240
14,503,759
2,353,824
1,537,696
364,192
750,866
1,836,471
1,730,536
863,613
29,419
8,151
901,183
­2,428
0
0
0
0
0
­2,428
0
Exhibit PB­31D, Summary of Increases and Decreases
DHP­22
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Funding Increases and Decreases
b)
Transfers Out
8. Program Increases
a) Annualization of New FY 2015 Program
b) One­Time FY 2016 Increases
c) Program Growth in FY 2016
O&M (01)
­2,428
Budget Activity
RDT&E (02)
Procurement (03)
0
0
DHP Total
­2,428
2,160,686
0
1,397,332
763,354
370,000
0
0
370,000
78,032
0
78,032
2,608,718
0
1,397,332
1,211,386
9. Program Decreases
a) Annualization of FY 2015 Program Decreases
b) One­Time FY 2015 Increases
c) Program Decreases in FY 2016
­2,143,978
0
­182,343
­1,961,635
­1,149,854
0
0
­1,149,854
­21,309
0
0
­21,309
­3,315,141
0
­182,343
­3,132,798
FY 2016 Budget Request
30,889,940
980,101
373,287
32,243,328
373,287
9,082,298
14,892,683
2,415,658
1,677,827
327,967
750,614
1,742,893
980,101
373,287
In­House Care
Private Sector Care
Consolidated Health Support
Information Management
Management Activities
Education and Training
Base Operations/Communications
RDT&E
Procurement
9,082,298
14,892,683
2,415,658
1,677,827
327,967
750,614
1,742,893
980,101
Exhibit PB­31D, Summary of Increases and Decreases
DHP­23
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
I. Description of Operations Financed: This Budget Activity Group provides the delivery
of patient care in the Continental United States (CONUS) and Outside the Continental
United States (OCONUS). This program includes the following:
Care in Department of Defense Medical Centers, Hospitals and Clinics ­ Resources medical
care in CONUS and OCONUS facilities which are staffed and equipped to provide inpatient
and outpatient care for both surgical and medical conditions for Military Health System
beneficiaries.
Dental Care ­ Resources dental care and services in CONUS and OCONUS for authorized
personnel through the operation of hospital departments of dentistry, installation dental
clinics and regional dental activities.
Pharmaceuticals ­ Resources pharmaceuticals specifically identified and measurable to the
provision of pharmacy services in CONUS and OCONUS facilities.
II. Force Structure Summary:
The In­House Care Budget Activity Group includes staffing to provide medical and dental
care in military facilities which provide the full range inpatient and ambulatory medical
and dental care services. In addition to medical and dental care, this Budget Activity
Group also includes medical center laboratories, substance abuse programs, facility on­
the­job training/education programs and federal health care sharing agreements. This
Budget Activity Group excludes operation of management headquarters for TRICARE Regional
Offices, deployable medical and dental units and health care resources devoted
exclusively to teaching.
In­House Care
IHC­25
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. MEDCENs, Hospitals &
Clinics (CONUS)
2. MEDCENs, Hospitals &
Clinics (OCONUS)
3. Pharmaceuticals (CONUS)
4. Pharmaceuticals
(OCONUS)
5. Dental Care (CONUS)
6. Dental Care (OCONUS)
Total
FY 2014
Actual
6,136,439
Budget
Request
6,111,692
Current
Estimate
Amount
Percent Appropriated
­107,131
­1.8
6,004,561 6,004,561
FY 2016
Estimate
6,442,816
427,103
472,527
0
0.0
472,527
472,527
503,688
1,392,576
119,662
1,527,596
142,889
­26,715
0
­1.8
0.0
1,500,881
142,889
1,500,881
142,889
1,480,323
132,683
428,553
46,906
8,551,239
481,951
62,431
8,799,086
0
0
-133,846
0.0
0.0
-1.5
481,951
62,431
8,665,240
481,951
62,431
8,665,240
461,647
61,141
9,082,298
1. FY 2014 actuals include $352.2M for Overseas Contingency Operations (OCO).
2. FY 2014 does not reflect Department of Defense (DoD) Medicare­Eligible Retiree Health Care Fund (MERHCF) of $1,361.3M (O&M only).
3. FY 2014 Omnibus Reprogramming ­$255.0M (In­House Care, Base) to Procurement, and ­$14.9M (In­House Care, OCO) to DoD. Total
Omnibus Reprogramming from the In­House Care Budget Activity Group was ­$269.9M.
4. FY 2015 estimate excludes $65.9M for OCO.
5. FY 2015 does not reflect DoD MERHCF of $1,400.7M (O&M only).
6. FY 2016 request excludes OCO.
7. FY 2016 does not reflect DoD MERHCF of $1,444.0M (O&M only).
In­House Care
IHC­26
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
8,799,086
­118,116
Change
FY 2015/FY 2016
8,665,240
­15,730
8,665,240
8,665,240
65,902
8,731,142
­65,902
8,665,240
203,667
­818
214,209
9,082,298
In­House Care
IHC­27
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) One­Time Congressional Increase for SOCOM Behavioral
Health.
2) One­Time Congressional Increase for CVN­73 Refueling
and Remodeling.
3) One­Time Congressional Decrease for Army Identified
Excess.
4) One­Time Congressional Decrease for Benefit Reform
Proposal (Consolidation of TRICARE Prime).
5) One­Time Congressional Decrease for Pharmacy Benefit
Reform Proposal.
6) One­Time Congressional Decrease for NICOE Satellite
Overstated Growth.
7) One­Time Congressional Decrease for FECA Expense
Transfer not properly accounted for.
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
1) Section 8080 ­ Decrease for Favorable Foreign
Currency Exchange Rates.
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
a. OCO and Other Supplemental Requested
1) OCO
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
Amount
Totals
8,799,086
­133,846
14,800
880
­76,000
­30,000
­26,715
­704
­377
­15,730
8,665,240
65,902
65,902
8,731,142
8,731,142
In­House Care
IHC­28
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
a. Transfers In
b. Transfers Out
1) Transfer of Advanced Life Support Services (ALS) from
Naval Hospital (NH) Lemoore to Commander, Navy Region
Southwest (CNRSW) Fire and Emergency Services (F&ES):
Transfers funding from the Defense Health Program to
Navy for provision of ALS Services. Naval Air
Station Lemoore F&ES, organized as part of the CNRSW
F&ES, will provide ALS ambulance services to areas
previously covered by the ALS contract service
provided by NH Lemoore. The action ensures
continuation of required capabilities while
eliminating duplication of effort and providing more
efficient use of resources.
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
1) Reversal of FY 2015 One­Time Congressional Decrease
(Army Identified Excess).
2) Reversal of FY 2015 One­Time Congressional Decrease
(Benefit Reform ­ Consolidation of TRICARE Prime).
3) Reversal of FY 2015 One­Time Congressional Decrease
(Pharmacy Benefit Reform).
4) Reversal of FY 2015 General Provisions (Section 8080
­ Favorable Foreign Currency Exchange Rates).
Amount
Totals
­65,902
8,665,240
203,667
­818
­818
385,273
77,748
30,690
27,329
16,092
In­House Care
IHC­29
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
5) Reversal of FY 2015 One­Time Congressional Decrease
(NICOE Satellite Overstated Growth).
6) Reversal of FY 2015 One­Time Congressional Decrease
(FECA Expense Transfer­­ Not Properly Accounted For).
c. Program Growth in FY 2016
1) Equipment ­ Air Force Medical Service (AFMS):
Internal funding realignment by the AFMS from
pharmacy to equipment to improve the organization's
life­cycle replacement rate. The FY 2015 In­House
Care equipment baseline funding is $334.1M.
2) FY 2015 Health Benefit Reform ­ Refills of
Maintenance Medications Through Military Treatment
Facility (MTF) Pharmacies or National Mail­Order
Pharmacy Program:
Provides additional pharmacy funds for projected
increased demand within the MTF pharmacies based on a
policy change outlined in the FY 2015 National
Defense Authorization Act, Section 702 which requires
eligible beneficiaries to refill non­generic
prescription maintenance medications through MTF
pharmacies (In­House Care Budget Activity Group) or
the National Mail­Order Pharmacy Program (Private
Sector Care Budget Activity Group). The FY 2015 In­
House Care pharmacy baseline funding is $1,643.8M.
3) FY 2016 Health Benefit Reform ­ Pharmacy Co­Pays:
Provides additional pharmacy funds for projected
increased demand within the MTF pharmacies due to an
expected shift in beneficiaries' preference for MTF
pharmacies as a result of proposed legislation
increasing retail pharmacy co­pays. The FY 2015 In­
Amount
720
Totals
386
45,659
36,490
30,528
In­House Care
IHC­30
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
House Care pharmacy baseline funding is $1,643.8M.
4) FY 2016 Health Benefit Reform ­ Consolidated Health
Plan Proposal:
Start­up costs to consolidate the TRICARE health plan
into a single plan to replace the current TRICARE
Prime, Standard and Extra health insurance­like
plans. This new plan will allow for better management
of healthcare by building a shared commitment with
our beneficiaries by providing greater choice and
flexibility in their healthcare benefit. The FY 2015
In­House Care Continental United States (CONUS)
Medical Care baseline funding is $6,004.6M. The FY
2015 In­House Care baseline staffing is 48,874
civilian FTEs and 13,678 contractors.
5) Healthcare Services ­ Air Force Medical Service
(AFMS):
Realigns funding from the IM/IT and Education and
Training Budget Activity Groups to purchase
approximately 180 contract providers and support
staff to enable the AFMS to maintain services at
Military Treatment Facilities, thereby mitigating the
impact of patients seeking care in the private
sector. The FY 2015 Air Force In­House Care baseline
funding is $1,433.8M. The FY 2015 Air Force In­House
Care baseline staffing is 4,925 civilian FTEs and
2,875 contractors.
6) Clinical Pharmacists and Telehealth Services:
Realigns funding from the Consolidated Health Support
Budget Activity Group to the In­House Care Budget
Activity Group for contract clinical pharmacists and
Amount
Totals
29,719
18,618
17,250
In­House Care
IHC­31
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
equipment to enhance the capability to more
efficiently provide telehealth consultations over a
greater geographic area. The FY 2015 Army In­House
Care baseline funding is $4,356.9M. The FY 2015 Army
In­House Care baseline staffing is 32,343 civilian
FTEs and 4,945 contractors.
7) Increased Supply Requirements ­ Air Force Medical
Service (AFMS):
Provides additional funding for supplies to match the
level required to support healthcare services based
on an AFMS reconciliation of budget requirements
against actual execution. The FY 2015 Air Force In­
House Care supplies baseline funding is $39.7M.
8) One More Civilian Paid Day:
Adjusts civilian payroll for one additional pay day
in FY 2016. The FY 2015 In­House Care civilian pay
baseline funding is $4,138.4M. The FY 2015 In­House
Care baseline staffing is 48,874 civilian FTEs.
9) Travel:
This funding is for emerging world­wide healthcare
support requirements, continuing education for
clinical currency of DoD mission, and Military Health
System staff credentialing requirements. The FY 2015
In­House Care travel baseline funding is $64.5M.
10) Initial Outfitting and Transition (IO&T):
Incremental funding to support IO&T requirements for
programmed projects such as the Pope Dental Clinic
Repair at Fort Bragg, NC; Clinic Modernization at
Minot Air Force Base, ND; Restoration of Pharmacies
at Naval Hospital, Bremerton, WA; Dental/Medical
Amount
Totals
17,167
16,090
8,613
7,619
In­House Care
IHC­32
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Clinic Replacement at Spandahlem Air Base, Germany;
Labor & Delivery Modernization at Eglin Air Force
Base, FL; and Patient Centered Medical Home
Reconfiguration at Fort Benning, GA. The FY 2015 In­
House Care IO&T baseline funding is $220.0M.
11) Tri­Service Workflow (TSWF) and Content Advisory
Group (CAG):
Funds expansion of ongoing TSWF and CAG efforts to
standardize the provision of quality health care
services and the associated electronic clinical
documentation through standardized electronic patient
documentation templates. These standardized
templates simultaneously enhance provider efficiency
and patient safety by influencing provider workflow,
while standardizing the clinical notes to facilitate
continuity of care. By directing patient care through
evidence based guidelines, the templates advocate for
appropriate patient care and result in a cost
avoidance to the Military Health System. Clinical
teams in the outpatient setting utilizing these
templates have shown better clinical results in
mental health, MRIs, heart attack and stroke,
reducing unnecessary hospitalization, procedures and
improving patient compliance resulting in significant
cost avoidance. The FY 2015 Continental United
States (CONUS) Medical Care baseline funding is
$6,004.6M. The FY 2015 In­House Care baseline
staffing is 48,874 civilian FTEs and 13,678
contractors.
9. Program Decreases
Amount
Totals
4,555
­171,064
In­House Care
IHC­33
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
1) Reversal of FY 2015 One­Time Congressional Increase
(SOCOM Behavioral Health).
2) Reversal of FY 2015 One­Time Congressional Increase
(CVN­73 Refueling and Remodeling).
c. Program Decreases in FY 2016
1) Pharmacy Realignment ­ Air Force Medical Service
(AFMS):
Internal realignments by the AFMS within the In­House
Care Budget Activity Group from pharmacy to equipment
and medical care contracts in support of direct
patient care. The FY 2015 Air Force In­House Care
pharmacy baseline funding is $532.9M.
2) Defense Health Agency Shared Services' Savings ­
Pharmacy and Medical Logistics (MEDLOG):
Savings of $11.8M due to the Pharmacy Shared Service
(from centralized drug purchasing rules, formulary
management, suspending coverage of newly approved FDA
drugs and centralization of pharmacy automation
contracts); and $9.2M in savings due to the MEDLOG
Shared Service (from a focus on Supply
Management,Equipment Management and MEDLOG Services).
The consolidation of like services across the
Military Health System will produce savings by
reducing redundancies and consolidating key
functional and business support areas. The FY 2015
Defense Health Program In­House Care baseline funding
is $6,477.1M. The FY 2015 In­House Care baseline
staffing is 48,874 civilian FTEs and 13,678
Amount
Totals
­15,140
­900
­99,687
­21,012
In­House Care
IHC­34
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
contractors.
3) Support Operation of Defense Health Agency Shared
Service ­ Health Information Technology (HIT):
Realigns funding to the IM/IT Budget Activity Group
in support of the organization of HIT. Funding is
realigned for supplies, travel and contract support
related to Information Management that transitions
from the Components to the Defense Health Agency to
enable the Shared Service to achieve the planned cost
reductions. The FY 2015 In­House Care baseline
funding is $6,477.1M. The FY 2015 In­House Care
baseline staffing is 48,874 civilian FTEs and 13,678
contractors.
4) Temporary Disability Retirement List (TDRL):
Realigns funding to the Consolidated Health Support
Budget Activity Group to expedite service member
medical status determinations for those members that
have been placed on the TDRL due to a long­lasting or
permanent change from a wound, illness or injury by
reducing the cycle time of the two evaluation boards
reviewing a Service member's case file documentation.
A Medical Evaluation Board (MEB) will review the
Service member's record to decide if he/she meets
medical retention standards. After the MEB, a
Physical Evaluation Board will be convened to
determine the Service member's disposition—return to
duty, separation or retirement, either permanent or
temporary.
The FY 2015 In­House Care baseline
funding is $6,477.1M. The FY 2015 In­House Care
baseline staffing is 48,874 civilian FTEs and 13,678
Amount
Totals
­17,799
­7,521
In­House Care
IHC­35
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
contractors.
5) Traumatic Brain Injury/Psychological Health (TBI/PH)
and Wounded, Ill and Injured (WII):
Resource requirements have decreased for the TBI/PH
and WII programs. Current data shows the number of
redeployments have dropped by 26% with a
corresponding decrease in associated workload. The
FY 2015 In­House Care baseline funding is $6,477.1M.
The FY 2015 In­House Care baseline staffing is 48,874
civilian FTEs and 13,678 contractors.
6) Civilian Human Resources Service Center (CHRSC):
Realigns funding from Navy's ­ Defense Health Program
(Bureau of Medicine and Surgery) In­House Care Budget
Activity Group to the Defense Health Agency ­
National Capital Region Medical Directorate's Base
Operations/Communications Budget Activity Group in
support of the CHRSC. The FY 2015 Continental United
States (CONUS) Medical Care baseline funding is
$6,004.6M. The FY 2015 In­House Care baseline
staffing is 48,874 civilian FTEs and 13,678
contractors.
7) 20% Headquarters Reduction:
Continuation of incremental 20% reduction to Defense
Health Program headquarters in compliance with the
Department of Defense July 31, 2013 memorandum, "20%
Headquarters Reduction," signed by the Deputy
Secretary of Defense. For the In­House Care Budget
Activity Group, the reductions are primarily in
contract personnel. The FY 2015 Continental United
States (CONUS) Medical Care baseline funding is
Amount
Totals
­6,290
­1,600
­1,007
In­House Care
IHC­36
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
$6,004.6M. The FY 2015 In­House Care baseline
staffing is 48,874 civilian FTEs and 13,678
contractors.
8) Support Operation of Defense Health Agency Shared
Service ­ Medical Logistics (MEDLOG):
Realigns funding to the Consolidated Health Support
Budget Activity Group in support of the MEDLOG Shared
Service. Funding is realigned to support the
transition of one civilian FTE to the Shared Service.
The FY 2015 In­House Care baseline funding is
$6,477.1M. The FY 2015 In­House Care baseline
staffing is 48,874 civilian FTEs and 13,678
contractors.
FY 2016 Budget Request
Amount
Totals
­108
9,082,298
In­House Care
IHC­37
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
IV. Performance Criteria and Evaluation Summary:
Population by Service ­ World Wide*
FY 2016
Change
Change
FY
2014/2015
FY
2015/2016
FY 2014
FY 2015
1,839,785
1,753,268
1,717,596
­86,517
­35,672
67,821
66,328
65,795
­1,493
­533
Air Force
891,788
855,272
858,520
­36,516
3,248
Marine Corps
442,367
431,459
429,337
­10,908
­2,122
Navy
855,098
822,092
828,555
­33,006
6,463
Navy Afloat
253,485
250,473
254,677
­3,012
4,204
20,924
28,356
30,154
7,432
1,798
4,371,268
4,207,248
4,184,634
­164,020
­22,614
Average Eligible Population
Catchment Area
Army
Coast Guard
Other/Unknown
Subtotal
In­House Care
IHC­38
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
IV. Performance Criteria and Evaluation Summary:
FY 2016
Change
FY
2014/2015
Change
FY
2015/2016
FY 2014
FY 2015
2,028,198
1,972,396
1,968,613
­55,802
­3,783
145,281
142,140
141,321
­3,141
­819
1,710,269
1,661,999
1,670,693
­48,270
8,694
Marine Corps
301,218
290,426
290,338
­10,792
­88
Navy
893,654
864,168
869,017
­29,486
4,849
Navy Afloat
53,185
52,590
53,443
­595
853
Other/Unknown
31,406
38,986
40,878
7,580
1,892
5,163,211
5,022,705
5,034,303
­140,506
11,598
Non­Catchment Area
Army
Coast Guard
Air Force
Subtotal
In­House Care
IHC­39
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
IV. Performance Criteria and Evaluation Summary:
FY 2016
Change
FY
2014/2015
Change
FY
2015/2016
FY 2014
FY 2015
3,867,983
3,725,664
3,686,209
­142,319
­39,455
213,102
208,468
207,116
­4,634
­1,352
2,602,057
2,517,271
2,529,213
­84,786
11,942
743,585
721,885
719,675
­21,700
­2,210
1,748,752
1,686,260
1,697,572
­62,492
11,312
306,670
303,063
308,120
­3,607
5,057
52,330
67,342
71,032
15,012
3,690
Total Average Eligible Population
Army
Coast Guard
Air Force
Marine Corps
Navy
Navy Afloat
Other/Unknown
Total
9,534,479
9,229,953 9,218,937
­304,526
­11,016
*Note: The data are derived from DEERS (December 2014). Numbers may not sum to totals due to
rounding.
DHP Requirements (in millions of
dollars)
Beneficiaries (000's)
Enrollees (000's)
30,219.2
30,012.0
30,889.9
­207
878
9,534
3,231
9,230
3,390
9,219
3,429
­304
159
­11
39
In­House Care
IHC­40
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
IV. Performance Criteria and Evaluation Summary:
Direct Care System Workload*
FY 2014
Inpatient Admissions, Non­Weighted
(SIDR Dispositions­All)
Inpatient Admissions, Weighted (MS­DRG
RWPs, Non Mental Health)
Inpatient Admissions, Occupied Bed Days
(Mental Health Only)
Average length of Stay (All Bed Days/
All Dispositions­All Diagnosis)
Ambulatory Visits, Non­Weighted
(Encounters, CAPER)
Ambulatory Visits, Weighted (Adj
Provider Aggregate RVUs, CAPER)
Ambulatory Procedures, Weighted
(Aggregate Weight APCs, CAPER)
Pharmacy (Number of Prescriptions
Filled)
FY 2015
FY 2016
Change
FY
2014/2015
Change
FY
2015/2016
258,261
244,900
247,084
­13,361
2,185
207,956
215,050
217,067
7,094
2,018
87,259
89,297
91,795
2,038
2,498
3.15
3.03
3.07
­0.12
0.04
38,188,888
39,099,293
39,573,218
910,405
473,925
80,074,777
84,396,247
85,369,983
4,321,471
973,736
11,006,494
10,548,774
10,607,991
­457,721
59,217
47,471,897
47,726,048
47,648,773
254,151
­77,275
In­House Care
IHC­41
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
IV. Performance Criteria and Evaluation Summary:
Dental Workload (Dental Weighted Values
(DWVs)*
Change
Change
FY
2015/2016
­578,476
FY 2014
12,218,127
FY 2015
13,740,506
FY 2016
13,162,030
FY
2014/2015
1,522,379
2,932,028
3,902,529
3,821,746
970,501
­80,783
15,150,155
17,643,035
16,983,776
2,492,880
­659,259
Active Duty
9,685,520
10,892,336
10,433,768
1,206,816
­458,568
Non­Active Duty
2,532,607
2,848,170
2,728,262
315,563
­119,908
12,218,127
13,740,506
13,162,030
1,522,379
­578,476
2,015,363
2,682,448
2,626,921
667,085
­55,527
916,665
1,220,081
1,194,825
303,416
­25,256
CONUS
OCONUS
Total DWVs
CONUS
Total CONUS
OCONUS
Active Duty
Non­Active Duty
Total OCONUS
2,932,028
3,902,529
3,821,746
970,501
­80,783
*Note: (1) FY 2014 Direct Care Workload data are from M2 and FY 2015­2016 data are from Service
Business Plans; (2) Dental Workload data provided by Service Dental Treatment Commands.
In­House Care
IHC­42
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
V. Personnel Summary
45,674
16,765
28,909
45,851
Change
FY 2014/
FY 2015
­677
­153
­524
­179
Change
FY 2015/
FY 2016
­354
­124
­230
­516
16,966
29,401
48,874
47,225
609
47,834
1,040
207
86.3
16,827
29,024
48,059
46,396
609
47,005
1,054
207
87.3
­50
­129
5,286
5,035
36
5,071
215
104
1.2
­139
­377
­815
­829
0
­829
14
0
1.0
13,678
13,105
225
­573
FY 2014
FY 2015
FY 2016
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Memo: Reimbursable Civilians Included
Average Annual Civilian Salary ($ in
thousands)
46,705
17,042
29,663
46,546
46,028
16,889
29,139
46,367
17,016
29,530
43,588
42,190
573
42,763
825
103
85.1
Contractor FTEs (Total)
13,453
Explanation of changes in Active Military End Strength: The change from FY 2014 to FY
2015 (­677) includes Army internal reprogrammings (­70) and Navy reductions (­315) and
Air Force reductions (­292) to meet requirements of the Budget Control Act. The change
from FY 2015 to FY 2016 (­354) includes Army internal realignments (­6), Navy internal
realignments (­6) and Air Force reductions (­342) to meet requirements of the Budget
Control Act.
In­House Care
IHC­43
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
Explanation of changes in Civilian FTEs: FY 2014­2015 change is not an increase in
staffing, but a reflection of the FY 2014 Actuals executing at a lower level than what
was programmed due to the impacts of Sequestration in FY 2013 followed by a furlough and
Continuing Resolution in FY 2014. FY 2015­2016 decrease reflects actions from a civilian
workforce analysis based on Department of Defense guidance to shape a properly sized and
highly capable workforce.
Explanation of changes in Contractor FTEs: FY 2014­2015 change is not an increase in
contractors, but similar to the civilians, a reflection of the FY 2014 Actuals executing
at a lower level. FY 2015­2016 decrease reflects efforts to become more efficient in the
reliance on contractor support via consolidation of requirements.
In­House Care
IHC­44
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l &
Spec Scheds
199 TOTAL CIV
COMPENSATION
308 Travel of
Persons
399 TOTAL TRAVEL
401 DLA Energy
(Fuel Products)
402 Service Fund
Fuel
411 Army Supply
412 Navy Managed
Supply, Matl
416 GSA Supplies
& Materials
417 Local Purch
Supplies & Mat
422 DLA Mat
Supply Chain
(Medical)
499 TOTAL
SUPPLIES &
MATERIALS
502 Army Fund
Equipment
503 Navy Fund
Equipment
505 Air Force
Fund Equip
506 DLA Mat
Supply Chain
(Const & Equip)
507 GSA Managed
Equipment
599 TOTAL
EQUIPMENT
PURCHASES
FY 2014
Actual
3,659,211
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
36,593
442,570
FY 2015
Estimate
4,138,374
Foreign
Currency
Rate Diff
0
Change
FY 2015/FY 2016
Price
Program
50,695
­74,473
FY 2016
Estimate
4,114,596
3,659,211
0
36,593
442,570
4,138,374
0
50,695
-74,473
4,114,596
58,750
0
1,057
4,643
64,450
60
1,097
8,613
74,220
58,750
393
0
0
1,057
9
4,643
­82
64,450
320
60
0
1,097
­23
8,613
49
74,220
346
3
0
0
33
36
0
­3
­24
9
0
588
0
0
0
7
5,047
­7
5,047
588
0
0
129
20
­5,176
­8
0
600
7,373
0
133
482
7,988
188
139
­138
8,177
9,261
0
166
39,396
48,823
0
830
175
49,828
18,837
0
­75
214
18,976
0
76
289
19,341
36,455
0
240
45,083
81,778
188
1,168
-4,833
78,301
4,984
0
63
­4,487
560
0
0
10
570
2,008
0
24
­1,833
199
0
0
4
203
53,473
0
0
­12,521
40,952
0
0
788
41,740
9,196
0
64
­5,658
3,602
0
36
­3,436
202
2,709
0
49
7,502
10,260
0
174
­1,475
8,959
72,370
0
200
-16,997
55,573
0
210
-4,109
51,674
In­House Care
IHC­45
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
OP 32 Line
601 Army
Industrial
Operations
611 Navy Surface
Warfare Ctr
633 DLA Document
Services
677 DISA Telecomm
Svcs ­
Reimbursable
696 DFAS
Financial
Operation (Other
Defense Agencies)
699 TOTAL DWCF
PURCHASES
706 AMC Channel
Passenger
719 SDDC Cargo
Ops­Port hndlg
771 Commercial
Transport
799 TOTAL
TRANSPORTATION
901 Foreign
National Indirect
Hire (FNIH)
902 Separation
Liab (FNIH)
912 Rental
Payments to GSA
(SLUC)
913 Purchased
Utilities (Non­
Fund)
914 Purchased
Communications
(Non­Fund)
915 Rents (Non­
GSA)
FY 2014
Actual
175
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
5
­180
FY 2015
Estimate
0
Foreign
Currency
Rate Diff
0
0
0
0
1,046
0
206
Change
FY 2015/FY 2016
Price
Program
0
0
812
812
0
12
4
828
59
654
1,759
0
­38
71
1,792
0
16
­157
65
0
1
0
66
3,041
0
54
­3,095
0
0
0
0
0
4,468
0
134
-1,966
2,636
0
-25
75
2,686
117
0
2
­119
0
0
0
0
0
2
0
0
15
17
0
7
­4
20
6,165
0
111
715
6,991
0
119
13
7,123
6,284
0
113
611
7,008
0
126
9
7,143
39,434
0
395
18,173
58,002
0
711
1,165
59,878
3,013
0
30
­30
3,013
0
37
­37
3,013
820
0
15
­807
28
0
0
1
29
1,770
0
32
7,438
9,240
0
157
62
9,459
1,852
0
33
4,137
6,022
0
102
9
6,133
12,733
0
229
4,975
17,937
0
305
2,190
20,432
FY 2016
Estimate
0
In­House Care
IHC­46
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
OP 32 Line
917 Postal
Services
(U.S.P.S)
920 Supplies &
Materials (Non­
Fund)
921 Printing &
Reproduction
922 Equipment
Maintenance By
Contract
923 Facilities
Sust, Rest, & Mod
by Contract
924
Pharmaceutical
Drugs
925 Equipment
Purchases (Non­
Fund)
930 Other Depot
Maintenance (Non­
Fund)
932 Mgt Prof
Support Svcs
933 Studies,
Analysis & Eval
934 Engineering &
Tech Svcs
937 Locally
Purchased Fuel
(Non­Fund)
955 Other Costs
(Medical Care)
960 Other Costs
(Interest and
Dividends)
964 Other Costs
(Subsistence and
Support of
FY 2014
Actual
1,084
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
19
­328
FY 2015
Estimate
775
Foreign
Currency
Rate Diff
0
762,752
0
28,222
6,074
0
155,208
Change
FY 2015/FY 2016
Price
Program
13
3
­351,935
439,039
233
16,253
55,318
510,843
110
2,961
9,145
0
155
­117
9,183
0
2,794
­36,361
121,641
0
2,068
12,824
136,533
175,510
0
3,159
­40,195
138,474
0
2,354
371
141,199
1,512,238
0
55,953
75,579
1,643,770
0
60,819
­91,583
1,613,006
364,960
0
13,503
­100,208
278,255
49
10,297
40,870
329,471
10
0
0
­10
0
0
0
0
0
8,437
0
152
2,317
10,906
0
185
­1,812
9,279
7,481
0
135
13,013
20,629
0
351
6,465
27,445
676
0
12
­688
0
0
0
0
0
70
0
2
285
357
0
­26
60
391
252,944
0
9,359
­53,498
208,805
1,568
7,784
90,016
308,173
947
0
17
­964
0
0
0
0
0
4,220
0
76
­2,081
2,215
0
38
6
2,259
FY 2016
Estimate
791
In­House Care
IHC­47
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
In-House Care
OP 32 Line
Persons)
986 Medical Care
Contracts
987 Other Intra­
Govt Purch
988 Grants
989 Other
Services
990 IT Contract
Support Services
999 TOTAL OTHER
PURCHASES
Total
FY 2014
Actual
Foreign
Currency
Rate Diff
Change
FY 2014/FY 2015
Price
Program
FY 2015
Estimate
Foreign
Currency
Rate Diff
Change
FY 2015/FY 2016
Price
Program
FY 2016
Estimate
1,097,159
0
40,594
­69,523
1,068,230
2,135
39,604
135,617
1,245,586
96,052
0
1,729
­24,721
73,060
0
1,242
570
74,872
2,584
174,631
0
0
47
3,144
­2,631
4,381
0
182,156
0
211
0
3,100
0
30,755
0
216,222
31,042
0
559
­7,879
23,722
0
403
5,356
29,481
4,713,701
0
160,320
-558,600
4,315,421
4,196
145,952
288,109
4,753,678
8,551,239
0
198,657
-84,656
8,665,240
4,444
199,223
213,391
9,082,298
In­House Care
IHC­48
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
I. Description of Operations Financed: This Budget Activity Group provides for all
medical and dental care plus pharmaceuticals received by DoD­eligible beneficiaries in
the private sector. This includes the Civilian Health and Medical Program of the
Uniformed Services (CHAMPUS) Program, the TRICARE Managed Care Support Contracts (MCSC),
the Uniformed Services Family Health Program (USFHP), the TRICARE Overseas Program, the
Supplemental Care Program, TRICARE Mail Order Pharmacy, the National Retail Pharmacy,
TRICARE Reserve Select (TRS), which is a premium based program for Reserves and their
family members, and various support activities.
Pharmaceuticals - Purchased Health Care: Includes pharmaceutical costs associated with
contractual pharmacy services providing authorized benefits to eligible beneficiaries via
the TRICARE Mail Order Pharmacy Program (TMOP).
National Retail Pharmacy - Includes pharmaceutical costs associated with contractual
pharmacy services providing authorized benefits to eligible beneficiaries via the TRICARE
Retail Pharmacy Program (TTRx). TRRx provides network pharmaceutical prescription
benefits for medications from local economy establishments.
TRICARE Managed Care Support Contracts (MCSC) ­ The TRICARE Managed Care Support
Contracts provide a managed care program which integrates a standardized health benefits
package with military treatment facilities and civilian network providers on a regional
basis. With the full deployment of TRICARE, all but a small portion of the standard
Civilian Health and Medical Program of the Uniformed Services benefits have been absorbed
into the MCSC. Includes health care costs provided in civilian facilities and by private
practitioners to retired military personnel and authorized family members of Active Duty,
retired, or deceased military service members.
Military Treatment Facility (MTF) Enrollees Purchased Care - Includes underwritten costs
for providing health care benefits to the Military Treatment Facility Prime enrollees in
Private Sector Care
PSC­49
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
I.
Description of Operations Financed (cont.)
the private sector as authorized under the Civilian Health and Medical Program of the
Uniformed Services.
Dental Purchased Care - Includes the government paid portion of insurance premiums which
provides dental benefits in civilian facilities and by private practitioners for the
beneficiaries who are enrolled in the Dental Program. Beneficiaries eligible for
enrollment are: (a) Active Duty family members and (b) select reservists or individual
ready reservist (IRR) and family members.
Uniformed Services Family Health Program (USFHP) -Provides TRICARE­like benefits
authorized through contracts with designated civilian hospitals in selected geographic
markets to beneficiaries that reside in one of these markets and who are enrolled in the
program.
Supplemental Care - Health Care -This program provides the TRICARE Prime benefit to
Active Duty Service Members and other designated eligible patients who receive health
care services in the civilian sector and non­DoD facilities either referred or non­
referred from the MTF including emergency care. This program also covers health care
sought in the civilian sector or non­DoD facilities due to Active Duty assignments in
remote locations under TRICARE Prime Remote. Care to Active Duty members stationed
overseas who receive health care in the private sector paid under this program will
appear in the Overseas program element.
Supplemental Care - Dental - Provides for uniform dental care and administrative cost for
Active Duty members receiving dental care services in the civilian sector to include
Veterans' Affairs facilities. All dental claims are managed, paid and reported by the
Military Medical Support Office (MMSO) or through contractual services.
Continuing Health Education/Capitalization of Assets (CHE/CAP) -Provides for support of
graduate medical education and capital investment within civilian facilities that
provides services to the Military Health System and Medicare.
Private Sector Care
PSC­50
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
I.
Description of Operations Financed (cont.)
Overseas Purchased Health Care -Includes coverage for delivery of TRICARE Prime benefits
in civilian facilities by private practitioners to eligible Active Duty and Active Duty
Family Members through the TRICARE Overseas and Global Remote Overseas Programs. The
program also includes health care provided to retiree and retiree family members residing
overseas who are eligible under the TRICARE Standard option and Medicare programs.The
Supplemental Care program which funds health care provided in the private sector to
Active Duty members and other designated eligible beneficiaries.
Miscellaneous Purchased Health Care -Provides for payments of health care services in
civilian facilities by private practitioners not captured in other specifically defined
elements.Includes administrative, management, and health care costs for Alaska claims,
Custodial Care, Continuing Health Care Benefits Program, Dual­Eligible Beneficiaries
Program, Defense Health Agency (DHA) managed demonstrations and congressionally directed
health care programs, and the TRICARE Reserve Select Program which is a premium based
option available to Selected Reservists and their family members. The qualifying Dual­
Eligible Beneficiaries claims are paid by the Medicare Eligible Retiree Health Care Fund
(MERHCF).
Miscellaneous Support Activities -Provides for payments of costs for functions or
services in support of health care delivery not actual health care. Contracts for
marketing and education functions, claims auditing, e­Commerce and the National Quality
Monitoring Service are reflected in this program element.%3
II. Force Structure Summary:
Approximately 9.2 million DoD beneficiaries are eligible to receive care under private
sector care programs, including approximately 2.4 million Medicare eligible
beneficiaries. Excluded from the budget figures presented are health care costs for
Military Retirees, Retiree Family Members and Survivors who qualify and receive benefits
through the Medicare program. These costs are paid from the Medicare Eligible Retiree
Health Care Fund (MERHCF). The MCSCs provide a uniform, triple­option health care plan to
eligible beneficiaries, allowing them to enroll in the health maintenance organization
Private Sector Care
PSC­51
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
II. Force Structure Summary (cont.)
(HMO) type plan known as TRICARE Prime, or utilize a civilian preferred provider network
(TRICARE Extra), or remain with the Standard Civilian Health and Medical Program of the
Uniformed Services benefit (TRICARE standard).
Private Sector Care
PSC­52
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. Pharmaceuticals
Purchased Health Care
2. National Retail
Pharmacy
3. Managed Care Support
Contracts
4. MTF Enrollee Purchased
Care
5. Dental Purchased Care
6. Uniformed Services
Family Health Program
7. Supplemental Care ­
Health Care
8. Supplemental Care ­
Dental
9. Continuing Health
Education/Capitalization
10. Overseas Purchased
Health Care
11. Miscellaneous
Purchased Health Care
12. Miscellaneous Support
Activities
Total
1. FY 2014
2. FY 2014
3. FY 2014
4. FY 2014
$157.1M to
FY 2014
Actual
489,682
Budget
Request
1,003,970
Current
Estimate
Amount
Percent Appropriated
­519,687
­51.8
484,283
484,283
FY 2016
Estimate
852,493
1,733,743
1,172,830
612,827
52.3
1,785,657
1,785,657
1,125,025
6,465,955
6,940,240
­750,352
­10.8
6,189,888
6,189,888
6,493,776
2,497,389
2,352,436
­28,786
­1.2
2,323,650
2,323,650
2,524,033
320,268
460,480
334,322
475,973
­20,518
14,750
­6.1
3.1
313,804
490,723
313,804
490,723
356,647
514,464
1,282,333
1,494,016
­227,270
­15.2
1,266,746
1,266,746
1,282,120
161,069
163,431
­25,281
­15.5
138,150
138,150
142,315
341,621
453,721
­52,125
­11.5
401,596
401,596
429,909
270,055
357,867
­39,096
­10.9
318,771
318,771
303,711
626,071
533,021
104,766
19.7
637,787
637,787
713,048
98,196
130,772
21,932
16.8
152,704
152,704
155,142
14,746,862
15,412,599
-908,840
-5.9
14,503,759 14,503,759 14,892,683
actuals include $288.3M for Overseas Contingency Operations (OCO).
actuals do not include Department of Defense Medicare­Eligible Retiree Health Care Fund(MERHCF) of $7,394.6M (O&M Only).
actuals include Defense Health Program, 13/14 (O&M) Carryover ($308M) pursuant to PL 113­6, Title VI, 127 STAT. 293­294.
Omnibus Reprogramming ­$411.7M: PSC (Base) ­$165.8M to Research, Development, Test and Evaluation (RDT&E); PSC (Base) ­
Department of Defense (DoD); PSC (Base)­$0.009M to TMIP­J (RDT&E); and, PSC (OCO)­$88.8M to DoD.
Private Sector Care
PSC­53
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
III. Financial Summary ($ in thousands)
5.
6.
7.
8.
FY
FY
FY
FY
2015
2015
2016
2016
estimate excludes $214.3M for OCO.
estimate does not include Department of Defense Medicare­Eligible Retiree Health Care Fund(MERHCF) of $7,220.0M (O&M Only).
request excludes OCO.
request does not include Department of Defense Medicare­Eligible Retiree Health Care Fund(MERHCF) of $8,036.6M (O&M Only).
Private Sector Care
PSC­54
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
15,412,599
­908,840
Change
FY 2015/FY 2016
14,503,759
14,503,759
14,503,759
214,259
534,299
14,718,018
­214,259
14,503,759
­145,375
14,892,683
Private Sector Care
PSC­55
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) FY 2015 One­Time Congressional Adjustment:
Restoration of benefit proposals.
2) FY 2015 One­Time Congressional Adjustment:
Historical under­execution and excess growth.
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
a. OCO and Other Supplemental Requested
1) OCO Supplemental
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
1) Reversal of one­time Congressional decrease
(historical under­execution and excess growth).
c. Program Growth in FY 2016
1) Other Healthcare Programs:
Amount
Totals
15,412,599
­908,840
148,715
­1,057,555
14,503,759
214,259
214,259
14,718,018
14,718,018
­214,259
14,503,759
534,299
1,259,812
1,102,598
101,933
Private Sector Care
PSC­56
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Increase to baseline requirements includes costs
associated with family member dental program contract
transition, Continuing Health
Education/Capitalization of Assets (CHE/CAP), TRICARE
Reserve Select (TRS) Program, and Uniformed Services
Family Health Program (USFHP). The FY 2015 Private
Sector Care Family Member Dental Program,
Miscellaneous Purchased Health Care (TRS),CHE/CAP,
and USFHP baseline funding is $1,843.9M.
2) FY 2016 Health Benefit Reform ­ Consolidated Health
Plan:
Assumed initial costs to consolidate the TRICARE
health plan into a single plan to replace the current
TRICARE Prime, Standard and Extra health insurance­
like products that will better manage costs by
building a shared commitment to health care while
offering beneficiaries more flexibility and choice.
The FY 2015 Private Sector Care Managed Care Support
Contract baseline funding is $6,189.9M.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
c. Program Decreases in FY 2016
1) Eligible Beneficiary Population Downsizing:
Savings generated from planned reductions to the
Total Force end­strength and associated family
members. The FY 2015 Private Sector Care Managed Care
Support Contracts, Military Treatment Facility
Enrollee Purchased Care, Pharmaceuticals Purchased
Health Care and National Retail Pharmacy baseline
Amount
Totals
55,281
­1,405,187
­901,315
Private Sector Care
PSC­57
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
funding is $10,783.5M.
2) FY 2016 Health Benefit Reform ­ Pharmacy Co­Pays:
Assumed savings resulting from additional increases
to retail pharmacy co­pays and mandatory use of mail
order or Military Treatment Facility (MTF) pharmacies
for maintenance drugs. The FY 2015 Private Sector
Care Retail Pharmacy baseline funding is $1,785.7M.
3) Savings from Defense Health Agency (DHA) Shared
Serice­Health Plan
Savings associated with the Health Plan Shared
Service. Savings come from the closure of the
Continental United States (CONUS) TRICARE Service
Centers; increased efforts to collect third­party
health care insurance payments; and a projected
reduction in private sector care usage due to reduced
redeployment assessment appointments that will allow
for more availability of Military Treatment
Facilities' appointments to beneficiaries who
previously used the Private Sector Care network. The
FY 2015 Private Sector Care Managed Care Support
Contracts and MTF Enrollee Purchased Care baseline
funding is $8,513.5M
FY 2016 Budget Request
Amount
Totals
­374,018
­129,854
14,892,683
Private Sector Care
PSC­58
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
IV. Performance Criteria and Evaluation Summary:
FY 2014
Estimate
FY 2015
Estimate
FY 2016
Estimate
Change
FY 2014/2015
Change
FY 2015/2016
Uniformed Service Family Health
Services:
DoD Enrollees (Non­MERHCF
Eligible)
78,622
80,588
82,602
1,969
2,014
Admissions
345,788
324,084
312,782
­21,704
­11,302
Weighted Workload­Inpatient RWPs
325,349
304,814
294,088
­20,535
­10,726
47,237,883
47,549,308
49,124,862
311,425
1,575,554
107,765,566
108,515,578
112,124,850
750,012
3,609,272
29,913,983
28,298,628
27,987,343
­1,615,355
­311,285
4,109,533
3,990,357
4,002,328
­119,176
11,971
Workload for Medical Care and
Pharmacy:
Visits
Weighted Workload­Outpatient RVUs
Retail Pharmacy Prescriptions
Mail Order Prescriptions
Private Sector Care
PSC­59
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
V. Personnel Summary
N/A
Private Sector Care
PSC­60
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Private Sector Care
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
308 Travel of Persons
399 TOTAL TRAVEL
634 Navy Base Support (NAVFEC)
647 DISA Enterprise Computing
Centers
671 DISA DISN Subscription
Services (DSS)
699 TOTAL DWCF PURCHASES
771 Commercial Transport
799 TOTAL TRANSPORTATION
912 Rental Payments to GSA (SLUC)
921 Printing & Reproduction
924 Pharmaceutical Drugs
925 Equipment Purchases (Non­Fund)
932 Mgt Prof Support Svcs
933 Studies, Analysis & Eval
934 Engineering & Tech Svcs
986 Medical Care Contracts
987 Other Intra­Govt Purch
989 Other Services
990 IT Contract Support Services
999 TOTAL OTHER PURCHASES
Total
FY 2014
Actual
418
418
58
5,291
Change
FY 2014/FY 2015
Price
Program
8
38
8
38
3
­61
­39
1,270
FY 2015
Estimate
464
464
0
6,522
Change
FY 2015/FY 2016
Price
Program
8
13
8
13
0
0
­653
777
FY 2016
Estimate
485
485
0
6,646
40
1
­41
0
0
0
0
5,389
15
15
193
5,100
2,223,425
46
8,698
2,474
380
12,455,807
17,862
1,918
25,137
14,741,040
14,746,862
-35
0
0
3
92
82,266
1
157
45
7
460,865
322
35
452
544,245
544,218
1,168
­15
-15
­196
­2,342
­35,751
­47
4,355
­584
­387
­761,739
5,971
1,143
1,065
-788,512
-787,321
6,522
0
0
0
2,850
2,269,940
0
13,210
1,935
0
12,154,933
24,155
3,096
26,654
14,496,773
14,503,759
-653
0
0
0
48
83,988
0
225
33
0
449,733
411
53
453
534,944
534,299
777
0
0
0
2,612
­376,410
0
29
6
0
227,381
60
9
148
-146,165
-145,375
6,646
0
0
0
5,510
1,977,518
0
13,464
1,974
0
12,832,047
24,626
3,158
27,255
14,885,552
14,892,683
Private Sector Care
PSC­61
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
I. Description of Operations Financed: This Budget Activity Group (BAG) encompasses nine
functions supporting military medical readiness and delivery of patient care worldwide.
The nine medical support functions include:
Examining Activities ­ Resources administering physical examinations and performing
evaluations of medical suitability for military service. Includes resources required for
Armed Forces Examination and Entrance Stations and the Department of Defense (DoD)
Medical Examination Review Board.
Other Health Activities - Resources organizations and functions that support the
provision of health care for Department of Defense beneficiaries. Examples include:
central medical laboratories; medical services squadrons; Navy Medicine Regional
Commands; public affairs; the Women, Infants and Children Program; humanitarian actions;
family advocacy; patient affairs; and contribution of resources for beneficiary health
care at the Federal Health Care Center North Chicago, Illinois.
Military Public/Occupational Health - Resources Military Public Health manpower,
supplies, permits, certification and licensure fees, support equipment, and the
associated requirements specifically identified for management, direction, and operation
of disease prevention and control. Examples include: epidemiology; medical entomology;
drinking water safety; monitoring hazardous waste disposal; food and facility sanitation;
wellness/health promotion and education; community health nursing; medical intelligence;
disease and climate illness; disease prevention and control; hearing conservation; and
health and injury surveillance.
Veterinary Services ­ Resources the management, direction and operation of DoD's
worldwide veterinary missions, as well as veterinary support requirements for other
specified federal agencies. Includes veterinary care of government­owned animals,
Consolidated Health Support
CHS­63
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
I.
Description of Operations Financed (cont.)
procedures involving animals in clinical investigation departments, and control of
zoonotic and veterinary public health diseases.
Military Unique - Other Medical Activities - Resources unique military medical functions
and activities that have a relationship to the size of the military population supported
and are not included in any other program elements. Examples of programs include:
physiological training units; drug abuse detection laboratories; optical repair and
fabrication laboratories; pandemic influenza preparedness; medical logistics offices;
medical support offices; medical materiel activities; deployment planning; and plans,
operation and training offices in military treatment facilities.
Aeromedical Evacuation System - Resources the operation and administration of the
Aeromedical Evacuation System; costs associated with intra­ and inter­theater patient
transportation; and operations to sustain the Aeromedical Evacuation Epidemiology
Laboratory.
Service Support to Other Health Activities ­ Resources to support USTRANSCOM's Global
Patient Movement Requirements Center.
Joint Pathology Center (JPC) - Resources manpower, equipment, facilities, and the
associated operation and maintenance of the JPC including pathology education,
consultation, and research services provided to the Department of Defense and other
Federal Agencies.
Federal Advisory Committee Act (FACA) Advisory Board Activities ­ Resources the FACA
Advisory Board and subcommittee functions, meetings, support, studies and other
activities. FACA is composed of those committees, boards, commissions, councils, task
forces and similar groups which have been established to advise officers and agencies in
Consolidated Health Support
CHS­64
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
I.
Description of Operations Financed (cont.)
the executive branch of the Federal Government and must follow the regulatory and
statutory requirements related to FACA in Title 5 Appendix, United States Code (U.S.C.).
II. Force Structure Summary:
Consolidated Health Support includes a variety of programs supporting such functions as
examining activities, military public and occupational health, veterinary services,
aeromedical evacuation, and various activities that have a relationship to the size of
the military population supported and are not included in other Budget Activity Groups.
Consolidated Health Support
CHS­65
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. Examining Activities
2. Other Health Activities
3. Military Public /
Occupational Health
4. Veterinary Services
5. Military Unique­Other
Med Activities
6. Aeromedical Evaluation
System
7. Service Support to
Other Health Activities­
TRANSCOM
8. Joint Pathology Center
(JPC)
9. Support to FACA
Advisory Board Activities
Total
FY 2014
Actual
72,102
751,303
430,395
Budget
Request
90,311
929,354
452,463
Current
Estimate
Amount
Percent Appropriated
­1,624
­1.8
88,687
88,687
­36,164
­3.9
893,190
893,190
­27,067
­5.0
425,396
425,396
FY 2016
Estimate
92,350
825,655
517,939
26,022
632,125
33,306
882,315
327
­43,744
.0
­4.0
33,633
838,571
33,633
838,571
34,946
861,529
44,852
47,328
0
0.0
47,328
47,328
54,973
1,465
1,571
0
0.0
1,571
1,571
2,359
21,401
23,537
0
0.0
23,537
23,537
23,952
2,057
1,911
0
0.0
1,911
1,911
1,955
1,981,722
2,462,096
-108,272
-4.4
2,353,824
2,353,824
2,415,658
1. FY 2014 actuals include $56.9M for Overseas Contingency Operations (OCO).
2. FY 2014 Omnibus Reprogramming returned to the Department of Defense ­$52.3M.
3. FY 2014 $130.3M transferred: DoD­VA Health Care Sharing Incentive Fund, Veterans Affairs, P.L. 111­84, section 1706, 123 STAT.
2574 ($15.0M) and the Joint DoD­VA­ Medical Facility Demonstration Fund, Veteran Affairs for the Federal Health Care Center (FHCC),
North Chicago, P.L. 113­76, section 8098, 128 STAT, 128, ($115.3M).
4. FY 2014 available funding without transfer to VA: Actuals ($1,981.7M) + VA transfer (+$130.3M) = $2,139.8M.
5. FY 2015 estimate excludes $15.3M for OCO.
6. FY 2016 request excludes OCO.
Consolidated Health Support
CHS­66
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
2,462,096
­101,400
Change
FY 2015/FY 2016
2,353,824
­6,872
2,353,824
2,353,824
15,311
48,123
2,369,135
­15,311
2,353,824
13,711
2,415,658
Consolidated Health Support
CHS­67
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) One time Congressional increase for Wounded Warrior
Military Adaptive Sports Program.
2) One time Congressional increase for therapeutic
service dog training.
3) One time program Congressional decrease for
historical under execution.
4) One time program Congressional decrease for travel
reduction not properly accounted for.
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
1) Section 8080 ­ program decrease for favorable foreign
currency exchange rates.
2) Section 8024 ­ program decrease for Federally Funded
Research and Development Centers.
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
a. OCO and Other Supplemental Requested
1) OCO
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
Amount
Totals
2,462,096
­108,272
5,000
1,000
­100,000
­7,400
­6,742
­130
2,353,824
15,311
15,311
2,369,135
2,369,135
­15,311
2,353,824
Consolidated Health Support
CHS­68
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C.
6.
7.
8.
Reconciliation of Increases and Decreases
Price Change
Functional Transfers
Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
1) Reverses FY 2015 decrease for historical under
execution.
2) Reverses FY 2015 decrease for travel reduction not
properly accounted for.
3) Reverses FY 2015 general provisions decrease for
favorable foreign currency exchange rates.
4) Reverses FY 2015 general provisions decrease for
Federally Funded Research and Development Centers.
c. Program Growth in FY 2016
1) Warrior Care Program Office:
Realigns Warrior Care Program Office from the
Management Activities Budget Activity Group (BAG) to
the Consolidated Health Support BAG to accurately
capture civilian pay and contract support where it
will execute. Warrior Care Program Office was
transferred to the Defense Health Program (DHP) in FY
2014. This program office provides oversight of the
Defense Department's Integrated Disability Evaluation
System and Warrior Care Program. The FY 2015
baseline funding for the Warrior Care Program Office
is $30.8M. The FY 2015 baseline staffing is 7
civilian FTEs and 148 contractors.
2) Temporary Disability Retirement List (TDRL):
Realigns funding to the Consolidated Health Support
(CHS) Budget Activity Group (BAG) from the In­House
Amount
Totals
48,123
192,222
101,070
7,479
6,814
131
29,784
12,837
Consolidated Health Support
CHS­69
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Care BAG ($7.5M) and Training and Education BAG
($5.3M) to expedite service member medical status
determinations for those members that have been
placed on the TDRL, due to a long­lasting or
permanent change from a wound, illness or injury by
reducing the cycle time of the two evaluation boards
reviewing a Service member's case file documentation.
A Medical Evaluation Board (MEB) will review the
Service member's record to decide if he/she meets
medical retention standards. After the MEB, a
Physical Evaluation Board (PEB) will be convened to
determine the Service member's disposition—return to
duty, separation, or retirement, either permanent or
temporary. TDRL requirements were previously
included in Integrated Disability Evaluation System
(IDES) that was funded from FY 2014 to FY 2016. In FY
2015 the TDRL funding was included in the $104.6M
IDES baseline. The FY 2015 IDES staffing is 1,072
civilian FTEs, and 159 contractors.Note: The IDES
decrease is found in Section 9.c.1.
3) Combating Antibiotic Resistant Bacteria (CARB):
Provides funding for the military­relevant programs
within the Countering Biological Threats and
promoting the Global Health Security Agenda (GHSA), a
high priority for the President and his
Administration including the National Security
Council, the Office of Management and Budget (OMB),
and the Office of Science and Technology Policy,
consistent with the following objectives: •
Strengthen global capabilities with at least thirty
Amount
Totals
10,290
Consolidated Health Support
CHS­70
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
partner countries, to prevent, detect, and respond to
biological threats, whether naturally occurring,
deliberate, or accidental. • Prevent avoidable
epidemics; including prevention of naturally
occurring outbreaks and intentional or accidental
releases. • Detect, characterize, and report emerging
biological threats early through real­time bio
surveillance. • Respond rapidly and effectively to
biological threats of international concern. This is
a new program without FY 2015 baseline resources.
4) Temporary Disability Retired List (TDRL) Legal
Support:
Provides funding for additional legal support for
Army active duty personnel who are undergoing the
TDRL process. In FY 2015 the TDRL funding was part
of the $104.6M Integrated Disability System (IDES)
baseline. The FY 2015 IDES baseline staffing was
1,072 civilian FTEs, and 159 contractors.
5) Equipment (Air Force Medical Service):
Increases equipment funding primarily attributable to
a realignment by the Air Force to maintain health
care support equipment life cycle replacement average
rate of eight years, replenish air en­route
equipment, and medical readiness training equipment.
The FY 2015 Consolidated Health Support equipment
baseline funding is $36.5M.
6) One More Civilian Paid Day:
Adjusts civilian payroll for one additional pay day
for FY 2016. The FY 2015 Consolidated Health Support
(CHS) civilian baseline funding is $980.4M. The CHS
Amount
Totals
6,000
4,281
3,756
Consolidated Health Support
CHS­71
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
staffing baseline is 10,728 civilian FTEs.
7) Leased Space (Air Force Medical Service):
Realigns funding to the Consolidated Health Support
(CHS) Budget Activity Group (BAG) from the Base
Operations and Communications BAG for real property
leases aligning these costs with their supporting
programs including the Multi­Market Office and
Central Appointing Office in San Antonio, Texas. The
FY 2015 Air Force CHS baseline funding is $305.0M.
The FY 2015 Air Force CHS baseline staffing is 1,054
civilian FTEs, and 640 contractors.
8) MILCON Transition Requirements (Army):
Provides additional funding to support transition
requirements for Army MILCON projects including: the
Hospital replacement at Fort Irwin, California;
dental and behavioral health clinic addition at
Schofield Barracks, Hawaii; and a health clinic
alteration at Vilseck, Germany. The FY 2015 Army
Consolidated Health Support Transition baseline
funding is $37.0M.
9) Public Health Testing and Screening (Navy ­ Bureau of
Medicine and Surgery):
Increases funding for Navy Medicine support for
mandated public health testing and screening for
active duty (e.g., Hepatitis B and Hepatitis C and
human immunodeficiency virus). The FY 2015 Navy
Consolidated Health Support funding baseline is
$55.9M. The Navy baseline staffing is 1,579 civilian
FTEs and 1,609 contractors.
10) Support for Operations of Defense Health Agency
Amount
Totals
3,150
2,441
2,200
1,429
Consolidated Health Support
CHS­72
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
(DHA) Shared Services ­ Medical Logistics and Public
Health:
Realigns resources to the Consolidated Health Support
Budget Activity Group (BAG) for the following Shared
Services and Budget Activities:
Medical Logistics.
($­0.1M, ­1 FTEs), Base Operations/Communications BAG
($­0.9M, ­8 FTEs), Management Activities BAG.
Public Health.
($­0.3, 5 FTEs), Management Activities BAG
($­0.1M, ­1 FTE), In­House Care BAG.
The FY 2015 Consolidated Health Support (CHS)
baseline funding is $2,353.8M. The FY 2015 CHS
baseline staffing is 10,728 civilians FTEs and 3,396
contractors.
11) Travel:
Increases Consolidated Health Support (CHS) Budget
Activity Group (BAG) travel to support military
population health, occupational health, and disease
prevention requirements including occupational safety
and health inspections and combating antibiotic
resistant bacteria around the globe. The FY 2015 CHS
travel baseline funding is $52.0M.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
1) Reverses one time Congressional increase for Wounded
Warrior Military Adaptive Sports Program.
2) Reverses one time Congressional increase for
therapeutic service dog training.
Amount
Totals
560
­178,511
­5,053
­1,010
Consolidated Health Support
CHS­73
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
c. Program Decreases in FY 2016
1) Integrated Disability Evaluation System (IDES):
Reduces funding for the Integrated Disability System
(iDES). iDES was funded for a two years, from FY
2014 to FY 2016. Some IDES requirements are now
included in the Temporary Disability Retired List
(TDRL) effort that expedites service member medical
status determinations for those members that have
been placed on the TDRL, due to long­lasting or
permanent change from wound, illness, or injury. The
FY 2015 IDES funding baseline was $104.6M. The FY
2015 IDES staffing baseline was 1,072 civilian FTEs,
and 159 contractors.
2) Reduced Requirements for Traumatic Brain
Injury/Psychological Health (TBI/PH) and Wounded, Ill
and Injured (WII) Programs:
Resource requirements have decreased for the TB/PH
and WII programs. Current data shows the number of
redeployers have dropped by 26%, for which there is a
corresponding decrease in associated workload. The
FY 2015 Army CHS baseline funding is $1,258.3M. The
FY 2015 Army CHS baseline staffing is 7,672 civilian
FTEs, and 516 contractors.
3) Wounded, Ill and Injured (WII) Realignment to Other
Core Programs:
Realigns available funding from the Consolidated
Health Support (CHS) Budget Activity Group (BAG) to
In­House Care BAG (for contract clinical pharmacists
and equipment to enhance the capability to
efficiently provide teleheath consultations over a
Amount
Totals
­49,177
­27,049
­21,900
Consolidated Health Support
CHS­74
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
greater geographic area); Management Activities BAG
(for Rehabilitation and Reintegration (R2R) programs
for the Wounded Ill and Injured), and Education and
Training BAG (for wellness education courses
addressing unhealthy lifestyles and behaviors for the
Army Medical Department Center and School). The FY
2015 Consolidated Health Service BAG baseline funding
is $2,353.8M. The FY 2015 CHS baseline staffing is
10,728 civilian FTEs and 3,396 contractors.
4) Savings from Defense Health Agency (DHA) Public
Health and Medical Logistics Shared Services:
Reduced requirements based on Shared Services'
savings: Public Health Shared Service: ($­11.9M) from
optimization of service member medical assessments,
streamlining and elimination duplicate referral, and
optimizing medical surveillance activities and
databases) and $­8.6M for Medical Logistics Shared
Service: ($­8.6M) from a focus on Supply Management,
Equipment Management and MEDLOG Services. The
consolidation of like services across the MHS will
produce savings by reducing redundancies and
consolidating key functional and business support
areas. The FY 2015 Consolidated Health Support (CHS)
baseline funding is $2,353.8M. The FY 2015 CHS
baseline staffing is 10,728 civilians FTEs and 3,396
contractor CMEs.
5) Defense Centers of Excellence (DCoE) Reduction:
Reduces funding based on reduced requirements for
DCoE. Current data shows the number of redeployers
have dropped by 26%, for which there is a
Amount
Totals
­20,543
­15,000
Consolidated Health Support
CHS­75
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
corresponding decrease in associated workload. The
FY 2015 CHS baseline funding is $2,353.8M. The FY
2015 CHS baseline staffing is 10,728 civilian FTEs,
and 3,396 contractors.
6) Post Deployment Health Reassessment Assessment
Reduction:
Reduces funding for comprehensive health screening
requirements that examine physical and behavioral
concerns associated with service member deployments
due to a reduction of deployments and redeployments.
The FY 2015 Consolidated Health Support (CHS)
baseline funding is $2,353.8M. The FY 2015 CHS
baseline staffing is 10,728 civilian FTEs, and 3,396
contractors.
7) Occupational Medicine (Air Force Medical Service):
Reduced requirements for occupational medicine
service contracts within the Air Force Medical
Service based upon an operational medicine support
analysis. The FY 2015 Air Force baseline funding is
$305.0M. The FY 2015 Air Force baseline staffing is
1,054 civilian FTEs, and 640 contractors.
8) Support for Operation of Defense Health Agency Shared
Services ­ Health Information Technology, Contracting
and Facilities:
Realigns resources from the Consolidated Health
Support (CHS) Budget Activity Group (BAG) for the
operation of the following Shared Services: Health
information Technology.(­$2.8M, ­30 FTEs),
Information Management BAG; Contracting.(­$4.3M, ­44
FTEs), Management Activities BAG. Facilities.(­$0.9M,
Amount
Totals
­12,500
­11,548
­8,013
Consolidated Health Support
CHS­76
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
­10 FTEs), Management Activities BAG. The FY 2015
CHS baseline funding is $2,353.8M. The FY 2015 CHS
baseline staffing is 10,728 civilians FTEs and 3,396
contractors.
9) Civilian Manpower Analysis:
Decreases civilian personnel requirements including
(­29) Army FTEs due to a reduction of deployments and
redeployments and to support the Secretary of
Defense's direction to shape a properly sized and
highly capable civilian workforce that complements
the military and provides sufficient oversight and
management of the contract support elements of the
Total Force. The FY 2015 Consolidated Health Support
civilian pay baseline funding is $2,353.8M. The FY
2015 Consolidated Health Support baseline staffing is
10,728 civilian FTEs and 3,396 contractors.
10) Population Health (Air Force Medical Service):
Reduced Air Force Medical Service requirements for
service support from other non­federal agencies based
on a reduction of Active Duty and family members.
The FY 2015 Air Force CHS baseline funding is
$305.0M. The FY 2015 Air Force CHS baseline staffing
is 1,054 civilian FTEs, and 640 contractors.
11) Chemical, Biological, Radiological, Nuclear and
Explosive (CBRNE) Training:
Realigns funding from the Consolidated Health Support
(CHS) Budget Activity Group (BAG) to the Education
and Training BAG for proper execution. The FY 2015
Defense Health Agency (DHA) CHS baseline funding is
$347.7M. The FY 2015 DHA CHS baseline staffing is 53
Amount
Totals
­2,999
­1,924
­1,271
Consolidated Health Support
CHS­77
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
civilian FTEs, and 554 contractors.
12) Comprehensive Pain Management Realignment (Defense
Health Agency (DHA) ­ National Capital Region Medical
Directorate ­ NCR­MD):
Realigns funding supporting the transfer of the
Comprehensive Pain Management projects, including
Extension of Community Health Outcomes, from the
Consolidated Health Support Budget Activity Group to
the In­House Care Budget Activity Group for proper
execution. The FY 2015 DHA NCR­MD baseline funding
is $55.9M. The FY 2015 DHA NCR­MD CHS baseline
staffing is 332 civilian FTEs, and 77 contractors.
FY 2016 Budget Request
Amount
Totals
­524
2,415,658
Consolidated Health Support
CHS­78
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
IV. Performance Criteria and Evaluation Summary:
FY 2014
Actuals
FY 2015
Estimate
FY 2016
Estimate
1,533,579
1,515677
­49,600
­17,902
274
267
273
­7
6
2,470
2,335
2,372
­135
37
109
268
293
159
25
Active Duty Force Structure 1,583,179
Military Entrance Processing
Stations Workload (000's)
1)Spectacles/Inserts
Fabricated (000's)
2) Veterinary Lab Procedures
(000's)
Change FY
2014/2015
Change FY
2015/2016
1) Spectacles/Inserts. FY 2014 to FY 2015 decrease reflects the Department of Defense
forces drawdown. The FY 2015 to FY 2016 increase reflects the anticipated extension of
new frame types to retirees.
2) Veterinary Lab Procedures: FY 2014 to FY 2015 increase reflects FY 2014 actual
procedures lower than forecast due to the Brooke Army Medical Center, Texas closure from
May to August and FY 2014 laboratory shortages at Camp Humphrey, Korea. The FY 2015 to
FY 2016 increase reflects additional annual requirements met by increased capacity due to
equipment modernization.
Consolidated Health Support
CHS­79
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
V. Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Average Annual Civilian Salary ($ in
thousands)
Contractor FTEs (Total)
8,739
2,818
5,921
8,791
Change
FY 2014/
FY 2015
­209
­90
­119
­76
Change
FY 2015/
FY 2016
­104
14
­118
­157
2,849
6,099
10,728
10,134
141
10,275
453
95.3
2,811
5,980
9,748
9,164
141
9,305
443
96.9
7
­83
705
697
­86
611
94
2.4
­38
­119
­980
­970
0
­970
­10
1.6
2,539
2,305
­164
­234
FY 2014
FY 2015
FY 2016
9,052
2,894
6,158
9,024
8,843
2,804
6,039
8,948
2,842
6,182
10,023
9,437
227
9,664
359
92.9
2,703
Military End Strength: The decrease from FY 2014 to FY 2015 of (­209) includes Army
transfer of Warrior Transition Units to Army Line (­143); Army internal realignments
(­16), Navy internal realignments (+24), and Air Force reductions to meet Budget Control
Act requirements (­10), and Air Force reversal of previously programmed reductions for
closure of military treatment facility at Eielson AFB, Alaska (+34). The decrease from FY
2015 to FY 2016 of (­104) includes Navy and Air Force internal realignments reductions to
meet the requirements of the Budget Control Act and Army reductions due to the service
drawdown.
Consolidated Health Support
CHS­80
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
Civilian FTEs: The increase of civilian personnel from FY 2014 ­ FY 2015 is accounted for
by the Warrior Care, Combating Antibiotic Resistant Bacteria and Temporary Disability
Retirement List programs. The decrease in civilian personnel from FY 2015 ­ FY 2016
reflects the end of the two­year iDES incremental funding, manpower reductions supporting
a civilian workload analysis, Public Health and Contracting shared service efficiencies,
and the Secretary of Defense's mandated 20% reduction in headquarters funding.
Contractor FTEs: The decreases in contractor personnel from FY 2014 ­ FY 2015 and FY 2015
­ 2016 reflect reduced requirements for Traumatic Brain Injury/Psychological Health
(TBI/PH) and Wounded, Ill and Injured (WII) Programs, Public Health and Contracting
shared service efficiencies, and a reduction as per the Secretary of Defense's mandated
20% reduction in headquarters funding.
Consolidated Health Support
CHS­81
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l &
Spec Scheds
199 TOTAL CIV
COMPENSATION
308 Travel of
Persons
399 TOTAL TRAVEL
401 DLA Energy
(Fuel Products)
402 Service Fund
Fuel
411 Army Supply
412 Navy Managed
Supply, Matl
414 Air Force
Consol Sust AG
(Supply)
416 GSA Supplies
& Materials
417 Local Purch
Supplies & Mat
422 DLA Mat
Supply Chain
(Medical)
499 TOTAL
SUPPLIES &
MATERIALS
503 Navy Fund
Equipment
506 DLA Mat
Supply Chain
(Const & Equip)
507 GSA Managed
Equipment
599 TOTAL
EQUIPMENT
PURCHASES
FY 2014
Actual
904,593
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
9,046
72,292
FY 2015
Estimate
985,931
Foreign
Currency
Rate Diff
0
904,593
0
9,046
41,049
0
41,049
54
Change
FY 2015/FY 2016
Price
Program
12,078
­89,153
72,292
985,931
0
12,078
-89,153
908,856
739
2,835
44,623
0
759
560
45,942
0
0
739
1
2,835
­19
44,623
36
0
0
759
­3
560
24
45,942
57
1
0
0
44
45
0
­3
­39
3
0
276
0
0
0
3
72
­159
72
120
0
0
2
4
­74
­2
0
122
0
0
0
43
43
0
­1
2
44
507
0
9
884
1,400
0
24
0
1,424
680
0
12
2,241
2,933
0
50
7
2,990
250
0
­1
1,725
1,974
0
8
31
2,013
1,768
0
24
4,831
6,623
0
81
-51
6,653
9
0
0
17
26
0
0
0
26
0
0
0
118
118
0
1
0
119
331
0
6
241
578
0
10
­156
432
340
0
6
376
722
0
11
-156
577
FY 2016
Estimate
908,856
Consolidated Health Support
CHS­82
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
OP 32 Line
601 Army
Industrial
Operations
633 DLA Document
Services
634 Navy Base
Support (NAVFEC)
635 Navy Base
Support (NAVFEC
Other Support
Services)
671 DISA DISN
Subscription
Services (DSS)
675 DLA
Disposition
Services
677 DISA Telecomm
Svcs ­
Reimbursable
679 Cost
Reimbursable
Purchase
699 TOTAL DWCF
PURCHASES
706 AMC Channel
Passenger
719 SDDC Cargo
Ops­Port hndlg
771 Commercial
Transport
799 TOTAL
TRANSPORTATION
901 Foreign
National Indirect
Hire (FNIH)
902 Separation
Liab (FNIH)
912 Rental
Payments to GSA
FY 2014
Actual
989
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
31
­1,020
FY 2015
Estimate
0
Foreign
Currency
Rate Diff
0
0
0
0
0
0
0
Change
FY 2015/FY 2016
Price
Program
0
0
626
626
0
­14
­551
61
0
15
15
0
0
0
15
0
0
11
11
0
0
0
11
4
0
0
10
14
0
­1
2
15
0
0
0
3
3
0
0
0
3
101
0
8
­109
0
0
0
0
0
0
0
0
4
4
0
0
0
4
1,094
0
39
-460
673
0
-15
-549
109
30,288
0
545
­30,833
0
0
0
400
400
0
0
0
108
108
0
42
­39
111
3,985
0
72
30,786
34,843
0
592
1,648
37,083
34,273
0
617
61
34,951
0
634
2,009
37,594
24,856
0
248
9,475
34,579
0
424
­919
34,084
1,417
0
14
­14
1,417
0
17
­17
1,417
5,052
0
91
­4,640
503
0
9
­176
336
FY 2016
Estimate
0
Consolidated Health Support
CHS­83
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
OP 32 Line
(SLUC)
913 Purchased
Utilities (Non­
Fund)
914 Purchased
Communications
(Non­Fund)
915 Rents (Non­
GSA)
917 Postal
Services
(U.S.P.S)
920 Supplies &
Materials (Non­
Fund)
921 Printing &
Reproduction
922 Equipment
Maintenance By
Contract
923 Facilities
Sust, Rest, & Mod
by Contract
924
Pharmaceutical
Drugs
925 Equipment
Purchases (Non­
Fund)
926 Other
Overseas
Purchases
930 Other Depot
Maintenance (Non­
Fund)
932 Mgt Prof
Support Svcs
933 Studies,
Analysis & Eval
934 Engineering &
FY 2014
Actual
Foreign
Currency
Rate Diff
Change
FY 2014/FY 2015
Price
Program
FY 2015
Estimate
Foreign
Currency
Rate Diff
Change
FY 2015/FY 2016
Price
Program
FY 2016
Estimate
1,463
0
26
­836
653
0
11
­84
580
1,386
0
25
3,999
5,410
0
92
­115
5,387
5,196
0
94
­3,006
2,284
0
39
1,051
3,374
108
0
2
­65
45
0
1
­1
45
91,838
0
1,653
59,144
152,635
31
2,595
­1,583
153,678
2,653
0
48
­1,490
1,211
0
21
425
1,657
5,204
0
94
­1,530
3,768
0
64
1,360
5,192
8,726
0
157
­815
8,068
0
137
­31
8,174
44,547
0
1,648
1,474
47,669
0
1,764
10,970
60,403
42,926
0
772
­7,957
35,741
0
608
4,437
40,786
0
0
0
39
39
0
1
­1
39
0
0
0
395
395
0
7
0
402
76,677
0
1,380
46,764
124,821
0
2,122
­5,989
120,954
14,662
0
264
3,948
18,874
0
321
­8,129
11,066
1,462
0
26
­1,488
0
0
0
319
319
Consolidated Health Support
CHS­84
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Consolidated Health Support
OP 32 Line
Tech Svcs
937 Locally
Purchased Fuel
(Non­Fund)
955 Other Costs
(Medical Care)
957 Other Costs
(Land and
Structures)
960 Other Costs
(Interest and
Dividends)
964 Other Costs
(Subsistence and
Support of
Persons)
986 Medical Care
Contracts
987 Other Intra­
Govt Purch
988 Grants
989 Other
Services
990 IT Contract
Support Services
998 Other Costs
(SOCOM Only)
999 TOTAL OTHER
PURCHASES
Total
FY 2014
Actual
Foreign
Currency
Rate Diff
Change
FY 2014/FY 2015
Price
Program
FY 2015
Estimate
Foreign
Currency
Rate Diff
Change
FY 2015/FY 2016
Price
Program
FY 2016
Estimate
197
0
4
­64
137
0
­10
49
176
91,080
0
3,370
32,887
127,337
0
4,711
­21,895
110,153
14
0
0
­14
0
0
0
0
0
449
0
8
753
1,210
0
21
1
1,232
104
0
2
292
398
0
7
0
405
281,826
0
10,428
180,693
472,947
0
17,499
78,232
568,678
75,333
0
1,356
­14,055
62,634
0
1,065
3,823
67,522
7,902
178,868
0
0
142
3,220
­8,003
­15,066
41
167,022
0
0
1
2,839
­1
39,092
41
208,953
34,289
0
617
­24,443
10,463
0
178
233
10,874
370
0
4
­374
0
0
0
0
0
998,605
0
25,693
256,003
1,280,301
31
34,544
101,051
1,415,927
1,981,722
0
36,164
335,938
2,353,824
31
48,092
13,711
2,415,658
Consolidated Health Support
CHS­85
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
I. Description of Operations Financed:
This Budget Activity Group (BAG) provides for the Health Information Technology resources
required to support the Military Health System; includes the DoD Healthcare Management
System Modernization (DHMSM), and shows the restructuring of the integrated Electronic
Health Record to the Defense Medical Information Exchange (DMIX) Program. This Budget
Activity Group includes the following:
Service Medical IM/IT ­ Resources non­centrally managed, Service Medical Information
Management/Information Technology (IM/IT) Programs in the following functional areas: 1)
Service medical funded support for Functional Area Applications (service unique
information systems); 2) Communications and Computing Infrastructure to include long
haul/wide area communications, office automation and video teleconferencing; 3) Related
Technical Activities, which includes spectrum management, data administration,
development of architectures, facilitation of interoperability and technical integration;
and 4) Information Assurance, which includes all efforts that protect and defend
information and information systems by ensuring their availability, integrity,
authentication, confidentiality and non­repudiation.
DHP IM/IT Support Programs ­ Resources services in support of the Military Health System
Health Information Technology Directorate and can be contracted out or provided by other
DoD agencies. Services deliver modifications to contractor owned IM/IT systems to meet
Congressional and other medical commercially regulated mandated changes; medical
functional IM/IT support personnel; and funding to support centrally managed office
automation.
Tri-Service IM/IT ­ Resources services and legacy Information Technology systems that are
shared within all components of the Military Health System, excluding the Integrated
Electronic Health Record and the DoD Healthcare Management System Modernization Program
Information Management
INFOM­87
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
I.
Description of Operations Financed (cont.)
(DHMSM) and the Defense Medical Information Exchange (DMIX), that are managed by the
Health Information Technology (HIT) Directorate of the Defense Health Agency. Resourced
HIT activities include: Innovation and Advanced Technology; Infrastructure and
Operations; Solution Delivery; Information Delivery; Cyber Security; and Portfolio
Management and Customer Relations. These resources are used for program management of DHA
programs, system and infrastructure sustainment, annual software licensing fees, and
software and hardware maintenance fees, including resources incrementally transferring
from DHP Components to the HIT Shared Service.
Integrated Electronic Health Record (iEHR) ­ Resources iEHR information technology
acquisition program to provide seamless integrated sharing of electronic health data
between the Department of Defense (DoD) and the Department of Veterans Affairs. In March
2008, the DHP embarked upon Electronic Health Record (EHR) modernization planning,
establishing the initial Electronic Health Records Way Ahead (EHRWA). In March 2011, the
Program was expanded to include the VA in a joint initiative to implement a new,
integrated electronic health record for both Departments, called the Integrated
Electronic Health Record (iEHR) program. Secretary of Defense Memorandum titled
“Integrated Electronic Health Records,” dated May 2013, provided additional direction to
the program:
• DoD shall continue near­term coordinated efforts with VA to develop data federation,
presentation, and interoperability. This near­term goal shall be pursued as a first
priority separately from the longer­term goal of health record information technology
(IT) modernization.
• DoD shall pursue a full and open competition for a core set of capabilities for EHR
modernization.
Information Management
INFOM­88
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
I.
Description of Operations Financed (cont.)
To fulfill Secretary of Defense directive, parallel programs have been defined, splitting
the original iEHR program into two distinct areas. In the Under Secretary of Defense for
Acquisition, Technology and Logistics (USD (AT&L)) Acquisition Decision Memoranda (ADM),
dated June 21, 2013 and January 2, 2014, the former joint DoD and VA Integrated
Electronic Health Record (iEHR) program was restructured to pursue two separate but
related healthcare information technology efforts, the DoD Healthcare Management System
Modernization (DHMSM) program and a newly defined iEHR focused on providing seamless
integrated sharing of electronic health data between the DoD and VA to be called Defense
Medical Information Exchange (DMIX). The remaining iEHR Increment 1 (iEHR Inc 1) was
significantly de­scoped to only the Medical Single Sign­on/Context Management (MSSO/CM)
implemented at James A. Lovell Federal Health Care Center (JAL FHCC).
Department of Defense Healthcare Management System Modernization Program (DHMSM) ­
Resources modernization of the legacy DoD health care electronic health record (EHR)
information technology systems. DHMSM will acquire and support deployment,
implementation, and sustainment of an electronic health record (EHR) system that replaces
the DoD legacy DHP inpatient and outpatient EHR systems. Overarching goal of the program
is to enable healthcare teams to deliver high­quality, safe care and preventive services
to patients through the use of easily accessible standards­based computerized patient
records resulting in: improved accuracy of diagnoses and impact on health outcomes;
increased patient participation in the healthcare process; improved patient­centered care
coordination; and increased practice efficiencies in all settings, including operational
environments.
DoD Medical Information Exchange and Interoperability (DMIX) – Resources the acquisition
of the capabilities necessary to securely and reliably exchange standardized, normalized,
Information Management
INFOM­89
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
I.
Description of Operations Financed (cont.)
and correlated health data with all partners through standard data / information exchange
mechanisms. DMIX program will acquire the capabilities necessary to securely and
reliably exchange standardized, normalized, and correlated health data with all partners
through standard data/information exchange mechanisms. This allows users in different
places and different organizations to access, use, and supplement health data (technical
interoperability) that has a shared meaning so users (assisted by computers) are able to
make care decisions (Semantic Interoperability – Level 4). DMIX manages the data
exchange capability from legacy data stores in order to prepare for the transition to the
modernized Electronic Health Record platform being acquired by DoD Healthcare Management
System Modernization (DHMSM). DMIX consists of a family of capability initiatives
supporting the seamless exchange of standardized health data among DoD, VA, other Federal
agencies, and private providers as well as benefits administrators. The DMIX program
provides the capability for health care providers to access and view complete and
accurate patient health records from a variety of data sources thereby allowing
healthcare providers to make faster and higher quality care decisions. DMIX was
established in accordance with the joint memo from USD(C) and USD(AT&L) titled "Joint
Memorandum on Major Defense Acquisition Program and Major Automated Information System
Program Resource Transparency in Department of Defense Budget Systems" dated June 27,
2013.
II. Force Structure Summary:
This program funds concept exploration, management and sustainment of automated
information systems, communications and computing infrastructure, related technical
activities and information assurance supporting military medical readiness and promoting
quality healthcare services to members of the Armed Forces, their families, and others
entitled to DoD healthcare.
Information Management
INFOM­90
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. Service Medical IM/IT
2. DHP IM/IT Support
Programs
3. Tri­Service IM/IT
4. Integrated Electronic
Health Record (iEHR)
5. DoD Healthcare
Management System
Modernization (DHMSM)
6. DoD Medical Information
Exchange and
Interoperability (DMIX)
Total
1.
2.
3.
4.
5.
FY
FY
FY
FY
FY
2014
2014
2015
2015
2016
FY 2014
Actual
641,078
91,459
Budget
Request
630,195
99,189
Current
Estimate
Amount
Percent Appropriated
­3,965
­0.6
626,230
626,230
0
0.0
99,189
99,189
FY 2016
Estimate
363,095
38,417
682,258
110,124
723,411
46,998
­15,686
0
­2.2
0.0
707,725
46,998
707,725
46,998
1,107,884
19,500
0
57,554
0
0.0
57,554
57,554
89,188
0
0
0
n/a
0
0
59,743
1,524,919
1,557,347
-19,651
-1.3
1,537,696
1,537,696
1,677,827
actuals include $2.2M for Overseas Contingency Operations (OCO).
does not reflect Departmental DoD Medicare­Eligible Retiree Health Care Fund (MERHCF) of $10.4M (O&M only).
estimate does not reflect DoD Medicare­Eligible Retiree Health Care Fund (MERHCF) of $5.4M (O&M only).
estimate and FY 2016 request exclude OCO.
does not reflect DoD Medicare­Eligible Retiree Health Care Fund (MERHCF)of $5.6M (O&M only).
Information Management
INFOM­91
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
1,557,347
­19,651
Change
FY 2015/FY 2016
1,537,696
1,537,696
1,537,696
15,965
1,537,696
124,166
1,677,827
1,537,696
Information Management
INFOM­92
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) FY 2015 one­time Congressional addition for Health
Artifact and Image Management Solution (HAIMS).
2) FY 2015 one­time Congressional decrease for other
Intra­governmental purchases ­ unjustfied growth.
3) FY 2015 one­time Congressional decrease for Travel
Reduction ­­ not properly accounted.
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
1) Reverses FY 2015 Congressional distributed
adjustments intra­governmental purchases ­
unjustified growth.
2) Reverses FY 2015 Congressional distributed
Amount
Totals
1,557,347
­19,651
3,600
­22,300
­951
1,537,696
1,537,696
1,537,696
1,537,696
15,965
214,063
22,052
961
Information Management
INFOM­93
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
adjustments travel reduction not properly accounted
for.
c. Program Growth in FY 2016
1) DoD Medical Information Exchange and Interoperability
(DMIX):
Realigns funding to the DMIX from Research,
Development, Test and Evaluation ($14.3M) and the
integrated Electronic Health Record (iEHR), ($45.4M)
for the Joint Electronic Health Record
Interoperability (JEHRI) to support initiatives
developed with the data federation accelerator
project and data sharing/interoperability efforts
between the Department of Defense and the Department
of Veterans Affairs. The DMIX program does not have
a FY 2015 baseline. Note: JEHRI realigns funding
within the IM/IT BAG and shown as a negative in
9.c.(1) together with iEHR funding adjustments.
2) Medical Community of Interest (Med­COI) and
Virtualization:
Increases funding for Military Health System
Virtualization and Med­COI programs including
sustainment and improvements necessary to technically
refresh the infrastructure of the two programs to
support the integration of Enterprise­wide Tri­
Service information technology. The programs
increase hosting capacity and standardize services to
enable the Initial Operating Capability of the next
generation Individual Electronic Health Record. The
FY 2015 IM/IT baseline funding is $1,537.7M. The FY
2015 IM/IT baseline staffing is 2,032 civilians FTEs
Amount
Totals
59,743
37,011
Information Management
INFOM­94
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
and 4,034 contractors.
3) Support Operations of Defense Health Agency (DHA)
Shared Service ­ Health Information Technology (HIT):
Realigns funding from the In­House Care (­$17.6M),
Consolidated Health Support (­$2.8M), Education and
Training (­$0.1), and Base Operations/Communications
(­$5.6M) to the Information Management BAG to support
the operations of the HIT Shared Service. The FY
2015 IM/IT baseline funding is $1,537.7M. The FY
2015 DHP IM/IT baseline staffing is 2,032 civilians
FTEs and 4,034 contractors.
4) Department of Defense Healthcare Management System
Modernization (DHMSM):
Increases funding to support the integration of
enterprise­wide IT to include DoD Healthcare
Management System Modernization (DHMSM) funding for
necessary common infrastructure and local testing
requirements conducted in the Pacific Northwest
Region to meet the Initial Operating Capability
deployment schedule set by the Secretary of Defense
for the DoD Medical Information Exchange and
Interoperability Program. The FY 2015 DHMSM baseline
funding is $15.6M.
5) Armed Forces Health Longitudinal Technology
Application (AHLTA) and Composite Health Care System
(CHCS):
Increases funding for the sustainment of the AHLTA
and CHCS systems until the next generation electronic
health record is fully deployed. The FY 2015 IM/IT
baseline funding is $1,537.7M. The FY 2015 IM/IT
Amount
Totals
26,093
13,770
13,432
Information Management
INFOM­95
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
baseline staffing is 2,032 civilian FTEs, and 4,034
contractors.
6) National Capital Region Medical Directorate (NCR­MD)
Information Technology:
Realigns funding from the Base Operations and
Communications Budget Activity Group (BAG) to the
IM/IT BAG to support increased requirements for
information assurance activities, Computer Network
Defense Service Provider, enterprise software
licenses, the joint medical network, help desk and
equipment refresh. The FY 2015 DHA NCR­MD IM/IT
baseline funding is $68.1M. The FY 2015 DHA NCR­MD
IM/IT baseline staffing is 50 civilian FTEs, and 225
contractors.
7) Manpower Analysis (Army and Defense Health Agency):
Increases funding for the Army ($7.3M) for the
sustainment of Information Management activities and
systems (e.g., Medical Operational Data System) not
transitioning to the Health Information Technology
(HIT) in the FY 2016 phase. Also, increases funding
to the Defense Health Agency $2.8M to support the
HIT. The FY 2015 Army IM/IT baseline funding is
$223.2M. The FY 2015 Army IM/IT baseline staffing is
1,012 civilian FTEs, and 44 contractors. The FY 2015
Defense Health Agency baseline funding is $900.2M.
The FY 2015 Defense Health Agency IM/IT baseline
staffing is 231 civilian FTEs, and 3,220 contractors.
8) Pacific­Based Joint Information Technology Center
(PJITC):
Realigns initial Research, Development, Test and
Amount
Totals
10,223
10,118
5,174
Information Management
INFOM­96
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Evaluation (RDT&E) Pacific­Based Joint Information
Technology Center (PJITC) funding to Operation and
Maintenance (O&M) funding for proper budget
execution. Beginning in FY 2016, funds staff and
associated program activities. The FY 2015 PJITC
RDT&E baseline funding is $8.1M. The FY 2015 PJTIC
IM/IT baseline staffing is 3 civilian FTEs, funded by
the Health Information Technology Directorate, and 17
contractors.
9) Equipment:
Provides additional funding for Military Treatment
Facility IT equipment including wireless, mobile and
other personal computing devices to meet the average
life cycle replacement rate of five years. The FY
2015 IM/IT equipment baseline funding request is
$39.9M.
10) Tri­Service Workflow (TSWF) and Content Advisory
Group (CAG):
Funds expansion of ongoing TSWF and CAG efforts to
standardize the provision of quality health care
services and the associated electronic clinical
documentation through standardized electronic patient
documentation templates. These standardized
templates simultaneously enhance provider efficiency
and patient safety by influencing provider workflow,
while standardizing the clinical notes to facilitate
continuity of care. By directing patient care through
evidence based guidelines, the templates advocate for
appropriate patient care and result in a cost
avoidance to the Military Health System. Clinical
Amount
Totals
5,019
4,044
Information Management
INFOM­97
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
teams in the outpatient setting utilizing these
templates have shown better clinical results in
mental health, heart attack and stroke, reducing
unnecessary hospitalization, procedures and improving
patient compliance resulting in significant cost
avoidance. The FY 2015 IM/IT baseline funding is
$1,537.7M. The FY 2015 IM/IT baseline staffing is
2,032 civilian FTEs, and 4,034 contractors.
