CDR Esan O. Simon
MD, MBA, FS, USPHS
NJ HOSA Leadership Conference
March 19 – 20, 2011
Sewell, NJ

I. Speaker Background
II. PHS Commission Corps
III. Mission & Organization of the PHS
IV. History of the Corps
V. PHS in the U.S. Coast Guard
VI. U.S. Coast Guard Operations
VII. Health Professions Scholarships

A. Education
College: Harvard University ’94
Medical School: Emory University ’98
Internship: Pediatrics ‘99 (Naval Medical
Center Portsmouth, VA)
-Flight Surgery: Naval Aerospace
Medicine Institute ’00
Residency: Mayo Clinic Family Medicine ‘10

B. Professional Experience
– Flight Surgeon: CVW3 (Virginia Beach, VA)
’00 – ’02
– Flight Surgeon: NASC (Pensacola, FL)
’02 – ’04
– Flight Surgeon: USCG Air Station Elizabeth
City (Elizabeth City, NC) ‘04 – ’07
– Regional Practice Director: USCG Clinic
(Cape May, NJ) ’10 – present

II. PHS Commissioned Corps
More than 6,000 full-time, highly qualified public health professionals.
Driven by a passion for public service.

II. PHS Commissioned Corps
Serve on the frontlines in the
Nation's fight against disease and poor health conditions.
Leaders in Researchadvancing public health science.

Army
Navy
Marines
Air Force
Coast Guard
PHS Commissioned Corps
NOAA Commissioned Corps

Protect, promote, and advance the health and safety of our Nation.
Leadership &
Excellence in
Public Health
Practices
Rapid &
Effective
Response to
Public Health
Needs
Advancement of Public
Health Science

• CORE MISSIONS
– Provide urgently needed public health and clinical expertise in response to large-scale local, regional, and national public health emergencies and disasters
– Work with other nations and international agencies to address global health challenges
– Conduct and support cutting-edge research for the prevention, treatment, and elimination of disease, health disparities, and injury

• CORE VALUES
– Provide essential public health and health care services to underserved and disadvantaged populations
– Prevent and control injury and the spread of disease
– Ensure that the Nation's food supply, drinking water, drugs, medical devices, and environment are safe

(Core Values, cont.)
Provides vision and purpose in public health through inspiration, dedication, and loyalty.
Leadership
Service
Demonstrates a commitment to public health through compassionate actions and stewardship of time, resources, and talents
Exemplifies uncompromising ethical conduct and maintains the highest standards or responsibility and accountability
Integrity
Excellence Exhibits superior performance and continues improvement in knowledge and expertise

President Adams signs the Relief of Sick and Disabled Seamen Act on 16 July 1798.
1798 - John Adams, 2 nd president of the United States, signed the Relief of Sick and Disabled Seamen Act.
1799 - Congress extended the Act to cover every officer and sailor in the
U.S. Navy leading to the creation of a network of local Marine Hospitals along major waterways.
1870 – Marine Hospital Service administration was centralized with its headquarters in Washington, DC, under the position of supervising surgeon (later Surgeon General).

1871 - John Maynard Woodworth, the first supervising surgeon, adopted a military model.
Woodworth instituted examinations for applicants, put physicians in uniforms, and created a cadre of mobile, career-service physicians who can be assigned to various marine hospitals.
1878 - Congress enacted the National
Quarantine Act to prevent the introduction of contagious and infectious diseases into the US.
– The Marine Hospital Service was tasked to administer immunizations programs and control epidemic diseases (i.e. smallpox, yellow fever, and cholera).

1889 - Legislation formalized the Commissioned
Corps as the uniformed services component of the
Marine Hospital Service. Congress organized
Corps officers along military lines, with titles and pay corresponding to Army and Navy grades.
1902 “Marine Hospital Service” expanded to “Public Health and Marine
Hospital Service” to reflect growing responsibilities.
The Service now managed state quarantines and the medical inspection of arriving immigrants, such as those landing at Ellis Island in New York

1912 “Public Health and Marine
Hospital Service” was shortened to the
“Public Health Service” (PHS) and their powers broadened by Congressauthorizing investigations into human diseases, sanitation, water supplies, and sewage disposal.
1930 and 1944 - Commissioned
Corps was expanded to include engineers, dentists, research scientists, nurses, and other health care specialists.

