Defense Health Agency Pharmacy Operations The Hard Part

Defense Health Agency Pharmacy Operations: The Hard Part Begins… David W. Bobb, RPH, JD Chief, Pharmacy Operations Division Defense Health Agency November 20, 2019 “Medically Ready Force…Ready Medical Force” 1

DHA and POD Changes ∎ DHA Leadership Change Ø 3 September 2019 - Change of Responsibility Ceremony Ø LTG Ronald Place is the new DHA Director ∎ Ø Ø Ø POD Leadership Changes Bill Blanche retired Henry Gibbs will lead Purchased Care Branch Matt York will lead Informatics Branch Hiring new Industry Liaison New DHA POD leadership (December 2019) “Medically Ready Force…Ready Medical Force”

Plan 3 version 6 Transition Roadmap - 638 pages 1. 1. 1. Describes the transition of MTFs to DHA ADC under the market construct 1. 1. 2. Describes the management structure through which the DHA assumes ADC 1. 1. 3. Establishes functions, proposed staffing, and org structure of Markets. 1. 1. 4. Establishes functions, proposed staffing, and organizational structure of the Small Market and Stand-Alone MTF Organization (SSO) that will manage and oversee both the Small Markets and the Stand-Alone MTFs that are not aligned to a Market. 1. 1. 5. Establishes the functions, proposed staffing, and organizational structure of the Defense Health Region (DHR) Europe (DHR-E) and DHR Indo -Pacific (DHR-IP) that will manage and oversee OCONUS MTFs that are not aligned to Markets or the SSO. 1. 1. 6. Outlines the staffing of military and civilian personnel in the DHA at HQ, Markets, and MTFs. “Medically Ready Force…Ready Medical Force” 3

Objective I 1 May 2019 – 31 Dec 2019 Ø Ø DHA ADC of CONUS MTFs – starts 1 Oct 19 ADC executed through DS relationship with Service IMOs t. IMO certifies 4 markets from 5+3 Build DHA capacity and capability to support 4 initial markets Ø Strategic pause in market standup to allow DHA HQ to mature Ø OCONUS support continues “Medically Ready Force…Ready Medical Force” 4

Objective II 1 Jan 2020 – 30 Sep 2020 Ø DHA assumes responsibility of t. IMO markets and certifies 17 additional markets Ø Build DHA capability and capacity Ø Service IMOs divest CONUS markets Ø SSs remain with Service IMOs Ø Overseas support continues “Medically Ready Force…Ready Medical Force” 5

Objective III 1 Jan 2020 – 30 Sep 2020 Ø DHA certifies SSO and assumes responsibility of SSO Ø Service IMOs divest CONUS SSs and realign personnel to SSO Ø RHC A/C end direct support Ø Overseas support continues “Medically Ready Force…Ready Medical Force” 6

Objective IV 1 Jan 2020 – 30 Sep 2021 Ø Service IMOs divest OCONUS MTFs and realign personnel to DHRs Ø DHA certifies DHR-E and DHR-IP Ø Service IMOs end direct support Ø DHA HQ and FCs reach full operational capability and capacity “Medically Ready Force…Ready Medical Force” 7

POD Organizational Changes Ø Six Senior pharmacist SMEs to service as Market pharmacists Ø Serve as pharmacy SMEs for market leadership Ø Conduit between MTF pharmacies and DHA POD Ø All will be uniformed pharmacists initially Ø Will be a resource for MTF pharmacies Ø Change in Pharmacy Working Group structure Ø MTF Advisory Board Ø Subject Interest Groups “Medically Ready Force…Ready Medical Force” 8

Non-Formulary Memo DHA POD Memo 19 -001 Ø Non-Formulary meds for those who are not enrolled to, or referred from the MTF Ø Not a new policy Ø Restatement of current policy Ø Does not mesh with the “Recapture” mantra Ø No policy will cover every contingency Ø Use professional judgment Ø Expect more things like this as we move forward “Medically Ready Force…Ready Medical Force” 9

“When you walk to the edge of all the light you have and take that first step into the darkness of the unknown, You must believe that one of two things will happen. There will be something solid for you to stand upon or you will be taught to fly. ” - Patrick Overton “Medically Ready Force…Ready Medical Force” 10

Defense Health Agency Pharmacy Operations Update Questions? ? ? “Medically Ready Force…Ready Medical Force” 11