11) IM/IT Appropriation Realignment:
Realigns funding from the Procurement Budget Activity
to the IM/IT Operation and Maintenance (O&M) to
sustain requirements for Secure Messaging to comply
with the Federal Risk and Authorization Program. The
FY 2015 IM/IT baseline funding is $1,537.7M. The FY
2015 IM/IT baseline staffing is 2,032 civilian FTEs,
and 4,034 contractors.
12) Travel:
Funds travel for emerging world­wide healthcare
support requirements, including Health Information
Technology transition from an initial operating
capability to a full operational capability, Defense
Healthcare Management System Modernization Program
requirements, and to ensure the Defense Medical
Information Exchange Program meets the FY 2016
initial deployment schedule. Includes funding for
Defense Health Agency­National Capital Region Medical
Directorate increased travel requirements. The
IM/IT BAG travel baseline funding is $3.4M.
13) One More Civilian Paid Day:
Adjusts civilian payroll for one additional pay day
Amount
Totals
3,285
2,190
807
Information Management
INFOM­98
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
for FY 2016. The FY 2015 IM/IT Budget Activity Group
(BAG) baseline civilian funding is $216.1M. The
IM/IT baseline staffing is 2,032 civilian FTEs.
14) Realigned Wounded, Ill and Injured (WII)
Requirements:
Realigns funds from the Base Operations and
Communications Budget Activity Group to the IM/IT
Budget Activity Group for proper execution of Army
Medical Action Plan (AMAP) requirements. The FY 2015
Army IM/IT baseline funding is $223.2M. The FY 2015
Army IM/IT baseline staffing is 1,012 civilian FTEs,
and 44 contractors.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
1) Reverses FY 2015 one­time Congressional addition for
Health Artifact and Image Management Solution
(HAIMS).
c. Program Decreases in FY 2016
1) Integrated Electronic Health Record (iEHR)
Realignments:
Realigns funding from Joint Electronic Health Record
Interoperability (JEHRI) and from Research,
Development, Test and Evaluation to DoD Medical
Information Exchange (DMIX) to support initiatives
developed with the data federation accelerator
project and data sharing/interoperability efforts
between the Department of Defense and the Department
of Veterans Affairs. The FY 2015 iEHR baseline
funding is $57.6M. The FY 2015 iEHR baseline
Amount
Totals
141
­89,897
­3,629
­45,399
Information Management
INFOM­99
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
staffing is 76 civilian FTEs, and 350 contractors.
2) Savings from the Defense Health Agency Shared Service
­ Health Information Technology (HIT):
Reduces funding through a phased consolidation of
Health Information Technology functions and
activities from the Components to the Defense Health
Agency including the consolidation of like services
across the Military Health System to reduce
redundancies. Implements re­engineering of IM/IT
business management and analysis, infrastructure
consolidation, and portfolio rationalization. The FY
2015 IM/IT baseline funding is $1,537.7M. The FY
2015 DHP IM/IT baseline staffing is 2,032 civilians
FTEs and 4,034 contractors.
3) Healthcare Services ­ Air Force Medical Service
(AFMS):
Realigns funding from the IM/IT and Education and
Training Budget Activity Groups (BAGs) to the In­
House Care BAG to fund approximately 180 contract
providers and support staff to backfill positions
vacated due to the military end strength reductions.
This will allow the AFMS to maintain healthcare
services at Military Treatment Facilities, thereby
preventing patients from being referred for care in
the private sector. The FY 2015 Air Force IM/IT
baseline funding is $167.8M. The FY 2015 Air Force
IM/IT baseline staffing is 199 civilian FTEs, and 444
contractors.
4) Enterprise­Wide Information Technology Sustainment
and Investments:
Amount
Totals
­21,774
­12,846
­5,019
Information Management
INFOM­100
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Realigns funding from operations and maintenance,
sustainment to procurement for additional Defense
Systems Network node support and an enhancement for
the coding and compliance editor as a result of the
termination of and/or consolidations of IM/IT
initiatives including: eForms and Data Domain
licenses, reduction in funding since Java Exchange
Platform (JXP), Disability Evaluation System­
Information Technology Initiative, and a reduction in
associated management and infrastructure support. The
FY 2015 IM/IT baseline funding is $1,537.7M. The FY
2015 IM/IT baseline staffing is 2,032 civilians FTEs
and 4,034 contractors.
5) 20% HQ Reduction:
Continuation of incremental 20% reduction to Defense
Health Program (DHP) headquarters in compliance with
the Department of Defense July 31, 2013 memorandum,
"20% Headquarters Reduction," signed by the Deputy
Secretary of Defense. The reduction applies to the
total headquarters budget and IM/IT support
contracts. The FY 2015 IM/IT baseline funding is
$1,537.7M. The FY 2015 IM/IT baseline staffing is
2,032 civilians FTEs and 4,034 contractors.
FY 2016 Budget Request
Amount
Totals
­1,230
1,677,827
Information Management
INFOM­101
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
IV. Performance Criteria and Evaluation Summary:
As of 30 September 2014, the below listed DHP IM/IT systems met or exceeded the following
performance metrics:
Operational Availability [operational of at least 98.5%]: AHLTA, CHCS, DMLSS, DOEHRS­IH,
Essentris, HAIMS, NMIS, PHIMT, PSR, SRTS, TOL, SNPMIS, DOEHRS­HC, JMAR, TEWLS, TRAC2ES,
CCE, EAS IV, MDR, PEPR, TED, MHSLearn, TPOCS, Operations Center Wide Area Network, Army
Military Treatment Facility Network, Online Medical Material Network, Defense Health
Network, DoD/VA Gateway, DHA Health.mil and Identity Authentication Services.
User Satisfaction Survey [minimum user satisfaction survey score of at least 75% for
training and 4 of 5 for service]:
> Training:
AHLTA, CHCS, DMLSS, DOEHRS­IH, EIDS and TMIP­J.
> Service: Military Health System Enterprise­wide Service Desk, the MHS Network Support
Services, and Army Network Management Service Helpdesk.
Timeliness in resolving trouble tickets or incident reports (minimum closure rate of
90%):
> Severity I tickets closed in 90 days: CHCS, CCQAS, HAIMS, PSR, S3, SRTS, DOEHRS­IH,
DMLSS, TRAC2ES, DHMSRi, PEPR, TED and M2.
> Severity II tickets closed within 180 days: CHCS, CCQAS, HAIMS, PSR, S3, SRTS, DOEHRS­
IH, DMLSS, TRAC2ES, DHMSRi, PEPR, TED, M2 and TMIP­J.
Information Management
INFOM­102
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
IV. Performance Criteria and Evaluation Summary:
Data Processing Completeness/Timeliness:
> 98.3% of theater encounters appropriately accessible to MHS and the Department of
Veterans Affairs users: TMIP­J
> 99.9% of theater inpatient and outpatient records successfully processed in the Theater
Medical Data Store: TMIP­J
> 97.0% of 24­hour daily processing rate of data processed from external data stores:
DMLSS
Acronym List:
CCE
CCQAS
CHCS
CIS
DHMSRi
DMLSS
DOEHRS
Coding and Compliance Editor
Centralized Credentials and Quality Assurance
System
Composite Health Care System
Clinical Information System (Essentris)
Defense Integrated Military Human Resources
System ­ Internet
Defense Medical Logistics Standard Support
Defense Occupational and Environmental Health
Information Management
INFOM­103
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
IV. Performance Criteria and Evaluation Summary:
­HC
DOEHRS
­IH
EAS IV
HAIMS
JMAR
MHS
LEARN
MDR
NMIS
PEPR
PHIMT
PSR
S3
SNPMIS
SRTS
TED
TRAC2­
ES
TEWLS
TMIP­J
TOL
Readiness System – Hearing Conservation
Defense Occupational and Environmental Health
Readiness System ­ Industrial Hygiene
Expense Assignment System IV
Health Artifact and Image Management Solution
Joint Medical Asset Repository
Military Health System Learning Management
System
Military Health System Data Repository
Nutrition Management Information System
Patient Encounter processing and Reporting
Patient Movement Item Tracking system
Patient Safety Reporting
Surgical Scheduling System
Special Needs Program Management Information
System
Spectacle Request and Transmission System
TRICARE Encounter Data
Transportation Command (TRANSCOM) Regulating and
Command and Control Evacuation System –
Increment 2
Theater Enterprise Wide Medical Logistics System
Theater Medical Information System ­ Joint
TRICARE On Line
Information Management
INFOM­104
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
IV. Performance Criteria and Evaluation Summary:
TPOCS
Third Party Outpatient Collection System
Information Management
INFOM­105
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
V. Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Average Annual Civilian Salary ($ in
thousands)
Contractor FTEs (Total)
458
152
306
466
Change
FY 2014/
FY 2015
­5
­3
­2
7
Change
FY 2015/
FY 2016
­14
5
­19
­9
149
326
2,032
1,976
13
1,989
43
106.4
150
316
1,982
1,927
13
1,940
42
119.0
1
6
269
254
3
257
12
­0.1
1
­10
­50
­49
0
­49
­1
12.6
4,034
5,228
­720
1,194
FY 2014
FY 2015
FY 2016
477
150
327
468
472
147
325
475
148
320
1,763
1,722
10
1,732
31
106.5
4,754
Military:
The decrease from FY 2014 to FY 2015 of (­5) includes Air Force reduction (­5) to meet
requirements of the Budget Control Act. The decrease from FY 2015 to FY 2016 of (­14)
includes Navy (+4) for DOD Integrated Electronic Health Record and Air Force (­18) to
meet requirements of the Budget Control Act.
Information Management
INFOM­106
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
Civilian:
The increase of civilian personnel from FY 2014 ­ FY 2015 reflects Navy and Defense
Health Agency insourcing initiatives and increases due to end of year adjustments for all
DHP components as FY 2014 actuals were less than programmed due hiring lag impacted by
Sequestration in FY 2013. The decrease from FY 2015 ­ FY 2016 reflects 20% Headquarters
and Component civilian workload analysis.
Contractor:
The decrease in contractor personnel from FY 2014 ­ FY 2015 reflects Air Force IM/IT
contract reduction and the Defense Health Agency's 20% reduction in headquarters. The
increase from FY 2015 ­ FY 2016 reflects increases in sustainment funding for the Armed
Forces Health Longitudinal Technology Application and Composite Health Care Systems,
Medical Community of Interest, and Virtualization enhancement and changes for the
Integrated Electronic Health Record restructuring to the Defense Medical Information
Exchange.
Information Management
INFOM­107
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l & Spec Scheds
199 TOTAL CIV COMPENSATION
308 Travel of Persons
399 TOTAL TRAVEL
412 Navy Managed Supply, Matl
416 GSA Supplies & Materials
417 Local Purch Supplies & Mat
422 DLA Mat Supply Chain (Medical)
499 TOTAL SUPPLIES & MATERIALS
503 Navy Fund Equipment
506 DLA Mat Supply Chain (Const &
Equip)
507 GSA Managed Equipment
599 TOTAL EQUIPMENT PURCHASES
601 Army Industrial Operations
614 Space & Naval Warfare Center
633 DLA Document Services
635 Navy Base Support (NAVFEC
Other Support Services)
647 DISA Enterprise Computing
Centers
671 DISA DISN Subscription
Services (DSS)
677 DISA Telecomm Svcs ­
Reimbursable
679 Cost Reimbursable Purchase
699 TOTAL DWCF PURCHASES
771 Commercial Transport
799 TOTAL TRANSPORTATION
901 Foreign National Indirect Hire
(FNIH)
902 Separation Liab (FNIH)
FY 2014
Actual
185,759
185,759
2,287
2,287
47
466
37
12
562
0
14
Change
FY 2014/FY 2015
Price
Program
1,858
25,658
1,858
25,658
41
1,050
41
1,050
1
­48
8
186
1
403
0
52
10
593
0
141
0
­12
FY 2015
Estimate
213,275
213,275
3,378
3,378
0
660
441
64
1,165
141
2
Change
FY 2015/FY 2016
Price
Program
2,613
17,042
2,613
17,042
57
2,190
57
2,190
0
0
11
2
7
1
0
1
18
4
0
3
0
1
FY 2016
Estimate
232,930
232,930
5,625
5,625
0
673
449
65
1,187
144
3
1,267
1,281
18,454
53,731
318
186
23
23
576
688
18
2
­379
-250
­8,378
­45,646
­315
­188
911
1,054
10,652
8,773
21
0
15
15
844
142
0
0
3
7
2,857
­102
0
341
929
1,076
14,353
8,813
21
341
80,165
­593
2,498
82,070
­8,215
9,660
83,515
12,939
246
­5,985
7,200
­669
1,328
7,859
79
6
­67
18
0
1
19
0
165,872
331
331
1,887
0
943
6
6
19
9
-58,072
­96
-96
927
9
108,743
241
241
2,833
0
-7,898
4
4
35
2
14,087
0
0
­74
11
114,932
245
245
2,794
53
1
­1
53
1
­1
53
Information Management
INFOM­108
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Information Management
OP 32 Line
912 Rental Payments to GSA (SLUC)
913 Purchased Utilities (Non­Fund)
914 Purchased Communications (Non­
Fund)
915 Rents (Non­GSA)
917 Postal Services (U.S.P.S)
920 Supplies & Materials (Non­
Fund)
921 Printing & Reproduction
922 Equipment Maintenance By
Contract
923 Facilities Sust, Rest, & Mod
by Contract
925 Equipment Purchases (Non­Fund)
926 Other Overseas Purchases
932 Mgt Prof Support Svcs
933 Studies, Analysis & Eval
934 Engineering & Tech Svcs
937 Locally Purchased Fuel (Non­
Fund)
955 Other Costs (Medical Care)
960 Other Costs (Interest and
Dividends)
964 Other Costs (Subsistence and
Support of Persons)
986 Medical Care Contracts
987 Other Intra­Govt Purch
988 Grants
989 Other Services
990 IT Contract Support Services
999 TOTAL OTHER PURCHASES
Total
FY 2014
Actual
4,564
3
6,006
Change
FY 2014/FY 2015
Price
Program
82
2,208
0
201
108
9,410
FY 2015
Estimate
6,854
204
15,524
Change
FY 2015/FY 2016
Price
Program
117
581
3
14
264
293
FY 2016
Estimate
7,552
221
16,081
1,828
172
6,713
33
3
121
­1,048
­57
13,072
813
118
19,906
14
2
338
110
0
939
937
120
21,183
939
3,344
17
60
594
81
1,550
3,485
26
59
­529
­174
1,047
3,370
5
0
295
300
5
95
400
47,776
0
48,032
1,257
8,378
9
860
0
865
23
151
0
­9,804
1
­4,059
2,155
­8,225
­9
38,832
1
44,838
3,435
304
0
660
0
762
58
5
0
5,012
1
32,984
141
3,020
0
44,504
2
78,584
3,634
3,329
0
81,530
0
3,017
0
­54,378
142
30,169
142
1,116
2
­22,717
1
8,568
145
1
0
­1
0
0
0
0
7,746
58,128
2
23,527
866,927
1,168,827
1,524,919
287
1,046
0
423
15,605
22,721
25,602
­8,033
35,327
­2
30,871
8,625
18,292
-12,825
0
94,501
0
54,821
891,157
1,209,840
1,537,696
0
1,607
0
932
15,150
21,156
15,965
15,631
­8,543
0
2,721
61,331
90,836
124,166
15,631
87,565
0
58,474
967,638
1,321,832
1,677,827
Information Management
INFOM­109
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
I. Description of Operations Financed: This Budget Activity Group is comprised of
Services' Medical Headquarters and Defense Health Agency's functions supporting Military
Health System (MHS) worldwide patient care delivery:
Management Headquarters ­ Resources required for the U.S. Army Medical Command, the Navy
Bureau of Medicine and Surgery, the Air Force Medical Service, and the Defense Health
Agency personnel identified as management headquarters staff that coordinate and oversee
the provision of health care within the Military Health System.
Defense Health Agency ­ This program element contains funding for Defense Health Agency
(DHA) operating costs supporting delivery of patient care worldwide for members of the
Armed Forces, family members, and others entitled to DoD health care. Oversees and
maintains DoD Unified Medical Program resources for all medical activities. The Defense
Health Agency became the Operation of Record in FY 2015.
TRICARE Management Activity - Resources required for the operation of the TRICARE
Management Activity. These operating costs support delivery of patient care worldwide for
members of the Armed Forces, family members, and others entitled to DoD health care. This
also includes the TRICARE Regional Offices (TROs), the Military Medical Support Office
(MMSO), and the Pharmacoeconomic Center (PEC). FY 2014 was the last year this Activity
was financed.
II. Force Structure Summary:
Force Structure Summary: Management Headquarters includes resources necessary to support
headquarters functions outlined in DoD Directive 5100.73, Major Department of Defense
Headquarters Activities. Within the Military Health System, this includes the cost of
operating the Defense Health Agency, the U.S. Army Medical Command, the Navy Bureau of
Medicine and Surgery, and the Air Force Medical Service.
Management Activities
MACT­111
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
Defense Health Agency
(Started FY 2015)
Management Headquarters
TRICARE Management
Activity (Ended FY 2014)
Total
FY 2014
Actual
0
Budget
Request
220,890
Current
Estimate
Amount
Percent Appropriated
­1,278
­0.6
219,612
219,612
FY 2016
Estimate
186,750
130,747
194,258
145,333
0
­753
0
­0.5
n/a
144,580
0
144,580
0
141,217
0
325,005
366,223
-2,031
-0.6
364,192
364,192
327,967
1. FY 2014 actuals include $1.5M for Overseas Contingency Operations (OCO).
2. FY 2015 estimate and FY 2016 request exclude OCO.
Management Activities
MACT­112
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
366,223
­2,031
Change
FY 2015/FY 2016
364,192
364,192
364,192
5,444
364,192
­41,669
327,967
364,192
Management Activities
MACT­113
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) One­time FY 2015 Congressional Adjustment: Travel
Reduction.
2) One­time FY 2015 Congressional Adjustment: Reduction
in Civilian FTEs (Not Properly Accounted For).
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
1) Reversal of FY 2015 One­time Congressional Decrease:
Travel Reduction.
2) Reversal of FY 2015 One­time Congressional Decrease:
Reduction in Civilian FTEs (Not Properly Accounted
For).
c. Program Growth in FY 2016
Amount
Totals
366,223
­2,031
­1,261
­770
364,192
364,192
364,192
364,192
5,444
20,940
1,278
781
Management Activities
MACT­114
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
1) Defense Health Program Contract Support Realignment:
Realigns funding within the Management Activities BAG
from IT Contract Support Services to Management and
Professional Support Services and Engineering and
Technical Services in support of the Health
Facilities Shared Service and Pharmacy Shared
Service. The Health Facility Shared Service will
streamline the process through which facility
requirements are identified and prioritized, new
facilities are planned and designed, older facilities
are restored/modernized, and all facilities are
maintained and operated. The Pharmacy Shared Service
will provide a collaborative process with Army
Medicine, Navy Medicine and Air Force Medicine that
will focus on pharmacy standardization across the
enterprise, accountability and performance measures,
increased utilization of cost­effective points of
service and how to best allocate resources for proper
execution. The FY 2015 Management Activities BAG
baseline funding is $364.2M. The FY 2015 baseline
staffing is 1,490 civilian FTEs and 680 contractots.
2) Support for Defense Health Agency Shared Services
Operations:
Realigns funding from various Budget Activity Groups
(BAGs) to support 44 civilian FTEs ($6.0M) and
contracts, supplies and travel ($0.1M) in support of
the following Shared Services: Contracting,
Facilities, Health Information Technology and Health
Plan. The FY 2015 Management Activities baseline
funding is $364.2M.
Amount
7,851
Totals
6,051
Management Activities
MACT­115
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
3) Wounded Ill and Injured (WII) Realignment:
Realigns funding from the Consolidated Health Support
(CHS) Budget Activity Group (BAG) to Management
Activities BAG for the comprehensive oversight for
all Rehabilitation and Reintegration (R2R) Programs
and Policies for the Wounded Ill and Injured. This
institutes the strategic planning, guidance and
standard of care for injury prevention, physical
performance, optimization, rehabilitation and
transition of soldiers with a plethora of diagnoses.
The FY 2015 Management Activities BAG baseline
funding is $364.2M. The FY 2015 baseline staffing is
1,490 civilian FTEs and 680 contractors.
4) Equipment:
Funds increased office equipment requirements to
support the realignment of organizations to the
Defense Health Agency. The FY 2015 Management
Activities BAG equipment baseline funding is $1.2M.
5) One More Civilian Paid Day:
Adjusts civilian payroll for one additional paid day
for FY 2016. The FY 2015 Management Activities BAG
baseline funding is $364.2M. The FY 2015 baseline
civilian staffing is 1,490 civilian FTEs.
6) Travel:
Funds travel for emerging world­wide healthcare
oversight requirements to include AF Unit
Environmental Inspections and Flight Medicine
Initiatives to Implement and Standardize health
assessments and workflows. Funding also supports
continuing education for readiness and currency of
Amount
2,650
Totals
859
755
715
Management Activities
MACT­116
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
DoD mission and MHS staff credentialing requirements.
The FY 2015 Management Activities BAG travel baseline
funding is $4.6M.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
c. Program Decreases in FY 2016
1) Warrior Care Program Office Realignment:
Realigns funding for the Warrior Care Program Office
from Management Activities Budget Activity Group
(BAG), to Consolidated Health Support BAG to
accurately capture civilian pay and contract support
where it will execute. Warrior Care Program Office
was transferred to Defense Health Program (DHP) in
2014. This program office provides policy and
oversight of the Department of Defense's Integrated
Disability Evaluation System and Warrior Care
Program. The FY 2015 baseline funding for the Warrior
Care Program Office is $30.8M. The FY 2015 baseline
staffing is 7 civilian FTEs and 148 contractors.
2) 20% Management Headquarters Reduction:
Continuation of incremental 20% reduction to Defense
Health Program (DHP) headquarters in compliance with
the Department of Defense July 31, 2013 memorandum,
"20% Headquarters Reduction," signed by the Deputy
Secretary of Defense.
The reduction applies to the
total headquarters budget and includes civilian FTEs,
contract personnel and supplies and materials.
Reduction in the Management Activities Budget
Activity Group (BAG) include Management Headquarters
Amount
Totals
­62,609
­29,784
­14,802
Management Activities
MACT­117
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
and Defense Health Agency (DHA). The FY 2015
Management Activities BAG baseline funding is
$364.2M. The FY 2015 baseline staffing is 1,490
civilian FTEs and 680 contractors.
3) Defense Health Program Contract Support Realignment:
Realigns funding within the Management Activities BAG
from IT Contract Support Services to Management and
Professional Support Services and Engineering and
Technical Services in support of the Health
Facilities Shared Service and Pharmacy Shared
Service. The Health Facility Shared Service will
streamline the process through which facility
requirements are identified and prioritized, new
facilities are planned and designed, older facilities
are restored/modernized, and all facilities are
maintained and operated. The Pharmacy Shared Service
will provide a collaborative process with Army
Medicine, Navy Medicine and Air Force Medicine that
will focus on pharmacy standardization across the
enterprise, accountability and performance measures,
increased utilization of cost­effective points of
service and how to best allocate resources for proper
execution. The FY 2015 Management Activities BAG
baseline funding is $364.2M. The FY 2015 baseline
staffing is 1,490 civilian FTEs and 680 contractors.
4) Audit Readiness Realignment:
Realigns funding to Department of Defense for central
execution of the Audit Readiness program for select
Defense Agencies and Activities.
5) Financial Improvement and Audit Readiness (FIAR)
Amount
Totals
­7,851
­5,700
­2,589
Management Activities
MACT­118
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Initiative:
Reduces one­time funding requirement from FY 2015 to
FY 2016 for FIAR initiative preparation work in
support of the Secretary of Defense's DoD FIAR goals
and timelines. Funding supported the Independent
Public Auditor contract issued to provide examination
of the Statement of Budgetary Activity for all FY
2015 DHP appropriations.
6) Support for Defense Health Agency Shared Services
Operations:
Realigns funding to various Budget Activity Groups
(BAGs) to support 11 civilian FTEs (+$1,378K) and
contracts, supplies and travel (+505K) in support of
the following Shared Services: Health Facilities,
Health Information Technology, Medical Logistics, and
Public Health. The FY 2015 Management Activities BAG
funding baseline is $364.2M
FY 2016 Budget Request
Amount
Totals
­1,883
327,967
Management Activities
MACT­119
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
IV. Performance Criteria and Evaluation Summary:
Refer to the Personnel Summary in Section V.
Management Activities
MACT­120
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
V. Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Average Annual Civilian Salary ($ in
thousands)
Contractor FTEs (Total)
731
554
177
730
Change
FY 2014/
FY 2015
­172
­117
­55
­67
Change
FY 2015/
FY 2016
2
0
2
­86
613
203
1,490
1,485
1,485
5
132.2
554
176
1,409
1,404
1,404
5
134.7
­40
­27
90
89
89
1
2.2
­59
­27
­81
­81
­81
0
2.5
680
483
­19
­197
FY 2014
FY 2015
FY 2016
901
671
230
883
729
554
175
816
653
230
1,400
1,396
1,396
4
130.0
699
Narrative Explanation of changes in Military Personnel: the change from FY 2014 to FY
2015 of (­117) includes Navy internal realignments (+14) and Air Force reductions (­75)
to meet requirements of the Budget Control Act. The change from FY 2015 to FY 2016
includes Navy internal realignments (+4) and Air Force internal realignments (­1).
Narrative Explanation of changes in Civilian Personnel: Change from 2014 ­ 2015 reflects
lower execution in FY 2014 due to lingering effects of hiring freeze and sequestration.
Change from 2015 ­ 2016 is associated with reduction of 74 FTEs to align with directed
decreases in Headquarters support and the realignment of 7 FTEs to the Consolidated
Management Activities
MACT­121
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
Health Support BAG as part of the realignment of Warrior Care Policy Office.
Narrative Explanation of changes in Contractor FTEs: Change from FY 2014 ­ 2015
associated with phased Management Headquarters indirect support contract reductions.
Change from FY 2015 ­ 2016 decrease resulting from the realignment of the Warrior Care
Program Office to the Consolidated Health Support BAG.
Management Activities
MACT­122
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l & Spec Scheds
199 TOTAL CIV COMPENSATION
308 Travel of Persons
399 TOTAL TRAVEL
412 Navy Managed Supply, Matl
417 Local Purch Supplies & Mat
499 TOTAL SUPPLIES & MATERIALS
601 Army Industrial Operations
634 Navy Base Support (NAVFEC)
647 DISA Enterprise Computing
Centers
699 TOTAL DWCF PURCHASES
771 Commercial Transport
799 TOTAL TRANSPORTATION
901 Foreign National Indirect Hire
(FNIH)
FY 2014
Actual
181,470
181,470
5,673
5,673
1
288
289
364
8
156
Change
FY 2014/FY 2015
Price
Program
1,815
13,101
1,815
13,101
102
­1,214
102
-1,214
0
0
5
364
5
364
11
­375
0
­8
­1
­155
FY 2015
Estimate
196,386
196,386
4,561
4,561
1
657
658
0
0
0
Change
FY 2015/FY 2016
Price
Program
2,406
­9,653
2,406
-9,653
78
1,898
78
1,898
0
1
11
0
11
1
0
0
0
0
0
0
FY 2016
Estimate
189,139
189,139
6,537
6,537
2
668
670
0
0
0
528
84
84
344
10
2
2
3
-538
155
155
87
0
241
241
434
0
4
4
5
0
1
1
1
0
246
246
440
902 Separation Liab (FNIH)
912 Rental Payments to GSA (SLUC)
913 Purchased Utilities (Non­Fund)
914 Purchased Communications (Non­
Fund)
154
604
0
474
2
11
0
9
­2
­615
439
1,050
154
0
439
1,533
2
0
7
26
­2
0
­67
­40
154
0
379
1,519
915 Rents (Non­GSA)
917 Postal Services (U.S.P.S)
920 Supplies & Materials (Non­
Fund)
921 Printing & Reproduction
922 Equipment Maintenance By
Contract
923 Facilities Sust, Rest, & Mod
by Contract
925 Equipment Purchases (Non­Fund)
932 Mgt Prof Support Svcs
4
0
3,074
0
0
55
25
391
10,129
29
391
13,258
0
7
225
0
­1
­5,963
29
397
7,520
34
0
1
0
689
417
724
417
12
7
0
­12
736
412
4
0
­2
2
0
­1
1
1,605
82,799
29
1,490
­393
­34,443
1,241
49,846
21
847
986
3,358
2,248
54,051
Management Activities
MACT­123
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Management Activities
OP 32 Line
933 Studies, Analysis & Eval
934 Engineering & Tech Svcs
955 Other Costs (Medical Care)
960 Other Costs (Interest and
Dividends)
964 Other Costs (Subsistence and
Support of Persons)
986 Medical Care Contracts
987 Other Intra­Govt Purch
988 Grants
989 Other Services
990 IT Contract Support Services
999 TOTAL OTHER PURCHASES
Total
FY 2014
Actual
14,257
1,578
61
33
Change
FY 2014/FY 2015
Price
Program
257
­6,049
28
­1,414
2
9,516
1
­34
FY 2015
Estimate
8,465
192
9,579
0
Change
FY 2015/FY 2016
Price
Program
144
264
3
4,493
354
2,859
0
0
FY 2016
Estimate
8,873
4,688
12,792
0
7
0
7
14
0
0
14
469
7,538
0
17,798
6,124
136,961
325,005
17
136
0
320
110
2,471
4,405
­478
­184
18
34,352
9,408
22,914
34,782
8
7,490
18
52,470
15,642
162,346
364,192
0
127
0
892
266
2,945
5,444
­1
3,383
0
­27,265
­15,908
-33,916
-41,669
7
11,000
18
26,097
0
131,375
327,967
Management Activities
MACT­124
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
I. Description of Operations Financed: This Budget Activity Group is comprised of three
primary categories that provide support for education and training opportunities for
personnel within the Defense Health Program:
Health Professions Scholarship Program (HPSP)- Resources required for the Armed Forces
HPSP, the Financial Assistance Program (FAP), Health Professions Loan Repayment Program
(HPLRP), and other pre­commissioning professional scholarship programs. These funds are
used for educational expenses including tuition, fees and reimbursed expenses (e.g.
books, supplies and equipment).
Uniformed Services University of the Health Sciences (USUHS) - Resources required for
operation and maintenance of this Department of Defense (DoD) funded university that
produces an average of 650 graduates annually, including physicians, advanced practice
nurses, advanced practice dentists and other health professionals from the School of
Medicine, Graduate School of Nursing, Postgraduate Dental College, National Capital Area
Graduate Medical Education Residency Programs and Graduate Education Programs leading to
a masters or doctoral degree in public health, healthcare administration, clinical
psychology and the biomedical sciences.
Other Education and Training - Resources required for specialized skill training and
professional development education programs for health care personnel at the Medical
Education and Training Campus (METC), U.S. Army Medical Department Center and School,
Navy Bureau of Medicine and Surgery sponsored schools, and Air Force medical professions
education and training programs. Includes formal educational programs for health care
personnel at civilian academic institutions, civilian medical facilities and facilities
of non­DoD governmental agencies. Professional development provides officer, enlisted,
and civilian medical personnel with the specialized skills and knowledge required to
perform highly technical health service missions.
Education and Training
EDT­125
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
II. Force Structure Summary:
Education and training resources provide tuition and other educational expenses for the
Armed Forces HPSP, FAP residencies, and the HPLRP. USUHS resources fund operation and
maintenance requirements necessary to operate a DoD­funded medical school that trains
doctors, as well as offering graduate programs for nurses and professionals in the
biological sciences. The remaining resources are required for professional development
education, training programs and specialized skills training necessary to accomplish the
mission.
Education and Training
EDT­126
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. Health Professions
Scholarship Program
2. Uniformed Services
University of the Health
Services
3. Other Education and
Training
Total
1.
2.
3.
FY 2014
Actual
226,337
Budget
Request
304,081
148,738
146,301
0
0.0
146,301
146,301
154,649
276,411
300,484
0
0.0
300,484
300,484
301,887
651,486
750,866
0
0.0
750,866
750,866
750,614
Amount
Current
Estimate
Percent Appropriated
0
0.0
304,081
304,081
FY 2016
Estimate
294,078
FY 2014 actuals include $10.5M for Overseas Contingency Operations (OCO).
FY 2015 estimate excludes $5.1M for OCO.
FY 2016 request excludes OCO.
Education and Training
EDT­127
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
750,866
Change
FY 2015/FY 2016
750,866
750,866
750,866
5,059
25,015
755,925
­5,059
750,866
­25,267
750,614
Education and Training
EDT­128
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
a. OCO and Other Supplemental Requested
1) OCO
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
c. Program Growth in FY 2016
1) Travel:
This funding is for travel required by students to
attend classes needed to obtain required
accreditation. The FY 2015 Education and Training
travel baseline funding is $59.0M.
2) Curricular Reform:
Provides funding for the Uniformed Services
Amount
Totals
750,866
750,866
5,059
5,059
755,925
755,925
­5,059
750,866
25,015
15,362
6,633
3,800
Education and Training
EDT­129
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
University of the Health Sciences (USUHS) curricular
reform to meet accrediting organizations' changing
requirements for medical education mandating a shift
to a competency­based (outcomes) model. The FY 2015
USUHS baseline funding is $146.3M. The FY 2015 USUHS
baseline staffing is 622 civilian FTEs and 44
contractors.
3) Army Medical Department (AMEDD) Center and School:
Realigns funding from the Consolidated Health Support
Budget Activity Group to the Education and Training
Budget Activity Group for AMEDD wellness education
courses addressing unhealthy lifestyles and
behaviors. These courses give students the knowledge
to go out and teach wellness (i.e. "train the
trainer" type of courses). The FY 2015 Army
Education and Training baseline funding is $231.3M.
The FY 2015 Army Education and Training baseline
staffing is 695 civilian FTEs and 30 contractors.
4) Chemical, Biological, Radiological, Nuclear and
Explosives (CBRNE) Program Realignment:
Realigns funding from the Consolidated Health Support
Budget Activity Group to the Education and Training
Budget Activity Group to align budget consistent with
execution at the National Center for Disaster
Medicine and Public Health (NCDMPH) for CBRNE at
USUHS. The FY 2015 USUHS baseline funding is
$146.3M. The FY 2015 USUHS baseline staffing is 622
civilian FTEs and 44 contractors.
5) Realignment of Army Medical Action Plan (AMAP)
Funding:
Amount
Totals
2,000
1,271
917
Education and Training
EDT­130
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Realigns Wounded, Ill and Injured (WII) funding from
the Base Operations/Communications Budget Activity
Group to the Education and Training Budget Activity
Group to budget consistent with actual AMAP
execution. The FY 2015 Army Education and Training
baseline funding is $231.3M. The FY 2015 Army
Education and Training baseline staffing is 695
civilian FTEs and 30 contractors.
6) One More Civilian Paid Day:
Adjusts civilian payroll for one additional pay day
in FY 2016. The FY 2015 Education and Training
Civilian Pay baseline funding is $193.4M. The FY
2015 Education and Training baseline staffing is
2,014 civilian FTEs.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
c. Program Decreases in FY 2016
1) Health Professions Scholarship Program (HPSP)/Health
Professions Loan Repayment Program (HPLRP)
Reconciliation ­ Air Force Medical Service (AFMS):
Reduces the AFMS HPSP/HPLRP programs due to the
decrease in active duty endstrength and family member
support. Realigns funds to medical contracts and
supplies in the In­House Care Budget Activity Group.
The FY 2015 Air Force Education and Training baseline
funding is $208.9M. The FY 2015 Air Force Education
and Training baseline staffing is 382 civilian FTEs
and 66 contractors.
2) Traumatic Brain Injury/Psychological Health (TBI/PH)
Amount
Totals
741
­40,629
­14,641
­10,411
Education and Training
EDT­131
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
and Wounded, Ill and Injured (WII):
Resource requirements have decreased for the TBI/PH
and WII programs. Current data shows the number of
redeployments have decreased by 26% with a
corresponding decrease in associated workload. The
FY 2015 Education and Training baseline funding is
$750.9M. The FY 2015 Education and Training baseline
staffing is 2,014 civilian FTEs and 258 contractors.
3) Temporary Disability Retirement List (TDRL):
Realigns funding to the Consolidated Health Support
Budget Activity Group to expedite service member
medical status determinations for those members that
have been placed on the TDRL due to a long­lasting or
permanent change from a wound, illness or injury by
reducing the cycle time of the two evaluation boards
reviewing a Service member's case file documentation.
A Medical Evaluation Board (MEB) will review the
Service member's record to decide if he/she meets
medical retention standards. After the MEB, a
Physical Evaluation Board will be convened to
determine the Service member's disposition—return to
duty, separation or retirement, either permanent or
temporary. The FY 2015 Education and Training
baseline funding is $750.9M. The FY 2015 Education
and Training baseline staffing is 2,014 civilian FTEs
and 258 contractors.
4) Realignment of HPSP Funding to Support Public Health
and Utilities ­ Navy:
Reduces Navy Medicine HPSP requirements due to lower
HPSP tuition inflation rates and reduced student
Amount
Totals
­5,316
­4,401
Education and Training
EDT­132
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
levels. Realigns Navy Medicine HPSP funding to fund
utility increases in the Pacific area ($2.2M to the
Base Operations/Communications Budget Activity Group)
and to support mandated public health testing and
screening for active duty ­ e.g. Hepatitis B,
Hepatitis C and HIV ($2.2M to the Consolidated Health
Support Budget Activity Group). The FY 2015 Navy
Education and Training baseline funding is $155.5M.
The FY 2015 Navy Education and Training baseline
staffing is 288 civilian FTEs and 99 contractors.
5) Equipment:
Reduces equipment funding to match approved life­
cycle replacement rate. The FY 2015 Education and
Training equipment baseline funding is $17.7M.
6) Funding Realignments:
Realigns funds among multiple programs and between
Budget Activity Groups to align funding for proper
execution. The FY 2015 Education and Training
baseline funding is $750.9M. The FY 2015 Education
and Training baseline staffing is 2,014 civilian FTEs
and 258 contractors.
7) 20% Headquarters Reduction:
Continuation of incremental 20% reduction to Defense
Health Program headquarters in compliance with the
Department of Defense July 31, 2013 memorandum, "20%
Headquarters Reduction," signed by the Deputy
Secretary of Defense.
The reduction applies to the
total headquarters budget (supplies, materials,
communications, IM/IT support, equipment) and in this
Budget Activity Group includes reductions in Other
Amount
Totals
­2,708
­1,729
­1,313
Education and Training
EDT­133
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Intra­Government Purchases. The FY 2015 Education
and Training baseline funding is $750.9M. The FY
2015 Education and Training baseline staffing is
2,014 civilians FTEs and 258 contractors.
8) Support Operation of Defense Health Agency Shared
Service ­ Health Information Technology (HIT):
Realigns funding to the IM/IT Budget Activity Group
in support of the HIT Shared Service. Funding is
realigned for supplies, travel and contract support
related to Information Management that transitions
from the Components to the Defense Health Agency to
enable the Shared Service to achieve the planned cost
reductions. The FY 2015 Education and Training
baseline funding is $750.9M. The FY 2015 Education
and Training baseline staffing is 2,014 civilian FTEs
and 258 contractors.
FY 2016 Budget Request
Amount
Totals
­110
750,614
Education and Training
EDT­134
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
IV. Performance Criteria and Evaluation Summary:
(Student/Trainee Count)
Officer Acquisition1
Graduate Medical Education2
Professional Development3
Other Education and Training
Programs4
Medical Education and Training
Campus5
FY 2014
6,797
1,438
37,880
31,422
FY 2015
7,294
1,400
45,324
34,981
FY 2016
7,378
1,397
44,555
34,354
Change
FY 2014/2015
497
­38
7,444
3,559
Change
FY 2015/2016
84
­3
­769
­627
15,983
18,119
16,749
2,136
­1,370
1
Officer Acquisition is the summation of Health Professions Scholarship Program (HPSP) Total Student
Participants and USUHS Total Student Load.
2 Graduate Medical Education (GME) is the number of GME Graduates.
3 Professional Development is the summation of Officer ­ Professional Development/Leadership Training
Graduates and Enlisted ­ Professional Development/Leadership Training Graduates.
4 Other Education and Training Programs is a summation of Officer ­ All Other Training Graduates and
Enlisted ­ All Other Training Graduates.
5 Medical Education and Training Campus (METC) is the number of METC Graduates.
Education and Training
EDT­135
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
V. Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Memo: Reimbursable Civilians Included
Average Annual Civilian Salary ($ in
thousands)
Contractor FTEs (Total)
15,636
7,302
8,334
15,625
Change
FY 2014/
FY 2015
1,351
490
861
­118
Change
FY 2015/
FY 2016
22
8
14
686
7,049
7,890
2,014
2,012
1
2,013
1
12
96.6
7,298
8,327
1,881
1,879
1
1,880
1
12
98.1
­167
49
216
216
0
216
0
0
.3
249
437
­133
­133
0
­133
0
0
1.5
258
217
34
­41
FY 2014
FY 2015
FY 2016
14,263
6,804
7,459
15,057
15,614
7,294
8,320
14,939
7,216
7,841
1,798
1,796
1
1,797
1
12
96.3
224
Explanation of changes in Active Military End Strength: The change from FY 2014 to FY
2015 (+1,351) reflects the FY 2014 number now at a lower level than what was programmed.
The change from FY 2015 to FY 2016 (+22) includes Army internal realignments (­3) and
Navy internal realignments (+25).
Explanation of changes in Civilian FTEs: FY 2014­2015 change is not an increase in
staffing, but a reflection of the FY 2014 Actuals executing at a lower level than what
Education and Training
EDT­136
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
was programmed due to the impacts of Sequestration in FY 2013 followed by a furlough and
Continuing Resolution in FY 2014. FY 2015­2016 decrease reflects actions from a civilian
workforce analysis based on Department of Defense guidance to shape a properly sized and
highly capable workforce.
Explanation of changes in Contractor FTEs: FY 2014­2015 change is not an increase in
contractors, but similar to the civilians, a reflection of the FY 2014 Actuals executing
at a lower level. FY 2015­2016 decrease reflects efforts to become more efficient in the
reliance on contractor support via consolidation of requirements.
Education and Training
EDT­137
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l & Spec Scheds
199 TOTAL CIV COMPENSATION
308 Travel of Persons
399 TOTAL TRAVEL
401 DLA Energy (Fuel Products)
402 Service Fund Fuel
411 Army Supply
412 Navy Managed Supply, Matl
414 Air Force Consol Sust AG
(Supply)
416 GSA Supplies & Materials
417 Local Purch Supplies & Mat
422 DLA Mat Supply Chain (Medical)
499 TOTAL SUPPLIES & MATERIALS
503 Navy Fund Equipment
506 DLA Mat Supply Chain (Const &
Equip)
507 GSA Managed Equipment
599 TOTAL EQUIPMENT PURCHASES
601 Army Industrial Operations
614 Space & Naval Warfare Center
633 DLA Document Services
634 Navy Base Support (NAVFEC)
671 DISA DISN Subscription
Services (DSS)
677 DISA Telecomm Svcs ­
Reimbursable
699 TOTAL DWCF PURCHASES
771 Commercial Transport
799 TOTAL TRANSPORTATION
901 Foreign National Indirect Hire
FY 2014
Actual
171,905
171,905
51,482
51,482
118
0
95
350
0
Change
FY 2014/FY 2015
Price
Program
1,719
19,778
1,719
19,778
927
6,619
927
6,619
3
1
0
116
1
­90
4
960
0
3
FY 2015
Estimate
193,402
193,402
59,028
59,028
122
116
6
1,314
3
Change
FY 2015/FY 2016
Price
Program
2,369
­12,525
2,369
-12,525
1,003
6,633
1,003
6,633
­9
125
­8
­108
0
1
46
­21
0
0
FY 2016
Estimate
183,246
183,246
66,664
66,664
238
0
7
1,339
3
1,673
115
52
2,403
0
0
30
2
0
40
0
0
­148
269
­25
1,086
595
379
1,555
386
27
3,529
595
379
26
7
0
62
0
4
53
0
0
50
10
13
1,634
393
27
3,641
605
396
49
49
2
428
9
0
0
1
1
0
5
1
0
0
430
1,404
­2
327
­10
218
55
480
1,454
0
760
0
218
55
8
12
0
12
0
­1
­5
1
24
0
1
0
5
5
489
1,490
0
773
0
222
55
14
1
­15
0
0
0
0
453
1,204
1,204
4
7
22
22
0
573
­596
-596
0
1,033
630
630
4
6
11
11
0
11
0
0
0
1,050
641
641
4
Education and Training
EDT­138
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Education and Training
OP 32 Line
(FNIH)
902 Separation Liab (FNIH)
913 Purchased Utilities (Non­Fund)
914 Purchased Communications (Non­
Fund)
915 Rents (Non­GSA)
917 Postal Services (U.S.P.S)
920 Supplies & Materials (Non­
Fund)
921 Printing & Reproduction
922 Equipment Maintenance By
Contract
923 Facilities Sust, Rest, & Mod
by Contract
925 Equipment Purchases (Non­Fund)
930 Other Depot Maintenance (Non­
Fund)
932 Mgt Prof Support Svcs
934 Engineering & Tech Svcs
937 Locally Purchased Fuel (Non­
Fund)
955 Other Costs (Medical Care)
959 Other Costs (Insurance
Claims/Indmnties)
964 Other Costs (Subsistence and
Support of Persons)
986 Medical Care Contracts
987 Other Intra­Govt Purch
988 Grants
989 Other Services
990 IT Contract Support Services
999 TOTAL OTHER PURCHASES
Total
FY 2014
Actual
Change
FY 2014/FY 2015
Price
Program
FY 2015
Estimate
Change
FY 2015/FY 2016
Price
Program
FY 2016
Estimate
57
0
286
1
0
5
­1
76
528
57
76
819
1
1
14
­1
0
2
57
77
835
1,111
3
28,155
20
0
506
868
5
6,397
1,999
8
35,058
34
0
596
61
0
1,783
2,094
8
37,437
1,434
1,861
26
33
361
3,080
1,821
4,974
31
85
­87
226
1,765
5,285
390
7
­36
361
6
­97
270
27,491
84
494
2
­11,735
­86
16,250
0
276
0
­2,278
0
14,248
0
373
0
117
7
0
3
8,754
2
­120
9,134
2
0
155
0
0
­6,034
1
0
3,255
3
0
227,931
3
13,676
0
62,474
­3
304,081
0
18,245
0
­28,248
0
294,078
0
1,147
21
­1,027
141
2
998
1,141
4,639
18,277
43,881
64,063
2,683
423,990
651,486
172
329
790
1,153
48
17,293
20,009
965
­4,750
­12,549
­1,711
­985
50,507
79,371
5,776
13,856
32,122
63,505
1,746
491,790
750,866
214
236
546
1,080
30
21,552
25,015
6,142
3,389
6,396
­2,714
1,001
-19,460
-25,267
12,132
17,481
39,064
61,871
2,777
493,882
750,614
Education and Training
EDT­139
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
I. Description of Operations Financed: Base Operations (BASOPS)/Communications refers to
the resources dedicated to the operation and maintenance of Military Health System (MHS)
facilities. BASOPS provides for facilities and services at military medical
activities world­wide supporting active duty combat Service missions, reserve and guard
components, training and eligible beneficiaries. The program consists of eight
components:
Facility Restoration and Modernization ­ Facility Restoration and Modernization ­
Resources required for facilities' restoration and modernization projects including
repair and replacement due to excessive age, natural disaster, fire, accident, or other
causes. Modernization includes alteration of facilities solely to implement new or higher
standards (including regulatory changes), to accommodate new functions, or to replace
building components that typically last more than 30 years (such as foundations and
structural members).
Facility Sustainment ­ Resources required for maintenance and repair activities necessary
to keep facilities in good working order. It includes regularly scheduled adjustments and
inspections, preventive maintenance tasks, emergency response and service calls for minor
repairs. Sustainment also includes major repairs or replacement of facility components
(usually accomplished by contract) that are expected to occur periodically throughout the
life cycle of facilities. This work includes regular roof replacement, refinishing of
wall surfaces, repairing and replacement of heating and cooling systems, replacing tile
and carpeting, etc.
Facilities Operations ­ Resources required for fire prevention and protection including
crash rescue, emergency response, and disaster preparedness; engineering readiness;
utilities to include plant operation and purchase of commodity; refuse collection and
disposal to include recycling operations; pavement clearance including snow and ice
removal from roads; lease costs for real property including off­base facilities; grounds
maintenance and landscaping; real property management and engineering services including
special inspections of facilities and master planning; pest control; and custodial
Base Operations/Communications
BOCOM­141
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
I.
Description of Operations Financed (cont.)
services.
Base Communications ­ Resources required to provide base communication services to
Military Health System medical activities. This includes non­tactical, non­DCS (Defense
Communications System), base communication facilities and equipment systems that provide
local communications worldwide.
Base Operations Support ­ Resources required to provide comptroller services, data
processing services, information activities, legal activities, civilian personnel
administration, military personnel administration, printing and reproduction, facility
safety, management analysis/engineering services, retail supply operations, supply
activities, procurement operations, storage activities, transportation activities,
physical security and police activities, laundry and dry cleaning, food services, and
morale, welfare and recreation activities.
Environmental ­ Resources required to comply with environmental laws, regulations,
criteria, and standards. This includes manpower, training, travel, and supplies.
Visual Information Systems ­ Resources required to provide manpower, travel, contractual
service, procurement of supplies and materials, expense equipment, necessary facilities
and the associated services specifically identifiable to visual information productions,
services, and support.
Demolition/Disposal of Excess Facilities ­ Resources required for demolition and/or
disposal costs associated with excess facilities, including buildings or any other
permanent or temporary structure as well as pavements, utility systems, and other
supporting infrastructure. Includes environmental costs directly attributable to
demolition/disposal to include inspection and removal of hazardous material (such as
lead­based paint or asbestos).
II. Force Structure Summary:
The Base Operations and Communications Budget Activity Group (BAG) includes staffing and
contracts to provide base operation support services to the Military Health System
facilities, planning and oversight of medical infrastructure operations and facility
Base Operations/Communications
BOCOM­142
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
II. Force Structure Summary (cont.)
systems maintenance to include life support systems. Infrastructure alterations are
necessary to keep up with modern medical practices and improve efficiencies. This BAG
primarily awards contracts to achieve these specialized infrastructure changes. In
addition to infrastructure and system operations, this BAG also includes essential base
support activities such as environmental waste removal, custodial service, grounds and
surface maintenance including mowing, landscaping, road maintenance and snow removal,
security and guard service, and base communication systems. Many of the activities and
services received use routine contract services that are cost efficient and assure timely
repair and service availability to avoid disruptive services within the medical facility.
The funds in this BAG assist the Military Health System medical facilities adherence to
the standards of the Joint Commission inspections for medical facilities. This BAG
excludes funding of medical staff and providers associated directly with the delivery of
healthcare to patients.
Base Operations/Communications
BOCOM­143
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. Facility
Restoration/Modernization
­ CONUS
2. Facility
Restoration/Modernization
­ OCONUS
3. Facility Sustainment ­
CONUS
4. Facility Sustainment ­
OCONUS
5. Facilities Operations ­
Health Care (CONUS)
6. Facilities Operations ­
Health Care (OCONUS)
7. Base Communications ­
CONUS
8. Base Communications ­
OCONUS
9. Base Operations ­ CONUS
10. Base Operations ­
OCONUS
11. Environmental
Conservation
12. Pollution Prevention
13. Environmental
Compliance
14. Visual Information
Systems
FY 2014
Actual
877,648
Budget
Request
283,309
Current
Estimate
Amount
Percent Appropriated
150,000
52.0
433,309
433,309
FY 2016
Estimate
311,214
87,308
46,525
0
0.0
46,525
46,525
28,874
540,795
380,004
0
0.0
380,004
380,004
441,655
89,173
74,467
0
0.0
74,467
74,467
75,688
316,631
412,410
0
0.0
412,410
412,410
403,300
51,985
36,822
0
0.0
36,822
36,822
39,728
32,365
40,661
0
0.0
40,661
40,661
41,083
4,468
5,134
0
0.0
5,134
5,134
5,225
385,891
21,393
345,237
24,199
2,777
0
.8
0.0
348,014
24,199
348,014
24,199
338,691
24,707
0
0
0
n/a
0
0
0
874
22,043
264
25,281
0
0
0.0
0.0
264
25,281
264
25,281
267
23,090
7,434
9,381
0
0.0
9,381
9,381
9,371
Base Operations/Communications
BOCOM­144
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
15. Demolition
Total
FY 2014
Actual
Budget
Request
0
2,438,008
0
1,683,694
Current
Estimate
Percent Appropriated
0
n/a
0
0
152,777
9.1
1,836,471 1,836,471
Amount
FY 2016
Estimate
0
1,742,893
1. This Budget Activity Group contains no Overseas Contingency Operations (OCO) funds in FY 2014, FY 2015 and FY 2016.
2. FY 2015 estimate includes general provision Sec. 8072 $4.0M increase for Fisher Houses funding.
Base Operations/Communications
BOCOM­145
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2015
1,683,694
148,777
Change
FY 2015/FY 2016
1,836,471
4,000
1,836,471
1,836,471
1,836,471
31,099
­1,610
­123,067
1,742,893
1,836,471
Base Operations/Communications
BOCOM­146
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) Facility infrastructure funding increase:
Funding to improve the facility condition index of
medical buildings used in the delivery of healthcare
to beneficiaries.
2) Reduction to funding ­ excessive requirements:
Funding reduced citing excessive requirements for
Force Health Protection and Physical Security
requirements.
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
1) Sec. 8072 funding for Fisher House
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
a. Transfers In
b. Transfers Out
1) Transfer from DHP to Washington Headquarters
Services:
Amount
Totals
1,683,694
152,777
150,000
­1,223
4,000
1,836,471
1,836,471
1,836,471
1,836,471
31,099
­1,610
­1,142
Base Operations/Communications
BOCOM­147
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Permanent transfer of responsibilities and management
of Employee Assistance Program (EAP) to Washington
Headquarters Services (WHS) from the National Capital
Region Medical Directorate.
2) Transfer from DHP to Navy Installations Command:
Transfers additional physical security personel and
associated funding to conclude base installation
transfer at NMC Portsmouth, VA. from DHP to Navy
Installation Command (CNIC). (8 Civilian FTEs).
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
1) Reverses one­time Congressional adjustment ­
excessive requirements
Reverses one­time Congressional adjustment for
excessive Force Health Protection and Physical
Security requirements.
c. Program Growth in FY 2016
1) Facility Sustainment Program:
The MHS strategy for the sustainment program is to
fund sustainment at 100% for maintenance based on
scheduled life cycle requirements in medical
facilities and 90% for non­clinical facilities. This
strategy reduces potential shifting requirements to
restoration due to failures of major systems such as
HVAC, generators, and roofs by keeping them in proper
working condition during their life cycle. The FY
2015 Sustainment baseline funding is $454.5M.
2) Increased Utility Costs:
Funds increased costs for utilities at healthcare
Amount
Totals
­468
73,014
1,203
55,118
6,419
Base Operations/Communications
BOCOM­148
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
facilities stateside and overseas with $2.2M funds
coming from the Education and Training Budget
Activity Group (BAG) as a result of lower
requirements for scholarships. The FY 2015 Facility
Operations baseline funding is $449.2M.
3) Facility Investments for Restoration and
Modernization (R&M) Program:
The Military Health System (MHS) strategy for R&M
provides funding to improve the overall condition of
MHS facilities in the delivery of health care. The
strategy is based on investing 80% toward inadequate
facilities and 20% for MHS and medical initiatives
such as new missions, critical life, health, safety
restoration. The FY 2015 Restoration and
Modernization baseline funding is $479.8M.
4) Support for Defense Health Agency Health Facilities
Shared Service­Health Facilities:
Realigns funds to Base Operations/Communications
(BOS) BAG from Service Components' Consolidated
Health Support (CHS) and Management Activities (MA)
BAGs to the Defense Health Agency for the Health
Facilities Shared Service's operating costs. $0.3M to
pay requirements for supplies, travel and
professional service costs and 14 FTEs with
associated civilian pay of $2.4M. The FY 2015 Base
Operations/Communications BAG funding baseline is
$1,836.5M.
5) Civilian Human Resources Service Center:
Realigns funding from Navy Bureau of Medicine Surgery
(BUMED) In­House Care Budget Activity to BOS BAG for
Amount
Totals
5,422
2,702
1,600
Base Operations/Communications
BOCOM­149
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
operational costs to support Civilian Human Resources
Service Center at National Capital Regional Medical
Direcorate.
6) One More Civilian Paid Day:
Adjusts civilian payroll for one additional pay day
for FY 2016. The FY 2015 Base Operations and
Communications civilian pay baseline funding is
$192.4M. The FY 2015 Base Operations/Communications
baseline staffing is 1,848 civilian FTEs.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
1) Reverse One­time Congressional adjustment ­
Facilities Infrastructure:
One­time Congressional adjustment to reverse Facility
Infrastructure funding provided to improve the
facility condition index of medical buildings used in
the delivery of healthcare to beneficiaries.
2) Reverse One­time Congressional adjustment ­ Sec. 8072
Fisher House:
c. Program Decreases in FY 2016
1) National Capital Region ­ Medical Directorate IM/IT:
Realigns funding from BOS BAG as the result of
reduced contracting administrative fees to
Information Management/Technology (IM/IT) BAG to
support increased requirements for information
assurance activities, Computer Network Defense
Service Provider, enterprise licenses, the joint
Amount
Totals
550
­196,081
­152,550
­4,061
­10,223
Base Operations/Communications
BOCOM­150
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
medical network, helpdesk and equipment refresh
activities. The FY 2015 Base Operations baseline
funding is $372.2M.
2) Traumatic Brain Injury/Psychological Health (TBI/PH)
and Wounded, Ill and Injured (WII) Under­Execution:
Reduced requirements for base operating costs and
supplies for the Traumatic Brain Injury/Psychological
Health (TBI/PH) and Wound, Ill and Injured (WII)
Programs. In FY 2013, the number of redeployments
dropped by 26%, with a corresponding decrease in
associated workload. The FY 2015 Base Operations
baseline funding is $372.2M.
3) Defense Health Agency (DHA) Health Facilities Shared
Service Savings:
Reduced requirement for health facilities services
due to the consolidation of the Health Facilities
Portfolio Management under the DHA. This phased­in
Military Health System (MHS) Shared Service's plan
utilizes an automated facility inventory tool to
reduce duplication and redundant medical facilities
functions. The consolidation of like health facility
services across the MHS is projected to achieve
economies of scale and cost reductions for the
Defense Health Program.
4) Support of Shared Services' Civilian Personnel:
Realigns funds for 36 FTEs and associated civilian
pay requirements from DHP Service Components' BAG 7
Base Operations/Communications to the Defense Health
Agency. Specifics of realignment: BAG 4 Information
Management/Technology ($2.0M) for Health Information
Amount
Totals
­8,186
­3,881
­3,878
Base Operations/Communications
BOCOM­151
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Technology (HIT) Shared Service; BAG 3 Consolidated
Health ($0.8M) for Medical Logistics (MEDLOG) Share
Service and BAG 5 Management Activities ($1.1M) for
Contracting Shared Service.
5) Support of Shared Services' Operational Costs:
MEDLOG, HIT and Contracting:
Realigns funds for operational requirements such as
travel, contracts, and supplies from DHP Service
Components' BAG 7 Base Operations/Communications to
align Shared Services under the DHA. Specifics of
realignment: BAG 3 Consolidated Health ($.03M) for
Medical Logistics (MEDLOG) Shared Service; BAG 4
IM/IT ($3.6M) for Health Information Technology (HIT)
Shared Service and BAG 5 Management Activities
($.01M) for Contracting Shared Service.
6) Realignment of Leased Space ­Air Force:
Realigns funding from the BOS BAG to the Consolidated
Health Support (CHS) Budget Activity Group (BAG) for
real property leases aligning these costs with their
supporting programs including the Multi­Market Office
and Central Appointing Office in San Antonio, TX.
The FY 2015 Defense Health Program Facility
Operations baseline funding is $449.2M.
7) Environmental Compliance:
Improved requirements determination process for
Drinking Water Program reduced program costs while
sustaining compliance with Federal and all other
applicable regulations. The FY 2015 Environmental
Compliance baseline funding is $25.3M.
8) Realignment of Army Medical Action Plan (AMAP)
Amount
Totals
­3,667
­3,150
­2,568
­2,560
Base Operations/Communications
BOCOM­152
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
Funding:
Realigns funds for Wounded, Ill and Injured (WII)
from the BOS BAG to these BAGs: ($1.6M) Consolidated
Health Support, ($.092)M Information
Management/Technology and ($0.9M) Education and
Training Budget Activity Groups for Army Medical
Action Plan (AMAP) requirements proper execution.
9) Defense Financial Accounting Services (DFAS) Rate
Reduction:
Reduction of funding due to rate changes for DFAS.
10) Manpower Review and Realignment ­ Army:
Zero based realignment of civilian manpower among
Budget Activity groups by Army to position personnel
for FY 2016 Command Plan regarding mission
requirements.
11) 20% Headquarters Reduction:
Continuation of incremental 20% reduction to Defense
Health Program (DHP) headquarters in compliance with
the Department of Defense July 31, 2013 memorandum,
"20% Headquarters Reduction," signed by the Deputy
Secretary of Defense. The reduction applies to both
direct and indirect support and applies to the total
headquarters budget (supplies, materials,
communications, IT/IM support, equipment). The FY
2015 baseline staffing is 1,848 Civilians and 312
Contractors for BAG 7.
FY 2016 Budget Request
Amount
Totals
­982
­261
­114
1,742,893
Base Operations/Communications
BOCOM­153
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
IV. Performance Criteria and Evaluation Summary:
See performance criteria located with Exhibit OP­5 Facilities Sustainment, Restoration
and Modernization (Attachment 4).
Base Operations/Communications
BOCOM­154
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
V. Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Average Annual Civilian Salary ($ in
thousands)
Contractor FTEs (Total)
2,212
510
1,702
2,219
Change
FY 2014/
FY 2015
­87
­34
­53
­39
Change
FY 2015/
FY 2016
­12
­7
­5
­49
534
1,734
1,848
1,709
52
1,761
87
83.3
514
1,705
1,698
1,562
52
1,614
84
85.8
­15
­24
69
38
21
59
10
­1.6
­20
­29
­150
­147
0
­147
­3
2.5
312
381
­174
69
FY 2014
FY 2015
FY 2016
2,311
551
1,760
2,307
2,224
517
1,707
2,268
549
1,758
1,779
1,671
31
1,702
77
84.9
486
Explanation of changes in Military End Strength: The change from FY 2014 to FY 2015 of
(­87) includes internal realignments for Navy (­39) and Air Force (­48). FY 2016 changes
for Military personnel are Navy realignment (­12).
Explanation of changes in Civilian FTEs: The reduction of civilian FTEs from FY 2014 to
FY 2015 is a zero based realignment among BOS and various Budget Activity Groups (BAGs),
including In­House Care, Information Management and Consolidated Health Support. The
change from FY 2015 to FY 2016 includes a reduction of 3 civilians in accordance with the
Base Operations/Communications
BOCOM­155
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
Civilian Workload Analysis and transfers among BAGs for (­22) Shared Service staffing
realignments and transfers out of the DHP (­8) for CNIC and Manpower zero based
realignments of (­113) in Navy and (­4) in Army.
Explanation of changes to Contractor FTEs: Fluctuations of contractor FTE counts are due
to the methodology that the accounting system uses to compute staffing. Improvements in
the methodology to compute contractor FTEs are in the process. Consequently, we expect
better accuracy in future cycles.
Base Operations/Communications
BOCOM­156
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l &
Spec Scheds
199 TOTAL CIV
COMPENSATION
308 Travel of
Persons
399 TOTAL TRAVEL
401 DLA Energy
(Fuel Products)
402 Service Fund
Fuel
411 Army Supply
412 Navy Managed
Supply, Matl
416 GSA Supplies
& Materials
417 Local Purch
Supplies & Mat
422 DLA Mat
Supply Chain
(Medical)
499 TOTAL
SUPPLIES &
MATERIALS
503 Navy Fund
Equipment
507 GSA Managed
Equipment
599 TOTAL
EQUIPMENT
PURCHASES
601 Army
Industrial
Operations
614 Space & Naval
Warfare Center
631 Navy Base
Support (NFESC)
FY 2014
Actual
149,825
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
1,498
1,472
FY 2015
Estimate
152,795
Foreign
Currency
Rate Diff
0
149,825
0
1,498
19,522
0
19,522
2,656
Change
FY 2015/FY 2016
Price
Program
1,872
­9,712
1,472
152,795
0
1,872
-9,712
144,955
351
­10,673
9,200
0
156
933
10,289
0
0
351
59
-10,673
2,504
9,200
5,219
0
0
156
­381
933
587
10,289
5,425
195
0
4
­12
187
0
­14
­49
124
0
130
0
0
0
2
38
38
38
170
0
0
1
6
­39
­3
0
173
1,399
0
25
145
1,569
0
27
­3
1,593
1,061
0
19
627
1,707
0
29
3
1,739
249
0
­1
181
429
0
2
8
439
5,690
0
108
3,521
9,319
0
-330
504
9,493
50
0
1
122
173
0
0
4
177
103
0
2
103
208
0
4
­3
209
153
0
3
225
381
0
4
1
386
2,160
0
67
­2,227
0
0
0
0
0
16
0
0
­16
0
0
0
0
0
1,590
0
11
4,731
6,332
0
709
­5,673
1,368
FY 2016
Estimate
144,955
Base Operations/Communications
BOCOM­157
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
OP 32 Line
633 DLA Document
Services
634 Navy Base
Support (NAVFEC)
635 Navy Base
Support (NAVFEC
Other Support
Services)
671 DISA DISN
Subscription
Services (DSS)
677 DISA Telecomm
Svcs ­
Reimbursable
679 Cost
Reimbursable
Purchase
680 Building
Maint Fund Purch
691 DFAS
Financial
Operations (Army)
692 DFAS
Financial
Operations (Navy)
693 DFAS
Financial
Operations (Air
Force)
696 DFAS
Financial
Operation (Other
Defense Agencies)
699 TOTAL DWCF
PURCHASES
719 SDDC Cargo
Ops­Port hndlg
724 MSC Afloat
Prepositioning
DLA
FY 2014
Actual
132
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
7
­70
FY 2015
Estimate
69
Foreign
Currency
Rate Diff
0
34,872
0
1,730
16,871
0
3,492
Change
FY 2015/FY 2016
Price
Program
­1
­22
11,349
47,951
0
­163
­10,343
37,445
219
30,265
47,355
0
0
14,781
62,136
0
66
567
4,125
0
­383
454
4,196
197
0
15
3,611
3,823
0
76
­15
3,884
0
0
0
966
966
0
16
3
985
0
0
0
37,846
37,846
0
863
1,102
39,811
16,667
0
­1,732
2,277
17,212
0
227
­1,075
16,364
6,781
0
96
­6,230
647
0
20
­29
638
0
0
0
0
0
0
0
2,867
2,867
2,971
0
52
­921
2,102
0
118
­267
1,953
85,749
0
531
82,148
168,428
0
1,482
1,783
171,693
625
0
­139
582
1,068
0
414
­392
1,090
201
0
6
­207
0
0
0
0
0
FY 2016
Estimate
46
Base Operations/Communications
BOCOM­158
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
OP 32 Line
771 Commercial
Transport
799 TOTAL
TRANSPORTATION
901 Foreign
National Indirect
Hire (FNIH)
902 Separation
Liab (FNIH)
912 Rental
Payments to GSA
(SLUC)
913 Purchased
Utilities (Non­
Fund)
914 Purchased
Communications
(Non­Fund)
915 Rents (Non­
GSA)
917 Postal
Services
(U.S.P.S)
920 Supplies &
Materials (Non­
Fund)
921 Printing &
Reproduction
922 Equipment
Maintenance By
Contract
923 Facilities
Sust, Rest, & Mod
by Contract
925 Equipment
Purchases (Non­
Fund)
930 Other Depot
Maintenance (Non­
Fund)
FY 2014
Actual
1,772
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
32
­1,029
FY 2015
Estimate
775
Foreign
Currency
Rate Diff
0
2,598
0
-101
951
0
205
Change
FY 2015/FY 2016
Price
Program
13
623
-654
1,843
0
427
231
2,501
10
26
987
0
12
­414
585
0
2
­2
205
0
3
­3
205
43,349
0
780
­25,593
18,536
0
315
­697
18,154
202,617
0
3,647
524
206,788
0
3,515
32,747
243,050
27,445
0
494
3,124
31,063
0
528
­857
30,734
22,595
0
407
­9,095
13,907
0
236
­5,055
9,088
2,088
0
38
­178
1,948
0
33
1
1,982
45,219
0
814
­14,091
31,942
152
546
­2,283
30,357
7,302
0
131
­3,620
3,813
0
65
­72
3,806
3,702
0
67
10,182
13,951
0
237
5,378
19,566
417,428
0
7,514
­58,897
366,045
246
6,227
81,828
454,346
12,806
0
231
­5,044
7,993
0
136
­32
8,097
977
0
18
948
1,943
0
33
­1,335
641
FY 2016
Estimate
1,411
Base Operations/Communications
BOCOM­159
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Base Operations/Communications
OP 32 Line
932 Mgt Prof
Support Svcs
933 Studies,
Analysis & Eval
937 Locally
Purchased Fuel
(Non­Fund)
955 Other Costs
(Medical Care)
957 Other Costs
(Land and
Structures)
964 Other Costs
(Subsistence and
Support of
Persons)
986 Medical Care
Contracts
987 Other Intra­
Govt Purch
988 Grants
989 Other
Services
990 IT Contract
Support Services
998 Other Costs
(SOCOM Only)
999 TOTAL OTHER
PURCHASES
Total
FY 2014
Actual
556
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
10
80
FY 2015
Estimate
646
Foreign
Currency
Rate Diff
0
12
0
0
3,301
0
58,589
Change
FY 2015/FY 2016
Price
Program
11
460
­10
2
0
0
867
869
73
­1,514
1,860
0
­136
169
1,893
0
2,167
­59,135
1,621
0
60
495
2,176
1,006,894
0
18,124
­545,184
479,834
1,433
8,182
­149,361
340,088
75
0
1
­76
0
0
0
0
0
339
0
13
­352
0
0
0
0
0
188,843
0
3,399
­99,726
92,516
0
1,573
­5,797
88,292
4,000
116,973
0
0
72
2,106
­72
86,212
4,000
205,291
0
354
68
3,496
­4,068
­70,378
0
138,763
7,782
0
140
1,692
9,614
0
163
­10
9,767
423
0
4
­427
0
0
0
0
0
2,174,471
0
40,262
-720,228
1,494,505
2,185
25,303
-118,417
1,403,576
2,438,008
0
42,652
-644,189
1,836,471
2,185
28,914
-124,677
1,742,893
FY 2016
Estimate
1,117
Base Operations/Communications
BOCOM­160
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
I. Description of Operations Financed: Base Operations (BASEOPS) Facilities Sustainment,
Restoration Modernization activities refers to the routine repair, maintenance and
modernization of Military Health System (MHS) medical and dental facilities
located world­wide where delivery of health care occurs within military installations and
satellite locations.
Facility Restoration and Modernization ­ Resources required for facilities' restoration
and modernization projects including repair and replacement due to excessive age, natural
disaster, fire, accident, or other causes. Modernization includes alteration of
facilities solely to implement new or higher standards (including regulatory changes), to
accommodate new functions, or to replace building components that typically last more
than 30 years (such as foundations and structural members).
Facility Sustainment ­ Resources required for maintenance and repair activities necessary
to keep facilities in good working order. It includes regularly scheduled adjustments and
inspections, preventive maintenance tasks, emergency response and service calls for minor
repairs. Sustainment also includes major repairs or replacement of facility components
(usually accomplished by contract) that are expected to occur periodically throughout the
life cycle of facilities. This work includes regular roof replacement, refinishing of
wall surfaces, repairing and replacement of heating and cooling systems, replacing tile
and carpeting, etc.
Demolition ­ Resources required for demolition and/or disposal costs associated with
excess facilities, including buildings or any other permanent or temporary structure as
well as pavements, utility systems, and other supporting infrastructure. Includes
environmental costs directly attributable to demolition/disposal to include inspection
and removal of hazardous material (such as lead­based paint or asbestos).
II. Force Structure Summary:
The medical facilities maintenance programs combine together to keep the medical
structures operating as designed and without failure in the delivery of healthcare
services to the beneficiaries. The Sustainment program provides services typically by
Facilities Sustainment, Restoration, and Modernization
FSRM­161
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
II. Force Structure Summary (cont.)
contract for scheduled and routine lifecycle maintenance to include repairs to
structures. Examples of sustainment repairs are painting, HVAC maintenance and roof
replacements. Restoration and modernization (R/M) keeps our facilities current with
advances in medical care delivery and patient throughput. R/M includes staffing to
provide design and oversight of medical and dental facilities which provide the full
range of inpatient and ambulatory medical and dental care services. DHA initiatives such
as Right facilities in the Right places are fully engaged with restoration and
modernization projects to accomplish the DHA mission.
Facilities Sustainment, Restoration, and Modernization
FSRM­162
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
III. Financial Summary ($ in thousands)
FY 2015
Congressional Action
A. BA Subactivities
1. Facility
Restoration/Modernization
­ CONUS
2. Facility
Restoration/Modernization
­ OCONUS
3. Facility Sustainment ­
CONUS
4. Facility Sustainment ­
OCONUS
5. Demolition
Total
FY 2014
Actual
877,648
Budget
Request
283,309
Current
Estimate
Amount
Percent Appropriated
150,000
52.0
433,309
433,309
FY 2016
Estimate
311,214
87,308
46,525
0
0.0
46,525
46,525
28,874
540,795
380,004
0
0.0
380,004
380,004
441,655
89,173
74,467
0
0.0
74,467
74,467
75,688
0
1,594,924
0
784,305
0
150,000
n/a
19.1
0
934,305
0
934,305
0
857,431
1. This Budget Activity Group contains no Overseas Contingency Operations (OCO) funds in FY 2014, FY 2015 and FY 2016.
Facilities Sustainment, Restoration, and Modernization
FSRM­163
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
III. Financial Summary ($ in thousands)
Change
FY 2015/FY 2015
784,305
150,000
B. Reconciliation Summary
Baseline Funding
Congressional Adjustments (Distributed)
Congressional Adjustments (Undistributed)
Adjustments to Meet Congressional Intent
Congressional Adjustments (General Provisions)
Subtotal Appropriated Amount
Fact­of­Life Changes (2015 to 2015 Only)
Subtotal Baseline Funding
Supplemental
Reprogrammings
Price Changes
Functional Transfers
Program Changes
Current Estimate
Less: Wartime Supplemental
Normalized Current Estimate
Change
FY 2015/FY 2016
934,305
934,305
934,305
17,809
934,305
­94,683
857,431
934,305
Facilities Sustainment, Restoration, and Modernization
FSRM­164
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
FY 2015 President's Budget Request (Amended, if applicable)
1. Congressional Adjustments
a. Distributed Adjustments
1) Facility Infrastructure funding to improve the
facility condition index of medical buildings used in
the delivery of healthcare to beneficiaries.
.
b. Undistributed Adjustments
c. Adjustments to Meet Congressional Intent
d. General Provisions
FY 2015 Appropriated Amount
2. OCO and Other Supplemental Enacted
3. Fact­of­Life Changes
FY 2015 Baseline Funding
4. Reprogrammings (Requiring 1415 Actions)
Revised FY 2015 Estimate
5. Less: OCO and Other Supplemental Appropriations and
Reprogrammings (Items 2 and 4)
FY 2015 Normalized Current Estimate
6. Price Change
7. Functional Transfers
8. Program Increases
a. Annualization of New FY 2015 Program
b. One­Time FY 2016 Increases
c. Program Growth in FY 2016
1) Facility Sustainment Program:
The MHS strategy for the sustainment program is to
fund sustainment at 100% for maintenance based on
scheduled life cycle requirements in medical
facilities and 90% for non­clinical facilities. This
Amount
Totals
784,305
150,000
150,000
934,305
934,305
934,305
934,305
17,809
60,540
55,118
Facilities Sustainment, Restoration, and Modernization
FSRM­165
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
strategy reduces potential shifting to restoration
due to failures of major systems such as HVAC,
generators, roofs and minor repairs by keeping them
in proper working condition during their life cycle.
The FY 2015 Sustainment baseline funding is $454.5M.
2) Facility Investments for Restoration/Modernization
(R&M) Program:
The Military Health System (MHS) strategy for R&M
provides funding to improve the overall condition of
MHS facilities in the delivery of health care. The
strategy is based on investing 80% toward inadequate
facilities and 20% for MHS and medical initiatives
such as new missions, critical life, health, safety
restoration. The FY 2015 Restoration and
Modernization baseline funding is $479.8M.
9. Program Decreases
a. Annualization of FY 2015 Program Decreases
b. One­Time FY 2015 Increases
1) One­time Congressional adjustment to reverse Facility
Infrastructure funding to improve the facility
condition index of medical buildings used in the
delivery of healthcare to beneficiaries.
c. Program Decreases in FY 2016
1) Defense Health Agency (DHA) Health Facilities Shared
Service Savings:
Reduced requirement for health facilities services
due to the consolidation of the Health Facilities
Portfolio Management under the DHA. This phased­in
Military Health System (MHS) Shared Service plan
utilizes an automated facility inventory tool to
Amount
Totals
5,422
­155,223
­152,550
­1,669
Facilities Sustainment, Restoration, and Modernization
FSRM­166
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
III. Financial Summary ($ in thousands)
C. Reconciliation of Increases and Decreases
reduce duplication and redundant medical facilities
functions. The consolidation of like health facility
services across the MHS is projected to achieve
economies of scale and cost reductions for the
Defense Health Program. The FY 2015 Facilities
Sustainment, Restoration, and Modernization funding
baseline is $934.3M.
2) Defense Health Agency (DHA) ­ Support of Health
Facilities Shared Service:
Realigns funds for operational requirements such as
travel, contracts and supplies from DHP Service
Components BAG 7 to align Shared Services under the
DHA BAGS: Consolidated Health Support,IM/IT and
Management Activities.
3) Manpower Review and Realignment ­ Army:
Zero based realignment of civilian manpower among
Budget Activity Groups by Army to position personnel
for FY 2016 Command Plan regarding mission
requirements.
FY 2016 Budget Request
Amount
Totals
­743
­261
857,431
Facilities Sustainment, Restoration, and Modernization
FSRM­167
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
IV. Performance Criteria and Evaluation Summary:
Facility Sustainment Funding:
Facility Sustainment Model Requirement:
Sustainment Rate (MILPERS not
included):
FY 2014
489,723
488,274
100%
FY 2015
454,471
504,663
90%
FY 2016
517,343
527,297
98%
Change
FY
2014/2015
­35,252
16,389
Change
FY
2015/2016
62,872
22,634
Facilities Sustainment, Restoration, and Modernization
FSRM­168
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
V. Personnel Summary
Active Military End Strength (E/S) (Total)
Officer
Enlisted
Active Military Average Strength (A/S)
(Total)
Officer
Enlisted
Civilian FTEs (Total)
U.S. Direct Hire
Foreign National Direct Hire
Total Direct Hire
Foreign National Indirect Hire
Average Annual Civilian Salary ($ in
thousands)
Contractor FTEs (Total)
15
9
6
15
Change
FY 2014/
FY 2015
0
0
0
0
Change
FY 2015/
FY 2016
0
0
0
0
9
6
245
228
13
241
4
92.4
9
6
217
203
13
216
1
96.0
0
0
­62
­74
13
­61
­1
­7.1
0
0
­28
­25
0
­25
­3
3.6
18
32
18
14
FY 2014
FY 2015
FY 2016
15
9
6
15
15
9
6
15
9
6
307
302
0
302
5
99.5
0
Note: The change in Civilian FTEs from FY 2014 through FY 2015 is a zero based
realignment within Base Operations Budget Activity Group (BAG) or various BAGs in the
Defense Health Program. FY 2016 changes for FSRM civilians zero based realignments are
(­24) in Navy and (­3) in Army.
Note: Changes in the method used to count Contractors and the volume of Facility
Sustainment, Restoration and Maintenance contracts related to facility projects cause the
number of contractors to fluctuate from year to year.
Facilities Sustainment, Restoration, and Modernization
FSRM­169
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
VI.