1930 and 1944 - Corps officers expanded to include engineers, dentists, research scientists, nurses, and other health care specialists, as well as physicians.

2006 to Present-The Commissioned Corps continues to fulfill its mission to protect and promote the public health of our Nation. With more than
6,000 active-duty officers, the Corps is working both nationally and internationally to create a global world free of preventable disease, sickness, and suffering.

PHS Commissioned Corps Today:
Fills essential public health leadership and service roles in over 20 Federal Agencies and Programs.

• Physician (988)
• Dentist (376)
• Nurse (1405)
• Pharmacist (1000)
• Dietitian (92)
• Engineer (404)
• Environmental Health Officer (365)
• Scientist (247)
• Veterinarian (85)
• Therapist (140)
– Occupational, Physical, Speech, & Audiology
• Health Services Officer (1010)
– Physician Asst, Info Tech, Med Admin, Optometrist, Social Worker,
Lab Tech, Health Admin, & Mental Health

I. Health Care Professionals
Physicians (60)
Dentists (60)
Pharmacists (16)
PA’s/NP’s (40 tot; 31 CG 9 PHS)
Physical Therapists (3)
Health Service Officers (8)
Environmental Health Officers(18)
Clinic Administrators (43)
II. Health Services Technicians (HS)- 738
-includes dental/pharmacy/XRAY techs

V. PHS in the
U.S. Coast Guard
•
•MEDICAL FACILITIES
•35 Outpatient Clinics/7 Satellite Clinics (AAAHC
Accredited)
- 6 Clinics co-located with MTFs (Honolulu, LA, San
Diego, Charleston, Selfridge, Sacramento)
- Clinics typically comprised of 2+ Medical Officers
- Vibrant Aviation Medicine component
• 2 Clinics with low acuity inpatient capability
- Coast Guard Academy
- Coast Guard Training Center Cape May
• 62 Sick Bays afloat & 72+ Sick Bays ashore - staffed by
IDHSs/HS (without MO at unit)

V. PHS in the
U.S. Coast Guard
• US COAST GUARD OFFICE OF HEALTH
SERVICES MISSION
– To provide health care to active duty and reserve members in support of Coast Guard missions
– To ensure the medical and dental readiness of all Coast
Guard members
– To ensure the availability of quality, cost effective health care for all eligible beneficiaries

Maritime Safety
• Search and Rescue
• Ice Operations
• Marine Safety
• Boating Safety
Maritime Mobility
• Aids to Navigation
• Polar & Domestic Ice Breaking
• Bridge Administration
• Maritime Transportation
Homeland & Maritime Security
• Port & Waterways Security
• Drug Interdiction
• Alien Migrant Interdiction
• Law and Treaty Enforcement
Protection of Natural
Resources
• Marine Pollution Education, Prevention,
Response and Enforcement
• Foreign Vessel Inspections
• Living Marine Resources Protection
• Marine and Environmental Science
Humanitarian &
Disaster Response National Defense

• AN AVERAGE COAST GUARD DAY
• Save 14 lives
• Board 193 ships and boats
• Assist 98 people in distress
• Escort over 20 larger passenger vessels, military vessels and High
Interest Vessels
• Launch 164 aircraft missions, logging 317 hours
• Service 135 aids-to-navigation and correct 23 aids-to-navigation discrepancies
• Conduct 74 Search and Rescue Cases
• Interdict and rescue 17 illegal migrants
• Respond to 12 oil/chemical/HAZMAT spills
• Seize over 1,000 lbs of illegal drugs valued at $12.9M
• Complete 31 Port State Control safety and environmental exams on foreign vessels
ALL HAZARDS, ALL THREATS, ALWAYS READY: SEMPER PARATUS

VI. U.S. Coast Guard Operations-
Operational Platforms
CASA CN-235
HH-60 Jayhawk
MH-68A Stingray
HH-65 Dolphin
HC-130 Hercules

VI. U.S. Coast Guard Operations-
Operational Platforms
Patrol Boat
Polar Icebreakers
Medium Endurance Cutter
National Security Cutter
High Endurance Cutter