OP 32 Line Items as Applicable (Dollars in thousands):
OP 32 Line
101 Exec, Gen’l &
Spec Scheds
199 TOTAL CIV
COMPENSATION
308 Travel of
Persons
399 TOTAL TRAVEL
401 DLA Energy
(Fuel Products)
402 Service Fund
Fuel
411 Army Supply
412 Navy Managed
Supply, Matl
416 GSA Supplies
& Materials
417 Local Purch
Supplies & Mat
422 DLA Mat
Supply Chain
(Medical)
499 TOTAL
SUPPLIES &
MATERIALS
503 Navy Fund
Equipment
507 GSA Managed
Equipment
599 TOTAL
EQUIPMENT
PURCHASES
631 Navy Base
Support (NFESC)
633 DLA Document
Services
634 Navy Base
Support (NAVFEC)
FY 2014
Actual
30,002
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
300
­8,163
FY 2015
Estimate
22,139
Foreign
Currency
Rate Diff
0
30,002
0
300
240
0
240
85
Change
FY 2015/FY 2016
Price
Program
271
­1,660
-8,163
22,139
0
271
-1,660
20,750
4
80
324
0
6
­16
314
0
0
4
2
80
­11
324
76
0
0
6
­6
-16
75
314
145
77
0
2
­13
66
0
­5
­60
1
0
0
0
0
0
0
16
70
16
70
0
0
0
2
­16
­1
0
71
957
0
17
­820
154
0
3
­2
155
148
0
3
525
676
0
11
1
688
56
0
0
53
109
0
0
2
111
1,323
0
24
-180
1,167
0
5
-1
1,171
19
0
0
9
28
0
0
1
29
23
0
0
11
34
0
1
­1
34
42
0
0
20
62
0
1
0
63
340
0
2
5,380
5,722
0
641
­5,622
741
0
0
0
46
46
0
­1
1
46
0
0
0
25,380
25,380
0
­86
­11,196
14,098
FY 2016
Estimate
20,750
Facilities Sustainment, Restoration, and Modernization
FSRM­170
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
OP 32 Line
635 Navy Base
Support (NAVFEC
Other Support
Services)
671 DISA DISN
Subscription
Services (DSS)
699 TOTAL DWCF
PURCHASES
719 SDDC Cargo
Ops­Port hndlg
771 Commercial
Transport
799 TOTAL
TRANSPORTATION
901 Foreign
National Indirect
Hire (FNIH)
902 Separation
Liab (FNIH)
912 Rental
Payments to GSA
(SLUC)
913 Purchased
Utilities (Non­
Fund)
914 Purchased
Communications
(Non­Fund)
915 Rents (Non­
GSA)
920 Supplies &
Materials (Non­
Fund)
921 Printing &
Reproduction
922 Equipment
Maintenance By
Contract
923 Facilities
FY 2014
Actual
12,640
Foreign
Currency
Rate Diff
0
Change
FY 2014/FY 2015
Price
Program
164
195
FY 2015
Estimate
12,999
Foreign
Currency
Rate Diff
0
1
0
0
12,981
0
0
Change
FY 2015/FY 2016
Price
Program
0
8,937
­1
0
0
0
0
0
166
31,000
44,147
0
554
-7,880
36,821
0
0
5
5
0
2
­2
5
5
0
0
4
9
0
0
0
9
5
0
0
9
14
0
2
-2
14
527
0
5
­61
471
0
6
­415
62
25
0
0
0
25
0
0
0
25
8
0
0
­7
1
0
0
0
1
263
0
5
­142
126
0
2
0
128
502
0
9
­503
8
0
0
0
8
96
0
2
­98
0
0
0
0
0
11,294
0
203
­2,441
9,056
152
157
­134
9,231
0
0
0
1
1
0
0
0
1
1,550
0
28
10,182
11,760
0
200
­1,074
10,886
359,059
0
6,463
­80,574
284,948
246
4,848
68,855
358,897
FY 2016
Estimate
21,936
Facilities Sustainment, Restoration, and Modernization
FSRM­171
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Facilities Sustainment, Restoration, and Modernization
OP 32 Line
Sust, Rest, & Mod
by Contract
925 Equipment
Purchases (Non­
Fund)
930 Other Depot
Maintenance (Non­
Fund)
932 Mgt Prof
Support Svcs
937 Locally
Purchased Fuel
(Non­Fund)
955 Other Costs
(Medical Care)
957 Other Costs
(Land and
Structures)
986 Medical Care
Contracts
987 Other Intra­
Govt Purch
989 Other
Services
990 IT Contract
Support Services
999 TOTAL OTHER
PURCHASES
Total
FY 2014
Actual
Foreign
Currency
Rate Diff
Change
FY 2014/FY 2015
Price
Program
FY 2015
Estimate
Foreign
Currency
Rate Diff
Change
FY 2015/FY 2016
Price
Program
FY 2016
Estimate
4,539
0
82
­3,276
1,345
0
23
4
1,372
8
0
0
59
67
0
1
­52
16
77
0
1
­78
0
0
0
0
0
2
0
0
0
2
0
0
0
2
33,970
0
1,257
­34,160
1,067
0
39
­1,106
0
1,005,394
0
18,097
­543,657
479,834
1,433
8,182
­149,361
340,088
135
0
5
­140
0
0
0
0
0
74,590
0
1,343
­37,340
38,593
0
656
­1,157
38,092
58,288
0
1,049
­20,201
39,136
354
671
­684
39,477
4
0
0
8
12
0
0
0
12
1,550,331
0
28,549
-712,428
866,452
2,185
14,785
-85,124
798,298
1,594,924
0
29,043
-689,662
934,305
2,185
15,624
-94,683
857,431
Facilities Sustainment, Restoration, and Modernization
FSRM­172
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
In-House Care
Defense Medical Centers,
Hospitals and Medical Clinics­
0807700HP
CONUS
Defense Medical Centers,
Hospitals and Medical Clinics­
0807900HP
OCONUS
0807701HP
Pharmaceuticals­CONUS
0807901HP
Pharmaceuticals­OCONUS
0807715HP
Dental Care Activities­CONUS
0807915HP
Dental Care Activities­OCONUS
Subtotal In-House Care
Private Sector Care
Pharmaceuticals ­ Purchased
0807702HP
Health Care
Pharmaceuticals ­ National
0807703HP
Retail Pharmacy
TRICARE Managed Care Support
0807723HP
(MCS) Contracts
0807738HP
MTF Enrollees ­ Purchased Care
0807741HP
Dental ­ Purchased Care
Uniformed Services Family Health
0807742HP
Program (USFHP)
0807743HP
Supplemental Care ­ Health Care
0807745HP
Supplemental Care ­ Dental
0807747HP
Continuing Health
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
Change
6,136,439
6,004,561
6,442,816
­131,878
­2.1%
438,255
7.3%
427,103
472,527
503,688
45,424
10.6%
31,161
6.6%
1,392,576
119,662
428,553
46,906
8,551,239
1,500,881
142,889
481,951
62,431
8,665,240
1,480,323
132,683
461,647
61,141
9,082,298
108,305
23,227
53,398
15,525
114,001
7.8%
19.4%
12.5%
33.1%
1.3%
­20,558
­10,206
­20,304
­1,290
417,058
­1.4%
­7.1%
­4.2%
­2.1%
4.8%
489,682
484,283
852,493
­5,399
­1.1%
368,210
76.0%
1,733,743
1,785,657
1,125,025
51,914
3.0%
­660,632
­37.0%
6,465,955
6,189,888
6,493,776
­276,067
­4.3%
303,888
4.9%
2,497,389
320,268
460,480
2,323,650
313,804
490,723
2,524,033
356,647
514,464
­173,739
­6,464
30,243
­7.0%
­2.0%
6.6%
200,383
42,843
23,741
8.6%
13.7%
4.8%
1,282,333
161,069
341,621
1,266,746
138,150
401,596
1,282,120
142,315
429,909
­15,587
­22,919
59,975
­1.2%
­14.2%
17.6%
15,374
4,165
28,313
1.2%
3.0%
7.1%
Percent
FY 2015/2016
Change
Exhibit PB­11, Cost of Medical Activities
DHP­173
Percent
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
0807749HP
0807751HP
0807752HP
Education/Capitalization of
Assets Program
Overseas Purchased Health Care
Miscellaneous Purchased Health
Care
Miscellaneous Support Activities
Subtotal Private Sector Care
Consolidated Health Support
0801720HP
Examining Activities
0807714HP
Other Health Activities
Military Public/Occupational
0807705HP
Health
0807760HP
Veterinary Services
Military Unique Requirements ­
0807724HP
Other Medical
0807725HP
Aeromedical Evacuation System
Service Support to Other Health
0807730HP
Activities ­ TRANSCOM
0807786HP
Joint Pathology Center (JPC)
Support to FACA Advisory Board
0903300HP
Activities
Subtotal Consolidated Health
Support
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
270,055
626,071
318,771
637,787
303,711
713,048
48,716
11,716
18.0%
1.9%
­15,060
75,261
­4.7%
11.8%
98,196
14,746,862
152,704
14,503,759
155,142
14,892,683
54,508
-243,103
55.5%
-1.6%
2,438
388,924
1.6%
2.7%
72,102
751,303
430,395
88,687
893,190
425,396
92,350
825,655
517,939
16,585
141,887
­4,999
23.0%
18.9%
­1.2%
3,663
­67,535
92,543
4.1%
­7.6%
21.8%
26,022
632,125
33,633
838,571
34,946
861,529
7,611
206,446
29.2%
32.7%
1,313
22,958
3.9%
2.7%
44,852
1,465
47,328
1,571
54,973
2,359
2,476
106
5.5%
7.2%
7,645
788
16.2%
50.2%
21,401
2,057
23,537
1,911
23,952
1,955
2,136
­146
10.0%
­7.1%
415
44
1.8%
2.3%
1,981,722
2,353,824
2,415,658
372,248
18.8%
61,790
2.6%
Change
Percent
FY 2015/2016
Change
Exhibit PB­11, Cost of Medical Activities
DHP­174
Percent
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
641,078
626,230
363,095
­14,848
­2.3%
­263,135
­42.0%
91,459
99,189
38,417
7,730
8.5%
­60,772
­61.3%
110,124
46,998
19,500
­63,126
­57.3%
­27,498
­58.5%
0
57,554
89,188
57,554
100.0%
31,634
55.0%
0
0
59,743
0
0.0%
59,743
100.0%
Change
Percent
FY 2015/2016
Change
Percent
Information Technology/Information
Management
0807781HP
Non­Central Information
Management/Information
Technology
0807783HP
DHP Information
Management/Information
Technology Support Programs
0807784HP
Integrated Electronic Health
Record (iEHR)
0807787HP
DoD Healthcare Management
Systems
0807788DHA DoD Medical Information Exchange
and Interoperability
0807793HP
MHS Tri­Service Information
Management/Information
Technology
Subtotal Information Management
682,258
707,725
1,107,884
25,467
3.7%
400,159
56.5%
1,524,919
1,537,696
1,677,827
12,777
0.8%
140,131
9.1%
Management Activities
0807798HP
Management Activities
0807704DHA Defense Health Agency
0807709HP
TRICARE Management Activity
Subtotal Management Activities
130,747
0
194,258
325,005
144,580
219,612
0
364,192
141,217
186,750
0
327,967
13,833
219,612
­194,258
39,187
10.6%
100.0%
­100.0%
12.1%
­3,363
­32,862
0
-36,225
­2.3%
­15.0%
0.0%
-9.9%
226,337
304,081
294,078
77,744
34.3%
­10,003
­3.3%
148,738
146,301
154,649
­2,437
­1.6%
8,348
5.7%
Education and Training
Armed Forces Health Professions
0806722HP
Scholarship Program
0806721HP
Uniformed Services University of
Exhibit PB­11, Cost of Medical Activities
DHP­175
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
276,411
651,486
300,484
750,866
301,887
750,614
24,073
99,380
8.7%
15.3%
1,403
-252
0.5%
0.0%
877,648
433,309
311,214
­444,339
­50.6%
­122,095
­28.2%
87,308
46,525
28,874
­40,783
­46.7%
­17,651
­37.9%
540,795
89,173
316,631
380,004
74,467
412,410
441,655
75,688
403,300
­160,791
­14,706
95,779
­29.7%
­16.5%
30.2%
61,651
1,221
­9,110
16.2%
1.6%
­2.2%
51,985
36,822
39,728
­15,163
­29.2%
2,906
7.9%
32,365
4,468
385,891
21,393
874
22,043
7,434
2,438,008
40,661
5,134
348,014
24,199
264
25,281
9,381
1,836,471
41,083
5,225
338,691
24,707
267
23,090
9,371
1,742,893
8,296
666
­37,877
2,806
­610
3,238
1,947
-601,537
25.6%
14.9%
­9.8%
13.1%
­69.8%
14.7%
26.2%
-24.7%
422
91
­9,323
508
3
­2,191
­10
-93,578
1.0%
1.8%
­2.7%
2.1%
1.1%
­8.7%
­0.1%
-5.1%
30,219,241
30,012,048
30,889,940
-207,047
-0.7%
877,848
2.9%
Change
Percent
FY 2015/2016
Change
Percent
the Health Sciences
0806761HP
Other Education and Training
Subtotal Education and Training
Base Operations/Communications
Facilities Restoration and
0806276HP
Modernization ­ CONUS
Facilities Restoration and
0806376HP
Modernization ­ OCONUS
0806278HP
Facilities Sustainment ­ CONUS
0806378HP
Facilities Sustainment ­ OCONUS
Facilities Operations ­ Health
0807779HP
Care ­ CONUS
Facilities Operations ­ Health
0807979HP
Care ­ OCONUS
0807795HP
Base Communications ­ CONUS
0807995HP
Base Communications ­ OCONUS
0807796HP
Base Operations ­ CONUS
0807996HP
Base Operations ­ OCONUS
0807754HP
Pollution Prevention
0807756HP
Environmental Compliance
0807790HP
Visual Information Systems
Subtotal Base
Operations/Communications
Subtotal DHP Operation and
Maintenance
Exhibit PB­11, Cost of Medical Activities
DHP­176
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
Procurement (Program Elements 0807720HP &
0807721HP)
Dental Equipment
Food Service, Preventive
Medicine, and Pharmacy Equipment
Medical Information System
Equipment
Medical Patient Care
Administrative Equipment
Medical/Surgical Equipment
Other Equipment
Pathology/Lab Equipment
Radiographic Equipment
Procurement (Program Elements 0807744HP)
Theater Medical Information
Program ­ Joint (TMIP­J)
Procurement (Program Elements 0807784HP)
Electronic Health Record (EHR)
Subtotal Procurement
Research, Development, Test and Evaluation
0601101HP
In­House Laboratory Independent
Research (ILIR)
0601117HP
Basic Operational Medical
Research Sciences
0602115HP
Applied Biomedical Technology
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
541
22,216
299
1,659
308
3,009
­242
­20,557
­44.7%
­92.5%
9
1,350
3.0%
81.4%
190,184
145,127
149,897
­45,057
­23.7%
4,770
3.3%
11,156
3,144
5,944
­8,012
­71.8%
2,800
89.1%
67,733
185,861
21,858
206,215
14,817
10,972
11,850
108,219
20,057
22,744
13,663
148,274
­52,916
­174,889
­10,008
­97,996
­78.1%
­94.1%
­45.8%
­47.5%
5,240
11,772
1,813
40,055
35.4%
107.3%
15.3%
37.0%
0
3,145
1,494
3,145
100.0%
­1,651
­52.5%
0
705,764
9,181
308,413
7,897
373,287
9,181
-406,532
100.0%
-57.6%
­1,284
66,158
­14.0%
21.5%
2,894
3,151
3,599
257
8.9%
448
14.2%
5,805
9,059
7,397
3,254
56.1%
­1,662
­18.3%
59,968
73,201
58,251
13,233
22.1%
­14,950
­20.4%
Change
Percent
FY 2015/2016
Change
Exhibit PB­11, Cost of Medical Activities
DHP­177
Percent
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
0602787HP
0603002HP
0603115HP
0604110HP
0605013HP
0605023HP
0605025HP
0605026HP
0605039DHA
0605145HP
0605502HP
0606105HP
0607100HP
Medical Technology (AFRRI)
Medical Advanced Technology
(AFRRI)
Medical Technology Development
Medical Products Support and
Advanced Concept Development
Information Technology
Development
Integrated Electronic Health
Record (iEHR)
Theater Medical Information
Program ­ Joint (TMIP­J)
DoD Healthcare Management System
Modernization (DHMSM)
DoD Medical Information Exchange
and Interoperability (DMIX)
Medical Products and Support
Systems Development
Small Business Innovative
Research (SBIR) Program
Medical Program­Wide Activities
Medical Products and
Capabilities Enhancement
Activities
Subtotal RDT&E
Total Defense Health Program
FY 2014
FY 2015
FY 2016
FY 2014/2015
FY 2015/2016
Actuals1
1,139
284
Estimate2
1,241
310
Estimate2
1,222
305
Change
102
26
Percent
9.0%
9.2%
Change
­19
­5
Percent
­1.5%
­1.6%
1,109,743
296,634
1,201,188
150,822
231,051
103,443
91,445
­145,812
8.2%
­49.2%
­970,137
­47,379
­80.8%
­31.4%
44,451
21,696
19,312
­22,755
­51.2%
­2,384
­11.0%
19,912
68,267
9,216
48,355
242.8%
­59,051
­86.5%
23,783
22,042
22,100
­1,741
­7.3%
58
0.3%
0
91,394
438,376
91,394
100.0%
346,982
379.7%
0
0
11,000
0
0.0%
11,000
100.0%
14,415
26,649
15,906
12,234
84.9%
­10,743
­40.3%
47,882
0
0
­47,882
­100.0%
0
0.0%
68,277
15,097
44,042
17,474
41,567
17,356
­24,235
2,377
­35.5%
15.7%
­2,475
­118
­5.6%
­0.7%
1,710,284
1,730,536
980,101
20,252
1.2%
-750,435
-43.4%
32,635,289
32,050,997
32,243,328
-593,327
-1.9%
193,571
0.6%
Exhibit PB­11, Cost of Medical Activities
DHP­178
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
Medicare Eligible Accrual Fund Receipts
Direct Care
Private Sector Care
Military Personnel Accounts
Total Medicare Eligible Accrual
Fund
Research, Development, Test & Evaluation By
Program Title
Congressionally Directed
Programs
DHA Central Information
Technology Development
Service Information Technology
Development
Small Business Innovative
Research
Medical Technology Development
Biomedical Technology
Armed Forces Radiobiology
Research Institute (AFRRI)
In­House Laboratory Independent
Research (ILIR)
Medical Advanced Technology
(AFRRI)
Medical Products Support and
Advanced Concept Development
Medical Products and Support
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
1,371,694
7,394,596
488,363
9,254,653
1,406,036
7,720,034
491,930
9,618,000
1,449,570
8,036,580
496,850
9,983,000
34,342
325,438
3,567
363,347
2.5%
4.4%
0.7%
3.9%
43,534
316,546
4,920
365,000
3.1%
4.1%
1.0%
3.8%
822,786
1,076,115
0
253,329
30.8%
­1,076,115
­100.0%
27,665
11,241
12,937
­16,424
­59.4%
1,696
15.1%
16,786
10,455
6,375
­6,331
­37.7%
­4,080
­39.0%
23,847
0
0
­23,847
­100.0%
0
0.0%
337,586
37,388
1,139
108,267
10,143
1,117
114,276
14,672
1,222
­229,319
­27,245
­22
­67.9%
­72.9%
­1.9%
6,009
4,529
105
5.6%
44.7%
9.4%
2,894
2,836
3,599
­58
­2.0%
763
26.9%
284
279
305
­5
­1.8%
26
9.3%
249,006
0
4,000
­249,006
­100.0%
4,000
100.0%
14,415
1,806
855
­12,609
­87.5%
­951
­52.7%
Change
Percent
FY 2015/2016
Change
Percent
Exhibit PB­11, Cost of Medical Activities
DHP­179
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Cost of Medical Activities
Systems Development
Medical Program­Wide Activities
Medical Products and
Capabilities Enhancement
Activities
Basic Operational Medical
Research Sciences
Integrated Electronic Health
Record (iEHR)
Theater Medical Information
Program ­ Joint (TMIP­J)
DoD Healthcare Management System
Modernization (DHMSM)
DoD Medical Information Exchange
and Interoperability (DMIX)
GDF Medical Research Enhancement
Total Research, Development,
Test and Evaluation
1/ FY 2014
for RDT&E,
2/ FY 2015
3/ FY 2016
FY 2014
FY 2015
FY 2016
FY 2014/2015
Actuals1
Estimate2
Estimate2
68,277
15,097
38,074
0
41,567
0
­30,203
­15,097
­44.2%
­100.0%
3,493
0
9.2%
0.0%
5,805
0
0
­5,805
­100.0%
0
0.0%
63,526
68,267
9,216
4,741
7.5%
­59,051
­86.5%
23,783
22,042
22,100
­1,741
­7.3%
58
0.3%
0
91,394
438,376
91,394
100.0%
346,982
379.7%
0
0
11,000
0
0.0%
11,000
100.0%
0
1,710,284
288,500
1,730,536
299,601
980,101
288,500
20,252
100.0%
1.2%
11,101
-750,435
3.8%
-43.4%
Change
Percent
FY 2015/2016
Change
Percent
includes OCO funding of 715.484M for O&M, Congressional Special Interests (CSI) of ­948.739M for O&M, 822.786M
and ­229.417M for Procurement
includes CSI of ­1,001.261M for O&M, +1,076.115M for RDT&E
reflects Requested Amounts
Exhibit PB­11, Cost of Medical Activities
DHP­180
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Personnel Summary
FY 2014 Actual
FY 2015 Estimate
FY 2016 Estimate
FY15­16 Change
End
Avg
End
Avg
End
Avg
End
Avg
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Active Military – Assigned to DHP
Army Total
26,887
26,886
26,339
26,613
26,313
26,327
­26
­286
Officers
12,463
12,658
11,883
12,173
11,906
11,895
23
­278
Enlisted
14,424
14,228
14,456
14,440
14,407
14,432
­49
­8
28,286
28,286
27,964
28,126
27,966
27,965
2
­161
8,892
8,892
8,843
8,868
8,845
8,844
2
­24
19,394
19,394
19,121
19,258
19,121
19,121
0
­137
Navy Total
Officers
/1
Enlisted
Air Force Total
29,279
29,861
30,261
29,770
29,825
30,044
­436
274
Officers
10,050
10,120
10,774
10,412
10,645
10,710
­129
298
Enlisted
19,229
19,741
19,487
19,358
19,180
19,334
­307
­24
Total Active Duty
85,033
84,564
84,509
84,104
84,336
­460
­173
31,405
31,670
31,500
31,453
31,396
31,449
­104
­4
Enlisted
53,047
53,363
53,064
53,056
52,708
52,887
­356
­169
/1
84,452
Officers
Includes one USMC DHP officer strength
Exhibit PB­11A, Personnel Summary
DHP­181
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Personnel Summary
FY 2014 Actual
FY 2015 Estimate
FY 2016 Estimate
FY15­16 Change
End
Avg
End
Avg
End
Avg
End
Avg
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Active Military ­ Non DHP Medical
Army Total
24,994
23,674
23,844
24,419
23,921
23,883
77
­537
Officers
4,305
4,275
4,112
4,209
4,116
4,114
4
­95
Enlisted
20,689
19,399
19,732
20,211
19,805
19,769
73
­442
Navy Total
8,366
8,366
8,366
8,366
8,366
8,366
0
0
Officers
1,852
1,852
1,852
1,852
1,852
1,852
0
0
Enlisted
6,514
6,514
6,514
6,514
6,514
6,514
0
0
2,195
2,096
2,195
2,195
2,208
2,202
13
7
Officers
857
821
857
857
867
862
10
5
Enlisted
1,338
1,275
1,338
1,338
1,341
1,340
3
2
35,555
34,135
34,405
34,980
34,495
34,450
90
­530
Officers
7,014
6,948
6,821
6,918
6,835
6,828
14
­90
Enlisted
28,541
27,188
27,584
28,063
27,660
27,622
76
­441
Air Force Total
Total Active Duty
Exhibit PB­11A, Personnel Summary
DHP­182
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Personnel Summary
FY 2014 Actual
I.
FY 2015 Estimate
FY 2016 Estimate
FY15­16 Change
End
Avg
End
Avg
End
Avg
End
Avg
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Civilian Personnel ­ US Direct Hire
Army
36,560
36,251
40,375
41,021
39,120
38,846
­1,255
­2,175
Navy
10,762
10,579
11,571
11,385
11,237
11,051
­334
­334
Air Force
5,943
6,159
7,074
6,367
6,958
6,251
­116
­116
Defense Health Agency
5,717
5,335
5,890
5,874
6,306
6,290
416
416
58,982
58,324
64,910
64,647
63,621
62,438
­1,289
­2,209
Total
II.
Civilian Personnel ­ Foreign National Direct Hire
Army
461
468
436
431
436
431
0
0
Navy
357
321
365
342
365
342
0
0
Air Force
189
146
171
172
171
172
0
0
0
0
0
0
0
0
0
0
1,007
935
972
945
972
945
0
0
Defense Health Agency
Total
III.
Civilian Personnel ­ Foreign National Indirect Hire
Army
824
693
1,053
1,033
1,053
1,033
0
0
Navy
430
416
448
430
448
430
0
0
Air Force
145
184
165
161
165
161
0
0
3
4
5
5
5
5
0
0
1,402
1,297
1,671
1,629
1,671
1,629
0
0
Defense Health Agency
Total
Exhibit PB­11A, Personnel Summary
DHP­183
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Personnel Summary
FY 2014 Actual
IV.
FY 2016 Estimate
FY15­16 Change
End
Avg
End
Avg
End
Avg
End
Avg
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Total Civilian Personnel
Army
37,845
37,412
41,864
42,485
40,609
40,310
­1,255
­2,175
Navy
11,549
11,316
12,384
12,157
12,050
11,823
­334
­334
Air Force
6,277
6,489
7,410
6,700
7,294
6,584
­116
­116
Defense Health Agency
5,720
5,339
5,895
5,879
6,311
6,295
416
416
61,391
60,556
67,553
67,221
66,264
65,012
­1,289
­2,209
58,982
58,324
64,910
64,647
63,621
62,438
­1,289
­2,209
1,007
935
972
945
972
945
0
0
1,402
1,297
1,671
1,629
1,671
1,629
0
0
61,391
60,556
67,553
67,221
66,264
65,012
­1,289
­2,209
213
115
218
219
218
219
0
0
Total
V.
FY 2015 Estimate
/1
Summary Civilian Personnel
U.S. Direct Hire
Foreign National
Direct Hire
Foreign National
Indirect Hire
Total, Civilians
/1
/1 Includes reimbursable
civilians ­ memo
Exhibit PB­11A, Personnel Summary
DHP­184
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Personnel Summary
FY 2014 Actual
FY 2015 Estimate
FY 2016 Estimate
FY15­16 Change
End
Avg
End
Avg
End
Avg
End
Avg
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Strength
SPECIAL INTEREST MANPOWER
TRICARE Regional Offices (TRO):
Military
0
0
1
1
1
1
0
0
Civilian
111
111
139
139
139
139
0
0
Military
0
0
0
0
0
0
0
0
Civilian
80
94
115
115
86
86
­29
­29
Defense Health Agency (PE 0807798)
Army Management Headquarters (PE 0807798)
Military
128
171
129
129
129
129
0
0
Civilian
539
557
573
566
516
509
­57
­57
Navy Management Headquarters (PE 0807798)
Military
215
215
231
223
236
234
5
11
Civilian
158
157
156
153
143
140
­13
­13
Exhibit PB­11A, Personnel Summary
DHP­185
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Personnel Summary
FY 2014 Actual
FY 2015 Estimate
FY 2016 Estimate
FY15­16 Change
End
Avg
End
Avg
End
Avg
End
Avg
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Strength
Air Force Management Headquarters (PE 0807798)
Military
399
392
324
362
324
324
0
­38
Civilian
107
107
124
118
100
94
­24
­24
Note: Some numbers do not add due to rounding.
Exhibit PB­11A, Personnel Summary
DHP­186
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
FY 2014
FY 2015
Actuals * Estimate **
FY 2016 FY 2014-2015 FY 2015-2016
Estimate
Change
Change
Population - Average Eligible Beneficiaries, CONUS
Active Duty ***
1,398,432
1,355,277
1,339,282
­43,155
­15,995
Active Duty Family Members
2,144,104
2,071,473
2,043,744
­72,631
­27,729
Retirees
1,060,661
983,459
976,298
­77,202
­7,161
Family Members of Retirees
2,369,634
2,207,992
2,221,856
­161,642
13,864
Subtotal Eligible
6,972,831
6,618,201
6,581,180
­354,630
­37,021
2,233,223
2,288,319
2,314,706
55,096
26,387
9,206,054
8,906,520
8,895,886
­299,534
­10,634
184,747
178,302
176,395
­6,445
­1,907
23,557
22,636
22,541
­921
­95
7,497
6,984
6,941
­513
­43
Medicare Eligible Beneficiaries ****
Total Average Eligible Beneficiaries
Population - Average Eligible Beneficiaries, OCONUS
Active Duty ***
Active Duty Family Members
Retirees
Family Members of Retirees
54,727
56,107
57,051
1,380
944
Subtotal Eligible
270,528
264,029
262,928
­6,499
­1,101
57,897
59,403
60,120
1,506
717
328,425
323,432
323,048
­4,993
­384
Active Duty ***
1,583,179
1,533,579
1,515,677
­49,600
­17,902
Active Duty Family Members
2,167,661
2,094,109
2,066,285
­73,552
­27,824
Retirees
1,068,158
990,443
983,239
­77,715
­7,204
Family Members of Retirees
2,424,361
2,264,099
2,278,907
­160,262
14,808
Subtotal Eligible
7,243,359
6,882,230
6,844,108
­361,129
­38,122
6,998
6,691
6,564
­307
­127
1,727
1,732
1,712
5
­20
Medicare Eligible Beneficiaries
Total Average Eligible Beneficiaries
Population - Average Eligible Beneficiaries, Worldwide
Medicare Eligible Beneficiaries:
Active Duty Family Members
Guard/Reserve Family Members
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­187
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
1,085,068
1,106,918
1,119,357
21,850
12,439
Eligible Family Members of Retirees *****
714,142
728,347
736,539
14,205
8,192
Survivor
480,791
499,552
505,681
18,761
6,129
2,394
4,482
4,973
2,088
491
Total Medicare Eligible Beneficiaries
2,291,120
2,347,722
2,374,826
56,602
27,104
Total Average Eligible Beneficiaries
9,534,479
9,229,952
9,218,934
­304,527
­11,018
Eligible Retirees
Other
Notes:
1.
(*) 2014 Actuals are actual MHS eligible beneficiaries from FY2014FM12. (**) 2015 Estimate is projected number of MHS eligible
beneficiaries from FY2014FM12. (DEERS data were extracted on 12/02/2014).
2.
(***) Active duty and active duty guard/reserve beneficiaries were excluded from being counted as Medicare Eligible.
3.
(****) The US "Medicare Eligible Beneficiaries" are defined as MERHCF beneficiaries: Active Duty Family Members, Guard/Reserve
Family Members, Eligible Retirees, Eligible Family Members of Retirees, Inactive Guard/Reserve, Inactive Guard/Reserve Family Members,
Survivors, and Others
4.
(*****) The Worldwide "Eligible Family Members of Retirees" are defined as MERHCF beneficiaries: Family Members of Retirees,
Inactive Guard/Reserves, and Inactive Guard/Reserve Family Members
5.
Numbers may not sum to totals due to rounding.
6.
USFHP enrollees who are also Medicare Eligible are shown in Eligible Beneficiaries, not under Medicare Eligible Beneficiaries.
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­188
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
FY 2014
FY 2015
FY 2016
FY 2014-2015
FY 2015-2016
Actuals
Estimate
Estimate
Change
Change
TRICARE Region ­ North
846,681
875,384
895,004
28,703
19,620
TRICARE Region ­ South
986,960
1,057,225
1,073,374
70,265
16,149
TRICARE Region ­ West
967,692
1,045,901
1,049,986
78,209
4,085
TRICARE Region ­ Europe
142,765
136,509
136,641
­6,256
132
TRICARE Region ­ Pacific
221,113
207,915
207,082
­13,198
­833
3,992
2,577
2,577
­1,415
0
Enrollees - Direct Care
TRICARE Region ­ Latin America
Alaska
Sub­Total CONUS Regions
Sub­Total OCONUS Regions
Total Direct Care Enrollees
62,287
64,361
64,558
2,074
197
2,801,333
2,978,510
3,018,364
177,177
39,854
430,157
411,362
410,858
­18,795
­504
3,231,490
3,389,872
3,429,222
158,382
39,350
*Source: FY14 = DEERS; FY15 and 16 = Service Medical Departments Business Plans
Enrollees are only TRICARE PRIME Enrollees enrolled to a military treatment facility.
Excludes "Plus" empanelled and other TRICARE space available users.
Enrollees - Managed Care Support Contract
TRICARE Region ­ North
437,935
425,578
420,671
­12,356
­4,907
TRICARE Region ­ South
580,692
564,307
557,800
­16,384
­6,507
TRICARE Region ­ West
379,760
369,046
364,790
­10,715
­4,256
1,398,387
1,358,931
1,343,261
­39,456
­15,670
Total MCS Contracts
Infrastructure
56
56
55
0
­1
Medical Clinics
359
359
360
0
1
Dental Clinics
249
249
249
0
0
Veterinary Clinics
253
253
253
0
0
Inpatient Facilities
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­189
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
Direct Care System Workload (from M2 and Business Planning Tool)
Inpatient Admissions, Non­Weighted (SIDR Dispositions­All)
Inpatient Admissions, Weighted (MS­DRG RWPs, Non Mental Health)
Inpatient Admissions, Occupied Bed Days (Mental Health Only)
Average Length of Stay (ALL Bed Days/All Dispositions)
258,261
244,900
247,084
­13,361
2,185
207,956
215,050
217,067
7,094
2,018
87,259
89,297
91,795
2,038
2,498
3.15
3.03
3.07
­0.12
0.04
Ambulatory Visits, Non­Weighted (Encounters, CAPER)
38,188,888
39,099,293
39,573,218
910,405
473,925
Ambulatory Visits, Weighted (Adj Provider Aggregate RVUs, CAPER)
80,074,777
84,396,247
85,369,983
4,321,471
973,736
Ambulatory Procedures, Weighted (Aggregate Weight APCs, CAPER)
11,006,494
10,548,774
10,607,991
­457,721
59,217
Number of Outpatient Pharmacy Prescriptions "Scripts"
47,471,897
47,726,048
47,648,773
254,151
­77,275
.
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­190
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
FY 2014
FY 2015
FY 2016
FY 2014-2015
FY 2015-2016
Actuals
Estimate
Estimate
Change
Change
12,218,127
13,740,506
13,162,030
1,522,379
­578,476
Dental Workload (Dental Weighted Values (DWVs)(from Components)
CONUS
2,932,028
3,902,529
3,821,746
970,501
­80,783
15,150,155
17,643,035
16,983,776
2,492,880
­659,259
Active Duty
9,685,520
10,892,336
10,433,768
1,206,816
­458,568
Non­Active Duty
2,532,607
2,848,170
2,728,262
315,563
­119,908
Total CONUS
12,218,127
13,740,506
13,162,030
1,522,379
­578,476
2,015,363
2,682,448
2,626,921
667,085
­55,527
916,665
1,220,081
1,194,825
303,416
­25,256
2,932,028
3,902,529
3,821,746
970,501
­80,783
179,435
168,002
162,000
­11,433
­6,002
OCONUS
Total DWVs
CONUS
OCONUS
Active Duty
Non­Active Duty
Total OCONUS
Private Sector Workload
Managed Care Support Contracts (TRICARE Prime)
Inpatient Admissions
180,600
169,093
163,052
­11,507
­6,041
Outpatient Visits
32,552,016
32,778,567
33,876,538
226,551
1,097,971
Outpatient Relative Weighted Units (RVUs)
73,035,649
73,543,952
76,007,426
508,303
2,463,474
152,487
142,771
137,670
­9,716
­5,101
Inpatient Relative Weighted Product (RWPs)
TRICARE Extra/Standard
Inpatient Admissions
Inpatient Relative Weighted Product (RWPs)
Outpatient Visits
Outpatient Relative Weighted Units (RVUs)
136,510
127,812
123,246
­8,698
­4,566
14,316,717
14,416,357
14,899,256
99,640
482,899
34,205,019
34,443,074
35,596,801
238,055
1,153,727
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­191
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
Overseas CHAMPUS
Inpatient Admissions
13,866
13,311
13,112
­555
8,238
7,909
7,790
­330
­119
Outpatient Visits
369,150
354,384
349,068
­14,766
­5,316
Outpatient Relative Weighted Units (RVUs)
524,898
528,551
520,623
3,653
­7,928
Inpatient Relative Weighted Product (RWPs)
­200
.
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­192
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Medical Workload Data - DHP Summary
FY 2014
FY 2015
FY 2016
FY 2014-2015
FY 2015-2016
Actuals
Estimate
Estimate
Change
Change
29,913,983
28,298,628
27,987,343
­1,615,355
­311,285
4,109,533
3,990,357
4,002,328
­119,176
11,971
Enrollment ­ Single Plan
297,611
285,111
282,260
­12,500
­2,851
Enrollment ­ Family Plan
437,001
418,647
414,460
­18,354
­4,186
Enrollment ­ Survivor Single Plan
2,023
1,938
1,919
­85
­19
Enrollment ­ Survivor Family Plan
3,292
3,154
3,122
­138
­32
82,832
85,897
89,075
3,065
3,178
Pharmacy
Retail
Number of Scripts
Mail Order
Number of Scripts
TRICARE Dental Program
Uniformed Services Family Health Plan
Enrollees (Non­Medicare eligible, DoD Only)
Exhibit PB­11B, Medical Workload and Productivity Data
DHP­193
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Advisory and Assistance Services
$ in Thousands
FY 2015
Estimate
FY 2016
Estimate
4,426
221,146
225,572
74,832
178,569
253,401
71,965
208,739
280,704
II. Studies, Analysis & Evaluations
FFRDC Work
Non­FFRDC Work
Subtotal
8,616
31,527
40,143
6,000
47,340
53,340
6,000
47,861
53,861
III. Engineering & Technical Services
FFRDC Work
Non­FFRDC Work
Subtotal
244
12,230
12,474
289
209
498
8,339
8,339
278,189
307,239
342,904
Appropriation: Operation and Maintenance
I. Management & Professional Support Services
FFRDC Work
Non­FFRDC Work
Subtotal
TOTAL
FY 2014
Actual
Exhibit PB­15, Advisory and Assistance Services
DHP­195
(This page intentionally left blank)
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Major DoD Headquarters Activities
FY 2014 Actual1
Category/Organization
Appropriation
Military
Avg
Strength
FY 2015 Estimate
Civ
FTEs
Total
Manpower
Total
Obligation
($000)
Military
Avg
Strength
FY 2016 Estimate
Civ
FTEs
Total
Manpower
Total
Obligation
($000)
145,333
DHP, 0807798
O&M, DHP
­
766
766
267,821
­
965
965
DHP, 0807714
O&M, DHP
­
421
421
108,101
­
­
­
­
Military
Avg
Strength
Total
Obligation
($000)
Civ
FTEs
Total
Manpower
­
947
947
143,260
­
88
88
29,220
­
DHP, 0807704
O&M, DHP
­
­
­
­
­
­
­
­
­
122
DHP, 0807796
O&M, DHP
­
­
­
­
­
­
­
­
­
3
Total DHP O&M
-
1,187
-
965
965
-
1,160
1,187
375,922
145,333
122
70,335
3
322
1,160
243,137
Exhibit PB­22, Major DoD Headquarters Activities
DHP­197
(This page intentionally left blank)
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Operation and Maintenance
Quality of Life Activities
Exhibit OP­34, Quality of Life Activities
DHP­199
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Operation and Maintenance
Quality of Life Activities
Exhibit OP­34, Quality of Life Activities
DHP­200
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Funds Budgeted for Environmental Projects
Exhibit PB­28, Summary of Budgeted Environmental Projects
DHP­201
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Funds Budgeted for Environmental Projects
Exhibit PB­28, Summary of Budgeted Environmental Projects
DHP­202
Defense Health Program
Fiscal Year (FY) 2016 Budget Estimates
Operation and Maintenance
Summary of Funds Budgeted for Environmental Projects
Exhibit PB­28, Summary of Budgeted Environmental Projects
DHP­203
(This page intentionally left blank)
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Program
Appropriation Procurement ($ M)
Line
Item
FY 2014
Actual
FY 2015
Enacted
FY 2016
Base
FY 2016
OCO
641.577
283.030
330.504
0.000
64.187
13.057
33.392
Theater Medical Information
Program ­ Joint
0.000
3.145
Integrated Electronic Health
Record
0.000
Information Technology
Development and Sustainment ­
DoD Healthcare Management
System Modernization
DoD Medical Information
Exchange and Interoprability
No.
Nomenclature
1
Items greater than $250,000 each:
Medical Equipment ­
Replacement/Modernization
Medical Equipment ­ New
Facility Outfitting
FY 2016
Total
Request
FY 2017
Estimate
FY 2018
Estimate
FY 2019
Estimate
FY 2020
Estimate
330.504
395.504
408.424
451.163
448.997
0.000
33.392
20.347
9.530
26.538
11.554
1.494
0.000
1.494
2.413
2.689
2.850
2.907
9.181
7.897
0.000
7.897
1.043
0.075
0.076
0.079
0.000
0.000
0.000
0.000
0.000
181.458
663.956
684.084
699.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Exhibit P­1, Procurement Program
DHP­205
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Program
The Defense Health Program (DHP) Procurement Budget represents a critical element of the Department's capability to provide
high quality, cost effective health care for active duty and other eligible beneficiaries. Funds identified in this submission
support the acquisition of equipment for facilities in the Army, Navy, Air Force, and National Capital Region Medical
Directorate (NCRMD). Those facilities range from sophisticated tertiary care medical centers to outpatient medical and dental
clinics and physiological training units. This equipment is essential to provide high quality health care services that meet
accepted standards of practice. The required safety standards, related laws and regulatory requirements from credentialing and
health care standard setting organizations influence and affect the requirement for, cost of, and replacement and modernization
of medical equipment.
Without the identified resources, the DHP's capability to meet the Department's medical equipment
requirements will be severely degraded.
The Department, through the DHP, procures a wide variety of medical items ranging from surgical, radiographic, and pathologic
apparatus to medical administrative support equipment. The items to be procured by the resources identified in this schedule
are selected by way of a thorough investment equipment justification process. The identification and justification process
begins at the Military Treatment Facility (MTF) level. From there, the requirements are reviewed by functional specialty
advisor groups (Surgeon General level), medical logistics experts (Service component), Health Care Support Offices
(geographically oriented), and ultimately the Defense Health Agency (Tri­Service level). At each level, the requirements are
reviewed for the necessity, value, and utility of investment.
Development of an effective equipment replacement and modernization program is a complicated process. In comparison to
equipment in other functional areas, the useful life of medical equipment is short. As the current inventory reaches
obsolescence, replacements are generally more sophisticated, technologically advanced, and expensive. To ensure that the
Department is procuring the appropriate technology for deployment in the most useful locations, the DHP incorporates functional
expertise from each echelon of the Department's medical structure into the budget development process. This submission
represents a balanced, comprehensive approach to the Military Health Systems’ investment equipment requirements.
The requirements funded by the DHP Procurement Budget are diverse. The budget funds replacement of aging real property support
system in existing facilities and medical information system implementation, initial training, software purchases and hardware
replacements, such as servers and End User Devises (EUDs).
The Theater Medical Information Program ­ Joint (TMIP­J) integrates components of the Military Health System sustaining base
systems and the Services´ medical information systems to ensure timely interoperable medical support for mobilization,
deployment and sustainment of all Theater and deployed forces in support of any mission. Funding will be used for
implementation and training through FY15. Starting in FY16, Procurement funding transitions to support Operational Medicine
Support implementation and training activities (FY16 = $1.494M, FY17 = $2.413M, FY18 = $2.689M, FY19 = $2.850M, and FY20 =
$2.907M).
Exhibit P­1, Procurement Program
DHP­206
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Program
The former joint DoD and Department of Veterans Affairs (VA) Electronic Health Record (EHR) program has been restructured
within the DoD to pursue two separate but related healthcare information technology efforts, the DoD Healthcare Management
System Modernization (DHMSM) Program and the DoD EHR/Defense Medical Information Exchange (DMIX) Program. In the Under
Secretary of Defense for Acquisition, Technology and Logistics (USD (AT&L)) Acquisition Decision Memoranda (ADM), dated June
21, 2013 and January 2, 2014, the former joint DoD and VA Integrated Electronic Health Record (iEHR) Program was restructured
to pursue two separate but related healthcare information technology efforts, the DoD Healthcare Management System
Modernization (DHMSM) program and a newly defined iEHR, Defense Medical Information Exchange (DMIX). focused on providing
seamless integrated sharing of electronic health data between the DoD and VA. The remaining iEHR Increment 1 (iEHR Inc 1) was
significantly de­scoped to only the Medical Single Sign­on/Context Management (MSSO/CM) implemented at James A. Lovell Federal
Health Care Center (JAL FHCC).
Information Technology Deployment and Sustainment ­ DoD Healthcare Management System Modernization (DHMSM) will acquire and
support deployment, implementation, and sustainment of an electronic health record (EHR) system that replaces the DoD legacy
MHS inpatient and outpatient EHR systems. Overarching goal of the program is to enable healthcare teams to deliver high­
quality, safe care and preventive services to patients through the use of easily accessible standards­based computerized
patient records resulting in: improved accuracy of diagnoses and impact on health outcomes; increased patient participation in
the healthcare process; improved patient­centered care coordination; and increased practice efficiencies in all settings,
including operational environments.
DoD Medical Information Exchange (DMIX) Program will acquire the capabilities necessary to securely and reliably exchange
standardized, normalized, and correlated health data with all partners through standard data/information exchange mechanisms.
This allows users in different places and different organizations to access, use, and supplement health data (technical
interoperability) that has a shared meaning so users (assisted by computers) are able to make care decisions (Semantic
Interoperability – Level 4). DMIX manages the data exchange capability from legacy data stores in order to prepare for the
transition to the modernized Electronic Health Record platform being acquired by DoD Healthcare Management System Modernization
(DHMSM). DMIX consists of a family of capability initiatives supporting the seamless exchange of standardized health data
among DoD, VA, other Federal agencies, and private providers as well as benefits administrators. The DMIX program provides the
capability for health care providers to access and view complete and accurate patient health records from a variety of data
sources thereby allowing healthcare providers to make faster and higher quality care decisions. DMIX was established in
accordance with the joint memo from Under Secretary of Defense (Comptroller) and USD(AT&L) titled "Joint Memorandum on Major
Defense Acquisition Program and Major Automated Information System Program Resource Transparency in Department of Defense
Budget Systems" dated June 27, 2013.
Exhibit P­1, Procurement Program
DHP­207
(This page intentionally left blank)
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
BUDGET ITEM JUSTIFICATION SHEET
DATE: February 2015
APPROPRIATION / BUDGET ACTIVITY :
P­1 ITEM NOMENCLATURE: Replacement/Modernization
97*0130
Quantity
Total Cost ($ M)
Dental Equipment
Food Service,
Preventive Med, Pharmacy
Equipment
Medical Information
System Equipment
Medical Patient
Care Administrative Equip
Medical/Surgical
Equipment
Other Equipment
Pathology/Lab
Equipment
Radiographic
Equipment
FY 2014
FY 2015
FY 2016
FY 2016
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
Actuals
Enacted
Base
OCO
Total
Request
Estimate
Estimate
Estimate
Estimate
641.577
0.541
283.030
0.299
330.504
0.308
0.000
0.000
330.504
0.308
395.504
0.323
408.424
0.335
451.163
0.348
448.997
0.362
12.861
1.466
1.828
0.000
1.828
2.971
3.220
3.450
3.543
186.476
141.937
149.897
0.000
149.897
179.483
170.306
193.193
182.412
11.156
3.144
4.470
0.000
4.470
6.170
6.485
6.763
6.848
54.261
171.387
13.824
4.805
18.238
7.829
0.000
0.000
18.238
7.829
26.274
8.654
28.027
13.143
29.702
14.834
30.630
15.060
19.990
11.614
11.685
0.000
11.685
17.749
19.268
20.272
20.960
184.905
105.941
136.249
0.000
136.249
153.880
167.640
182.601
189.182
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­209
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
REMARKS
The most significant medical equipment investments will be in the radiographic, surgical, and information
systems functional areas. The driving factors are rapid technological advancements in these areas and the
need for DoD’s health care delivery system to maintain the standards of care set by the civilian health
care sector. Procurement investments for information systems will cover software license acquisitions,
infrastructure, hardware replacement such as End User Devices, Local Area Network (LAN) upgrades and
servers supporting Military Health System (MHS) Information Management/Information Technology (IM/IT) which
is composed of the MHS Health Information Technology Program (Tri­Service component, previously known as
centrally­managed IM/IT), three Military Departments (MilDep) medical IM/IT components, Defense Health
Agency (DHA) IM/IT, and the National Capital Region Medical Directorate (NCRMD) IM/IT. Funding will also
support deployment of the Wounded, Ill, Injured (WII) Health Artifact and Image Management Solution
(HAIMS).
Financing an adequate equipment acquisition budget is critical in retaining the Department’s medical
workload in­house and controlling purchased healthcare costs in the private sector. The items supported by
this budget are the result of an extensive investment equipment justification process and are necessary to
provide properly trained medical department personnel and high quality, cost effective health care services
for the eligible beneficiary population.
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­210
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
BUDGET ITEM JUSTIFICATION SHEET
DATE: February 2015
APPROPRIATION / BUDGET ACTIVITY :
97*0130
P­1 ITEM NOMENCLATURE: New Facility Outfitting
Quantity
Total Cost ($ M)
Dental Equipment
Food Service,
Preventive Med, Pharmacy
Equipment
Medical Information
System Equipment
Medical Patient Care
Administrative Equip
Medical/Surgical
Equipment
Other Equipment
Pathology/Lab
Equipment
Radiographic
Equipment
FY 2014
FY 2015
FY 2016
FY 2016
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
Actuals
Enacted
Base
OCO
Total
Request
Estimate
Estimate
Estimate
Estimate
64.187
0.000
13.057
0.000
33.392
0.000
0.000
0.000
33.392
0.000
20.347
0.000
9.530
0.000
26.538
0.000
11.554
0.000
9.355
0.193
1.181
0.000
1.181
0.258
0.089
0.344
0.152
3.708
3.190
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.474
0.000
1.474
0.000
0.000
0.000
0.000
13.472
14.474
0.993
6.167
1.819
14.915
0.000
0.000
1.819
14.915
1.285
14.305
0.442
7.457
1.717
18.511
0.758
8.020
1.868
0.236
1.978
0.000
1.978
0.316
0.109
0.420
0.186
21.310
2.278
12.025
0.000
12.025
4.183
1.433
5.546
2.438
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­211
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
REMARKS
The new facility outfitting program element of the DHP Procurement Budget funds the acquisition and
installation of commercially available equipment to furnish new and expanded facilities being completed
under military construction projects in support of dental services, health care delivery, health care
training, and other health care activities. The items range from dental, surgical, radiographic, and
pathologic equipment to medical administrative support equipment. The new facility outfitting program
provides critical support to the Military Health System’s military medical construction program.
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­212
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
BUDGET ITEM JUSTIFICATION SHEET
APPROPRIATION / BUDGET ACTIVITY
97*0130
:
DATE: February 2015
P­1 ITEM NOMENCLATURE: Theater Medical Information Program ­ Joint
(TMIP­J)
FY 2014
FY 2015
FY 2015
FY 2015
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
Actuals
Enacted
Base
OCO
Total
Request
Estimate
Estimate
Estimate
Estimate
0.000
0.000
3.145
3.145
1.494
1.494
0.000
0.000
1.494
1.494
2.413
2.413
2.689
2.689
2.850
2.850
2.907
2.907
Quantity
Total Cost ($ M)
TMIP­J
REMARKS
The Theater Medical Information Program ­ Joint (TMIP­J) integrates components of the Military Health System
sustaining base systems and the Services´ medical information systems to ensure timely interoperable medical
support for mobilization, deployment and sustainment of all Theater and deployed forces in support of any
mission. Funding will be used for implementation and training through FY15. Starting in FY16, Procurement funding
transitions to support Operational Medicine Support implementation and training activities (FY16 = $1.494M, FY17
= $2.413M, FY18 = $2.689M, FY19 = $2.850M, and FY20 = $2.907M).
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­213
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
BUDGET ITEM JUSTIFICATION SHEET
DATE: February 2015
APPROPRIATION / BUDGET ACTIVITY :
97*0130 P­1 ITEM NOMENCLATURE: Integrated Electronic Health Record
FY 2014
FY 2015
FY 2015
FY 2015
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
Actuals
Enacted
Base
OCO
Total
Request
Estimate
Estimate
Estimate
Estimate
0.000
0.000
9.181
9.181
7.897
7.897
0.000
0.000
7.897
7.897
1.043
1.043
0.075
0.075
0.076
0.076
0.079
0.079
Quantity
Total Cost ($ M)
EHR
REMARKS
The former joint DoD and Department of Veterans Affairs (VA) Electronic Health Record (EHR) program has been
restructured within the DoD to pursue two separate but related healthcare information technology efforts, the DoD
Healthcare Management System Modernization (DHMSM) program and the DoD EHR/Defense Medical Information Exchange
(DMIX) program. In the Under Secretary of Defense for Acquisition, Technology and Logistics (USD (AT&L))
Acquisition Decision Memoranda (ADM), dated June 21, 2013 and January 2, 2014, the former joint DoD and VA
Integrated Electronic Health Record (iEHR) program was restructured to pursue two separate but related healthcare
information technology efforts, the DoD Healthcare Management System Modernization (DHMSM) program and a newly
defined iEHR, Defense Medical Information Exchange (DMIX), focused on providing seamless integrated sharing of
electronic health data between the DoD and VA. The remaining iEHR Increment 1 (iEHR Inc 1) was significantly de­
scoped to only the Medical Single Sign­on/Context Management (MSSO/CM) implemented at James A. Lovell Federal
Health Care Center (JAL FHCC).
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­214
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
BUDGET ITEM JUSTIFICATION SHEET
DATE: February 2015
:
97*0130
P­1 ITEM NOMENCLATURE: Information Technology Development and
Sustainment ­ DoD Healthcare Management System Modernization
FY 2014
FY 2015
FY 2015
FY 2015
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
Actuals
Enacted
Base
OCO
Total
Request
Estimate
Estimate
Estimate
Estimate
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
181.458
181.458
663.956
663.956
684.084
684.084
699.014
699.014
APPROPRIATION / BUDGET ACTIVITY
Quantity
Total Cost ($ M)
DHMSM
REMARKS
Information Technology Deployment and Sustainment ­ DoD Healthcare Management System Modernization (DHMSM) will
acquire and support deployment, implementation, and sustainment of an electronic health record (EHR) system that
replaces the DoD legacy MHS inpatient and outpatient EHR systems. Overarching goal of the program is to enable
healthcare teams to deliver high­quality, safe care and preventive services to patients through the use of easily
accessible standards­based computerized patient records resulting in: improved accuracy of diagnoses and impact on
health outcomes; increased patient participation in the healthcare process; improved patient­centered care
coordination; and increased practice efficiencies in all settings, including operational environments.
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­215
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
Procurement Budget Item Justification
BUDGET ITEM JUSTIFICATION SHEET
DATE: February 2015
:
97*0130
P­1 ITEM NOMENCLATURE: DoD Medical Information Exchange and
Interoprability
FY 2014
FY 2015
FY 2015
FY 2015
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
Actuals
Enacted
Base
OCO
Total
Request
Estimate
Estimate
Estimate
Estimate
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
APPROPRIATION / BUDGET ACTIVITY
Quantity
Total Cost ($ M)
DHMSM
REMARKS
DoD Medical Information Exchange and Interoprability (DMIX) program will acquire the capabilities necessary to
securely and reliably exchange standardized, normalized, and correlated health data with all partners through
standard data/information exchange mechanisms. This allows users in different places and different organizations to
access, use, and supplement health data (technical interoperability) that has a shared meaning so users (assisted
by computers) are able to make care decisions (Semantic Interoperability – Level 4). DMIX manages the data
exchange capability from legacy data stores in order to prepare for the transition to the modernized Electronic
Health Record platform being acquired by DoD Healthcare Management System Modernization (DHMSM). DMIX consists of
a family of capability initiatives supporting the seamless exchange of standardized health data among DoD, VA,
other Federal agencies, and private providers as well as benefits administrators. The DMIX program provides the
capability for health care providers to access and view complete and accurate patient health records from a variety
of data sources thereby allowing healthcare providers to make faster and higher quality care decisions. DMIX was
established in accordance with the joint memo from Under Secretary of Defense (Comptroller) and USD(AT&L) titled
"Joint Memorandum on Major Defense Acquisition Program and Major Automated Information System Program Resource
Transparency in Department of Defense Budget Systems" dated June 27, 2013.
Exhibit P­40, Budget Item Justification, Procurement Program
DHP­216
Fiscal Year (FY) 2016 Budget Estimates
Defense Health Program
RDT&E Programs
Appropriation:
R-1
Line
Item
No
Program
Element
Number
1
0601101
2
0601117
3
0602115
4
0602787
5
0603002
6
0603115
7
0604110
8
0605013
9
0605023
10
0605025
11
0605026
RDT&E, Defense Health Program ($s M)
Item
In­House Laboratory
Independent Research
(ILIR)
Basic Operational
Medical Research
Sciences
Applied Biomedical
Technology
Medical Technology
(AFRRI)
Medical Advanced
Technology (AFRRI)
Medical Technology
Development
Medical Products Support
and Advanced Concept
Development
Information Technology
Development
Integrated Electronic
Health Record (iEHR)
Theater Medical
Information Program ­
Joint (TMIP­J)
Information Technology
Development ­ DoD
Healthcare Management
System Modernization
(DHMSM)
Budget
Activity
FY 2014
Actual
FY 2015
Enacted
FY 2016
Base
FY 2016
OCO
FY 2016
Total
Request
FY 2017
Estimate
FY 2018
Estimate
FY 2019
Estimate
FY 2020
Estimate
2
2.894
3.151
3.599
0.000
3.599
3.653
3.879
3.943
4.013
2
5.805
9.059
7.397
0.000
7.397
9.417
10.395
10.666
10.889
2
59.968
73.201
58.251
0.000
58.251
68.797
80.447
83.982
89.223
2
1.139
1.241
1.222
0.000
1.222
1.242
1.331
1.356
1.383
2
0.284
0.310
0.305
0.000
0.305
0.310
0.332
0.338
0.345
2
1109.743
1201.188
231.051
0.000
231.051
250.488
267.321
265.167
267.228
2
296.634
150.822
103.443
0.000
103.443
129.137
140.826
146.781
149.354
2
44.451
21.696
19.312
0.000
19.312
19.679
23.582
21.386
21.813
2
19.912
68.267
9.216
0.000
9.216
8.125
0.000
0.000
0.000
2
23.783
22.042
22.100
0.000
22.100
22.140
22.180
22.619
23.071
2
0.000
91.394
438.376
0.000
438.376
260.501
0.000
0.000
0.000
Total Budget Activity 2
1710.284
1730.536
980.101
0.000
980.101
836.386
Notes:
1.) FY 2014 actual includes congressional additions, reductions, and statutory reductions for FFRDC/SBIR.
2.) FY 2015 enacted includes congressional additions, reductions, and statutory reductions for FFRDC/SBIR.
615.492
622.693
Exhibit R­1, RDT&E Programs
DHP­217
635.108
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory Independent Research (ILIR)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
3.712
2.894
3.151
3.599
- 3.599
3.653
3.879
3.943
4.013 Continuing Continuing
010A: CSI - Congressional
Special Interests
0.000
- 0.315
- - - - - - - Continuing Continuing
240A: Infectious Disease
(USUHS)
0.520
0.404
0.397
0.433
- 0.433
0.440
0.471
0.480
0.490 Continuing Continuing
240B: Military Operational
Medicine (USUHS)
1.593
1.242
1.217
1.330
- 1.330
1.354
1.451
1.479
1.509 Continuing Continuing
240C: Combat Casualty Care
(USUHS)
1.599
1.248
1.222
1.836
- 1.836
1.859
1.957
1.984
2.014 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Uniformed Services of the Health Sciences (USUHS), this program element supports basic medical research at the Uniformed Services University of the Health
Sciences (USUHS). It facilitates the recruitment and retention of faculty; supports unique research training for military medical students and resident fellows; and allows
the University’s faculty researchers to collect pilot data towards military relevant medical research projects in order to secure research funds from extramural sources
(estimated $135 million annually). Approximately 110 intramural research projects are active each year, including 32 faculty start-ups. Projects are funded on a peerreviewed, competitive basis. Results from these studies contribute to the fund of knowledge intended to enable technical approaches and investment strategies within
Defense Science and Technology (S&T) programs.
The ILIR program at USUHS is designed to answer fundamental questions of importance to the military medical mission of the Department of Defense in the areas of
Combat Casualty Care, Infectious Diseases, Military Operational Medicine, and Chemical, Biological, and Radiologic Defense. The portfolio of research projects will
vary annually because this research is investigator-initiated. Examples of typical research efforts are detailed in R-2a.
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 1 of 9
R-1 Line #1
Volume 1 - 1
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Change Proposal Center for Rehabilitation
Sciences (CRSR) - Project 240C
FY 2014
3.088
2.894
-0.194
- - - - - - -0.194
- R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory Independent Research (ILIR)
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
2.836
3.151
0.315
- - - 0.315
- - - - 3.099
3.599
0.500
- - - 3.099
3.599
0.500
0.500
- 0.500
Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 010A: CSI - Congressional Special Interests
FY 2014
Congressional Add: 468A – Program Increase: Restore Core Research Funding Reduction (USUHS)
FY 2015
- 0.315
Congressional Add Subtotals for Project: 010A
- 0.315
Congressional Add Totals for all Projects
- 0.315
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), Program Element (PE) 0601101-In-House
Laboratory Independent Research (-$0.194 million) to DHP RDT&E, PE 0605502-Small Business Innovation Research (SBIR) Program (+$0.194 million).
FY 2015: Restores core research funding to the DHP RDT&E, PE 0601101-In-House Laboratory Independent Research (+$0.315 million).
FY 2016: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), Program Element (PE) 0601117-Basic
Operational Medical Research Sciences (-$0.500 million) to DHP RDT&E, PE 0601101-In-House Laboratory Independent Research (+$0.500 million).
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 2 of 9
R-1 Line #1
Volume 1 - 2
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
010A: CSI - Congressional
Special Interests
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Prior
Years
FY 2014
- FY 2015
- 0.315
FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- FY 2017
- - Project (Number/Name)
010A / CSI - Congressional Special
Interests
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The FY15 DHP Congressional Special Interest (CSI) funding is directed toward core research initiatives in Program Element (PE) - In-House Laboratory Independent
Research (ILIR). Because of the CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
Congressional Add: 468A – Program Increase: Restore Core Research Funding Reduction (USUHS)
FY 2014 FY 2015
- 0.315
FY 2014 Accomplishments: No Funding Programmed.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the In-House Laboratory Independent Research (ILIR) Program Element (PE) 0601101.
Congressional Adds Subtotals
- 0.315
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 3 of 9
R-1 Line #1
Volume 1 - 3
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
240A: Infectious Disease
(USUHS)
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Prior
Years
0.520
FY 2014
FY 2015
0.404
0.397
FY 2016
Base
0.433
FY 2016
OCO
FY 2016
Total
- 0.433
FY 2017
0.440
FY 2018
Project (Number/Name)
240A / Infectious Disease (USUHS)
FY 2019
0.471
0.480
Cost To
FY 2020 Complete
Total
Cost
0.490 Continuing Continuing
A. Mission Description and Budget Item Justification
Infectious Diseases: Immunology and molecular biology of bacterial, viral and parasitic disease threats to military operations. These threats include Bartonella
bacilliformis, Clostridium difficile, Escherichia coli and their Shiga toxins, Henipaviruses (Hendra & Nipah), Hepatitis A, Helicobacter pylori, HIV, HTLV-1, Leishmaniasis,
Litomosoides sigmodontis, Malaria, Neisseria gonorrhoeae, Shigella spp., Streptococcus, and Methicillin-resistant Staphylococcus aureus (MRSA).
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.404
Title: Infectious Disease
FY 2015
0.397
FY 2016
0.433
Description: Infectious Diseases: Immunology and molecular biology of bacterial, viral and parasitic disease threats to military
operations. These threats include Bartonella bacilliformis, Clostridium difficile, E. coli and their Shiga toxins, Henipaviruses
(Hendra & Nipah), Hepatitis A, Helicobacter pylori, HIV, HTLV-1, Leishmaniasis, Malaria, Neisseriae gonorrhea, Shigella spp.,
Streptococcus, Staphylococcus, and Typhoid fever.
FY 2014 Accomplishments:
Representative projects include the following: determination of the factors responsible for maintaining and driving the immune
response against helminth, such as Litomosoides sigmodontis, (parasitic worm) infections eventually leading to effective vaccines
against these infections; characterization of the alternative energy-generating pathways in C. difficile as a potential target to
prevent the transmission and recurrence of Clostridium difficile infection (CDI), the leading cause of nosocomial, antibioticassociated diarrhea; investigation of skin and soft tissue infections (SSTI) in the military population, generally caused by
community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), towards the development of novel prevention and
treatment strategies; investigation of the Henipaviruses and their bat hosts towards the development of novel intervention and
vaccine strategies; development of a cutaneous Leishmaniasis vaccine to prevent parasitic infection; elucidation of the natural
transmission of Bartonella bacilliformis by the sand fly towards disease prevention and control; analysis of genetic factors resulting
in colonization of the host intestinal tract by Escherichia coli O157:H7, the most common infectious cause of bloody diarrhea &
hemorrhagic colitis; understand how antibiotic resistance mutations in Neisseria gonorrhoeae (Gc), whose infections occur at a
high incidence throughout the world and in the United States and U.S. military, may influence the spread of resistant strains which
subsequently threatens control methods as well as our capacity to limit the spread of human immunodeficiency virus; design of
a new class of anti-viral therapeutics (HAIVA prep) for critical conditions like acute pulmonary infection (with different types of
flu viruses), and for vaccination purposes in imminent flu endemics; and the health behaviors and deployment factors that are
associated with acquisition of sexually transmitted diseases (STDs).
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 4 of 9
R-1 Line #1
Volume 1 - 4
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Project (Number/Name)
240A / Infectious Disease (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
These projects will support the essential military mission by advancing our understanding of both the transmission and the internal
mechanisms of a spectrum of pernicious and/or common diseases that may be faced by warfighters both at home and abroad.
In turn, that understanding opens avenues to better control, diagnosis, and treatment of both natural and manmade biological
threats.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
We will continue to investigate infectious diseases that impact soldiers from the standpoint of lost “man-days” to death. We
recognize that infectious disease can severely hamper combat readiness and effectiveness, and therefore we will continue to
concentrate our efforts on diagnosis and treatment of those naturally occurring infectious diseases that can affect the war fighter
by further development of vaccines, drugs, and diagnostic tools.
FY 2016 Plans:
Efforts will continue within the Infectious Disease research area in FY 2016. Specific investigator-initiated projects compete for
funding each year, usually with two to three-year project periods. Therefore, no detailed description of the research is possible at
this time.
Accomplishments/Planned Programs Subtotals
0.404
0.397
0.433
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 5 of 9
R-1 Line #1
Volume 1 - 5
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
240B: Military Operational
Medicine (USUHS)
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Prior
Years
1.593
FY 2014
FY 2015
1.242
1.217
FY 2016
Base
1.330
FY 2016
OCO
FY 2016
Total
- 1.330
FY 2017
1.354
FY 2018
Project (Number/Name)
240B / Military Operational Medicine
(USUHS)
FY 2019
1.451
1.479
Cost To
FY 2020 Complete
Total
Cost
1.509 Continuing Continuing
A. Mission Description and Budget Item Justification
Military Operational Medicine: Sustainment of individual performance; mapping and managing deployment and operational stressors; cognitive enhancement; use of
dietary and nutritional supplements and military and medical training readiness.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
1.242
Title: Military Operational Medicine
FY 2015
1.217
FY 2016
1.330
Description: Military Operational Medicine: Sustainment of individual performance; mapping and managing deployment and
operational stressors; cognitive enhancement; and military and medical training readiness.
FY 2014 Accomplishments:
Representative projects will include the following: refinement of a single item post traumatic stress disorder (PTSD) screening
tool for use in the DOD Primary Care system; understanding and attenuating deleterious effects of tobacco, alcohol, stress
and their interactions upon military personnel; forecasting levels of full or threshold PTSD, depression, health and alcohol
problems within the military population; determination of the unique proteomic signature for the diagnosis and assessment of
the neuro-immune response to traumatic brain injury (TBI) towards early assessment of the disease in the military and veteran
population; understanding the determinants of health promoting behaviors towards preventing obesity in both active duty
military and their family members; identifying signaling pathways that control satiety and dietary triggers towards prevention of
obesity; implementation of a neuromuscular routine that minimizes musculoskeletal injury in military academy cadets; study the
relationship between previous ankle injury, a common event in military populations, and future serious injury, such as ACL injury
as musculoskeletal injury (MSK-1) is the #1 cause of lost and limited duty in the U.S. military; evaluation of suicidal behaviors
within recent suicide deaths of active duty service members to aid in identification and prevention efforts; determination of the
psychosocial and biomedical risks and protective factors for heart failure and ischemia within the military and veteran population;
and the determination of non-invasive neurological biomarkers for heat intolerance using in vivo Magnetic Resonance Imaging
(MRI) and Spectroscopy (MRS).
These studies support the essential military mission by enhancing and protecting the health, performance and fitness of soldiers
throughout the deployment cycle. These studies strive to increase our understanding of and ability to manipulate the physiological
mechanisms of stress and immunity, human sleep and seasonal cycles, and neurological changes necessary for short- and longterm memory. Their discoveries should enable warfighters to stay awake longer with fewer detriments to performance; lead
to better strategies for enhancing and preserving memory and reasoning capabilities under battle conditions; help understand
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 6 of 9
R-1 Line #1
Volume 1 - 6
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Project (Number/Name)
240B / Military Operational Medicine
(USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
and ultimately prevent and treat neuropsychiatric illnesses such as depression and PTSD; and assist deployed troops and their
families better prepare for and contend with common, significant stressors related to the deployment cycle.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
Our efforts will concentrate on biomedical solutions that protect and enhance the health, performance, and fitness of our soldiers.
Our focus will continue to be to understand stress as it is related to performance and health. We will also study performance
in environmental extremes. Our goal is to lay the ground work that will establish platforms that build biomedical products and
solutions that mitigate risk to soldiers and protect them from “head to toe” both on the battlefield and at home.
FY 2016 Plans:
Efforts will continue within the Military Operational Medicine research area in FY 2016. Specific investigator-initiated projects
compete for funding each year, usually with two to three-year project periods. Therefore, no detailed description of the research is
possible at this time.
Accomplishments/Planned Programs Subtotals
1.242
1.217
1.330
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 7 of 9
R-1 Line #1
Volume 1 - 7
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
240C: Combat Casualty Care
(USUHS)
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Prior
Years
1.599
FY 2014
FY 2015
1.248
1.222
FY 2016
Base
1.836
FY 2016
OCO
FY 2016
Total
- 1.836
FY 2017
1.859
FY 2018
Project (Number/Name)
240C / Combat Casualty Care (USUHS)
FY 2019
1.957
1.984
Cost To
FY 2020 Complete
Total
Cost
2.014 Continuing Continuing
A. Mission Description and Budget Item Justification
Combat Casualty Care: Ischemia and reperfusion injury, traumatic brain and peripheral nerve injury, neural control of pain, endotoxic shock, cryotherapy, malignant
hyperthermia, inflammation, soman induced neuropathology and wound healing, and the advancement of rehabilitative care for service members with combat related
injuries, particularly those with orthopaedic trauma, limb loss and neurological complications.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
1.248
Title: Combat Casualty Care
FY 2015
1.222
FY 2016
1.836
Description: Combat Casualty Care: Ischemia and reperfusion injury, traumatic brain and peripheral nerve injury, neural control
of pain, endotoxic shock, cryotherapy, malignant hyperthermia, inflammation, and wound healing.
FY 2014 Accomplishments:
Representative projects will include: investigation of synaptic plasticity in temporal lobe epilepsy and possible development of
novel therapies; determination whether BMP-2 is a effective therapy to promotes recapitulation of the meninges surrounding the
spinal cord; understanding the contribution of inflammation to post-injury loss of function after traumatic brain and spinal cord
injury; investigate the underlying mechanisms involved in heart failure and drug-induced arrhythmias; identifying how the formation
of nerve cell circuits in the brain are affected by psychological stress and traumatic brain injury; analysis of the underlying
mechanisms responsible for the development of tolerance following the chronic use of opiates for severe pain; development of
psychological interventions to be used with military health care providers who experience post-traumatic stress symptoms to
prevent burn-out; and development of accurate millisecond-level assessment tools and computer based analyses to assist in the
evaluation and assessment of traumatic brain injury.
These studies also support the essential military mission by further exploring the mechanism of pain control for an established
treatment; providing the groundwork for effective treatments to limit nerve damage and encourage regeneration; and identifying
a possible cause for life-threatening complications due to the combination of exertion and injury common under heavy battlefield
conditions.
FY 2015 Plans:
Our efforts will concentrate on diagnosis and treatment for our wounded warriors to reduce mortality and morbidity resulting from
injuries on the battlefield. We will study physical and biological determinants of brain injury and post-traumatic stress disorder. In
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 8 of 9
R-1 Line #1
Volume 1 - 8
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0601101HP / In-House Laboratory
Independent Research (ILIR)
Project (Number/Name)
240C / Combat Casualty Care (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
addition, we will also focus on rehabilitation for amputees and pain management. Our goal is to understand how to best care for
soldiers who have suffered any type of physical or mental traumatic injury in the field.
FY 2014
FY 2015
FY 2016
We will continue to foster the four research focuses in FY2015 that will support advances in clinical and rehabilitation strategies.
New research studies will advance inter-service rehabilitation research that is relevant to the care of injured service members and
to provide the necessary platform for transferring novel technologies into the clinical practice at the MTFs.
Our proposed research for FY15 and beyond seeks to extend our current projects for the following three years as part of a
broader effort to establish a post-injury monitoring project to follow patients with orthopedic and extremity trauma for succeeding
years as they move through their life course.
FY 2016 Plans:
Efforts will continue within the Combat Casualty Care research area in FY 2016. Specific investigator-initiated projects compete
for funding each year, usually with two to three-year project periods. Therefore, no detailed description of the research is possible
at this time.
We will continue to foster the four research focuses in FY2016 that will support advances in clinical and rehabilitation strategies.
In particular, efforts in FY2016 have the potential to benefit all DoD sites with an instrumented gait analysis laboratory that care for
patients with lower extremity injury. While the current focus of this program is to provide a long-term follow-up/outcome measure
for evaluating patients with amputations and limb salvage, the Gait Quality Index (GQI) we are developing may be applied to any
patient population with a lower extremity injury and/or gait deviation. The GQI provides a tool to evaluate patients across various
DoD sites with a standardized three-component score, allowing for improved multi-site collaboration in research.
Accomplishments/Planned Programs Subtotals
1.248
1.222
1.836
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0601101HP: In-House Laboratory Independent Research...
Defense Health Program
UNCLASSIFIED
Page 9 of 9
R-1 Line #1
Volume 1 - 9
UNCLASSIFIED
THIS PAGE INTENTIONALLY LEFT BLANK
UNCLASSIFIED
Volume 1 - 10
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0601117HP / Basic Operational Medical Research Sciences
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
5.000
5.805
9.059
7.397
- 7.397
9.417
10.395
10.666
10.889 Continuing Continuing
100A: CSI - Congressional
Special Interests
2.237
- 1.578
- - - - - - - Continuing Continuing
371A: GDF-Basic Operational
Medical Research Sciences
2.763
5.805
7.481
7.397
- 7.397
9.417
10.395
10.666
10.889 Continuing Continuing
A. Mission Description and Budget Item Justification
Guidance for Development of the Force-Basic Operational Medical Research Sciences: This program element (PE) provides support for basic medical research directed
toward greater knowledge and understanding of the fundamental principles of science and medicine that are relevant to the improvement of Force Health Protection.
Research in this PE is designed to address the following: Areas of interest to the Secretary of Defense regarding Wounded Warriors, capabilities identified through the
Joint Capabilities Integration and Development System, and sustainment of priority investments in science, technology, research, and development as stated in the
Quadrennial Defense Review. Program development is peer-reviewed and coordinated with all of the Military Services, appropriate Defense Agencies or Activities
and other Federal Agencies, to include the Department of Veterans Affairs, the Department of Health and Human Services, and the Department of Homeland Security.
This coordination occurs through the planning and execution activities of the Joint Program Committees (JPCs), established for the Defense Health Program Research,
Development, Test and Evaluation (RDT&E) funding. Research supported by this PE includes coagulopathy of trauma (inability of blood to clot normally), polytrauma
(multiple traumatic injuries) and blast injury, military infectious diseases, and operational medicine. Funds in this PE are for basic research that promises to provide
important new approaches to complex military medical problems. As the research efforts mature, the most promising efforts will transition to applied research (PE
0602115HP) or technology development (PE 0603115HP) funding.
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Change Proposal Center for Rehabilitation
Sciences (CRSR) - Project 371A
PE 0601117HP: Basic Operational Medical Research Scien...
Defense Health Program
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
6.074
5.805
-0.269
- - - - - - -0.269
- 7.481
9.059
1.578
- - - 1.578
- - - - 7.897
7.397
-0.500
- - - 7.897
7.397
-0.500
-0.500
- -0.500
UNCLASSIFIED
Page 1 of 6
R-1 Line #2
Volume 1 - 11
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0601117HP / Basic Operational Medical Research Sciences
Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 100A: CSI - Congressional Special Interests
FY 2014
Congressional Add: 461A – Program Increase: Restore Core Research Funding Reduction (Army)
FY 2015
- 1.578
Congressional Add Subtotals for Project: 100A
- 1.578
Congressional Add Totals for all Projects
- 1.578
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), Program Element (PE) 0601117-Basic
Operational Medical Research Sciences (-$0.269 million) to DHP RDT&E, PE 0605502-Small Business Innovation Research (SBIR) Program (+$0.269 million).
FY 2015: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0601101-Basic Operational Medical Research Sciences (+$1.578 million).
FY 2016: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), Program Element (PE) 0601117-Basic
Operational Medical Research Sciences (-$0.500 million) to DHP RDT&E, PE 0601101-In-House Laboratory Independent Research (+$0.500 million).
PE 0601117HP: Basic Operational Medical Research Scien...
Defense Health Program
UNCLASSIFIED
Page 2 of 6
R-1 Line #2
Volume 1 - 12
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
100A: CSI - Congressional
Special Interests
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0601117HP / Basic Operational Medical 100A / CSI - Congressional Special
Research Sciences
Interests
Prior
Years
2.237
FY 2014
FY 2015
- 1.578
FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- FY 2017
- - FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The FY14 DHP Congressional Special Interest (CSI) funding is directed research for TBI/PH. Because of the CSI annual structure, out-year funding is not programmed.
The FY15 DHP Congressional Special Interest (CSI) funding is directed toward core research initiatives in Program Element (PE) 0601117 - Basic Operational Medical
Research Sciences. Because of the CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
Congressional Add: 461A – Program Increase: Restore Core Research Funding Reduction (Army)
FY 2014 FY 2015
- 1.578
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Products Support and Advanced Concept Development Program
Element (PE) - 0604110.
Congressional Adds Subtotals
- 1.578
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0601117HP: Basic Operational Medical Research Scien...
Defense Health Program
UNCLASSIFIED
Page 3 of 6
R-1 Line #2
Volume 1 - 13
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
371A: GDF-Basic Operational
Medical Research Sciences
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0601117HP / Basic Operational Medical 371A / GDF-Basic Operational Medical
Research Sciences
Research Sciences
Prior
Years
2.763
FY 2014
FY 2015
5.805
FY 2016
Base
7.481
7.397
FY 2016
OCO
FY 2016
Total
- 7.397
FY 2017
9.417
FY 2018
10.395
FY 2019
10.666
Cost To
FY 2020 Complete
Total
Cost
10.889 Continuing Continuing
A. Mission Description and Budget Item Justification
Guidance for Development of the Force-Basic Operational Medical Research Sciences: Basic research described here will be focused on enhancement of knowledge
to support capabilities identified through the Joint Capabilities Integration and Development System (JCIDS) process and sustainment of priority investments in
science, technology, research, and development as stated in the Quadrennial Defense Review. Within this Program Element, research will be conducted in the
general categories of coagulopathy of trauma (inability of blood to clot normally), polytrauma (multiple traumatic injuries) and blast injury, military infectious diseases,
and operational medicine. Polytrauma and blast injury efforts will focus on fundamental mechanisms to support devices and therapeutics for hemorrhage (bleeding)
control, resuscitation and blood products, and blast injury models and performance standards for protections systems. Military infectious diseases research program
is conducting basic research to identify biomarkers for detecting bacterial wound infections. Operational medicine is focusing on fundamental mechanisms to support
research on prevention of training and operational injury, nutrition and dietary supplements, psychological health and resilience, operational exposure standards for
cumulative mild traumatic brain injury, fatigue mechanisms, biomarkers (indicators) of inhalational exposure to toxic substances, and military operational computational
modeling.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
5.805
7.481
Title: Project 371 GDF – Basic Operational Medical Research Sciences
FY 2016 FY 2016 FY 2016
Base
OCO
Total
7.397
- 7.397
Description: Provide support for basic medical research directed toward attaining greater knowledge and
understanding of fundamental principles of science and medicine relevant to the improvement of medical care in
operationally relevant environments.
FY 2014 Accomplishments:
The military operational medicine research program conducted studies to understand fundamental mechanisms
of injury following exposure to blast, which will inform the development of exposure guidelines. Other research
efforts included the identification of biomarkers (biological indicators of disease) for inhalation exposure to toxic
substances such as burn pit emissions and sand from Afghanistan, and biomarkers indicative of neurological
effects due to jet fuel exposure.
The combat casualty care research program conducted studies on coagulopathy of trauma through a consortium
of five universities.
FY 2015 Plans:
PE 0601117HP: Basic Operational Medical Research Scien...
Defense Health Program
UNCLASSIFIED
Page 4 of 6
R-1 Line #2
Volume 1 - 14
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0601117HP / Basic Operational Medical 371A / GDF-Basic Operational Medical
Research Sciences
Research Sciences
B. Accomplishments/Planned Programs ($ in Millions)
Military infectious diseases research is supporting antimicrobial countermeasures to discover antibacterial
agents for biofilms (a group of microorganisms in which cells stick to each other on a surface), detect multidrugresistant organisms (MDROs), identify MDRO biomarkers, and develop new targets. These laboratory studies
provide an understanding of the mechanisms that make organisms infectious and mechanisms that render the
human body response effective to prevent diseases caused by infectious agents.
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
Military operational medicine research is continuing studies to understand the mechanisms of multiple low level
blast exposures in animal models of repeated blast and blunt impact injuries, and identify potential biomarkers
of pulmonary exposure to toxic substances from burn pit emissions, natural dust from Afghanistan and the
interactions between pollutants, which are associated with adverse health outcomes and lung disease. Studies
in nutrition and dietary supplements are assessing dietary status of different Service member populations.
Additional studies include the identification of novel pharmacological interventions to promote sleep quality, and
refine algorithms that predict the effects of fatigue countermeasures, such as caffeine and naps, to optimize
warfighter physical and cognitive performance.
Combat casualty care basic research is identifying underlying pathophysiologic (functional changes associated
with injury) mechanisms associated with coagulopathy (inability of blood to clot normally) of trauma, and
identifying potential diagnostic and therapeutic targets of coagulopathy of trauma.
FY 2016 Base Plans:
Military infectious diseases research will support basic research laboratory studies in wound infection prevention,
treatment, and management to develop antibacterial agents targeting biofilms and MDROs, and host and
microbial biomarkers for early detection of infection. Outcomes from FY15-16 laboratory studies will identify
bacterial targets for prevention/treatment of diseases caused by bacterial agents.
Military operational medicine research will identify mechanisms of blast injury that will guide the development
of interventions for mitigating blast-induced brain injury. Will start studies to identify and assess anger, risky
behaviors, grief, guilt, cognitive difficulties, substance abuse, and misuse of prescription medications in the
military. Will start studies to identify gender-specific factors that impact military task performance, will define
minimal physical requirements for entry into physically demanding military occupations, will investigate novel
interventions to evaluate effectiveness in treating PTSD symptoms, will conduct basic studies to define medical
standards for noise injury criteria, and will identify novel interventions to promote sleep quality and nonpharmacological approaches to reduce the need for sleep in order to sustain warfighter readiness.
PE 0601117HP: Basic Operational Medical Research Scien...
Defense Health Program
UNCLASSIFIED
Page 5 of 6
R-1 Line #2
Volume 1 - 15
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0601117HP / Basic Operational Medical 371A / GDF-Basic Operational Medical
Research Sciences
Research Sciences
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
Combat casualty care basic research will define the cellular mechanisms involved in the abnormal bleeding
that occurs following severe trauma. The results from these studies will be included in the design of the next
generation of hemostatic (process to stop bleeding) products.
FY 2016 OCO Plans:
N/A
Accomplishments/Planned Programs Subtotals
5.805
7.481
7.397
- 7.397
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
Research is evaluated through in-progress reviews, DHP-sponsored review & analysis meetings, quarterly and annual status reports, and progress reviews to ensure
that milestones are being met and deliverables are transitioned on schedule. The benchmark performance metric for transition of research conducted with basic science
funding is the attainment of a maturity level that is typical of Technology Readiness Level 2 or the equivalent for knowledge products.
PE 0601117HP: Basic Operational Medical Research Scien...
Defense Health Program
UNCLASSIFIED
Page 6 of 6
R-1 Line #2
Volume 1 - 16
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Total Program Element
Prior
Years
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical Technology
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
118.565
59.968
73.201
58.251
- 58.251
68.797
80.447
83.982
55.883
15.000
25.303
- - - - - - - - - 3.150
- 3.150
3.157
2.552
1.949
1.949 Continuing Continuing
3.377
3.535
2.968
- - - - - - - Continuing Continuing
306C: Core Adv Diagnostics &
Epigenomics Applied Research
(AF)
- - - 1.728
- 1.728
1.757
1.987
2.025
2.066 Continuing Continuing
306D: Core Occupational,
Bioenvironmental, Aerospace
Medicine & Toxicology Applied
Research (AF)
- - - 1.728
- 1.728
1.758
1.988
2.026
2.066 Continuing Continuing
372A: GDF Applied Biomedical
Technology
59.305
33.023
37.755
43.579
- 43.579
53.913
64.631
68.517
73.488 Continuing Continuing
0.000
8.410
7.175
8.066
- 8.066
8.212
9.289
9.465
9.654 Continuing Continuing
200A: Congressional Special
Interests
246A: Combating Antibiotic
Resistant Bacteria (CARB) WRAIR Discovery and Wound
Program (Army)
306B: Advanced Diagnostics
& Therapeutics Research &
Development (AF)
447A: Military HIV Research
Program (Army)
89.223 Continuing Continuing
- - - A. Mission Description and Budget Item Justification
For the Guidance for Development of the Force - Applied Biomedical Technology: This applied research funding is to refine concepts and ideas into potential solutions
to military health and performance problems, with a view towards evaluating technical feasibility. Included are studies and investigations leading to candidate solutions
that may involve use of animal models for testing in preparation for initial human testing. Research in this Program Element (PE) is designed to address the following:
Areas of interest to the Secretary of Defense regarding Wounded Warriors, capabilities identified through the Joint Capabilities Integration and Development System,
and sustainment of priority investments in science, technology, research, and development as stated the strategy and initiatives described in the Quadrennial Defense
Review. Program development is peer-reviewed and fully coordinated with all Military Services, appropriate Defense Agencies or Activities, and other federal agencies,
to include the Department of Veterans Affairs, the Department of Health and Human Services, and the Department of Homeland Security. This coordination occurs
through the planning and execution activities of the Joint Program Committees (JPCs), established for the Defense Health Program (DHP) Research, Development,
Test and Evaluation (RDT&E) funding. Research supported by this PE includes hemorrhage (bleeding) and resuscitation, diagnosis and treatment of brain injury,
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 1 of 22
R-1 Line #3
Volume 1 - 17
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0602115HP / Applied Biomedical Technology
treatments for extremity trauma (injury to tissue, head, face, jaw, and mouth, lungs, and burns), forward surgical intensive critical care, and en route care. Operational
medicine efforts focus on injury prevention and reduction, psychological health and resilience, physiological health, and environmental health. Rehabilitation applied
research focuses on neuromusculoskeletal injuries, pain management, regenerative medicine and sensory systems. Applied research efforts are also developing
radiation medical countermeasures. And, within the area of military infectious diseases, applied researchers focus on wound infection prevention and antimicrobial
countermeasures. As research efforts mature, the most promising efforts will transition to technology development (PE 0603115HP) or advanced concept development
(PE 0604110HP) funding.
For the Army Medical Command, beginning in FY14, the military HIV research program funding is transferred from the Army to the Defense Health Program. Work
in this area includes refining improved identification methods to determine genetic diversity of the virus, preclinical work in laboratory animals including non-human
primates to identify candidates for global HIV-1 vaccine, and evaluating and preparing overseas sites for clinical trials with these vaccine candidates.
For the Army Medical Command, beginning in FY15, funding is provided to develop strategies to prevent, mitigate, and treat antibiotic resistant bacteria in wounds
through the Combating Antimicrobial Resistant Bacteria - WRAIR Discovery and Wound Program.
The Army Medical Command also received DHP Congressional Special Interest (CSI) research funding focused on Peer-Reviewed Traumatic Brain Injury and
Psychological Health Research. Because of the CSI annual structure, out-year funding is not programmed.
For the Air Force, this PE funds applied research which seeks to promote ‘omic’-informed personalized medicine, advanced diagnostic technologies and occupational
toxicology with an emphasis on targeted prevention, diagnosis, and treatment. The delivery of pro-active, evidence-based, personalized medicine will improve health
in Warfighters and beneficiaries by providing care that is specific to the situation and patient, to include preventing disease or injury, early and accurate diagnosis,
and selection of appropriate and effective treatment. Personalized medicine will reduce morbidity, mortality, mission impact of illness/injury, and healthcare costs
while increasing health and wellness of the AF population and efficiency of the healthcare system. This applied research supports multiple focus areas, each of which
represents an identified barrier/gap which must be addressed for successful implementation of ‘omic-informed personalized medicine. Focus areas for applied research
include knowledge generation research; ethical legal and social issues/policy research; bioinformatics research; educational research; research for development of
advanced genomic diagnostic system. For efforts supported by this program element, research will be pursued with the intent to support solutions that answer Air Force
specific needs. During this process, the efforts of other government agencies in those areas will be assessed to avoid redundancy.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 2 of 22
R-1 Line #3
Volume 1 - 18
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Realignment in Support of the Global Health
Security Agenda (GHSA) Initiative - Project
246A
FY 2014
46.761
59.968
13.207
- - - 15.000
- - -1.793
- R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical Technology
FY 2015
FY 2016 Base
FY 2016 OCO
47.898
73.201
25.303
- - - 25.303
- - - - FY 2016 Total
55.101
58.251
3.150
- - - 55.101
58.251
3.150
3.150
- 3.150
Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 200A: Congressional Special Interests
FY 2014
Congressional Add: 426A – Traumatic Brain Injury and Psychological Health (TBI/PH) (Army)
FY 2015
15.000
- Congressional Add: 469A – CSI - Restore Core Applied Biomedical Technology (PE 0602115) (Army)
- 4.941
Congressional Add: 469B – CSI - Restore Core Applied Biomedical Technology (PE 0602115) (Air Force)
- 0.742
Congressional Add: 462A – CSI - GDF Restore Core Applied Biomedical Technology (PE 0602115) (Army)
- 19.620
Congressional Add Subtotals for Project: 200A
15.000
25.303
Congressional Add Totals for all Projects
15.000
25.303
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), Program Element (PE) 0602115-Applied
Biomedical Technology (-$1.793 million) to DHP RDT&E, PE 0605502-Small Business Innovation Research (SBIR) Program (+$1.793 million).
FY 2014: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0602115-Applied Biomedical Technology (+$15.000 million).
FY 2015: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0602115-Applied Biomedical Technology (+$25.303 million).
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 3 of 22
R-1 Line #3
Volume 1 - 19
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical Technology
FY2016: Realignment Global Health Security Agenda (GHSA) adjustment to DHP RDT&E, PE 0602115-Applied Biomedical Technology (+$3.150 million).
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 4 of 22
R-1 Line #3
Volume 1 - 20
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
200A: Congressional Special
Interests
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
FY 2014
55.883
FY 2015
15.000
25.303
FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
200A / Congressional Special Interests
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
- - Total
Cost
- A. Mission Description and Budget Item Justification
For FY14, DHP Congressional Special Interest (CSI) funding is directed to stimulate innovative research through a competitive, peer-reviewed research program
focused on peer-reviewed traumatic brain injury and psychological health research. Because of the CSI annual structure, out-year funding is not programmed.
The FY15 DHP Congressional Special Interest (CSI) funding is directed toward core research initiatives in Program Element (PE) 0602115 - Applied Biomedical
Technology. Because of the CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
Congressional Add: 426A – Traumatic Brain Injury and Psychological Health (TBI/PH) (Army)
FY 2014 FY 2015
15.000
- FY 2014 Accomplishments: The Traumatic Brain Injury and Psychological Health (TBI/PH) Congressional
Special Interest program aimed to execute studies that inform the development of strategies to prevent, mitigate,
and treat the effects of combat-relevant traumatic stress and TBI on function, wellness, and overall quality of life,
including interventions across the deployment lifecycle for warriors, veterans, family members, caregivers, and
communities. A key priority of the TBI/PH applied research program was to complement ongoing DoD efforts to
ensure the health and readiness of our military forces by promoting a better standard of care for psychological
health disorders and TBI in the areas of prevention, detection, diagnosis (identification of the nature and cause
of an illness), treatment, and rehabilitation. Program announcements, programmatic reviews, Service-requested
nominations, and ongoing studies that would benefit from program acceleration have been incorporated to
address these priorities and gather proposals. In the area of TBI, researchers performed investigations to find a
universally-agreed upon concussion grading system, and continued experiments into the effects of penetrating
injuries on the brain and experiments on the effects of blasts on the brain. Proposals were solicited in the areas
of blast-induced hyper-acceleration upon the generation of TBI and the role of inflammation in spreading TBI
damage. Multiple awards relevant to combat casualty care were made including development of a large animal
model of penetrating ballistic brain injury and development of metrics to define concussion and grade TBI. In the
area of psychological health, researchers performed investigations to diagnose, prevent, and reduce symptoms
of PTSD, and understand predictors of violence among workers in military settings.
Congressional Add: 469A – CSI - Restore Core Applied Biomedical Technology (PE 0602115) (Army)
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 5 of 22
- R-1 Line #3
4.941
Volume 1 - 21
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
200A / Congressional Special Interests
FY 2014
FY 2015
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Applied Biomedical TechnologyProgram Element (PE) - 0602115.
Congressional Add: 469B – CSI - Restore Core Applied Biomedical Technology (PE 0602115) (Air Force)
- 0.742
- 19.620
15.000
25.303
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Applied Biomedical TechnologyProgram Element (PE) - 0602115.
Congressional Add: 462A – CSI - GDF Restore Core Applied Biomedical Technology (PE 0602115) (Army)
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Applied Biomedical TechnologyProgram Element (PE) - 0602115.
Congressional Adds Subtotals
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
Individual efforts are monitored through a quarterly project performance reporting system and program management review process -- performance is measured against
standardized criteria for cost, schedule and performance (technical objectives), key performance parameters, and resolution of Force Health Protection gaps. Variances,
deviations, and/or breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of Science and Technology (S&T)
governance. Annual reviews are also conducted in person for all of the projects within a specific program area.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 6 of 22
R-1 Line #3
Volume 1 - 22
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
246A: Combating Antibiotic
Resistant Bacteria (CARB) WRAIR Discovery and Wound
Program (Army)
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
3.150
FY 2016
Total
- 3.150
FY 2017
3.157
FY 2018
Project (Number/Name)
246A / Combating Antibiotic Resistant
Bacteria (CARB) - WRAIR Discovery and
Wound Program (Army)
FY 2019
2.552
1.949
Cost To
FY 2020 Complete
Total
Cost
1.949 Continuing Continuing
A. Mission Description and Budget Item Justification
At the President’s direction in late 2013, a National Strategy was created to address the critical issue of antimicrobial resistance. This strategy was devised using
an interagency approach and ultimately approved at the executive level (2014). Inherent in this work are DoD sponsored efforts to support the DOD’s beneficiaries,
but that simultaneously complement national efforts to prevent, detect, and control illness and death related to infections caused by antibiotic-resistant bacteria. One
critical need identified is for new therapeutics, to include antibiotics. This effort’s focus is on the development of new/novel antibiotics, especially one targeting the
most resistant and worrisome Gram negative bacterial pathogens, using existing expertise at the Walter Reed Army Institute of Research (WRAIR), and leveraging
other WRAIR capabilities to identify viable candidate targets for advanced discovery. This project supports (both directly and indirectly) Global Health Security Agenda
priorities to respond rapidly and effectively to biological threats of international concern.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Combating Antibiotic Resistant Bacteria (CARB) - WRAIR Discovery and Wound Program (Army)
FY 2015
- FY 2016
3.150
Description: Initiate an antibacterial (AB) drug discovery program directed toward military relevant drug-resistant bacteria that (a)
encompasses assessment of external products/candidates/leads that may meet DoD requirements, (b) opens active intramuralbased discovery efforts of new potential products/candidates/leads for development, and (c) initiates partnerships with external
collaborators to develop/co-develop new potential AB treatment therapeutics.
FY 2014 Accomplishments:
No funding programmed. Targeted year of execution funding will be made available for this Global Health Security Agenda
(GHSA) initiative.
FY 2015 Plans:
Funding will be made avilable in the year of execution (FY2015). First year of funding establishes the research program and
initiates assessment of antibacterial programs from companies that have exited the commercial antibacterial drug discovery (direct
contact and literature publications) market for potential leads; identifies and hire staff; develops desired therapeutic product profile
criteria and DoD-focused Target Product Profiles to meet military requirements; identifies chemical hits/leads with development
potential; performs assays to assess potential lead candidates; synthesizes key chemical compounds and newly designed lead
optimization chemical compounds; begins to establish in vivo (living organism) model standards; identifies late stage potential
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 7 of 22
R-1 Line #3
Volume 1 - 23
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
246A / Combating Antibiotic Resistant
Bacteria (CARB) - WRAIR Discovery and
Wound Program (Army)
B. Accomplishments/Planned Programs ($ in Millions)
external programs that could potentially treat military relevant resistant bacteria; establishes agreements if intellectual property is
involved; acquires 2-4 compounds and assesses for effectiveness in laboratory and/or animal models.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
Applied research efforts will continue to identify chemical compounds for assessment in the laboratory and testing in animals, and
complete market analysis of external antibiotic programs to identify small molecules that are in early drug discovery (pre-clinical,
1-4 years away from advanced development) that may be expanded or elaborated. Will obtain rights if intellectual property is
owned by existing companies or complete partner agreements in order to explore and co-develop new antibiotics leads, then
conduct screening against military relevant strains and biofilms (microorganisms in which cells stick to each other on a surface) to
select compounds for continued development.
Accomplishments/Planned Programs Subtotals
- - 3.150
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
An Acquisition Strategy will be developed to support future Milestone B when a clinical development candidate is identified and reaches TRL-6.
E. Performance Metrics
Performance metrics of the CARB drug discovery program will be provided through semi-annual status reports, periodic reviews by the Military
Infectious Diseases Research Program Integrating Integrated Product Team (IIPT) and in-process reviews (IPR) conducted by USAMRMC Decision Gate process. The
performance metric benchmark is progression of research projects to Technology Readiness Level (TRL) 5 and their schedule to transition.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 8 of 22
R-1 Line #3
Volume 1 - 24
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
306B: Advanced Diagnostics
& Therapeutics Research &
Development (AF)
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
FY 2014
3.377
FY 2015
3.535
FY 2016
Base
2.968
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
306B / Advanced Diagnostics &
Therapeutics Research & Development (AF)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
Advanced Diagnostics & Therapeutics Clinical Translational Applied Research (Air Force): This project provides applied research funding needed to increase efficiency
and efficacy of care across the spectrum of Advanced Diagnostics and Therapeutics requirements in the defined Modernization Thrust Areas to improve and enhance
clinical Diagnosis, Identification, Quantification and Mitigation (DIQM) methods, techniques protocols, guidelines and practices for all DoD wounded, ill and/or injured
beneficiaries.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
3.535
Title: Advanced Diagnostics & Therapeutics Research & Development (AF)
FY 2015
2.968
FY 2016
- Description: This project provides applied research funding needed to perform research in the area of diagnostic assay
development/refinement for diseases of operational significance. This will support increased efficiency and efficacy of care across
the spectrum of Advanced Diagnostics and Therapeutics requirements in the defined Portfolio Areas. In addition, this project will
support research for biosurveillance/occupational health activities and support research of evidence based therapeutics.
FY 2014 Accomplishments:
Continued to support regenerative medicine program at Armed Forces Institute of Regenerative Medicine. Perform AF Surgeon
General directed deep dive on Health as a National Strategic Imperative/Lifestyle Medicine. Continued review of nanotechnology
research projects at the Massachusetts Institute of Technology as they relate to En-Route Care and Expeditionary Medicine
missions. Transfer the leadership of the continuing forum to educate leaders on futures based thinking from AFMS/SG to
OSD/HA. Continued support and development of Personalized Medicine/Genomic Medicine through specific outcome-based
milestones for upcoming PC2 task assignment. Continue to leverage joint diagnostic efforts to meet AF mission requirements.
Continue to analyze findings / outcomes of intramural project to identify and characterize epigenetic biomarkers of stress caused
by high altitude conditions in a collaborative clinical translational research project in collaboration with the Uniformed Services
University of the Healthcare Sciences (USUHS) to clinical practice / practice guidelines. Continue to support regenerative
medicine program at Armed Forces Institute of Regenerative Medicine. Perform AF Surgeon General directed deep dive on
Health as a National Strategic Imperative/Lifestyle Medicine. Continued review of nanotechnology research projects at the
Massachusetts Institute of Technology as they relate to En-Route Care and Expeditionary Medicine missions. Transfer the
leadership of the continuing forum to educate leaders on futures based thinking from AFMS/SG to OSD/HA. Continued support
and development of Personalized Medicine/Genomic Medicine through specific outcome-based milestones for upcoming PC2
task assignment. Continue to leverage joint diagnostic efforts to meet AF mission requirements. Continue to analyze findings /
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 9 of 22
R-1 Line #3
Volume 1 - 25
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
306B / Advanced Diagnostics &
Therapeutics Research & Development (AF)
B. Accomplishments/Planned Programs ($ in Millions)
outcomes of intramural project to identify and characterize epigenetic biomarkers of stress caused by high altitude conditions in
a collaborative clinical translational research project in collaboration with the Uniformed Services University of the Healthcare
Sciences (USUHS) to clinical practice / practice guidelines. Began project evaluating Middle Eastern Respiratory Syndrome
Coronavirus (MERS-CoV) and Influenza A/H7N9 on the Biomeme smart-device based pathogen identification system to meet
USAF requirements for infectious disease characterization. Initiated project to reduce the time to detection of the etiological
agent(s) responsible for sepsis infection. Obtained IRB approval for analysis of the Chagas disease threat within high-risk military
and civilian populations. Completed allelic discrimination of single nucleotide polymorphisms associated with metformin response
in MHS patients with Type II Diabetes.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
Continue to support regenerative medicine program at Armed Forces Institute of Regenerative Medicine. Develop a process to
effectively evaluate potential therapies/diagnostics/solutions to improve practices across the AFMS Complete AFMS Innovations
nanotechnology research projects in collaboration with the Massachusetts Institute of Technology to address gaps in Hemorrhage
control/hydration status, Pain management portable ultrasonography, and Compartment syndrome. Complete genomics clinical
utility study.
FY 2016 Plans:
No Funding Programmed.
Accomplishments/Planned Programs Subtotals
3.535
2.968
- C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc).
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 10 of 22
R-1 Line #3
Volume 1 - 26
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
306C: Core Adv Diagnostics &
Epigenomics Applied Research
(AF)
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
1.728
FY 2016
Total
- 1.728
FY 2017
1.757
FY 2018
Project (Number/Name)
306C / Core Adv Diagnostics &
Epigenomics Applied Research (AF)
FY 2019
1.987
2.025
Cost To
FY 2020 Complete
Total
Cost
2.066 Continuing Continuing
A. Mission Description and Budget Item Justification
This project provides applied research funding needed to perform research in the area of assay development/refinement for diseases of operational significance/
conditions. This will support increased efficiency and efficacy of care across the spectrum of Advanced Diagnostics and Therapeutics requirements in the defined
Portfolio Areas. In addition, this project will support research for biosurveillance/occupational health activities and research/development of evidence based therapeutics
B. Accomplishments/Planned Programs ($ in Millions)
Title: Core Adv Diagnostics & Epigenomics Applied Research (AF)
FY 2014
- FY 2015
- FY 2016
1.728
- - 1.728
Description: This project provides applied research funding needed to perform research in the area of assay development/
refinement for diseases of operational significance/conditions. This will support increased efficiency and efficacy of care across
the spectrum of Advanced Diagnostics and Therapeutics requirements in the defined Portfolio Areas. In addition, this project will
support research for biosurveillance/occupational health activities and research/development of evidence based therapeutics
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
In support of personalized treatment for type 2 diabetes and cardiovascular disease, provide a predictive genetic therapeutic
strategy based on pharmacogenetic therapies at the onset of diagnosis and aimed at delaying disease progression. Perform
intramural project for the rapid identification of etiological pathogens of sepsis in support of same-day treatment-specific
modalities. Leverage joint personalized medicine efforts to identify biomarkers of physiological response to opioid use. Transition
smartphone-based pathogen identification system to meet Air Force requirements for personalized medicine and infectious
disease characterization. Provide an analysis of the Chagas disease threat within high-risk military populations to determine if
force health protection measures should be implemented to decrease exposure risk.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
N/A
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 11 of 22
R-1 Line #3
Volume 1 - 27
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
306C / Core Adv Diagnostics &
Epigenomics Applied Research (AF)
C. Other Program Funding Summary ($ in Millions)
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 12 of 22
R-1 Line #3
Volume 1 - 28
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
306D: Core Occupational,
Bioenvironmental, Aerospace
Medicine & Toxicology Applied
Research (AF)
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
1.728
FY 2016
Total
- 1.728
FY 2017
1.758
FY 2018
Project (Number/Name)
306D / Core Occupational,
Bioenvironmental, Aerospace Medicine &
Toxicology Applied Research (AF)
FY 2019
1.988
2.026
Cost To
FY 2020 Complete
Total
Cost
2.066 Continuing Continuing
A. Mission Description and Budget Item Justification
This project supplies applied research funding needed to further develop approaches aimed at increasing the understanding of AF occupational and environmental
hazards, advancing new concepts in developing methods of treatment in aeromedical care, and exploring new mechanisms to enhance human performance in critical
Air Force occupations in the defined Modernization Thrust Areas to improve and enhance, maintain, preserve, and restore personnel performance, with the end goal of
positively affecting personalized health and performance.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Core Occupational, Bioenvironmental, Aerospace Medicine & Toxicology Applied Research (AF)
FY 2014
- FY 2015
- FY 2016
1.728
- - 1.728
Description: This project supplies applied research funding needed to further develop approaches aimed at increasing the
understanding of AF occupational and environmental hazards, advancing new concepts in developing methods of treatment in
aeromedical care, and exploring new mechanisms to enhance human performance in critical Air Force occupations in the defined
Modernization Thrust Areas to improve and enhance, maintain, preserve, and restore personnel performance, with the end goal of
positively affecting personalized health and performance.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Begin to develop advanced diagnostics for brain effects from hypobaria in USAF high altitude ops. Develop mitigation approaches
and therapeutics to counter effects from air transport and low-dose hypobaric exposures to the brain and traumatized organ
systems. Develop passive dosimeters to support 24/7 exposure monitoring.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
N/A
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 13 of 22
R-1 Line #3
Volume 1 - 29
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
306D / Core Occupational,
Bioenvironmental, Aerospace Medicine &
Toxicology Applied Research (AF)
C. Other Program Funding Summary ($ in Millions)
Remarks
D. Acquisition Strategy
ongoing scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for
proposal are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and
any necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.***
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 14 of 22
R-1 Line #3
Volume 1 - 30
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
372A: GDF Applied Biomedical
Technology
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
FY 2014
59.305
FY 2015
33.023
37.755
FY 2016
Base
FY 2016
OCO
43.579
FY 2016
Total
- 43.579
FY 2017
53.913
FY 2018
Project (Number/Name)
372A / GDF Applied Biomedical Technology
FY 2019
64.631
68.517
Cost To
FY 2020 Complete
Total
Cost
73.488 Continuing Continuing
A. Mission Description and Budget Item Justification
Guidance for Development of the Force - Applied Biomedical Technology: Applied biomedical technology research will focus on refining concepts and ideas into
potential solutions to military problems and conducting analyses of alternatives to select the best potential solution for further advanced technology development.
Applied research will be conducted in the general categories of trauma, polytrauma (multiple traumatic injuries) and blast injury, rehabilitation, diagnosis and treatment
of brain injury, radiation countermeasures, operational health and performance, physiological health, and psychological health and well-being for military personnel and
families. Trauma, polytrauma and blast injury applied research focuses on control of bleeding, tissue viability (survival potential of a tissue or organ), diagnosis and life
support, cranio-maxillofacial (head, neck, face, and jaw) injury, evacuation applications and practices, forward surgical applications, blast injury models and performance
standards for protection systems, blast induced brain injury models, diagnostics and metrics for hearing loss and protection, blast exposure and breaching (process used
to force open closed and/or locked doors), scar contracture (tightening of muscle, tendons, ligaments or skin that prevents normal movement), treatment of ocular and
visual system traumatic injury, wound infection prevention and management, rapid screening of fresh whole blood, and antimicrobial (a substance that kills or inhibits
the growth of microorganisms) countermeasures. Applied research in traumatic brain injury (TBI) focuses on diagnosis and treatment, disentanglement of combat
stress injuries, and TBI in evaluations and clinical management. Operational medicine applied researchers also focus on injury prevention strategies for training and
operational environments, sustainment of operational performance, early assessment and interventions to support Service member psychological and cognitive health,
nutrition and dietary supplements, military, family and community psychological health and resilience, biomarkers of inhalation and other exposure to toxic substances,
and military operational computational modeling. Applied research in radiation countermeasures includes activities to demonstrate capabilities to treat and mitigate the
effects of acute radiation syndrome following radiation exposure.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
33.023
Title: GDF Applied Biomedical Technology
FY 2015
37.755
FY 2016
43.579
Description: Applied Biomedical Technology Research focuses on refining concepts and ideas into potential solutions to
military problems and conducting analyses of alternatives to select the best potential solution for further advanced technology
development.
FY 2014 Accomplishments:
Military infectious disease research supported the development of the rapid Nucleic Acid Test screening of donor derived fresh
whole blood in emergency settings for infectious diseases. Down selection of the Nucleic Acid Testing platform was moved to
the right one year due to technical issues with industry partners and will be done in Q1FY15. Five projects were funded with the
aim to develop antimicrobial countermeasures to combat multiple-drug resistant bacterial infections, and to identify and validate
host and pathogen biomarkers to detect bacterial infections in wounds. Under acute respiratory diseases, continued support to
maintain core competency (subject matter experts).
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 15 of 22
R-1 Line #3
Volume 1 - 31
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
372A / GDF Applied Biomedical Technology
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
FY 2015
FY 2016
Military operational medicine is grouped into four portfolios of injury prevention and reduction, psychological health and resilience,
physiological health, and environmental health and protection. Injury prevention and reduction conducted applied research
studies on blast injury models and performance standards for protections systems, blast exposure during breaching (process
used to force open closed and/or locked doors), and diagnostics and metrics for hearing loss and protection. Psychological health
and resilience focused on providing solutions that build service members, family and community resilience to sustain and restore
psychological health and readiness, diagnosis of deployment-related psychological health problems, diagnosis of post-traumatic
stress disorder (PTSD), military family and warfighter resilience, and suicide prevention. Physiological health conducted research
on nutrition and dietary supplements, and the environmental health portfolio focused on pulmonary (pertaining to the lungs)
health in the deployed environment, the incidence of pulmonary disease in returned warfighters, and warfighter performance and
sustainment in extreme environments (such as extreme heat, cold, or altitude).
Combat casualty care research supported multi-year studies, initiated in FY12 and FY13 with applied research being divided into
portfolios for hemorrhage and resuscitation, neurotrauma, traumatic tissue injury, forward surgical intensive critical care, and joint
enroute care. Within the hemorrhage and resuscitation portfolio, a consortium of universities took a systems biology approach
to studying the coagulopathy of trauma. Others efforts studied techniques for modulating inflammation. The neurotrauma
research efforts studied mechanisms and treatments for TBI, distinguished between primary and tertiary blast injury, evaluated
neurophysiologic and systematic changes during aero-medical evacuation and enroute care, investigated TBI in animals using
advanced magnetic resonance imaging (MRI) and histopathology (microscopic examination of tissue) techniques, conducted a
military relevant model of closed concussive head injury in longitudinal studies characterizing and validating single and repetitive
mild TBI, and developed biomarkers in animals for progressive tau (human brain protein) pathology after TBI. The traumatic
tissue injury research portfolio is starting pre-clinical trials in face restoration. Forward surgical/intensive critical care research
started research to address pre-hospital care, emergency care, surgical care, intensive care, nursing care, advanced monitoring
and battlefield medical equipment. Joint enroute care conducted studies to automate comprehensive clinical practice guidelines
to improve enroute care of combat casualties, to access blood vessels in hemorrhagic (profuse bleeding) cases, and characterize
human blood vessels in normal and low blood pressure trauma patients. Promising candidate products were evaluated for
transition from applied research into technology development.
Radiation health effects research pursued strategies for protection, mitigation, and treatment of radiation-induced tissue injury
due to high doses of radiation exposure. Conducted animal studies in mice and non-human primates to characterize several
compounds with the potential to mitigate or prevent Acute Radiation Syndrome resulting from lethal doses of radiation. Additional
efforts identified targets for safe, effective, and FDA-approved prevention, mitigation or treatment of radiation injury, and increased
understanding of the molecular mechanisms by which radiation injuries are initiated and cell cycling pathways triggered leading to
multi-organ system dysfunction and death.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 16 of 22
R-1 Line #3
Volume 1 - 32
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
372A / GDF Applied Biomedical Technology
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
FY 2015
FY 2016
Clinical and rehabilitative medicine conducted studies in neuromusculoskeletal (system of nerves, muscles, and bones that
enable movement) injury, pain management, regenerative medicine, and/or sensory (hearing and sight) system traumatic injury
that identified and evaluated candidate approaches for incorporation into restoration and rehabilitation strategies and medical
products. Specific focus areas included: neuromusculoskeletal injury rehabilitation strategies and devices, prosthetics & orthotics
(device/support that corrects/relieves an orthopedic problem), neural interfaces (invasive and non-invasive methods of using
the brain for device control), the prevention of heterotopic ossification (growth of bone in abnormal places like soft tissue), and
treatment of training injuries to the musculoskeletal system; novel therapeutics and devices for pain management; regenerative
medicine-based approaches for limb (extremities) and digit (fingers, thumbs and toes) salvage, craniomaxillofacial (skull, face
and jaw) reconstruction, scarless wound healing, burn repair, genitourinary restoration and addressing compartment syndrome
(muscle, nerve and vascular damage due to swelling post-injury); and restoration and rehabilitation of sensory system injury,
including vision, hearing and balance injury and dysfunction. Clinical and rehabilitative medicine supported studies that started in
FY13 and focused on evaluating and down-selecting novel diagnostic and treatment strategies in the areas of pain management
and sensory system (vision, hearing, and balance) restoration and rehabilitation.
FY 2015 Plans:
Military infectious disease research is supporting multi-year studies in wound infection prevention and management and
antimicrobial countermeasures; development of four novel FDA-approved therapeutics (e.g., drugs) to mitigate wound infection
& biofilm processes, developing tools and practices for the detection/prevention of microbial infections in wounds and/or guide
clinical wound management, performing confirmatory laboratory studies and initial animal studies to demonstrate drug potency
and demonstrate biomarker accuracy and degree of confidence in identifying pathogens. Efforts to maintain core competency
(subject matter expertise) in acute respiratory diseases and diagnostic systems for infectious diseases are continuing.
Military operational medicine is grouped into four portfolios of injury prevention and reduction, psychological health, physiological
health, and environmental health and performance. Injury prevention and reduction is establishing risk factors for heat injury
susceptibility, establishing blast injury animal models for low-level repetitive blast exposure standards, and developing models
of inner ear function to establish hearing injury criteria. Psychological health portfolio research is performing retrospective
analysis of military workplace violence, examining reintegration difficulties following deployment, establishing an animal model
for dependency and withdrawal associated with substance abuse, and establishing associations between deployment and
psychological and physiological health problems. Physiological health is developing a reporting system for adverse events
associated with dietary supplement use, and developing computational models that can predict bone and muscle health status.
Environmental health and performance is studying select candidate biomarkers (biological indicators of health outcomes and
disease) for inhalation exposure to toxic substances, and conducting dehydration studies to select stress biomarkers of hydration
status.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 17 of 22
R-1 Line #3
Volume 1 - 33
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
372A / GDF Applied Biomedical Technology
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
FY 2015
FY 2016
Combat casualty care applied research is grouped into portfolios for hemorrhage (bleeding) and resuscitation, neurotrauma,
traumatic tissue injury, forward surgical intensive critical care, and joint enroute care. The hemorrhage and resuscitation research
portfolio is supporting studies assessing the effectiveness of Valproic Acid, a FDA-approved anti-seizure drug, and ethinyl
estradiol to increase survival of severe hemorrhage, establishing effects of modulating the inflammatory immune response
associated with hemorrhagic shock and trauma. Neurotrauma research is developing traumatic brain injury (TBI) biomarkers
(indicator of biological state or the past or present existence of a particular type of organism or molecule) and screening tools.
The Traumatic tissue injury research portfolio is supporting treatments to address acute lung injury and to enhance healing of
complex injuries of the face, extremities, groin and pelvis. Forward surgical intensive critical care is researching resuscitative
interventions through seamless critical care. Enroute care, research aims to improve field management and safe air transport of
patients with head and spine injuries.
Radiation health effects research pursues strategies for protection, mitigation, and treatment of radiation-induced tissue injury
due to high doses of radiation exposure. Conduct animal studies in mice and non-human primates to address research data
gaps and to characterize several compounds with potential to mitigate or prevent Acute Radiation Syndrome (ARS) resulting from
lethal doses of radiation. The research aims to identify mechanisms of action, effectiveness, and safety in animal models in the
development of therapeutics for ARS hematopoietic (bone marrow) sub-syndrome.
Clinical and rehabilitative medicine research is conducting applied research in the areas of neuromusculoskeletal injury, pain
management, regenerative medicine, and/or sensory (hearing and sight) system traumatic injury. The neuromusculoskeletal
injury portfolio is examining the impact of biopsychosocial effects on rehabilitation, improving the current technology available
for residual limb-device interface, and developing objective metrics for device prescription and training. In pain management,
research is studying enhanced chronic pain management using receptor antagonists (agents that block biochemical responses).
Regenerative medicine research is studying novel tissue-engineered nerve grafts for currently unrepairable nerve injury, and
treatment for re-innervated (restored nerve function) muscle. Sensory systems research is studying pre-clinical testing of
sustained release drugs to prevent blinding complications following eye injury, and developing therapeutic drugs for hearing
restoration after noise induced hearing loss.
FY 2016 Plans:
Military infectious diseases research will support multi-year studies in wound infection prevention and management and
antimicrobial countermeasures, and will continue development efforts of four antibacterial projects and two projects for the
detection of microbial infections in wounds. Studies will be aimed at development of novel therapeutics (drugs), biomarkers and
clinical practice guidelines to mitigate wound infection and biofilm processes. Molecule(s) showing efficacy in laboratory studies
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 18 of 22
R-1 Line #3
Volume 1 - 34
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
372A / GDF Applied Biomedical Technology
B. Accomplishments/Planned Programs ($ in Millions)
and initial animal studies, and/or biomarkers demonstrating accuracy in identifying pathogens will be further developed. Efforts to
maintain core competency (subject matter expertise) in acute respiratory diseases will be continued.
FY 2014
FY 2015
FY 2016
Military operational medicine is grouped into four portfolios of injury prevention and reduction, psychological health, physiological
health, and environmental health and performance. Injury prevention and reduction will perform validation studies of risk factors
for heat injury susceptibility, will validate blast injury animal models for low-level repetitive blast exposure standards, and will
improve models of inner ear function to establish hearing injury criteria. Psychological health will conduct research to establish
predictors of military workplace violence, will develop strategies for effective reintegration following deployment, and will continue
establishing associations between deployment and psychological and physiological health problems to inform development of
policies and guidelines. Physiological health will develop interventions for sustainable weight loss in military families, and will
continue the development of computational models that can predict bone and muscle health status. Environmental health and
protection portfolio research will refine candidate biomarkers (biological indicators of health outcomes and disease) for inhalation
exposure to toxic substances and for stress response to mild and moderate dehydration in clinical populations.
Combat casualty care applied research is divided into portfolios for hemorrhage (bleeding) and resuscitation, neurotrauma,
traumatic tissue injury, forward surgical intensive critical care, and joint enroute care. Hemorrhage and resuscitation will identify
new diagnostic tools and continue the development of treatments for abnormal hemorrhage following injury. Neurotrauma
research will further develop traumatic brain injury (TBI) biomarkers and screening tools for far-forward medical evaluation of
warriors. Forward surgical intensive critical care will study the effectiveness of acute lifesaving interventions in the pre-hospital/
hospital setting. Traumatic tissue injury researchers will study the mechanisms of acute lung injury, and research the use of lasers
to prevent scar tissue formation. Enroute care will study the physiology of patient transport (effects of altitude, temperature on
patients), and develop new non-invasive monitoring technologies.
Radiation health effects research will continue strategies for protection, mitigation, and treatment of radiation-induced tissue injury
due to high doses of radiation exposure. Will conduct animal studies in mice and non-human primates to address research data
gaps and to characterize several compounds with potential to mitigate or prevent Acute Radiation Syndrome (ARS) resulting from
lethal doses of radiation. Mitigators and therapeutics of ARS will focus primarily on bone marrow (hematopoietic), and to a lesser
degree on gastrointestinal and pulmonary sub-syndromes. Based on research accomplishments, compounds will be evaluated
as potential candidates for transition toward advanced development. Will identify mechanisms of action and demonstrate proof
of principle for radioprotectants (prophylactics). Additional efforts will identify targets for safe, effective, and FDA-approved
prevention, mitigation or treatment of radiation injury, and will increase understanding of the molecular mechanisms by which
radiation injuries are initiated and cell cycling pathways triggered leading to multi-organ system dysfunction and death.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 19 of 22
R-1 Line #3
Volume 1 - 35
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
372A / GDF Applied Biomedical Technology
B. Accomplishments/Planned Programs ($ in Millions)
Clinical and rehabilitative medicine research will pursue down-selection of candidate products for transition to technology
development in the areas of neuromusculoskeletal injury, pain management, regenerative medicine, and/or sensory (hearing,
sight and balance) system traumatic injury. Will conduct applied research in neuromusculoskeletal injuries to provide products
and information solutions for diagnosis, treatment and rehabilitation after service-related injuries. Will study the effectiveness of
leading solutions to alleviate acute and chronic battlefield pain, investigate solutions to replace or regenerate human cells, tissues,
or organs to restore or establish normal tissue function, and conduct applied research to identify therapeutic targets to restore
visual, auditory, and vestibular dysfunction associated with traumatic injury.
Accomplishments/Planned Programs Subtotals
FY 2014
33.023
FY 2015
FY 2016
37.755
43.579
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Evaluate technical feasibility of potential solutions to military health issues. Implement models into data or knowledge and test in a laboratory environment. Milestone A
packages will be developed to transition promising products to technology development funding.
E. Performance Metrics
Research is evaluated through in-progress reviews, DHP-sponsored review and analysis meetings, quarterly and annual status reports to include information on
publications, intellectual property, additional funding support, and progress reviews to ensure that milestones are met and deliverables are transitioned on schedule.
The benchmark performance metric for transition of research conducted with applied research funding is the attainment of a maturity level that is at least Technology
Readiness Level (TRL) 4, and typically TRL 5, or the equivalent for knowledge products. Products nearing attainment of TRL 5 will be considered for transition.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 20 of 22
R-1 Line #3
Volume 1 - 36
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Prior
Years
447A: Military HIV Research
Program (Army)
FY 2014
- FY 2015
8.410
7.175
FY 2016
Base
FY 2016
OCO
8.066
FY 2016
Total
- 8.066
FY 2017
8.212
FY 2018
Project (Number/Name)
447A / Military HIV Research Program
(Army)
FY 2019
9.289
9.465
Cost To
FY 2020 Complete
Total
Cost
9.654 Continuing Continuing
A. Mission Description and Budget Item Justification
This project conducts research on the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Work in this area includes
refining improved identification methods to determine genetic diversity of the virus and evaluating and preparing overseas sites for clinical trials with global vaccine
candidates. Additional activities include refining candidate vaccines for preventing HIV and undertaking preclinical studies (studies required before testing in humans)
to assess vaccine for potential to protect and/or manage the disease in infected individuals. This project is jointly managed through an Interagency Agreement between
US Army Medical Research Materiel Command (USAMRMC) and the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health
(NIH). This project contains no duplication of effort within the Military Departments or other government organizations. The cited work is also consistent with the
Assistant Secretary of Defense, Research and Engineering Science and Technology focus areas, and supports the principal area of Military Relevant Infectious
Diseases to include HIV.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
8.410
Title: Military HIV Research Program
FY 2015
7.175
FY 2016
8.066
Description: This project conducts research on HIV, which causes AIDS. Work in this area includes refining improved
identification methods to determine genetic diversity of the virus and evaluating and preparing overseas sites for future vaccine
trials. Additional activities include refining candidate vaccines for preventing HIV and undertaking preclinical studies (studies
required before testing in humans) to assess vaccine for potential to protect and/or manage the disease in infected individuals.
FY 2014 Accomplishments:
Program transitioned from the Army to DHP. Identified and characterized new populations who are at high risk of being infected
with HIV for clinical evaluation of potential new vaccine candidates. Identified and develop new clinical trial sites at overseas
locations to test and down-select best candidates for HIV vaccine. Initiated production of additional vaccines for various worldwide HIV subtypes and initiated pre-clinical evaluation in non-human primates. Identify and characterize new populations who are
at high risk of being infected with HIV for clinical evaluation of potential new vaccine candidates. Identify and develop new clinical
trial sites at overseas locations to test and down-select best candidates for HIV vaccine. Initiate production of additional vaccines
for various world-wide HIV subtypes and initiate pre-clinical evaluation in non-human primates.
FY 2015 Plans:
Complete production of additional vaccine candidates for various world-wide subtypes. Develop improved methods to evaluate
immune responses to selected HIV vaccine candidates in non-human primates. Analyze host genetic factors related to HIV
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 21 of 22
R-1 Line #3
Volume 1 - 37
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602115HP / Applied Biomedical
Technology
Project (Number/Name)
447A / Military HIV Research Program
(Army)
B. Accomplishments/Planned Programs ($ in Millions)
acquisition and disease progression in acute HIV infection to inform vaccine development. Complete down-selection of best
candidates for use in Phase 1 safety studies in human volunteers.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
Will continue to produce additional vaccine candidates for various world-wide subtypes. Will characterize these new sub-types
and evaluate their capability to induce protective immune responses in non-human primates. Will down-select one or more
vaccine candidates for use in safety studies in human volunteers.
Accomplishments/Planned Programs Subtotals
8.410
7.175
8.066
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
The program receives periodic funding from Division of AIDS of NIAID ranging from $10-20 M/year through an Interagency Agreement with USAMRMC.
D. Acquisition Strategy
N/A
E. Performance Metrics
Performance of the HIV research program is monitored and evaluated through an external peer review process, with periodic reviews by the HIV Program Steering
Committee and the Military Infectious Diseases Research Program Integrating Integrated Product Team (IIPT) and in-process reviews (IPR) conducted via the
USAMRMC Decision Gate process to include Defense Health Agency representation.
PE 0602115HP: Applied Biomedical Technology
Defense Health Program
UNCLASSIFIED
Page 22 of 22
R-1 Line #3
Volume 1 - 38
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology (AFRRI)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
4.718
1.139
1.241
1.222
- 1.222
1.242
1.331
1.356
1.383 Continuing Continuing
020: CSI - Congressional
Special Interests
0.000
- 0.124
- - - - - - - Continuing Continuing
241A: Biodosimetry (USUHS)
0.963
0.232
0.228
0.249
- 0.249
0.254
0.272
0.277
0.283 Continuing Continuing
241B: Internal Contamination
(USUHS)
0.500
0.121
0.119
0.131
- 0.131
0.133
0.143
0.146
0.149 Continuing Continuing
241C: Radiation
Countermeasures (USUHS)
3.255
0.786
0.770
0.842
- 0.842
0.855
0.916
0.933
0.951 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Uniformed Services University of the Health Sciences (USUHS), Armed Forces Radiobiology Research Institute (AFRRI), this program supports developmental
research to investigate new approaches that will lead to advancements in biomedical strategies for preventing, treating, assessing and predicting the health effects of
human exposure to ionizing radiation. Program objectives focus on preventing or mitigating the health consequences from exposures to ionizing radiation that represent
the highest probable threat to U.S. forces in current tactical, humanitarian and counterterrorism mission environments. New protective and therapeutic strategies will
broaden the military commander's options for operating within nuclear or radiological environments by minimizing both short-and long-term risks of adverse health
consequences. Advances in assessment, prognostication, and therapy in case of actual or suspected radiation exposures will enhance triage, treatment decisions and
risk assessment in operational settings.
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
1.216
1.139
-0.077
- - - - - - -0.077
1.117
1.241
0.124
- - - 0.124
- - - 1.222
1.222
- - - - 1.222
1.222
- Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 020: CSI - Congressional Special Interests
FY 2014
Congressional Add: 472A – Program Increase: Restore Core Research Funding Reduction (USUHS)
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 1 of 14
FY 2015
- R-1 Line #4
0.124
Volume 1 - 39
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology (AFRRI)
Congressional Add Details ($ in Millions, and Includes General Reductions)
Congressional Add Subtotals for Project: 020
Congressional Add Totals for all Projects
FY 2014
- FY 2015
0.124
- 0.124
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0602787-Medical Technology (AFRRI) ($0.077 million) to DHP RDT&E PE 0605502-Small Business Innovation Research (SBIR) Program (+$0.077 million).
FY 2015: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0602787-Medical Technology (AFRRI) (+$0.124 million).
FY 2016: No Change.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 2 of 14
R-1 Line #4
Volume 1 - 40
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
020: CSI - Congressional
Special Interests
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Prior
Years
FY 2014
- FY 2015
- 0.124
FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- FY 2017
- - Project (Number/Name)
020 / CSI - Congressional Special Interests
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The FY15 DHP Congressional Special Interest (CSI) funding is directed toward core research initiatives in Program Element (PE) 0602787 - Medical Technology
(AFRRI). Because of the CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
Congressional Add: 472A – Program Increase: Restore Core Research Funding Reduction (USUHS)
FY 2014 FY 2015
- 0.124
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Technology (AFRRI) Program Element (PE) - 0602787.
Congressional Adds Subtotals
- 0.124
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 3 of 14
R-1 Line #4
Volume 1 - 41
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
241A: Biodosimetry (USUHS)
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Prior
Years
0.963
FY 2014
FY 2015
0.232
0.228
FY 2016
Base
FY 2016
OCO
0.249
FY 2016
Total
- 0.249
FY 2017
0.254
FY 2018
Project (Number/Name)
241A / Biodosimetry (USUHS)
FY 2019
0.272
0.277
Cost To
FY 2020 Complete
Total
Cost
0.283 Continuing Continuing
A. Mission Description and Budget Item Justification
Biodosimetry (USUHS): For the Uniformed Services University of the Health Sciences (USUHS), the mission and research objectives for biodosimetry are to assess
radiation exposure by developing and providing biological and biophysical dosimetry capabilities for acute, protracted, and prior radiation exposures.
.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.232
Title: Biodosimetry (USUHS)
FY 2015
0.228
FY 2016
0.249
FY 2014 Accomplishments:
-Established the dosimetry map for protracted (Low-Dose-Rate or LDR) 60Co irradiation for murine model; initiated comparison
studies between LDR and prompt radiation on selected biomarkers in murine models.
-Completed study evaluating effects of 2 different dose rates on hematology and select proteomic biomarkers.
-Began to evaluate protein biomarkers, hematological parameters, and clinical signs ranging 1d – 2d in partial-body irradiated
mice.
-Continued to evaluate whether epigenetic markers can be used to discriminate low-dose from high-dose radiation.
-Determined if there is a chromosomal aberration difference between external radiation and internalized depleted uranium.
-Evaluated whether the profile of chromosomal aberrations in human samples are able to discriminate uranium exposure from
other toxic exposures.
-Determined histological effects of radiation on intestinal organoid cultures.
-Sent conditioned media samples from irradiated intestinal organoid cultures for proteomic analysis by liquid chromatographytandem mass spectrometry to identify biomarkers.
-Investigated impact of improving chromosome condensation on the ability to automate detection and counting of interphase
chromosome aberrations.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 4 of 14
R-1 Line #4
Volume 1 - 42
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241A / Biodosimetry (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Developed and integrated a spooler for automatic gene expression data inclusion from experiments and literature for indexing
into the automated analysis system.
-Evaluated applicability of new hardware, imaging tools, and suitability for use of mobile platforms and tablets in the automated
chromosome aberration scoring system.
-Sustained efforts to provide necessary proof-of-concept dose-response data to transition combined proteomic and hematological
concept for further development of diagnostic devices (i.e., hand-held, field deployable).
-Reported on evaluation of both radiation induced hematological and plasma protein biomarkers in the early-phase after irradiation
partial-body exposure model using x-ray source with lead shielding and mice restrained by holders.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
-Sustain studies evaluating new radiation-responsive biomarkers in animal models for early-phase and organ-specific
bioindicators.
-Begin a pilot study using samples from the mouse and NHP total-body irradiation models to permit testing of the measurement of
novel tissue- and organ-specific biomarkers in peripheral blood using commercially available antibodies and assays developed at
AFRRI.
-Begin to analyze blood chemistry data collected in the NHP dose-response study with limited supportive care and in the highdose study with full supportive care (G-CSF, antibiotics, blood transfusions, etc.) to evaluate radiation damage to specific organs.
-Begin to analyze results of necropsies performed on NHPs (limited and full supportive care) to determine the radiation dosedependent damage to different organs/tissues and correlate those results with levels of tissue/organ-specific protein biomarkers. Initiate studies to evaluate effects of even lower dose rates on hematology and select radiation biomarkers.
-Determine whether epigenetic markers can discriminate between chronic low dose and repeated low dose exposures.
-Determine whether epigenetic markers can discriminate between external radiation and internalized depleted uranium.
FY 2016 Plans:
-Establish a partial-body radiation model using mice involving exposure of the abdomen with AFRRI’s small animal irradiator to
support studies identifying and validating organ (i.e., small intestine, kidney) injury biomarkers.
-Establish murine model system to measure low dose epigenetic markers.
-Examine radiation-induced mitochondrial DNA (mtDNA) deletion in animal samples from low and high doses of radiation
exposure using a nested real-time PCR method, and evaluate the sensitivity and specificity of mtDNA deletion in response to
gamma-radiation.
-Develop a circulating micro-RNA profile in γ-irradiated animal model.Select the radiation-sensitive micro-RNAs that are stable and
easy to calibrate in serum as radiation biomarkers to monitor radiation injury and efficacy of radiation countermeasures.
-Evaluate proinflammatory cytokines as biomarkers to monitor ionizing radiation-induced acute and chronic injury and evaluate the
efficacy of radiation countermeasures.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 5 of 14
R-1 Line #4
Volume 1 - 43
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241A / Biodosimetry (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Determine the mechanisms of circulating micro-RNA and proinflammatory cytokine release after radiation exposure.
Accomplishments/Planned Programs Subtotals
FY 2014
0.232
FY 2015
FY 2016
0.228
0.249
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
By FY14
-Identify radiation biomarkers that are dependent on exposure dose-rate and specific for various ARS subsyndromes.
-Demonstrate accurate radiological detection of radiation biomarkers from biological samples into quartiles of doses 0-1 Gy, 1-3 Gy, 3-6 Gy, 6-10 Gy, and greater than
10Gy.
-Characterize partial-body radiation murine models over a protracted time period and compare results with prompt irradiation on selected biomarkers.
-Provide preliminary analysis of the enhanced utility of combined hematological and protein biomarkers for biodosimetry applications following photon and mixed
fieldneutron total-body irradiations in a total-body irradiation murine model.
-Identify subset of biomarkers useful for radiation dose assessment when confounded with thermal burns.
Complete report of select radiation biomarkers that are dependent upon dose-rate.
-Report on gender and age effects as well as partial-body irradiation effects on the evaluated panel of protein biomarkers in mouse model.
-Submit samples from radiation-exposed intestinal epithelial cell organoid cultures for Liquid Chromatography-Tandem Mass Spectrometry analysis for novel
radiationbiomarker discovery.
-Score histological injury to intestinal organoid cultures after irradiation.
-Measure specific methylation and histone changes using RT-PCR in low dose and high dose bronchial cells.
-Measure chromosomal aberrations in lymphocytes from gamma ray and depleted uranium exposed mice (spleen tissues).
-Measure intra-chromosomal aberrations using mBAND technology in human samples from individuals potentially exposed to toxic materials during deployment.
-Improve condensation of interphase chromatin into discrete chromosomes capable to be read through high-throughput image capture tools.
-Establish and incorporate Absorption Color Pigment (ACP) method for automated image extractors within CLASP.
-Provide report to validate specificity and sensitivity statistical models for the automated image system and analyses thereby testing CLASP efficiency.
-Evaluate the applicability and efficiency of developed SOPs after inclusion of multi-parametric approaches within CLASP.
By FY15
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 6 of 14
R-1 Line #4
Volume 1 - 44
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0602787HP / Medical Technology
241A / Biodosimetry (USUHS)
(AFRRI)
-Characterize partial-body radiation murine models over aprotracted time period and compare results with prompt irradiation on selected biomarkers.
-Perform a pilot study using samples from the mouse and NHP total-body irradiation models to permit testing of the measurement of novel tissue- and organ-specific
biomarkers in peripheral blood using commercially available antibodies and assays developed at AFRRI.
-Complete analysis of blood chemistry data collected in the NHP dose-response study with limited supportive care and in the high-dose study with full supportive care
(G-CSF, antibiotics, blood transfusions, etc.) to evaluate radiation damage to specific organs.
-Complete analysis of results of necropsies performed on NHPs (limited and full supportive care) to determine radiation dose-dependent damage to different organs/
tissues and correlate those results with levels of tissue/organ-specific protein biomarkers.
-Begin to evaluate the identified tissue- and organ-specific biomarkers in partial-body irradiation models.
-Provide necessary proof-of-concept dose-response data to transition combined proteomic and hematological concept for further development of diagnostic devices
(i.e.,hand-held, field deployable) and obtain the necessary FDA approval. Prepare preliminary report for FDA on combined utility of hematological and protein biomarkers
forbiodosimetry applications in two FDA-required animal models.
-Identify other radiation biomarkers that are dependent on exposure dose-rate.
-Validate dosimetric response of 3 biomarkers from IEC organoids exposed to 0-16 Gy gamma-ray radiation.
-Measure specific methylation and histone changes usingRT-PCR in low dose and high dose murine spleen samples.
-Identify proteomic markers from irradiated organoid cultures for validation by enzyme linked immunosorbent assay.
-Characterize dose profile for partial-body exposures using AFRRI’s small animal irradiator (SAARP).
-Establish assays for candidate radiation biomarkers for assessment of injury to specific radiation-sensitive organs.
-Initiate studies to evaluate radiation-induced chromosomal damage in murine radiation model.
By FY16
-Initiate partial-body exposure study to characterize organ specific injury biomarkers using abdomen exposures of mice.
-Report on measurements of miRNA levels to identify organ-specific injury biomarkers.
-Measure the incidence of leukemia development in vivo after chronic or repeated exposure to low dose radiation in a murine model.
-Continue to refine the combination of radiation biomarkers in blood with the best balance of discrimination of sensitivity and specificity.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 7 of 14
R-1 Line #4
Volume 1 - 45
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Prior
Years
241B: Internal Contamination
(USUHS)
0.500
FY 2014
FY 2015
0.121
0.119
FY 2016
Base
FY 2016
OCO
0.131
FY 2016
Total
- 0.131
FY 2017
0.133
FY 2018
Project (Number/Name)
241B / Internal Contamination (USUHS)
FY 2019
0.143
0.146
Cost To
FY 2020 Complete
Total
Cost
0.149 Continuing Continuing
A. Mission Description and Budget Item Justification
Internal Contamination (USUHS): For the Uniformed Services University of the Health Sciences (USUHS), the mission and research objective for Internal Contamination
is to determine whether the short-term and long-term radiological and toxicological risks of embedded metals warrant changes in the current combat and post-combat
fragment removal policies for military personnel. Additionally, the biological effects of internalization of radioactive elements from Radiological Dispersal Devices (RDDs)
and depleted uranium weapons, as well as therapeutic approaches to enhance the elimination of radionuclides from the body are being investigated.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Internal Contamination (USUHS)
FY 2014
0.121
FY 2015
0.119
FY 2016
0.131
0.121
0.119
0.131
FY 2014 Accomplishments:
-Determined the efficacy of molecularly imprinted polymers on reducing the body burden of internalized radionuclides using a
rodent model system.
-Validated combinatorial approach of depleted uranium-induced damage to cellular epigenetic machinery using an in vivo model.
FY 2015 Plans:
-Test novel leukemia countermeasures to determine if chemoprevention mechanism involves modification of chromatin regulation
in depleted uranium-induced leukemia in vivo.
-Design feasibility study to determine if non-radioactive metals can substitute as template molecules for high-specific activity
radionuclides in the synthesis of molecularly imprinted polymers.
FY 2016 Plans:
-Initiate study to assess the applicability of molecularly imprinted polymers in the decontamination of skin exposed to
radionuclides.
-Begin development and validation of a polytrauma model to assess the combined effects of mild traumatic brain injury and lowlevel radiation exposure, from external or internalized sources, in a rodent model system.
-Test novel countermeasure to low dose radiation and determine if chromatin remodeling is involved.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 8 of 14
R-1 Line #4
Volume 1 - 46
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241B / Internal Contamination (USUHS)
D. Acquisition Strategy
N/A
E. Performance Metrics
By FY14
-Complete assessment of combinatorial approach for assessing depleted uranium-induced damage.
-Conclude evaluation of molecularly imprinted polymers as decorporation agents.
By FY15
-Initiate study to assess feasibility of using non-radioactive templates in the synthesis of molecularly imprinted polymers to radioactive metals.
-Complete in vivo study on the mechanism of depleted uranium-induced leukemia.
By FY16
-Conclude feasibility assessment studies on the possibility of using non-radioactive templates for the synthesis of molecularly imprinted polymers designed to bind
radioactive metals.
-Initiate in vitro/in vivo model system study to assess novel countermeasure to low dose radiation leukemia that targets specific chromatin remodeling.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 9 of 14
R-1 Line #4
Volume 1 - 47
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
241C: Radiation
Countermeasures (USUHS)
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Prior
Years
3.255
FY 2014
FY 2015
0.786
0.770
FY 2016
Base
FY 2016
OCO
0.842
FY 2016
Total
- 0.842
FY 2017
0.855
FY 2018
Project (Number/Name)
241C / Radiation Countermeasures
(USUHS)
FY 2019
0.916
0.933
Cost To
FY 2020 Complete
Total
Cost
0.951 Continuing Continuing
A. Mission Description and Budget Item Justification
Radiation Countermeasures (USUHS): For the Uniformed Services University of the Health Sciences (USUHS), this program supports developmental, mission directed
research to investigate new concepts and approaches that will lead to advancements in biomedical strategies for preventing and treating the health effects of human
exposure to ionizing radiation as well as radiation combined with injuries (burns, wounds, hemorrhage). Research ranges from exploration of biological processes
likely to form the basis of technological solutions, to initial feasibility studies of promising solutions. Program objectives focus on mitigating the health consequences
from exposures to ionizing radiation, in the context of probable threats to U.S. forces in current tactical, humanitarian and counterterrorism mission environments. New
protective and therapeutic strategies will broaden the military commander's options for operating within nuclear or radiological environments by minimizing both shortand long-term risks of adverse health consequences.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.786
Title: Radiation Countermeasures (USUHS)
FY 2015
0.770
FY 2016
0.842
FY 2014 Accomplishments:
- Evaluated the radioprotective and mitigative/therapeutic effects of nano-gamma-tocotrienol (GT3) in mouse model
- Determined acute and late effects of radiation-induced bone damage and prevention by GT3 after whole body radiation.
- Analyzed global protein profiling after radiation in mouse spleen and kidney with varying doses and times after radiation.
- Evaluated radiation-induced micro-RNA changes in mouse jejunum after GT3 treatment.
- Evaluated the efficacy of a combined pharmaceutical regimen against radiation combined injury (irradiation followed immediately
by skin wound trauma).
-Determined effectiveness of combined therapy of G-CSF and ALXN4100TPO, a thrombopoietin receptor agonist, to prevent,
mitigate, or inhibit the long-term deleterious responses to radiation combined injury.
-Evaluated the micro-RNA profile in mouse serum after radiation alone and combination with wound trauma.
-Evaluated the efficacy of IL-10 as a countermeasure to radiation and combined injury-associated effects on bone
microarchitecture, strength, tissue-level cellular mechanisms, biomarkers of bone metabolism and immune effects.
-Explored the role of the immune system in bone’s response to radiation and combined injury (i.e. osteoimmunology).
-Investigated the molecular mechanisms involved in radiation, wounding, hemorrhage, and/or combined injury.
-Investigated the effects of mixed neutron/gamma radiation on secondary immune organs (liver, spleen).
-Determined the efficacy of CDX-301 as a radiation mitigator after mixed neutron/gamma radiation.
-Investigated the effect(s) of CDX-301 on hematopoietic cells in the lung, spleen, bone marrow when administered after mixed
neutron/gamma radiation.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 10 of 14
R-1 Line #4
Volume 1 - 48
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241C / Radiation Countermeasures
(USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Explored the role that sclerostin, an inhibitor of osteoblastogenesis, has on radiation and/or combined injury-associated
reductions in bone mass and its effects on Wnt/β-catenin signaling.
-Determined whether protection of bone marrow environment epigenetic changes following radiation can prevent radiation
leukemia.
-Continued study of the mitigation of radiation injury using apoptotic pathway markers in mice receiving TS-mobilized progenitors.
-Performed genome-wide transcriptomic and proteomic profiling to elucidate coordinate pathway activation markers associated
with tocopherol-mediated bioactivity.
-Performed RNA-sequence profiling of small RNA, as well as mRNA transcriptomes, antibody microarray and 2D gel
electrophoresis profiling of low and high abundance proteomes with samples obtained after tocopherol succinate (TS) treatment.
-Small molecule inhibitors for candidate signaling pathways associated with TS activity were utilized to determine their
requirements for CSF family member production, most notably, G-CSF production.
-Screened several human primary organ-specific cell types (epithelial, fibroblast, endothelial, etc.) for CSF transcript up-regulation
in response to alpha-tocopherol.
-Determined radioprotection (drug administered before irradiation) with 10 new compounds.
-Tested radioprotection by BB-001 and ODSH.
-Determined the efficacy of filgrastim (administered after irradiation) and ALXN4100TPO (administered prior to radiation) on
radiation lethality and how the combination influences hematopoietic end points as measured by circulating blood elements.
-Tested efficacy of ALXN4100TPO in different mouse strains.
-Evaluated microRNAs and inflammatory factors as radiation biomarkers.
-Evaluated the radioprotective and mitigative/therapeutic effects of tilorone hydrochloride in in vivo animal model.
-Studied the role of inflammatory pathways in ionizing radiation-induced bone marrow failure.
-Established 3 dimensional coculture in vitro model to evaluate the effects of bone marrow endothelial cells (BMEC) on
hematopoietic stem and progenitor cells (HSPC) in a 3D environment.
-Initiated ex vivo culture of murine BMEC for in vivo studies.
-Tested hypothesis that EC improve animal survival after gamma irradiation.
-Tested functional roles of EC in hematopoietic support after irradiation.
-Tested hypothesis that Ang/Tie2 pathway is involved in animal survival after irradiation.
-Tested functional roles of Ang/Tie2 pathway in hematopoietic support after irradiation.
-Initiated analysis of gene array data from irradiated human marrow endothelial cells and hematopoietic progenitor cells.
-Completed establishing the combined injury model with radiation followed by hemorrhage.
-Completed evaluation of peg-G-CSF and Alxn4100TPO co-therapy after irradiation and wound combined injury.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
-Evaluate RANKL-mediated signaling pathways in skeletal tissues after radiation and their modulation by gamma-tocotrienol.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 11 of 14
R-1 Line #4
Volume 1 - 49
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241C / Radiation Countermeasures
(USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Examine radiation-induced neuronal damage and mitigation by GT3 using cell culture and mouse brain.
-Evaluate the role of nrf2 pathway after radiation in microglial cells and its modulation by GT3.
-Evaluate intracellular signaling pathways in mechanisms of efficacy of GT3 in different mouse tissues after radiation.
-Determine the role of hedgehog signaling in hematopoietic recovery following sub-lethal dose of radiation (in vitro and in vivo
study).
-Determine the role of HIF-1a and HIF-2a in the regulation of erythropoiesis after radiation, and effect of GT3.
-Continue to evaluate micro-RNA profiles in mouse serum after both radiation alone and combination with wound trauma with
treatment with countermeasures.
-Determine the potential efficacy of a sclerostin antibody, which inhibits radiation-induced reductions in bone formation.
-Continue to explore the role of the immune system in bone’s response to radiation and combined injury.
-Determine whether phenylbutyrate-induced suppression of neoplastic transformation of bronchial tissue is radiation dose
dependent (low versus high) and whether epigenetic or genetic processes are predominant.
-Study transcriptomics in various subsets of TS-mobilized progenitors.
-Continue to evaluate changes in hematopoietic cell populations in multiple organs (spleen, lung, liver, bone marrow) in irradiated
mice treated with bone marrow endothelial cells.
-Evaluate alterations in signaling pathways and cytokine profiles in response to bone marrow endothelial cell induced responses
to gamma radiation.
-Complete analysis of gene array data from irradiated human marrow endothelial cells and hematopoietic progenitor cells.
-Characterize mTOR-AKT and MAPK signal mediation of radiation-hemorrhage combined injury.
-Identify dynamic changes in circulatory blood cell counts, bone marrow cellularity and ileum structure morphology after radiationwound combined injury.
-Evaluate systemic bacterial infection after radiation-wound combined injury.
-Screen 10-15 drugs in a mouse model for their radiation countermeasure potential.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
-Continue to correlate mTOR-AKT and MAPK signaling network and ATP production after radiation-hemorrhage combined injury.
-Continue to elucidate mechanisms underlying ghrelin efficacy on survival improvement after radiation-wound combined injury by
profiling cytokine/chemokine, signal transduction pathway activation, and miRNA regulation.
-Improve low dose risk assessment knowledge base by determining whether chronic or repeated low dose exposure in a murine
model induces leukemia in comparison to a high dose radiation exposure.
-Study efficacy biomarkers for Ex-RAD using in vitro and in vivo systems.
-Study whether elevated levels of pAkt are associated with survival.
-Investigate various signaling pathways for Ex-RAD biomarkers.
Accomplishments/Planned Programs Subtotals
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 12 of 14
R-1 Line #4
0.786
0.770
0.842
Volume 1 - 50
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241C / Radiation Countermeasures
(USUHS)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
By FY14
-Complete evaluation of the therapeutic effects of G-CSF and ALXN4100TPO on survival after radiation combined injury.
-Complete evaluation of the micro-RNA profile in mouse serum after radiation alone and combination with wound trauma.
-Complete evaluation of IL-10 as a countermeasure to radiation combined injury-induced bone loss and effects on immune system.
-Complete evaluation of molecular mechanisms involved in radiation, wounding, hemorrhage, and/or combined injury.
-Complete determination of the role that sclerostin has on radiation and/or combined injury-associated reductions in bone mass and its effects on Wnt/β-catenin
signaling in bone.
-Measure methylation and histone changes in radiation-leukemogenic mice.
-Begin analysis of underlying mechanisms of therapeutic effects of G-CSF, TS-mobilized progenitors, and ALXN4100TPO after radiation combined injury.
-Complete studies on CDX-301 mechanism(s) of action.
-Complete DRF studies with filgrastim using our optimized schedule.
-Repeat strain survival studies to determine LD50 in four mouse strains.
-Establish supportive care in rhesus macaque model to include antibiotic treatment, blood transfusions and thereby establish LD50 in primates.
-Complete establishing the combined injury model with radiation followed by hemorrhage.
-Complete evaluation of peg-G-CSF and Alxn4100TPO co-therapy after irradiation-wound combined injury.
By FY15
-Begin determining the potential efficacy of a sclerostin antibody to inhibit combined injury-induced bone loss.
-Evaluate effect of chronic or repeated low dose radiation on neoplastic transformation of bronchial tissue.
-Initiate investigations into mechanisms of mitigation/protection by BB-001. Determine optimum dose and time schedules, followed by DRF studies.
-Characterize mTOR-AKT and MAPK signal mediation of radiation-hemorrhage combined injury.
-Identify dynamic changes in circulatory blood cell counts, bone marrow cellularity and ileum structure morphology after radiation-wound combined injury.
-Determine systemic bacterial infection after radiation-wound combined injury.
-Complete low dose study on bronchial tissues measuring low dose responses in vitro.
-Evaluate effect of chronic or repeated low dose radiation on neoplastic transformation of bronchial tissue.
-Screen 10-15 drugs in a mouse model for their radiation countermeasure potential.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 13 of 14
R-1 Line #4
Volume 1 - 51
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0602787HP / Medical Technology
(AFRRI)
Project (Number/Name)
241C / Radiation Countermeasures
(USUHS)
By FY16
-Correlate mTOR-AKT and MAPK signaling network and ATP production after radiation-hemorrhage combined injury.
-Characterize dynamic changes in cytokine/chemokine concentrations, signal transduction pathways, and miRNA regulation after radiation-wound combined injury.
-Measure the incidence of leukemia development in vivo after chronic or repeated exposure to low dose radiation in a murine model.
-Evaluate effects of Ex-RAD on phosphorylated Akt.
-Elucidate cell survival role of pAkt.
-Study apoptotic pathway targets for identification of biomarkers for Ex-RAD.
PE 0602787HP: Medical Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 14 of 14
R-1 Line #4
Volume 1 - 52
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced Technology (AFRRI)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
0.989
0.284
0.310
0.305
- 0.305
0.310
0.332
0.338
0.345 Continuing Continuing
030A: CSI - Congressional
Special Interests
0.000
- 0.031
- - - - - - - Continuing Continuing
242A: Biodosimetry (USUHS)
0.594
0.171
0.167
0.183
- 0.183
0.186
0.199
0.202
0.206 Continuing Continuing
242B: Radiation
Countermeasures (USUHS)
0.395
0.113
0.112
0.122
- 0.122
0.124
0.133
0.136
0.139 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Uniformed Services University of the Health Sciences/ Armed Forces Radiobiology Research Institute (USUHS/AFRRI), this program supports applied research
for advanced development of biomedical strategies to prevent, treat and assess health consequences from exposure to ionizing radiation. It capitalizes on findings under
PE 0602787HP, Medical Technology, and from industry and academia to advance novel medical countermeasures into and through pre-clinical studies toward newly
licensed products. Program objectives focus on mitigating the health consequences from exposures to ionizing radiation(alone or in combination with other injuries) that
represent the highest probable threat to US forces in current tactical, humanitarian and counterterrorism mission environments. Findings from basic and developmental
research are integrated into focused advanced technology development studies to produce the following: (1) protective and therapeutic strategies; (2) novel biological
markers and delivery platforms for rapid, field-based individual medical assessment; and (3) experimental data needed to build accurate models for predicting casualties
from complex injuries involving radiation and other battlefield insults. The AFRRI, because of its multidisciplinary staff and exceptional laboratory and radiation facilities,
is uniquely positioned to execute the program as prescribed by its mission.
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
0.304
0.284
-0.020
- - - - - - -0.020
0.279
0.310
0.031
- - - 0.031
- - - 0.305
0.305
- - - - 0.305
0.305
- Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 030A: CSI - Congressional Special Interests
FY 2014
Congressional Add: 473A – Program Increase: Restore Core Research Funding Reduction (USUHS)
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 1 of 9
FY 2015
- R-1 Line #5
0.031
Volume 1 - 53
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced Technology (AFRRI)
Congressional Add Details ($ in Millions, and Includes General Reductions)
Congressional Add Subtotals for Project: 030A
FY 2014
Congressional Add Totals for all Projects
- FY 2015
0.031
- 0.031
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0603002-Advanced Technology (AFRRI)
(-$0.020 million) to DHP RDT&E PE 0605502-Small Business Innovation Research (SBIR) Program (+$0.020 million).
FY 2015: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0603002-Advanced Technology (AFRRI) (+$0.031 million).
FY 2016: No Change.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 2 of 9
R-1 Line #5
Volume 1 - 54
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
030A: CSI - Congressional
Special Interests
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced
Technology (AFRRI)
Prior
Years
FY 2014
- FY 2015
- 0.031
FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- FY 2017
- - Project (Number/Name)
030A / CSI - Congressional Special
Interests
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The FY15 DHP Congressional Special Interest (CSI) funding is directed toward core research initiatives in Program Element (PE) 0603002 - Medical Advanced
Technology (AFRRI). Because of the CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
Congressional Add: 473A – Program Increase: Restore Core Research Funding Reduction (USUHS)
FY 2014 FY 2015
- 0.031
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: The FY15 DHP Congressional Special Interest (CSI) funding is directed toward core research
initiatives in Program Element (PE) 0603002 - Medical Advanced Technology (AFRRI). Because of the CSI
annual structure, out-year funding is not programmed.
Congressional Adds Subtotals
- 0.031
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 3 of 9
R-1 Line #5
Volume 1 - 55
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
242A: Biodosimetry (USUHS)
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced
Technology (AFRRI)
Prior
Years
0.594
FY 2014
FY 2015
0.171
0.167
FY 2016
Base
0.183
FY 2016
OCO
FY 2016
Total
- 0.183
FY 2017
0.186
FY 2018
Project (Number/Name)
242A / Biodosimetry (USUHS)
FY 2019
0.199
0.202
Cost To
FY 2020 Complete
Total
Cost
0.206 Continuing Continuing
A. Mission Description and Budget Item Justification
Biodosimetry (USUHS): For the Uniformed Services University of the Health Sciences (USUHS), this program supports applied research for advanced development
of biomedical and biophysical strategies to assess health consequences from exposure to ionizing radiation. It capitalizes on findings under PE 0602787HP, Medical
Technology, and from industry and academia to advance novel biological markers and delivery platforms for rapid, field-based individual dose assessment and
experimental data needed to build accurate models for predicting casualties from complex injuries involving radiation and other battlefield insults.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.171
Title: Biodosimetry (USUHS)
FY 2015
0.167
FY 2016
0.183
FY 2014 Accomplishments:
-Continued the evaluation and validation of new radiation-responsive biomarkers in higher order animal (NHP) and human models
for biodosimetric diagnostic applications.
-Sustained efforts to establish a quality control and assurance plan for measurement of dose by cytogenetic chromosome
aberration assay.
-Optimized an interphase cytogenetic assay for high-dose and partial-body dose assessment.
-Participated in two cytogenetic biodosimetry exercises that demonstrated the ability to successfully ship from military operations
in CONUS and the laboratory’s accuracy for dose assessment of unknown samples in an inter-laboratory comparison study.
-Determined the feasibility of developing an early phase (<7 days) radiation dose assessment model and algorithm using
predictive biomarkers from AFRRI archived minipig hematology and serum chemistry data for estimating a 1.6-2 Gy radiation
dose.
-Established baseline levels of body weight, body width, body temperature, hematology, blood chemistry, proteomic biomarkers,
and ARS severity scores in the nonhuman primate total body irradiation model prior to irradiation.
-Reported on study using samples from the NHP total-body dose-response irradiation model, to permit testing of the measurement
of organ specific biomarkers in isolated peripheral blood using commercially available antibodies.
-A full dose-response algorithm dose assessment (6 h – 7 d) was developed for combinations of selected protein and
hematological biomarkers in the NHP total-body irradiation model.
-Determined the feasibility of developing an early phase (<7 days) radiation dose assessment model and algorithm for estimating
radiation doses between 1-8.5 Gy using archived NHP urine metabolite data.
-Developed and validated a radiation dose algorithm using NHP hematology and plasma proteomic biomarker results using
independent (“blinded”) samples.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 4 of 9
R-1 Line #5
Volume 1 - 56
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced
Technology (AFRRI)
Project (Number/Name)
242A / Biodosimetry (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Establish LIMS (Laboratory Information Management Systems) modules and controls for remote access. Tested, validated
and released the developed BETA version of the automated chromosome aberration scoring system to end user using a virtual
protocol network.
-Developed specificity and sensitivity models as well as multi-parametric approaches for internal automated self-validation of data
before end-user reporting for the automated chromosome aberration analysis system.
-Developed and established ultra-high-throughput miRNA based triage models.
-Contributed to the preparation of a summary report for FDA use on the diagnostic utility of combined hematological and proteomic
approach for triage biodosimetry applications based on the combination of hematological and proteomic biomarker results using
the minipigs and nonhuman primate model systems.
-Continued to provide necessary proof-of-concept dose-response data to transition combined proteomic and hematological
concept for further development of diagnostic devices (i.e., hand-held, field deployable) for necessary FDA approval.
-Began to develop the protocol on evaluated and newly developed protein biomarkers for use in human radiation accident cases.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
-Contribute to the further evaluation of discovered new radiation-responsive biomarkers in higher order animal and human models
for diagnostic biodosimetry applications.
-Begin a pilot study using samples from the mouse and NHP total-body irradiation models to permit testing of the measurement of
novel tissue- and organ-specific biomarkers in peripheral blood using commercially available antibodies and assays developed at
AFRRI.
-Begin to analyze blood chemistry data collected in the NHP dose-response study with limited supportive care and in the highdose study with full supportive care (G-CSF, antibiotics, blood transfusions, etc.) to evaluate radiation damage to specific organs.
-Begin to analyze results of necropsies performed on NHPs (limited and full supportive care) to determine radiation dosedependent damage to different organs/tissues and correlate those results with levels of tissue/organ-specific protein biomarkers.
-Complete NHP-specific ARS category score system based on multiple biodosimetric endpoints (i.e., clinical signs, peripheral
blood cell counts, and radiation-responsive protein expression profile).
-Sustain efforts to provide necessary proof-of-concept dose-response data to transition combined proteomic and hematological
concept for further development of diagnostic devices (i.e., hand-held, field deployable) and obtain necessary FDA approval.
-Complete report for FDA on combined utility of hematological and protein biomarkers for biodosimetry applications in two FDA
required animal models.
-Continue preparation of report for FDA on combined utility of hematological and protein biomarkers for biodosimetry applications
using GLP study results.
-Begin to develop the protocol for evaluating newly discovered protein biomarkers for use in human radiation accident cases.
FY 2016 Plans:
-Report a dose response algorithm using amylase activity 1 day after exposure.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 5 of 9
R-1 Line #5
Volume 1 - 57
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced
Technology (AFRRI)
Project (Number/Name)
242A / Biodosimetry (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Extend dose response radiation calibration curves to include low doses (10 cGy) and low-dose rates (10 cGy/min) for the
lymphocyte metaphase spread dicentric assay.
-Initiate efforts to adopt centromeric straining using the interphase chromosome aberration assay to permit scoring of dicentric
aberrations
Accomplishments/Planned Programs Subtotals
FY 2014
0.171
FY 2015
FY 2016
0.167
0.183
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
By FY 2014
-Evaluate proof of concept of two NHP radiation injury algorithms for estimating METREPOL Response Category (RC) 3, by comparing their differences, such as in the
blood-based biomarkers selected, the derived beta (weighted-interaction ) coefficients, amount of co-linearity between the independent variables, data collection timepoints and the RC estimation efficiency percentages as indicated by multiple-R values.
-Begin to develop the protocol on evaluated and newly developed protein biomarkers for use in human radiation accident cases.
-Establish and evaluate hardware and automated machinery architecture within CLASP for its implementation, throughput and efficiency after inclusion of new
multiparametric approaches with end user reporting.
-Integration of new imaging and analysis methods within CLASP to develop Boolean operations based on machine learning for automated close to human prediction,
using Artificial Intelligence.
-Establish and develop filter-assays for quick distinction of Very Low Priority (VLP) cohorts to develop an effective triage dose model for miRNA based gene expression
profiles.
-Integrate and cross-link the existing CLASP platform to incorporate pathway and genomic data from established search engines to provide a better user annotation.
By FY 2015
-Perform a pilot study using samples from the mouse and NHP total-body irradiation models to permit testing of the measurement of novel tissue- and organ-specific
biomarkers in peripheral blood using commercially available antibodies and assays developed at AFRRI.
-Complete analysis of blood chemistry data collected in the NHP dose-response study with limited supportive care and in the high-dose study with full supportive care
(G-CSF, antibiotics, blood transfusions, etc.) to evaluate radiation damage to specific organs.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 6 of 9
R-1 Line #5
Volume 1 - 58
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0603002HP / Medical Advanced
242A / Biodosimetry (USUHS)
Technology (AFRRI)
-Complete analysis of results of necropsies performed on NHPs (limited and full supportive care) to determine radiation dose-dependent damage to different organs/
tissues and correlate those results with levels of tissue/organ-specific protein biomarkers.
-Begin to evaluate the identified tissue- and organ-specific biomarkers in partial-body irradiation models.
-Exercise protocols for evaluation of newly developed proteomic biomarkers for use in radiation accident cases.
-Provide necessary proof-of-concept dose-response data to transition combined proteomic and hematological concept for further development of diagnostic devices (i.e.,
hand-held, field deployable) to obtain the necessary FDA approval.
-Report on natural history of ARS in NHP using total body irradiation radiation dose response model.
-Establish a gamma-ray dose response calibration curve for high-dose and partial-body cytogenetic assay.
By FY2016
-Initiate efforts to expand AFRRI’s dose assessment tools to include plasma protein biomarkers.
-Provide an updated report on AFRRI’s radiation calibration curves expanded to include low dose (10 cGy) and low-dose rates (10 cGy/min) for the metaphase spread
dicentric chromosome aberration assay.
-Demonstrate the utility of a multiple parameter biodosimetry diagnostic system.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 7 of 9
R-1 Line #5
Volume 1 - 59
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
242B: Radiation
Countermeasures (USUHS)
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced
Technology (AFRRI)
Prior
Years
0.395
FY 2014
FY 2015
0.113
0.112
FY 2016
Base
FY 2016
OCO
0.122
FY 2016
Total
- 0.122
FY 2017
0.124
FY 2018
Project (Number/Name)
242B / Radiation Countermeasures
(USUHS)
FY 2019
0.133
0.136
Cost To
FY 2020 Complete
Total
Cost
0.139 Continuing Continuing
A. Mission Description and Budget Item Justification
Radiation Countermeasures (USUHS): For the Uniformed Services University of the Health Sciences (USUHS), this program supports applied research for advanced
development of biomedical strategies to prevent, treat and assess health consequences from exposure to ionizing radiation. It capitalizes on findings under PE
0602787HP, Medical Technology, and from industry and academia to advance novel medical countermeasures into and through pre-clinical studies toward newly
licensed products. Program objectives focus on mitigating the health consequences from exposures to ionizing radiation alone or in combination with other injuries,
in the context of probable threats to US forces in current tactical, humanitarian and counterterrorism mission environments. Findings from basic and developmental
research are integrated into highly focused advanced technology development studies yielding protective and therapeutic strategies.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.113
Title: Radiation Countermeasures (USUHS)
FY 2015
0.112
FY 2016
0.122
FY 2014 Accomplishments:
-Complete study examining effects of genistein in combination with G-CSF as a radiation countermeasure regimen.
-Complete study evaluating effects of the role of the estrogen receptor on genistein-induced radioprotection.
-Complete PK/PD analysis of NHP study samples for GT3.
-Complete pilot NHP study for GT3 and analyze various biomarkers.
-Investigate the radiomitigation potential of TS-mobilized progenitors in large animals (minipig or NHP).
-Compare efficacy of CDX-301 as a radiation countermeasure when administered after pure gamma-rays or mixed neutron/
gamma fields.
-Complete study evaluating bone marrow endothelial cells as a radiation mitigator.
FY 2015 Plans:
-Evaluate radioprotective effects of genistein as a function of radiation dose rate.
-Study GT3 biomarkers for efficacy in nonhuman primates.
FY 2016 Plans:
-Assess the effects of reduced doses of the radiation protector genistein in combination with other radioprotectors to increase both
the therapeutic index and radioprotective efficacy.
-Study radioprotective efficacy of two drug combination acting through two different mechanisms of action such as gammatocotrienol (GT3) and amifostine.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 8 of 9
R-1 Line #5
Volume 1 - 60
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603002HP / Medical Advanced
Technology (AFRRI)
Project (Number/Name)
242B / Radiation Countermeasures
(USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
-Study radioprotective efficacy of Ex-RAD in different strains of mice.
FY 2014
Accomplishments/Planned Programs Subtotals
0.113
FY 2015
FY 2016
0.112
0.122
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
By FY 2014
-Complete study evaluating radioprotective effects when genistein is combined with a leucocyte growth factor.
-Complete study evaluating effects of the role of the estrogen receptor on genistein-induced radioprotection.
-Study the radioprotective efficacy of GT3 in at least six nonhuman primates.
-Survival, hematopoietic measures, and cytokine measurements in mice administered CDX-301 after pure gamma rays or mixed neutron/gamma fields.
By FY 2015
-Evaluate radioprotective effect of genistein as a function of radiation dose rate.
-Study efficacy biomarkers for GT3 efficacy in NHP.
-Study efficacy of TS-mobilized progenitors in large animals (mini pig or NHP).
By FY 2016
-Assess the effects of reduced doses of the radiation protector genistein in combination with other radioprotectors to increase both the therapeutic index and
radioprotective efficacy.
-Evaluate effects of GT3 and amifostine combination.
PE 0603002HP: Medical Advanced Technology (AFRRI)
Defense Health Program
UNCLASSIFIED
Page 9 of 9
R-1 Line #5
Volume 1 - 61
UNCLASSIFIED
THIS PAGE INTENTIONALLY LEFT BLANK
UNCLASSIFIED
Volume 1 - 62
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology Development
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
1,370.321
1,109.743
1,201.188
231.051
- 231.051
250.488
267.321
265.167
300A: CSI - Congressional
Special Interests
1,061.685
802.400
975.057
- - - - - - - 238C: Enroute Care Research &
Development (Budgeted) (AF)
3.685
4.666
3.394
1.340
- 1.340
- - - - Continuing Continuing
238D: Core Enroute Care R&D Clinical Translational Focus (AF)
0.000
- - 0.997
- 0.997
2.045
2.240
2.282
2.328 Continuing Continuing
238E: Core Enroute Care R&D
- Aerospace Medicine/Human
Performance Focus (AF)
0.000
- - 0.997
- 0.997
2.045
2.239
2.282
2.327 Continuing Continuing
61.968
35.074
34.378
37.580
- 37.580
38.211
40.942
41.720
42.554 Continuing Continuing
247A: Elimination of Malaria in
Southeast Asia (CARB) (Navy)
0.000
0.200
- 2.060
- 2.060
2.064
1.548
- - Continuing Continuing
247B: Mitigate the Global Impact
of Sepsis Through ACESO
(CARB) (Navy)
0.000
0.425
- 1.040
- 1.040
1.135
1.238
- - Continuing Continuing
284B: USAF Human Physiology,
Systems Integration, Evaluation
& Optimization Research
(Budgeted) (AF)
2.646
3.694
2.280
1.700
- 1.700
- - - - Continuing Continuing
284C: Core Human Performance
R&D - Clinical Translational
Focus (AF)
0.000
- - 1.003
- 1.003
2.349
2.664
2.762
2.817 Continuing Continuing
284D: Core Human Performance
R&D - Aerospace Medicine/
Human Performance Focus (AF)
0.000
- - 1.002
- 1.002
2.348
2.663
2.761
2.816 Continuing Continuing
285A: Operational Medicine
Research & Development
(Budgeted) (AF)
8.146
6.851
1.983
- - - - - - - Continuing Continuing
243A: Medical Development
(Lab Support) (Navy)
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 1 of 105
R-1 Line #6
267.228 Continuing Continuing
- - Volume 1 - 63
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology Development
285B: Core Operational
Medicine R&D - Clinical
Translational Focus (AF)
0.000
- - 0.929
- 0.929
1.147
1.350
1.360
1.387 Continuing Continuing
285C: Core Operational
Medicine R&D - Aerospace/
Human Performance Focus (AF)
0.000
- - 0.928
- 0.928
1.147
1.349
1.360
1.387 Continuing Continuing
14.728
14.508
12.558
8.173
- 8.173
10.653
10.833
10.950
11.169 Continuing Continuing
307C: Core Force Health
Protection R&D - Clinical
Translational Focus (AF)
0.000
- - 1.000
- 1.000
1.500
2.235
2.375
2.463 Continuing Continuing
307D: Core Force Health
Protection R&D - Aerospace
Medicine/Human Performance
Focus (AF)
0.000
- - 1.000
- 1.000
1.500
2.235
2.375
2.463 Continuing Continuing
308B: Expeditionary Medicine
Research & Development
(Budgeted) (AF)
2.847
4.769
4.699
1.180
- 1.180
1.160
1.560
1.640
1.673 Continuing Continuing
308C: Core Expeditionary
Medicine R&D - Clinical
Translational Focus (AF)
0.000
- - 1.503
- 1.503
1.500
1.497
1.501
1.531 Continuing Continuing
308D: Core Expeditionary
Medicine R&D - Aerospace/
Human Performance Focus (AF)
0.000
- - 1.502
- 1.502
1.499
1.497
1.500
1.530 Continuing Continuing
309A: Regenerative Medicine
(USUHS)
6.877
7.031
9.190
9.489
- 9.489
9.646
9.823
10.009
10.209 Continuing Continuing
128.139
168.541
113.048
116.775
- 116.775
134.178
149.012
150.022
149.701 Continuing Continuing
13.077
11.965
8.664
7.299
- 7.299
5.709
4.068
3.553
3.624 Continuing Continuing
307B: Force Health Protection,
Advanced Diagnostics/
Therapeutics Research &
Development (Budgeted) (AF)
373A: GDF - Medical
Technology Development
378A: CoE-Breast Cancer
Center of Excellence (Army)
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 2 of 105
R-1 Line #6
Volume 1 - 64
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
379A: CoE-Gynecological
Cancer Center of Excellence
(Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology Development
11.425
10.707
7.570
6.377
- 6.377
4.989
3.555
3.105
3.167 Continuing Continuing
381A: CoE-Integrative
Cardiac Health Care Center of
Excellence (Army)
4.822
3.674
3.594
3.520
- 3.520
3.368
3.214
3.057
3.118 Continuing Continuing
382A: CoE-Pain Center of
Excellence (Army)
3.652
2.784
- - - - - - - - Continuing Continuing
382B: CoE-Pain Center of
Excellence (USUHS)
0.000
- 2.722
2.823
- 2.823
2.871
3.247
3.310
3.376 Continuing Continuing
13.516
7.771
6.907
6.260
- 6.260
5.456
4.628
3.300
3.366 Continuing Continuing
398A: CoE-Neuroscience Center
of Excellence (USUHS)
1.822
1.857
- - - - - - - - - - 429A: Hard Body Armor Testing
(Army)
1.356
- - - - - - - - - - - 431A: Underbody Blast Testing
(Army)
20.929
10.938
4.818
2.679
- 2.679
1.869
- - - - - 448A: Military HIV Research
Program (Army)
0.000
6.663
5.773
6.589
- 6.589
6.702
7.579
7.722
7.877 Continuing Continuing
830A: Deployed Warfighter
Protection (Army)
9.001
5.225
4.553
5.306
- 5.306
5.397
6.105
6.221
6.345 Continuing Continuing
383A: CoE-Prostate Cancer
Center of Excellence (USUHS)
A. Mission Description and Budget Item Justification
Guidance for Development of the Force - Medical Technology Development provides funds for promising candidate solutions that are selected for initial safety and
effectiveness testing in animal studies and/or small scale human clinical trials regulated by the US Food and Drug Administration prior to licensing for human use.
Research in this program element (PE) is designed to address areas of interest to the Secretary of Defense related to Wounded Warriors, capabilities identified through
the Joint Capabilities Integration and Development System, and sustainment of priority investments in science, technology, research, and development as stated in
the Quadrennial Defense Review. Program development and execution is peer-reviewed and fully coordinated with all of the Military Services, appropriate Defense
agencies or activities and other federal agencies, to include the Department of Veterans Affairs, the Department of Health and Human Services, and the Department of
Homeland Security. This coordination occurs through the planning and execution activities of the Joint Program Committees (JPCs), established for the Defense Health
Program (DHP) Research, Development, Test, and Evaluation (RDT&E) funding. Research supported by this PE includes JPC-1: medical simulation, health informatics,
JPC-2: wound infection prevention and management, antimicrobial countermeasures, diagnostic systems for infectious diseases, JPC-5: injury prevention and reduction,
psychological health and resilience, physiological health, environmental health and protection, JPC-6: hemorrhage (bleeding) and resuscitation, neurotrauma (diagnosis
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 3 of 105
R-1 Line #6
Volume 1 - 65
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0603115HP / Medical Technology Development
and treatment of brain injury), traumatic tissue injury, forward surgical intensive critical care, joint en route care, military medical photonics, and JPC-8: rehabilitation
of neuro-musculoskeletal injuries, pain management, regenerative medicine, and sensory system traumatic injury, restoration and rehabilitation. As research efforts
mature, the most promising will transition to advanced concept development funding, PE 0604110. For knowledge products, successful findings will transition into
clinical practice guidelines.
For the Army Medical Command, the Underbody Blast (UBB) Testing medical research project provides funds to establish a scientific and statistical basis for
evaluating skeletal injuries to vehicle occupants during ground vehicle UBB events. Areas of interest to the Secretary of Defense are medical research that provides
an understanding of the human response and tolerance limits and injury mechanisms needed to accurately predict skeletal injuries to ground combat vehicle occupants
caused by UBB events. This enhanced understanding will support the establishment of an improved capability to conduct Title 10 Live Fire Test and Evaluation and to
make acquisition decisions.
For the Army Medical Command, beginning in FY14, Military Human Immunodeficiency Virus (HIV) Research Program funding was transferred from the Army to the
DHP. This project funds research to develop candidate HIV vaccines, to assess their safety and effectiveness in human subjects, and to protect military personnel from
risks associated with HIV infection.
For the Army Medical Command, the Armed Forces Pest Management Board (AFPMB) Deployed Warfighter Protection project provides for the development of new or
improved protection of ground forces from disease-carrying insects.
For the Army Medical Command, four Centers of Excellence (CoE) receive medical technology development funds. The Breast Cancer CoE (Army) provides a
multidisciplinary approach as the standard of care for treating breast diseases and breast cancer. The Gynecologic CoE (Army) focuses on characterizing the molecular
alterations associated with benign and malignant gynecologic disease and facilitates the development of novel early detection, prevention and biologic therapeutics (a
medicinal preparation created by a biological process used to treat diseases) for the management of gynecologic disease. The Cardiac Health CoE (Army) provides
evidence-based personalized patient engagement approaches for comprehensive cardiac (pertaining to the heart) event prevention through education, outcomes
research and technology tools, as well as molecular research to detect cardiovascular (CV) (pertaining to the heart and blood vessels) disease at an early stage to
ultimately discover a signature for CV health, to find new genes that significantly increase risk for heart attack in Service members and other beneficiaries, and identify
molecular markers of obesity and weight loss. The Pain CoE (Army) examines the relationship between acute (rapid onset and/or short course) and chronic (persistent
or long-lasting, usually longer than 3 months) pain and focuses on finding, implementing, and evaluating the most effective methods of relieving the acute pain caused
by combat trauma and the effect this has throughout the continuum to rehabilitation and reintegration. In FY15, the Pain CoE funding line is transferred from Army to the
Uniformed Services University of the Health Sciences (USUHS).
In FY14, DHP funded the following Congressional Special Interest (CSI) peer-reviewed directed research programs: Amyotrophic Lateral Sclerosis (ALS) (degenerative
neuronal disorder that causes muscle weakness and atrophy throughout the body), Autism, Bone Marrow Failure Disease, Ovarian Cancer, Multiple Sclerosis (MS)
(disease that affects the brain and the spinal cord and causes severe physical and mental complications), Cancer, Lung Cancer, Orthopedics Research, Spinal Cord
Research, Vision, Traumatic Brain Injury and Psychological Health (TBI/PH), Breast Cancer, Prostate Cancer, Gulf War Illness, Alcohol and Substance Use Disorders,
Medical Research, Alzheimer’s Research, Reconstructive Transplant, Global HIV/AIDS Prevention, Tuberous Sclerosis Complex (rare multi-system genetic disease that
causes growth of non-malignant tumors in the brain and other vital organs), Duchenne Muscular Dystrophy (gene mutation in boys that causes muscle degeneration
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 4 of 105
R-1 Line #6
Volume 1 - 66
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0603115HP / Medical Technology Development
and eventual death). CSIs also included the following programs: Joint Warfighter Medical Research, Trauma Clinical Research Repository, Orthotics and Prosthetics
Outcomes, and HIV/AIDS Program Increase. Because of the CSI annual structure, out-year funding is not programmed.
For the Navy Bureau of Medicine and Surgery, this program element includes funds for research management support costs. The Outside Continental US (OCONUS)
laboratories conduct focused medical research on vaccine development for Malaria, Diarrhea Diseases, and Dengue Fever. In addition to entomology, HIV studies,
surveillance and outbreak response under the Global Emerging Infections Surveillance (GEIS) program and risk assessment studies on a number of other infectious
diseases that are present in the geographical regions where the laboratories are located. The CONUS laboratories conduct research on Military Operational Medicine,
Combat Casualty Care, Diving and Submarine Medicine, Infectious Diseases, Environmental and Occupational Health, Directed Energy, and Aviation Medicine and
Human Performance.
For the Air Force Medical Service (AFMS), medical research and development programs are divided into five primary thrust areas: Enroute care, Expeditionary
Medicine, Operational Medicine (in-garrison care), Force Health Protection (FHP) (detect, prevent, threats), and Human Performance. Expeditionary Medicine is
focused on care on the battlefield and in field hospitals prior to transporting patients out of theater to CONUS, and studies trauma resuscitation, hemorrhage control,
and other life-saving interventions to keep critically wounded patients alive in the golden hour and to the next level of care. The AFMS is the only service transporting
patients on long aeromedical evacuation missions from theater to Landstuhl and from Landstuhl to CONUS. Therefore, the Enroute Care thrust area studies include
optimal time for patient transport, cabin altitude, noise, vibration, and environmental issues affecting patient physiology on the aircraft, and the Human Performance
thrust area compliments Enroute Care through its studies on medic and aircrew performance on long missions, as well as special operations forces performance.
Medical development and biomedical technology investments in FHP seek to deliver an improved FHP capability across the full spectrum of operations with research
that prevents injury/illness through improved identification and control of health risks. Under FHP, sub-project areas include: Directed Energy, Occupational and
Environmental Health, and Advanced Diagnostics/Therapeutics. Operational medicine is focused on in garrison care – our next most critical issue post OIF/OEF – and
how to care for the whole patient and consideration of comorbidities in treatment of wounded warriors and dependents.
For the Uniformed Services University of the Health Sciences (USUHS), medical development programs include the Prostate Cancer Center of Excellence (CoE),
the Center for Neuroscience and Regenerative Medicine, and the Pain CoE. The Prostate CoE, formerly a CSI, was chartered in 1992 to conduct basic, clinical,
and translational research programs to combat diseases of the prostate. The Center's mission is fulfilled primarily through its three principal programs -- the Clinical
Translational Research Center, the Basic Science Research Program, and the Tri-Service Multicenter Prostate Cancer Database, which encompasses its clinical
research work with other participating military medical centers. These affiliated sites contribute data and biospecimens obtained from prostate cancer patients who
participate in clinical trials. The Center for Neuroscience and Regenerative Medicine (CNRM) brings together the expertise of clinicians and scientists across disciplines
to catalyze innovative approaches to traumatic brain injury (TBI) research. CNRM research programs emphasize aspects of high relevance to military populations, with a
primary focus on patients at the Walter Reed National Military Medical Center. Beginning in FY15, the Pain CoE funding line is transferred from Army to USUHS.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 5 of 105
R-1 Line #6
Volume 1 - 67
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Program Increase in Support of the Global
Health Security Agenda (GHSA) - Project 247
• Realignment - Project 307B
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology Development
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2014
FY 2016 Total
290.852
1,109.743
818.891
- - - 802.400
- 34.452
-17.961
- 226.131
1,201.188
975.057
- - - 975.057
- - - - 231.951
231.051
-0.900
- - - 231.951
231.051
-0.900
3.100
- 3.100
- - -4.000
- -4.000
Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 300A: CSI - Congressional Special Interests
FY 2014
FY 2015
Congressional Add: 245A - Amyotrophic Lateral Sclerosis (ALS) Research
7.500
7.500
Congressional Add: 293A - Autism Research
6.000
6.000
Congressional Add: 296A - Bone Marrow Failure Disease Research
3.200
3.200
20.000
20.000
Congressional Add: 310A - Ovarian Cancer Research
Congressional Add: 328A - Multiple Sclerosis Research
5.000
5.000
Congressional Add: 335A - Peer-Reviewed Cancer Research
25.000
50.000
Congressional Add: 336A - Peer-Reviewed Lung Cancer Research
10.500
10.500
Congressional Add: 337A - Peer-Reviewed Orthopedic Research
30.000
30.000
Congressional Add: 338A - Peer-Reviewed Spinal Cord Research
30.000
30.000
Congressional Add: 339A - Peer-Reviewed Vision Research
10.000
10.000
Congressional Add: 352A - Traumatic Brain Injury/ Psychological Health Research
100.000
105.000
Congressional Add: 380A - Peer-Reviewed Breast Cancer Research
120.000
120.000
Congressional Add: 390A - Peer-Reviewed Prostate Cancer Research
80.000
80.000
Congressional Add: 392A - Gulf War Illness Peer-Reviewed Research
20.000
20.000
4.000
4.000
Congressional Add: 396A - Research in Alcohol and Substance Use Disorders
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 6 of 105
R-1 Line #6
Volume 1 - 68
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology Development
Congressional Add Details ($ in Millions, and Includes General Reductions)
FY 2014
200.000
FY 2015
247.500
Congressional Add: 417A - Peer-Reviewed Alzheimer Research
12.000
12.000
Congressional Add: 439A - Joint Warfighter Medical Research
65.000
30.000
Congressional Add: 452A - Peer-Reviewed Reconstructive Transplant Research
15.000
15.000
5.000
- 10.000
10.000
Congressional Add: 456A - HIV/AIDS Program
7.000
12.900
Congressional Add: 540A - Global HIV/AIDS Prevention (Navy)
8.000
8.000
Congressional Add: 660A - Tuberous Sclerosis Complex (TSC)
6.000
6.000
Congressional Add: 790A - Duchenne Muscular Dystrophy
Congressional Add: 400A - Peer-Reviewed Medical Research
Congressional Add: 453A - Trauma Clinical Research Repository
Congressional Add: 454A - Orthotics and Prosthetics Outcomes Research
3.200
3.200
Congressional Add: 459A - Peer-Reviewed Epilepsy Research
- 7.500
Congressional Add: 474A – Program Increase: Restore Core Research Funding Reduction (Army)
- 7.575
Congressional Add: 474B – Program Increase: Restore Core Research Funding Reduction (Navy)
- 6.856
Congressional Add: 474C – Program Increase: Restore Core Research Funding Reduction (Air Force)
- 10.228
Congressional Add: 474D – Program Increase: Restore Core Research Funding Reduction (USUHS)
- 2.514
Congressional Add: 463A – Program Increase: Restore Core Research Funding Reduction (GDF)
- 94.584
Congressional Add Subtotals for Project: 300A
802.400
975.057
Congressional Add Totals for all Projects
802.400
975.057
Change Summary Explanation
FY2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0603115-Medical Technology
Development (-$17.961 million) to DHP RDT&E, PE 0605502-Small Business Innovation Research (SBIR) Program (+$17.961 million).
FY 2014: Congressional Special Interest (CSI) additions to DHP RDT&E, PE 0603115-Medical Technology Development (+$802.400 million).
FY 2015: Congressional Special Interest (CSI) additions to DHP RDT&E, PE 0603115-Medical Technology Development (+$975.057 million).
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 7 of 105
R-1 Line #6
Volume 1 - 69
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology Development
FY2015: Transfer of Pain Center of Excellence (CoE) from Army DHP RDT&E, PE 0603115-Medical Development Technology Development (-$2.722 million) to
USUHS DHP RDT&E, PE 0603115-Medical Development Technology Development (+$2.722 million).
FY 2015: Change Proposal to merge USUHS DHP RDT&E, PE 0603115-Medical Development Technology Development (+$1.533 million) Center of Excellence
for Neuroscience with Regenerative Medicine.
FY 2016: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0603115-Medical Technology
Development (-$4.000 million) to DHP RDT&E PE 0604110-Medical Products Support and Advanced Concept Development (+$4.000 million).
FY2016: Realignment Global Health Security Agenda (GHSA) adjustment to DHP RDT&E, PE 0603115-Medical Technology Development (+$3.100 million).
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 8 of 105
R-1 Line #6
Volume 1 - 70
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
300A: CSI - Congressional
Special Interests
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
1,061.685
FY 2015
802.400
FY 2016
Base
975.057
FY 2016
OCO
- FY 2016
Total
- FY 2017
- - Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
- - Total
Cost
- A. Mission Description and Budget Item Justification
In FY14, the Defense Health Program funded Congressional Special Interest (CSI) directed research. The strategy for the FY14 Congressionally-directed research is
to stimulate innovative research through a competitive, peer-reviewed research program, and focused medical research at intramural and extramural research sites.