VI. U.S. Coast Guard Operations-
Operational Platforms
Motor Lifeboats
Utility Boats
Defender Class Response Boats Port Security Patrol Boats

VI. U.S. Coast Guard Operations-
Drug Interdiction

VI. U.S. Coast Guard Operations-
Alien Migrant Interdiction

VI. U.S. Coast Guard Operations-
General Maritime Law Enforcement
•Boating Under the
Influence (BUI)
•Rules of the Road
•Boating Regulations
•Support of local Law
Enforcement Agencies

VI. U.S. Coast Guard Operations-
Search and Rescue
50,000 calls per year

VI. U.S. Coast Guard Operations-
Search and Rescue
USCG Rescue Swimmer
USCG H60 Jayhawk Helicopter

•Inspections of ships, especially foreign flagged ships
VI. U.S. Coast Guard Operations-
Global Merchant Fleet

VI. U.S. Coast Guard Operations-
Fisheries Enforcement
•Domestic Fisheries
Enforcement
•High Seas Drift Net
Enforcement

VI. U.S. Coast GuardOperations-
Marine Environmental Protection
•Minimize oil spill damage
•Oil Pollution Act of 1990
(OPA-90) – Exxon Valdez

VI. U.S. Coast Guard Operations-
Aids to Navigation
World’s largest
ATON system
-Over 50,000 buoys, fixed markers, and lighthouses
-LORANC (‘10)

1999 Hospital center at Fort Dix, NJ, for Kosovo refugees
2001 Terrorist attacks
2001 Anthrax attacks
2004 Tsunami and
Earthquake in
Indonesia
2006 Earthquake in
Hawaii

2005 Hurricanes Katrina & Rita
>2500 Corps Officers, >1200 federal employees
• Evacuation Triage
• Federal Medical Shelters
• Safe Drinking Water
• Safe Food and Pharmaceuticals
• Vaccinations (Td, Hep A, Influenza)
• Waste Water Systems
• Evaluated Hospitals, Shelters,
Nursing Homes, Schools
• Sick and abandoned animals
• Comfort and assurance

2008 Hurricane Gustav & Ike
• 6,000 officers placed on alert
• 800 officers deployed
• Established 4 Federal Medical Shelters (LA & TX)
• Disease surveillance, Environmental health assessments, & Food service site inspections (TX)

Emergency Response:
Haitian Operations
• 2009
– Haiti Earthquake
• Coast Guard was the first of the US Forces onscene in Port Au Prince
• MEDEVAC > 120 critically injured
• Evacuated ~ 936 American citizens

Emergency Response:
Haitian Operations

Emergency Response:
Deepwater Horizon
• 2010 Deepwater Horizon Oil Spill
– 48,000+ personnel
– 10,000 Vessels of Opportunity
– 125 aircraft
– 1000+ organizations
– USCG Response:
• 4,500 Coast Guard personnel deployed (~10% of Coast
Guard workforce)
• Assumed command & control immediately after the disaster occurred

Emergency Response:
Deepwater Horizon
In situ burns
Beach cleanup

•
•
• Government Options :
Income-Based Repayment & Public Service Forgiveness: www.ibrinfo.org
Public Service Fact Sheet: http://studentaid.ed.gov/students/attachments/siteresources/LoanForgivenessv4.pdf
•
• http://www.finaid.org/calculators/ibr.phtml
Indian Health Service: http://www.loanrepayment.ihs.gov/
• HRSA :
• http://www.hrsa.gov/loanscholarships/index.html
• National Health Service Corps http://nhsc.bhpr.hrsa.gov/
• State Obligations
• Arizona: http://www.azdhs.gov/hsd/az_loan_repayment.htm
• List of Options & Programs:
• http://services.aamc.org/fed_loan_pub/index.cfm?fuseaction=public.welcome&CFID=684850&CF
TOKEN=12636529
• Army: http://www.goarmy.com/amedd/medical/corps_benefits.jsp
• Air Force: http://www.airforce.com/pdf/hpsp_scholarship.pdf
• Navy: http://www.med.navy.mil/sites/navmedmpte/accessions/pages/healthprofessionsscholarshipprogr am_prospective.aspx