Specific peer-reviewed research efforts include the following: Amyotrophic Lateral Sclerosis (ALS) (degenerative neuronal disorder that causes muscle weakness and
atrophy throughout the body), Autism, Bone Marrow Failure Disease, Ovarian Cancer, Multiple Sclerosis, Cancer, Lung Cancer, Orthopedic Research, Spinal Cord
Research, Vision, Traumatic Brain Injury and Psychological Health (TBI/PH), Breast Cancer, Prostate Cancer, Gulf War Illness, Alcohol and Substance Use Disorders,
Medical Research, Alzheimer Research, Joint Warfighter Medical Research, Reconstructive Transplant, Trauma Clinical Research Repository, Orthotics and Prosthetics
Outcomes, HIV/AIDS, Global HIV/AIDS Prevention, Tuberous Sclerosis Complex (rare multi-system genetic disease that causes growth of non-malignant tumors in the
brain and other vital organs), and Duchenne Muscular Dystrophy (gene mutation affecting boys that causes muscle degeneration and eventual death). Because of the
CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
7.500
7.500
Congressional Add: 245A - Amyotrophic Lateral Sclerosis (ALS) Research
FY 2014 Accomplishments: This Congressional Special Interest initiative provided funds for research in
Amyotrophic Lateral Sclerosis (ALS) (a degenerative neuronal disorder that causes muscle weakness and
atrophy throughout the body). The ALS Research Program is a broadly-competed, peer-reviewed research
program with the goal to contribute to a cure for ALS by funding innovative preclinical research to develop new
treatments for ALS. Two award mechanisms were offered in FY14, the Therapeutic Development Award and
the Therapeutic Idea Award. Applications were received in August 2014 followed by scientific peer review in
October 2014. Funding recommendations will be made at programmatic review in December 2014. Awards will
be made by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Amyotrophic Lateral Sclerosis
(ALS) Research.
Congressional Add: 293A - Autism Research
6.000
6.000
FY 2014 Accomplishments: This Congressional Special Interest initiative provided funds for research
in Autism Research, to improve treatment outcomes of Autism Spectrum Disorder (ASD), lead to a better
understanding of ASD, and integrate basic science and clinical observations by promoting innovative research.
The Autism Research Program has funded research at universities, hospitals, nonprofit and for-profit institutions,
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 9 of 105
R-1 Line #6
Volume 1 - 71
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
as well as private industry. Two award mechanisms were offered in FY14, the Clinical Trial Award and the
Idea Development Award. Applications were received in October 2014 followed by scientific peer review in
December 2014. Funding recommendations will be made at programmatic review in February 2015. Awards will
be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Autism Research.
Congressional Add: 296A - Bone Marrow Failure Disease Research
3.200
3.200
20.000
20.000
5.000
5.000
FY 2014 Accomplishments: This Congressional Special Interest initiative funded research for bone
marrow failure diseases. The mission of the program is to sponsor innovative research that will advance the
understanding of inherited and acquired bone marrow failure diseases, and improve the health and life of
individuals living with these diseases, with the ultimate goal of prevention and/or cure. This effort has solicited
research proposals focused on bone marrow failure syndromes and their long-term effects from the basic
science and clinical research sectors. In FY14, applications were accepted through one funding opportunity,
the Idea Development Award, released in March 2014. Applications were received in August 2014 followed
by scientific peer review in October 2014. Funding recommendations will be made at programmatic review in
January 2015. Award(s) will be made by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Bone Marrow Failure Disease
Research.
Congressional Add: 310A - Ovarian Cancer Research
FY 2014 Accomplishments: This Congressional Special Interest initiative funded research in Ovarian Cancer.
In striving to achieve the goal of eliminating ovarian cancer, the Ovarian Cancer Research Program (OCRP) is
challenging the research community to address high impact, innovative research. The FY14 OCRP supported
innovative ideas that provide new paradigms, leverages critical resources, facilitates synergistic, multidisciplinary
partnerships, and cultivates the next generation of investigators in ovarian cancer. Six award mechanisms were
offered: Pilot Award, Clinical Translational Leverage Award, Investigator-Initiated Award, the Ovarian Cancer
Academy Awards recruiting the Academy Leadership and Early-Career Investigators, and the Ovarian Cancer
Academy Collaborative Award. Application submission deadlines were in August 2014 and in January 2015
followed by scientific peer reviews in October 2014 and March 2015. Funding recommendations will be made at
the programmatic reviews in December 2014 and April 2015. Awards will be made by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Ovarian Cancer Research.
Congressional Add: 328A - Multiple Sclerosis Research
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 10 of 105
R-1 Line #6
Volume 1 - 72
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2014 Accomplishments: This Congressional Special Interest initiative funded research in Multiple Sclerosis
(MS). The mission of the program is to support pioneering concepts and high-impact research relevant to
the prevention, etiology (causes or origins of), pathogenesis (the mechanism(s) that cause(s) MS or the
development of MS), assessment, and treatment of MS. This year specific areas of MS research focus were not
stipulated. A new mechanism, the Investigator Initiated Partnership Award was offered to encourage synergistic
partnerships between clinicians and research scientists inside and outside the MS field that will accelerate the
movement of promising ideas in MS into clinical applications. Applications were received in September 2014
followed by scientific peer review in November 2014. Funding recommendations will be made at programmatic
review in January 2015. Awards will be made by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Multiple Sclerosis Research.
Congressional Add: 335A - Peer-Reviewed Cancer Research
25.000
50.000
10.500
10.500
FY 2014 Accomplishments: This Congressional Special Interest research initiative was for the study of
cancers designated by Congress. The goal of the Peer-Reviewed Cancer Research Program is to improve
the quality of life by significantly decreasing the impact of cancer on Service members, their families, and
the American public. The funds appropriated by Congress were directed for research in the following areas:
blood cancers, cancers related to exposures to radiation (ionizing), colorectal cancer, genetic cancer research,
kidney cancer, Listeria vaccine (bacterial-based vaccine) for cancer, melanoma and other skin cancers,
mesothelioma (rare form of cancer developed from the protective lining that cover many of the internal organs
of the body caused by exposure to asbestos), myeloproliferative disorders (abnormal growth of blood cells in
bone marrow), neuroblastoma (extracranial solid cancer), pancreatic cancer, and pediatric brain tumors. Two
award mechanisms to support these topic areas were released in April 2014: the Career Development Award
and the Idea Award with Special Focus. Applications were received in September 2014 followed by scientific
peer review in November 2014. Funding recommendations will be made at programmatic review in February
2015. Awards will be made by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Cancer Research.
Congressional Add: 336A - Peer-Reviewed Lung Cancer Research
FY 2014 Accomplishments: This Congressional Special Interest initiative funded research in Lung Cancer. The
goal of the Peer-Reviewed Lung Cancer Research Program is to eradicate deaths from lung cancer to better
the health and welfare of military Service members, Veterans, their families, and the American public. This
research effort is offering four award mechanisms in FY14: the Career Development, the Clinical Exploration,
the Concept, and the Idea Development Awards. Applications were received in August and September 2014
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 11 of 105
R-1 Line #6
Volume 1 - 73
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
followed by scientific peer review in October and November 2014. Funding recommendations will be made at
programmatic review in January 2015. Awards will be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Lung Cancer
Research.
Congressional Add: 337A - Peer-Reviewed Orthopedic Research
30.000
30.000
30.000
30.000
FY 2014 Accomplishments: This Congressional Special Interest research initiative supported orthopedic
research to advance optimal treatment and rehabilitation from neuromusculoskeletal (bone, muscle, tendon,
ligament, nerve, and cartilage) injuries sustained during combat or combat-related activities. The overall goal
of the Peer Reviewed Orthopedic Research Program is to provide all Warriors affected by orthopedic injuries
sustained in the defense of our Constitution the opportunity for optimal recovery and restoration of function.
Six award mechanisms are being offered in FY14: Clinical Trial Award, Clinical Trial Development Award,
Idea Development Award, Outcomes Research Award, Translational Research Award, and Expansion Award.
Applications were received in August and October 2014 followed by scientific peer review in December 2014.
Funding recommendations will be made at programmatic review in February 2015. Awards will be made by
September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Orthopedic
Research.
Congressional Add: 338A - Peer-Reviewed Spinal Cord Research
FY 2014 Accomplishments: This Congressional Special Interest research initiative supported Spinal Cord
Injury (SCI) research. The FY14 SCIRP challenged the scientific community to design innovative research that
will foster new directions for and address neglected issues in the field of SCI-focused research. Applications
from investigators within the military Services, and applications involving multidisciplinary collaborations
among academia, industry, the military Services, the Department of Veterans Affairs (VA), and other federal
Government agencies were highly encouraged. Though the SCIRP supports groundbreaking research, all
projects must demonstrate solid scientific rationale. The SCIRP has identified three Areas of Encouragement
for the FY14 program. Pre-hospital, en route care, and early hospital management of SCI, development,
validation, and timing of promising interventions to address consequences of SCI and to improve recovery and
identification and validation of best practices in SCI. Projects focused on other research areas relevant to SCI
were submitted for consideration, provided that sufficient justification is included in the application. In FY14 four
award mechanisms were offered including: Clinical Trial, Investigator-Initiated Research, Qualitative Research
and Translational Research Awards. Pre-applications were due in July 2014; invited full applications were due in
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 12 of 105
R-1 Line #6
Volume 1 - 74
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
October 2014 followed by scientific peer review in December 2014. Funding recommendations will be made at
programmatic review in February 2015. Awards will be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Spinal Cord
Research.
Congressional Add: 339A - Peer-Reviewed Vision Research
10.000
10.000
100.000
105.000
FY 2014 Accomplishments: This Congressional Special Interest research effort for Peer-Reviewed Vision
Research targeted the causes, effects and treatments of eye damage, visual deficits due to traumatic
brain injury (TBI) and diseases that, despite their different pathogenesis (mechanisms that occur during
disease development), all have a common end result -- degeneration of the critical components of the eye
and impairment or loss of vision. The results of this research are intended to be used for restoration and
maintenance of visual function to ensure and sustain combat readiness. Basic, translational (conversion of
findings in basic science to practical applications) and clinical research efforts were sought to ensure that
results of scientific research will be used to directly benefit the lives of military, Veteran and civilian populations.
Critical areas of research include advances and improvements in: vision rehabilitation strategies and quality
of life measures, vision restoration following traumatic injury, mitigation and treatment of traumatic injuries,
treatment for war-related injuries and diseases to ocular structures and the visual system, treatment of visual
dysfunction (abnormal functioning pertaining to the eyes) associated with TBI, and modeling and simulation of
traumatic ocular injury. To meet the goals of the program, two award mechanisms supported vision research,
the Translational Research and the Hypothesis Development Awards. Pre-applications were reviewed in
November 2013, applications submitted in February 2014, the scientific peer review occurred in March 2014,
and programmatic review was held in May 2014. Ten applications were recommended for funding and are
currently being negotiated.
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Vision Research.
Congressional Add: 352A - Traumatic Brain Injury/ Psychological Health Research
FY 2014 Accomplishments: The Traumatic Brain Injury and Psychological Health (TBI/PH) Congressional
Special Interest research program aims to prevent, mitigate, and treat the effects of combat-relevant traumatic
stress and TBI on function, wellness, and overall quality of life, including interventions across the deployment
lifecycle for warriors, Veterans, family members, caregivers, and communities. Key priorities of the FY14
TBI/PH research program were to support projects aligned with the National Research Action Plan, address
Congressional intent, enable significant research collaborations, and complement ongoing Department of
Defense (DoD) efforts to ensure the mental health and readiness of our military forces by promoting a better
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 13 of 105
R-1 Line #6
Volume 1 - 75
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
standard of care for PH and TBI in the areas of prevention, detection, diagnosis, treatment, and rehabilitation. In
addition to service-requested nominations, individual Broad Agency Announcement applications, and promising
ongoing studies, four program announcements (PAs) were released to solicit applications that address these
priorities. The Psychological Health Research Award PA is intended to support both applied (preclinical)
research and clinical trials within specific topic areas addressing the prevention and treatment of militaryrelevant psychological health issues. The Neurosensory and Rehabilitation Research Award PA Supports both
applied (preclinical) research and clinical trials addressing TBI within specific focus areas of pain management,
hearing loss/dysfunction, balance disorders, tinnitus, vision, or physical rehabilitation associated with TBI. The
Investigative Treatments for TBI and PTSD Clinical Trial Award PA responds to Section 704 of the National
Defense Authorization Act for Fiscal Year 2014 and supports investigational treatments (including diagnostic
testing) of TBI and PTSD received by members of the Armed Forces in health care facilities other than military
treatment facilities. The Community Partners in Mental Health Research Award PA responds to Section
706 of the National Defense Authorization Act for Fiscal Year 2013 by supporting research on the causes,
development, and innovative treatment of mental health, substance use disorders, TBI, and suicide prevention
in members of the National Guard and Reserves, their family members, and their caregivers. Application
submission deadlines for the PAs are in November 2014, January 2015, and February 2015. Scientific peer
reviews will be held in January and March 2015 followed by programmatic reviews in March and May 2015.
Awards will be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Traumatic Brain Injury/
Psychological Health Research.
Congressional Add: 380A - Peer-Reviewed Breast Cancer Research
120.000
120.000
FY 2014 Accomplishments: This Congressional Special Interest research initiative was for Breast Cancer
research. The Breast Cancer Research Program challenged the scientific community to design research that
addresses the urgency of ending breast cancer. Applications were required to address at least one of ten
overarching challenges, which were focused on preventing breast cancer, identifying what makes the breast
susceptible to cancer, determining why some women get breast cancer while others do not, distinguishing
aggressive breast cancer from indolent cancers, conquering the problems of over-diagnosis and overtreatment,
identifying what drives breast cancer growth and determining how to stop it, identifying why some breast
cancers become life-threatening metastases, determining how to prevent recurrence, revolutionizing treatment
regiments with safe and effective interventions, and eliminating the mortality associated with metastasis. To
support the program’s vision of ending breast cancer, three award mechanisms were developed to support
meritorious breast cancer research: Breakthrough Award, Era of Hope Scholar Award, and Innovator Award.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 14 of 105
R-1 Line #6
Volume 1 - 76
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
The Breakthrough Award accepts applications under four funding levels, depending on the scope of the research
project, which could range from initial proof-of-concept to clinical trials. The Breakthrough Award was offered
twice during this fiscal year. Program Announcements (PAs) were released in March and September 2014.
Application submission deadlines were in May and August 2014 for the first PAs. Application submission
deadlines for the second PAs will be in December 2014 and January 2015. Scientific peer review was held in
July and October 2014 and will be held again in March 2015 followed by programmatic reviews in September
2014, December 2014, January 2015, May 2015, and June 2015. Awards will be made by September 2015.
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Breast Cancer
Research.
Congressional Add: 390A - Peer-Reviewed Prostate Cancer Research
80.000
80.000
FY 2014 Accomplishments: This Congressional Special Interest research is for Prostate Cancer research.
The vision for this effort is to conquer prostate cancer by funding research to eliminate death from prostate
cancer and enhance the well-being of men experiencing the impact of the disease. To address the most
critical current needs in prostate cancer research and clinical care, the Prostate Cancer Research Program
(PCRP) developed four overarching challenges to be addressed by the research community: (1) develop
better tools for early detection of clinically relevant disease, (2) distinguish aggressive from indolent disease
in men newly diagnosed with prostate cancer, (3) develop effective treatments and address mechanisms of
resistance for men with high risk or metastatic prostate cancer, and (4) develop strategies to optimize the
physical and mental health of men with prostate cancer. In addition, research projects are being solicited in
the areas of biomarker development, genetics, imaging, mechanisms of resistance, survivorship and palliative
care, therapy, and tumor and microenvironment biology. To meet these goals for FY14, the following twelve
award mechanisms were developed: Biomarker Development Award, Clinical Exploration Award, Collaborative
Undergraduate HBCU Student Summer Training Award, Exploration-Hypothesis Development Award, Health
Disparity Research Award, Idea Development Award, Laboratory-Clinical Transition Award, Physician Research
Training Award, Population Science Impact Award, Postdoctoral Research Training Award, Prostate Cancer
Biospecimen Resource Site Award, and Synergistic Idea Development Award. All Program Announcements
were released in May 2014. The applications for the Exploration-Hypothesis Development Award were received
and scientifically peer reviewed in July 2014, and recommended for funding at programmatic review in October
2014. Applications for the remaining funding mechanisms were received in September 2014-October 2014, and
will undergo scientific peer review in November 2014-December 2014. Funding recommendations for these
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 15 of 105
R-1 Line #6
Volume 1 - 77
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
mechanisms will be made at programmatic reviews in January 2015-February 2015. Awards will be made by
September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Prostate Cancer
Research.
Congressional Add: 392A - Gulf War Illness Peer-Reviewed Research
20.000
20.000
4.000
4.000
FY 2014 Accomplishments: This Congressional Special Interest research initiative was for Gulf War Illness
research. The program’s vision of improving the health and lives of Veterans who have the complex symptoms
known as Gulf War Illness was addressed through the funding of innovative research to identify effective
treatments, to improve its definition and diagnosis, and to better understand its pathobiology (study of structural
and functional manifestations of a disease with emphasis on the biological aspects) and symptoms. Applications
were accepted for FY14 through five award mechanisms: the Clinical Trial Award, the Innovative Treatment
Evaluation Award, the Investigator-Initiated Research Award (IIRA), the Investigator-Initiated Research
Expansion Award and a New Investigator Award. The IIRA included an option that encourages research
focused on developing a consensus case definition for Gulf War Illness. Application submission deadlines are
in September 2014 and January 2015 followed by scientific peer review in November 2014 and March 2015.
Funding recommendations will be made at programmatic review in January 2015 and May 2015. Awards will be
made by September 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Gulf War Illness Peer-Reviewed
Research.
Congressional Add: 396A - Research in Alcohol and Substance Use Disorders
FY 2014 Accomplishments: This Congressional Special Interest research effort on Research in Alcohol and
Substance Use Disorders was a competitive program to create translational research addressing alcohol and
substance abuse issues. The goal of the program was to identify and develop new medications to improve
treatment outcomes for alcohol and substance use disorders, especially related to traumatic brain injury and
post-traumatic stress disorder(PTSD), through organizing multidisciplinary, team-based research efforts to
translate contemporary basic knowledge into enhanced clinical protocols. The projects will study the hypothesis
that prior traumatic stress experience will increase drug and alcohol seeking and that systemic administration of
certain medications decrease the impact of stress-related stimuli on drug and alcohol seeking in preclinical and
clinical studies of patients with both PTSD/ Substance Use Disorder. Other funded areas of research included
studies on PTSD and protecting degeneration of the nervous system against alcohol toxicity on the nerves
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 16 of 105
R-1 Line #6
Volume 1 - 78
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
in order to determine the pathophysiologic significance (functional changes associated with disease or injury)
following traumatic stress.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Research in Alcohol and Substance
Use Disorders.
Congressional Add: 400A - Peer-Reviewed Medical Research
200.000
247.500
12.000
12.000
FY 2014 Accomplishments: This Congressional Special Interest initiative for the Peer Reviewed Medical
Research Program continues to strive for its vision to improve the health and well-being of all military Service
members, Veterans, and beneficiaries by supporting military health-related research of exceptional scientific
merit. Applications are required to address at least one of the following 25 Congressionally-directed topics:
acupuncture, arthritis, chronic migraine and post-traumatic headache, congenital heart disease, DNA vaccine
technology for post-exposure prophylaxis, dystonia, epilepsy, food allergies, fragile X syndrome, hereditary
angioedema, illnesses related to radiation exposure, inflammatory bowel disease, interstitial cystitis, lupus,
malaria, metabolic disease, neuroprosthetics (artificial extensions to the body that restore or improve function
of the nervous system lost due to disease or injury), pancreatitis, polycystic kidney disease, post-traumatic
osteoarthritis, psychotropic medications, respiratory health, rheumatoid arthritis, segmental bone defects
(injuries in which a section of bone is completely shattered or absent), and tinnitus (perception of sound, such
as ringing, when no actual sound is present). Five award mechanisms are being offered in FY14: the Clinical
Trial Award, the Discovery Award, the Focused Program Award, the Investigator-Initiated Research Award, and
the Technology/ Therapeutic Development Award. For the Discovery Award, application receipt occurred in July
2014, scientific peer review was conducted in September 2014, and funding recommendations will be made
during programmatic review in January 2015. For the remaining mechanisms, application receipt will occur in
October and November 2014, peer review will be conducted in December 2014 and January 2015, and funding
recommendations will be made during programmatic review in March 2015. Awards will be made by September
2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Medical Research.
Congressional Add: 417A - Peer-Reviewed Alzheimer Research
FY 2014 Accomplishments: This Congressional Special Interest research program was to study Alzheimer's
disease. The mission of the Peer Reviewed Alzheimer Research Program continued to be two-fold. The
program sought to 1) build an integrated program devoted to understanding the association between Traumatic
Brain Injury (TBI) and Alzheimer's disease (AD), and 2) reduce the burden on caregivers and individuals affected
by TBI-AD symptoms, especially in the military community. The program offered three funding mechanisms
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 17 of 105
R-1 Line #6
Volume 1 - 79
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
in order to meet the program's mission. These are the 1) Convergence Science Research Award (CSRA), 2)
Quality of Life Research Award (QUAL), and 3) Military Risk Factors Research Award (MRFA). The focus areas
for the FY14 CSRA mechanism were expanded to include research that examines the role of non-neuronal cells
(cells of the brain other than neurons e.g., glia) in TBI/AD pathogenesis. The CSRA mechanism also continued
to request for research applications on genomic and proteomic studies to investigate the linkages between TBI
and AD.
The FY14 QUAL mechanism is to fund research which explores technologies, tests, interventions,
epidemiological studies, or devices with the potential to benefit individuals suffering from the symptoms of TBI or
AD, while reducing caregiver burden. The MRFA mechanism is to facilitate high-impact, systematic, populationbased research investigating the association between TBI and the subsequent development of AD. The FY14
Program Announcements were released in September of 2014, with pre-applications, full applications, peer
review, and programmatic review thereafter. Awards will be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Alzheimer
Research.
Congressional Add: 439A - Joint Warfighter Medical Research
65.000
30.000
15.000
15.000
FY 2014 Accomplishments: The Joint Warfighter Medical Research Program (JWMRP) was intended to
provide continuing support for promising previously funded Congressional Special Interest (CSI) projects.
The focus was to augment and accelerate high priority DoD and Service medical requirements that are close
to achieving their objectives and yield a benefit to military medicine. The JWMRP directly supported military
medical research in medical training and health information sciences, military infectious diseases, military
operational medicine, combat casualty care, radiation health effects, and clinical and rehabilitative medicine.
For the FY14 JWMRP, through an iterative process of recommendations, prior year CSI-funded projects were
nominated for consideration by the Services, Joint Program Committees, and execution management agencies/
activities. Those projects deemed by the Joint Program Committees to have the highest priority to fill critical
research or materiel gaps and those projects close to developing a product were invited to submit a preapplication and full application for the next level of effort. The external scientific peer review was completed in
June 2014. The programmatic review was completed in August 2014 and 32 projects were recommended for
funding. Award negotiations will be complete by the end of the third quarter of FY15.
FY 2015 Plans: This Congressional Special Interest research initiative is for Joint Warfighter Medical Research.
Congressional Add: 452A - Peer-Reviewed Reconstructive Transplant Research
FY 2014 Accomplishments: This Congressional Special Interest research initiative for Reconstructive
Transplant Research (RTR) is to accelerate the movement of promising ideas in restorative transplantation into
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 18 of 105
R-1 Line #6
Volume 1 - 80
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
clinical application. The initiative is intended to support both new and established scientists across a broad
spectrum of disciplines in research projects that are likely to have a major impact on RTR. Proposals are due in
October 2014, scientific peer review is planned for December 2014, and programmatic review will take place in
February 2015. Awards will be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Peer-Reviewed Reconstructive
Transplant Research.
Congressional Add: 453A - Trauma Clinical Research Repository
5.000
- 10.000
10.000
FY 2014 Accomplishments: This Congressional Special Interest research initiative studied the development of
a Trauma Clinical Research Repository. The purpose of the repository is to capture data in theater for review
and research on patient care and outcomes.
Congressional Add: 454A - Orthotics and Prosthetics Outcomes Research
FY 2014 Accomplishments: FY 2014 Accomplishments: This Congressional Special Interest research
initiative was offered for the first time in FY14. It is intended to support research that evaluates the comparative
effectiveness of and functional outcomes associated with prosthetic and orthotic clinical interventions, and/
or other rehabilitation interventions, for Service members and Veterans who have undergone limb salvage or
limb amputation. The results of this research are intended to improve our understanding of and ultimately the
implementation of the most effective prosthetic prescription, treatment, rehabilitation, and secondary health
effect prevention options for patients, clinicians, other caregivers, and policymakers. Basic, translational
(conversion of findings in basic science to practical applications) and clinical research efforts are sought to
ensure that results of scientific research will be used to directly benefit the lives of military, Veteran and civilian
populations. Studies will be sought that: compare different standard care approaches, include patient-centric
outcome assessments, have the potential to lead to new knowledge that can be developed into new clinical
practice guidelines and/or new prescription algorithms for prosthetic and orthotic devices, have the potential
to lead to new technology developments that can lead to improved prosthetic devices, therefore improving
patient outcomes, provide information on quality of life, reintegration, and/or return to duty as it pertains to
those patients who use a prosthetic or orthotic device due to limb trauma. Studies may also be proposed that
consider outcome factors related to health care delivery and clinical decision-making such as cost, accessibility,
adoption of medical policy, and patient preferences. Studies should have a clinical focus, and may include
methodologies and designs such as surveys, retrospective data analyses, simulation modeling, longitudinal
observation, cross sectional observation, case control, or qualitative research study designs. Collaboration
with military researchers and clinicians is encouraged. Joint DoD-VA studies, including longitudinal outcome
studies, are particularly sought. A Program Announcement was released in October 2014. A total of 109 prePE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 19 of 105
R-1 Line #6
Volume 1 - 81
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
applications were received as of the pre-application receipt deadline in November 2014. Invitations to submit
a full application are scheduled to be released in December 2014, with an application submission deadline in
January 2015. Peer review is currently scheduled for March 2015, with programmatic review set for April 2015.
Awards will be made by September 2015.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Orthotics and Prosthetics Outcomes
Research.
Congressional Add: 456A - HIV/AIDS Program
7.000
12.900
8.000
8.000
FY 2014 Accomplishments: This Congressional Special Interest research initiative complements the funding
for the HIV/AIDS research program. Several potential vaccine candidates were down-selected for further testing
in human volunteers to study their ability to provoke an immune response that can protect against HIV either as
a single vaccine or combination of various subtypes.
FY 2015 Plans: This Congressional Special Interest research initiative is forHIV/AIDS Program.
Congressional Add: 540A - Global HIV/AIDS Prevention (Navy)
FY 2014 Accomplishments: This Congressional Special Interest project supports Global HIV/AIDS Prevention
research. Program emphasis is placed on (1) building a national research infrastructure by funding large,
multidisciplinary program projects focused on detection; (2) encouraging innovative approaches to research
by funding new ideas and technology with or without supporting preliminary data; and (3) recruiting new,
independent investigators for careers in research, as well as more senior investigators new to the research
field. The strategy for the FY 2014 Congressionally directed research identified above is to stimulate innovative
research through a competitive, peer reviewed research program, as well as focused medical research at
intramural and extramural research sites. Specific research efforts include HIV/AIDS. The HIV/AIDS Prevention
program conducts on-site visits to determine eligible areas for technical assistance and resource support.
The program provides support to defense forces in the following areas: (1) HIV prevention, which includes
training of medical personnel and peer educators, education of military members, provision of condoms and
other prevention materials, provision of educational materials such as brochures, posters, and booklets (2)
care for HIV-infected individuals and their families to include provision of electronic medical record programs,
medications to treat HIV-related issues, physician education, and clinic infrastructure support, (3) treatment
services including provision of laboratory services such as HIV test kits, and other laboratory equipment, and
(4) strategic information including systems to collect information on the effectiveness of HIV treatment and
prevention programs and generate databases of such information to guide treatment and prevention programs.
The HIV/AIDS Prevention program provided technical assistance and resource support for 25 foreign defense
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 20 of 105
R-1 Line #6
Volume 1 - 82
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
forces in FY 2013. Accomplishments included over 45,000 individuals that received testing and counseling
services for HIV and received their test results; 29,752 military members and their dependents targeted with
HIV prevention interventions; more than 1,100 health care workers successfully completed an in-service training
program; and 2,893 pregnant women knew their HIV status based on testing and counseling services provided
to them. Accomplishments for FY 2014 will be reported after the end of the 2014 fiscal year, once annual
program result data is collected. Because of the CSI annual structure, out-year funding is not programmed.
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Global HIV/AIDS Prevention.
Congressional Add: 660A - Tuberous Sclerosis Complex (TSC)
6.000
6.000
3.200
3.200
FY 2014 Accomplishments: The Congressional Special Interest research initiative for Tuberous Sclerosis
Complex (TSC) encouraged innovative research to improve the lives of individuals with TSC through
understanding the pathogenesis and manifestations of TSC and developing improved diagnostic and treatment
approaches. Within this context, the FY14 TSCRP encouraged applications that address vital program focus
areas of Clinical Aspects of TSC, Personalization of Care and/or Optimization of Treatments. This research
effort offered three award mechanisms to support TSC research: Idea Development, Exploration-Hypothesis
Development, and Pilot Clinical Trial Awards. Applications were due July 2014, followed by scientific peer
review in September 2014, and funding recommendations made at programmatic review in November 2014.
Awards will be will be made by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Tuberous Sclerosis Complex (TSC).
Congressional Add: 790A - Duchenne Muscular Dystrophy
FY 2014 Accomplishments: This Congressional Special Interest initiative was for research focused on
Duchenne Muscular Dystrophy (DMD) (gene mutations in dystrophin affecting approximately 1 in 3600 boys
causing muscle degeneration and eventual death). The goal for this research program is to extend and improve
the function, quality of life, and lifespan for all individuals diagnosed with DMD by supporting research to better
inform the development of drugs, devices, and other interventions and promote their effective clinical testing.
Within this context, this program encourages applications that address a number of focus areas including: 1)
discovery and qualification of pharmacodynamic (the biochemical and physiological effects of drugs on the
body, their mechanisms of action, and the relationship between drug concentration and effect), prognostic,
and predictive biomarkers (characteristic that is objectively measured and evaluated as an indicator of normal
biologic processes, pathogenic processes, or biological responses to a therapeutic intervention); 2) assessment
of clinical trial outcomes; 3) extension or expansion of preclinical translational data; and 4) novel interventions to
improve clinical care and quality of life. A total of two award mechanisms were offered in 2014, the InvestigatorPE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 21 of 105
R-1 Line #6
Volume 1 - 83
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Initiated Research Award and the Therapeutic Idea Award. Applications were received in October 2014 with
scientific peer review in January 2015 and programmatic review in March 2015. Awards will be made by
September 2015.
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2014
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Duchenne Muscular Dystrophy.
Congressional Add: 459A - Peer-Reviewed Epilepsy Research
- 7.500
- 7.575
- 6.856
- 10.228
- 2.514
- 94.584
FY 2014 Accomplishments: No funding programmed. FY15 DHP Congressional Special Interest (CSI) Item.
FY 2015 Plans: This Congressional Special Interest research initiative is forPeer-Reviewed Epilepsy Research.
Congressional Add: 474A – Program Increase: Restore Core Research Funding Reduction (Army)
FY 2014 Accomplishments: No funding programmed. FY15 DHP Congressional Special Interest (CSI) Item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Technology Development Program Element (PE) - 0603115.
Congressional Add: 474B – Program Increase: Restore Core Research Funding Reduction (Navy)
FY 2014 Accomplishments: No funding programmed. FY15 DHP Congressional Special Interest (CSI) Item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Technology Development Program Element (PE) - 0603115.
Congressional Add: 474C – Program Increase: Restore Core Research Funding Reduction (Air Force)
FY 2014 Accomplishments: No funding programmed. FY15 DHP Congressional Special Interest (CSI) Item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Technology Development Program Element (PE) - 0603115.
Congressional Add: 474D – Program Increase: Restore Core Research Funding Reduction (USUHS)
FY 2014 Accomplishments: No funding programmed. FY15 DHP Congressional Special Interest (CSI) Item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Technology Development Program Element (PE) - 0603115.
Congressional Add: 463A – Program Increase: Restore Core Research Funding Reduction (GDF)
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 22 of 105
R-1 Line #6
Volume 1 - 84
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
Project (Number/Name)
300A / CSI - Congressional Special
Interests
FY 2015
FY 2014 Accomplishments: No funding programmed. FY15 DHP Congressional Special Interest (CSI) Item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Technology Development Program Element (PE) - 0603115.
Congressional Adds Subtotals
802.400
975.057
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Research proposals will be solicited by program announcements resulting in grants, contracts, or other transactions.
E. Performance Metrics
N/A
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 23 of 105
R-1 Line #6
Volume 1 - 85
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
238C: Enroute Care Research &
Development (Budgeted) (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
3.685
FY 2015
4.666
3.394
FY 2016
Base
1.340
FY 2016
OCO
FY 2016
Total
- 1.340
FY 2017
- Project (Number/Name)
238C / Enroute Care Research &
Development (Budgeted) (AF)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to advance aeromedical transport capabilities through the research and development of rapid, more efficient, and safer patient transport from
the point of injury to definitive care and to understand the effects of altitude on seriously injured war fighters. Efforts will focus on translating technological advancements
and groundbreaking clinical research into transitionable products. The sub-project areas include: Physiological Effects of Aeromedical Evacuation on patients and crew
which includes the optimization of provider performance and patient care, impact of transport times on En-Route Trauma and Resuscitative Care, and En-Route Patient
Safety which includes technology advances and assessment. Because patients experience multiple handoffs between teams of caregivers during transport between
austere environments and definitive care, efforts in the En-Route Patient Safety sub-project area examine human factors considerations in order to develop new and
enhance existing methods to mitigate risk in all en-route care environments.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
4.666
Title: Enroute Care Research & Development (Budgeted) (AF)
FY 2015
3.394
FY 2016
1.340
Description: This project area seeks to advance aeromedical transport capabilities through the research and development
of rapid, more efficient, and safer patient transport from the point of injury to definitive care and to understand the effects of
altitude on seriously injured war fighters. Efforts will focus on translating technological advancements and groundbreaking clinical
research into transitionable products. The sub-project areas include: Physiological Effects of Aeromedical Evacuation on patients
and crew which includes the optimization of provider performance and patient care, impact of transport times on En-Route Trauma
and Resuscitative Care, and En-Route Patient Safety which includes technology advances and assessment. Because patients
experience multiple handoffs between teams of caregivers during transport between austere environments and definitive care,
efforts in the En-Route Patient Safety sub-project area examine human factors considerations in order to develop new and
enhance existing methods to mitigate risk in all en-route care environments.
FY 2014 Accomplishments:
Continued research to enhance the care of acutely injured AE trauma patients through projects assessing closed loop technology
for autonomous control of oxygenation and ventilation. Continued research to improve AE trauma patient care through the
development and assessment of continuous, real-time vital sign monitoring system. Continued research assessing the clinical
effect of prolonged hypobaria during AE on TBI, how AE affects blood volume responsiveness, improve pain management
during AE, and identify/mitigate factors impacting patient safety during AE. Continued study of optimal time to transport patients.
Continued development of the multi-channel negative pressure wound treatment device and monitor FDA 510K process. Began
swine study to investigate post AE effects on coagulation and inflammation. Began a retrospective study of the efficacy of cabin
altitude restrictions on AE patients. Continued automation of CCATT patient record, perform operational test. Began development
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 24 of 105
R-1 Line #6
Volume 1 - 86
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
238C / Enroute Care Research &
Development (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
of en route care retrospective research database. Began investigating new research and development requirements based
on results of prior studies and warfighter gap analyses. Completed Air Worthiness certification for simulator mannequin and
initiated use on Aeromedical Evacuation (AE) and Critical Care Transport Team (CCATT) training flights – transitioned to the
CCATT Pilot Unit. Continued research to enhance the care of acutely injured AE trauma patients though projects assessing
closed loop technology for autonomous control of oxygenation and ventilation. Completed and archived miniaturized Extra
Corporal Membrane Oxygenation (ECMO) device bovine study. Analyzed initial results of research assessing the clinical effect of
prolonged hypobaria during AE on Traumatic Brain Injury (TBI), how AE affects blood volume responsiveness, pain assessment
during AE, and factors impacting patient safety during AE. Began assessing how the transport of psychiatric patients impacts
AE crew protocols. Continued research examining medical records of traumatically injured patients transported by Critical Care
Air Transport Teams (CCATT). Conducted research prospectively characterizing the incidence and success of Life Saving
Interventions (LSI) performed by combat medics during pre-hospital and en route care. Began research for identifying optimal
time to transport patients to ensure best outcomes. Began investigations into advanced development options for AE material
solutions: began testing for a portable electrical power source; began development of a negative pressure multi-channel negative
pressure wound therapy device; awarded and initiated automation of the CCATT patient record (Form 3899L) onto a widelyaccepted portable physiologic monitoring device; and supported Air Mobility Command (AMC) in prototype development for a
replacement aircraft patient loading system. Spear-headed DoD Information Assurance Certification and Accreditation Program
(DIACAP) for telemedicine capability of a physiologic monitoring device in support of AMC requirements, which will allow for
transmission of aeromedical electronic medical information across DoD information platforms. Presented research findings
in peer-reviewed journals and at national meetings. Completed study on the following: effects of AE on the injury response,
including potential worsening of the systemic inflammatory response, increased susceptibility to infection, and secondary brain
injury after traumatic brain injury; the effects of hypobaric hypoxia exposure on a crush muscle crush injury during air transport.
Continue research to enhance the care of acutely injured AE trauma patients through projects assessing closed loop technology
for autonomous control of oxygenation and ventilation. Continue research assessing the clinical effect of prolonged hypobaria
during AE on TBI, how AE affects blood volume responsiveness, improve pain management during AE, and identify/mitigate
factors impacting patient safety during AE. Continue to study optimal time to transport patients. Continue development of the multichannel negative pressure wound treatment device and monitor FDA 510K process. Begin Began swine study to investigate post
AE effects on coagulation and inflammation. Begin Began a retrospective study of the efficacy of cabin altitude restrictions on AE
patients. Begin Began study to determine the effects of altitude on patients requiring ECMO system for respiratory support during
transport. Continue automation of CCATT patient record, perform operational test. Begin Began development of en route care
retrospective research database. Begin Began investigating new research and development requirements based on results of
prior studies and warfighter gap analyses.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 25 of 105
R-1 Line #6
Volume 1 - 87
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
238C / Enroute Care Research &
Development (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Plan and test for transition of miniaturized Extra Corporal Membrane Oxygenation device to Air Mobility Command (AMC) for
Aeromedical Evacuation (AE) and Combat Casualty Air Transport Team (CCATT) and lung team use on long flight missions.
Monitor technology readiness level of closed loop ventilation and oxygenation. Analyze final results of research describing
blood administration, analgesics used, and burn care provided during Critical Care Air Transport. Development of new clinical
practice guidelines and validation of existing guidelines for CCATT. Evaluate and describe current en route care practices from
point of injury to in-theatre military treatment facilities. Provide descriptive analysis of non-traumatically injured patients and
the clinical care provided during transport out of theatre on CCATT. Analyze final results of research assessing the clinical
effect of prolonged hypobaria during AE, how AE affects blood volume responsiveness, improving pain management during AE,
and factors impacting patient safety during AE, and determine translational elements of completed research or need for further
studies. Complete and transition automated CCATT patient record and multi-channel negative pressure wound therapy device
to acquisition process. Analyze results of cabin altitude restriction retrospective study, which should lead to better evidencebased decision-making for when to fly low. Continue swine study to investigate post AE effects on coagulation and inflammation.
Continue investigating new research and development requirements based on results of prior studies and warfighter gap
analyses.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
Analyze final results of swine study investigating post AE effects on coagulation and inflammation, which will lead to a knowledge
platform to develop guidelines for evacuation strategies during transport of combat casualties. Pursuant system build and
demonstration of the closed loop ventilation and oxygen delivery system, the data from the pre-hospital use of capnometry and
the ventilator registry will be used to define the requirements of a system to perform closed loop ventilation. Continue pursuing the
AFMS strategic goal A1 to “Transform the En-route Care System” based on war fighter identified gaps and validated requirements.
Begin and/or continue work that will improve mission effectiveness in the A2AD environment such as closed loop technologies
and enabling capabilities leading to autonomous patient transport.”
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, PE 0807714HP: Other
Consolidated Health Support
Remarks
FY 2014
13.049
PE 0603115HP: Medical Technology Development
Defense Health Program
FY 2015
13.441
FY 2016
Base
13.844
FY 2016
OCO
- FY 2016
Total
13.844
UNCLASSIFIED
Page 26 of 105
FY 2017
14.259
FY 2018
14.655
FY 2019
- R-1 Line #6
4.666
3.394
1.340
Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
Volume 1 - 88
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
238C / Enroute Care Research &
Development (Budgeted) (AF)
D. Acquisition Strategy
Broad Area Announcement (BAA) and Intramural calls for proposal are used to award initiatives in this program and project following determinatinons of scientific and
technical merit, validation of need, prioritization, selection and any necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 27 of 105
R-1 Line #6
Volume 1 - 89
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
238D: Core Enroute Care R&D Clinical Translational Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
0.997
FY 2016
OCO
FY 2016
Total
- 0.997
FY 2017
2.045
FY 2018
Project (Number/Name)
238D / Core Enroute Care R&D - Clinical
Translational Focus (AF)
FY 2019
2.240
2.282
Cost To
FY 2020 Complete
Total
Cost
2.328 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to advance aeromedical transport capabilities through the research and development of rapid, more efficient, and safer patient transport from
the point of injury to definitive care and to understand the effects of altitude on seriously injured war fighters. Efforts will focus on translating technological advancements
and groundbreaking clinical research into transitionable products. The sub-project areas include: Physiological Effects of Aeromedical Evacuation on patients and crew
which includes the optimization of provider performance and patient care, impact of transport times on En-Route Trauma and Resuscitative Care, and En-Route Patient
Safety which includes technology advances and assessment. Because patients experience multiple handoffs between teams of caregivers during transport between
austere environments and definitive care, efforts in the En-Route Patient Safety sub-project area examine human factors considerations in order to develop new and
enhance existing methods to mitigate risk in all en-route care environments.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Enroute Care R&D - Clinical Translational Focus (AF)
FY 2015
- FY 2016
0.997
Description: This project area seeks to advance aeromedical transport capabilities through the research and development
of rapid, more efficient, and safer patient transport from the point of injury to definitive care and to understand the effects of
altitude on seriously injured war fighters. Efforts will focus on translating technological advancements and groundbreaking clinical
research into transitionable products. The sub-project areas include: Physiological Effects of Aeromedical Evacuation on patients
and crew which includes the optimization of provider performance and patient care, impact of transport times on En-Route Trauma
and Resuscitative Care, and En-Route Patient Safety which includes technology advances and assessment. Because patients
experience multiple handoffs between teams of caregivers during transport between austere environments and definitive care,
efforts in the En-Route Patient Safety sub-project area examine human factors considerations in order to develop new and
enhance existing methods to mitigate risk in all en-route care environments.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Analyze final results of swine study investigating post AE effects on coagulation and inflammation, which will lead to a knowledge
platform to develop guidelines for evacuation strategies during transport of combat casualties. Pursuant system build and
demonstration of the closed loop ventilation and oxygen delivery system, the data from the pre-hospital use of capnometry and
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 28 of 105
R-1 Line #6
Volume 1 - 90
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
238D / Core Enroute Care R&D - Clinical
Translational Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
the ventilator registry will be used to define the requirements of a system to perform closed loop ventilation. Continue pursuing the
AFMS strategic goal A1 to “Transform the En-route Care System” based on war fighter identified gaps and validated requirements.
Begin and/or continue work that will improve mission effectiveness in the A2AD environment such as closed loop technologies
and enabling capabilities leading to autonomous patient transport.”
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 0.997
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 29 of 105
R-1 Line #6
Volume 1 - 91
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
238E: Core Enroute Care R&D
- Aerospace Medicine/Human
Performance Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
0.997
FY 2016
Total
- 0.997
FY 2017
2.045
FY 2018
Project (Number/Name)
238E / Core Enroute Care R&D - Aerospace
Medicine/Human Performance Focus (AF)
FY 2019
2.239
2.282
Cost To
FY 2020 Complete
Total
Cost
2.327 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to advance aeromedical evacuation (AE), Critical Care Air Transport Team (CCATT), and Tactical Critical Care Evacuation Team (TCCET)
capabilities through the research and development of rapid, more efficient, and safer patient transport from the pre-staging for strategic or intra-theater air evacuation to
definitive care, and to understand the effects of transport on injured war fighters. Efforts will focus on translating technological advancements and groundbreaking clinical
research into translatable practice and technology products. The sub-project areas include: Impact of Transport on patients and crew which includes the optimization
of provider performance and patient care, En-Route Medical Technologies which includes technology advances and assessment, and En-Route Patient Safety which
includes efforts to ensure the safe transport of patients through the AE system.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Enroute Care R&D - Aerospace Medicine/Human Performance Focus (AF)
FY 2015
- FY 2016
0.997
Description: This project area seeks to advance aeromedical evacuation (AE), Critical Care Air Transport Team (CCATT), and
Tactical Critical Care Evacuation Team (TCCET) capabilities through the research and development of rapid, more efficient,
and safer patient transport from the pre-staging for strategic or intra-theater air evacuation to definitive care, and to understand
the effects of transport on injured war fighters. Efforts will focus on translating technological advancements and groundbreaking
clinical research into translatable practice and technology products. The sub-project areas include: Physiological Effects of
Aeromedical Evacuation on patients and crew which includes the optimization of provider performance and patient care, impact of
transport times on En-Route Trauma and Resuscitative Care, and En-Route Patient Safety which includes technology advances
and assessment. Because patients experience multiple handoffs between teams of caregivers during transport between
austere environments and definitive care, efforts in this the En-Route Patient Safety sub-project area will examine human factors
considerations in en-route patient safety in order to develop new and enhance existing methods to mitigate risk in all en-route care
environments.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 30 of 105
R-1 Line #6
Volume 1 - 92
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
238E / Core Enroute Care R&D - Aerospace
Medicine/Human Performance Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Continue development of the en route care retrospective research database. Continue research to improve patient outcomes
by providing advanced notification of resuscitation needs. Continue research to identify the effects of altitude preconditioning
and also biomarkers as predictors of acute lung injury prior to AE. Begin simulation research program: validate skill / outcome
measures, develop simulation improvements / technologies to achieve those outcomes, understand perishability of skills.
Continue investigating new research and development requirements based on results of prior studies and warfighter gap
analyses. Continue closed loop interventions research and development.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 0.997
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 31 of 105
R-1 Line #6
Volume 1 - 93
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
243A: Medical Development
(Lab Support) (Navy)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
61.968
FY 2015
35.074
34.378
FY 2016
Base
37.580
FY 2016
OCO
FY 2016
Total
- 37.580
FY 2017
38.211
FY 2018
Project (Number/Name)
243A / Medical Development (Lab Support)
(Navy)
FY 2019
40.942
41.720
Cost To
FY 2020 Complete
Total
Cost
42.554 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Navy Bureau of Medicine and Surgery, this program element (PE) includes costs related to laboratory management and support salaries of government
employees that are not paid from science/research competitively awarded funding. The Outside Continental U.S. (OCONUS) laboratories conduct focused medical
research on vaccine development for Malaria, Diarrhea Diseases, and Dengue Fever. In addition to entomology, HIV studies, surveillance and outbreak response under
the Global Emerging Infections Surveillance (GEIS) program and risk assessment studies on a number of other infectious diseases that are present in the geographical
regions where the laboratories are located. The CONUS laboratories conduct research on Military Operational Medicine, Combat Casualty Care, Diving and Submarine
Medicine, Infectious Diseases, Environmental and Occupational Health, Directed Energy, and Aviation Medicine and Human Performance.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
35.074
Title: Medical Development (Lab Support) (Navy)
FY 2015
34.378
FY 2016
37.580
Description: RDT&E funds for operating and miscellaneous support costs at RDT&E laboratories, including facility, equipment
and civilian personnel costs that are not directly chargeable to RDT&E projects. Excludes military manpower and related costs,
non-RDT&E base operating costs, and military construction costs, which are included in other appropriate programs.
FY 2014 Accomplishments:
Provided operating and miscellaneous support costs at BUMED research laboratories. Continued to provide support for
technologically advanced cutting edge research equipment for research and data acquisition, automated sampling and real time
statistical analysis of biomedical research data utilizing data information systems integral with new equipment. Continued to
provide replacement of obsolete general purpose research equipment.
Additional Funding received will be used for 64 administrative civilian FTE's that had to be reprogrammed from the overhead
account, due to new financial model. Funding will also be used for existing government inherent civilian vacancies that are not in
the current manpower controls.
FY 2015 Plans:
Provide operating support for eight medical RDT&E labs across 15 product lines to develop products and strategies that protect,
treat, rehabilitate and enhance the performance of the Warfighter, and enable the labs to meet or exceed science performance
metric objectives.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 32 of 105
R-1 Line #6
Volume 1 - 94
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
243A / Medical Development (Lab Support)
(Navy)
B. Accomplishments/Planned Programs ($ in Millions)
Continue to provide operating support for eight medical RDT&E labs across 15 product lines to develop products and strategies
that protect, treat, rehabilitate and enhance the performance of the Warfighter, and enable the labs to meet or exceed science
performance metric objectives.
Accomplishments/Planned Programs Subtotals
FY 2014
35.074
FY 2015
FY 2016
34.378
37.580
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
Metrics include timely and proportionate distribution of funds to labs and product lines to optimize resource utilization in the development and evaluation of products that
protect, treat, rehabilitate and enhance the performance of the Warfighter.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 33 of 105
R-1 Line #6
Volume 1 - 95
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
247A: Elimination of Malaria in
Southeast Asia (CARB) (Navy)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
0.200
- FY 2016
Base
2.060
FY 2016
OCO
FY 2016
Total
- 2.060
FY 2017
2.064
FY 2018
Project (Number/Name)
247A / Elimination of Malaria in Southeast
Asia (CARB) (Navy)
FY 2019
1.548
Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
This project seeks to demonstrate that malaria can be eliminated in a specific geographically defined area of endemicity through a comprehensive multi-disciplined
approach including enhanced surveillance, research to maximize the impact of intervention strategies, and quality improvement of current tools for malaria elimination.
The demonstration will focus on Vietnam where multi-drug resistant malaria is prevalent and as such represents a significant threat to US personnel. Additionally,
the Vietnamese military and Ministry of Health have a high level of interest in malaria control and will collaborate in the malaria elimination demonstration project,
significantly improving the chances of success of this project. Successful completion of this project could significantly enhance force health protection and global
engagement by providing a vetted approach to malaria control in the Southeast Asia region where multi-drug resistant malaria is a major infectious disease threat. This
project supports (both directly and indirectly in a priority country - Vietnam) Global Health Security Agenda priorities: Prevent Avoidable Epidemics; Detect Threats Early;
and Respond Rapidly and Effectively to biological threats of international concern.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.200
Title: Elimination of Malaria in Southeast Asia (CARB) (Navy)
FY 2015
- FY 2016
2.060
Description: This project seeks to demonstrate that malaria can be eliminated in a specific geographically defined area
of endemicity through a comprehensive multi-disciplined approach including enhanced surveillance, operations research
to maximize the impact of intervention strategies, and quality improvement of current tools for malaria elimination. The
demonstration will focus on Vietnam where multi-drug resistant malaria is prevalent and as such represents a significant threat to
US personnel. Additionally the Vietnamese military and Ministry of Health have a high level of interest in malaria control and will
collaborate in the malaria elimination demonstration project significantly improving the chances of success of this project.
FY 2014 Accomplishments:
No funding programmed. Targeted year of execution funding will be made available for this Global Health Security Agenda
(GHSA) initiative.
FY 2015 Plans:
No funding programmed. Targeted year of execution funding will be made available for this Global Health Security Agenda
(GHSA) initiative.
FY 2016 Plans:
The first objective of this project, which is to enhance the malaria surveillance in Vietnam, will be completed in FY14. The malaria
surveillance system is being optimized to define exactly where transmission is occurring with novel mapping to support targeted
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 34 of 105
R-1 Line #6
Volume 1 - 96
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
247A / Elimination of Malaria in Southeast
Asia (CARB) (Navy)
B. Accomplishments/Planned Programs ($ in Millions)
interventions and the monitoring and evaluation of their impact. It will build upon existing funded projects, leveraging investments
from the US Government, international partners and non-Government Agencies.
FY 2014
FY 2015
FY 2016
In FY15, surveillance efforts started in 2014 will expand to include military personnel, a mobile group working in malaria endemic
areas of Vietnam. This population has traditionally been excluded from global malaria control programs and comprehensive
malaria burden data is not available. The Vietnamese People’s Army Military Medicine Department (MMD) has requested a crosssectional study be conducted to determine the parasite carriage rate and proportion of drug-resistant parasites within the military.
This study is critical to understanding the malaria burden in this segment of the Vietnamese population and is a pre-requisite for
additional malaria elimination efforts planned for FY16 and leverage FY14 investments.
In FY16, after establishing a baseline parasite carriage rate and drug resistant burden in FY15 for the military, research efforts
will focus on improving the quality of detecting individuals carrying the malaria parasite, treatment (the drugs themselves and the
adherence to them) and the implementation of rigorous investigation of each case to determine the origin of infection to prevent
further infections.
The impact of the malaria interventions under study will be evaluated (and re-evaluated) to determine which quality improvement
practices should be scaled up or if additional interventions are needed. The most effective combinations of interventions for
different epidemiological strata in Vietnam will be determined to select and then directly evaluate the impact of the selected
interventions on malaria parasite carriage and disease rates in an on-going iterative fashion (operations research). Collected
malaria surveillance and intervention data will be modelled to measure impact of previous interventions in Vietnam. The most
promising intervention or combination of interventions will be recommended for deployment for eliminate malaria in the defined
geographic region of study in Vietnam.
Accomplishments/Planned Programs Subtotals
0.200
- 2.060
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 35 of 105
R-1 Line #6
Volume 1 - 97
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
247A / Elimination of Malaria in Southeast
Asia (CARB) (Navy)
E. Performance Metrics
Successful execution of this project will be measured by significant reduction of malaria parasite incidence and prevalence in the geographic area of study. Study results
and recommendations will be reported in refereed professional journals and policy recommendations submitted to the Vietnamese and US Governments.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 36 of 105
R-1 Line #6
Volume 1 - 98
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
247B: Mitigate the Global Impact
of Sepsis Through ACESO
(CARB) (Navy)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
0.425
- FY 2016
Base
1.040
FY 2016
OCO
FY 2016
Total
- 1.040
FY 2017
1.135
FY 2018
Project (Number/Name)
247B / Mitigate the Global Impact of Sepsis
Through ACESO (CARB) (Navy)
FY 2019
1.238
Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
This project seeks to demonstrate that the impact of sepsis (severe infections) in Egypt can be mitigated through the Austere Environment Consortium for Enhanced
Sepsis Outcomes (ACESO) approach of discovering common, host-based pathogenic pathways for improved recognition and management of sepsis and point of care
(POC) diagnostic and prognostic biomarker panels. Sepsis is the common path to end-organ damage and death for a large proportion of globally-important infectious
diseases. This project will improve the understanding of disease pathogenesis and antimicrobial resistance mechanisms through network and biomarker analysis
thus offering unique opportunities for improving sepsis diagnosis and management. Insight into the disease pathogenesis of sepsis, and host factors which predict
susceptibility, and sepsis severity provides opportunity for targeted interventions to forestall morbidity and mortality. Furthermore, enhanced knowledge of emerging
antimicrobial resistance in strategic regions informs ongoing surveillance and mitigation efforts of critical importance to deployed forces. Successful completion of
this project will provide reliable antimicrobial resistance data for forces deploying to Egypt and the region and also document improved methods for the treatment and
management of sepsis. ACESO is an international consortium of sepsis researchers led by NMRC that has established a network of sepsis research sites in SE Asia
and Sub-Saharan Africa to improve clinical outcomes and advance our understanding of pathogenesis, biomarkers of sepsis and antimicrobial resistance trends. The
proximity of NAMRU-3 to the largest infectious disease hospital in Egypt (Abbassia Fever Hospital) affords an unparalleled opportunity for ACESO expansion and will
provide critical severe infection and antimicrobial resistance data from the important North African Theater. This project supports (both directly and indirectly) Global
Health Security Agenda priorities: Prevent Avoidable Epidemics; Detect Threats Early; and Respond Rapidly and Effectively to biological threats of international concern.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
0.425
Title: Mitigate the Global Impact of SepSis Through ACESO (CARB) (Navy)
FY 2015
- FY 2016
1.040
Description: This project seeks to demonstrate that the impact of sepsis in Egypt can be mitigated through the Austere
Environment Consortium for Enhanced Sepsis Outcomes (ACESO) approach of discovering common, host-based pathogenic
pathways for improved recognition and management of sepsis. This project will improve understanding of pathogenesis and
antimicrobial resistance mechanisms through network and biomarker analysis to offer unique opportunities for improving sepsis
diagnosis and management. Most specifically, ACESO will execute biomarker discovery identifying diagnostic and prognostic
biomarker panels which may improve sepsis management in all environments including resourced and austere.
FY 2014 Accomplishments:
No funding programmed. Targeted year of execution funding will be made available for this Global Health Security Agenda
(GHSA) initiative.
FY 2015 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 37 of 105
R-1 Line #6
Volume 1 - 99
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
247B / Mitigate the Global Impact of Sepsis
Through ACESO (CARB) (Navy)
B. Accomplishments/Planned Programs ($ in Millions)
No funding programmed. Targeted year of execution funding will be made available for this Global Health Security Agenda
(GHSA) initiative.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
FY14 efforts will be directed towards the development and approval of research protocols by NAMRU-3 and Ministry of Health
Scientific Review Board and Institutional Review Board, as well as, the development of agreements, securing required equipment
and supplies, and the recruitment of necessary contract staff to initiate patient enrollment during first quarter of FY15.
FY15 efforts will support the continuation of the observational study of patients with sepsis in Egypt admitted to the Abbassia
Fever Hospital, adjacent to NAMRU-3, Cairo. The goals of this study are to 1) identify diagnostic and prognostic markers, 2)
investigate common pathogenic pathways, 3) describe the spectrum of pathogens causing sepsis, 4) describe the treatment
strategies currently in use, and 5) assess the long-term sequelae. Adult patients with suspected infection and evidence of
systemic inflammation will be considered for enrollment. Laboratory testing will augment the testing routinely performed at the
hospital microbiology laboratory, and will include diagnostic tests (e.g. blood cultures, malaria smears, HIV tests, and serology),
molecular diagnostics (e.g. microarray analysis, multiplex PCR, and sequencing), and assays measuring the host-response
(biomarker assays and host transcriptome arrays). Sophisticated analytic and statistical approaches will be applied to this
complex data set to identify diagnostic and prognostic markers for sepsis and to investigate common pathogenic pathways.
FY16 funding will support the continuation of the observational study at the Abbassia Fever Hospital and the sophisticated analytic
and statistical approaches will be applied to this complex data set to identify diagnostic and prognostic markers for sepsis and to
investigate common pathogenic pathways.
Accomplishments/Planned Programs Subtotals
0.425
- 1.040
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
Successful execution of this project will be measured by significant reduction in the mortality rate from sepsis, reduced hospitalization days, and by the number and
impact factor of publications in refereed professional journals.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 38 of 105
R-1 Line #6
Volume 1 - 100
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
284B: USAF Human Physiology,
Systems Integration, Evaluation
& Optimization Research
(Budgeted) (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
2.646
FY 2015
3.694
2.280
FY 2016
Base
1.700
FY 2016
OCO
FY 2016
Total
- FY 2017
1.700
- Project (Number/Name)
284B / USAF Human Physiology, Systems
Integration, Evaluation & Optimization
Research (Budgeted) (AF)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to enhance, optimize & sustain performance of Air Force personnel through the evaluation and alleviation of health effects associated with
carrying out assigned missions. This work addresses unique Air Force operational environments such as the mitigation of stress on personnel involved in remote piloted
aircraft operations. The sub-project areas include: Cognitive Performance which includes fatigue management, Physiological Performance and Targeted Conditioning
which includes training techniques for optimal performance, and identification of solutions related to Operational and Environmental Challenges to Performance.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
3.694
Title: USAF Human Physiology, Systems Integration, Evaluation & Optimization Research (Budgeted) (AF)
FY 2015
2.280
FY 2016
1.700
Description: This project area seeks to enhance, optimize & sustain performance of Air Force personnel through the evaluation
and alleviation of health effects associated with carrying out assigned missions. This work addresses unique Air Force
operational environments such as the mitigation of stress on personnel involved in remote piloted aircraft operations. The subproject areas include: Cognitive Performance which includes fatigue management, Physiological Performance and Targeted
Conditioning which includes training techniques for optimal performance, and identification of solutions related to Operational and
Environmental Challenges to Performance.
FY 2014 Accomplishments:
Completed high altitude/U-2 pilot imaging and comparison baseline studies. Completed mountain altitude acclimatization
research. Completed the study on risk and protective factors and social-occupational impairment among AF Special Operations
Forces personnel. Assessed fatigue management using non-visual light stimulation. Expanded ongoing studies on understanding
hypoxia, focusing on previously unidentified latent effects. Began initial evaluations of potential technologies capable of providing
in-flight assessment of pilot physiological measures. Kick-off new study looking at acute MRI changes and time course of
development secondary to hypobaric exposure in select AF physiology and pilot populations
FY 2015 Plans:
Complete high altitude/U-2 pilot imaging and comparison baseline studies. Complete the study on risk and protective factors and
social-occupational impairment among AF Special Operations Forces personnel and evaluate some of the measures instituted
as a result of this effort. Pursue human systems integration studies. Assess novel fatigue and cognitive management modalities.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 39 of 105
R-1 Line #6
Volume 1 - 101
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
284B / USAF Human Physiology, Systems
Integration, Evaluation & Optimization
Research (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Expand ongoing studies on understanding hypoxia, focusing on previously unidentified latent effects. Initiate Pilot Physiology and
Cognitive Performance to determine physiological impacts during manned flight to determine mitigations needed to maintain /
optimize performance. Perform development of fitness readiness algorithms to enhance AF personnel training and prevent
injuries.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
Expand evaluations of promising fatigue and cognitive management modalities. Conclude efforts identifying the effects of
combining over-the-counter stimulants with Modafinil, which may stimulate the need for further research. Apply results from
high altitude and hypoxia studies to refine this line of research to define what is a “safe” altitude and potentially spur operational
changes. Implement plans to pursue human systems integration studies, focusing on identified gaps.Mature a comprehensive
program working to define and mitigate the extreme physiological demands of higher altitudes to include decompression sickness
and hypoxia. Expand on previous studies to understand and mitigate fatigue, cognitive overload and how these conditions
magnify each other. Advance understanding of appropriate selection as it pertains to new accessions, job placement, injury
reduction, and retention.
Accomplishments/Planned Programs Subtotals
3.694
2.280
1.700
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
SEE OTHER PROGRAM FUNDING SUMMARY FOR PROJECT CODE 238C WHICH IS A SUMMARY OF OTHER PROGRAM FUNDING SUPPORT TO ALL
PROJECTS AND PROGRAMS IN THIS PE FOR DHP-AF
D. Acquisition Strategy
Broad Area Announcement (BAA) and Intramural calls for proposal are used to award initiatives in this program and project following determinatinons of scientific and
technical merit, validation of need, prioritization, selection and any necessary legal and/or regulatory approvals (IRB, etc).
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 40 of 105
R-1 Line #6
Volume 1 - 102
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
284C: Core Human Performance
R&D - Clinical Translational
Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- FY 2016
Base
- 1.003
FY 2016
OCO
FY 2016
Total
- 1.003
FY 2017
2.349
FY 2018
Project (Number/Name)
284C / Core Human Performance R&D Clinical Translational Focus (AF)
FY 2019
2.664
2.762
Cost To
FY 2020 Complete
Total
Cost
2.817 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to enhance, optimize & sustain performance of Air Force personnel through the evaluation and alleviation of health effects associated with
carrying out assigned missions. This work addresses unique Air Force operational environments such as the mitigation of stress on personnel involved in remote piloted
aircraft operations. The sub-project areas include: Cognitive Performance which includes fatigue management, Physiological Performance and Targeted Conditioning
which includes training techniques for optimal performance, and identification of solutions related to Operational and Environmental Challenges to Performance.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Core Human Performance R&D - Clinical Translational Focus (AF)
FY 2014
- FY 2015
- FY 2016
1.003
- - 1.003
Description: This project area seeks to enhance, optimize & sustain performance of Air Force personnel through the evaluation
and alleviation of health effects associated with carrying out assigned missions. This work addresses unique Air Force
operational environments such as the mitigation of stress on personnel involved in remote piloted aircraft operations. The subproject areas include: Cognitive Performance which includes fatigue management, Physiological Performance and Targeted
Conditioning which includes training techniques for optimal performance, and identification of solutions related to Operational and
Environmental Challenges to Performance.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Mature a comprehensive program working to define and mitigate the extreme physiological demands of higher altitudes to include
decompression sickness and hypoxia. Expand on previous studies to understand and mitigate fatigue, cognitive overload and
how these conditions magnify each other. Advance understanding of appropriate selection as it pertains to new accessions, job
placement, injury reduction, and retention.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
N/A
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 41 of 105
R-1 Line #6
Volume 1 - 103
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
284C / Core Human Performance R&D Clinical Translational Focus (AF)
C. Other Program Funding Summary ($ in Millions)
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 42 of 105
R-1 Line #6
Volume 1 - 104
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
284D: Core Human Performance
R&D - Aerospace Medicine/
Human Performance Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
1.002
FY 2016
OCO
FY 2016
Total
- 1.002
FY 2017
2.348
FY 2018
Project (Number/Name)
284D / Core Human Performance R&D Aerospace Medicine/Human Performance
Focus (AF)
FY 2019
2.663
2.761
Cost To
FY 2020 Complete
Total
Cost
2.816 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to enhance, optimize & sustain performance of Air Force personnel through the evaluation and alleviation of health effects associated with
carrying out assigned missions. This work addresses unique Air Force operational environments such as the mitigation of stress on personnel involved in piloted
aircraft, as well as remote piloted aircraft operations, aviation performance and injury prevention, and personalized optimization of performance of AF personnel. The
sub-project areas include: AF Aircrew Physiology and Cognition Performance which includes pilot performance monitoring and interventions, fatigue management, AF
unique Physiological Performance and Targeted Conditioning Mitigation which includes personalized performance and training techniques for optimal performance,
Aviator Injury Prevention and Performance Optimization, Select training and simulation to optimize performance of AF operators and personnel, and identification of
solutions related to Operational and Environmental Challenges to Performance.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Human Performance R&D - Aerospace Medicine/Human Performance Focus (AF)
FY 2015
- FY 2016
1.002
Description: This project area seeks to enhance, optimize & sustain performance of Air Force personnel through the evaluation
and alleviation of health effects associated with carrying out assigned missions. This work addresses unique Air Force
operational environments such as the mitigation of stress on personnel involved in piloted aircraft, as well as remote piloted
aircraft operations, aviation performance and injury prevention, and personalized optimization of performance. The sub-project
areas include: AF Aircrew Physiology and Cognition Performance which includes pilot performance monitoring and interventions,
fatigue management, AF unique Physiological Performance and Targeted Conditioning Mitigation which includes personalized
performance and training techniques for optimal performance, Aviator Injury Prevention and Performance Optimization,
Select training and simulation to optimize performance of AF operators and personnel, and identification of solutions related to
Operational and Environmental Challenges to Performance.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 43 of 105
R-1 Line #6
Volume 1 - 105
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
284D / Core Human Performance R&D Aerospace Medicine/Human Performance
Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Continue assessment of in-flight pilot performance monitoring. Begin assessment of potential physiological measures capable of
capturing physiological and cognitive state of AF pilot and operator personnel. Evaluate current / planned technologies employed
in current generation aircraft against human performance limitations to address changes needed to technology or identify
performance optimization techniques. Conclude efforts identifying the effects of combining over-the-counter stimulants with
Modafinil, which may stimulate the need for further research. Apply results from high altitude and hypoxia studies to refine this
line of research and potentially spur operational and training changes, and identify areas needed for further research. Implement
plans to pursue human systems integration studies, focusing on identified gaps. Conduct operational based vision research.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 1.002
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.***
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 44 of 105
R-1 Line #6
Volume 1 - 106
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
285A: Operational Medicine
Research & Development
(Budgeted) (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
8.146
FY 2015
6.851
1.983
FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- - FY 2017
- Project (Number/Name)
285A / Operational Medicine Research &
Development (Budgeted) (AF)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Operational Medicine Thrust Area develops validated solutions for the delivery of preventative care, intervention and treatment to Active Duty members and DoD
beneficiaries. The primary focus areas include: physiologic and psychological health; sub-topics include resilience, personalized medicine, patient safety, and care
coordination. Basic research initiatives are developed and translated into practice; advanced technology initiatives are focused on prevention and treatment of chronic
disease such as obesity and diabetes. Personalized medicine focuses on genomic issues related to autism, asthma, and obesity.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
6.851
Title: Operational Medicine Research & Development (Air Force)
FY 2015
1.983
FY 2016
- Description: The Operational Medicine Thrust Area develops validated solutions for the delivery of preventative care, intervention
and treatment to Active Duty members and DoD beneficiaries. The primary focus areas include: physiologic and psychological
health; sub-topics include resilience, personalized medicine, patient safety, and care coordination. Basic research initiatives
are developed and translated into practice; advanced technology initiatives are focused on prevention and treatment of chronic
disease such as obesity and diabetes. Personalized medicine focuses on genomic issues related to autism, asthma, and obesity.
FY 2014 Accomplishments:
Continued patient centered/personalized medicine research efforts related to autism and obesity. Aligned resources with
academia and other health agencies to evaluate outcomes of standardized diabetes prevention initiatives, including online
resources. Determined if medication therapy management program for patients with chronic pain at a large Military Treatment
Facility reduced costs and improved outcomes. Evaluate personalized prevention and treatment efforts related to PatientCentered Precision Care. Building on previous work, identified opportunities for advanced development of mobile health
application technologies within the MHS for personalized disease prevention and management. Began evaluation of utilization
and effectiveness of current AF mental health/family support programs for the purposes of identifying gaps and possible solutions
to areas such as marital discord, family maltreatment, binge drinking, and suicide.
FY 2015 Plans:
Continue patient centered/personalized medicine research efforts related to autism and obesity. Align resources with academia
and other health agencies to evaluate outcomes of standardized diabetes prevention initiatives, including online resources.
Through intramural efforts, determine if a medication therapy management program for patients with chronic pain at a large
Military Treatment Facility will reduce costs and improve outcomes. Evaluate personalized prevention and treatment efforts related
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 45 of 105
R-1 Line #6
Volume 1 - 107
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
285A / Operational Medicine Research &
Development (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
to Patient-Centered Precision Care. Building on previous work, identify opportunities for advanced development of mobile health
application technologies within the MHS for personalized disease prevention and management. Begin evaluation of utilization
and effectiveness of current AF mental health/family support programs for the purposes of identifying gaps and possible solutions
to areas such as marital discord, family maltreatment, binge drinking, and suicide.Building on previous work, concentrate on
the use of mobile health technologies to integrate evidenced-based solutions into clinical practice and the EHR to positively
influence behavior and promote health. Further the work related to AF mental health/family support by pilot testing proposed
solutions to specified issues in an effort to translate solutions into AFMS wide practice. Determine the timeliness of communication
(information exchange) of clinical information and the effectiveness of communication processes to identify gaps or potential
patient safety issues that may impact outcomes to include morbidity and mortality. Begin regenerative/reconstructive research to
validate technologies for surgical reconstruction of service members with previously non-reconstructable injuries, and investigate
devices for advanced wound healing. Continue evaluate personalized prevention and treatment efforts related to Patient-Centered
Precision Care in the areas of chronic pain following traumatic brain injury, post-traumatic stress disorder, and substance abuse.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
6.851
1.983
- C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Broad Area Announcement (BAA) and Intramural calls for proposal are used to award initiatives in this program and project following determinations of scientific and
technical merit, validation of need, prioritization, selection and any necessary legal and/or regulatory approvals (IRB, etc).
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 46 of 105
R-1 Line #6
Volume 1 - 108
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
285B: Core Operational
Medicine R&D - Clinical
Translational Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- FY 2016
Base
- 0.929
FY 2016
OCO
FY 2016
Total
- 0.929
FY 2017
1.147
FY 2018
Project (Number/Name)
285B / Core Operational Medicine R&D Clinical Translational Focus (AF)
FY 2019
1.350
1.360
Cost To
FY 2020 Complete
Total
Cost
1.387 Continuing Continuing
A. Mission Description and Budget Item Justification
The Operational Medicine Thrust Area develops validated solutions for the delivery of preventative care, intervention and treatment to Active Duty members and DoD
beneficiaries. The primary focus areas include: physiologic and psychological health; sub-topics include resilience, personalized medicine, patient safety, and care
coordination. Basic research initiatives are developed and translated into practice; advanced technology initiatives are focused on prevention and treatment of chronic
disease such as obesity and diabetes. Personalized medicine focuses on genomic issues related to autism, asthma, and obesity.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Operational Medicine R&D - Clinical Translational Focus (AF)
FY 2015
- FY 2016
0.929
Description: The Operational Medicine Thrust Area develops validated solutions for the delivery of preventative care, intervention
and treatment to Active Duty members and DoD beneficiaries. The primary focus areas include: physiologic and psychological
health; sub-topics include resilience, personalized medicine, patient safety, and care coordination. Basic research initiatives
are developed and translated into practice; advanced technology initiatives are focused on prevention and treatment of chronic
disease such as obesity and diabetes. Personalized medicine focuses on genomic issues related to autism, asthma, and obesity.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Further identify practical health delivery platforms using health services research to adapt innovative, evidence-based health
solutions to improve troop to beneficiary health. Pilot feasibility studies and expand to large scale, standardized implementation
research to address current high diagnoses rates of musculoskeletal pain, anxiety/depressive disorders, autism, obesity and
other chronic disease states. Research health priorities using data analytics to define and validate occupational and physical
health performance measures to identify degrees of health needed to optimize, sustain and enhance health practices to improve
troop reliability. Initiate research to enhance accession health and minimize/prevent training injury patterns. Assess the physical
and psychological/cultural impact of Women in Combat. Research and incorporate health information technology to develop
clinical communication networks to train providers and engage beneficiaries through integrated communities of care. Utilize
patient genomic information to individualize population health services. Continue regenerative/reconstructive research to validate
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 47 of 105
R-1 Line #6
Volume 1 - 109
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
285B / Core Operational Medicine R&D Clinical Translational Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
technologies for surgical reconstruction of service members with previously non-reconstructable injuries. Continue development in
the areas of chronic pain following traumatic brain injury, post-traumatic stress disorder, and substance abuse.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 0.929
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 48 of 105
R-1 Line #6
Volume 1 - 110
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
285C: Core Operational
Medicine R&D - Aerospace/
Human Performance Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
0.928
FY 2016
Total
- 0.928
FY 2017
1.147
FY 2018
Project (Number/Name)
285C / Core Operational Medicine R&D Aerospace/Human Performance Focus (AF)
FY 2019
1.349
1.360
Cost To
FY 2020 Complete
Total
Cost
1.387 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to provide research and development affecting AF beneficiary populations requiring specialized handling during routine medical care such as
pilots, RPA operators, special tactics operators and personnel reliability program members. Research will evaluate and determine if special approaches to personal
health and performance are required for these beneficiaries. It will also ascertain if conditions not found in the general patient population are applicable to those in this
area of interest and conversely if there are conditions or trends in this population requiring attention that are not normally found in the general AF / DoD beneficiary pool.
Overall research in this project will support optimization of health care delivery services to all AF / DoD beneficiaries but will focus on high-value asset personnel.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Core Operational Medicine R&D - Aerospace/Human Performance Focus (AF)
FY 2014
- FY 2015
- FY 2016
0.928
- - 0.928
Description: This project area seeks to provide research and development affecting AF beneficiary populations requiring
specialized handling during routine medical care such as pilots, RPA operators, special tactics operators and personnel reliability
program members. Research will evaluate and determine if special approaches to personal health and performance are required
for these beneficiaries. It will also ascertain if conditions not found in the general patient population are applicable to those in this
area of interest and conversely if there are conditions or trends in this population requiring attention that are not normally found in
the general AF / DoD beneficiary pool. Overall research in this project will support optimization of health care delivery services to
all AF / DoD beneficiaries but will focus on high-value asset personnel.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Conduct research into select AF Flight Medicine enrollees identifying health and performance preventative and intervention needs.
Evaluate human performance practice on general AF populations identifying success and areas of improvement required.Perform
evaluation of aeromedical care service delivery methods assessing for efficacy and efficiency in promoting beneficial outcomes in
operators and their families.
Accomplishments/Planned Programs Subtotals
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 49 of 105
R-1 Line #6
Volume 1 - 111
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
285C / Core Operational Medicine R&D Aerospace/Human Performance Focus (AF)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 50 of 105
R-1 Line #6
Volume 1 - 112
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
307B: Force Health Protection,
Advanced Diagnostics/
Therapeutics Research &
Development (Budgeted) (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
14.728
FY 2014
FY 2015
14.508
12.558
FY 2016
Base
8.173
FY 2016
OCO
FY 2016
Total
- 8.173
FY 2017
FY 2018
10.653
Project (Number/Name)
307B / Force Health Protection, Advanced
Diagnostics/Therapeutics Research &
Development (Budgeted) (AF)
FY 2019
10.833
10.950
Cost To
FY 2020 Complete
Total
Cost
11.169 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to deliver improved capabilities across the full spectrum of operations in the areas of Directed Energy and Occupational and Environmental
Health. Research in the Directed Energy sub-project area seeks to develop technologies to "detect to warn" and "detect to protect" AF operators such that they can
take appropriate actions to prevent or minimize exposure leading to adverse health effects. Research in the Occupational and Environmental Health sub-project area
involves the assessment and implementation of innovative new technologies that enable effective surveillance, detection, identification, and mitigation of hazardous
chemical, biological, and physical hazards that present a health risk to our forces and threaten to degrade and disrupt the missions they execute. Air Force FHP efforts
focus on health protection across the spectrum of AF air and ground operations. These include hazards presented to high performance and high flyer aircraft crews
facing extreme environments within their flight envelopes that are potentially more sensitive to physiologic and cognitive stressors and rely on aircraft systems to provide
life support for protection. Because Air Force installations are typically very strategically important in combat execution, they are more often tied to performing ops at
fixed locations; therefore, they drive the need to detect and identify the USAF- and environment-specific risks posed by chemical, biological, directed energy, and other
radiological and physical hazards immediately and on-site so that operations can be resumed as quickly as possible. This requires enhanced monitoring capability, such
as man-portable gold-standard hazard detection. Research is needed to improve these capabilities and to account for emerging threats. The mission needs driving
the ability to detect also drives the need to rapidly reduce or mitigate threats once discovered. State of the art detection and monitoring equipment, therefore, is also an
important FHP research need.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Force Health Protection, Advanced Diagnostics/Therapeutics Research & Development (Budgeted) (Air Force)
FY 2014
14.508
FY 2015
12.558
FY 2016
8.173
Description: This project area seeks to deliver improved capabilities across the full spectrum of operations in the areas of
Directed Energy and Occupational and Environmental Health. Research in the Directed Energy sub-project area seeks to
develop technologies to "detect to warn" and "detect to protect" AF operators such that they can take appropriate actions to
prevent or minimize exposure leading to adverse health effects. Research in the Occupational and Environmental Health subproject area involves the assessment and implementation of innovative new technologies that enable effective surveillance,
detection, identification, and mitigation of hazardous chemical, biological, and physical hazards that present a health risk to our
forces and threaten to degrade and disrupt the missions they execute. Air Force FHP efforts focus on health protection across
the spectrum of AF air and ground operations. These include hazards presented to high performance and high flyer aircraft
crews facing extreme environments within their flight envelopes that are potentially more sensitive to physiologic and cognitive
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 51 of 105
R-1 Line #6
Volume 1 - 113
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
307B / Force Health Protection, Advanced
Diagnostics/Therapeutics Research &
Development (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
stressors and rely on aircraft systems to provide life support for protection. Because Air Force installations are typically very
strategically important in combat execution, they are more often tied to performing ops at fixed locations; therefore, they drive the
need to detect and identify the USAF- and environment-specific risks posed by chemical, biological, directed energy, and other
radiological and physical hazards immediately and on-site so that operations can be resumed as quickly as possible. This requires
enhanced monitoring capability, such as man-portable gold-standard hazard detection. Research is needed to improve these
capabilities and to account for emerging threats. The mission needs driving the ability to detect also drives the need to rapidly
reduce or mitigate threats once discovered. State of the art detection and monitoring equipment, therefore, is also an important
FHP research need.
FY 2014
FY 2015
FY 2016
FY 2014 Accomplishments:
Tested miniaturized sensors to identify toxic breathing air and hypoxic aircrew. Initiated research and development for the
integration and demonstration of advanced medical, physiological status sensors and exposure sensors in a laboratory
environment to prepare them for aircraft integration. Delveloped a compact, insulated, leak-proof, laboratory-approved transport
system for shipping food samples from remote locations to the laboratory. Developed prototype devices to detect and quantify
lasers used to illuminate aircraft and qualify the health threat to aircrew. Analyzed methodologies and challenges associated
with the establishment of a genome data repository for future implementation of genomic medicine. Continued to develop a highcontent, rapid throughput toxicological capability with pleuripotent stem-cells allowing for a rapid screening of possible threats
in the aerospace environment. Developed extremely light weight and easy to use methodologies enabling Air Force Special
Operators to diagnose pathogens with almost no medical support in the field. Performed a comprehensive study of aircraft
breathing air quality across the Air Force fleet to ensure risks are understood and mitigated if needed.
FY 2015 Plans:
Continue to engage with the Precision Care Advisory Panel (PCAP), a joint service committee to provide service-specific
operational and policy guidance for the implementation of personalized medicine within the DoD. Initiated study to perform highcontent, rapid throughput toxicology with pluripotent cells allowing for a rapid screening of possible threats in the aerospace
environment.
FY 2016 Plans:
Continue evaluating foreign made, clinical lasers to validate that the devices meet U.S. safety and health standards. Continue the
investigation of biomarkers associated with laser lesions, which is exploring the biophysical interactions between directed energy
and biological tissue at optical frequencies. Continue developing a retinal injury atlas database for use by clinicians and further
apply data to perform a bioinformatics-based analysis of retinal injury treatment alternatives. Continue studying high-powered
microwave exposures to establish dose-response relationships. Continue developing and testing prototype devices to detect and
quantify lasers used to illuminate aircraft and characterize the health threat to exposed aircrew and pilots. Start transition to the AF
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 52 of 105
R-1 Line #6
Volume 1 - 114
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
307B / Force Health Protection, Advanced
Diagnostics/Therapeutics Research &
Development (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
public health community a recently developed compact, insulated, leak-proof, laboratory-approved transport system for shipping
contaminated food samples from remote locations to an analytical laboratory; also, explore technology transfer potential to the
civilian public health sector. Continue research to develop miniaturized sensors to identify hypoxic/toxic aircrew environments.
Continue research to perform high-content, rapid throughput screening with pluripotent cells allowing for rapid determination of
possible toxic threats in the aerospace environment. Complete studies to further improve HAPSITE capabilities to detect other
classes of chemicals. Complete the Problem Definition Study (PDS) to develop a Portfolio Management Tool to define a research
strategy that identifies critical and specific phased research studies and technology developments that are required to detect
and characterize airborne pollution hazards in the deployed environment with specific relevance to the AF. Perform field testing
of smaller/more capable sensors for monitoring remote environmental health hazards and physiological parameters. Continue
identifying and characterizing health effects associated with exposure to AF-relevant nanomaterials.
Accomplishments/Planned Programs Subtotals
FY 2014
14.508
FY 2015
FY 2016
12.558
8.173
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Broad Area Announcement (BAA) and Intramural calls for proposal are used to award initiatives in this program and project following determinations of scientific and
technical merit, validation of need, prioritization, selection and any necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 53 of 105
R-1 Line #6
Volume 1 - 115
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
307C: Core Force Health
Protection R&D - Clinical
Translational Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
1.000
FY 2016
OCO
FY 2016
Total
- 1.000
FY 2017
1.500
FY 2018
Project (Number/Name)
307C / Core Force Health Protection R&D Clinical Translational Focus (AF)
FY 2019
2.235
2.375
Cost To
FY 2020 Complete
Total
Cost
2.463 Continuing Continuing
A. Mission Description and Budget Item Justification
This project seeks to deliver improved capabilities across the full spectrum of operations in the areas of Directed Energy and Occupational and Environmental Health.
Research in the Directed Energy sub-project area seeks to develop technologies to "detect to warn" and "detect to protect" AF operators such that they can take
appropriate actions to prevent or minimize exposure leading to adverse health effects. Research in the Occupational and Environmental Health sub-project area
involves the assessment and implementation of innovative new technologies that enable effective surveillance, detection, identification, and mitigation of hazardous
chemical, biological, and physical hazards that present a health risk to our forces and threaten to degrade and disrupt the missions they execute. Air Force FHP efforts
focus on health protection across the spectrum of AF air and ground operations. These include hazards presented to high performance and high flyer aircraft crews
facing extreme environments within their flight envelopes that are potentially more sensitive to physiologic and cognitive stressors and rely on aircraft systems to provide
life support for protection. Because Air Force installations are typically very strategically important in combat execution, they are more often tied to performing ops at
fixed locations; therefore, they drive the need to detect and identify the USAF- and environment-specific risks posed by chemical, biological, directed energy, and other
radiological and physical hazards immediately and on-site so that operations can be resumed as quickly as possible. This requires enhanced monitoring capability, such
as man-portable gold-standard hazard detection. Research is needed to improve these capabilities and to account for emerging threats. The mission needs driving
the ability to detect also drives the need to rapidly reduce or mitigate threats once discovered. State of the art detection and monitoring equipment, therefore, is also an
important FHP research need.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Force Health Protection R&D - Clinical Translational Focus (AF)
FY 2015
- FY 2016
1.000
Description: This project seeks to deliver improved capabilities across the full spectrum of operations in the areas of Directed
Energy and Occupational and Environmental Health. Research in the Directed Energy sub-project area seeks to develop
technologies to "detect to warn" and "detect to protect" AF operators such that they can take appropriate actions to prevent
or minimize exposure leading to adverse health effects. Research in the Occupational and Environmental Health sub-project
area involves the assessment and implementation of innovative new technologies that enable effective surveillance, detection,
identification, and mitigation of hazardous chemical, biological, and physical hazards that present a health risk to our forces
and threaten to degrade and disrupt the missions they execute. Air Force FHP efforts focus on health protection across the
spectrum of AF air and ground operations. These include hazards presented to high performance and high flyer aircraft crews
facing extreme environments within their flight envelopes that are potentially more sensitive to physiologic and cognitive stressors
and rely on aircraft systems to provide life support for protection. Because Air Force installations are typically very strategically
important in combat execution, they are more often tied to performing ops at fixed locations; therefore, they drive the need
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 54 of 105
R-1 Line #6
Volume 1 - 116
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
307C / Core Force Health Protection R&D Clinical Translational Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
to detect and identify the USAF- and environment-specific risks posed by chemical, biological, directed energy, and other
radiological and physical hazards immediately and on-site so that operations can be resumed as quickly as possible. This requires
enhanced monitoring capability, such as man-portable gold-standard hazard detection. Research is needed to improve these
capabilities and to account for emerging threats. The mission needs driving the ability to detect also drives the need to rapidly
reduce or mitigate threats once discovered. State of the art detection and monitoring equipment, therefore, is also an important
FHP research need.
FY 2014
FY 2015
FY 2016
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Continue evaluating foreign made, clinical lasers to validate that the devices meet U.S. safety and health standards. Continue
the investigation of biomarkers associated with laser lesions, which is exploring the biophysical interactions between directed
energy and biological tissue at optical frequencies. Continue developing a retinal injury atlas database for use by clinicians and
further apply data to perform a bioinformatics-based analysis of retinal injury treatment alternatives. Continue studying highpowered microwave exposures to establish dose-response relationships. Continue developing and testing prototype devices
to detect and quantify lasers used to illuminate aircraft and characterize the health threat to exposed aircrew and pilots. Start
transition to the AF public health community a recently developed compact, insulated, leak-proof, laboratory-approved transport
system for shipping contaminated food samples from remote locations to an analytical laboratory; also, explore technology
transfer potential to the civilian public health sector. Continue research to develop miniaturized sensors to identify hypoxic/
toxic aircrew environments. Continue research to perform high-content, rapid throughput screening with pluripotent cells
allowing for rapid determination of possible toxic threats in the aerospace environment. Complete studies to further improve
HAPSITE capabilities to detect other classes of chemicals. Complete the Problem Definition Study (PDS) to develop a Portfolio
Management Tool to define a research strategy that identifies critical and specific phased research studies and technology
developments that are required to detect and characterize airborne pollution hazards in the deployed environment with specific
relevance to the AF. Perform field testing of smaller/more capable sensors for monitoring remote environmental health hazards
and physiological parameters. Continue identifying and characterizing health effects associated with exposure to AF-relevant
nanomaterials.Proposed expansion of Genomic Studies to include analysis of conditions with operational and clinical importance,
based on an assessment of AFMS needs. Continue AFMS Innovation initiatives including demonstration projects for process
improvements, leadings practices, disruptive and transformative technologies. Analysis of genomics survey data to identify
gaps in genomic education, and development of educational programs to correct these gaps. Utilization of patient modeling
algorithms to identify pharmacogenomic interventions that can improve patient health and reduce healthcare costs across the
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 55 of 105
R-1 Line #6
Volume 1 - 117
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
307C / Core Force Health Protection R&D Clinical Translational Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
AFMS. Provide further analysis in educational interventions for the proper use of genetic testing within the AFMS. Research
for pharmacogenomics for anti-depressents and pain medication within the AFMS. Analysis of methodologies and challenges
associated with the establishment of an AFMS genome data repository for future implementation of genomic medicine. To
augment capabilities for genomic research within the AFMS, the USAF will continue participation in National Human Genome
Institute pharmacogenomic research projects. Continue to develop a high-content, rapid throughput toxicological capability with
pluripotent cells allowing for a rapid screening of possible threats in the aerospace environment. Develop methodologies that a
extremely light weight and easy to use for Air Force Special Operators to diagnose pathogens with almost no medical support in
the field. Perform a comprehensive study of aircraft breathing air quality across the Air Force fleet to ensure risks are understood
and mitigated if needed. Complete evaluating foreign made, clinical lasers to validate that the devices meet U.S. safety and health
standards. Complete the investigation of biomarkers associated with laser lesions, which is exploring the biophysical interactions
between directed energy and biological tissue at optical frequencies. Continue developing a retinal injury atlas database for use
by clinicians and further apply data to perform a bioinformatics-based analysis of retinal injury treatment alternatives. Continue
studying high-powered microwave exposures to establish dose-response relationships. Continue developing and testing prototype
devices to detect and quantify lasers used to illuminate aircraft and characterize the health threat to exposed aircrew and pilots.
Complete the transition to the AF public health community a recently developed compact, insulated, leak-proof, laboratoryapproved transport system for shipping contaminated food samples from remote locations to an analytical laboratory. Complete
the technology transfer to the civilian public health sector. Complete research to develop miniaturized sensors to identify hypoxic/
toxic aircrew environments. Continue research to perform high-content, rapid throughput screening with pluripotent cells allowing
for rapid determination of possible toxic threats in the aerospace environment. Develop new and innovative technologies to detect
and assess hazardous chemical, biological, and physical agents relevant to AF deployment and garrison operations. Initiate
studies identified the Problem Definition Study (PDS) and research strategy to detect and characterize airborne pollution hazards
(to include burn pits) in the deployed environment. Continue field testing of smaller/more capable sensors for monitoring remote
environmental health hazards and physiological parameters. Continue identifying and characterizing health effects associated with
exposure to AF-relevant nanomaterials.Continue AFMS Innovation demonstration initiatives, including process improvements,
leadings practices, disruptive and transformative technologies. Continued support for the AFMS Clinical Utility Study to include
initial analysis of impact of genomic risk data on study participants. Analysis of recruited AF cohorts for diseases and conditions
of operational importance. Continued support for research into educational interventions for the proper use of genetic testing
within the AFMS and pharmacogenomics research regarding the use of anti-depressants and pain medication within the AFMS.
Implementation of genomic education program at USAF testing facility to measure impact of education on genetic test utilization,
clinical care, and patient outcomes. Pharmacogenomic demonstration projects at AFMS sites and AF MTFs to test the impact on
patient health and healthcare costs. Investigation of methodologies and requirements for Air Force Medical System bioinformatics
tools and processes, including the development of the AFMS digital Biobank and the integration of genomic data into clinical
workflow through the development of predictive modeling clinical decision support tools that integrate with Electronic Medical
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 56 of 105
R-1 Line #6
FY 2014
FY 2015
FY 2016
Volume 1 - 118
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
307C / Core Force Health Protection R&D Clinical Translational Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Records. Continue to develop a high-content, rapid throughput toxicological capability with pluripotent cells allowing for a rapid
screening of possible threats in the aerospace environment.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 1.000
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 57 of 105
R-1 Line #6
Volume 1 - 119
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
307D: Core Force Health
Protection R&D - Aerospace
Medicine/Human Performance
Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
1.000
FY 2016
OCO
FY 2016
Total
- 1.000
FY 2017
1.500
Project (Number/Name)
307D / Core Force Health Protection R&D Aerospace Medicine/Human Performance
Focus (AF)
FY 2018
FY 2019
2.235
2.375
Cost To
FY 2020 Complete
Total
Cost
2.463 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area conducts research to Identify, evaluate and control occupational hazards in the workplace-including all settings such as deployed, in the aircraft, in
the industrial (in garrison) environment or during emergency response. Information gained means risks are more fully understood with respect to potential mission
impact or long-term health effect (Go vs. No Go above some pre-defined hazard level). Key focus areas include a better understanding of dosing, rates of dosing, and
mechanistic effects of chemical, biological, radiological, directed energy, and other occupational exposure threats. This includes subtle cognitive effects where there is
potential mission impact. Technological opportunities towards non-invasive sensing of the human and the environment are growing and can be exploited to enhance
understanding of the risks and enable development of appropriate mitigation and treatment options
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Force Health Protection R&D - Aerospace Medicine/Human Performance Focus (AF)
FY 2015
- FY 2016
1.000
Description: This project area conducts research to Identify, evaluate and control occupational hazards in the workplaceincluding all settings such as deployed, in the aircraft, in the industrial (in garrison) environment or during emergency response.
Information gained means risks are more fully understood with respect to potential mission impact or long-term health effect (Go
vs. No Go above some pre-defined hazard level). Key focus areas include a better understanding of dosing, rates of dosing, and
mechanistic effects of chemical, biological, radiological, directed energy, and other occupational exposure threats. This includes
subtle cognitive effects where there is potential mission impact. Technological opportunities towards non-invasive sensing of the
human and the environment are growing and can be exploited to enhance understanding of the risks and enable development of
appropriate mitigation and treatment options
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Continue to develop a high-content, rapid throughput toxicological capability with pleuripotent stem-cells allowing for a rapid
screening of possible threats in the aerospace environment. Develop and validate devices or methods that are extremely light
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 58 of 105
R-1 Line #6
Volume 1 - 120
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
307D / Core Force Health Protection R&D Aerospace Medicine/Human Performance
Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
weight and easy to use for Air Force Special Operators to diagnose pathogens with almost no medical support in the field.
Perform comprehensive study of aircraft breathing air quality across the Air Force fleet to ensure risks are understood and
mitigated if needed. Develop capabilities for remote sensing. Develop capabilities to efficiently and effectively continuously
monitor personnel exposures, securely transmit the information and capture in searchable database for future reference.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 1.000
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 59 of 105
R-1 Line #6
Volume 1 - 121
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
308B: Expeditionary Medicine
Research & Development
(Budgeted) (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
2.847
FY 2015
4.769
4.699
FY 2016
Base
1.180
FY 2016
OCO
FY 2016
Total
- 1.180
FY 2017
1.160
FY 2018
Project (Number/Name)
308B / Expeditionary Medicine Research &
Development (Budgeted) (AF)
FY 2019
1.560
1.640
Cost To
FY 2020 Complete
Total
Cost
1.673 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area identifies cutting edge techniques and technologies that can be employed by AF medics during contingency operations. Sub-project areas include:
Expeditionary Logistics and Expeditionary Casualty Care. Expeditionary Logistics seeks to develop/validate novel procedures, materials, techniques, and tools to
reduce size and weight, optimize power requirements, and minimize logistics footprint associated with expeditionary operations. It also examines ways to standardize
equipment and supplies used by medical response teams because of the increasing number of missions that find teams from different countries working together.
Expeditionary Casualty Care focuses on optimizing existing and developing new casualty care tools and techniques, improving methods and techniques for remote
monitoring and triage systems, identifying and mitigating issues related to casualty care in an expeditionary setting, and validation of best-fit technologies in casualty
care missions.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
4.769
Title: Expeditionary Medicine Research & Development (Air Force)
FY 2015
4.699
FY 2016
1.180
Description: This project area identifies cutting edge techniques and technologies that can be employed by AF medics during
contingency operations. Sub-project areas include: Expeditionary Logistics and Expeditionary Casualty Care. Expeditionary
Logistics seeks to develop/validate novel procedures, materials, techniques, and tools to reduce size and weight, optimize power
requirements, and minimize logistics footprint associated with expeditionary operations. It also examines ways to standardize
equipment and supplies used by medical response teams because of the increasing number of missions that find teams from
different countries working together. Expeditionary Casualty Care focuses on optimizing existing and developing new casualty
care tools and techniques, improving methods and techniques for remote monitoring and triage systems, identifying and mitigating
issues related to casualty care in an expeditionary setting, and validation of best-fit technologies in casualty care missions.
FY 2014 Accomplishments:
Transition the Trauma Specific Vascular Injury Shunt device, and proceed to fielding and procurement. Initiate research on
therapeutic drugs given by first responders to slow body functions providing more time to transfer of seriously wounded to
definitive care. Continue research on a novel technique for infection control of traumatic wounds, predicting blood needs using
pre-hospital vital signs, and hemorrhagic shock resuscitation. Pursue additional research to mature the multi-channel negative
pressure wound treatment system and continue to address advanced development issues. Continue research addressing needs
related to Expeditionary Casualty Care and Expeditionary Logistics. Completed the FDA approval process for the Trauma Specific
Vascular Injury Shunt (TS-VIS). Completed follow on studies evaluating applied predictive algorithms for the continuous noninvasive monitoring of patient status in order to predict actionable interventions. Evaluated clinical utility of prototype laser device
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 60 of 105
R-1 Line #6
Volume 1 - 122
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
308B / Expeditionary Medicine Research &
Development (Budgeted) (AF)
B. Accomplishments/Planned Programs ($ in Millions)
for hemorrhage control and tissue cutting and archived results for future inquiries. Transitioned Virtual Medical Trainer (09)
software platform for preparing leaders and decision makers to hone communication and planning skills for interagency disaster
response efforts. Completed testing of predictive algorithms in field-deployable burn diagnostic tool to ultimately improve longterm prognosis. Completed research on predicting oxygen needs based on clinical variables and testing novel techniques for
infection control of traumatic wounds to include a bioelectric dressing and topical agent for antibiotic resistant bacteria. Continued
studies for predicting blood needs using pre-hospital vital signs, development of portable sterilization technology for surgical
instruments in remote setting.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
Continue research and development of therapeutic interventions to sustain life through transfer to definitive care to include
research on blood sparing drugs for hemorrhagic shock resuscitation and treatment for neuroprotection, rhabdomyolysis
and ischemia-reperfusion injury. Complete research on coagulopathy, hemorrhagic shock resuscitation and other life-saving
interventions (LSIs), and development of portable sterilization technology for surgical instruments in remote settings. Build
on ongoing work with concentration on therapeutic interventions to sustain life through transfer to definitive care. Continue
development of multi-channel negative pressure wound treatment system. Complete transitioning and fielding of TS-VIS via
commercial or advanced development partners. Continue research addressing needs related to Expeditionary Casualty Care and
Expeditionary Logistics.
FY 2016 Plans:
Continue research and development of therapeutic interventions to sustain life through transfer to definitive care to include
research on blood sparing drugs for hemorrhagic shock resuscitation and treatment for neuroprotection, rhabdomyolysis and
ischemia-reperfusion injury. Transition multi-channel negative pressure wound treatment system to advanced development.
Support advanced development of TS-VIS if necessary. Continue research addressing needs related to Expeditionary Casualty
Care and Expeditionary Logistics.
Accomplishments/Planned Programs Subtotals
4.769
4.699
1.180
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Broad Area Announcement (BAA) and Intramural calls for proposal are used to award initiatives in this program and project following determinations of scientific and
technical merit, validation of need, prioritization, selection and any necessary legal and/or regulatory approvals (IRB, etc).
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 61 of 105
R-1 Line #6
Volume 1 - 123
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
308B / Expeditionary Medicine Research &
Development (Budgeted) (AF)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 62 of 105
R-1 Line #6
Volume 1 - 124
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
308C: Core Expeditionary
Medicine R&D - Clinical
Translational Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
1.503
FY 2016
OCO
FY 2016
Total
- 1.503
FY 2017
1.500
FY 2018
Project (Number/Name)
308C / Core Expeditionary Medicine R&D Clinical Translational Focus (AF)
FY 2019
1.497
1.501
Cost To
FY 2020 Complete
Total
Cost
1.531 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area identifies cutting edge techniques and technologies that can be employed by AF medics during contingency operations. Sub-project areas include:
Expeditionary Logistics and Expeditionary Casualty Care. Expeditionary Logistics seeks to develop/validate novel procedures, materials, techniques, and tools to
reduce size and weight, optimize power requirements, and minimize logistics footprint associated with expeditionary operations. It also examines ways to standardize
equipment and supplies used by medical response teams because of the increasing number of missions that find teams from different countries working together.
Expeditionary Casualty Care focuses on optimizing existing and developing new casualty care tools and techniques, improving methods and techniques for remote
monitoring and triage systems, identifying and mitigating issues related to casualty care in an expeditionary setting, and validation of best-fit technologies in casualty
care missions.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Core Expeditionary Medicine R&D - Clinical Translational Focus (AF)
FY 2015
- FY 2016
1.503
Description: This project area identifies cutting edge techniques and technologies that can be employed by AF medics during
contingency operations. Sub-project areas include: Expeditionary Logistics and Expeditionary Casualty Care. Expeditionary
Logistics seeks to develop/validate novel procedures, materials, techniques, and tools to reduce size and weight, optimize power
requirements, and minimize logistics footprint associated with expeditionary operations. It also examines ways to standardize
equipment and supplies used by medical response teams because of the increasing number of missions that find teams from
different countries working together. Expeditionary Casualty Care focuses on optimizing existing and developing new casualty
care tools and techniques, improving methods and techniques for remote monitoring and triage systems, identifying and mitigating
issues related to casualty care in an expeditionary setting, and validation of best-fit technologies in casualty care missions.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
Continue research and development of therapeutic interventions to sustain life through transfer to definitive care to include
research on blood sparing drugs for hemorrhagic shock resuscitation and treatment for neuroprotection, rhabdomyolysis and
ischemia-reperfusion injury. Transition multi-channel negative pressure wound treatment system to advanced development.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 63 of 105
R-1 Line #6
Volume 1 - 125
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
308C / Core Expeditionary Medicine R&D Clinical Translational Focus (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Support advanced development of TS-VIS if necessary. Continue research addressing needs related to Expeditionary Casualty
Care and Expeditionary Logistics.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
- 1.503
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 64 of 105
R-1 Line #6
Volume 1 - 126
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
308D: Core Expeditionary
Medicine R&D - Aerospace/
Human Performance Focus (AF)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
1.502
FY 2016
Total
- 1.502
FY 2017
1.499
FY 2018
Project (Number/Name)
308D / Core Expeditionary Medicine R&D Aerospace/Human Performance Focus (AF)
FY 2019
1.497
1.500
Cost To
FY 2020 Complete
Total
Cost
1.530 Continuing Continuing
A. Mission Description and Budget Item Justification
This project area seeks to standardize training in use of deployed equipment and supplies because of the increasing number of missions that find teams from different
countries working together. Evaluation of skills required in an environment with a lack of air dominance and vast geographic distances in future theaters that increases
the tactical field care required and tactical evacuation care phases of casualty care in Role II care that may be unavailable for up to 48 hrs after injury and casualties will
be maintained by field providers. Determination of what is required to train peacetime military care providers military medical providers with minimal experience in prehospital or acute trauma/critical care yet expert delivery of this care is absolutely required in an austere, isolated environment
B. Accomplishments/Planned Programs ($ in Millions)
Title: Core Expeditionary Medicine R&D - Aerospace/Human Performance Focus (AF)
FY 2014
- FY 2015
- FY 2016
1.502
- - 1.502
Description: : This project area seeks to standardize training in use of deployed equipment and supplies because of the
increasing number of missions that find teams from different countries working together. Evaluation of skills required in an
environment with a lack of air dominance and vast geographic distances in future theaters that increases the tactical field care
required and tactical evacuation care phases of casualty care in Role II care that may be unavailable for up to 48 hrs after injury
and casualties will be maintained by field providers. Determination of what is required to train peacetime military care providers
military medical providers with minimal experience in pre-hospital or acute trauma/critical care yet expert delivery of this care is
absolutely required in an austere, isolated environment
FY 2014 Accomplishments:
No Funding Programmed.
FY 2015 Plans:
No Funding Programmed.
FY 2016 Plans:
Establish the optimal timing to establish a capability when and where needed as expected to meet the “golden hour” requirement
and hold patients until movement is available, stabilize and treat during transport, and provide effective, integrated HSS across
service lines. Assess what resuscitation goals (e.g. evidence-based markers) are required during various phases of patient
movement and different patient conditions to improve outcomes.
Accomplishments/Planned Programs Subtotals
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 65 of 105
R-1 Line #6
Volume 1 - 127
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
308D / Core Expeditionary Medicine R&D Aerospace/Human Performance Focus (AF)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Interagency Agreements and Interservice Support Agreements with the US Army, US Navy and the Department of Homeland Security are used to support ongoing
scientific and technical efforts within this program -- these agreements are supplemented with Broad Area Announcement (BAA) and Intramural calls for proposal
are used to award initiatives in this program and project following determinations of scientific and technical merit, validation of need, prioritization, selection and any
necessary legal and/or regulatory approvals (IRB, etc)
E. Performance Metrics
Individual initiatives are measured through a quarterly annual project performance reporting system and program management review process -- performance is
measured against standardized criteria for cost, schedule and performance (technical objectives) and key performance parameters. Variances, deviations and/or
breaches in key areas are reviewed and a decision is rendered on any adjustments through a formalized process of S&T governance.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 66 of 105
R-1 Line #6
Volume 1 - 128
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
309A: Regenerative Medicine
(USUHS)
FY 2014
6.877
FY 2015
7.031
9.190
FY 2016
Base
9.489
FY 2016
OCO
FY 2016
Total
- 9.489
FY 2017
9.646
FY 2018
9.823
Project (Number/Name)
309A / Regenerative Medicine (USUHS)
FY 2019
10.009
Cost To
FY 2020 Complete
Total
Cost
10.209 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Uniformed Services University of the Health Sciences (USUHS), the Center for Neuroscience and Regenerative Medicine (CNRM) brings together the expertise
of clinicians and scientists across disciplines to catalyze innovative approaches to traumatic brain injury (TBI) research. CNRM Research Programs emphasize aspects
of high relevance to military populations, with a primary focus on patients at the Walter Reed National Military Medical Center.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
7.031
Title: Regenerative Medicine (USUHS)
FY 2015
9.190
FY 2016
9.489
Description: The Center for Neuroscience and Regenerative Medicine (CNRM) brings together the expertise of clinicians
and scientists across disciplines to catalyze innovative approaches to traumatic brain injury (TBI) research. CNRM Research
Programs emphasize aspects of high relevance to military populations, with a primary focus on patients at the Walter Reed
National Military Medical Center. The CNRM has established 11 research cores and funded over 104 research projects.
FY 2014 Accomplishments:
-Natural history studies are identifying relevant outcome measures across the spectrum of TBI and co-morbid psychological health
issues. Military and civilian cohort studies are addressing the post-injury progression from hyper-acute through chronic stages.
This hyper-acute imaging is revealing changes that occur within the first hours and days after injury, demonstrating the importance
of early MRI to better diagnose brain injury.
-Under the Acute Studies Core, established productive clinical research program to address acute TBI injuries at Virginia
Commonwealth University, Suburban Hospital and Washington Hospital Center that has resulted in recruitment of more than 300
participants into acute TBI studies with imaging. These early clinical interactions are also directly connected to longitudinal follow
up at the NIH CC with potential for recruitment into other CNRM studies.
-Across the spectrum of TBI severity and times post-injury, 2,719 patients have enrolled in CNRM clinical research protocols
through 2014.
-TBI clinical database has been implemented with policies for submission and sharing across CNRM investigators and institutions
at USU, WRNMMC, and NIH, Importantly, the CNRM database is aligned with the Federal Interagency TBI Research (FITBIR)
database.
-State-of-the-art neuropathological center established under Dr. Dan Perl with infrastructure for brain specimen acquisition,
evaluation, storage, and distribution. This brain repository is the first dedicated to military service members.
-Advanced neuroimaging capabilities, including: acquisition of simultaneous human MRI and PET, improving diffusion imaging
for clinical requirements, testing novel PET ligands for inflammation and neurodegeneration. The CNRM Siemens Biograph mMR
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 67 of 105
R-1 Line #6
Volume 1 - 129
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
309A / Regenerative Medicine (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
System was the second installed in a U.S. clinical setting and the first to scan a human patient using simultaneous MRI and PET.
771 subjects have been scanned through July 31,2014.
-The Translational Imaging core continues to develop novel scanning protocols for rodent microPET, microCT, and 7T MR,
especially as relevant to specialized needs for TBI pathologies and with consideration of comparison with the human scanning
applications.
-The Image Processing Core has implemented a database platform for managing the CNRM Imaging Repository with integration
of the database with the Informatics database addressed following initial deployment.
-CNRM researchers are detecting molecular biomarkers of inflammation and neurodegeneration, including auto-antibodies that
persist in blood and allow identification of transient responses to central nervous system damage. The center is collaborating
in the biomarkers component of the Chronic Effects of Neurotrauma Consortium, a multi-site Veterans Affairs and Defense
Department effort.
-Pre-clinical studies across multiple TBI models are identifying mechanisms of CNS damage and repair, including molecular
and cellular substrates of neuroregeneration and neuroplasticity. The range of TBI models is particularly designed to address
the spectrum of injury experienced by military service members. A state-of-the-art Advanced Blast Simulator is being used for
pathological, imaging, and behavioral analyses.
-Hosted the annual National Capital Area TBI Research Symposium with no registration fees. The symposium has brought
together scientists from local institutions and organizations to network, exchange data and ideas, and advance TBI research and
treatment.
-CNRM research project information was uploaded into the Federal RePORTER database in spring 2014. This contribution now
allows project information to be publicly available and easily searchable, thus paving the way for other Defense Department
funding agencies to follow suit.
-Through summer-2014, CNRM has published over 140 peer-reviewed publications. In addition, CNRM researchers have
presented at numerous national and international conferences.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
CNRM objectives include: (1) Continue interdisciplinary, collaborative studies that bring together expertise across USU,
WRNMMC, and intramural NIH to address the highest priority TBI research in diagnosis through treatment and recovery as
relevant to military service members; (2) Continue operational capability of all Cores to provide efficient research infrastructure
with high quality resources and technical expertise; (3)Fund start-up research of one new USU Radiology faculty member to
maintain translational neuroimaging capability; (4) Define focus areas of next research stage and best funding format for those
directions, optimize research teams, and support new research projects pending availability of FY15-16 funding; (5) Disseminate
findings of CNRM basic, translational, and clinical research; (6) Host internal CNRM data discussions to foster cross-fertilization
of expertise and innovative development across basic, translational, and clinical research; (7) Host annual research symposium
to foster interaction between CNRM investigators and other local research organizations; (8) Support open data access to
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 68 of 105
R-1 Line #6
Volume 1 - 130
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
309A / Regenerative Medicine (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
completed clinical studies to qualified federal and academic investigators; (9) Provide human brain and biofluids specimens for
use in approved research protocols within CNRM and to other qualified federal and academic investigators; (10) Partner with
other funding agencies and commercial entities to advance translation of CNRM research; (11) Merge the research work of the
Neuroscience Center of Excellence (MCNCoE)through development of research fellowship program.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
CNRM objectives include: (1) Continue interdisciplinary, collaborative studies that bring together expertise across USU,
WRNMMC, and intramural NIH to address the highest priority TBI research in diagnosis through treatment and recovery as
relevant to military service members; (2) Continue operational capability of all Cores to provide efficient research infrastructure
with high quality resources and technical expertise; (3)Fund start-up research of one new USU Radiology faculty member to
maintain translational neuroimaging capability; (4) Define focus areas of next research stage and best funding format for those
directions, optimize research teams, and support new research projects pending availability of FY16-17funding; (5) Disseminate
findings of CNRM basic, translational, and clinical research; (6) Host internal CNRM data discussions to foster cross-fertilization
of expertise and innovative development across basic, translational, and clinical research; (7) Host annual research symposium to
foster interaction between CNRM investigators and other local research organizations; (8) Support open data access to completed
clinical studies to qualified federal and academic investigators; (9) Provide human brain and biofluids specimens for use in
approved research protocols within CNRM and to other qualified federal and academic investigators; (10) Partner with other
funding agencies and commercial entities to advance translation of CNRM research;(11) Support fellowship program to facilitate
neuroscience and regenerative medicine research capabilities at DoD sites in NCA.
Accomplishments/Planned Programs Subtotals
7.031
9.190
9.489
C. Other Program Funding Summary ($ in Millions)
FY 2016
FY 2016
FY 2016
Cost To
Line Item
FY 2014
FY 2015
Base
OCO
Total
FY 2017
FY 2018
FY 2019
FY 2020 Complete Total Cost
• BA-1, 0806721HP:
8.755
8.912
9.090
- 9.090
9.272
9.458
9.647
9.840 Continuing Continuing
Uniformed Services University
of the Health Sciences
Remarks
Provides funding to conduct Natural History study; Infrastructure to support the CNRM program; and salaries of neuroscience faculty and technical and administrative
support personnel.
D. Acquisition Strategy
N/A
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 69 of 105
R-1 Line #6
Volume 1 - 131
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
309A / Regenerative Medicine (USUHS)
E. Performance Metrics
Center for Neuroscience and Regenerative Medicine: In FY14 through FY16, identify, design protocols, perform scientific and program reviews, and conduct research in
Clinical Core activities such as Phenotyping, Imaging and Imaging Analysis, to aid in patient diagnosis and evaluation.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 70 of 105
R-1 Line #6
Volume 1 - 132
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
373A: GDF - Medical
Technology Development
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
128.139
FY 2015
168.541
113.048
FY 2016
Base
116.775
FY 2016
OCO
FY 2016
Total
- 116.775
FY 2017
134.178
FY 2018
Project (Number/Name)
373A / GDF - Medical Technology
Development
FY 2019
149.012
150.022
Cost To
FY 2020 Complete
Total
Cost
149.701 Continuing Continuing
A. Mission Description and Budget Item Justification
Guidance for Development of the Force - Medical Technology Development provides funds for promising candidate solutions that are selected for initial safety and
effectiveness testing in animal studies and/or small-scale human clinical trials regulated by the US Food and Drug Administration prior to licensing for human use.
Research in this PE is designed to address the following: areas of interest to the Secretary of Defense regarding Wounded Warriors, capabilities identified through
the Joint Capabilities Integration and Development System, and sustainment of priority investments in science, technology, research and development as stated in
the Quadrennial Defense Review. Program development and execution is peer reviewed and fully coordinated with all of the Military Services, appropriate Defense
Agencies or Activities and other Federal Agencies, to include the Department of Veterans Affairs, the Department of Health and Human Services, and the Department of
Homeland Security. This coordination occurs through the planning and execution activities of the Joint Program Committees (JPCs), established for the Defense Health
Program (DHP) Research Development Test and Evaluation (RDT&E) funding. Research supported by this PE includes(JPC-1): medical simulation, health informatics,
(JPC-2): wound infection prevention and management, antimicrobial countermeasures, diagnostic systems for infectious diseases, (JPC-5): injury prevention and
reduction, psychological health and resilience, physiological health, environmental health and protection, (JPC-6): hemorrhage (bleeding) and resuscitation, neurotrauma
(diagnosis and treatment of brain injury), traumatic tissue injury, forward surgical intensive critical care, joint en route care, military medical photonics, and (JPC-8):
rehabilitation of neuro-musculoskeletal injuries, pain management, regenerative medicine, and sensory system traumatic injury, restoration and rehabilitation. As
research efforts mature, the most promising will transition to advanced concept development funding, PE 0604110. For knowledge products, successful findings will
transition into clinical practice guidelines.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
168.541
Title: GDF – Medical Technology Development
FY 2015
113.048
FY 2016
116.775
Description: Funds provide for the development of medical technology candidate solutions and components of early prototype
systems for test and evaluation. Promising drug and vaccine candidates, knowledge products, and medical devices and
technologies are selected for initial safety and effectiveness testing in small scale human clinical trials.
FY 2014 Accomplishments:
The medical simulation and information sciences research program conducted research in two primary research portfolios:
Medical Simulation and Training, and Health Informatics and Information Technology. Medical simulation and training focused
on research to support combat medic training and inform decisions regarding the reduction and refinement of live-tissue training.
Began development of open-source virtual tissue advancement program to better understand the tissue characteristics needed
to integrate into medical models for future simulations. Additional emphasis was placed on the technologies to teach and train
effective team performance. Health informatics and information technology progressed in evaluating algorithms to provide nurses
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 71 of 105
R-1 Line #6
Volume 1 - 133
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
with appropriate medical information to inform better decisions. Progress was also made in developing a test environment for
electronic health records, allowing developers a robust environment to optimize products before launch to live systems.
FY 2014
FY 2015
FY 2016
The military infectious diseases research program funded a multi-year, clinical study for development of an antibacterial drug
against multiple drug resistant bacteria to mitigate hard to treat wound infections. A study in humans evaluated safety and
effectiveness of a bacteriophage (viruses in bacteria) cocktail against Staphylococcus aureus (a drug-resistant bacteria) with
the aim to develop novel skin and soft tissue infection treatment options. An additional study was initiated to reduce surgical
site infection rates during complex combat-related wounds, which will help reduce the need for an extended course of systemic
antibiotics, irrigation, and surgical debridement. Evaluated effectiveness to detect bacterial infections in wounds aimed to reduce
excess empiric antibiotic use while awaiting conventional culture and susceptibility results. Research was initiated on the Next
Generation Diagnostic Systems to detect malaria, dengue, and chikungunya.
Military operational medicine research is grouped into four portfolios of injury prevention and reduction, psychological health
and resilience, physiological health, and environmental health and protection. Injury prevention and reduction developed
standards for low level, repetitive blast exposures during breaching (process used to force open closed and/or locked doors),
developed performance and musculoskeletal health metrics (pertaining to muscle and bone health)for Warfighters in military
training environments, and developed blast and auditory injury models to provide medical injury criteria. Psychological health
and resilience evaluated behavioral interventions to treat alcohol and substance abuse, determined the feasibility of cognitive
behavioral interventions (a type of therapy that focuses on examining the relationships among thoughts, feelings and behaviors)
for the treatment of PTSD, evaluated interventions to build resiliency in military families and Warfighters, and initiated efforts
to improve accurate suicide prevention screening and delivery of innovative peer leader-led suicide prevention interventions.
Physiological health developed guidelines for nutritional supplementation to minimize injuries during initial military training and
developed interventions for dietary and weight loss in Warfighters. Environmental health and performance measured health
effects of chemical exposures (e.g., permethrin, an insecticide used to treat uniforms), measured biomarkers of pulmonary health
(pertaining to the lungs) from exposures to toxic substances in the deployed environment to assess health and disease outcomes,
and developed decision aids for managing thermal physiological strain.
Combat casualty care is grouped into portfolios for hemorrhage and resuscitation, neurotrauma, traumatic tissue injury, forward
surgical intensive critical care, joint enroute care, and military medical photonics. Hemorrhage and resuscitation developed
platelet-derived agents to stop bleeding and modulate immune inflammatory responses, foams to stop internal bleeding,
enhanced storage of red blood cells, and low blood volume resuscitation techniques, conducted a clinical trial on using plasma
first during resuscitation of traumatic hemorrhages, developed techniques to reduce pathogens in whole blood. Neurotrauma
developed biomarkers (substance, such as a protein, indicating the presence of a condition) for TBI, developed a prehospital
drug for TBI, conducted a clinical trial on Eye-Trac technology to diagnose and assess TBI, conducted a pivotal clinical trial
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 72 of 105
R-1 Line #6
Volume 1 - 134
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
on a preconditioning oral nutritional supplement as a possible treatment for TBI, and developed neuroassessment protocols
to standardize treatment practice. Traumatic tissue injury conducted research on face restoration, orthopedic advances, and
compartment syndrome (a life-threatening condition resulting from injury wherein increased pressure occurs within legs or arms).
The traumatic tissue injury program also conducted outcomes-related research on genitourinary injury (a follow-up to the basic
epidemiology study done earlier, looking at long-term outcomes). Forward surgical intensive critical care conducted a clinical
study on a technique using an endovascular (minimally invasive surgery to access regions of the body via major blood vessels)
balloon to open occlusions of the aorta in severe pelvic fracture and hemorrhagic shock cases, started research on intensive care
interventions with the Joint Trauma System in the US Army Institute of Surgical Research. Joint enroute care conducted research
on real-time, physiologic monitoring across the battle space, supported a patient immobilization effort, developed improved field
management and safe air transport of patients with head and spine injuries, developed a joint-force aeromedical transport litter
immobilization and stabilization platform, and developed an enroute care registry to better track best practices. Military medical
photonics developed optical technology for military medical applications with a focus on the use of lasers, spectroscopy, and
imaging.
FY 2014
FY 2015
FY 2016
Clinical and rehabilitative medicine advanced studies in neuromusculoskeletal injury rehabilitation, pain management,
regenerative medicine, and sensory system restoration and rehabilitation after traumatic injury. Extended studies started in
FY13 to support development and preclinical evaluations of candidate technologies for restoration and rehabilitation strategies
and medical products. In pain management, a pain outcome registry tracked treatment results and created evidence-based
clinical guidelines for care, studied the effects of a treatment drug on burn pain, and evaluated methadone and opioid related
adverse events. Regenerative medicine initiated clinical studies for craniomaxillofacial intraoral defects (defects within the mouth),
immunomodulation strategies for composite tissue allotransplantation (hand and face transplantation), and skin coverage following
burn injury. Sensory systems research started studies to verify the prevalence of central auditory processing disorders in blastexposed Warfighters, evaluated computerized oculomotor (eye motion) vision screening to expedite the diagnosis of TBI-related
oculomotor dysfunctions in a military population, studied the effects of blast exposure on the hearing of deployed Navy and Marine
Corps personnel, and evaluated cochlear implants to improve hearing for active duty Service members.
FY 2015 Plans:
Medical simulation and information sciences research program is focusing in two primary research portfolios: Medical simulation
and training and health informatics and information technology. Medical simulation and training research is continuing
development of an open source virtual tissue advancement model that will be open to developers and end-users, allowing them to
focus on content creation into a variety of simulation system tools and for end-users to better validate simulation systems. Medical
simulation is supporting research to improve the realism of virtual standardized patients (avatars) used for high volume scenario
rehearsal as well as for those hard-to-come-by cases, through improved artificial intelligence and realistic body language within a
medical context. Medical simulation is releasing a program announcement focused on effective ways to interface with technology
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 73 of 105
R-1 Line #6
Volume 1 - 135
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
through gestures or facial expressions that are military medically relevant. Medical simulation is also requesting proposals via a
program announcement to improve en route care methods for wounded Service members. This effort is focusing on the hand-offs
and transfer of patients between providers.
FY 2014
FY 2015
FY 2016
Military infectious diseases research is focusing on Next Generation Diagnostic Systems, where we are developing the capability
to detect malaria, dengue, and chikungunya, achieving TRL-6, and preparing for transition to Medical Countermeasure Systems
for advanced development. Evaluating the results of the bacteriophage (a group of viruses that infect and replicate in bacteria)
study to determine a path forward. The wound infection prevention and management host/pathogen biomarker project, for
detection of bacterial infection in wounds, is completing laboratory and initial animal studies to confirm its effectiveness and
accuracy. Under antimicrobial countermeasures, clinical studies continue for the development of an antibacterial drug against
multiple drug resistant bacteria and to reduce surgical site infection rates that often occur with complex combat-related wounds.
Several studies are also being initiated for the development of antibacterial or other wound infection prevention strategies.
Military operational medicine research is grouped into four portfolios of injury prevention and reduction, psychological health
and resilience, physiological health, and environmental health and protection. Injury prevention and reduction is validating blast
and auditory injury models to deliver guidelines for medical injury criteria, validating medical criteria standards for low level,
repetitive blast exposures during breaching (process used to force open closed or locked doors), and verifying performance and
musculoskeletal health metrics of Service members in military training environments. Psychological health is determining the
effectiveness of behavioral interventions to treat alcohol and substance abuse, evaluating cognitive behavioral interventions (a
type of therapy that focuses on examining the relationships among thoughts, feelings and behaviors) for the treatment of PTSD,
improving interventions to build resiliency in military families and Warfighters, and improving accuracy of suicide prevention
screening. Physiological health is evaluating interventions to promote and sustain weight loss in Warfighters and military families,
and validating a policy for vitamin supplementation to reduce injuries during operational and training scenarios. Environmental
health and performance is validating decision aids for managing thermal physiological work strain (ability to perform work tasks
safely in hot environments), determining health outcomes of chemical exposures (e.g., permethrin, an insecticide used to treat
uniforms), determining specific biomarkers of pulmonary health (pertaining to the lungs) from exposures to toxic substances in the
deployed environment and specific stress response biomarkers of mild and moderate dehydration for assessing hydration status
of Warfighters.
Combat casualty care is grouped into portfolios for hemorrhage and resuscitation, neurotrauma, traumatic tissue injury, forward
surgical intensive critical care, joint enroute care, and military medical photonics. Hemorrhage and resuscitation is conducting
clinical assessments of new agents that control severe internal bleeding and can be administered by first responders at or near
the point of injury, developing multiple new TBI diagnostic approaches that when used together provide a more comprehensive
diagnosis than what is currently available, evaluate ability to control the immune inflammatory response in hemorrhage.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 74 of 105
R-1 Line #6
Volume 1 - 136
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Neurotrauma is pursuing successful efforts from FY14 in developing biomarkers (substance, such as a protein, indicating the
presence of a condition) for TBI, validating results of a clinical trial on Eye-Trac technology to diagnose and assess TBI, and
finalizing neuroassessment protocols to standardize treatment practice. Traumatic tissue injury is continuing work on cellular
and extracorporeal therapies for acute lung injury and fracture putty for improved bone fracture repairs. In addition the portfolio
is developing strategies for maxillofacial (mouth, jaw, and neck) stabilization techniques for initial wound coverage and potential
treatments and conducting studies to understand the impact of both the injuries and certain treatments on long term outcomes.
Forward surgical intensive critical care is supporting development of a virtual intensive care unit linking patient movement and
medical support providers at all levels within the theater of operations, developing guidelines for resuscitative interventions,
including comprehensive resuscitation and rewarming of casualties after severe blood loss, continuing a FY14 clinical study using
an endovascular (minimally invasive surgery to access regions of the body via major blood vessels) balloon to open occlusions
(blocked blood vessels) of the aorta in severe pelvic fracture and hemorrhagic shock cases, and conducting a pilot clinical study
of bioengineered blood vessels for vascular trauma. Joint enroute care is continuing the evaluation of the joint-force aeromedical
air transport litter immobilization and stabilization platform, with emphasis on patient safety, impact of transport, and medical
technology. Military medical photonics is developing technologies that focus on the use of advanced optical technologies,
including lasers, spectroscopy, and imaging.
FY 2014
FY 2015
FY 2016
Clinical and rehabilitative medicine is continuing efforts and down-selecting products for advanced development for
neuromusculoskeletal (system of nerves, muscles, and bones that enable movement) injury rehabilitation, pain management,
regenerative medicine, and sensory system restoration and rehabilitation after traumatic injury. Neuromusculoskeletal injury
rehabilitation is evaluating the safety and effectiveness of candidate technologies for restoration and rehabilitation medical
products. Pain management is tracking methadone and opioid related adverse events; developing novel treatments to control
pain, to include battlefield pain, burn pain, neuropathic (nervous system) pain, and chronic pain after amputation; studying
modulation of inflammatory cells as an approach to mitigate spinal cord injury neuropathic pain; studying effects of peripherally
administered opioids, and developing nerve blocks for knee and hip arthroplasty (joint replacement) in Veterans. Regenerative
medicine is focusing on novel approaches to engineer regeneration and repair of damaged muscle tissue, to repair nerve gap
injuries, to repair blood vascular injury, and evaluating methods to prevent tissue rejection of allografts (a tissue graft from a
donor). Sensory systems is conducting research to verify central auditory processing disorders in blast-exposed Warfighters,
evaluating computerized oculomotor vision screening to expedite the diagnosis of TBI-related oculomotor dysfunctions in a military
population, testing cochlear implants for active-duty Service members, clinically assessing pharmacotherapy of hidden noise
injury toward a molecular understanding of noise-induced hearing loss, developing a portable mild TBI screening device based
on evaluation of a patient’s gait, preventing noise damage to cochlear synapses, and developing a silica-collagen composite for
corneal replacement.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 75 of 105
R-1 Line #6
Volume 1 - 137
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Medical simulation and information sciences research will focus on the medical simulation and training portfolio. Medical
simulation will complete the virtual tissue advancement research which should provide open source resources to enable
developers to create more appropriate virtual tissue simulations. En route training research will continue addressing several
issues with providing care to wounded Service members during transport and transfer between providers. Research evaluating
the effectiveness of gaming in virtual environments with combat medics will be investigated. Will evaluate training metrics that
can best be translated into optimal patient outcomes. This will provide educators the building blocks to create better trainers in the
future and begin the long process of linking evidenced-based training to actual patient outcomes.
FY 2014
FY 2015
FY 2016
Military infectious diseases research will support a clinical trial to develop therapies for antibiotic-resistant bacteria. Positive
results in this clinical trial will be used to support further clinical testing. Skin and soft tissue infections in military trainees will
be studied under wound infection prevention and management. The information gained will be used to develop prevention
and treatment solutions that will protect the military training force from Staphylococcal skin infection. Progression from FY15
diagnostic assays for selected bacteria that are commonly found in wound infections will be developed for use on an already FDAapproved diagnostic system. These assays will result in quicker diagnosis and appropriate treatment.
Military operational medicine research is grouped into four portfolios of injury prevention and reduction, psychological health and
resilience, physiological health, and environmental health and protection. Injury prevention and reduction will develop low level
blast exposure guidelines and auditory injury standards for health hazard assessments, and will develop predictive models of
military performance and the likelihood of musculoskeletal (muscle and bone tissues) injury in military training and applicable to
operational environments. Psychological health will incorporate behavioral intervention regimens into clinical practice guidelines
for the treatment of alcohol and substance abuse, will compare cognitive behavioral interventions(a type of therapy that focuses
on examining the relationships among thoughts, feelings and behaviors)for the treatment of PTSD to current standards of care,
and will deliver validated interventions for enhanced resiliency in military families and Warfighters, as well as, more accurate
suicide prevention screening tools. Physiological health will develop dietary supplement interventions to promote resiliency
to brain injuries and sustain cognitive performance in Warfighters, and will transition policy and guidelines to the Services for
improved nutrition during training and operations that will sustain Warfighter performance, health and readiness. Environmental
health will incorporate decision aids for managing thermal physiological work strain into physiological health status monitoring
for Warfighters to provide extended health, performance and safety assessments, will develop strategies to mitigate adverse
health and disease outcomes of chemical exposures (e.g., permethrin, an insecticide used to treat uniforms), and will validate the
appropriate stress response biomarkers of pulmonary health (pertaining to the lungs) from exposures to toxic substances in the
deployed environment and specific stress response biomarkers of mild and moderate dehydration for assessing hydration status
of Warfighters.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 76 of 105
R-1 Line #6
Volume 1 - 138
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Combat casualty care research is grouped into portfolios for hemorrhage and resuscitation, neurotrauma, traumatic tissue injury,
forward surgical intensive critical care, joint enroute care, and military medical photonics. Hemorrhage and resuscitation will test
immune system modulating drugs to treat hemorrhagic shock, and evaluate drugs to control the immune inflammatory response
in hemorrhage. Neurotrauma will continue validating a multi-site collaborative TBI endpoints study to improve clinical trial design
to inform/accelerate FDA approval of TBI diagnostic tools and therapeutic agents. Traumatic tissue injury will continue the
development of a putty to repair fractures, address treatments for acute lung injury, enhance limb and craniofacial salvage, and
improve wound healing in the acute setting. Forward surgical intensive critical care will transition to advanced development the
vascular occlusion (blocked blood vessels) devices for the treatment of acute hemorrhage and technology to detect cardiovascular
collapse. Joint enroute care research will develop new patient immobilization technology, and study the physiologic impact of
patient transport. Military medical photonics will develop technologies that focus on the use of advanced optical technologies,
including lasers, spectroscopy, and imaging.
FY 2014
FY 2015
FY 2016
Clinical and rehabilitative medicine will transfer current efforts and down-select products to advanced development for
neuromusculoskeletal (system of nerves, muscles, and bones that enable movement) injury rehabilitation, pain management,
regenerative medicine, and sensory system restoration and rehabilitation after traumatic injury. Clinical and rehabilitative
medicine will support development of preclinical and pilot/early-phase clinical evaluations of candidate technologies for restoration
and rehabilitation strategies and medical products. Specific focus areas will include: neuromusculoskeletal injury rehabilitation
strategies and devices; prosthetics; (artificial device that replaces a missing body part); orthotics (devices used to support or
supplement a weakened joint or limb); neural interfaces (invasive and non-invasive methods of using the brain and/or nerves in
the arms and legs for device control and the prevention and treatment of heterotopic ossification (bone formation in soft tissue
following injury); novel therapeutics and devices for pain management; regenerative medicine-based approaches for limb and
digit salvage; craniomaxillofacial (skull, face and jaw) reconstruction; scarless wound healing; repair of skin injury resulting from
burns; composite tissue allotransplantation (tissue/organ transplantation between genetically different individuals) and associated
immune system modulation technologies; genitourinary (genital and urinary organs) restoration; and advancing diagnosis,
restoration and rehabilitation of injured and dysfunctional sensory systems, including vision (total orbit, cornea, retina, ocular
nerve), hearing (hair cells, tympanic membrane, cochlea, auditory nerve) and balance (vestibular complex).
Accomplishments/Planned Programs Subtotals
168.541
113.048
116.775
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 77 of 105
R-1 Line #6
Volume 1 - 139
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
373A / GDF - Medical Technology
Development
D. Acquisition Strategy
Mature and demonstrate safety and effectiveness of medical procedures, medical devices, and drug and vaccine candidates intended to prevent or minimize effects
from battlefield injuries, diseases, and extreme or hazardous environments. Milestone B packages will be developed to transition promising products into advanced
development.
E. Performance Metrics
Research is evaluated through In-Progress Reviews, quarterly and annual status reports, and Program Office and/or progress reviews to ensure that milestones
are being met and deliverables will be transitioned on schedule. The benchmark performance metric for transition of research conducted with medical technology
development funding will be the attainment of maturity level that is typical of Technology Readiness Level 6 or the equivalent for knowledge products.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 78 of 105
R-1 Line #6
Volume 1 - 140
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
378A: CoE-Breast Cancer
Center of Excellence (Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
13.077
FY 2014
FY 2015
11.965
8.664
FY 2016
Base
7.299
FY 2016
OCO
FY 2016
Total
- 7.299
FY 2017
5.709
FY 2018
Project (Number/Name)
378A / CoE-Breast Cancer Center of
Excellence (Army)
FY 2019
4.068
3.553
Cost To
FY 2020 Complete
Total
Cost
3.624 Continuing Continuing
A. Mission Description and Budget Item Justification
The Breast Cancer CoE (Army) provides a multidisciplinary approach as the standard of care for treating breast diseases and breast cancer. This approach integrates
prevention, screening, diagnosis, treatment and continuing care, incorporation of advances in risk reduction, biomedical informatics, tissue banking and translational
research. The project is based on a discovery science paradigm, leveraging high-throughput molecular biology technology and our unique clinically well-characterized
tissue repository with advances in biomedical informatics leading to hypothesis-generating discoveries that are then tested in hypothesis-driven experiments. The
objective of this research is to reduce the incidence, morbidity (illness), and mortality (death) of breast diseases and breast cancer among all military beneficiaries.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
11.965
Title: Breast Cancer Center of Excellence
FY 2015
8.664
FY 2016
7.299
Description: Provides a multidisciplinary approach as the standard of care for treating breast diseases and breast cancer.
FY 2014 Accomplishments:
In FY14, the Breast Cancer CoE (Army), also referred to as the Clinical Breast Care Project (CBCP), at Walter Reed National
Military Medical Center (WRNMMC) Bethesda continued to accrue subjects annually to the core CBCP protocols. The CBCP
continued to acquire, through consented protocol, specimens (normal and abnormal breast tissues and tumors, lymph nodes,
metastatic (spread of a cancer from one organ or part to another non-adjacent organ or part) deposits, blood and its components,
bone marrow) annually from subjects with all types of breast diseases and cancer. The repository continued to be utilized as the
basis for all molecular analyses in CBCP labs, as outlined in the CBCP Core Protocols allowing for global expression analysis of
the DNA, RNA, and protein features and as the basis for intramural and extramural collaborations for secondary usage research.
CBCP performed whole-genome DNA sequencing on DNA from 60 cases of breast cancer; continued the development of and
support of a robust laboratory information management system to ensure proper tracking of data acquisition and a clinically
relevant and laboratory research-linked prospective database to support translational research and ultimately support physician
decision making; continued development of an analytical system for integrative data analysis and mining, and further refined a
breast knowledge base to support research activities in CBCP; utilized Clinical Laboratory Workflow System as the data analysis
tool and integrated Armed Forces Health Longitudinal Technology Application (AHLTA) data from the military’s main electronic
medical record; identified research subjects at high-risk for development of breast cancer, and employed risk reduction strategies;
completed genomic and proteomic analysis of samples collected at various developmental stages of breast cancer; and presented
findings in peer-reviewed publications and at national meetings.
FY 2015 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 79 of 105
R-1 Line #6
Volume 1 - 141
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
378A / CoE-Breast Cancer Center of
Excellence (Army)
B. Accomplishments/Planned Programs ($ in Millions)
The Clinical Breast Care Project will continue performing whole genome DNA sequencing on DNA from cases of breast cancer;
continue development of and support of a robust laboratory information management system to ensure proper tracking of data
acquisition and a clinically relevant and laboratory research-linked prospective, database to support translational research and
ultimately support physician decision making; continue development of an analytical system for integrative data analysis and
mining, and further refine a breast knowledge base to support clinical and research activities in the Breast Cancer CoE; utilize
Clinical Laboratory Workflow System as the data analysis tool and integrated Armed Forces Health Longitudinal Technology
Application data from the military’s main electronic medical record; identify and counsel patients at high risk for development of
breast cancer, and employ risk reduction strategies; perform targeted research by conducting DNA and protein analysis of Stages
I, II, and III breast cancer, cancer found in the breast ducts and lobules, and pre-malignant breast lesions; and will present findings
in peer-reviewed publications and at national meetings.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
The Clinical Breast Care Project will conduct clinical studies to relate genomic and functional heterogeneity and metastasis with
breast cancer patient outcomes. The program will continue to collect and catalog breast cancer tumors and blood from DoD
beneficiaries and include donor consented samples in the Tissue and Blood libraries for analysis; conduct studies to determine
if there is a correlation between environmental chemical burden and molecular aberrations with breast cancer patient outcomes;
conduct human epidermal growth factor receptor 2 (HER2) targeted therapy optimization studies to gain a better understanding of
the molecular changes associated with alterations in HER2 expression. Results are expected to lead to a more precise diagnosis
and customized treatment plans of patients diagnosed with HER2+ breast cancer.
Accomplishments/Planned Programs Subtotals
11.965
8.664
7.299
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Disseminate medical knowledge products resulting from research and development through articles in peer-reviewed journals, revised clinical practice guidelines,
incorporation into training curriculum throughout the Military Health System, and other applicable means.
E. Performance Metrics
Performance is judged on the number of active protocols, the number of articles that appear in peer-reviewed journals, and the number of contact hours in support of the
training of residents and fellows in the Military Health System.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 80 of 105
R-1 Line #6
Volume 1 - 142
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
379A: CoE-Gynecological
Cancer Center of Excellence
(Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
11.425
FY 2014
FY 2015
10.707
7.570
FY 2016
Base
6.377
FY 2016
OCO
FY 2016
Total
- 6.377
FY 2017
4.989
FY 2018
Project (Number/Name)
379A / CoE-Gynecological Cancer Center of
Excellence (Army)
FY 2019
3.555
3.105
Cost To
FY 2020 Complete
Total
Cost
3.167 Continuing Continuing
A. Mission Description and Budget Item Justification
The Gynecologic Cancer Center of Excellence (Army) focuses on characterizing the molecular alterations associated with benign and malignant gynecologic disease
and facilitates the development of novel early detection, prevention and novel biologic therapeutics for the management of gynecologic disease. The objective of this
research is to reduce the incidence, morbidity (illness), and mortality (death) of gynecologic diseases among all military beneficiaries.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
10.707
Title: Gynecologic Cancer Center of Excellence (Army)
FY 2015
7.570
FY 2016
6.377
Description: The Gynecologic Cancer Center of Excellence focuses on characterizing the molecular alterations associated with
benign and malignant gynecologic disease and facilitates the development of novel early detection, prevention and novel biologic
therapeutics for the management of gynecologic disease.
FY 2014 Accomplishments:
The Gynecologic Cancer Center of Excellence conducted retrospective longitudinal (observations over long periods of historical
time) and prospective (observations during a current or future study period) validation studies of biomarker candidates from
our previous studies of gynecologic cancer metastasis and recurrence, patient survival, drug resistance and racial disparities
in cancer outcome. These investigations rely on collected specimens as well as external biospecimen (materials taken from
the human body, such as blood, plasma, urine, etc., that can be used for diagnosis and analysis) collections, such as the
Gynecologic Oncology Group (GOG)-249 randomized treatment trial and the Prostate, Lung, Ovarian and Colorectal (PLCO)
trial. The candidates identified in our preclinical models are being evaluated in human trials as surrogates/predictors of response
to progesterone/progestin and vitamin D. Hypotheses generated from systems-level integration of molecular studies were
evaluated using models of ovarian and endometrial (pertaining to the lining of the uterus) cancer. These novel hypotheses
establish the framework for the next generation of molecularly targeted therapeutics and diagnostic therapy for gynecologic
cancer patient management. Novel molecular candidates are being incorporated into a newly established ensemble of safety
and efficacy gynecologic cancer clinical trials aimed at directing endometrial or ovarian cancer patients with specific molecular
defects/alterations to tailored molecular targeting regimens, and testing new therapeutics for treatment of newly diagnosed and
recurrence/refractory (resistant, unresponsive to surgery or therapy) cancer patients. The intervention trial will remain open
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 81 of 105
R-1 Line #6
Volume 1 - 143
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
379A / CoE-Gynecological Cancer Center of
Excellence (Army)
B. Accomplishments/Planned Programs ($ in Millions)
to accrual to evaluate the effects of stress intervention on recurrence of disease in ovarian cancer, and to evaluate biomarker
changes in serial biofluids (biological fluids like blood, urine, breast milk, and cerebrospinal fluid).
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
The Gynecologic Cancer Center of Excellence conducts retrospective longitudinal and prospective validation studies of biomarker
candidates from our previous studies of gynecologic cancer metastasis and recurrence, patient survival, drug resistance and
racial disparities in cancer outcome. These investigations will rely on collected specimens as well as external biospecimen
(materials taken from the human body such as blood, plasma, urine, etc that can be used for diagnosis and analysis) collections,
such as the Gynecologic Oncology Group (GOG)-249 randomized treatment trial and the Prostate, Lung, Ovarian and Colorectal
(PLCO) trial. The candidates identified in preclinical models will be evaluated in human trials as surrogates/predictors of
response to progesterone/progestin and vitamin D. Hypotheses generated from systems-level integration of molecular studies
will be evaluated using models of ovarian and endometrial cancer. These novel hypotheses establish the framework for the
next generation of molecularly targeted therapeutics and diagnostic therapy for gynecologic cancer patient management.
Novel molecular candidates will be incorporated into a newly established ensemble of safety and efficacy gynecologic cancer
clinical trials aimed at directing endometrial or ovarian cancer patients with specific molecular defects/alterations to tailored
molecular targeting regimens, and testing new therapeutics for treatment of newly diagnosed and recurrence/refractory (resistant,
unresponsive to surgery or therapy) cancer patients. The intervention trial will remain open to accrual to evaluate the effects of
stress intervention on recurrence of disease in ovarian cancer, and to evaluate biomarker changes in serial biofluids.
FY 2016 Plans:
The Gynecologic Cancer Center of Excellence will continue validation efforts of identified molecular targets for the treatment of
ovarian and endometrial cancers, evaluate the effect of stress intervention on the recurrence of ovarian cancer, work with the
Walter Reed National Military Medical Center Cancer Risk and Prevention Clinic to develop a Clinical Practice Guideline for
cancer screening and prevention in patients with hereditary cancer risk syndromes, and develop strategies to overcome Taxol(a
chemotherapy drug)-resistance in gynecologic cancer cells.
Accomplishments/Planned Programs Subtotals
10.707
7.570
6.377
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Disseminate medical knowledge products resulting from research and development through articles in peer-reviewed journals, revised clinical practice guidelines,
incorporation into training curriculum throughout the Military Health System, and other applicable means.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 82 of 105
R-1 Line #6
Volume 1 - 144
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
379A / CoE-Gynecological Cancer Center of
Excellence (Army)
E. Performance Metrics
Performance of the Gynecological Cancer Center of Excellence is judged on the number of active protocols, the number of articles that appear in peer-reviewed
journals, and the number of contact hours in support of the training of residents and fellows in the Military Health System.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 83 of 105
R-1 Line #6
Volume 1 - 145
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
381A: CoE-Integrative
Cardiac Health Care Center of
Excellence (Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
4.822
FY 2015
3.674
3.594
FY 2016
Base
3.520
FY 2016
OCO
FY 2016
Total
- 3.520
FY 2017
3.368
FY 2018
Project (Number/Name)
381A / CoE-Integrative Cardiac Health Care
Center of Excellence (Army)
FY 2019
3.214
3.057
Cost To
FY 2020 Complete
Total
Cost
3.118 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Cardiac Health Center of Excellence (Army), also known as the Integrative Cardiac Health Project (ICHP), the focus is the investigation of cutting-edge patientcentric approaches to cardiovascular disease (CVD), risk assessment and risk reduction by incorporating biomolecular (pertaining to organic molecules occurring in
living organisms) research to detect CVD at an early stage, and identifying markers of increased risk for heart attack in Service members. Using a systems biology
outcomes research approach, ICHP characterizes relationships between CVD, other cardio-metabolic disease states and maladaptive lifestyle behavior patterns unique
to Service members such as pre-diabetes, stress, obesity and sleep disorders with the aim of targeting these disorders in their pre-clinical phase and achieving ideal/
optimal cardiovascular health goals outlined by the American Heart Association. ICHP’s ultimate goal is to translate the evidence-based research findings for application
into clinical practice in an effort to achieve the following research aims: (1) improve Force Health by better understanding the CVD risk susceptibility of military-specific
populations such as Wounded Warriors through leading-edge research using novel tools and technologies, (2) investigate and create transformational models of
healthcare delivery through personalized CVD prevention tracks as an adjunct to traditional care, and (3) refine individualized prevention strategies through statistical
data modeling to define the most cost-effective and sustainable approaches in promoting cardiovascular health throughout the military lifecycle.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
3.674
Title: Cardiac Health Center of Excellence (Army)
FY 2015
3.594
FY 2016
3.520
Description: The focus is the investigation of cutting edge patient-centric approaches to cardiovascular disease (CVD), risk
assessment and risk reduction by incorporating biomolecular research to detect CVD at an early stage, and identifying markers of
increased risk for heart attack in Service members.
FY 2014 Accomplishments:
The Cardiac Health Center of Excellence (Army), also known as the Integrative Cardiac Health Project (ICHP), continued
research studies initiated in FY12-13. Data collection from approved FY12-13 protocols is continuing and being analyzed and
synthesized. ICHP is translating and communicating best practices to the services in order to augment clinical practice. Utilizing
our Knowledge to Action framework, ICHP are incorporating findings from studies for new hypothesis generation and development
of new protocols for FY14-18 to expand the use of point-of-care technology in the ICHP model, whole genome sequencing for
early CVD detection, and investigating the use of serum biomarker maps for personalized CVD risk assessment in Wounded
Warriors.
FY 2015 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 84 of 105
R-1 Line #6
Volume 1 - 146
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
381A / CoE-Integrative Cardiac Health Care
Center of Excellence (Army)
B. Accomplishments/Planned Programs ($ in Millions)
The Cardiac Health Center of Excellence (Army), also known as the Integrative Cardiac Health Project (ICHP), continues
conducting research studies initiated in FY13-14. Data collection from approved FY13-14 protocols is analyzed and synthesized.
ICHP continues translating and communicating best practices to the services in order to augment clinical practice. Utilizing our
Knowledge to Action framework, ICHP continues incorporating findings from our studies for new hypothesis generation and
development of new protocols for FY15-19 to expand the use of point-of-care technology in the ICHP model, whole-genome
sequencing for early CVD detection, and investigating the use of serum biomarker maps for personalized CVD risk assessment in
Wounded Warriors.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
The Cardiac Health Center of Excellence (Army) will develop clinical practice guidelines or tools for cardiovascular health and
internal medicine, conduct clinical studies to investigate the effectiveness of lifestyle change interventions and the effects on
preclinical atherosclerosis (plaque deposits in artery) measures, continue molecular studies to understand the cardiovascular risk
in wounded warriors, explore predictive biomarkers (biological indicators of disease) over time, conduct clinical study to examine
effectiveness of point-of-care technology in pre-diabetic patients at risk for cardiovascular disease, and explore predictive patterns
for the development of diabetes, a cardiovascular disease equivalent.
Accomplishments/Planned Programs Subtotals
3.674
3.594
3.520
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Disseminate medical knowledge products resulting from research and development through articles in peer reviewed journals, revised clinical practice guidelines, and
training of residents and fellows in the Military Health System
E. Performance Metrics
Integrative Cardiac Health Care Center of Excellence performance is judged on high impact discoveries, development of new diagnostic and treatment strategies,
identification of emerging issues of disease feature and patterns, the amount of extramural funding received, the number of active protocols, the number of articles that
appear in peer reviewed journals, and the number of contact hours in support of the training of medical students, residents and post-doctoral fellows in the Military Health
System.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 85 of 105
R-1 Line #6
Volume 1 - 147
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
382A: CoE-Pain Center of
Excellence (Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
3.652
FY 2015
2.784
- FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- - FY 2017
- Project (Number/Name)
382A / CoE-Pain Center of Excellence
(Army)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Pain Center of Excellence (Army) examines the relationship between acute and chronic pain and focuses on finding, implementing, and evaluating the most
effective methods of relieving the acute pain caused by combat trauma and the effect pain has throughout the continuum of care to rehabilitation and reintegration. The
Pain Center of Excellence is an integral part of the Defense and Veterans Center for Integrative Pain Management (DVCIPM) whose mission is to become a referral
center that supports world-class clinical pain services, provides education on all aspects of pain management, coordinates and conducts Institutional Review Boardapproved clinical research and Institutional Animal Care and Use Committee-approved basic laboratory and translational pain research, and serves as the advisory
organization for developing enterprise-wide pain policy for the Military Health System. In FY15, the Pain CoE funding line is transferred from Army to USUHS.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
2.784
Title: Pain Center of Excellence (Army)
FY 2015
- FY 2016
- Description: The Pain Center of Excellence examines the relationship between acute and chronic pain and focuses on finding,
implementing, and evaluating the most effective methods of relieving the acute pain caused by combat trauma and the effect pain
has throughout the continuum of care to rehabilitation and reintegration.
FY 2014 Accomplishments:
The Pain Center of Excellence members of the Defense and Veterans Center for Integrative Pain Management (DVCIPM)
continues to validate major lines of effort including the Defense and Veterans Pain Rating Scale (DVPRS), Pain Assessment
Screening Tool and Outcomes Registry/Patient Reported Outcome Measurement Information System (PASTOR/PROMIS), and
Extension for Community Healthcare Outcomes (ECHO) programs. DVCIPM continues to explore pain management therapeutic
options to develop and optimize best practice guidelines for the treatment of pain. The research program focuses on evaluation
of current medications for improved pain management, clinical assimilation study of integrative medicine modalities including
yoga and acupuncture, and exploration of the pathophysiology (study of functional changes associated with disease or injury)
and molecular mechanisms of pain with established and new academic partners. DVCIPM continues to provide subject matter
expertise, coordination, and guidance to all services and Veterans Health Administration regarding pain-related issues in support
of the Pain Task Force.
FY 2015 Plans:
No funding programmed. Program transferred to USUHS starting in FY 2015.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 86 of 105
R-1 Line #6
Volume 1 - 148
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
382A / CoE-Pain Center of Excellence
(Army)
B. Accomplishments/Planned Programs ($ in Millions)
No Funding Programmed.
FY 2014
Accomplishments/Planned Programs Subtotals
2.784
FY 2015
FY 2016
- - C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Disseminate medical knowledge products resulting from research and development through articles in peer-reviewed journals, revised clinical practice guidelines,
incorporation into training curriculum throughout the Military Health System, and other applicable means.
E. Performance Metrics
Performance by the Pain Center of Excellence is judged on the number of active protocols, the number of articles that appear in peer reviewed journals, and the number
of contact hours in support of the training of residents and fellows in the Military Health System.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 87 of 105
R-1 Line #6
Volume 1 - 149
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
382B: CoE-Pain Center of
Excellence (USUHS)
FY 2014
- FY 2015
- 2.722
FY 2016
Base
2.823
FY 2016
OCO
FY 2016
Total
- 2.823
FY 2017
2.871
FY 2018
Project (Number/Name)
382B / CoE-Pain Center of Excellence
(USUHS)
FY 2019
3.247
3.310
Cost To
FY 2020 Complete
Total
Cost
3.376 Continuing Continuing
A. Mission Description and Budget Item Justification
The Pain Center of Excellence (Army) examines the relationship between acute and chronic pain and focuses on finding, implementing, and evaluating the most
effective methods of relieving the acute pain caused by combat trauma and the effect pain has throughout the continuum of care to rehabilitation and reintegration. The
Pain Center of Excellence is an integral part of the Defense and Veterans Center for Integrative Pain Management (DVCIPM) whose mission is to become a referral
center that supports world-class clinical pain services, provides education on all aspects of pain management, coordinates and conducts Institutional Review Boardapproved clinical research and Institutional Animal Care and Use Committee-approved basic laboratory and translational pain research, and serves as the advisory
organization for developing enterprise-wide pain policy for the Military Health System. In FY15, the Pain CoE funding line is transferred from Army to USUHS.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
- Title: Pain Center of Excellence (USUHS)
FY 2015
2.722
FY 2016
2.823
Description: The Pain Center of Excellence examines the relationship between acute and chronic pain and focuses on finding,
implementing, and evaluating the most effective methods of relieving the acute pain caused by combat trauma and the effect pain
has throughout the continuum of care to rehabilitation and reintegration.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
The Uniformed Services University of the Health Sciences (USUHS) will assume the research oversight of the DVCIPM beginning
in FY 2015. The Pain Center of Excellence members of the Defense and Veterans Center for Integrative Pain Management
(DVCIPM) will focus primarily on further developing the Pain Assessment Screening Tool and Outcomes Registry/Patient
Reported Outcome Measurement Information System (PASTOR/PROMIS); to include data collection, report generation, and
the study of biomarkers in pain. DVCIPM will continue to explore pain management therapeutic options to develop and optimize
best practice guidelines for the treatment of pain. The research program will focus on evaluation of current medications for
improved pain management, clinical assimilation study of integrative medicine modalities such as battlefield acupuncture, and the
exploration of the pathophysiology (functional change) and molecular mechanisms of pain with established, and new academic
partners. DVCIPM will provide subject matter expertise, coordination, and guidance to all the armed services and the Veterans
Health Administration regarding pain-related issues in support of the Pain Task Force.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 88 of 105
R-1 Line #6
Volume 1 - 150
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
382B / CoE-Pain Center of Excellence
(USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
The Uniformed Services University of the Health Sciences (USUHS) will assume the research oversight of the DVCIPM beginning
in FY 2015. The Pain Center of Excellence members of the Defense and Veterans Center for Integrative Pain Management
(DVCIPM) will focus primarily on further developing the Pain Assessment Screening Tool and Outcomes Registry/Patient
Reported Outcome Measurement Information System (PASTOR/PROMIS); to include data collection, report generation, and
the study of biomarkers in pain. DVCIPM will continue to explore pain management therapeutic options to develop and optimize
best practice guidelines for the treatment of pain. The research program will focus on evaluation of current medications for
improved pain management, clinical assimilation study of integrative medicine modalities such as battlefield acupuncture, and the
exploration of the pathophysiology (functional change) and molecular mechanisms of pain with established, and new academic
partners. DVCIPM will provide subject matter expertise, coordination, and guidance to all the armed services and the Veterans
Health Administration regarding pain-related issues in support of the Pain Task Force.
Accomplishments/Planned Programs Subtotals
FY 2014
- FY 2015
FY 2016
2.722
2.823
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Disseminate medical knowledge products resulting from research and development through articles in peer-reviewed journals, revised clinical practice guidelines,
incorporation into training curriculum throughout the Military Health System, and other applicable means.
E. Performance Metrics
Performance by the Pain Center of Excellence is judged on the number of active protocols, the number of articles that appear in peer reviewed journals, and the number
of contact hours in support of the training of residents and fellows in the Military Health System.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 89 of 105
R-1 Line #6
Volume 1 - 151
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
383A: CoE-Prostate Cancer
Center of Excellence (USUHS)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
13.516
FY 2015
7.771
6.907
FY 2016
Base
6.260
FY 2016
OCO
FY 2016
Total
- 6.260
FY 2017
5.456
FY 2018
Project (Number/Name)
383A / CoE-Prostate Cancer Center of
Excellence (USUHS)
FY 2019
4.628
3.300
Cost To
FY 2020 Complete
Total
Cost
3.366 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Uniformed Services University of the Health Sciences (USUHS), the Prostate Cancer Center of Excellence (CoE), formerly a Congressional Special Interest
program, the Center for Prostate Disease Research (CPDR), was chartered in 1992 to conduct basic, clinical and translational research programs to combat diseases of
the prostate. The CPDR studies prostate cancer and prostate diseases in the military health care system. The program’s mission is fulfilled primarily through its three
principal programs- the Clinical Translational Research, the Basic Science Research and the Tri-Service Multicenter Database which includes five participating military
medical centers. The CPDR has been conducting patient centric cutting-edge translational research to improve the management of all stages of prostate cancer for over
22 yrs as recognized by nearly 400 scientific publications. CPDR has also been committed to the research training of the next generation of DoD doctors and scientists
(USU medical and graduate students and Walter Reed residents). Many of the trainees are now service chiefs and program directors in prestigious military and civilian
medical centers.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
7.771
Title: CoE-Prostate Cancer Center of Excellence (USUHS)
FY 2015
6.907
FY 2016
6.260
Description: The CPDR is at the forefront of cutting-edge clinical research improving diagnosis and treatment of prostate cancer
involving new modalities such as, MRI guided biopsy, and evaluation of new drugs and vaccines for advanced prostate cancer.
The CPDR Database continues to highlight emerging issues in prostate cancer management such as, treatment outcomes, ethnic
differences and quality of life. In light of current treatment challenges with early detected prostate cancers in PSA testing era and
poorly understood biology of prostate cancer, CPDR’s high-impact research is focusing on cancer causing genes that will lead to
better diagnostic and prognostic markers in the management of the disease. New gene discoveries are also unraveling ethnic
differences of prostate cancer biology that has potential to enhance personalized medicine.
FY 2014 Accomplishments:
• Evaluate the efficacy of the newly developed MRI guided biopsy technology in the diagnosis of clinically significant prostate
cancer.
• Assess new FDA approved drugs and vaccines for the treatment of the metastatic disease.
• Investigate minimally invasive modalities for the treatment of early detected prostate cancer.
• Analyze the features of onset and progression of prostate cancer among DoD prostate disease patients in relation to ethnicity
and obesity.
• Complete a new collaborative study with Genomic Health towards the evaluation of early prognostic gene expression markers for
differentiating indolent versus aggressive disease.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 90 of 105
R-1 Line #6
Volume 1 - 152
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
383A / CoE-Prostate Cancer Center of
Excellence (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
• Using the CPDR ERG-MAb, continue to enhance the ERG-based stratification of prostate cancer world-wide in collaboration with
Biocare Medical Inc.
• Complete the evaluation of ERG oncoprotein frequency in patient populations of China, Germany, Hungary, Japan, India,
Malaysia, Philippines and Switzerland.
• Develop and enhance strategies to inhibit ERG-mediated oncogenesis using small molecule inhibitors, ERG-MAb and ERG
vaccine.
• Complete the integrated comparative evaluations of genomics and transcriptomics (expression level of RNA molecules in a given
cell population) datasets of African American and Caucasian American patients.
• Accelerate prostate cancer-related genome queries by acquiring high-throughput technologies to support advanced
bioinformatics capabilities.
• Provide solution for the unmet need of prognostic biomarkers that will differentiate between indolent and aggressive disease.
Evaluate the NanoString platform towards this goal.
• Enhance the CPDR discovery of male hormone signaling-based stratification of prostate cancer, conceptually similar to breast
cancer.
• Define new mechanisms of male hormone receptor regulation towards developing innovative therapeutic strategies.
• Improve non-invasive approaches for the detection of prostate cancer in urine or blood specimens by evaluating prostate cancer
antigens, as well as auto-antibodies.
• Continue to enhance and transform Prostate Cancer COE database and biospecimen banks to a national center for academic
and industrial collaborations to accelerate translational research
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
• Continue to conduct long-term comparisons of efficacy, morbidity, mortality and quality-of-life impact for accepted and emerging
treatments for prostate cancer to include robot assisted radical prostatectomy, external beam radiotherapy, brachytherapy, high
intensity focused ultrasound, and active surveillance. Assess the impact of these treatments with or without neoadjuvant and
adjuvant hormonal or other novel therapies.
• Compare the features of disease onset and progression between DoD and civilian prostate cancer patient populations.
• Continue focus on long-term studies of the epidemiology to include clinical progression of the disease defined by metastasis,
ethnicity, obesity, quality-of-life-adjusted survival and prostate cancer specific death.
• Evaluate traditional and emerging molecular marker panels for differentiating indolent versus aggressive disease for guiding
treatment decisions.
• Leverage the CPDR discovery of the ETS-related gene (ERG), the first major prostate cancer-causing gene identified, which is
present in over half of prostate cancers in Western countries, and can be used for precision diagnosis and therapy.
• Develop new molecular strategies for improving prostate cancer diagnosis and prognosis, specifically to find replacement for
PSA test.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 91 of 105
R-1 Line #6
Volume 1 - 153
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
383A / CoE-Prostate Cancer Center of
Excellence (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
• Establish the molecular bases of ethnic differences in prostate cancer biology by employing integrated comparative genomics
and transcriptomics.
• Develop new paradigms for the identification and treatment of highly aggressive prostate cancers based on hormone signaling
defects.
• Continue to evaluate cancer biology of prostate cancer relevant genes and/or proteins using transgenic and knockout mice
models.
• Identify molecular determinants of prostate cancer susceptibility in high-risk groups such as African Americans.
• Continue to develop and maintain long-term molecular specimen resources for translational investigations at CPDR and
collaborations with other institutions.
• Maintain the state-of-the-art CPDR translational research infrastructure and expertise to train the next generation of DoD
physicians and scientists.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
Clinical Research Focusing on Precise Diagnosis and Therapy:
•Assess new FDA approved therapies; e.g., Enzalutamide, Abiraterone Acetate, Provenge and Radium-223, and vaccine therapy
therapies.
•Evaluate the newest aspects for prostate biopsy procedure using MRI-ultrasound fusion image technology for improving
diagnosis of clinically significant cancer.
•Leverage the vision of long-term biospecimens and database for timely collaborative studies, complete the collaborative
validation study of the Oncotype DX-Prostate Cancer prognostic panel to differentiate indolent prostate cancers from the
aggressive disease.
•Develop more accurate prognostic models to predict organ-confined (curable) and outcome (survival) after the above-noted
treatments.
•Conduct long-term comparisons of efficacy, morbidity, mortality and quality-of-life impact for accepted and emerging treatments
for early stage prostate cancer.
•Conduct a long-term study of the epidemiology of prostate cancer, to include the tracking of changing stage, age at diagnosis,
racial makeup, long-term survival, and quality-of-life-adjusted survival.
CPDR Tri-Service National Database Operations:
•Build clinical models for predicting probability of prostate cancer detection in the diagnosis phase, optimal treatment decision in
the treatment phase, and outcome based treatment in the follow-up phase.
•Integrate clinical and molecular biomarker prognostic variables for evaluating patient diagnosis, progression, and treatment
outcomes.
•Facilitate collaborations between basic science research and clinical research at the CPDR and other institutions.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 92 of 105
R-1 Line #6
Volume 1 - 154
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
383A / CoE-Prostate Cancer Center of
Excellence (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
•Support translational research at WRNMMC where clinical data are linked to tissue and serum data banks to support molecular
genetic studies.
•Provide a resource for education/training of urology, radiation oncology, medical oncology and other residents, fellows, and
students.
Biospecimen Banking Effort:
•Leverage the unique whole mounted prostate specimen bank with long post-treatment follow up for the identification of early
prognostic markers of indolent or progressive disease.
•Complete validation of Oncotype DX® Prostate Cancer prognostic assay with Genomic Health, Inc. to distinguish between
indolent and aggressive prostate cancer utilizing diagnostic biopsy specimens.
•Support our major new initiative of CaP genome analysis in African American patients by NextGen sequencing technologies.
•Complete the translation of the new post-DRE urine assay developed at CPDR for the detection of prostate cancer by immunecytochemistry based platform.
•Enhance DOD, Government and other academic collaborations assessing the association of BRCA1&2 mutations in aggressive
CaP and defining the genetic determinants of African American prostate cancer.
•Maintain Bio-Medical Informatics Core to support the current information systems requirements of the CPDR programs.
New Biomarker and Therapeutic Target Discoveries:
•Continue to build on new molecular strategies at the CPDR for improving prostate cancer diagnosis and prognosis.
•Leverage new promising data on molecular differences of cancer gene defects between African American and Caucasian
American prostate cancer patients towards enhancing personalized medicine in diverse population represented in DOD equal
access healthcare system.
•Continue to enhance the clinical utility of the CPDR-ERG monoclonal antibody (100% specific for prostate cancer detection)
based new strategies of biological stratification and treatment of prostate cancer with in DoD and civilian setting.
•Develop and evaluate novel molecular therapeutic agents for early detected cancer targeting the most common ERG positive
prostate cancer with potential in leading to paradigm shift in new generation of prostate cancer therapeutics.
•Continue to define genetic and molecular determinants of prostate cancer in high-risk groups focusing on African-American men.
•Evaluate cancer biology of prostate cancer relevant genes or proteins using established and new experimental models.
•Continue to enhance hormonal mechanisms for more precise and effective therapeutic stratification of prostate cancers treated
by androgen ablation therapies.
•Leverage the CPDR discovery platforms for frequent and potentially causal prostate cancer gene alterations using cutting edge
technologies and well annotated and precisely processed bio-specimens.
Education and Training Program:
•Foster education and training in prostate cancer basic science and translational research and provide opportunities for postdoctoral fellows, residents, visiting scientists, medical and graduate students and summer interns.
•Utilize the CPDR developed structured molecular oncology training program in prostate cancer for physician and scientists.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 93 of 105
R-1 Line #6
FY 2014
FY 2015
FY 2016
Volume 1 - 155
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
383A / CoE-Prostate Cancer Center of
Excellence (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
•Invite leading experts in prostate cancer field to give state-of-the-art lectures as a part of education and training of post-doctoral
fellows, residents, graduate students and research staff.
•Sponsor research investigator programs for DOD physicians and scientists on prostate cancer research diagnosis, treatment and
therapeutic advances.
•Collaborate with other DOD, government, and private agencies in promoting and sponsoring prostate disease research
education.
Material and Knowledge Products - Continue to:
•Support new knowledge products through in-house initiatives and collaborative efforts with leading medical institutions and
biotechnology companies.
•Leverage the largest (27,500+ subjects) and long term (22+ years) multi-center CPDR database within the DOD for developing
more precise diagnostic and prognostic biomarkers and nomograms towards enhancing personalized medicine with special focus
on ethnically diverse patient population within the DOD.
•Enhance CPDR Biospecimen Bank which is considered to be a national treasure for new discoveries of prostate cancer
biomarkers and therapy targets.
•Leverage the growing intellectual property portfolio of USU-CPDR for developing innovative diagnostic and therapeutic products
and technologies to enhance the care of prostate cancer patients within the MHS.
Accomplishments/Planned Programs Subtotals
FY 2014
7.771
FY 2015
6.907
FY 2016
6.260
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
Prostate Cancer Center of Excellence: Performance is judged on high impact discoveries, development of new diagnostic and treatment strategies, identification of
emerging issues of disease feature and patterns, the amount of extramural funding received, the number of active protocols, the number of articles that appear in peer
reviewed journals, and the number of contact hours in support of the training of medical students, residents and post-doctoral fellows in the Military Health System.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 94 of 105
R-1 Line #6
Volume 1 - 156
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
398A: CoE-Neuroscience Center
of Excellence (USUHS)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
1.822
FY 2015
1.857
- FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- - FY 2017
- Project (Number/Name)
398A / CoE-Neuroscience Center of
Excellence (USUHS)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- - - Total
Cost
- A. Mission Description and Budget Item Justification
For the Uniformed Services University of the Health Sciences (USUHS), the Military Clinical Neuroscience Center of Excellence (MCNCoE), formerly a Congressional
Special Interest program, was chartered in 2002 to conduct basic, clinical, and translational research studies of militarily relevant neurological disorders affecting
U.S. service members and military beneficiaries. The Center's mission is to improve prevention, diagnosis, and treatment of neurological disorders that directly affect
warfighters through a multi-site research program that collaborates broadly with military, civilian and federal medical institutions. The MCNCoE goals include supporting
neuroscience education and research endeavors at military treatment facilities across the DOD healthcare system and facilitating a network of collaborations between
investigators across these facilities.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
1.857
Title: CoE-Neuroscience Center of Excellence (USUHS)
FY 2015
- FY 2016
- Description: The Military Clinical Neuroscience Center of Excellence (MCNCoE) is to improve prevention, diagnosis, and
treatment of neurological disorders that directly affect warfighters through a multi-site research program that collaborates broadly
with military, civilian and federal medical institutions. The MCNCoE’s approach to its goals includes supporting the research
potential of military treatment facilities across the DOD system as well as the national capital area, and facilitating a network of
collaborations between investigators across these facilities.
FY 2014 Accomplishments:
The MCNCoE will complete restructuring of its vision and mission. This restructuring began in 2013 and continues into 2014,
and includes re-codifying of the governance of MCNCoE, establishing a permanent external scientific advisory board (SAB).
The MCNCoE will fund new clinical research projects through a call for proposals reviewed by SAB, and enhance the capability
of MCNCoE to involve clinical neuroscientists across the DoD and at affiliated civilian academic centers in collaborative work
with MCNCoE. Plans include involvement of national and international research leaders in the field of neurology from national
capital area as well as across military healthcare system. Mission will also refocus on promoting education and training of military
medical students, residents, fellows and staff in clinical neuroscience standards of care, outcome measures, and research
initiatives with a focus on military-specific neurological conditions. With three ACGME accredited joint (tri-service) Military
Neurology training programs in the DoD affiliated with USUHS Neurology, restructuring will include evaluating and augmenting
clinical residency research opportunities in neurological disorders seen in military beneficiaries to include co-occurring conditions
of special interest such as traumatic brain injury, neurodegenerative conditions, post-traumatic headaches, depression, chronic
pain, epilepsy, nerve injury, post-traumatic stress disorders, and other clinical conditions that impact on full recovery. In sync with
the President's call for Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, MCNCoE is poised
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 95 of 105
R-1 Line #6
Volume 1 - 157
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
398A / CoE-Neuroscience Center of
Excellence (USUHS)
B. Accomplishments/Planned Programs ($ in Millions)
to leverage military neuroscience clinicians at USUHS, in the national capital area, across the DoD Military Treatment Facilities,
and with MTF academic affiliates to augment the understanding of human brain function which the President has established as
an “enormous mystery waiting to be unlocked” (April 2013).
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
None, MCNCoE research has been merged into the CNRM beginning in FY 2015.
FY 2016 Plans:
No Funding Programmed.
Accomplishments/Planned Programs Subtotals
1.857
- - C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
Performance of individual PIs will be judged on the number of active protocols, the number of articles that appear in peer reviewed journals, and the amount
of extramural funding received. Performance of the overall program will be also measured on the effective achievement of better communication and research
collaborations between neurology researchers across the DOD system, and on the ability of the Program to affect improvements to the academic curriculum at USUHS.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 96 of 105
R-1 Line #6
Volume 1 - 158
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
429A: Hard Body Armor Testing
(Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
FY 2014
1.356
FY 2015
- - FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- - FY 2017
- Project (Number/Name)
429A / Hard Body Armor Testing (Army)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- - - Total
Cost
- A. Mission Description and Budget Item Justification
The Hard Body Armor project plans to develop a surface-mounted sensor system that will add critical dynamic data to the current clay test procedure and develops
human skull fracture injury criteria for focused blunt impacts to the human head. This research develops and validates a method for assessing body armor performance
against blunt trauma and will be fully compatible with the current testing method. The adoption of armor and helmet design standards that estimate injury type and
severity based on biomechanics will allow designers to rationally create armor and helmets that protect each body region and allow the development of standards based
on true protection outcomes.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Hard Body Armor
FY 2014
- FY 2015
- FY 2016
- - - - Description: Develop a surface-mounted sensor system that will add critical dynamic data to the current clay test procedure and
develops human skull fracture injury criteria for focused blunt impacts to the human head.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Disseminate to the DoD testing community an improved biofidelic blast test manikin (model with characteristics that mimic pertinent human physical ones such as size,
shape, mass)that includes the capability to measure and predict skeletal occupant injury during under body blast events in combat and transport vehicles involving a
landmine or improvised explosive device.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 97 of 105
R-1 Line #6
Volume 1 - 159
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
429A / Hard Body Armor Testing (Army)
E. Performance Metrics
Principal investigators will participate in In-Progress Reviews, DHP-sponsored review and analysis meetings, submit quarterly and annual status reports, and/or are
subjected to Program Sponsor Representative progress review to ensure that milestones are being met and deliverables will be transitioned on schedule.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 98 of 105
R-1 Line #6
Volume 1 - 160
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
431A: Underbody Blast Testing
(Army)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
20.929
FY 2014
FY 2015
10.938
4.818
FY 2016
Base
2.679
FY 2016
OCO
FY 2016
Total
- 2.679
FY 2017
1.869
Project (Number/Name)
431A / Underbody Blast Testing (Army)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- - - Total
Cost
- A. Mission Description and Budget Item Justification
To better protect mounted warriors from the effects of underbody blast (UBB) caused by landmines or Improvised Explosive Devices (IEDs), the Underbody Blast (UBB)
Testing medical research project will provide new data on the biomechanics of human skeletal response that occurs in an attack on a ground combat vehicle. The data
will provide a biomedical basis for the development of a Warrior-representative blast test manikin (the Warrior Injury Assessment Manikin or WIAMan project) and the
required biomedically-valid injury criteria that can be used in Title 10 Live Fire Test and Evaluation to characterize dynamic events, the risk of injury to mounted warriors,
and to support acquisition decisions. This new data will also benefit the overall DoD effort in vehicle and protection technology for the UBB threat. This work is needed
to overcome the limitations of the current test manikin and injury criteria which were designed for the civilian automotive industry for frontal crash testing and as such are
not adequate in the combat environment. The current manikins do not represent the modern Soldier and were not designed for the vertical acceleration environment
associated with UBB events. Consequently, current LFT&E crew survivability assessment methodologies are limited in their ability to predict the types and severity of
injuries seen in these events. Due to this technology gap, military ground vehicles are being fielded without fully defined levels of injury risk and crew survivability for
UBB events. The data produced by this project will be used to satisfy a critical need for a scientifically valid capability for analyzing the risk of injury caused by UBB.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
10.938
Title: Underbody Blast Testing
FY 2015
4.818
FY 2016
2.679
Description: Will provide an understanding of the biomechanics of skeletal injuries that occur in a combat vehicle UBB event
involving a landmine or IED, and will provide the biomedical basis for the development of a Warrior-representative blast test
manikin and associated biomedically-validated injury criteria that can be used to characterize dynamic events and injury risks for
live-fire test and evaluation (LFT&E) crew survivability assessments and vehicle development efforts to better protect Warriors
from UBB threats.
FY 2014 Accomplishments:
The Underbody Blast Testing project focused on generating and providing medical research data needed to support the
development of the WIAMan anthropomorphic (resembling a human) test device concept and the first generation prototype.
The emphasis was on non-injurious testing conditions and biofidelity data but also included injurious testing. All body regions
were addressed including whole-body testing and also prioritized testing of the following body regions, foot and ankle, leg,
pelvis, lumbar spine, thoracic spine, cervical spine, torso, head and neck. Validation studies were conducted to contrast injuries
observed in theater with those created in the testing program to prioritize research. Emerging medical research data was used to
support the protection technology development and the modeling and simulation initiatives.
FY 2015 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 99 of 105
R-1 Line #6
Volume 1 - 161
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
431A / Underbody Blast Testing (Army)
B. Accomplishments/Planned Programs ($ in Millions)
The Underbody Blast Testing project is continuing medical research in the areas initiated in FY14 but with the emphasis shifting
during the year from non-injurious conditions to those which cause injuries. This will enable the development of initial human
injury probability curves that account for influences unique to the military and to the underbody blast environment. All data are
transitioning into the WIAMan project to enable the fabrication of the first and second generation prototype anthropometric test
devices (ATDs; manikins or crash test dummies). Validation studies are contrasting injuries observed in theater with those
created in the testing program to prioritize further research. Emerging medical research data are supporting the protection
technology development and the modeling and simulation initiatives.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
The Underbody Blast Testing project will continue medical research in the areas initiated in FY15 but with the emphasis shifting
to perform matched pair testing of the first generation WIAMan prototype. This will enable a pairwise comparison between the
human injury probability curves and the responsiveness of the WIAMan first generation prototype in the military and underbody
blast environments. This work will inform the development of whole-body injury criteria and the protective technology for use in
the underbody blast environment.
Accomplishments/Planned Programs Subtotals
10.938
4.818
2.679
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Produce biofidelity response corridors (BRC) and human injury probability curves (HIPC) for human skeletal response and tolerance in the military UBB environment and
transition them for use in the development of the WIAMan UBB test manikin and for general use in the RDT&E community. Develop injury assessment reference curves
for use with WIAMan manikin to support vehicle and protection technology acquisition decisions.
E. Performance Metrics
Performance metrics include the timely transition of actionable medical research from principal investigators for use in the development of the WIAMan UBB test manikin
and to benefit the RDT&E protection technology and acquisition community. Actionable medical research includes biofidelty response corridors (BRCs), human injury
probability curves (HIPC), and injury assessment reference curves (IARCs). Principal investigators (PI's) will participate in In-Progress Reviews, technical interchange
meetings, and theater injury analysis reviews. PIs will publish emerging results in the proceedings of injury biomechanics symposia and in relevant journals. As
required, PIs will participate in DHP-sponsored review and analysis meetings, submit quarterly and annual status reports, and are subjected to Program Sponsor
Representative progress review to ensure that milestones are being met and deliverables will be transitioned on schedule. An external peer review of the medical
research will be conducted to ensure the medical research is scientifically valid and suitable for accreditation for use in supporting acquisition decisions.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 100 of 105
R-1 Line #6
Volume 1 - 162
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
448A: Military HIV Research
Program (Army)
FY 2014
- FY 2015
6.663
5.773
FY 2016
Base
6.589
FY 2016
OCO
FY 2016
Total
- 6.589
FY 2017
FY 2018
6.702
Project (Number/Name)
448A / Military HIV Research Program
(Army)
FY 2019
7.579
7.722
Cost To
FY 2020 Complete
Total
Cost
7.877 Continuing Continuing
A. Mission Description and Budget Item Justification
This project funds research to develop candidate HIV vaccines, to assess their safety and effectiveness in human subjects, and to protect the military personnel from
risks associated with HIV infection. All HIV technology development is conducted in compliance with US Food and Drug Administration (FDA) regulations. Evaluations
in human subjects are conducted to demonstrate safety and effectiveness of candidate vaccines, as required by FDA regulation. Studies are conducted stepwise:
first, to prove safety; second, to demonstrate the desired effectiveness of the drug, vaccine, or device for the targeted disease or condition in a small study; and third,
to demonstrate effectiveness in large, diverse human population trials. All results are submitted to the FDA for evaluation to ultimately obtain approval (licensure) for
medical use. This project supports studies for effectiveness testing on small study groups after which they transition to the next phase of development for completion of
effectiveness testing in larger populations. This program is jointly managed through an Interagency Agreement between USAMRMC and the National Institute of Allergy
and Infectious Diseases (NIAID). This project contains no duplication with any effort within the Military Departments or other government organizations. The cited work
is also consistent with the Assistant Secretary of Defense, Research and Engineering Science and Technology focus areas.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
6.663
Title: Military HIV Research Program
FY 2015
5.773
FY 2016
6.589
Description: The Military HIV Research Program aims to develop candidate HIV vaccines, to assess their safety and
effectiveness in human subjects, and to protect the military personnel from risks associated with HIV infection.
FY 2014 Accomplishments:
The Military HIV Research Program conducted safety and effectiveness studies with a combination vaccine in human volunteers
at clinical trial sites world-wide and down-selected best candidates. Clinical trial results informed the need for further testing in
human volunteers to study the ability of HIV vaccine candidates to provoke an immune response that can protect against HIV.
FY 2015 Plans:
Conducting initial testing in humans for safety and effectiveness at CONUS and OCONUS sites with down-selected HIV-1
multivalent vaccine candidates, either a single vaccine or a combination of several sub-types. Preparing for large scale production
of vaccine candidates from various world-wide subtypes. These candidates will be used in future large scale clinical studies.
FY 2016 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 101 of 105
R-1 Line #6
Volume 1 - 163
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
448A / Military HIV Research Program
(Army)
B. Accomplishments/Planned Programs ($ in Millions)
The Military HIV Research Program will complete large scale production and characterization of selected vaccine candidates. Will
initiate large scale safety and effectiveness trials with one or more vaccine candidates either as single vaccine or combination of
several sub-types representing major world-wide distribution.
Accomplishments/Planned Programs Subtotals
FY 2014
6.663
FY 2015
5.773
FY 2016
6.589
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Mature and demonstrate candidate HIV vaccines, prepare and conduct human clinical studies to assess safety and effectiveness of candidate HIV vaccines. All HIV
technology development activities are conducted in compliance with FDA regulations. Best selected candidates will be transitioned to advanced development through
Milestone B.
E. Performance Metrics
Performance of the HIV research program will be monitored and evaluated through an external peer review process, with periodic reviews by the HIV Program Steering
Committee and the Military Infectious Diseases Research Program Integrating Integrated Product Team (IIPT) and in-process reviews (IPR) conducted by USAMRMC
Decision Gate process to include Defense Health Agency representation.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 102 of 105
R-1 Line #6
Volume 1 - 164
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Prior
Years
830A: Deployed Warfighter
Protection (Army)
FY 2014
9.001
FY 2015
5.225
4.553
FY 2016
Base
5.306
FY 2016
OCO
FY 2016
Total
- 5.306
FY 2017
5.397
FY 2018
Project (Number/Name)
830A / Deployed Warfighter Protection
(Army)
FY 2019
6.105
6.221
Cost To
FY 2020 Complete
Total
Cost
6.345 Continuing Continuing
A. Mission Description and Budget Item Justification
For the Armed Forces Pest Management Board (AFPMB), the Deployed Warfighter Protection project plans to develop new or improved protection for ground forces
from disease-carrying insects. The focus of this program is to develop new or improved systems for controlling insects that carry disease under austere, remote, and
combat conditions; understand the physiology of insecticidal activity to develop new compounds with greater specific activity and/or higher user acceptability; examine
existing area repellents for efficacy and develop new spatially effective repellent systems useful in military situations; develop new methods or formulations for treating
cloth to prevent vector biting; and expand the number of active ingredients and formulations of public health pest pesticides, products and application technologies
available for safe, and effective applications.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
5.225
Title: Deployed Warfighter Protection
FY 2015
4.553
FY 2016
5.306
Description: The Deployed Warfighter Protection project will develop new or improved protection for ground forces from diseasecarrying insects.
FY 2014 Accomplishments:
The Deployed Warfighter Protection (DWFP) research project focused on three major areas to develop products to control
biting insects, primarily mosquitoes and sand flies, that transmit force degrading diseases: personal protection systems, new
insecticides, and vector control/insecticide application technologies. The personal protection system for today's warfighter
relies upon permethrin treated uniforms, applying topical repellents to all exposed skin daily, and sleeping under an insecticide
treated net. These countermeasures are often ineffective for several reasons including low user acceptance and the logistical
burden of supplying and carrying these products. New personal protection system tools – such as lower concentration repellent
chemicals and spatial repellents - were in development by DWFP scientists and their partners. In the area of new insecticides,
expanded regulatory requirements and development of insecticide resistance have resulted in a reduction in the number of public
health pesticides available for controlling mosquitoes and sand flies. DWFP transitioned a patented Attractive Targeted Sugar
Bait (ATSB) delivery technology to a commercial partner as a novel reduced risk pesticide. This new mosquito control product
promises to revolutionize mosquito control. To improve the effectiveness and the sustainability of insect control operations in
deployed settings, the DWFP focused on developing updated insect control methods, lighter weight insecticide sprayers, and new
application technologies that take advantage of engineering advances such as smartphones and robotics.
FY 2015 Plans:
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 103 of 105
R-1 Line #6
Volume 1 - 165
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
830A / Deployed Warfighter Protection
(Army)
B. Accomplishments/Planned Programs ($ in Millions)
The Deployed Warfighter Protection (DWFP) research project is developing products that will enable deployed forces to better
protect themselves and control biting insects, primarily mosquitoes and sand flies, which transmit force degrading diseases. The
DWFP is focusing research efforts on critical gaps identified by the Services and Combatant Commands to control insect disease
vectors to provide solutions in three thrust areas: personal protection systems, new insecticides, and vector control/insecticide
application technologies. Within the enhanced personal protection systems, DWFP is evaluating the feasibility of bite-proof fabrics,
studying the durability of factory permethrin-treated uniforms, and searching for a replacement insecticide that safely outperforms
the current treated uniforms. Regarding spatial repellents, the DWFP down-selected and is extensively evaluating a chemical to
augment the use of personal topical repellents, such as DEET, which require frequent application, suffer from low levels of user
acceptability, and are short lived (lasting only hours). Such a spatial repellent promises to protect personnel when not in uniform
and when DEET or other skin repellents are not used. The DWFP is conducting early field tests of prototype micro-dispensers
and textile-based area/spatial-repellent dispensers; and conducting a preregistration meeting with the parent commercial company
and the EPA to determine steps required for regulatory approval of the repellent in the US. To counter the rising problem of
mosquito resistance to existing insecticides and the issue of currently approved insecticides being removed due to more stringent
regulatory requirements, the DWFP is focused on developing the next generation of insecticides which will be more effective at
protecting deployed personnel while also being safer for humans and the environment. The DWFP is collaborating with multiple
industry partners to develop such new insecticides for EPA registration. For vector control technologies, the DWFP is targeting
pesticide delivery methods that are more effective, efficient, and sustainable in austere and tropical environments. In addition to
materiel solutions/products, DWFP priorities include knowledge products that support vector control and disease risk reduction to
include improving current practices used in the field.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
In FY16 the Deployed Warfighter Protection (DWFP) research project will develop and field tools that enable deployed forces
to better protect themselves and control biting insects, primarily mosquitoes and sand flies, which transmit force degrading
diseases. This will be accomplished through research, testing and evaluation of products, patent submissions, licensing, and
EPA registrations for new insecticides. The DWFP will maintain its focus within personal protection systems, new insecticides,
and vector control/insecticide application technologies. For enhanced personal protection systems, protective clothing efforts
will review pending positive results of the FY15 evaluations of prototype bite proof fabric for commercialization; the alternative to
permethrin for treating combat uniforms will complete efficacy evaluations and, if effective, will be submitted to the Armed Forces
Pest Management Board (AFPMB) and the EPA for approval and registration. Within this same focus area, under area/spatial
repellents the DWFP will expand field tests focused on the best performing area/spatial-repellent dispensers evaluated in FY15
and will work with the EPA and associated industry partner to pursue EPA registration for military use. For new insecticides,
the DWFP will down select top performing novel molecular pesticides-tested in FY15 for expanded field testing; will conduct
faster, more efficient, lab based screening of potential plant-derived and synthetic insecticides to identify promising candidate
compounds; and will execute field evaluations of insecticides identified in FY15. For vector control/insecticide application
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 104 of 105
R-1 Line #6
Volume 1 - 166
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0603115HP / Medical Technology
Development
Project (Number/Name)
830A / Deployed Warfighter Protection
(Army)
B. Accomplishments/Planned Programs ($ in Millions)
technologies, lab and field testing of insecticide sprayer products identified as promising tools in FY15 will be conducted. Best
performing products/sprayers and technologies tested in FY15 will transition to commercial partners for submission to the AFPMB
for addition to the National Stock System.
Accomplishments/Planned Programs Subtotals
FY 2014
5.225
FY 2015
4.553
FY 2016
5.306
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Develop, mature and field new or improved products and strategies that protect US forces from disease-carrying insects. Secure registered trademarks, patents,
commercial partners, and/or EPA registration of new or improved insecticides, application technologies and repellent systems. Continue to partner with industry to field
products and coordinate with the Services and relevant Program Executive Offices (PEOs) to transition efforts.
E. Performance Metrics
Performance for the Deployed Warfighter Protection Program is measured by the insecticides and other products given EPA registration and added to the military stock
system, changes in pest management techniques or technologies used by the military to control biting/disease causing insects, patents, and peer-reviewed scientific
manuscripts. The Program conducts an annual Research Review during which a panel of DoD subject matter experts provides input on programmatic alignment and
strategic priorities.
PE 0603115HP: Medical Technology Development
Defense Health Program
UNCLASSIFIED
Page 105 of 105
R-1 Line #6
Volume 1 - 167
UNCLASSIFIED
THIS PAGE INTENTIONALLY LEFT BLANK
UNCLASSIFIED
Volume 1 - 168
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0604110HP / Medical Products Support and Advanced Concept Development
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
352.253
296.634
150.822
103.443
- 103.443
129.137
140.826
146.781
149.354 Continuing Continuing
374A: GDF-Medical Products
Support and Advanced Concept
Development
280.424
244.621
97.614
99.443
- 99.443
125.137
136.826
142.781
145.354 Continuing Continuing
67.933
49.000
53.208
- - - - - - - Continuing Continuing
3.896
3.013
- 4.000
- 4.000
4.000
4.000
4.000
4.000 Continuing Continuing
400Z: CSI - Congressional
Special Interests
434A: Medical Products
Support and Advanced Concept
Development (AF)
A. Mission Description and Budget Item Justification
Guidance for Development of the Force (GDF) - Medical Products Support and Advanced Concept Development: Funding supports (1) advanced concept development
of medical products that are regulated by the US Food and Drug Administration (FDA), (2) clinical and field validation studies supporting the transition of FDAlicensed and unregulated products and medical practice guidelines to the military operational user,(3) prototyping, (4) risk reduction and product transition efforts
for medical information technology applications such as coordination with the Program Execution Office for possible integration into the Military Health System, and
(5) medical simulation and training system technologies. This portfolio is designed to address areas of interest to the Secretary of Defense related to Wounded
Warriors, capabilities identified through the Joint Capabilities Integration and Development System, and the sustainment of priority investments in science, technology,
research, and development, as stated in the Quadrennial Defense Review. Program development and execution is peer-reviewed and fully coordinated with all of the
Military Services, appropriate Defense agencies or activities, and other federal agencies such as the Department of Veterans Affairs, the Department of Health and
Human Services, and the Department of Homeland Security. Coordination occurs through the planning and execution activities of the Defense Health Agency’s Joint
Program Committees (JPC), which were established to manage research, development, test and evaluation for Defense Health Program (DHP) sponsored research.
Research within this program element encompasses Medical Simulation and Information Sciences (through JPC-1), Military Infectious Disease (through JPC-2), Military
Operational Medicine (through JPC-5), Combat Casualty Care (through JPC-6), and Clinical and Rehabilitative Medicine (through JPC-8). As the research efforts
mature, the most promising efforts will transition to medical products and support systems development funding, Program Element 0605145.
For the Air Force Medical Service, funding in this program element supports technology development for the rapid transition of medical products and capabilities from
Air Force laboratories, and the ability to perform modifications /enhancements required to integrate commercial off-the-shelf (COTS) and near-COTS products into the
military operating environment. Ability to enhance or modify existing COTS is a cost effective technique we should maximize where possible, ensuring warfighters have
appropriate technology at hand to care for wounded at the point of injury through definitive care and on to rehabilitation and reintegration at the most efficient cost and
schedule possible. Significant benefits can be obtained from rapid insertion of high value / impact technologies into healthcare operations to address capabilities that
enter the acquisition life-cycle at high TRL levels that can readily be implemented with significant upside potential. Cannot ensure viability of S&T and translational
research efforts with a materiel component without correctly programmed funding for logical progression and transition of those activities in the product development
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 1 of 14
R-1 Line #7
Volume 1 - 169
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0604110HP / Medical Products Support and Advanced Concept Development
lifecycle. Ensures viability of S&T and translational research efforts with a materiel component by providing programmed funding for logical progression and transition of
those activities in the product development lifecycle.
The Army Medical Command received DHP Congressional Special Interest (CSI) research funding focused on Peer-Reviewed Traumatic Brain Injury/ Psychological
Health, and Peer-Reviewed Joint Warfighter Medical Research. The Uniformed Services University received CSI funding for the Therapeutics Service Dog Training
Program. Because of the CSI annual structure, out-year funding is not programmed.
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Program Realignment - Project 374A
• Program Realignment - Project 434A
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
132.430
296.634
164.204
-0.124
- - 49.000
- 126.369
-11.041
- - 97.787
150.822
53.035
-0.173
- - 53.208
- - - - - 95.815
103.443
7.628
- - - 95.815
103.443
7.628
3.628
4.000
- - 3.628
4.000
Congressional Add Details ($ in Millions, and Includes General Reductions)
Project: 400Z: CSI - Congressional Special Interests
FY 2014
FY 2015
Congressional Add: 427A - Traumatic Brain Injury/ Psychological Health
10.000
20.000
Congressional Add: 441A - Joint Warfighter Medical Research Program
35.000
20.000
4.000
3.000
Congressional Add: 455A - Therapeutic Service Dog Training Program (USUHS)
Congressional Add: 464A – Program Increase: Restore Core Research Funding Reduction (GDF)
- 10.208
Congressional Add Subtotals for Project: 400Z
49.000
53.208
Congressional Add Totals for all Projects
49.000
53.208
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0604110-Medical Products Support and
Advanced Concept Development (-$11.041 million) to DHP RDT&E PE 0605502-Small Business Innovation Research (SBIR) Program (+$11.041 million).
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 2 of 14
R-1 Line #7
Volume 1 - 170
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0604110HP / Medical Products Support and Advanced Concept Development
FY 2014: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0604110-Medical Products Support and Advanced Concept Development (+
$49.000 million).
FY 2014: Federally Funded Research and Development Center Reduction, PE 0604110-Medical Products Support and Advanced Concept Development (-$0.124
million).
FY 2015: Federally Funded Research and Development Center Reduction, PE 0604110-Medical Products Support and Advanced Concept Development (-$0.173
million).
FY 2015: Congressional Special Interest (CSI) Additions to DHP RDT&E, PE 0604110-Medical Products Support and Advanced Concept Development (+
$53.208 million).
FY 2016: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0603115-Medical Technology
Development (-$4.000 million) to DHP RDT&E PE 0604110-Medical Products Support and Advanced Concept Development (+$4.000 million).
FY 2016: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0605145-Medical Products and Support
System Development (-$3.628 million) to DHP RDT&E PE 0604110-Medical Products Support and Advanced Concept Development (+$3.628 million).
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 3 of 14
R-1 Line #7
Volume 1 - 171
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
374A: GDF-Medical Products
Support and Advanced Concept
Development
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 374A / GDF-Medical Products Support and
and Advanced Concept Development
Advanced Concept Development
Prior
Years
280.424
FY 2014
FY 2015
244.621
97.614
FY 2016
Base
FY 2016
OCO
99.443
FY 2016
Total
- 99.443
FY 2017
125.137
FY 2018
136.826
FY 2019
142.781
Cost To
FY 2020 Complete
Total
Cost
145.354 Continuing Continuing
A. Mission Description and Budget Item Justification
Guidance for Development of the Force (GDF)-Medical Products Support and Advanced Concept Development: This funding supports (1) clinical trials of promising
technologies that may provide solutions for the most pressing medical needs of the Warfighter, (2) accelerated transition of promising technologies to the field, and
(3) promulgation of new, evidence-based approaches to the practice of medicine as clinical practice guidelines. Research will be conducted in the following areas:
(1) Medical Simulation and Information Sciences/JPC-1. This JPC seeks to promote long-term efficiencies by defining processes improving the electronic healthcare
record/other medical related systems, and the implementation of new trends and advancements in technology to improve healthcare access, availability, continuity, cost
effectiveness, and quality. Initial candidates will be selected from those funded by other medical research sponsors in the Department, and from external sources such
as academia and industry, including efforts funded with prior year CSI funding; (2) Military Infectious Disease/JPC-2. This JPC supports the advanced development of
systems to rapidly detect pathogens (infectious agents)in fresh whole blood, as well as efforts related to the prevention and management of wound infections and the
development of antimicrobial countermeasures and infectious disease-related diagnostic systems; (3) Military Operational Medicine/JPC-5. This JPC supports clinical
assessments related to interventions for post-traumatic stress disorder (PTSD), nutrition and dietary supplementation to promote health and resilience, the development
of mitigation strategies to prevent hearing loss, the development of techniques to enhance military family and community health and resilience, validation trials for
enhanced suicide prevention, and the accomplishment of related field studies with end users; (4) Combat Casualty Care/JPC-6. This JPC supports clinical trials such
as those assessing biomarkers (biological indicators) for traumatic brain injury (TBI) and spinal cord injury, product development related to forward surgical/intensive
critical care, enroute care, hemorrhage and resuscitation, and treatments for tissue injury; (5) Clinical and Rehabilitative Medicine/JPC-8. Advanced development
efforts in this JPC involve clinical trials related to pain management and regenerative medicine.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
244.621
Title: GDF – Medical Product Support and Advanced Concept Development
FY 2015
97.614
FY 2016
99.443
Description: Product support and advanced concept development of medical products that are regulated by the US Food and
Drug Administration (FDA); the accelerated transition of FDA-licensed and unregulated products and medical practice guidelines
to the military operational user through clinical and field validation studies, prototyping, risk reduction, and product transition efforts
for medical information technology applications, and medical training systems technologies.
FY 2014 Accomplishments:
Medical Simulation and Information Sciences conducted research in two primary research portfolios -- Medical Simulation and
Training, and Health Informatics and Information Technology. Under the Medical Simulation and Training portfolio, development
began on the core (torso) portion (Phase 1) of the Advanced Modular Manikin. This platform will be used in the training of medical
intervention procedures. Under the Health Informatics and Information Technology portfolio, coordination continued on electronic
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 4 of 14
R-1 Line #7
Volume 1 - 172
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 374A / GDF-Medical Products Support and
and Advanced Concept Development
Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
medical information technology research to support care for the Warfighter, and to mitigate program risk for the Military Health
System. Identified options to reduce potential near- and long-term risks associated with information technology development and
legacy systems, and prepared for the transition to the Department of Defense modernized Electronic Health Record. Research
continued on closing gaps related to mobile health and personal health management, and advancing the ability to capture data
from the point of injury to the point of definitive care. This effort involves data transmission initiatives, new clinical decision support
algorithms, and patient identification issues incorporating patient consent, privacy, and security.
FY 2014
FY 2015
FY 2016
Military Infectious Diseases completed down-selection on a Next Generation Diagnostic System for the Combat Support Hospital.
Initiated advanced development on three polymerase chain reaction-based assays (malaria, dengue, and chikungunya) to be
used on the Next Generation Diagnostic System (NGDS).
Military Operational Medicine completed clinical trials on the use of improved psychotherapies (psychological treatment of mental
disorders) for the treatment of PTSD in Operation Iraqi Freedom/Operation Enduring Freedom returnees. These studies provided
evidence for the efficacy of delivering PTSD treatment in-home, and supported delivery of PTSD treatment in a shortened period
of time. In collaboration with the Veterans Administration, clinical trials were initiated examining the use of pharmaceuticals for
the treatment of deployment-related symptoms of PTSD (e.g., improving sleep and reducing nightmares). Clinical trials continued
on alcohol and substance abuse and suicide prevention interventions. Development was completed on actionable algorithms
for integration into physiological health status monitoring systems. Field studies were conducted with end users. Continued
initiatives developing mitigation strategies for prevention of hearing loss, and on safety and efficacy studies related to clinical
nutrition and dietary supplements.
Combat Casualty Care conducted research in Hemorrhage and Resuscitation, Neurotrauma, Traumatic Tissue Injury, Forward
Surgical Intensive Critical Care, and joint Enroute Care. Under Hemorrhage and Resuscitation: Initiated a Phase 2 clinical trial in
humans on a spray dried plasma product in support of a FDA Biologic License Application. Initiated Phase 2 and Phase 3 clinical
trials on a device to kill infectious organisms in fresh whole blood collected on the battlefield for transfusion. Conducted clinical
trials on the pre-hospital use of plasma. Under Neurotrauma: Conducted a DoD-Veteran’s Administration multi-site collaborative
study assessing the effectiveness of commonly prescribed off-label treatments for combat-related PTSD. Continued study
assessing the effectiveness of non-invasive diagnostic/assessment tools for Traumatic Brain Injury (TBI), and the assessment of
TBI biomarkers in patients with concussive injuries. Conducted clinical trials on a drug to treat concussions. Continued validation
studies on a smooth-pursuit eye tracking system to diagnose concussions. Under Forward Surgical Intensive Critical Care and
joint Enroute Care: Initiated advanced development on a system bringing advanced intensive care capabilities to frontline medics
and medical treatment facilities.
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 5 of 14
R-1 Line #7
Volume 1 - 173
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 374A / GDF-Medical Products Support and
and Advanced Concept Development
Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
Clinical and Rehabilitative Medicine sponsored advanced clinical studies within the areas of pain management, and regenerative
and rehabilitative therapies after traumatic injury. Continued clinical research and clinical trials for regenerative medicine-based
approaches for restoration of limb (arms and legs) and digit (fingers, thumbs and toes) salvage, craniomaxillofacial (skull, face
and jaw) reconstruction, scarless wound healing, burn repair, and genitourinary system (reproductive and urinary organs).
Continued composite tissue allotransplantation (hand and face transplantation) efforts and associated immune system modulation
technologies. Initiated clinical research and new clinical trials for pain management.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
Medical Simulation and Information Sciences conduct research in two primary research portfolios -- Medical Simulation and
Training, and Health Informatics and Information Technology. Under the Medical Simulation and Training portfolio, the Advanced
Modular Manikin Phase 1 effort continues developing a core (torso) portion for use in the training of medical intervention
procedures. Efforts are underway to assess the value of stress inoculation simulation training methodologies, technologies,
and techniques in better protecting Warfighters from deployment related psychological stresses and trauma. Under the Health
Informatics portfolio, efforts continue towards filling theater information technology research gaps such as the capturing and
transmission of point of injury data, the incorporation of theater health information into DoD and Veteran’s Administration health
systems, and technology issues related to a theater environment.
Military Infectious Disease continue advanced development on polymerase chain reaction-based assays for malaria, dengue, and
chikungunya to be used on the Next Generation Diagnostic System (NGDS) for Combat Support Hospitals. Efforts begin on an
antimicrobial countermeasures study supporting the development of an antibacterial drug effective against multiple drug resistant
bacteria. A clinical study on wound infection prevention and management begins.
Military Operational Medicine is applying the results of clinical trials to the development of clinical practice guidelines for improved
psychotherapies (psychological treatment of mental disorders) for the treatment of PTSD. Continue Veterans AdministrationDoD clinical trials studying the use of pharmaceuticals for the treatment of deployment-related symptoms of PTSD (e.g., improving
sleep and reducing nightmares). Complete clinical trials on alcohol and substance abuse and suicide prevention interventions,
and begin to apply results to the development of clinical practice guidelines. Continue integration of actionable algorithms into
physiologic status monitoring systems based on end user feedback. Validate data from human studies on nutrition and dietary
supplements.
Combat Casualty Care conducts research in Hemorrhage and Resuscitation, Neurotrauma, Traumatic Tissue Injury, Forward
Surgical Intensive Critical Care, and joint Enroute Care. Under Hemorrhage and Resuscitation: Continue Phase 2 and initiate
Phase 3 clinical trials supporting FDA Biologic License Application for a spray-dried plasma product. Complete clinical trials on a
device killing infectious organisms in fresh whole blood collected on the battlefield for transfusion. Under Neurotrauma: Continue
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 6 of 14
R-1 Line #7
Volume 1 - 174
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 374A / GDF-Medical Products Support and
and Advanced Concept Development
Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
a DoD-Veteran’s Affairs multi-site collaborative study assessing the effectiveness of commonly prescribed off-label treatments for
combat-related PTSD. Continue studying the effectiveness of non-invasive diagnostic tools for TBI and the assessment of TBI
biomarkers in patients with concussive injuries. Evaluate and validate two TBI biomarker point-of-care devices in conjunction with
a biomarker-specific diagnostic assay system. Continue to develop the Biomarker Assessment for Neurotrauma Diagnosis and
Improved Triage System (BANDITS) diagnostic. Validate pivotal clinical trial results from the Portable Neuromodulation Stimulator
(PONS) as a treatment for TBI balance disorders. Under Forward Surgical Intensive Care and joint Enroute Care: Continue
the advanced development of a system to provide advanced intensive care capabilities to first responders and frontline Military
Treatment Facilities.
FY 2014
FY 2015
FY 2016
Clinical and Rehabilitative Medicine continues to maximize the opportunity to transition current efforts to fielding, private
industry, or medical systems development. Continue clinical studies in the areas of pain management, and regenerative and
rehabilitative therapies for traumatic injury. Continue clinical trials for regenerative medicine-based approaches for restoration
of limb (arms and legs) and digit (fingers, thumbs and toes) salvage, craniomaxillofacial (skull, face and jaw) reconstruction,
scarless wound healing, repair of skin injury resulting from burns, and genitourinary system (reproductive and urinary organs).
Continue composite tissue allotransplantation (hand and face transplantation) efforts and associated immune system modulation
technologies. Transition product for battlefield pain management to late-phase FDA regulated clinical trials.
For the tri-service translational research at Military Treatment Facilities, collaborative efforts are underway to solicit and
make awards. Applications are to focus on advanced concept development efforts in combat casualty care, operational
medicine, infectious diseases, and/or clinical and rehabilitative medicine. These include clinical trials for validation of improved
psychotherapies (psychological treatment of mental disorders), improved pharmaceuticals (medications) and devices for the
treatment of TBI/PH.
FY 2016 Plans:
Medical Simulation and Information Sciences will conduct research in two primary research portfolios -- Medical Simulation and
Training, and Health Informatics and Information Technology. Under the Medical Simulation and Training portfolio, Phase 1 of
the Advanced Modular Manikin project will end with platform downselect and one award for a standardized manikin core (torso)
platform. Advanced Modular Manikin, Phase 2 will begin the development of task specific peripherals (i.e., arm, legs, and head)
for integration onto the core platform selected from Phase 1. Advanced development efforts will continue on a stress inoculation
simulation system to better protect Warfighters from the deployment related psychological stresses and trauma. Testing will
continue on next generation mobile technologies for more effective advanced distributed learning applications, and on systems
development for improved mobile health technologies, visualization of health related data, and medical provider decision support
algorithms.
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 7 of 14
R-1 Line #7
Volume 1 - 175
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 374A / GDF-Medical Products Support and
and Advanced Concept Development
Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
Military Infectious Diseases will initiate advanced development on one infectious disease polymerase chain reaction-based
assay to be used on the Next Generation Diagnostic System (NGDS). Clinical studies will continue on the development of an
antibacterial drug effective against multiple drug resistant bacteria, and on wound infection prevention and management.
FY 2014
FY 2015
FY 2016
Military Operational Medicine will continue the development of clinical practice guidelines for improved psychotherapies
(psychological treatment of mental disorders) for PTSD, for the use of pharmaceuticals for the treatment of deployment-related
symptoms of PTSD (e.g., improving sleep and reducing nightmares), and on alcohol and substance abuse and suicide prevention
interventions. Continue validation studies on clinical nutrition and dietary supplement safety and efficacy. Develop gender-specific
and gender-neutral standards that apply across garrison and combat operations to reduce injuries in the total force. Continue
efforts within the area of environmental health and protection to refine algorithms to reliably predict core body temperature from
non-invasive measurements (e.g., skin temperature and heart rate) for a physiological health status monitoring system. Initiate
studies assessing the use of a physiological health monitoring system to determine the prevalence and severity of pulmonary
disease in pre-deployed and returned service members.
Combat Casualty Care conducted research in Hemorrhage and Resuscitation, Neurotrauma, Traumatic Tissue Injury, Forward
Surgical Intensive Critical Care, and joint Enroute Care. Under Hemorrhage and Resuscitation: Complete Phase 2 and Phase 3
clinical trials supporting FDA Biologic License Application for a spray-dried plasma product. Complete clinical trials on a device
that kills infectious organisms in fresh whole blood. Initiate clinical trials on an intracavitary hemostatic product and a low-volume
resuscitation drug. Under Neurotrauma: Continue clinical trials on a point-of-care diagnostic tool for traumatic brain injury.
Continue studies advancing the development of TBI biomarker devices. Validate results of a multi-site collaborative TBI endpoints
study to improve clinical trial design. Continue the advanced development of novel diagnostics for traumatic brain injury. Under
Traumatic Tissue Injury: Continue the development of technologies transitioned from the Peer Reviewed Orthopedic Research
Program. Under Forward Surgical Intensive Critical Care and joint Enroute Care: Continue advanced development of a system to
provide advanced intensive care capabilities to first responders, frontline Military Treatment Facilities, and data collection systems
for battlefield point of injury
Clinical and Rehabilitative medicine will continue to transition current efforts to fielding or private industry for products/solutions/
guidelines. Complete late phase FDA regulated clinical trials for battlefield pain management products and submit a New Drug
Application with the US FDA. Continue the development of regenerative and rehabilitative therapies for traumatic injury. Progress
clinical trials for regenerative medicine-based approaches for restoration of limb (arms and legs) and digit (fingers, thumbs and
toes) salvage, craniomaxillofacial (skull, face and jaw) reconstruction, scarless wound healing, repair of skin injury resulting from
burns, and genitourinary system (reproductive and urinary organs). Improve non-invasive clinical monitoring of composite tissue
allotransplantation (hand and face transplantation) and continue support for associated immune system modulation technologies.
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 8 of 14
R-1 Line #7
Volume 1 - 176
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 374A / GDF-Medical Products Support and
and Advanced Concept Development
Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
Initiate clinical trials on methods to reconstruct facial features (such as lips and eyelids), test nerve allograft materials, and
enhance muscle regeneration.
FY 2014
FY 2015
FY 2016
The Tri-service translational research Military Treatment Facility-based studies recommended for funding in FY15 will recruit,
screen, and enroll patients and will begin to collect data for advanced concept development efforts in combat casualty care,
operational medicine, infectious diseases, and clinical and rehabilitative medicine. Examples of initiatives within this area
include clinical trials to validate improved psychotherapies (psychological treatment of mental disorders), and efforts to improve
pharmaceuticals (medications) and devices for the treatment of TBI/PH).
Accomplishments/Planned Programs Subtotals
244.621
97.614
99.443
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Test and evaluate medical device prototypes, medical procedures, and drug and vaccine candidates in government-managed Phase 2 clinical trials to gather data
required for military and regulatory requirements prior to production and fielding, to include FDA approval and Environmental Protection Agency registration.
E. Performance Metrics
Research will be evaluated through In-Progress Reviews, high-level DHP-sponsored review and analysis meetings, quarterly and annual status reports, and will
be subject to Program Office or Program Sponsor Representatives progress reviews to ensure that Decision Gate milestones are being met and deliverables will
be transitioned on schedule. In addition, Integrated Product Teams, if established for a therapy or device, will monitor progress in accordance with DoD Regulation
5000 series. The benchmark performance metric for transition of research supported in this PE will be the attainment of a maturity level that is typical of Technology
Readiness Level (TRL) 7.
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 9 of 14
R-1 Line #7
Volume 1 - 177
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
400Z: CSI - Congressional
Special Interests
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 400Z / CSI - Congressional Special Interests
and Advanced Concept Development
Prior
Years
67.933
FY 2014
FY 2015
49.000
FY 2016
Base
53.208
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The FY14 DHP Congressional Special Interest (CSI) funding supported peer-reviewed directed research for Traumatic Brain Injury and Psychological Health, and Joint
Warfighter Medical Research. Because of the CSI annual structure, out-year funding is not programmed.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
10.000
20.000
Congressional Add: 427A - Traumatic Brain Injury/ Psychological Health
FY 2014 Accomplishments: The Traumatic Brain Injury and Psychological Health (TBI/PH) Congressional
Special Interest research program aims to prevent, mitigate, and treat the effects of combat-relevant traumatic
stress and TBI on function, wellness, and overall quality of life, including interventions across the deployment
lifecycle for warriors, Veterans, family members, caregivers, and communities. Key priorities of the FY14
TBI/PH research program were to support projects aligned with the National Research Action Plan, address
Congressional intent, enable significant research collaborations, and complement ongoing Department of
Defense (DoD) efforts to ensure the mental health and readiness of our military forces by promoting a better
standard of care for PH and TBI in the areas of prevention, detection, diagnosis, treatment, and rehabilitation. In
addition to service-requested nominations, individual Broad Agency Announcement applications, and promising
ongoing studies, four program announcements (PAs) were released to solicit applications that address these
priorities. The Psychological Health Research Award PA is intended to support both applied (preclinical)
research and clinical trials within specific topic areas addressing the prevention and treatment of militaryrelevant psychological health issues. The Neurosensory and Rehabilitation Research Award PA Supports both
applied (preclinical) research and clinical trials addressing TBI within specific focus areas of pain management,
hearing loss/dysfunction, balance disorders, tinnitus, vision, or physical rehabilitation associated with TBI. The
Investigative Treatments for TBI and PTSD Clinical Trial Award PA responds to Section 704 of the National
Defense Authorization Act for Fiscal Year 2014 and supports investigational treatments (including diagnostic
testing) of TBI and PTSD received by members of the Armed Forces in health care facilities other than military
treatment facilities. The Community Partners in Mental Health Research Award PA responds to Section
706 of the National Defense Authorization Act for Fiscal Year 2013 by supporting research on the causes,
development, and innovative treatment of mental health, substance use disorders, TBI, and suicide prevention
in members of the National Guard and Reserves, their family members, and their caregivers. Application
submission deadlines for the PAs are in November 2014, January 2015, and February 2015. Scientific peer
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 10 of 14
R-1 Line #7
Volume 1 - 178
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 400Z / CSI - Congressional Special Interests
and Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
reviews will be held in January and March 2015 followed by programmatic reviews in March and May 2015.
Awards will be made by September 2015.
FY 2014
FY 2015
FY 2015 Plans: This Congressional Special Interest research initiative is for Traumatic Brain Injury/
Psychological Health.
Congressional Add: 441A - Joint Warfighter Medical Research Program
35.000
20.000
4.000
3.000
- 10.208
FY 2014 Accomplishments: The Joint Warfighter Medical Research Program (JWMRP) provides continuing
support for promising research previously funded under Congressional Special Interest programs. The focus is
to augment and accelerate high priority DoD and Service medical requirements that are close to achieving their
objectives, and yielding a benefit to military medicine. Project funding is divided into technology development
and engineering and manufacturing development efforts. The JWMRP directly supports military medical
research in military infectious diseases, combat casualty care, military operational medicine, medical training
and health information sciences, and clinical and rehabilitative medicine. Through an iterative process of
recommendations, prior year CSI-funded projects were nominated for consideration by the Services, Joint
Program Committees, and Execution Management Agency activities. Those projects deemed by the Joint
Program Committees to have the highest priority to fill critical research or materiel gaps, and those projects
close to developing a product were invited to submit a full proposal for the next level of effort. The scientific peer
review was completed in late June. The programmatic review was completed in August with the recommended
funding list for 16 projects forwarded to the Director of Research and Development, Defense Health Agency for
approval. Award negotiations will be complete by September 2015.
FY 2015 Plans: This Congressional Special Interest research initiative is for Joint Warfighter Medical Research
Program.
Congressional Add: 455A - Therapeutic Service Dog Training Program (USUHS)
FY 2014 Accomplishments: This Congressional Special Interest project will support Therapeutics Service Dog
Training research.
FY 2015 Plans: This Congressional Special Interest research initiative is for Therapeutic Service Dog Training
Program (USUHS).
Congressional Add: 464A – Program Increase: Restore Core Research Funding Reduction (GDF)
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 11 of 14
R-1 Line #7
Volume 1 - 179
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 400Z / CSI - Congressional Special Interests
and Advanced Concept Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
FY 2015
FY 2014 Accomplishments: No funding programmed. This is an FY 2015 DHP Congressional Special Interest
(CSI) spending item.
FY 2015 Plans: FY 2015 DHP Congressional Special Interest (CSI) spending item directed toward the restoral
of core research initiatives in the Medical Products Support and Advanced Concept Development Program
Element (PE) - 0604110.
Congressional Adds Subtotals
49.000
53.208
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Prior year CSI funded research will be assessed for developmental maturity and qualification for initial or continued advanced development funding. If advanced
development criteria are met, follow-on development will be solicited through a peer-reviewed process.
E. Performance Metrics
N/A
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 12 of 14
R-1 Line #7
Volume 1 - 180
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
434A: Medical Products
Support and Advanced Concept
Development (AF)
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 434A / Medical Products Support and
and Advanced Concept Development
Advanced Concept Development (AF)
Prior
Years
3.896
FY 2014
FY 2015
3.013
- FY 2016
Base
FY 2016
OCO
4.000
FY 2016
Total
- 4.000
FY 2017
4.000
FY 2018
FY 2019
4.000
4.000
Cost To
FY 2020 Complete
Total
Cost
4.000 Continuing Continuing
A. Mission Description and Budget Item Justification
Air Force Medical Products Support and Advanced Concept Development & Prototyping efforts are focused on achieving rapid transition of promising, high TRL
commercially-available off-the-shelf products through minor modifications and/or enhancements to address the most pressing medical needs of the Warfighter,
accelerating of the transition of those technologies to the operators in the field. Development, Modification and Enhancement projects will emphasize technologies
supporting Expeditionary Medicine, Enroute Care, Force Health Protection, Operational Medicine and Human Performance. Ensure Healthcare delivery remains current
and relevant. Provide critical capability to make and act on material solution investment decisions in an annual cycle. Derive benefits from rapid insertion of high value /
impact technologies into healthcare operations with programmed funding to address capabilities that enter the acquisition life-cycle at high TRL levels that can readily
be implemented with significant upside potential. Ensure viability of S&T and translational research efforts with a materiel component without programmed funding for
logical progression and transition of those activities in the product development lifecycle.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
3.013
Title: Medical Products Support and Advanced Concept Development (AF)
FY 2015
- FY 2016
4.000
Description: Rapidly transition key COTS and near-COTS based technology solutions to the warfighter through assessment/
evaluation and minor modification or enhancement of solutions to address threshold operational requirements and associated key
performance parameters.Provide core capability to rapidly transition key, high value and impact technologies to operational use
Provide core capability to logically progress initiatives and concepts in the S&T and translational/knowledge-focused programs
(6.1-6.3) into material solutions and conduct the advanced development and transition activities needed to ensure those products
are fielded in an effective, timely and efficient manner.
FY 2014 Accomplishments:
Completed transition of non-invasive Patient Warming & Cooling technology to Program of Record; expanded pathogen detection,
identification and quantification (DIQ) technology to operational use on existing COTS gas chromatograph, mass spectrometer
platforms to address harmful and potentially harmful microbial volatile organic compounds (MVOC) and improve Force Health
Protection. Completed transition of expanded multi-lingual voice translation COTS capability to operational use in beyond line of
site / comm-out settings requiring on-board hardware based rapid translation capability. Prepare and issue solicitation for award
of an advanced technology development effort to refine and transition the Cardiovascular Sonospectrographic Analyzer (CSA)
pursuant to the approved FY14 Omnibus Reprogramming action.
FY 2015 Plans:
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 13 of 14
R-1 Line #7
Volume 1 - 181
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0604110HP / Medical Products Support 434A / Medical Products Support and
and Advanced Concept Development
Advanced Concept Development (AF)
B. Accomplishments/Planned Programs ($ in Millions)
Award effort to refine and commercialize the Cardiovascular Sonospectrographic Analyzer (CSA). Conduct developmental
engineering activities to ready the device for inclusion in advanced clinical trials and guiding it to the FDA regulatory approval
pathway. Award effort to develop a next generation multi-channel infusion pump via a modified-COTS approach to rapidly
and safely deliver drugs and therapeutics to DoD wounded, ill and injured personnel in the field, in the air and while awaiting
evacuation to definitive care.
FY 2014
FY 2015
FY 2016
FY 2016 Plans:
Evaluate the Cardiovascular Sonospectrographic Analyzer (CSA), technology through clinical trials by improving sensitivity
and specificity and form factor enhancements to device that can process sound signatures of turbulent blood through partially
occluded arteries - target level of sensitivity is CT angiography--include device in ongoing and planned clinical trials for submission
of the 510K predicate device application to the FDA. Continue efforts to develop a next generation multi-channel and prepare for
predicate device submission to the FDA for transition of the technology.
Accomplishments/Planned Programs Subtotals
3.013
- 4.000
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
Partnership with the US Navy, AFRL and the Department of the Interior in inter-agency agreements and use (award of delivery orders and task assignments) to
engineering and manfacturing development IDIQ vehicles awarded under SBIR phase III provisions. Utilization of Small Business Innovative Research program direct
awards for Phase III transition efforts and a Cooperative Agreement structure through Foundations supporting military medical research and development programs.
E. Performance Metrics
Achievement of required TRL for each advanced concept development/product support project and fulfillment of estabilshed KPPs for same.
PE 0604110HP: Medical Products Support and Advanced Co...
Defense Health Program
UNCLASSIFIED
Page 14 of 14
R-1 Line #7
Volume 1 - 182
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Total Program Element
Prior
Years
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology Development
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
219.540
44.451
21.696
19.312
- 19.312
19.679
23.582
21.386
21.813 Continuing Continuing
239B: Health Services Data
Warehouse (Air Force)
0.000
1.112
0.717
0.908
- 0.908
0.962
1.436
1.461
1.490 Continuing Continuing
239F: IM/IT Test Bed (Air Force)
3.800
2.265
1.801
1.844
- 1.844
1.837
2.222
2.686
2.740 Continuing Continuing
283C: Medical Operational Data
System (MODS) (Army)
1.472
3.384
3.413
2.601
- 2.601
2.678
3.547
4.016
4.096 Continuing Continuing
283D: Army Medicine CIO
Management Operations
1.492
2.113
0.120
0.867
- 0.867
0.794
2.649
3.371
3.438 Continuing Continuing
283F: Army Warrior Care and
Transition System (AWCTS)
0.488
- - - - - - - - - Continuing Continuing
283H: Psychological and
Behavioral Health - Tools
for Evaluation, Risk, and
Management (PBH-TERM)
0.000
- - 0.080
- 0.080
0.080
0.080
0.080
0.082 Continuing Continuing
283I: Workload Management
System for Nursing-Internet
0.264
- - - - - - - - - Continuing Continuing
283J: Multi-Drug Resistant
Surveillance Network (MRSN)
1.374
- 0.807
0.844
- 0.844
0.878
- - - Continuing Continuing
283K: Veterinary Services
Systems Management (VSSM)
0.000
0.238
- - - - - - - - Continuing Continuing
283L: Pharmacovigilance
Defense Application System
0.000
- 0.300
0.275
- 0.275
0.400
0.350
0.350
0.357 Continuing Continuing
283M: Business Intelligence
Competency Center (BICC)
0.000
1.488
- - - - - - - - Continuing Continuing
283N: Corporate Dental System
(CDS)
0.000
0.709
- - - - - - - - Continuing Continuing
283P: Mobile HealthCare
Environment (MHCE)
0.000
0.273
- 0.362
- 0.362
0.300
0.417
0.331
0.338 Continuing Continuing
130.693
- - - - - - - - - Continuing Continuing
385A: Integrated Electronic
Health Record Inc 1 (Tri-Service)
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 1 of 82
R-1 Line #8
Volume 1 - 183
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
386A: Virtual Lifetime Electronic
Record (VLER) HEALTH (TriService)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology Development
14.464
- - - - - - - - - Continuing Continuing
423A: Defense Center of
Excellence (FHP&RP)
1.177
2.287
- - - - - - - - Continuing Continuing
423B: Defense Center of
Excellence (Army)
0.000
- 1.105
1.346
- 1.346
1.369
1.395
1.422
1.450 Continuing Continuing
435A: NICOE Continuity
Management Tool
2.855
- - - - - - - - - Continuing Continuing
446A: Disability Mediation
Service (DMS)
0.000
0.539
0.382
0.433
- 0.433
0.445
0.588
0.666
0.679 Continuing Continuing
480B: Defense Medical Human
Resources System (internet)
(DMHRSi) (Tri-Service)
0.585
- - - - - - - - - Continuing Continuing
480C: Defense Medical Logistics
Standard Support (DMLSS) (TriService)
5.370
4.478
3.978
1.933
- 1.933
- - - - Continuing Continuing
480D: Defense Occupational
and Environmental Health
Readiness System - Industrial
Hygiene (DOEHRS-IH) (TriService)
3.372
4.680
- - - - 3.633
3.694
2.803
2.859 Continuing Continuing
480F: Executive Information/
Decision Support (EI/DS) (TriService)
3.127
2.809
- 2.551
- 2.551
1.791
- - - Continuing Continuing
480G: Health Artifact and Image
Management Solution (HAIMS)
(Tri-Service)
0.000
5.828
0.304
- - - - - - - Continuing Continuing
480K: integrated Federal Health
Registry Framework (Tri-Service)
0.000
2.591
1.093
0.450
- 0.450
- - - - Continuing Continuing
28.731
- - - - - - - - - Continuing Continuing
480M: Theather Medical
Information Program - Joint
(TMIP-J) (Tri-Service)
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 2 of 82
R-1 Line #8
Volume 1 - 184
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology Development
480P: Other Related Technical
Activities (Tri-Service)
4.123
- 2.990
- - - 1.683
3.500
- - Continuing Continuing
480R: TMA E-Commerce (TMA)
2.934
- - - - - - - - - Continuing Continuing
480Y: Clinical Case
Management (Tri-Service)
2.925
- - - - - - - - - Continuing Continuing
480Z: Centralized Credentials
and Quality Assurance System
(CCQAS) (Tri-Service)
1.692
- - - - - - - - - Continuing Continuing
481A: Theather Enterprise Wide
Logistics System (TEWLS) TriService)
5.127
- - - - - - - - - Continuing Continuing
482A: E-Commerce (DHA)
0.000
5.526
2.494
2.766
- 2.766
2.829
3.704
4.200
4.284 Continuing Continuing
490I: Navy Medicine Chief
Information Officer
2.106
4.131
- - - - - - - - Continuing Continuing
490J: Navy Medicine Online
1.369
- 2.192
2.052
- 2.052
- - - - Continuing Continuing
MDAP/MAIS Code:
Other MDAP/MAIS Code(s): 465
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key technologies to overcome medical and military unique technology
barriers. Programs include Army service level support for the Army Warrior Care and Transition System (AWCTS), the Medical Operational Data System (MODS),
the Workload Management System for Nursing – Internet (WMSNi), the Psychological and Behavioral Health – Tools for Evaluation, Risk, and Management (PBHTERM), the Multidrug-Resistant Organism Repository and Surveillance Network (MRSN), the Business Intelligence Competency Center (BICC), the Mobile HealthCare
Environment (MHCE), the Corporate Dental System (CDS), and the Defense Center of Excellence (DCoE).
The Navy Medical Command RDT&E funding supports the development required for those systems which are integral to Navy Medicine (i.e., Navy Medicine Online
(NMO)). Navy Medicine also funds, when appropriate, a number of small-scale, opportunistic business improvements when the technology makes a sudden advance.
These projects are generally not in the scope of the TRICARE Management Activity (TMA) Central Programs such as the development/integration of Defense Optical
Fabrication Enterprise Management System (DOFEMS) into a fully automated system to support workload distribution, performance metrics, staffing requirements,
supply management, calculation of operating costs from the current independently or manually DOFEMS system. This effort will be a web based centralized
management tool and provide a standalone standard set of Lab Management software for all 26 Navy labs. Additionally, the re-design of HIV Management System
(HMS) will be more user friendly, less time to perform everyday tasks and prevents the need to maintain separate databases. The re-design will also automate and
minimize functions that require manual assistance and assist in fulfilling new requirements.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 3 of 82
R-1 Line #8
Volume 1 - 185
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0605013HP / Information Technology Development
For the Air Force Medical Service (AFMS), this program element supports IM/IT development requirements within four AFMS Chief Information Officer defined core
capabilities as essential to Air Force Medical Service IM/IT mission support. Data warehousing, reporting services, systems integration, and custom application
development are featured in almost all IM/IT systems and application requests. The information needs of the AFMS are growing in volume, complexity, and delivery
formats. In order to meet future requirements, aggregation of more and varied data sources require increasingly complex data warehousing capabilities. Demand for
dynamic analytic capability will require investments in business intelligence, predictive analytic tools, open source research data models, and emerging personalized
medicine analysis. Information is still largely produced in an ad hoc manner without standard methodologies, mapping of business requirements, transparent analytic
models, and distributed by office productivity software. Centralized production of standard reports, balance sheets, and dynamic query tools would relieve many
managers and action officer of routine work and increase leadership decision support. AFMS medical readiness reporting and tracking has set the standard in the
DoD for over a decade but multiple applications now encompass what has merged into a common process of tracking unit capability and personal health assessments.
Consolidation of medical readiness applications would streamline disability, medical readiness, deployment surveillance, and flying status tracking and reporting who
currently must move between multiple applications.
For the Air Force, the funding in this program element provides for sustainment of the IM/IT Test Bed (IMIT-TB) capability, which is a dedicated OT location and staff
encompassing the entire spectrum of healthcare services and products available in MTFs, to provide risk controlled testing of designated core and interim medical
applications in a live environment.
Military Health System (MHS) Health Information Technology (HIT) [previously known as Tri-Service IM/IT] - HIT activities include: Innovation and Advanced
Technology; Infrastructure & Operations; Solution Delivery; Information Delivery; Cyber Security; and Portfolio Management and Customer Relations. RDT&E program
includes funding for development/integration, modernization, test and evaluation for the Defense Health Agency initiatives, and any special interest that are shared
within all components of the Defense Health Program (DHP), excluding the Integrated Electronic Health Record, Defense Medical Information Exchange and the DoD
Healthcare Management System Modernization Program (DHMSM).
The DHP RDT&E appropriation includes the following TMA initiatives: Electronic Commerce System (E-Commerce): This system was developed for centralized
collection, integration, and reporting of accurate purchased care contracting and financial data. It provides an integrated set of data reports from multiple data sources
to management, as well as tools to control the end-to-end program change management process. E-Commerce is composed of several major applications including:
Contract Management (CM), utilizing Prism software to support contract action development and documentation; Resource Management (RM), employing Oracle
Federal Financials and TED interface software to support the budgeting, accounting, case recoupment, and disbursement processes; Document Management, utilizing
Document software to provide electronic storage, management, and retrieval of contract files; Management Tracking and Reporting, utilizing custom software to
provide reports to assist in the management and tracking of changes to the managed care contracts as well as current and out year liabilities; the Purchased Care and
Contractor’s Resource Center web sites that provide up-to-date financial information for both TMA and the Services concerning the military treatment facilities (MTFs),
and expenditures for MTF enrollee purchased care and supplemental care. E-Commerce includes an infrastructure of over 60 servers supporting development, test,
and production. E-Commerce is employed by several hundred users in more than 7 different organizations. Project oversight and coordination must be provided to
ensure that the needs of the disparate organizations are met without influencing system performance or support to any individual user. Server configurations must
remain current with respect to security policies, user authorizations, and interactions with other systems and functions. All of these activities must be managed and
coordinated on a daily basis.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 4 of 82
R-1 Line #8
Volume 1 - 186
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0605013HP / Information Technology Development
Disability Mediation Service (DMS): The VTA (Veteran’s Tracking Application) has been the primary system to track, record, and report data for the IDES (Integrated
Disability Evaluation System) process. The VTA is scheduled to sun-set, by VA (Veterans Affairs), and the data is being moved to another application. Migration of VTA
to another application creates the requirement to allow data exchange between Service non-medical case management and new VA DES (Disability Evaluation System)
IT application. The BEC (Benefits Executive Council) is looking to create a DMS (Disability Mediation Service), which is an integrator between the Services and VA.
The DMS will facilitate the improvement of non-medical case management tracking and IDES data/information management. It will eliminate redundant data entry within
DoD (Department of Defense), improving data quality by capturing more data for operational reporting from the Services and WCP, decrease backlog by eliminating data
entry duplication, and minimize impact to DoD Services by allowing the Services to continue using their existing/planned systems without requiring retraining on a new
applications.
The DMS will be created from existing technology. It will provide a mediation service to help isolate each system from changes and uniqueness in the other systems and
allow the Services and WCP to report and drill down on data that we capture during the exchange. This IT solution will not replace current DoD systems, but will require
some modifications and enhancements to those systems to support the date exchange. WCP will support development costs for these efforts. Services will assume
responsibility and POM costs for modifications, enhancements, and maintenance in the out years."
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Program Realignment - Project 480K
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
43.135
44.451
1.316
- - - - - 3.480
-2.164
- 21.696
21.696
- - - - - - - - - 18.862
19.312
0.450
- - - 18.862
19.312
0.450
0.450
- 0.450
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0605013-Information Technology
Development (-$2.164 million) to DHP RDT&E PE 0605502-Small Business Innovation Research (SBIR) Program (+$2.164 million).
FY 2015: Departmental Fiscal Guidance directed reductions to DHP RDT&E, PE 0605013-Information Technology Development (-$7.466 million).
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 5 of 82
R-1 Line #8
Volume 1 - 187
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0605013HP / Information Technology Development
FY 2015: Transfer between DHP RDT&E Components of the Defense Center of Excellence (FHP&RP) Program, PE 0605013-Information Technology
Development from the DHA (-$1.225 million) to Army (+$1.225 million).
FY 2016: Change Proposal adjustment to DHP RDT&E, PE 0605013-Information Technology Development (+0.450 million).
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 6 of 82
R-1 Line #8
Volume 1 - 188
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
239B: Health Services Data
Warehouse (Air Force)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
1.112
0.717
FY 2016
Base
FY 2016
OCO
0.908
FY 2016
Total
- 0.908
FY 2017
0.962
FY 2018
1.436
Project (Number/Name)
239B / Health Services Data Warehouse
(Air Force)
FY 2019
1.461
Cost To
FY 2020 Complete
Total
Cost
1.490 Continuing Continuing
A. Mission Description and Budget Item Justification
Previously known as Assessment Demonstration Center (ADC), Health Services Data Warehouse (HSDW) addresses and focuses on Air Force Medical Service
(AFMS) Data Strategy under the DoD and AF Net Centric Enterprise Services. HSDW will develop an Enterprise Data Warehouse (EDW) and Data Marts consolidating
databases and transition to a SOA architecture. Program will improve data collection, aggregation, analysis, and data visualization of medical information. New data
models will allow rapid development of enterprise-wide reports utilizing Business Intelligence tools.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
1.112
0.717
Title: 239B - Health Services Data Warehouse
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.908
- 0.908
Description: AFMS will purchase COTS software/licenses and build custom scripts for development of the data
warehouse. The COTS software will expedite consolidation and cleansing of data, measure data quality, merge
and organize data for reporting tools. These efforts will be used to complete the transition of CDM data into the
HSDW.
FY 2014 Accomplishments:
For FY14 RDTE funding, the AFMS will purchase COTS software/licenses and build custom scripts for
development of the data warehouse. The COTS software will expedite consolidation and cleansing of data,
measure data quality, merge and organize data for reporting tools. These efforts will be used to complete the
transition of CDM data into the HSDW.
FY 2015 Plans:
AFMS will continue to use COTS software to build custom scripts for development of the data warehouse. The
COTS software will expedite consolidation and cleansing of data, measure data quality, merge and organize
data for reporting tools. These efforts will be used to complete the transition of CDM data into the HSDW.
FY 2016 Base Plans:
AFMS will continue to use COTS software to build custom scripts for development of the data warehouse. The
COTS software will expedite consolidation and cleansing of data, measure data quality, merge and organize
data for reporting tools. These efforts will be used to complete the transition of CDM data into the HSDW.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 7 of 82
1.112
R-1 Line #8
0.717
0.908
- 0.908
Volume 1 - 189
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
Remarks
FY 2014
10.900
FY 2015
11.267
FY 2016
Base
4.011
FY 2016
OCO
- FY 2016
Total
4.011
FY 2017
4.072
FY 2018
4.133
Project (Number/Name)
239B / Health Services Data Warehouse
(Air Force)
FY 2019
4.195
Cost To
FY 2020 Complete Total Cost
4.250 Continuing Continuing
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 8 of 82
R-1 Line #8
Volume 1 - 190
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
239F: IM/IT Test Bed (Air Force)
3.800
FY 2014
FY 2015
2.265
1.801
FY 2016
Base
FY 2016
OCO
1.844
FY 2016
Total
- 1.844
FY 2017
1.837
FY 2018
2.222
Project (Number/Name)
239F / IM/IT Test Bed (Air Force)
FY 2019
2.686
Cost To
FY 2020 Complete
Total
Cost
2.740 Continuing Continuing
A. Mission Description and Budget Item Justification
Dedicated operational test (OT) location and staff encompassing the entire spectrum of healthcare services and products available in Military Treatment Facilities
(MTFs), to provide realistic, risk controlled testing of designated core and interim medical applications in an operationally realistic environment. Critical component of
ongoing capability development & fielding efforts, ensuring that each is supported by an independent, unbiased assessment of effectiveness, suitability, security, and
survivability in a realistic operational environment as required by the FAR 46.103, DoD 5000, and AFI 99-103. The AFMISTB is a complementary service to existing
MHS developmental, integration, interoperability, and security testing facilities, forming a logical test process continuum leading to effective deployment decisions.
Outcomes include decreasing life-cycle costs of IM/IT products by catching errors early in the acquisition process where they are less costly to fix, and increasing patient
safety by fielding operationally tested medical information systems.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
2.265
1.801
Title: 239F IM/IT Test Bed (Air Force)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
1.844
- 1.844
Description: Provide realistic, risk controlled testing of designated core and interim medical applications in an
operationally realistic environment. Critical component of ongoing capability development & fielding efforts,
ensuring that each is supported by an independent, unbiased assessment of effectiveness, suitability, security,
and survivability in a realistic operational environment as required by the FAR 46.103, DoD 5000, and AFI
99-103. The AFMISTB is a complementary service to existing MHS developmental, integration, interoperability,
and security testing facilities, forming a logical test process continuum leading to effective deployment decisions.
Outcomes include decreasing life-cycle costs of IM/IT products by catching errors early in the acquisition
process where they are less costly to fix, and increasing patient safety by fielding operationally tested medical
information systems.
FY 2014 Accomplishments:
Provided realistic, risk controlled testing of designated core and interim medical applications in an operationally
realistic environment. Critical component of ongoing capability development & fielding efforts, ensuring
that each is supported by an independent, unbiased assessment of effectiveness, suitability, security, and
survivability in a realistic operational environment as required by the FAR 46.103, DoD 5000, and AFI 99-103.
The AFMISTB offered complementary service to existing MHS developmental, integration, interoperability, and
security testing facilities, forming a logical test process continuum leading to effective deployment decisions.
Outcomes include decreasing life-cycle costs of IM/IT products by catching errors early in the acquisition
process where they are less costly to fix, and increasing patient safety by fielding operationally tested medical
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 9 of 82
R-1 Line #8
Volume 1 - 191
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
information systems. Led integration plans for all IMIT programs; developed conceptual systems test/integration
requirements. Provided technical/management leadership on EHR program development with zero test mishaps.
Evaluated 40 AF/Joint operational test programs; employed $11M test
assets/19K labor hours; no OT&E related delays. Catalyst for VPN linkage at premier DoD common
development site; leveraged Joint platform to complement AFMS.
Oversaw AFMS OT for 3 ACAT 1
programs/$3B; OT schedule on target.
Project (Number/Name)
239F / IM/IT Test Bed (Air Force)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2015 Plans:
Continue to provide realistic, risk controlled testing of designated core and interim medical applications in an
operationally realistic environment. Critical component of ongoing capability development & fielding efforts,
ensuring that each is supported by an independent, unbiased assessment of effectiveness, suitability, security,
and survivability in a realistic operational environment as required by the FAR 46.103, DoD 5000, and AFI
99-103. The AFMISTB is a complementary service to existing MHS developmental, integration, interoperability,
and security testing facilities, forming a logical test process continuum leading to effective deployment decisions.
Outcomes include decreasing life-cycle costs of IM/IT products by catching errors early in the acquisition
process where they are less costly to fix, and increasing patient safety by fielding operationally tested medical
information systems.
FY 2016 Base Plans:
Continue to provide realistic, risk controlled testing of designated core and interim medical applications in an
operationally realistic environment. Critical component of ongoing capability development & fielding efforts,
ensuring that each is supported by an independent, unbiased assessment of effectiveness, suitability, security,
and survivability in a realistic operational environment as required by the FAR 46.103, DoD 5000, and AFI
99-103. The AFMISTB is a complementary service to existing MHS developmental, integration, interoperability,
and security testing facilities, forming a logical test process continuum leading to effective deployment decisions.
Outcomes include decreasing life-cycle costs of IM/IT products by catching errors early in the acquisition
process where they are less costly to fix, and increasing patient safety by fielding operationally tested medical
information systems.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• N/A: N/A
FY 2014
- FY 2015
- PE 0605013HP: Information Technology Development
Defense Health Program
FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- UNCLASSIFIED
Page 10 of 82
FY 2017
- 2.265
FY 2018
- 1.801
FY 2019
- R-1 Line #8
1.844
- 1.844
Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
Volume 1 - 192
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
Project (Number/Name)
239F / IM/IT Test Bed (Air Force)
FY 2019
Cost To
FY 2020 Complete Total Cost
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 11 of 82
R-1 Line #8
Volume 1 - 193
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283C: Medical Operational Data
System (MODS) (Army)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
1.472
FY 2015
3.384
3.413
FY 2016
Base
FY 2016
OCO
2.601
FY 2016
Total
- 2.601
FY 2017
2.678
FY 2018
3.547
Project (Number/Name)
283C / Medical Operational Data System
(MODS) (Army)
FY 2019
4.016
Cost To
FY 2020 Complete
Total
Cost
4.096 Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding for the Medical Operational Data System (MODS) to deploy modernized data visualization capabilities
to enhance Army Unit and Individual Medical Readiness Reporting. MODS provides Army leadership with a responsive and reliable human resource and readiness
information management data system for all categories of military and civilian medical and support personnel. MODS provide Tri-Service support through applications
such as Electronic Profile, Behavioral Health, and Medical Education.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
3.384
3.413
Title: Medical Operational Data System (MODS)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
2.601
- 2.601
Description: Information management system to provide responsive and reliable human resource and medical
readiness data for all categories of military and civilian medical and support personnel.
FY 2014 Accomplishments:
FY14 certification/funding made it possible for the MODS program to propagate and strengthen its Three-Tiered
Object-Oriented Architecture making the development of critical software solutions more cost effective, wellperforming, predictable, extensible and uniformed. Products developed under this architecture include all Army
Deployment Health Assessments, core Period Health Assessment modules, and modifications needed for the
Tri-service mandated promotion of the Behavioral Health Data Portal. FY14 funding also allowed for the MODS
data warehouse to be complemented with robust data visualization tools. A proof-of-concept using these new
capabilities successfully produced a static instantiation of the complete physical data design of the entire medical
readiness domain for super users to analyze.
FY 2015 Plans:
FY15 funds are being used to elicit the entire business requirement and developmental design of the Electronic
Profile System using the Three-Tiered Object-Oriented Architecture. This is to be proceeded by the development
of a completely refactored solution. In addition, all design processes and products will be verified and validated
by a senior Federally-Funded Research and Development (FFRDC) Team – MITRE. The Human Resources
suite of applications will use this model in parallel. Additionally, the full production increment of MODS Data
Warehouse will be executed.
FY 2016 Base Plans:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 12 of 82
R-1 Line #8
Volume 1 - 194
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
FY16 funds will be used to respond to Milestone Decision Authority decisions to add new capabilities,
significantly enhance, and technically upgrade existing capabilities, and use federally funded research and
development center resources for system engineering and acquisition effectiveness services.
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-3, 0807721HP:
Replacement/Modernizaation
Remarks
FY 2015
3.384
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Project (Number/Name)
283C / Medical Operational Data System
(MODS) (Army)
3.413
FY 2016
Base
FY 2016
OCO
2.601
- FY 2016
Total
2.601
FY 2014
12.260
FY 2015
12.689
FY 2016
Base
13.326
FY 2016
OCO
- FY 2016
Total
13.326
FY 2017
13.726
FY 2018
14.138
FY 2019
14.392
Cost To
FY 2020 Complete Total Cost
14.642 Continuing Continuing
0.360
0.420
0.120
- 0.120
0.620
0.300
0.400
0.200 Continuing Continuing
D. Acquisition Strategy
Select the business, technical, and contract actions that will minimize cost, reduce program risk, and remain within schedule while meeting program objectives.
E. Performance Metrics
1. MEASURE: Data Warehouse reduces total number of database maintenance hours.
METRIC: % database maintenance hours = number of monthly database maintenance hours/total database maintenance hours of previous year average.
2. MEASURE: Data Warehouse supports queries and reports with few data errors (information quality/accuracy).
METRIC: % of reports and queries that contain data errors = total number of reports and queries with data errors /total number of reports and queries.
3. MEASURE: Data Warehouse provides the data needed by users and applications (information quality/completeness).
METRIC: % post-Data Warehouse = total number (post-Data Warehouse) queries and reports/total number (pre + post-Data Warehouse) queries and reports.
4. MEASURE: Three-Tier Object Oriented Architectural Design (3TOOAD) benefits are reduced costs for implementation of new functionalities.
METRIC: % of labor cost = cost of MSR for functional implementation/average cost of similar MSR from previous year(s).
5. MEASURE: Organizational and individual impact of Data Warehouse, 3TOOAD, and Robust Business Intelligence.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 13 of 82
R-1 Line #8
Volume 1 - 195
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
METRIC: >= 8.5 avg. benchmark score (0 to 10 scale) on quarterly quality and impact surveys from users.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 14 of 82
R-1 Line #8
Project (Number/Name)
283C / Medical Operational Data System
(MODS) (Army)
Volume 1 - 196
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283D: Army Medicine CIO
Management Operations
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
1.492
FY 2014
FY 2015
2.113
0.120
FY 2016
Base
FY 2016
OCO
0.867
FY 2016
Total
- 0.867
FY 2017
0.794
FY 2018
2.649
Project (Number/Name)
283D / Army Medicine CIO Management
Operations
FY 2019
3.371
Cost To
FY 2020 Complete
Total
Cost
3.438 Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Army Medicine CIO Management Operations program includes development projects for Army service level support. Specifically, the Army
Medicine CIO Management Operations encompasses the Army Medical CIO's Information Management/Information Technology (IM/IT) development activities to ensure
compliance with Congressional, Office of Management and Budget, DoD, and Military Health System requirements.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
2.113
0.120
Title: 283D - Army Medicine CIO Management Operations
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.867
- 0.867
Description: The Army Medicine CIO Management Operations will provide system development, engineering,
and testing requirements of interim Army medical applications in an operationally realistic, risk controlled test
environment to comply with Congressional, Office of Management and Budget, DoD, and Military Health System
requirements.
FY 2014 Accomplishments:
FY14 funds were used to complete system development, engineering, and testing requirements of Army Medical
applications, that provides realistic, risk controlled testing of designated core and interim medical applications in
an operationally realistic environment.
FY 2015 Plans:
For FY15, the Army Medicine CIO Management Operations is developing and enhancing a system that will
provide system development, engineering, and testing requirements of Army Medical applications, which
provides realistic, risk controlled testing of designated core and interim medical applications in an operationally
realistic environment.
FY 2016 Base Plans:
For FY16, the Army Medicine CIO Management Operations will be developing and enhancing a system that will
provide system development, engineering, and testing requirements of Army Medical applications, which will
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 15 of 82
R-1 Line #8
Volume 1 - 197
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
provides realistic, risk controlled testing of designated core and interim medical applications in an operationally
realistic environment.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-1, 0807721HP:
Replacement/Modernization
• BA-1, 0807798HP:
Management Headquarters
• BA-1, 0807796HP:
Base Operations
Remarks
Project (Number/Name)
283D / Army Medicine CIO Management
Operations
FY 2015
2.113
0.120
FY 2016
Base
FY 2016
OCO
0.867
FY 2016
Total
- 0.867
FY 2014
32.489
FY 2015
41.743
FY 2016
Base
38.125
FY 2016
OCO
- FY 2016
Total
38.125
FY 2017
35.696
FY 2018
36.230
FY 2019
41.664
Cost To
FY 2020 Complete Total Cost
41.664 Continuing Continuing
2.773
1.665
0.387
- 0.387
1.099
3.975
4.051
- Continuing Continuing
- 3.975
3.979
- 3.979
3.983
3.987
3.991
3.991 Continuing Continuing
- 2.805
2.853
- 2.853
2.901
2.950
3.001
3.001 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Periodic management evaluation based on ability to provide system development, engineering, and testing requirements of new Army medical applications.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 16 of 82
R-1 Line #8
Volume 1 - 198
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283F: Army Warrior Care and
Transition System (AWCTS)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
0.488
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- Project (Number/Name)
283F / Army Warrior Care and Transition
System (AWCTS)
FY 2018
- FY 2019
- - Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Army Warrior Care and Transition System (AWCTS) program includes development projects for Army service level support. Specifically, the
AWCTS is a family of systems that allows the integration of multiple business processes under the consolidated oversight of the Warrior Transition Command.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Army Warrior Care and Transition System (AWCTS)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: A family of systems that allows the integration of multiple business processes under the
consolidated oversight of the Warrior Transition Command.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807714HP:
Other Health Activities
Remarks
FY 2014
1.587
FY 2015
1.691
FY 2016
Base
1.776
FY 2016
OCO
- FY 2016
Total
1.776
FY 2017
1.865
FY 2018
1.958
- FY 2019
1.995
- - - Cost To
FY 2020 Complete Total Cost
1.995 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 17 of 82
R-1 Line #8
Volume 1 - 199
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
major decisions.
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
283F / Army Warrior Care and Transition
System (AWCTS)
E. Performance Metrics
1. MEASURE: Increase Soldier’s ability to access career and education, and communication with transition coordinators.
METRIC: Days from submitting request to an appointment or obtaining information
2. MEASURE: Provide the capability for staff to be able to gain visibility of a Soldier’s transition status.
METRIC: Days from submitting request to receiving status of Soldier.
3. MEASURE: Provide the capability for staff to analyze metrics and business processes.
METRIC: Days from requesting metrics/BP reports until receipt of data.
4. MEASURE: Provide the capability for automated workflow processes to decrease manual and decentralized processes.
METRIC: Percentage of automated processes versus manual processes
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 18 of 82
R-1 Line #8
Volume 1 - 200
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283H: Psychological and
Behavioral Health - Tools
for Evaluation, Risk, and
Management (PBH-TERM)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
- - FY 2016
Base
FY 2016
OCO
0.080
FY 2016
Total
- FY 2017
0.080
0.080
Project (Number/Name)
283H / Psychological and Behavioral
Health - Tools for Evaluation, Risk, and
Management (PBH-TERM)
FY 2018
0.080
FY 2019
0.080
Cost To
FY 2020 Complete
Total
Cost
0.082 Continuing Continuing
A. Mission Description and Budget Item Justification
The US Army Medical Command (MEDCOM) and Defense Centers of Excellence (DCOE) have partnered to develop this information technology project for joint service
level support. The PBH-TERM platform addresses two congressionally mandated initiatives including the behavioral health management within the Warrior Transition
Command (GH risk Management module/BHRM and within primary care settings (FIRST-STEPS). Further development efforts allow expansion of capabilities to
deliver ongoing user support and training via web-based modules within PBH-TERM and will provide costs casings in terms of staffing requirements, conferencing and
reporting.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Psychological and Behavioral Health – Tools for Evaluation, Risk, and Management (PBH-TERM)
FY 2014 FY 2015
- - FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.080
- 0.080
Description: PBH-TERM is a web-based psychological and Behavioral Health (BH) information technology
platform, which supports evidence-based, standardized and integrated BH risk and case management initiatives
as well as program evaluation for the Warrior Transition Command and Patient/Soldier-Centered BH (PCBH)
care in primary care settings.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
Adds self-service functionality with direct input by the eligible beneficiaries. Improves health system visibility;
add “view” only feature, which allows enhanced visibility by authorized BH providers. Adds program
management module for marriage and family therapy program.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 19 of 82
- R-1 Line #8
- 0.080
- 0.080
Volume 1 - 201
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
Remarks
FY 2014
0.153
FY 2015
0.090
FY 2016
Base
0.074
FY 2016
OCO
- FY 2016
Total
0.074
FY 2017
0.074
FY 2018
0.074
Project (Number/Name)
283H / Psychological and Behavioral
Health - Tools for Evaluation, Risk, and
Management (PBH-TERM)
FY 2019
0.074
Cost To
FY 2020 Complete Total Cost
0.074 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting congressional mandates and program objectives. Strategy is revised as required as a result of periodic program reviews or major
decisions.
E. Performance Metrics
FY16
Measure: Improved user efficiencies through automation of support/training modules and guidelines.
Baseline: January 2014, 25% user efficiency rating.
Target: March 2018, 90% user efficiency rating.
Source: Audits and analysis performed by Defense Centers of Excellence, Patient-Centered Behavioral Health personnel.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 20 of 82
R-1 Line #8
Volume 1 - 202
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283I: Workload Management
System for Nursing-Internet
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
0.264
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- Project (Number/Name)
283I / Workload Management System for
Nursing-Internet
FY 2018
- FY 2019
- - Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Workload Management System for Nursing – Internet (WMSNi) program includes development projects for Army service level support.
Specifically, the WMSNi supports clinical staff scheduling, based on known and projected patient care needs, for continuous 24x7 hospital operations.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Workload Management System for Nursing-Internet
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate
key information technologies to overcome medical and military unique technology barriers. The Workload
Management System for Nursing – Internet (WMSNi) program includes development projects for Army service
level support. Specifically, the WMSNi supports clinical staff scheduling, based on known and projected patient
care needs, for continuous 24x7 hospital operations.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
FY 2014
0.767
FY 2015
0.696
PE 0605013HP: Information Technology Development
Defense Health Program
FY 2016
Base
0.722
FY 2016
OCO
- FY 2016
Total
0.722
UNCLASSIFIED
Page 21 of 82
FY 2017
0.723
FY 2018
0.762
- FY 2019
0.723
R-1 Line #8
- - - Cost To
FY 2020 Complete Total Cost
0.723 Continuing Continuing
Volume 1 - 203
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
Project (Number/Name)
283I / Workload Management System for
Nursing-Internet
FY 2019
Cost To
FY 2020 Complete Total Cost
Remarks
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting congressional mandates and program objectives. Strategy is revised as required as a result of periodic program reviews or major
decisions.
E. Performance Metrics
1. MEASURE: All Tier 2 tickets were resolved as required.
METRIC: Maintain application including software components resolving 100% of all problems resolvable at the Tier 2 level
2. MEASURE: Hosted Environment up time maintained at 98%.
METRIC: Provide an operational readiness up time of 98% for the hosted environment, excluding scheduled maintenance windows
3. MEASURE: Execute required security patches to enterprise systems IAW Army directives.
METRIC: 95% of Security Patches and critical updates executed within required timeframe
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 22 of 82
R-1 Line #8
Volume 1 - 204
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283J: Multi-Drug Resistant
Surveillance Network (MRSN)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
1.374
FY 2015
- FY 2016
Base
0.807
FY 2016
OCO
0.844
FY 2016
Total
- 0.844
FY 2017
Project (Number/Name)
283J / Multi-Drug Resistant Surveillance
Network (MRSN)
FY 2018
0.878
FY 2019
- - Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Multi-Drug Resistant Surveillance Network (MRSN) program includes development projects for Army service level support. Specifically, the
MRSN is the Enterprise effort to collect and characterize bacterial isolates to inform best practice, such as patient management and antibiotic selection.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- 0.807
Title: Multi-Drug Resistant Surveillance Network (MRSN)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.844
- 0.844
Description: MRSN is the Enterprise effort to collect and characterize bacterial isolates to inform best practice,
such as patient management and antibiotic selection.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
Funding are being used to develop and Test Phase 2 Features of MRSN. Funding are also be used to develop
and deploy the First System Update which places the new features into production; and Phase 3 Features.
FY 2016 Base Plans:
Funding will be used to develop and Test Phase 3 Features of MRSN. Funding are also be used to finalize the
development and deployments of the System Updates which places the new features into production.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
Remarks
FY 2014
0.450
FY 2015
- PE 0605013HP: Information Technology Development
Defense Health Program
FY 2016
Base
0.565
FY 2016
OCO
- FY 2016
Total
0.565
UNCLASSIFIED
Page 23 of 82
FY 2017
0.544
FY 2018
0.757
0.807
FY 2019
0.775
R-1 Line #8
0.844
- 0.844
Cost To
FY 2020 Complete Total Cost
0.790 Continuing Continuing
Volume 1 - 205
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
283J / Multi-Drug Resistant Surveillance
Network (MRSN)
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Business metrics:
1. Turn-around time from receipt of isolate shipment to initial test results being available on MRSN System.
Current Performance : 2 weeks
Target Performance: 4 days
Data Source: Comparison of isolate receipt date and test result date
2. Time to prepare monthly Antibiogram Report
Current Performance: 8 weeks
Target Performance: 2 weeks
Data Source: Number of days following the end of the month that the report is distributed/posted
3. Antibiogram (or other major product) Report Views
Current Performance: N/A (not currently implemented)
Target Performance: 30 per month
Data Source: Server logs
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 24 of 82
R-1 Line #8
Volume 1 - 206
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283K: Veterinary Services
Systems Management (VSSM)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
0.238
- FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- FY 2017
- - Project (Number/Name)
283K / Veterinary Services Systems
Management (VSSM)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Veterinary Services Systems Management (VSSM) program includes development projects for Army service level support. Specifically, the
VSSM will capture veterinary health care treatment information to include laboratory findings from various medical institutions.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
0.238
- Title: Veterinary Services Systems Management (VSSM)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: VSSM is a worldwide web access application capable of capturing veterinary health care
treatment information to include laboratory findings of Military working dogs, all government owned animals, and
dependent owned animals, and dependent owned animals.
FY 2014 Accomplishments:
FY14 Funding for Veterinary Services Systems Management (VSSM) program was used to provide the
additional capability needed for a commercial laboratories interface to electronically exchange laboratory test
results data between the VSSM application and all approved commercial laboratories. ANTECH Laboratory is
the only commercial laboratory interface currently supports. FY14 Funds provides the solution scope allowing
Veterinary Services the ability to achieve the business objects of providing a clinically integrated, secure webbased application to support the Veterinary Services mission.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 25 of 82
0.238
R-1 Line #8
- - - - Volume 1 - 207
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
Project (Number/Name)
283K / Veterinary Services Systems
Management (VSSM)
FY 2014
2.068
FY 2015
1.689
FY 2016
Base
1.816
FY 2016
OCO
- FY 2016
Total
1.816
FY 2017
1.880
FY 2018
1.971
FY 2019
1.971
Cost To
FY 2020 Complete Total Cost
1.880 Continuing Continuing
0.500
- 0.450
- 0.450
0.750
- 0.500
0.500 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
MEASURE: The success of Commercial Laboratories Interface will be the capability in VSSM to electronically request and receive laboratory test results from approved
external commercial laboratories, resulting in minable data.
METRIC: The electronic laboratory test result data will be timely, accurate, and allow alerts for potential disease surveillances to be triggered in VSSM.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 26 of 82
R-1 Line #8
Volume 1 - 208
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283L: Pharmacovigilance
Defense Application System
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
- 0.300
FY 2016
Base
FY 2016
OCO
0.275
FY 2016
Total
- 0.275
FY 2017
0.400
Project (Number/Name)
283L / Pharmacovigilance Defense
Application System
FY 2018
0.350
FY 2019
0.350
Cost To
FY 2020 Complete
Total
Cost
0.357 Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information tehcnologies to overcome medical and military unique
technology barriers. The Pharmacoviligance Defense Application System (PVDAS) provides Military providers Defense Patient Safety reports from the Food and Drug
Administration (FDA) after a drug´s release to market.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- 0.300
Title: Pharmacoviligance Defense Application System (PVDAS)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.275
- 0.275
Description: The Pharmacoviligance Defense Application System (PVDAS) provides Military providers Defense
Patient Safety reports from the Food and Drug Administration (FDA) after a drug´s release to market.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
FY15 funding are being used to finalize the process improvements that provide improved information for making
military health system formulary decisions, better visibility into medical practice enhancing patient safety, and
greater access to drug risk/benefit information for military physicians.
FY 2016 Base Plans:
FY16 funding will be used to continue the process improvements that will provide improved information for
making military health system formulary decisions. This process improvement will also provide better visibility
into medical practice enhancing patient safety, and greater access to drug risk/benefit information for military
physicians.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 27 of 82
- R-1 Line #8
0.300
0.275
- 0.275
Volume 1 - 209
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-1, 0807714HP:
Other Health Activities
• BA-1, 0807798HP:
Management Headquarters
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
Project (Number/Name)
283L / Pharmacovigilance Defense
Application System
FY 2014
1.190
FY 2015
1.118
FY 2016
Base
1.205
FY 2016
OCO
- FY 2016
Total
1.205
FY 2017
1.311
FY 2018
1.474
FY 2019
1.544
Cost To
FY 2020 Complete Total Cost
1.696 Continuing Continuing
1.677
0.035
- - - - - - - Continuing Continuing
0.852
1.395
1.418
- 1.418
1.443
1.467
1.492
1.492 Continuing Continuing
1.200
- - - - - - - - Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
1. MEASURE: All Tier 2 tickets were resolved as required.
METRIC: Maintain application including software components resolving 100% of all problems resolvable at the Tier 2 level
2. MEASURE: Hosted Environment up time maintained at 98%.
METRIC: Provide an operational readiness up time of 98% for the hosted environment, where the application is never inoperable for longer than 3 business days
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 28 of 82
R-1 Line #8
Volume 1 - 210
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283M: Business Intelligence
Competency Center (BICC)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
1.488
- FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
283M / Business Intelligence Competency
Center (BICC)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Business Intelligence Competency Center (BICC) is the business intelligence capability and management processes, focused on providing
actionable data at the point of service that facilitates provisioning of actionable information for MTF Commanders, AMEDD Leadership and end users.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
1.488
- Title: Business Intelligence Competency Center (BICC)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The Business Intelligence Competency Center (BICC) is the business intelligence capability and
management processes, focused on providing actionable data at the point of service that facilitates provisioning
of actionable information for MTF Commanders, AMEDD Leadership and end users.
FY 2014 Accomplishments:
FY14 funds were used to continue the finalization of the baseline code for MEDCOM 360. MEDCOM 360
is a low complexity system utilizing pre-existing aggregated data sources to present de-identified data for
performance and quality reviews at the headquarters level. FY14 Funds were used to aggregate data from
several legacy systems into a single user friendly information source to meet patient care needs and chronic
disease management for the care team and case management. The information was aggregated up to clinic and
practice management personnel and was used for performance management, with the main focus at the patient/
care team level in order to provide actionable information. Funds were used to optimize order entry reporting
for pending and completed provider orders, and remaining bug fixes. Funds were used to integrate existing
alerts and transitioning of care functions, providing an increased stability and performance. Funds provided
user access management and security review for role based and CAC enabled access. Funds were used to
coordinate CHCS Cache SQL review with MEDCOM and DHA concerning interface data exchange.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 29 of 82
R-1 Line #8
Volume 1 - 211
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
No funding programmed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-3, 0807721HP:
replacement/Modernization
Remarks
Project (Number/Name)
283M / Business Intelligence Competency
Center (BICC)
FY 2015
1.488
- FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- - FY 2014
1.320
FY 2015
1.097
FY 2016
Base
1.163
FY 2016
OCO
- FY 2016
Total
1.163
FY 2017
1.155
FY 2018
1.398
FY 2019
0.947
Cost To
FY 2020 Complete Total Cost
0.947 Continuing Continuing
- 0.900
- - - - 0.050
- - Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 30 of 82
R-1 Line #8
Volume 1 - 212
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
283N: Corporate Dental System
(CDS)
FY 2014
- FY 2015
0.709
- FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- FY 2017
- - Project (Number/Name)
283N / Corporate Dental System (CDS)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Corporate Dental System (CDS) is the Dental digital web based DICOM image capture and viewing application.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
0.709
- Title: Corporate Dental System (CDS)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The Corporate Dental System (CDS) is the Dental digital web based DICOM image capture and
viewing application.
FY 2014 Accomplishments:
FY14 funds were used to provide all required imaging capabilities at USA dental facilities to include DICOM
image view, capture, store, and forward. Corporate Dental Imaging (CDI) 1.0 provides the capability to scan the
patient’s CAC which also verifies patient metadata within DEERS. CDI 1.0 can now capture images using the
hardware vendor’s Software Development Kit (SDK) for image enhancement and filtering rather than a TWAIN
driver. This version of CDI uses the SDK from Planmeca and Carestream and supports the Panograph (PX),
Cephalometric (DX), intra oral (IO), and Cone Beam CT modalities. FY14 funds were also used to create image
progression capabilities which allow capturing various image combinations depending on the images required
for care. CDI storage server can store, forward and verify that images taken at a dental facility are stored locally
and in the global repository at FT Sam Houston, TX. At the completion of this development cycle CDI became a
client-side capture and web-based viewing application that includes EDI identification in the DICOM image data;
enables Web viewing of the original DICOM images stored at the enterprise level, enables image enhancements
that are saved as layers on top of the original DICOM, and provides reporting for completed image studies,
series, and all individual I/O DICOM images taken.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 31 of 82
R-1 Line #8
Volume 1 - 213
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
No funding programmed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Managment/
Information Technology
• BA-1, 0807715HP:
Dental Care Activities
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
Project (Number/Name)
283N / Corporate Dental System (CDS)
FY 2015
0.709
- FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- - FY 2014
0.866
FY 2015
2.464
FY 2016
Base
2.517
FY 2016
OCO
- FY 2016
Total
2.517
FY 2017
2.571
FY 2018
2.627
FY 2019
2.685
Cost To
FY 2020 Complete Total Cost
2.685 Continuing Continuing
5.933
6.967
8.084
- 8.084
8.292
8.497
8.750
8.750 Continuing Continuing
- 2.100
2.541
- 2.541
2.614
2.688
2.757
- Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 32 of 82
R-1 Line #8
Volume 1 - 214
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
283P: Mobile HealthCare
Environment (MHCE)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
0.273
- FY 2016
Base
FY 2016
OCO
0.362
FY 2016
Total
- 0.362
FY 2017
0.300
FY 2018
0.417
Project (Number/Name)
283P / Mobile HealthCare Environment
(MHCE)
FY 2019
0.331
Cost To
FY 2020 Complete
Total
Cost
0.338 Continuing Continuing
A. Mission Description and Budget Item Justification
The Army Medical Command received PE 0605013 funding to identify, explore, and demonstrate key information technologies to overcome medical and military unique
technology barriers. The Mobile HealthCare Environment (MHCE) is the capability of secure, bidirectional messaging and data exchange between patients, providers
and clinics using any electronic device.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
0.273
- Title: Mobile HealthCare Environment (MHCE)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.362
- 0.362
Description: The Mobile HealthCare Environment (MHCE) is the capability of secure, bidirectional messaging
and data exchange between patients, providers and clinics using any electronic device.
FY 2014 Accomplishments:
FY14 funds established an enterprise presence for the system, Mobile Health Care Environment (MHCE). This
expansion provides the mobile health outreach used for patient care outside of clinical research protocols,
which was a limitation prior to FY14. Additionally, the MHCE system was modernized for both the research
and enterprise space to allow for the use of multimedia content, and end user tracking of interactions within the
mobile app. Finally the MHCE system was enhanced to including synchronization with biosensor technologies,
which will afford the DHA to provide at home monitoring of chronic conditions, such as diabetes in the future.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
FY16 certification/funding will be utilized to expand the MHCE functionality to include data exchange with other
systems, specifically a patient’s personal health record, and enterprise systems such as their electronic health
record.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 33 of 82
0.273
R-1 Line #8
- 0.362
- 0.362
Volume 1 - 215
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
Remarks
FY 2014
1.268
FY 2015
1.226
FY 2016
Base
1.285
FY 2016
OCO
- FY 2016
Total
1.285
FY 2017
1.350
FY 2018
1.416
Project (Number/Name)
283P / Mobile HealthCare Environment
(MHCE)
FY 2019
1.489
Cost To
FY 2020 Complete Total Cost
1.564 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 34 of 82
R-1 Line #8
Volume 1 - 216
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
385A: Integrated Electronic
Health Record Inc 1 (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
130.693
FY 2015
- - FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
385A / Integrated Electronic Health Record
Inc 1 (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
MDAP/MAIS Code: 465
A. Mission Description and Budget Item Justification
The integrated Electronic Health Record (iEHR) was approved to provide seamless integrated sharing of electronic health data between the DoD and Department of
Veterans Affairs (VA).
Commensurate with the OSD AT&L Acquisition Decision Memoranda (ADM), dated July 21, 2013 and January 2, 2014, the former joint DoD and VA iEHR program has
been restructured within the DoD to pursue two separate but related healthcare information technology efforts, the DoD Healthcare Management System Modernization
(DHMSM) program and a redefined iEHR program. These programs report through the PEO DoD Healthcare Management Systems (DHMS) to the USD (AT&L).
iEHR RDT&E is reported under the program element 0605013 through FY 2013 inclusive, but will be reported under new program element 0605023 for FY 2014 and
out.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Integrated Electronic Health Record (iEHR) Inc 1 (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The iEHR primary role is health care delivery services. iEHR is a collaborative effort between
the DoD and VA to share Health Care Resources to improve access to, and quality and cost effectiveness of,
health care as mandated by law. This investment is deeply embedded in the MHS Enterprise Roadmap as both
Departments have need for modernization/ replacement of existing legacy systems. This investment will use
a combination of an open architecture approach, and the purchase (in some instances) of GOTS and COTS
products.
FY 2014 Accomplishments:
No funding programmed in this program element.
FY 2015 Plans:
No funding programmed in this program element.
FY 2016 Base Plans:
No funding programmed in this program element.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 35 of 82
- R-1 Line #8
- - - - Volume 1 - 217
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
Remarks
FY 2014
- FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- FY 2018
- Project (Number/Name)
385A / Integrated Electronic Health Record
Inc 1 (Tri-Service)
FY 2019
- Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements. Program cost, schedule and performance are measured periodically using a systematic approach.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 36 of 82
R-1 Line #8
Volume 1 - 218
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
386A: Virtual Lifetime Electronic
Record (VLER) HEALTH (TriService)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
14.464
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- - Project (Number/Name)
386A / Virtual Lifetime Electronic Record
(VLER) HEALTH (Tri-Service)
FY 2018
FY 2019
- - Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The primary goal of the VLER Health initiative is to enable the secure sharing of health information (i.e., demographic and clinical data) between DoD and external
Federal and private sector partners which meets Meaningful Use (MU) requirements to improve healthcare quality, safety, and efficiency. By electronically sharing
health information using national standards, that information can support tracking key clinical conditions, communicating that information to better coordinate care, and
engaging patients in their own care. The VLER Health initiative provides clinicians with the most up-to-date information, potentially reducing redundant diagnostic tests,
medical errors, paperwork and handling, and overall healthcare costs. These benefits, in turn, align with the MHS quadruple aim by ensuring that the military force is
medically ready to deploy; the military beneficiary population remains healthy through focused prevention; patient care is convenient, equitable, safe, and of the highest
quality; and the total cost of healthcare is reduced through the reduction of waste and focus on quality.
VLER Health funding will be reflected in the Integrated Electronic Health Record Program Element 0605023 in FY 2014 and out.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Virtual Lifetime Electronic Record (VLER) HEALTH (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Work with Department of Veterans Affairs (VA), Department of Health & Human Services (HHS),
and Private Sector to expand VLER.
FY 2014 Accomplishments:
No funding programmed in this program element.
FY 2015 Plans:
No funding programmed in this program element.
FY 2016 Base Plans:
No funding programmed in this program element.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 37 of 82
- R-1 Line #8
- - - - Volume 1 - 219
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
Remarks
FY 2014
- FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- FY 2018
- Project (Number/Name)
386A / Virtual Lifetime Electronic Record
(VLER) HEALTH (Tri-Service)
FY 2019
- Cost To
FY 2020 Complete Total Cost
- D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements which are usually included in the MHS IT Annual Performance Plan. Program cost, schedule and performance
are measured periodically using a systematic approach.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 38 of 82
R-1 Line #8
Volume 1 - 220
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
423A: Defense Center of
Excellence (FHP&RP)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
1.177
FY 2015
2.287
- FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
423A / Defense Center of Excellence
(FHP&RP)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
Note
In FY15, transferred from FHP&R (Project Code 423A) to Army (Project Code 423B).
A. Mission Description and Budget Item Justification
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) is a United States Department of Defense (DoD) organization that
provides guidance across DoD programs related to psychological health (PH) and traumatic brain injury (TBI) issues. The organization’s mission statement is: “DCoE
assesses, validates, oversees and facilitates prevention, resilience, identification, treatment, outreach, rehabilitation, and reintegration programs for PH and TBI to
ensure the Department of Defense meets the needs of the USA's military communities, warriors and families.” DCoE focuses on education and training; clinical care;
prevention; research; and service member, family and community outreach. In collaboration with the Department of Veterans Affairs, the organization supports the
Department of Defense’s commitment of caring for service members from the time they enter service and throughout the completion of their service. DCoE also seeks
to mitigate the stigma that still deters some from reaching out for help for problems such as post-traumatic stress disorder and TBI. The organization has a leadership
role in collaborating with a national network of external entities[1] including non-profit organizations,[2] other DoD agencies, academia, Congress,[3] military services
and other federal agencies.[4] Public health service and civil service workers, including personnel from the Department of Veterans Affairs and individuals from all the
military services as well as contract personnel comprise the staff of DCoE. DCoE’s goals include providing the necessary resources to facilitate the care of service
members who experience TBI or PH concerns and ensuring that appropriate standards of care exist and are maintained across the Department of Defense. DCoE seeks
to create, identify and share best practices, conducting necessary pilot or demonstration projects to better inform quality standards when best practices or evidence
based recommendations are not readily available. Other DCoE goals include ensuring that program standards are executed and quality is consistent and creating a
system in which individuals across the United States expect and receive the same level and quality of service regardless of their service branch, component, rank or
geographic location. DCoE comprises eight directorates and six component centers responsible for TBI/PH issues. These DCoE entities execute programs, provide
clinical care, conduct research, identify and share best practices and provide strategic planning for PH and TBI across the DoD.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
2.287
- Title: Defense Center Of Excellence (FHP&RP)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: DCoE programs and products are developed to drive innovation across the continuum of care by
identifying treatment options and other clinical and research methods that deliver superior outcomes. Products
range from tools customized for health care providers to electronic resources for service members and families.
FY 2014 Accomplishments:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 39 of 82
R-1 Line #8
Volume 1 - 221
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Funds will be utilized to finalize the multi-phased upgrade and redesign of the afterdeployment.org website.
Afterdeployment.org will provide the latest in self-care tools that assist with a range of adjustment concerns
(combat stress, sleep problems, anger management, etc.), with an emphasis on exercise-based interactivity,
community support, and multimedia applications. For the T2 Toolkit (T2T), funding would be used for the final
phase of development focusing on the new generation of PH Mobile Apps that will enhance many area of PH for
DoD service members, family, and veterans.
FY 2014
Project (Number/Name)
423A / Defense Center of Excellence
(FHP&RP)
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
2.287
- - - - C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 40 of 82
R-1 Line #8
Volume 1 - 222
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
423B: Defense Center of
Excellence (Army)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
- 1.105
FY 2016
Base
FY 2016
OCO
1.346
FY 2016
Total
- 1.346
FY 2017
1.369
FY 2018
1.395
Project (Number/Name)
423B / Defense Center of Excellence (Army)
FY 2019
1.422
Cost To
FY 2020 Complete
Total
Cost
1.450 Continuing Continuing
Note
Transferred from FHP&R (Project Code 423A) to Army (Project Code 423B) in FY15.
A. Mission Description and Budget Item Justification
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury is administratively managed under the United States Army Medical Command
(MEDCOM) Organization that provides guidance across DoD program related to psychological health (PH) and traumatic brain injury (TBI) issues. The organizational
mission statement is: “DCoE’s mission is to improve the lives of our nation’s Service Members, Families, and Veterans by advancing excellence in psychological
health and traumatic brain injury prevention and care.” DCoE focuses on education and training; clinical care; prevention; research, and Service Member, Family, and
community outreach. In collaboration with the Department of Veterans Affairs, DCoE supports the DoD’s commitment of caring for service members from the time they
enter service and throughout the completion of their service. DCoE also seeks to mitigate the stigma that still deters some from reaching out for help for problems such
as post-traumatic stress disorder and TBI. The organization has a leadership role in collaborating with a national network of external entities to include: 1. Non-profit
organizations, 2. Other DoD agencies, academia, and Congress, 3. Military services and other federal agencies and, 4. Public Health Service and civil service workers,
to include personnel from the Department of Veterans Affairs and individuals from all military services as well as contractor personnel assigned to DCoE. DCoE’s goals
include providing the necessary resources to facilitate the care of service members who experience TBI and/or PH concerns and ensuring that appropriate standards of
care exist and are maintained across the DoD. DCoE seeks to create, identify, and share best practices; conducting necessary pilot or demonstration projects to better
inform quality standards when best practices or evidence-based recommendations are not available. Additional goals include ensuring that program standards are
executed and quality is consistent for all individuals throughout the United States so that they receive the same level and quality of service regardless of service branch,
component, rank, or location. DCoE is comprised of a HQs element and three component centers responsible for PH/TBI issues. These DCoE directorates and centers
execute programs, provide clinical care, conduct research, and identify and share best practices and provide strategic planning for all PH and TBI throughout the DoD.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- 1.105
Title: Defense Center of Excellence (Army)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
1.346
- 1.346
Description: DCoE programs and products are developed and implemented to drive innovation across the
continuum of care by identifying treatment options and other clinical and research methods that deliver superior
healthcare outcomes. Products range from tools customized for healthcare providers to electronic resources
such as online games and mobile apps for Service Members and their Families.
FY 2014 Accomplishments:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 41 of 82
R-1 Line #8
Volume 1 - 223
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
423B / Defense Center of Excellence (Army)
FY 2014
Plans noted and funded under Project 423A.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2015 Plans:
FY15 funds are being used to continue the development, modernization, sustainment, and release of mobile
apps, PH games, websites, and longitudinal services in support of the T2 Toolkit portfolio, as listed in the
FY2014 Accomplishments above. This new generation of PH mobile apps, games, and websites are improving
the PH outcomes for DoD Service Members, their Families, and Veterans. Continued for 2015 is the use of
RDT&E funds for the Deployment Health Clinical Center’s (DHCC) development of a module (FIRST STEPS)
in support of Psychological and Behavioral Health. This expansion effort is intended to further the focus of the
behavioral healthcare of all adult primary care. The emphasis within 2015 is to develop automated user training
in lieu of direct face-to-face training for Behavioral Health personnel.
FY 2016 Base Plans:
FY16 funds will be used to complete the development and transition to sustainment for the electronic capabilities
listed above. The T2 toolkit and its sub-components will be more fully developed in order to allow for further
collaboration and remote access to tools. RDT&E funding will be utilized to continue development of mobile
applications, 3D games, websites, and other applications. In addition, the DHCC FIRST STEPS module will
continue to evolve and develop capabilities to tailor reporting, track data by individual service, and monitor
conditions such as smoking cessation and obesity/weight management. This program will also add healthcare
facilitators in behavioral activation and motivational interviewing techniques with patients.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-1, 0807724HP: Military
Unique - Other Medical
Remarks
1.105
1.346
- 1.346
FY 2014
- FY 2015
2.097
FY 2016
Base
2.128
FY 2016
OCO
- FY 2016
Total
2.128
FY 2017
2.159
FY 2018
2.199
FY 2019
2.239
Cost To
FY 2020 Complete Total Cost
2.239 Continuing Continuing
- 1.396
1.478
- 1.478
1.549
1.588
1.685
1.685 Continuing Continuing
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 42 of 82
R-1 Line #8
Volume 1 - 224
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
423B / Defense Center of Excellence (Army)
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements. Program cost, schedule and performance are measured periodically using a systematic approach.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 43 of 82
R-1 Line #8
Volume 1 - 225
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
435A: NICOE Continuity
Management Tool
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
2.855
- FY 2015
- FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
435A / NICOE Continuity Management Tool
FY 2018
- FY 2019
Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The NICoE Continuity Management Tool (NCMT) is a business intelligence tool to perform healthcare modeling and analysis of NICoE activities.
Major capabilities defined by the NICoE in Jun 2009 and refined in Jun 2010 prior to the program procurement in Sep 2010, are subsystems that make up the NCMT
end-to-end system, and were prioritized in the following order: Continuity Management Subsystem, Scheduling Subsystem, Clinical Subsystem, Research Subsystem,
Training and Education Subsystem, Administration Subsystem.
Continuity Management Subsystem: Records every interaction with a particular Warrior and his or her Family as one entity to manage initial contact, referral, screening,
intake, pre-admission, admission, discharge and follow-up processes.
Scheduling Subsystem: Captures, organizes, displays the complex schedules of the NICoE. Used to manage patient appointments, the utilization of facility resources
including treatment rooms, modalities, provider staff and support staff.
Clinical Subsystem: A clinical application and clinical database that includes the functions that allow the user to store, classify, analyze, retrieve, interpret, present clinical
data. Allows the visualization of all of the various components of the patient’s health record: radiology, pathology, lab results, neurological assessments, etc.
Research Subsystem: Consists of the research database and the applications that allow the user to store, classify, analyze, retrieve, interpret, present data. Allows
NICoE to aggregate data from disparate systems, both within the NICoE and from partner organizations, helping the research move faster, with more agility, and with
purpose and direction supported by validated facts. Allows researchers to address many data challenges from a single system and transforms the way they do research.
Training and Education Subsystem: Provides the ability to share relevant research, diagnosis, treatment information with authorized users.
Administration Subsystem: Provides the ability to manage a portfolio of projects related to continuity of care, clinical operations, research, training and education
functions in the NICoE.
The NCMT is supported by Three Contracts: Hosting (Provides Hardware, Software, Maintenance), System Integration (Implements NICoE Functional Requirements,
Turns NICoE Ideas and Goals into Computer Screens, Templates, Applications – Capabilities) and Decision Support (Acquisition Management, Requirements Definition,
Implementation Planning).
The NICoE’s missions are to:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 44 of 82
R-1 Line #8
Volume 1 - 226
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0605013HP / Information Technology
435A / NICOE Continuity Management Tool
Development
1) Explore novel, promising, and futuristic solutions to the complex spectrum of combat brain injury from TBI to posttraumatic stress disorder (PTSD) and other
psychological injuries;
2) Ensure – through continuous outreach and high quality health care – that America embraces those who have served and sacrificed so much on its behalf; and
3) Train the next generation of providers in the most effective approaches to prevention, detection, and treatment options.
Currently the established AHLTA specification does not adequately support the specialized care and continuity management integration necessary to support NICoE
clinical operations and research. Additionally, AHLTA does not support the data mining and pattern recognition requirements of the NICoE.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: NICOE Continuity Management Tool
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The NCMT is a tool designed to perform healthcare modeling and analysis of NICoE activities.
Major capabilities include Continuity Management, Scheduling, Clinical Database, Research Database, Training
and Education, and Administration.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• 4187 807783: NCMT
• 4187 807781: NCMT
• 1690 807781: HEIS
• 4859 807781: JMED
• 4940 807781: JTFCMI
• 4940 807720: JTFCMI
FY 2014
- 3.819
- - 39.170
- FY 2015
- 3.961
- - 40.792
4.600
PE 0605013HP: Information Technology Development
Defense Health Program
FY 2016
Base
- 4.107
- - 41.610
- FY 2016
OCO
- - - - - - FY 2016
Total
- 4.107
- - 41.610
- UNCLASSIFIED
Page 45 of 82
FY 2017
- 4.259
- - 42.395
- FY 2018
- 4.332
- - 43.267
- - FY 2019
- - - - - - R-1 Line #8
- FY 2020
- - - - - - - Cost To
Complete
Continuing
Continuing
Continuing
Continuing
Continuing
Continuing
- Total Cost
Continuing
Continuing
Continuing
Continuing
Continuing
Continuing
Volume 1 - 227
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
• 4273 807781: Engineering
and Deployment
• 4280 807721: Engineering
and Deployment
• 4361 807781: IA
Operational Resiliency
• 4126 807781: Computer
Network Defense
• 4111 807781: Computer
Network Defense
• 4165 807781: Computer
Network Defense
• 4177 807781: Computer
Network Defense
• 4364 807781:
Workforce Development
Remarks
Project (Number/Name)
435A / NICOE Continuity Management Tool
FY 2014
- FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- FY 2018
- FY 2019
- Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
- - - - - - - - - Continuing Continuing
- - - - - - - - - Continuing Continuing
- - - - - - - - - Continuing Continuing
0.463
0.473
0.482
- 0.482
0.492
0.502
- - Continuing Continuing
- - - - - - - - - Continuing Continuing
- - - - - - - - - Continuing Continuing
- - - - - - - - - Continuing Continuing
D. Acquisition Strategy
This requirement is currently contracted through the USA Medical Research Activity. The vender is Evolvent Technologies Inc.
E. Performance Metrics
This performance metrics or milestones shall include, but is not limited to:
Coordination with Government representatives
Review, evaluation and transition of current support services
Transition of historic data to new contractor system
Government-approved training and certification process
Transfer of hardware warranties and software licenses
Transfer of all System/Tool documentation to include, at a minimum: user manuals, system administration manuals, training materials, disaster recovery manual,
requirements traceability matrix, configuration control documents and all other documents required to operate, maintain and administer systems and tools
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 46 of 82
R-1 Line #8
Volume 1 - 228
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
Project (Number/Name)
PE 0605013HP / Information Technology
435A / NICOE Continuity Management Tool
Development
If another contractor follows this contractor with work related to this work, this contractor will provide any developed source code (compiled and uncompiled, including
all versions, maintenance updates and patches) with written instructions for the source code on which this contractor has worked, so that an experienced software
engineer, previously not familiar with the source code can understand and efficiently work with the source code. In addition, this contractor will provide for 30 days, a
software engineer (or person of comparable work level) with significant experience working with the source code, to assist the new contractor
Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes
Disposition of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment, etc.
Transfer of Government Furnished Equipment (GFE) and Government Furnished Information (GFI), and GFE inventory management assistance
Applicable TMA debriefing and personnel out-processing procedures
Turn-in of all government keys, ID/access cards, and security codes.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 47 of 82
R-1 Line #8
Volume 1 - 229
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
446A: Disability Mediation
Service (DMS)
FY 2014
- FY 2015
0.539
0.382
FY 2016
Base
FY 2016
OCO
0.433
FY 2016
Total
- 0.433
FY 2017
0.445
FY 2018
0.588
Project (Number/Name)
446A / Disability Mediation Service (DMS)
FY 2019
0.666
Cost To
FY 2020 Complete
Total
Cost
0.679 Continuing Continuing
A. Mission Description and Budget Item Justification
"Disability Mediation Service (DMS):
The VTA (Veteran’s Tracking Application) has been the primary system to track, record, and report data for the IDES (Integrated Disability Evaluation System) process.
The VTA is scheduled to sun-set, by VA (Veterans Affairs), and the data is being moved to another application. Migration of VTA to another application creates the
requirement to allow data exchange between Service non-medical case management and new VA DES (Disability Evaluation System) IT application. The BEC (Benefits
Executive Council) is looking to create a DMS (Disability Mediation Service), which is an integrator between the Services and VA.
The DMS will facilitate the improvement of non-medical case management tracking and IDES data/information management. It will eliminate redundant data entry within
DoD (Department of Defense), improving data quality by capturing more data for operational reporting from the Services and WCP, decrease backlog by eliminating data
entry duplication, and minimize impact to DoD Services by allowing the Services to continue using their existing/planned systems without requiring retraining on a new
applications.
The DMS will be created from existing technology. It will provide a mediation service to help isolate each system from changes and uniqueness in the other systems and
allow the Services and WCP to report and drill down on data that we capture during the exchange. This IT solution will not replace current DoD systems, but will require
some modifications and enhancements to those systems to support the date exchange. WCP will support development costs for these efforts. Services will assume
responsibility and POM costs for modifications, enhancements, and maintenance in the out years."
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
0.539
0.382
Title: Disability Mediation Service (DMS)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.433
- 0.433
Description: The VTA (Veteran’s Tracking Application) has been the primary system to track, record, and report
data for the IDES (Integrated Disability Evaluation System) process. The VTA is scheduled to sun-set, by VA
(Veterans Affairs), and the data is being moved to another application. Migration of VTA to another application
creates the requirement to allow data exchange between Service non-medical case management and new VA
DES (Disability Evaluation System) IT application. The BEC (Benefits Executive Council) is looking to create a
DMS (Disability Mediation Service), which is an integrator between the Services and VA.
The DMS will facilitate the improvement of non-medical case management tracking and IDES data/information
management. It will eliminate redundant data entry within DoD (Department of Defense), improving data quality
by capturing more data for operational reporting from the Services and WCP, decrease backlog by eliminating
data entry duplication, and minimize impact to DoD Services by allowing the Services to continue using their
existing/planned systems without requiring retraining on a new applications.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 48 of 82
R-1 Line #8
Volume 1 - 230
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
The DMS will be created from existing technology. It will provide a mediation service to help isolate each system
from changes and uniqueness in the other systems and allow the Services and WCP to report and drill down on
data that we capture during the exchange. This IT solution will not replace current DoD systems, but will require
some modifications and enhancements to those systems to support the date exchange. WCP will support
development costs for these efforts. Services will assume responsibility and POM costs for modifications,
enhancements, and maintenance in the out years."
FY 2014
Project (Number/Name)
446A / Disability Mediation Service (DMS)
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2014 Accomplishments:
The Warrior Care Program Office realigned manpower and program control during in FY 2014. Necessary
project planning and requirement development have not progressed sufficiently to obtain DBT certification
required to execute. Program responsibility has been assigned and project is proposed to be realigned to
support the Joint Disability Evaluation System (JDES) project.
FY 2015 Plans:
Migration of VTA to another application creates the requirement to allow data exchange between Service nonmedical case management and new VA DES (Disability Evaluation System) IT application. The BEC (Benefits
Executive Council) is looking to create a DMS (Disability Mediation Service), which is an integrator between the
Services and VA. The DMS will be created from existing technology. It will provide a mediation service to help
isolate each system from changes and uniqueness in the other systems and allow the Services and WCP to
report and drill down on data that we capture during the exchange. This IT solution will not replace current DoD
systems, but will require some modifications and enhancements to those systems to support the date exchange.
WCP will support development costs for these efforts.
FY 2016 Base Plans:
Migration of VTA to another application creates the requirement to allow data exchange between Service nonmedical case management and new VA DES (Disability Evaluation System) IT application. The BEC (Benefits
Executive Council) is looking to create a DMS (Disability Mediation Service), which is an integrator between the
Services and VA. The DMS will be created from existing technology. It will provide a mediation service to help
isolate each system from changes and uniqueness in the other systems and allow the Services and WCP to
report and drill down on data that we capture during the exchange. This IT solution will not replace current DoD
systems, but will require some modifications and enhancements to those systems to support the date exchange.
WCP will support development costs for these efforts.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 49 of 82
0.539
R-1 Line #8
0.382
0.433
- 0.433
Volume 1 - 231
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
446A / Disability Mediation Service (DMS)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
To be determined when an approach has been determined.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 50 of 82
R-1 Line #8
Volume 1 - 232
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480B: Defense Medical Human
Resources System (internet)
(DMHRSi) (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
0.585
FY 2015
- - FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
480B / Defense Medical Human Resources
System (internet) (DMHRSi) (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Defense Medical Human Resources System – internet (DMHRSi) enables the Services to standardize and optimize the management of human resource assets
across the Military Health System (MHS). DMHRSi is a Web-based system that enables improved decision making by facilitating the collection and analysis of critical
human resource data. It standardizes medical human resource information and provides enterprise-wide visibility for all categories of human resources (Active Duty,
Reserve, Guard, civilian, contractor, and volunteer medical personnel); improves reporting of medical personnel readiness and; streamlines business processes to
improve data quality for management decision making and managing the business; provides Tri-Service visibility of associated labor costs and is source for personnel
cost data.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Defense Medical Human Resources System (internet) (DMHRSi) (Tri-Service)
FY 2014 FY 2015
- - FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The Defense Medical Human Resources System – internet (DMHRSi) enables the Services
to standardize and optimize the management of human resource assets across the Military Health System
(MHS). DMHRSi is a Web-based system that enables improved decision making by facilitating the collection
and analysis of critical human resource data. It standardizes medical human resource information and provides
enterprise-wide visibility for all categories of human resources (Active Duty, Reserve, Guard, civilian, contractor,
and volunteer medical personnel); improves reporting of medical personnel readiness and; streamlines business
processes to improve data quality for management decision making and managing the business; provides TriService visibility of associated labor costs and is source for personnel cost data.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 51 of 82
- R-1 Line #8
- - - - Volume 1 - 233
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
480B / Defense Medical Human Resources
System (internet) (DMHRSi) (Tri-Service)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 52 of 82
R-1 Line #8
Volume 1 - 234
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480C: Defense Medical Logistics
Standard Support (DMLSS) (TriService)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
5.370
FY 2014
FY 2015
4.478
3.978
FY 2016
Base
FY 2016
OCO
1.933
FY 2016
Total
- FY 2017
1.933
- Project (Number/Name)
480C / Defense Medical Logistics Standard
Support (DMLSS) (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
DMLSS provides the Military Medical Departments one standard Department of Defense (DoD) medical logistics system. The DMLSS suite of applications provides
the healthcare driven capability to support the medical logistics needs of the DoD community for critical medical commodities - pharmaceuticals and medical/surgical
supplies across the continuum of care from the battlefield to tertiary care at a major DoD military treatment facility (MTF). This capability is enabled by the partnership
of the Defense Logistics Agency (DLA) Defense Supply Center Philadelphia and the Military Health System (MHS) providing an industry to practitioner supply chain
for the medical commodity. The DMLSS Defense Logistics Agency Wholesale (DMLSS-W) applications are funded by Defense Logistics Agency while the garrison
medical treatment facilities and theater applications are funded by the Defense Health Program. The current DMLSS system provides full spectrum capability for medical
logistics management. Basic functionality includes stock control, Prime Vendor operations, preparation of procurement documents, research and price comparison for
products, property accounting, biomedical maintenance operations, capital equipment, property management, inventory, and a facility management application that
supports the operations of a fixed medical treatment facility physical plant and supports Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
accreditation requirements. DMLSS, in coordination with the Theater Medical Information Program – Joint (TMIP-J), is providing to the Services and the Combatant
Commanders the functional logistics capabilities necessary to rapidly project and sustain joint medical capabilities for medical logistics management of theater medical
materiel operations. Current products deployed to the theater include the DMLSS Customer Assistance Module (DCAM), a medical logistics ordering tool that allows
users to view their supplier’s catalog and generate electronic orders. Primarily focused on the theater environment, DCAM automates the Class VIII supply process
at the lower levels of care, and allows non-logisticians, who maintain their medical supplies as an additional duty, to electronically exchange catalog, order, and status
information with their supply activity.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
4.478
3.978
Title: Defense Medical Logistics Standard Support (DMLSS) (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
1.933
- 1.933
Description: Development, integration and modernization of DMLSS modules.
FY 2014 Accomplishments:
Develop additional logic in the Medical Master Catalog (MMC) to identify to the end user those products that
have been standardized by the Medical Material Enterprise Standardization Office (MMESO) and those items
that are sourced by a preferred distribution channel or at an available better price.
FY 2015 Plans:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 53 of 82
R-1 Line #8
Volume 1 - 235
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Support critical functional and technical changes in the Medical Logistics environment to include: implement
additional pharmaceutical (Holding Orders, Wide Area Work Flow (WAWF), Real-time Price verification) ordering
logic and catalog data for Pharmacy Global contract award. Implement additional business logic to support
equipment maintenance planning and equipment lifecycle management. Expand the Master Ordering Facility
functionality to support DoD support of Civil Authorities contingency operations. Provide foundational support for
regionalization of DMLSS application, reducing the deployed footprint without compromise in performance and
quality.
Project (Number/Name)
480C / Defense Medical Logistics Standard
Support (DMLSS) (Tri-Service)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2016 Base Plans:
Support DMLSS Regionalization and data consolidation, reducing the deployed footprint (Hardware and License)
without compromise in performance and quality and increasing access to near real time information.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
Remarks
FY 2014
51.405
FY 2015
30.291
FY 2016
Base
30.889
FY 2016
OCO
- FY 2016
Total
30.889
FY 2017
31.416
4.478
FY 2018
31.961
3.978
FY 2019
32.506
1.933
- 1.933
Cost To
FY 2020 Complete Total Cost
33.156 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements which are usually included in the MHS IT Annual Performance Plan. Program cost, schedule and performance
are measured periodically using a systematic approach. The results of these measurements are presented to management on a regular basis in various as part of
the Integrated Product and Process Development (IPPD) process, In Process Reviews (IPRs), or other reviews to determine program effectiveness and provide new
direction as needed to ensure the efficient use of resources. Performance metrics for specific projects may be viewed at the OMB Federal IT Dashboard website.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 54 of 82
R-1 Line #8
Volume 1 - 236
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480D: Defense Occupational
and Environmental Health
Readiness System - Industrial
Hygiene (DOEHRS-IH) (TriService)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
3.372
FY 2014
FY 2015
4.680
FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- - FY 2017
3.633
FY 2018
3.694
Project (Number/Name)
480D / Defense Occupational and
Environmental Health Readiness System
- Industrial Hygiene (DOEHRS-IH) (TriService)
FY 2019
2.803
Cost To
FY 2020 Complete
Total
Cost
2.859 Continuing Continuing
A. Mission Description and Budget Item Justification
Defense Occupational and Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH) is a comprehensive, automated information system that
provides a single point for assembling, comparing, using, evaluating, and storing occupational personnel exposure information, workplace environmental monitoring
data, personnel protective equipment usage data, observation of work practices data, and employee health hazard educational data. DOEHRS-IH will provide for
the definition, collection and analysis platform to generate and maintain a Service Member´s Longitudinal Exposure Record. DOEHRS-IH will describe the exposure
assessment, identify similar exposure groups, establish a longitudinal exposure record baseline to facilitate post-deployment follow-up, and provide information to enable
exposure-based medical surveillance and risk reduction.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Defense Occupational and Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH)
(Tri-Service)
FY 2014 FY 2015
4.680
- FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Configure, enhance and interface DOEHRS-IH modules.
FY 2014 Accomplishments:
This funding will be used to support Critical User Enhancements of the DOEHRS-IH system, including the web
application, the Mobile capability, and the Data Warehouse. Critical User Enhancements are Service-identified
technical software changes required to enhance the usability of the system in three core areas:
• Data control: Facilitate the user’s ability to access and edit all data fields, delete/mark invalid/outdate data,
move/migrate data and search for data criteria
• Workflow: Facilitate a smoother workflow and minimize unnecessary steps and clicks within the application.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 55 of 82
R-1 Line #8
Volume 1 - 237
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
480D / Defense Occupational and
Environmental Health Readiness System
- Industrial Hygiene (DOEHRS-IH) (TriService)
FY 2014
• System Management: Facilitate DOEHRS-IH program users ability to search for and gain access to
Occupational and Environmental Health (OEH) data, extract records and generate reports and create data
search criteria, generating information for analysis.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
4.680
- - - - FY 2014
13.200
FY 2015
7.517
FY 2016
Base
9.290
FY 2016
OCO
- FY 2016
Total
9.290
FY 2017
9.520
FY 2018
9.821
FY 2019
10.000
Cost To
FY 2020 Complete Total Cost
10.176 Continuing Continuing
0.108
0.239
0.113
- 0.113
- - - - Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements which are usually included in the MHS IT Annual Performance Plan. Program cost, schedule and performance
are measured periodically using a systematic approach. The results of these measurements are presented to management on a regular basis in various as part of
the Integrated Product and Process Development (IPPD) process, In Process Reviews (IPRs), or other reviews to determine program effectiveness and provide new
direction as needed to ensure the efficient use of resources. Performance metrics for specific projects may be viewed at the OMB Federal IT Dashboard website.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 56 of 82
R-1 Line #8
Volume 1 - 238
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480F: Executive Information/
Decision Support (EI/DS) (TriService)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
3.127
FY 2014
FY 2015
2.809
- FY 2016
Base
FY 2016
OCO
2.551
FY 2016
Total
- 2.551
FY 2017
1.791
Project (Number/Name)
480F / Executive Information/Decision
Support (EI/DS) (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
EI/DS is comprised of a central datamart Military Health System Data Repository (MDR) and several smaller datamarts: MHS Management Analysis and Reporting
Tool (M2), Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), and Purchased Care Operations Systems -TRICARE
Encounter Data (TED) & Patient Encounter Processing and Reporting (PEPR). Many of these operate within a Business Objects XI (BOXI) environment. EI/DS manages
receipt, processing, and storage of over 155 terabytes of data from both Military Treatment Facilities (MTF) and the TRICARE purchased care network systems. These
data include inpatient dispositions, outpatient encounters, laboratory, radiology, and pharmacy workload, TRICARE network patient encounter records, TRICARE mail
order pharmacy patient encounter records, beneficiary demographics, MTF workload and cost information, eligibility and enrollment, Pharmacy Data Transaction Service
data, customer satisfaction surveys, and data associated with the Wounded Warrior care. EI/DS provides centralized collection, storage and availability of data, in
various data marts, to managers, clinicians, and analysts for the management of the business of health care.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
2.809
- Title: Executive Inforamtion/Decision Support (EI/DS) (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
2.551
- 2.551
Description: Development, modernization, upgrades and testing for various EI/DS modules.
FY 2014 Accomplishments:
• Completed testing for Central Billing Events Repository in the Military Health System Data Repository (MDR) to
perform billing and collections activities.
• Provided the capability to download the National Plan and Provider Enumeration System file and to match the
National Provider Identifier (NPI) and Provider Record within TRICARE Encounter Data (TED). Modify Patient
Encounter Processing and Reporting (PEPR) to report revenue codes and NPI.
• Completed transition of International Classification of Diseases (ICD)-10 codes within TED.
• Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE)
- Developed a Fused Detection and Dashboard capability that will reduce the number of “false positive” alerts.
- Provided a user-defined customizable dashboard functionality; and,
- Provided drilldown capabilities so users can see the raw data and specific patient details underlying the “fused
alert.”
FY 2015 Plans:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 57 of 82
R-1 Line #8
Volume 1 - 239
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
480F / Executive Information/Decision
Support (EI/DS) (Tri-Service)
FY 2014
No funding programmed.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2016 Base Plans:
Develop the Enhanced Query capabilities which will substantially expand the scope of the current query
functionality. The enhanced query functionality will allow user to include parameters from all current and future
data sources to create specific disease case definitions. The query will also enable the user to define a specific
population, e.g., one or more MTFs, age-groups, etc. This enhanced functionality will expand ESSENCE’s
scope beyond the existing broad syndromes and allow users to monitor specific diseases, e.g., influenza.
Develop an enhanced reference table management capability. This will allow designated Service Authorized
“Super Users” to update key reference tables thus unlocking a cost traditionally borne by the Tier III support
vendor and allow greater agility and more accurate results within the ESSENCE Program
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
• BA-1, 0807752HP:
Miscellaneous Support Activities
Remarks
2.809
- 2.551
- 2.551
FY 2014
23.815
FY 2015
29.940
FY 2016
Base
31.070
FY 2016
OCO
- FY 2016
Total
31.070
FY 2017
32.080
FY 2018
32.586
FY 2019
33.298
Cost To
FY 2020 Complete Total Cost
33.964 Continuing Continuing
13.942
16.040
16.329
- 16.329
16.623
16.922
17.226
17.537 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements which are usually included in the MHS IT Annual Performance Plan. Program cost, schedule and performance
are measured periodically using a systematic approach. The results of these measurements are presented to management on a regular basis in various as part of
the Integrated Product and Process Development (IPPD) process, In Process Reviews (IPRs), or other reviews to determine program effectiveness and provide new
direction as needed to ensure the efficient use of resources. Performance metrics for specific projects may be viewed at the OMB Federal IT Dashboard website.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 58 of 82
R-1 Line #8
Volume 1 - 240
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480G: Health Artifact and Image
Management Solution (HAIMS)
(Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
5.828
FY 2016
Base
0.304
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
480G / Health Artifact and Image
Management Solution (HAIMS) (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Health Artifact and Image Management Solution (HAIMS) enables the DoD and the VA healthcare providers to have global access and awareness of artifacts and
images (A&I) generated during the healthcare delivery process. HAIMS will provide the new capability for users throughout the MHS to be aware and have access
to A&I that have been registered with the central “system”, currently on local workstations and Military Treatment Facility (MTF) Picture Archive and Communications
Systems (PACs). As patients move through the continuum of care from Continental United States to Theater and then return to DoD sustaining bases facilities,
healthcare A&I moves seamlessly and simultaneously with the patient. This advances several MHS strategy initiatives such as achievement of paperless record,
global access of Wounded Warrior scanned documents, and an alternative to finding storage space for paper records of merging MTFs. HAIMS will supply access
to VHA and other external A&I both inside and outside the Military Health System (MHS) Electronic Health Record (EHR). Funding has been provided within this
program element in prior years for HAIMS before if was identified as its own system in the budget cycle. HAIMS will experience Incremental development as each new
requirement is identified for FY 2014 and FY 2015.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
5.828
0.304
Title: Health Artifact and Image Management Solution (HAIMS) (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Integrate new functionality into HAIMS.
FY 2014 Accomplishments:
Develop Graphical User Interface (GUI) for asset preview capability.
Provide full functionality with one account (w/o multiple logins)
Provide functionality for Social Security Number (SSN) reduction and Data at Rest.
Interface with Veterans Benefits Administration.
Reduce Social Security Numbers in the application.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 59 of 82
R-1 Line #8
Volume 1 - 241
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
480G / Health Artifact and Image
Management Solution (HAIMS) (Tri-Service)
FY 2014
Develop interfaces for Health Readiness Record, additional Picture Archiving and Communications System
(PACS) based systems, additional non-PACS systems, and dental repositories.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2015 Plans:
Complete interface activities began in FY14 RDT&E to include improved search capabilities and monitoring
improvements.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
5.828
0.304
- - - FY 2014
17.205
FY 2015
20.075
FY 2016
Base
17.575
FY 2016
OCO
- FY 2016
Total
17.575
FY 2017
18.884
FY 2018
20.300
FY 2019
21.358
Cost To
FY 2020 Complete Total Cost
21.783 Continuing Continuing
5.828
1.991
9.500
- 9.500
12.500
12.604
13.732
14.007 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements which are usually included in the MHS IT Annual Performance Plan. Program cost, schedule and performance
are measured periodically using a systematic approach. The results of these measurements are presented to management on a regular basis in various as part of
the Integrated Product and Process Development (IPPD) process, In Process Reviews (IPRs), or other reviews to determine program effectiveness and provide new
direction as needed to ensure the efficient use of resources.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 60 of 82
R-1 Line #8
Volume 1 - 242
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480K: integrated Federal Health
Registry Framework (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
2.591
1.093
FY 2016
Base
FY 2016
OCO
0.450
FY 2016
Total
- FY 2017
0.450
- Project (Number/Name)
480K / integrated Federal Health Registry
Framework (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The purpose of an integrated Federal Health Registry capability is to provide a viable solution to fulfill a critical need for improved sharing and exchange of Service
member and Veteran health information and data between the Department of Defense - Health Affairs and the Department of Veterans Affairs-Veterans Health
Administration communities of interest (COIs) as mandated in Section 1635 of the 2008 National Defense Authorization Act (NDAA, 2008). This ability to share and
exchange vital health care data between the respective specialties of care is essential to conduct longitudinal analyses necessary to improve patient care and quality
of life outcomes. To maximize efficiencies and most effectively meet the needs of the functional communities, the Centers of Excellence (CoEs) have developed a
consolidated framework solution for an integrated Federal Health Registry capability. This effort provides a comprehensive solution that meets the specialty care
needs of each of the Services and Veteran Affairs that are represented by the Joint DoD and VA CoEs, (Army-Extremity Trauma and Amputation Center of Excellence;
TMA-Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury; Navy-DoD/VA Vision Center of Excellence; Air Force-Hearing Center of
Excellence; and JTFCAPMED-National Intrepid Center of Excellence).
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
2.591
1.093
Title: Federated Registry Framework (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
0.450
- 0.450
Description: Develop, integrate and test a common registry.
FY 2014 Accomplishments:
Funding to support a consolidated technical approach for the Centers of Excellence, which will provide a
repeatable process that includes integration of their registry requirements into federated subspecialty clinical
data elements that were determined by representative subject matter experts from the Tri-Services and
Veteran's Affairs.
FY 2015 Plans:
Funding to support a consolidated technical approach for the Centers of Excellence, which will provide a
repeatable process that includes integration of their registry requirements into federated subspecialty clinical
data elements that were determined by representative subject matter experts from the Tri-Services and
Veteran's Affairs.
FY 2016 Base Plans:
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 61 of 82
R-1 Line #8
Volume 1 - 243
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
Additional funding added in FY 2016 to finalize all development and testing necessary for a consolidated
technical approach.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807793HP: MHS
Tri-Service Information
• BA-3, 0807721HP:
Other Procurement,
Replacement/Modernization
Remarks
Project (Number/Name)
480K / integrated Federal Health Registry
Framework (Tri-Service)
FY 2015
2.591
1.093
FY 2016
Base
0.450
FY 2016
OCO
FY 2016
Total
- 0.450
FY 2014
0.258
FY 2015
2.433
FY 2016
Base
2.838
FY 2016
OCO
- FY 2016
Total
2.838
FY 2017
2.865
FY 2018
2.913
FY 2019
2.962
Cost To
FY 2020 Complete Total Cost
3.018 Continuing Continuing
- - 0.015
- 0.015
0.094
0.066
0.040
0.041 Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Program cost, schedule and performance are measured periodically using a systematic approach as required for Major Automated Information Systems (MAIS) per DoD
Directives and Instructions.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 62 of 82
R-1 Line #8
Volume 1 - 244
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480M: Theather Medical
Information Program - Joint
(TMIP-J) (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
28.731
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
480M / Theather Medical Information
Program - Joint (TMIP-J) (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Theater Medical Information Program - Joint (TMIP-J) integrates components of the Military Health System sustaining base systems and the Services´ medical
information systems to ensure timely interoperable medical support for mobilization, deployment and sustainment of all Theater and deployed forces in support of
any mission. TMIP-J enhances the clinical care and information capture at all levels of care in Theater, transmits critical information to the Theater Commander, the
evacuation chain for combat and non-combat casualties, and forges the theater links of the longitudinal health record to the sustaining base and the Department of
Veterans Affairs. TMIP-J is the medical component of the Global Combat Support System. TMIP-J provides information at the point of care and to the Theater tactical
and strategic decision makers through efficient, reliable data capture, and data transmission to a centralized Theater database. This delivers TMIP-J´s four pillars
of information support through the electronic health record, integrated medical logistics, patient movement and tracking, and medical command and control through
data aggregation, reporting and analysis tools for trend analysis and situational awareness. TMIP-J fulfills the premise of "Train as you fight" through the integration of
components which are identical or analogous to systems from the sustaining base. TMIP-J adapts and integrates these systems to specific Theater requirements and
assures their availability in the no- and low- communications settings of the deployed environment through store and forward capture and transmission technology.
TMIP-J RDT&E is reported under the program element 0605013 through FY 2013 inclusive, but will be reported under new program element 0605023 for FY 2014 and
out.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Theather Medical Information Program - Joint (TMIP-J) (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The Theater Medical Information Program - Joint (TMIP-J) integrates components of the Military
Health System sustaining base systems and the Services´ medical information systems to ensure timely
interoperable medical support for mobilization, deployment and sustainment of all Theater and deployed forces
in support of any mission. TMIP-J enhances the clinical care and information capture at all levels of care in
Theater, transmits critical information to the Theater Commander, the evacuation chain for combat and noncombat casualties, and forges the theater links of the longitudinal health record to the sustaining base and the
Department of Veterans Affairs. TMIP-J is the medical component of the Global Combat Support System. TMIPJ provides information at the point of care and to the Theater tactical and strategic decision makers through
efficient, reliable data capture, and data transmission to a centralized Theater database. This delivers TMIP-J
´s four pillars of information support through the electronic health record, integrated medical logistics, patient
movement and tracking, and medical command and control through data aggregation, reporting and analysis
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 63 of 82
R-1 Line #8
Volume 1 - 245
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
tools for trend analysis and situational awareness. TMIP-J fulfills the premise of "Train as you fight" through the
integration of components which are identical or analogous to systems from the sustaining base. TMIP-J adapts
and integrates these systems to specific Theater requirements and assures their availability in the no- and lowcommunications settings of the deployed environment through store and forward capture and transmission
technology.
Project (Number/Name)
480M / Theather Medical Information
Program - Joint (TMIP-J) (Tri-Service)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
TMIP-J RDT&E is reported under the program element 0605013 through FY 2013 inclusive, but will be reported
under new program element 0605023 for FY 2014 and out.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
- - - - - C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 64 of 82
R-1 Line #8
Volume 1 - 246
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480P: Other Related Technical
Activities (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
4.123
FY 2015
- FY 2016
Base
2.990
FY 2016
OCO
- FY 2016
Total
- - FY 2017
Project (Number/Name)
480P / Other Related Technical Activities
(Tri-Service)
FY 2018
1.683
FY 2019
3.500
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
Other Related Technical Activities includes funding for Information Technology activities common to multiple or all Tri-Service systems/programs and can not be
associated with any one individual Tri-Service initiative, which includes enterprise Messaging and other common IT services requirements. Funding is included in FY
2012 for International Classification of Diseases and Related Health Problems 10th edition (ICD-10). ICD-10 funding for FY 2013 and out is shown in the appropriate
initiative's Accomplishments/Planned Porgram sections within this program element.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- 2.990
Title: Other Related Technical Activities (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Develop, integrate, test of activities common to multiple or all Tri-Service IT activities.
FY 2014 Accomplishments:
No funding programmed/executed.
FY 2015 Plans:
Funding in support of Health Information Technology Shared Services investment.
FY 2016 Base Plans:
No funding programmed.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
FY 2014
- FY 2015
2.100
FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
2.310
FY 2018
2.730
2.990
FY 2019
- - - - Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 65 of 82
R-1 Line #8
Volume 1 - 247
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
480P / Other Related Technical Activities
(Tri-Service)
E. Performance Metrics
Each activity establishes performance measurements. Program cost, schedule and performance are measured periodically using a systematic approach. Since this is
an enterprise initiative which crosses mutliple initiatives, performance metrics of the common activities are part of and/or contributing factors in the measurement of the
performacne metrics of the individual initiatives.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 66 of 82
R-1 Line #8
Volume 1 - 248
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480R: TMA E-Commerce (TMA)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
2.934
FY 2015
- - FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
480R / TMA E-Commerce (TMA)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The DHP, RDT&E appropriation includes the following TMA initiatives: Electronic Commerce System(E-Commerce): This system was developed for centralized
collection, integration, and reporting of accurate purchased care contracting and financial data. It provides an integrated set of data reports from multiple data sources
to management, as well as tools to control the end-to-end program change management process. E-Commerce replaces multiple legacy systems. E-Commerce
consists of several major subsystems including: CM subsystem utilizing Prism software to support contract action development and documentation; the RM subsystem
utilizing Oracle Federal Financials and TED interface software to support the budgeting, accounting, case recoupment, and disbursement processes; the document
management subsystem utilizing Documentum software to provide electronic storage, management, and retrieval of contract files; Management Tracking and Reporting
subsystem utilizing custom software to provide reports to assist in the management and tracking of changes to the managed care contracts as well as current and
out year liabilities; the Purchased Care Web site that provides up-to-date financial information for both TMA and the Services concerning the military treatment
facilities’ (MTFs’) expenditures for MTF enrollee purchased care and supplemental care. E-Commerce includes 5 major subsystems and over 60 servers supporting
development, test, and production. The system will be utilized by several hundred users in more than 7 different organizations. Project oversight and coordination
must be provided to ensure that the needs of the disparate organizations are met without impacting the system performance or support to any individual user. Server
configurations must be kept current in terms of security policies, user authorizations, and interactions with other systems and functions. All of these activities must be
managed and coordinated on a daily basis.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: TMA E-Commerce (TMA)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The DHP, RDT&E appropriation includes the following TMA initiatives: Electronic Commerce
System(E-Commerce): This system was developed for centralized collection, integration, and reporting of
accurate purchased care contracting and financial data. It provides an integrated set of data reports from
multiple data sources to management, as well as tools to control the end-to-end program change management
process. E-Commerce replaces multiple legacy systems. E-Commerce consists of several major subsystems
including: CM subsystem utilizing Prism software to support contract action development and documentation;
the RM subsystem utilizing Oracle Federal Financials and TED interface software to support the budgeting,
accounting, case recoupment, and disbursement processes; the document management subsystem utilizing
Documentum software to provide electronic storage, management, and retrieval of contract files; Management
Tracking and Reporting subsystem utilizing custom software to provide reports to assist in the management
and tracking of changes to the managed care contracts as well as current and out year liabilities; the Purchased
Care Web site that provides up-to-date financial information for both TMA and the Services concerning the
military treatment facilities’ (MTFs’) expenditures for MTF enrollee purchased care and supplemental care. EPE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 67 of 82
R-1 Line #8
Volume 1 - 249
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
480R / TMA E-Commerce (TMA)
FY 2014
Commerce includes 5 major subsystems and over 60 servers supporting development, test, and production.
The system will be utilized by several hundred users in more than 7 different organizations. Project oversight
and coordination must be provided to ensure that the needs of the disparate organizations are met without
impacting the system performance or support to any individual user. Server configurations must be kept current
in terms of security policies, user authorizations, and interactions with other systems and functions. All of these
activities must be managed and coordinated on a daily basis.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2014 Accomplishments:
Implemented enhancement solutions to improve management of private sector care contracts, processing
of private sector care healthcare claims, compliance with DoD policy and guidance, and private sector care
operational efficiency. Completed healthcare claims and financial processing and reporting changes to
enhance compliance with IPv6, SFIS, PDS, and SLOA direction. Modified contract management and healthcare
claims processing to accommodate healthcare policy and contract changes. Improved private sector care
efficiencies and productivity by enhancing contract performance assessment, deliverable processing, and
refining operational and financial reporting. Continued receiving unqualified audit opinions through the upgrade
of accounting, budgeting, and audit processing. Finished the first phase of the pharmacy management
modernization activity to support the tracking of pharmaceutical manufacturer refunds and collections.
Implemented a change in appropriation order at the beginning of the fiscal year.
FY 2015 Plans:
-Program transfer in FY 2015 to project 482A.
FY 2016 Base Plans:
No funding programmed.
- Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807752HP:
Miscellaneous Support Activities
• BA-3, 0807721HP:
Replacement/Modernization
- - - - FY 2014
12.857
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- FY 2018
- FY 2019
- Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
0.500
- - - - - - - - Continuing Continuing
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 68 of 82
R-1 Line #8
Volume 1 - 250
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
C. Other Program Funding Summary ($ in Millions)
Line Item
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
Project (Number/Name)
480R / TMA E-Commerce (TMA)
FY 2019
Cost To
FY 2020 Complete Total Cost
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
The benchmark performance metric for transition of research supported in this PE will be the attainment of a maturity level that is typical of TRL8.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 69 of 82
R-1 Line #8
Volume 1 - 251
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480Y: Clinical Case
Management (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
2.925
FY 2015
- - FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
480Y / Clinical Case Management (TriService)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
Provides a seamless view of the care and the health of the patient from the origin of injury or illness to the end of the need for that episode of care. It will capture
relevant events, information, documents and other data to support the overall improvement of the patient’s condition utilizing medical Case Management practices. It will
provide the ability to collect clinical information in support of the medical Case Manager’s mission and will provide information gathered to MTFs and MSCSs.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Clinical Case Management (Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Provides a seamless view of the care and the health of the patient from the origin of injury or
illness to the end of the need for that episode of care. It will capture relevant events, information, documents
and other data to support the overall improvement of the patient’s condition utilizing medical Case Management
practices. It will provide the ability to collect clinical information in support of the medical Case Manager’s
mission and will provide information gathered to MTFs and MSCSs.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
- - - - - C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 70 of 82
R-1 Line #8
Volume 1 - 252
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
480Y / Clinical Case Management (TriService)
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 71 of 82
R-1 Line #8
Volume 1 - 253
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
480Z: Centralized Credentials
and Quality Assurance System
(CCQAS) (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
1.692
FY 2015
- - FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
480Z / Centralized Credentials and Quality
Assurance System (CCQAS) (Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Central Credentials Quality Assurance System (CCQAS) enables the military medical community to electronically manage the credentials, risk management,
and adverse privileging actions of medical personnel and is hosted at secure Defense Information Systems Agency facility. It is deployed worldwide to over 1,350
professional affairs coordinators in 535 locations and contains nearly 60,000 credentials records for Active Duty, Reserve, Guard, Civil Service, contractors, and
volunteers in the Military Health System. CCQAS tracks trends in medical malpractice claims in an effort to improve health care quality, ensure legal due process
for clinicians undergoing adverse actions, and assist the Medical Treatment Facilities in meeting Joint Commission on Accreditation of Healthcare Organization´s
accreditation standards.
B. Accomplishments/Planned Programs ($ in Millions)
Title: Centralized Credentials and Quality Assurance System (CCQAS) (Tri-Service)
FY 2014 FY 2015
- - FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: The Central Credentials Quality Assurance System (CCQAS) enables the military medical
community to electronically manage the credentials, risk management, and adverse privileging actions of
medical personnel and is hosted at secure Defense Information Systems Agency facility. It is deployed
worldwide to over 1,350 professional affairs coordinators in 535 locations and contains nearly 60,000 credentials
records for Active Duty, Reserve, Guard, Civil Service, contractors, and volunteers in the Military Health System.
CCQAS tracks trends in medical malpractice claims in an effort to improve health care quality, ensure legal due
process for clinicians undergoing adverse actions, and assist the Medical Treatment Facilities in meeting Joint
Commission on Accreditation of Healthcare Organization´s accreditation standards.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 72 of 82
- R-1 Line #8
- - - - Volume 1 - 254
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
480Z / Centralized Credentials and Quality
Assurance System (CCQAS) (Tri-Service)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 73 of 82
R-1 Line #8
Volume 1 - 255
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
481A: Theather Enterprise Wide
Logistics System (TEWLS) TriService)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
5.127
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- - FY 2017
- Project (Number/Name)
481A / Theather Enterprise Wide Logistics
System (TEWLS) Tri-Service)
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
Theater Enterprise-Wide Logistics System (TEWLS) supports critical medical logistics warfighter requirements in a net-centric environment. It ties the national, regional,
and deployed units into a single business environment. It creates the necessary links for planners, commercial partners, and AMEDD logisticians to accomplish essential
care in the theater through a single customer facing portal. It removes disparate data and replaces it with a single instance of actionable data. TEWLS supports today
´s modern, non-contiguous battlefield at the regional, COCOM, and Service levels by leveraging emerging Medical Materiel Executive Agency and Theater Lead Agent
infrastructure concepts to manage the entire medical supply chain from the industrial base to the end user.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- - Title: Theather Enterprise Wide Logistics System (TEWLS) Tri-Service)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Theater Enterprise-Wide Logistics System (TEWLS) supports critical medical logistics warfighter
requirements in a net-centric environment. It ties the national, regional, and deployed units into a single business
environment. It creates the necessary links for planners, commercial partners, and AMEDD logisticians to
accomplish essential care in the theater through a single customer facing portal. It removes disparate data and
replaces it with a single instance of actionable data. TEWLS supports today´s modern, non-contiguous battlefield
at the regional, COCOM, and Service levels by leveraging emerging Medical Materiel Executive Agency and
Theater Lead Agent infrastructure concepts to manage the entire medical supply chain from the industrial base
to the end user.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 74 of 82
- R-1 Line #8
- - - - Volume 1 - 256
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
481A / Theather Enterprise Wide Logistics
System (TEWLS) Tri-Service)
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 75 of 82
R-1 Line #8
Volume 1 - 257
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
482A: E-Commerce (DHA)
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
- FY 2015
5.526
2.494
FY 2016
Base
FY 2016
OCO
2.766
FY 2016
Total
- 2.766
FY 2017
2.829
FY 2018
3.704
Project (Number/Name)
482A / E-Commerce (DHA)
FY 2019
4.200
Cost To
FY 2020 Complete
Total
Cost
4.284 Continuing Continuing
A. Mission Description and Budget Item Justification
The DHP, RDT&E appropriation includes the following TMA initiatives: Electronic Commerce System(E-Commerce): This system was developed for centralized
collection, integration, and reporting of accurate purchased care contracting and financial data. It provides an integrated set of data reports from multiple data sources
to management, as well as tools to control the end-to-end program change management process. E-Commerce replaces multiple legacy systems. E-Commerce
consists of several major subsystems including: CM subsystem utilizing Prism software to support contract action development and documentation; the RM subsystem
utilizing Oracle Federal Financials and TED interface software to support the budgeting, accounting, case recoupment, and disbursement processes; the document
management subsystem utilizing Documentum software to provide electronic storage, management, and retrieval of contract files; Management Tracking and Reporting
subsystem utilizing custom software to provide reports to assist in the management and tracking of changes to the managed care contracts as well as current and
out year liabilities; the Purchased Care Web site that provides up-to-date financial information for both TMA and the Services concerning the military treatment
facilities’ (MTFs’) expenditures for MTF enrollee purchased care and supplemental care. E-Commerce includes 5 major subsystems and over 60 servers supporting
development, test, and production. The system will be utilized by several hundred users in more than 7 different organizations. Project oversight and coordination
must be provided to ensure that the needs of the disparate organizations are met without impacting the system performance or support to any individual user. Server
configurations must be kept current in terms of security policies, user authorizations, and interactions with other systems and functions. All of these activities must be
managed and coordinated on a daily basis.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
5.526
2.494
Title: E-Commerce (DHA)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
2.766
- 2.766
Description: The DHP, RDT&E appropriation includes the following TMA initiatives: Electronic Commerce
System(E-Commerce): This system was developed for centralized collection, integration, and reporting of
accurate purchased care contracting and financial data. It provides an integrated set of data reports from
multiple data sources to management, as well as tools to control the end-to-end program change management
process. E-Commerce replaces multiple legacy systems. E-Commerce consists of several major subsystems
including: CM subsystem utilizing Prism software to support contract action development and documentation;
the RM subsystem utilizing Oracle Federal Financials and TED interface software to support the budgeting,
accounting, case recoupment, and disbursement processes; the document management subsystem utilizing
Documentum software to provide electronic storage, management, and retrieval of contract files; Management
Tracking and Reporting subsystem utilizing custom software to provide reports to assist in the management
and tracking of changes to the managed care contracts as well as current and out year liabilities; the Purchased
Care Web site that provides up-to-date financial information for both TMA and the Services concerning the
military treatment facilities’ (MTFs’) expenditures for MTF enrollee purchased care and supplemental care. EPE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 76 of 82
R-1 Line #8
Volume 1 - 258
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Commerce includes 5 major subsystems and over 60 servers supporting development, test, and production.
The system will be utilized by several hundred users in more than 7 different organizations. Project oversight
and coordination must be provided to ensure that the needs of the disparate organizations are met without
impacting the system performance or support to any individual user. Server configurations must be kept current
in terms of security policies, user authorizations, and interactions with other systems and functions. All of these
activities must be managed and coordinated on a daily basis.
FY 2014
Project (Number/Name)
482A / E-Commerce (DHA)
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2014 Accomplishments:
Plans noted and funded under Project Project 480R.
FY 2015 Plans:
- Continue compliance enhancements and modernization of financial processing and reporting. Enhance
application functionality to respond to changes in health care policy and guidance, to improve operational
efficiency, and to continue providing operational personnel with effective financial, contract management, and
acquisition support capabilities. Enhance health care claims and financial processing to accommodate changes
in health care requirements and to improve contractor performance assessment and deliverable processing.
Implement accounting improvements to support user interface processing, audit support, financial and audit
reporting, and enterprise budget management. Finally, implement software changes, mandated by Congress
and the DoD, to accommodate financial application health care policy modifications, and BEA SFIS changes.
FY 2016 Base Plans:
Continue compliance enhancements and modernization of healthcare financial processing, contract operations,
and financial reporting. Enhance application functionality to respond to changes in healthcare policy and
guidance, to improve operational efficiency, and to continue providing DHA operational personnel with
effective financial, contract management, and acquisition management capabilities. Enhance healthcare
claims and financial processing to accommodate new healthcare contracts, to support processing changes
in healthcare requirements, and to improve private sector care contractor performance assessment and
deliverable processing. Enhance accounting and finance capabilities to improve the tracking of pharmaceutical
manufacturer refunds, dispute handling, collections, and case management. Implement accounting
improvements to support healthcare accounting operations, financial audit support, financial reporting, and
private sector care budget management. Finally, implement software changes, mandated by Congress and
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 77 of 82
R-1 Line #8
Volume 1 - 259
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
482A / E-Commerce (DHA)
FY 2014
the DoD, to accommodate financial application healthcare policy modifications, BEA SFIS changes, and PDS
compliance.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2016 OCO Plans:
No OCO
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807752HP:
Miscellaneous Support Activities
• BA-3, 0807721HP:
Replacement/Modernization
Remarks
Program transfer from project 480R.
5.526
2.494
2.766
- 2.766
FY 2014
- FY 2015
14.443
FY 2016
Base
14.615
FY 2016
OCO
- FY 2016
Total
14.615
FY 2017
14.933
FY 2018
14.438
FY 2019
14.286
Cost To
FY 2020 Complete Total Cost
14.543 Continuing Continuing
- - - - - - - 0.549
0.560 Continuing Continuing
D. Acquisition Strategy
N/A
E. Performance Metrics
The benchmark performance metric for transition of research supported in this PE will be the attainment of a maturity level that is typical of TRL8.
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 78 of 82
R-1 Line #8
Volume 1 - 260
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
490I: Navy Medicine Chief
Information Officer
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
2.106
FY 2014
FY 2015
4.131
- FY 2016
Base
FY 2016
OCO
- FY 2016
Total
- FY 2017
- - Project (Number/Name)
490I / Navy Medicine Chief Information
Officer
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
Navy Medicine CIO Management Operations - IM/IT RDT&E requests will be vetted through the Bureau of Navy Medicine (BUMED) Governance Process. BUMED IM/
IT CIO Governance will monitor progress and milestones every six months.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
4.131
- Title: Navy Medicine Chief Information Officer (CIO) Management Operations
FY 2016 FY 2016 FY 2016
Base
OCO
Total
- - - Description: Navy Medicine CIO Management Operations - IM/IT RDT&E requests will be vetted through the
Bureau of Navy Medicine (BUMED) Governance Process. BUMED IM/IT CIO Governance will monitor progress
and milestones every six months.
FY 2014 Accomplishments:
This is an ongoing activity recently enacted by the Navy Medicine IM/IT process which further defines/transforms
future IM/IT Medical Program Enhancements and Medical Capabilities.
The development/integration of Defense Optical Fabrication Enterprise Management System (DOFEMS) into
a fully automated system to support workload distribution, performance metrics, staffing requirements, supply
management, calculation of operating costs from the current independently or manually DOFEMS system.
This effort will be a web based centralized management tool and provide a standalone standard set of Lab
Management software for all 26 Navy labs.
The re-design of HIV Management System (HMS) so that it is user friendly, minimizes the amount of time
required to perform everyday tasks and prevents the need to maintain separate databases, automate and
minimize functions that require manual assistance and assist in fulfilling new requirements.
The development/integration of the Corporate Dental System (CDS) will replace the current Navy Dental system,
Dental Common Access System (DENCAS). The CDS is the Military Health System Enterprise solution
providing for the accurate collection, processing, and presentation of dental workload, readiness, scheduling,
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 79 of 82
R-1 Line #8
Volume 1 - 261
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
B. Accomplishments/Planned Programs ($ in Millions)
Project (Number/Name)
490I / Navy Medicine Chief Information
Officer
FY 2014
and digital radiographic information for both treatment operations and the oversight of management activities at
all levels of the dental enterprise.
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2015 Plans:
No funding programmed.
FY 2016 Base Plans:
No funding programmed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, 0807781HP: NonCentral Information Management/
Information Technology
• BA-1, PE 0807795HP: Base
Communications - CONUS
• BA-1, PE 0807995HP: Base
Communications - OCONUS
• BA-3, PE 0807720HP:
Initial Outfitting
• BA-3, PE 0807721HP:
Replacement/Modernization
Remarks
4.131
- - - - FY 2014
163.298
FY 2015
161.049
FY 2016
Base
163.730
FY 2016
OCO
- FY 2016
Total
163.730
FY 2017
164.098
FY 2018
167.023
FY 2019
157.459
Cost To
FY 2020 Complete Total Cost
160.293 Continuing Continuing
16.502
16.796
17.108
- 17.108
17.414
17.709
18.039
18.364 Continuing Continuing
2.416
2.458
2.505
- 2.505
2.549
2.595
2.640
2.688 Continuing Continuing
- - - - - - - - - Continuing Continuing
2.782
1.107
1.305
- 1.305
2.737
2.907
3.041
3.096 Continuing Continuing
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 80 of 82
R-1 Line #8
Volume 1 - 262
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
490J: Navy Medicine Online
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Prior
Years
FY 2014
1.369
FY 2015
- 2.192
FY 2016
Base
FY 2016
OCO
2.052
FY 2016
Total
- FY 2017
2.052
- Project (Number/Name)
490J / Navy Medicine Online
FY 2018
- FY 2019
- Cost To
FY 2020 Complete
Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The Navy Medicine Online System (NMO) is the designated data broker for Navy Medicine. NMO collects individual readiness information from legacy Navy Medicine
data systems (i.e SAMS,DENCAS, MEDBOLTT, etc.). NMO transmits select information to MRRS to support DoD IMR reporting, DHIMS Force Health Protection,
Master CMS, and other Navy systems. NMO also provides the programs used to manage the medical waiver process and to track USNA midshipmen medical issues.
The goal of this RDT&E effort is to merge NMKMS into Navy Medicine Online (NMO) as a data broker, to establish a single operational data warehouse for Navy
Medicine operational data, as well as to support programs for managing medical staffing planning and operational workload reports.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014 FY 2015
- 2.192
Title: Navy Medicine Online (NMO)
FY 2016 FY 2016 FY 2016
Base
OCO
Total
2.052
- 2.052
Description: The Navy Medicine Online System (NMO) is the designated data broker for Navy Medicine.
NMO collects individual readiness information from legacy Navy Medicine data systems (i.e SAMS,DENCAS,
MEDBOLTT, etc.). NMO transmits select information to MRRS to support DoD IMR reporting, DHIMS Force
Health Protection, Master CMS, and other Navy systems. NMO also provides the programs used to manage
the medical waiver process and to track USNA midshipmen medical issues. The goal of this RDT&E effort is
to merge NMKMS into Navy Medicine Online (NMO) as a data broker, to establish a single operational data
warehouse for Navy Medicine operational data, as well as to support programs for managing medical staffing
planning and operational workload reports.
FY 2014 Accomplishments:
No funding programmed.
FY 2015 Plans:
This is an ongoing activity recently enacted by the Navy Medicine IM/IT process which further defines/transforms
future IM/IT Medical Program Enhancements and Medical Capabilities.
FY 2016 Base Plans:
This is an ongoing activity recently enacted by the Navy Medicine IM/IT process which further defines/transforms
future IM/IT Medical Program Enhancements and Medical Capabilities.
Accomplishments/Planned Programs Subtotals
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 81 of 82
- R-1 Line #8
2.192
2.052
- 2.052
Volume 1 - 263
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605013HP / Information Technology
Development
Project (Number/Name)
490J / Navy Medicine Online
C. Other Program Funding Summary ($ in Millions)
N/A
Remarks
D. Acquisition Strategy
N/A
E. Performance Metrics
N/A
PE 0605013HP: Information Technology Development
Defense Health Program
UNCLASSIFIED
Page 82 of 82
R-1 Line #8
Volume 1 - 264
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic Health Record (iEHR)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
0.000
19.912
68.267
9.216
- 9.216
8.125
- - - Continuing Continuing
444A: Integrated Electronic
Health Record Inc 1/ Defense
Medical Information Exchange
(DMIX)
0.000
12.634
45.915
9.216
- 9.216
8.125
- - - Continuing Continuing
444B: Information Technology
Development - DoD Healthcare
Management System
Modernization (DHMSM)
0.000
4.720
- - - - - - - - Continuing Continuing
449A: Virtual Lifetime Electronic
Record (VLER) HEALTH
0.000
2.558
22.352
- - - - - - - Continuing Continuing
MDAP/MAIS Code:
Other MDAP/MAIS Code(s): 465
A. Mission Description and Budget Item Justification
In March 2008, the MHS embarked upon Electronic Health Record (EHR) modernization planning, establishing the initial Electronic Health Records Way Ahead
(EHRWA).
In March 2011, the Program was expanded to include the VA in a joint initiative to implement a new, integrated electronic health record for both Departments, called the
Integrated Electronic Health Record (iEHR) program.
Secretary Hagel’s Memorandum titled “Integrated Electronic Health Records,” dated May 2013, provided additional direction to the program:
• DoD shall continue near-term coordinated efforts with VA to develop data federation, presentation, and interoperability. This near-term goal shall be pursued as a first
priority separately from the longer-term goal of health record information technology (IT) modernization.
• DoD shall pursue a full and open competition for a core set of capabilities for EHR modernization.
To fulfill Secretary Hagel’s directive, parallel programs have been defined, splitting the original iEHR program into two distinct areas. In the Under Secretary of Defense
for Acquisition, Technology and Logistics (USD (AT&L)) Acquisition Decision Memoranda (ADM), dated June 21, 2013 and January 2, 2014, the former joint DoD
and VA Integrated Electronic Health Record (iEHR) program was restructured to pursue two separate but related healthcare information technology efforts, the DoD
Healthcare Management System Modernization (DHMSM) program and a newly defined iEHR focused on providing seamless integrated sharing of electronic health
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 1 of 9
R-1 Line #9
Volume 1 - 265
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0605023HP / Integrated Electronic Health Record (iEHR)
data between the DoD and VA to be called Defense Medical Information Exchange (DMIX). The remaining iEHR Increment 1 (iEHR Inc 1) was significantly de-scoped to
only the Medical Single Sign-on/Context management (MSSO/CM) implemented at James A. Lovell Federal Health Care Center (JAL FHCC).
iEHR RDT&E is reported under the program element (PE) 0605013 through FY 2013 inclusive, but iEHR, VLER Health and DHMSM will be reported under new program
element 0605023 for FY 2014.
In FY 2015, PE 0605023 will report only iEHR and VLER Health since DHMSM will have its own PE starting in FY 2015.
In FY 2016 and out, only iEHR Increment 1 will be reported in PE 0605023. DHMSM will continue to be only initiative reported in PE 0605026. However, new PE
06050039 is established for DMIX for FY 2016 and out. DMIX will incorporate the previous VLER Health and JEHRI initiatives.
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
• Integrated Electronic Health Record Inc
1/ Defense Medical Information Exchange
(DMIX)
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
64.100
19.912
-44.188
- - -43.614
- - - -0.574
- 68.267
68.267
- - - - - - - - - 34.560
9.216
-25.344
- - - 34.560
9.216
-25.344
-25.344
- -25.344
Change Summary Explanation
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0605023-Integrated Electronic Health
Record (iEHR) (-$0.574 million) to DHP RDT&E PE 0605502-Small Business Innovation Research (SBIR) Program (+$0.574 million).
FY 2014: Congressional Rescissions to DHP RDT&E, PE 0605013-Information Technology Development (-$43.614 million)
FY 2016: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0605023-Integrated Electronic Health
Record Inc 1 / Defense Medical Information Exchange (DMIX) (-$25.344 million).
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 2 of 9
R-1 Line #9
Volume 1 - 266
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
444A: Integrated Electronic
Health Record Inc 1/ Defense
Medical Information Exchange
(DMIX)
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
Prior
Years
FY 2014
- FY 2015
12.634
45.915
FY 2016
Base
9.216
FY 2016
OCO
FY 2016
Total
- 9.216
FY 2017
8.125
Project (Number/Name)
444A / Integrated Electronic Health
Record Inc 1/ Defense Medical Information
Exchange (DMIX)
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
MDAP/MAIS Code: 465
A. Mission Description and Budget Item Justification
In March 2008, the MHS embarked upon Electronic Health Record (EHR) modernization planning, establishing the initial Electronic Health Records Way Ahead
(EHRWA).
In March 2011, the Program was expanded to include the VA in a joint initiative to implement a new, integrated electronic health record for both Departments, called the
Integrated Electronic Health Record (iEHR) program.
Secretary Hagel’s Memorandum titled “Integrated Electronic Health Records,” dated May 2013, provided additional direction to the program:
• DoD shall continue near-term coordinated efforts with VA to develop data federation, presentation, and interoperability. This near-term goal shall be pursued as a first
priority separately from the longer-term goal of health record information technology (IT) modernization.
• DoD shall pursue a full and open competition for a core set of capabilities for EHR modernization.
To fulfill Secretary Hagel’s directive, parallel programs have been defined, splitting the original iEHR program into two distinct areas. In the Under Secretary of Defense
for Acquisition, Technology and Logistics (USD (AT&L)) Acquisition Decision Memoranda (ADM), dated June 21, 2013 and January 2, 2014, the former joint DoD
and VA Integrated Electronic Health Record (iEHR) program was restructured to pursue two separate but related healthcare information technology efforts, the DoD
Healthcare Management System Modernization (DHMSM) program and a newly defined iEHR focused on providing seamless integrated sharing of electronic health
data between the DoD and VA to be called Defense Medical Information Exchange (DMIX). The remaining iEHR Increment 1 (iEHR Inc 1) was significantly de-scoped to
only the Medical Single Sign-on/Context management (MSSO/CM) implemented at James A. Lovell Federal Health Care Center (JAL FHCC).
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
12.634
Title: Integrated Electronic Health Record Inc 1/ Defense Medical Information Exchange (DMIX) (Tri-Service)
FY 2015
45.915
FY 2016
9.216
Description: The iEHR Increment 1 initiative achieved Full Deployment Decision November 2014 and is targeted to reach Full
Deployment milestone by May 2016. Sustainment efforts for iEHR Increment 1 include the DoD sustainment of the James A
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 3 of 9
R-1 Line #9
Volume 1 - 267
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
Project (Number/Name)
444A / Integrated Electronic Health
Record Inc 1/ Defense Medical Information
Exchange (DMIX)
B. Accomplishments/Planned Programs ($ in Millions)
Lovell Federal Health Care Center (JAL FHCC) health care information technology that includes medical single sign-on/context
management (MSSO/CM). Program funding is also included to maintain DoD operations at the Interagency Program Office (IPO).
FY 2014
FY 2015
FY 2016
• The DoD/VA Interagency Program Office (IPO) was re-chartered on December 5, 2013. The mission focus is addressing
and coordinating the establishment of a clinical and technical standards profile and processes for data interoperability to
create seamless integration of health data for DoD and VA. The IPO will leverage national and international standards and
open architecture design principles to preserve flexibility, and foster data interoperability with each other and appropriate
commercial entities. The IPO will enhance existing DoD and VA efforts with The Office of the National Coordinator (ONC) for
Health Information Technology within the Health and Human Services (HHS) and other national and international standards
organizations and coordinate and monitor the common components required for health data sharing and interoperability. The
primary deliverables include technical data interoperability architecture requirements, interface control documentation, terminology
standards identification and data exchange guidance.
FY 2014 Accomplishments:
• Achieved a Milestone C July, 2014
• Achieved a Fielding Deployment Decision on November, 2014
FY 2015 Plans:
Funding for testing as needed.
FY 2016 Plans:
Funding for testing as needed.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, PE 0807784HP: Information
Technology Development • BA-3, 0807784HP:
Replacement/Modernization
Remarks
12.634
45.915
9.216
FY 2014
81.342
FY 2015
40.699
FY 2016
Base
19.500
FY 2016
OCO
- FY 2016
Total
19.500
FY 2017
22.212
FY 2018
34.247
FY 2019
40.533
Cost To
FY 2020 Complete Total Cost
41.349 Continuing Continuing
- 8.243
7.897
- 7.897
1.043
0.075
0.076
0.079 Continuing Continuing
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 4 of 9
R-1 Line #9
Volume 1 - 268
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
Project (Number/Name)
444A / Integrated Electronic Health
Record Inc 1/ Defense Medical Information
Exchange (DMIX)
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
iEHR/DMIX is a collaborative effort between the DoD and VA to share Health Care Resources to improve access to, and quality and cost effectiveness of, health care
as mandated by law. This investment is deeply embedded in the MHS Enterprise Roadmap as both Departments have need for modernization/ replacement of existing
legacy systems. This investment will use a combination of an open architecture approach, and the purchase (in some instances) of GOTS and COTS products.
E. Performance Metrics
Program cost, schedule and performance are measured periodically using a systematic approach as required for Major Automated Information Systems (MAIS) per DoD
Directives and Instructions.
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 5 of 9
R-1 Line #9
Volume 1 - 269
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
Prior
Years
444B: Information Technology
Development - DoD Healthcare
Management System
Modernization (DHMSM)
FY 2014
- FY 2015
4.720
FY 2016
Base
- - FY 2016
OCO
FY 2016
Total
- - FY 2017
- Project (Number/Name)
444B / Information Technology Development
- DoD Healthcare Management System
Modernization (DHMSM)
FY 2018
- FY 2019
Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
DHMSM will acquire and support deployment, and implementation of an electronic health record (EHR) system that replaces the DoD legacy MHS inpatient and
outpatient EHR systems. Overarching goal of the program is to enable healthcare teams to deliver high-quality, safe care and preventive services to patients through
the use of easily accessible standards-based computerized patient records resulting in: improved accuracy of diagnoses and medication; improved impact on health
outcomes; increased patient participation in the healthcare process; improved patient-centered care coordination; and increased practice efficiencies in all settings,
including operational environments.
DHMSM replaces DoD legacy healthcare systems with a commercial solution in use in other medical systems that is open, rendered as a modular architecture,
using standards-based/non-proprietary interfaces. DHMSM will support the Department’s goals of net centricity by providing a framework for full human and technical
connectivity and interoperability that allows DoD users and mission partners to share the information they need, when they need it, in a form they can understand and
act on with confidence, and protects information from those who should not have it. Once fielded, the EHR will support the following healthcare activities for DoD’s
44,000 practitioners and 9.5 million beneficiaries.
1. Clinical workflow and provider clinical decision support;
2. Capture, maintain, use, protect, preserve and share health data and information;
3. Retrieval and presentation of health data and information that is meaningful for EHR users regardless of where the patient’s records are physically maintained; and
4. Analysis and management of health information from multiple perspectives to include population health, military medical readiness, clinical quality, disease
management, and medical research.
B. Accomplishments/Planned Programs ($ in Millions)
FY 2014
4.720
Title: DoD Healthcare Management System Modernization (DHMSM)
FY 2015
- FY 2016
- Description: DHMSM will be executed to deliver uniform information management options across both garrison and theater
environments. DHMSM will focus on replacement of inpatient and outpatient systems, and will encompass deployment of the
enterprise EHR to fixed facilities as well as expeditionary components.
FY 2014 Accomplishments:
Program Planning Activities including:
• Finalized requirements.
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 6 of 9
R-1 Line #9
Volume 1 - 270
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
Project (Number/Name)
444B / Information Technology Development
- DoD Healthcare Management System
Modernization (DHMSM)
B. Accomplishments/Planned Programs ($ in Millions)
• Conducted multiple Industry days.
• Prepared supporting Acquisition Documentation to include Acquisition Strategy, Business Case, Engineering Master Plan, Cost
Benefit Analysis, Test Strategy, and Deployment and Supportability Plan.
• Developed and vetted multiple drafts of the Request for Proposal (RFP) Packages to insure completeness of the package to
capture the finalized requirements.
• Developed and staffed Acquisition artifacts to support Authority to Process (ATP) for RFP release.
• Received ATP for RFP release and released final RFP for full and open competition.
.
FY 2014
FY 2015
FY 2016
FY 2015 Plans:
Funding not programmed in this program element.
FY 2016 Plans:
Funding not programmed in this program element.
Accomplishments/Planned Programs Subtotals
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, PE 0807784HP: Information
Technology Development Integrated Electronic Health Record
Remarks
FY 2014
24.882
FY 2015
- FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- FY 2018
- FY 2019
- 4.720
- - Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Program cost, schedule and performance are measured periodically using a systematic approach per DoD directives and instructions.
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 7 of 9
R-1 Line #9
Volume 1 - 271
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
449A: Virtual Lifetime Electronic
Record (VLER) HEALTH
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
Prior
Years
FY 2014
- FY 2015
2.558
22.352
FY 2016
Base
- FY 2016
OCO
FY 2016
Total
- FY 2017
- - Project (Number/Name)
449A / Virtual Lifetime Electronic Record
(VLER) HEALTH
FY 2018
FY 2019
- Cost To
FY 2020 Complete
- Total
Cost
- Continuing Continuing
A. Mission Description and Budget Item Justification
The primary goal of the VLER Health initiative is to enable the secure sharing of health information (i.e., demographic and clinical data) between DoD and external
Federal and private sector partners which meets Meaningful Use (MU) requirements to improve healthcare quality, safety, and efficiency. By electronically sharing
health information using national standards, that information can support tracking key clinical conditions, communicating that information to better coordinate care, and
engaging patients in their own care. The VLER Health initiative provides clinicians with the most up-to-date information, potentially reducing redundant diagnostic tests,
medical errors, paperwork and handling, and overall healthcare costs. These benefits, in turn, align with the MHS quadruple aim by ensuring that the military force is
medically ready to deploy; the military beneficiary population remains healthy through focused prevention; patient care is convenient, equitable, safe, and of the highest
quality; and the total cost of healthcare is reduced through the reduction of waste and focus on quality
B. Accomplishments/Planned Programs ($ in Millions)
Title: Virtual Lifetime Electronic Record (VLER) HEALTH
FY 2014
2.558
FY 2015
22.352
FY 2016
- 2.558
22.352
- Description: Pursue the primary goal of the VLER Health initiative is to enable the secure sharing of health information (i.e.,
demographic and clinical data) between DoD and external Federal and private sector partners which meets Meaningful Use (MU)
requirements to improve healthcare quality, safety, and efficiency.
FY 2014 Accomplishments:
• Completed development and test of VLER Health 2.1.0.0 in support of expanding the VLER Health Exchange
FY 2015 Plans:
• Included in DMIX Data Exchange Initial Release
• Included in DMIX Data Exchange for DHMSM Integration testing
• Begin collapse of the BHIE DoD Adaptor and VLER DoD Adaptor to a single DoD Adaptor
• Begin upgrade of VLER DoD functionality limited to eHealth Exchange Gateway, GUI, C32/C62 generation
FY 2016 Plans:
No funding programmed for this initiative in this program element.
Accomplishments/Planned Programs Subtotals
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 8 of 9
R-1 Line #9
Volume 1 - 272
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
R-1 Program Element (Number/Name)
PE 0605023HP / Integrated Electronic
Health Record (iEHR)
C. Other Program Funding Summary ($ in Millions)
Line Item
• BA-1, PE 0807784: Integrated
Electronic Health Record (iEHR)
• BA-3, PE 0807784: Replacement/
Modernization, Integrated
Electronic Health Record
Remarks
Project (Number/Name)
449A / Virtual Lifetime Electronic Record
(VLER) HEALTH
FY 2014
3.900
FY 2015
6.299
FY 2016
Base
- FY 2016
OCO
- FY 2016
Total
- FY 2017
- FY 2018
- FY 2019
- Cost To
FY 2020 Complete Total Cost
- Continuing Continuing
- 0.938
- - - - - - - Continuing Continuing
D. Acquisition Strategy
Evaluate and use the most appropriate business, technical, contract and support strategies and acquisition approach to minimize costs, reduce program risks, and
remain within schedule while meeting program objectives. Strategy is revised as required as a result of periodic program reviews or major decisions.
E. Performance Metrics
Each program establishes performance measurements which are usually included in the MHS IT Annual Performance Plan. Program cost, schedule and performance
are measured periodically using a systematic approach.
PE 0605023HP: Integrated Electronic Health Record (iEH...
Defense Health Program
UNCLASSIFIED
Page 9 of 9
R-1 Line #9
Volume 1 - 273
UNCLASSIFIED
THIS PAGE INTENTIONALLY LEFT BLANK
UNCLASSIFIED
Volume 1 - 274
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130: Defense Health Program / BA 2: RDT&E
COST ($ in Millions)
Prior
Years
R-1 Program Element (Number/Name)
PE 0605025HP / Theater Medical Information Program - Joint (TMIP-J)
FY 2014
FY 2015
FY 2016
Base
FY 2016
OCO
FY 2016
Total
FY 2017
FY 2018
FY 2019
Cost To
FY 2020 Complete
Total
Cost
Total Program Element
0.000
23.783
22.042
22.100
- 22.100
22.140
22.180
22.619
23.071 Continuing Continuing
445A: Theater Medical
Information Program - Joint
(TMIP-J) (Tri-Service)
0.000
23.783
22.042
- - - - - - - Continuing Continuing
445B: Operational Medicine
Support
0.000
- - 22.100
- 22.100
22.140
22.180
22.619
23.071 Continuing Continuing
MDAP/MAIS Code:
Other MDAP/MAIS Code(s): M07
A. Mission Description and Budget Item Justification
The Theater Medical Information Program - Joint (TMIP-J) integrates components of the Military Health System sustaining base systems and the Services medical
information systems to ensure timely interoperable medical support for mobilization, deployment and sustainment of all Theater and deployed forces in support of
any mission. TMIP-J enhances the clinical care and information capture at all levels of care in Theater, transmits critical information to the Theater Commander, the
evacuation chain for combat and non-combat casualties, and forges the theater links of the longitudinal health record to the sustaining base and the Department of
Veterans Affairs. TMIP-J is the medical component of the Global Combat Support System. TMIP-J provides information at the point of care and to the Theater tactical
and strategic decision makers through efficient, reliable data capture, and data transmission to a centralized Theater database. This delivers TMIP-J´s four pillars
of information support through the electronic health record, integrated medical logistics, patient movement and tracking, and medical command and control through
data aggregation, reporting and analysis tools for trend analysis and situational awareness. TMIP-J fulfills the premise of "Train as you fight" through the integration of
components which are identical or analogous to systems from the sustaining base. TMIP-J adapts and integrates these systems to specific Theater requirements and
assures their availability in the no- and low- communications settings of the deployed environment through store and forward capture and transmission technology.
Operational Medicine Support (OpMedSpt):Due to the unique nature of the operational environment, the Military Health System must modernize the following
capabilities: medical command and control (MC2); medical situational awareness (MSA) (aggregation of operational medical data at a classified level, denying the
enemy access to data which could reveal operational plans); Defense blood management; assemblage management; and data interoperability with the pending EHR
solution and operational allies. The clinical needs of the operational community are to be met by the pending EHR solution, but there are functional needs, outside the
capture of clinical data, to inform decision making regarding the ability of the MHS to meet the needs of the medically ready force, to support the joint warfighter and
share data with line systems. It will support mission delivery and execution through the maximization of information technologies, driving standards compliance to ensure
non-EHR capabilities will effectively consume the data created through the use of the pending EHR solution in the operational environment, and to allow the solution
to share data with these other capabilities, eliminating the need for one to one interfaces, their limitations and cost. Along with the need to modernize those non-clinical
capabilities, this enterprise's risk mitigation strategy also supports ongoing missions and clinical needs in the operational environment until sufficient testing of pending
solutions can be accomplished in environments indicative of the operational environments, tactical, mobile and dismounted. TMIP-J (MSAT, TMDS, DCAM, TRAC2ES,
PE 0605025HP: Theater Medical Information Program - Jo...
Defense Health Program
UNCLASSIFIED
Page 1 of 6
R-1 Line #10
Volume 1 - 275
UNCLASSIFIED
Date: February 2015
Exhibit R-2, RDT&E Budget Item Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
R-1 Program Element (Number/Name)
0130: Defense Health Program / BA 2: RDT&E
PE 0605025HP / Theater Medical Information Program - Joint (TMIP-J)
AHLTA-T, MCC (formerly AHLTA-Mobile), Single Sign On, MMM, SAMS, and TC2) is the “umbrella” system for these solutions and the functional capabilities they
support and achieves Full Operational Capability (FOC) in FY15. While the modernization of the operational environment clinical solutions (AHLTA-T, MCC (AHLTAMobile) and TC2) is planned to take place under the auspices of the pending EHR solution, there is currently no such plan for the non-EHR capability modernization
activities. The Operational Medicine project was created to ensure the MHS is able to meet the needs of the joint warfighter, line and higher level headquarters for MC2,
MSA, Defense blood management and assemblage management.
B. Program Change Summary ($ in Millions)
Previous President's Budget
Current President's Budget
Total Adjustments
• Congressional General Reductions
• Congressional Directed Reductions
• Congressional Rescissions
• Congressional Adds
• Congressional Directed Transfers
• Reprogrammings
• SBIR/STTR Transfer
FY 2014
FY 2015
FY 2016 Base
FY 2016 OCO
FY 2016 Total
35.463
23.783
-11.680
- - - - - -7.791
-3.889
22.042
22.042
- - - - - - - - 22.100
22.100
- - - - 22.100
22.100
- Change Summary Explanation
FY 2014: Realignment from DHP RDT&E, PE 0605013-Information Technology Development (-$35.463 million) to DHP RDT&E, PE 0605025-Theater Medical
Information Program – Joint (TMIP-J) (+$35.463 million) for Theater Medical Information Program – Joint (TMIP-J).
FY 2014: Realignment from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E), PE 0605025-Theater Medical Information
Program – Joint (TMIP-J) (-$3.889 million) to DHP RDT&E PE 0605502-Small Business Innovation Research (SBIR) Program (+$3.889 million).
FY 2014: OMNIBUS Prior Approval Reprogramming (FY 14-11 PA) from Defense Health Program, Research, Development, Test and Evaluation (DHP RDT&E),
PE 0605025-Theater Medical Information Program – Joint (TMIP-J) (-$7.791 million) to DHP Procurement, PE 0807721/R&M CoPath Plus (+$7.791 million).
FY 2016: No Change.
PE 0605025HP: Theater Medical Information Program - Jo...
Defense Health Program
UNCLASSIFIED
Page 2 of 6
R-1 Line #10
Volume 1 - 276
UNCLASSIFIED
Date: February 2015
Exhibit R-2A, RDT&E Project Justification: PB 2016 Defense Health Program
Appropriation/Budget Activity
0130 / 2
COST ($ in Millions)
445A: Theater Medical
Information Program - Joint
(TMIP-J) (Tri-Service)
R-1 Program Element (Number/Name)
PE 0605025HP / Theater Medical
Information Program - Joint (TMIP-J)
Prior
Yea