“Manual Health Records Put Coast Guard Personnel at Risk”–GAO

The Federal Times is reporting that a GAO study found that two years after a failed $59.9M effort to produce an Electronic Health Record system,

“…the service continues to rely on a paper management system. That poses serious risks for personnel, a new Government Accountability Office report argues.

“According to the report, Coast Guard regional managers and clinic and sick bay administrators warned the GAO they are “unable to adequately track vital information such as medications,” which puts personnel at risk of medical complications.”

I will just note that, I have Kaiser, and they already have an excellent Electronic Health Record system. Maybe we could use theirs.

Does DOD have a system, maybe we could use theirs.

MEDICAL DOCUMENTATION OF ASBESTOS AND LEAD EXPOSURES ON COAST GUARD CUTTERS CONSTRUCTED PRIOR TO 1991

The Coast Guard is directing the documentation of possible exposure to asbestos and lead on ships that were built before 1991, which of course means most of them.

HEALTH, SAFETY AND WORK-LIFE SERVICE CENTER TECHNICAL DIRECTIVE 2017-009, HSWLSCTD 2017-009 14 December 2017

This TD applies to all Coast Guard members currently and previously assigned to CG cutters that were constructed prior to 1991. Documentation is for the purpose of identifying potential exposure to low levels of asbestos and lead below the Medical Surveillance Action Level (MSAL) required for enrollment into OMSEP. Medical documentation of these exposures may facilitate the processing of future Veterans Administration disability claims.

This is primarily aimed at active duty personnel, but an entry on the Coast Guard Retired Facebook page indicates an intention to also document possible exposure of those no longer on active duty.

New Coast Guard Officer Evals Don’t Go Far Enough–USNI

US Naval Institute has a discussion about how the new officer evaluation report (OER) might be improved.

This was always my least favorite part of being in the service. Frequently it seemed if you were honest and followed the instructions, it was the kiss of death–damning with faint praise.

Ultimately I came to believe we would be best served if the evaluation was a simple choice of three check boxes.

___ Make this officer Commandant

___ Does OK

___ Fire the SOB

Possible Checks/Alternatives to BMI as Weight Standard

I have to say I screwed up. I didn’t look up the current instruction before writing this.

The current instruction is COMDTINST M1020.8H “COAST GUARD WEIGHT AND BODY FAT STANDARDS PROGRAM MANUAL.” change 1, dated 17 April, 2015.

The current standards go beyond BMI and are more exhaustive than my suggestions.

1. General. Coast Guard body fat standards are mandated by reference (a), which states: “All the DoD components shall measure body fat using only the circumference-based method with one set of measurements (males: height, neck circumference, and abdominal circumference at the naval; females: height, neck circumference, waist circumference at the thinnest portion of the abdomen, and hips). This standardization avoids unnecessary confusion and perceptions of unfairness between services. No substitute methods of assessment are permitted.”
2. Standards for Separation. All members who exceed both their maximum allowable body fat (MABF) percentage by more than eight percent and exceed their maximum screening weight by more than 35 pounds are subject to separation. Screening weights and MABF percentages are listed in enclosure (1)

My original post is below.

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Last October I wrote a post about why Body Mass Index (BMI) should not be used as a sufficient indicator of excess weight for the service to forcibly discharge an individual, because it does not differentiate between fat and muscle, and because it unfairly penalizes taller people.

I related how it resulted in the discharge of a very fit petty officer whose only crime was that he had spent too much time in the gym building muscle mass.

BMI has only one overriding advantage–it is easy to determine.

Recently found this article, “Calling BS on BMI: How Can We Tell How Fat We Are?” which provides two simple and quick alternatives that, in fact, reflect fat content rather than simply weight.

  • “For adults, Laursen suggests getting out a tape measure. Measure your circumference at your belly button. If your waist circumference is half your height or less, you are at a healthy fat level, if you are over that number, your fat could put you at risk for ill health.
  • “If you want something even simpler, look at your hip to waist ratio. It’s something even a doctor could eyeball quickly. “If the waist is bigger than the hips, it tells me that the risk carried with that weight is much higher for that person for premature death,” Lopez-Jimenez said.”

These two tests, which might be used in combination, give a better indication of fat content (and fat, particularly belly fat, is really what we should be concerned with) than BMI. Additionally it insures that the individual will look reasonably “military” in uniform, something BMI does not do.

If we consider meeting these two criteria sufficient, BMI would no longer useful for setting upper weight limits. Lower limits perhaps, but I believe there are better standards for that as well.

Hearing: Coast Guard Requirements, Priorities, and Future Acquisition Plans (FY-2018)

 

May 18, the Commandant, Admiral Paul F. Zukunft, addressed the House Appropriations Homeland Security Subcommittee. The recorded testimony is above. It is fairly long (1h40m). The Commandant’s initial statement, following the introductions, begins at 8m40s and ends approximately minute 14.

The administration’s FY 2018 budget request was not available, but the Commandant was there to discuss future priorities, requirements, and programs. The Department Secretary, General Kelly, is expected to address the Subcommittee on May 24 at 3PM Eastern.

I will just mention a few of the items I thought significant.

Admiral Zukunft noted that Huntington Ingalls has begun cutting steel for NSC #9. Questioned about NSC#10, he said, if it were funded, the Coast Guard would of course use it, but that the Offshore Patrol Cutter (OPC) is the Coast Guard’s #1 priority. His response, that another NSC would have an effect on long-range operating cost, seemed to suggest anticipated significantly lower operating costs for the OPC. Significantly, there has been no mention of reducing the OPC program by one ship to offset the addition of NSC #9. (There is already a strong push to build more NSCs, a bill to authorized a multi-year buy of three more.)

He contended that the Coast Guard has taken a harder hit, due to budget restrictions, than other armed services and would need 5% annual growth and at least $2B annually for Acquisitions, Construction, and Improvements (AC&I). Later he stated that this annual AC&I appropriation would included about $300M annually for shore facilities. He pointed to a need to restore 1100 Reserve Billets and add 5,000 active duty military billets while retaining current levels of Civilian staff.

Apparently the FY2918 budget will begin a program to replace 35 Inland tenders at an estimated cost of approximately $25M each ($875M total). (Even if, in the unlikely event, this program were funded in only five years, that would only average $175M/year, so it is not a big program, but one that should have begun at least a decade ago.)

Cyber security for ports was discussed. The Commandant sees the Coast Guard role as decimating best practices, rather than imposing regulation. We now have a cyber program of record–still very small, two CG Academy graduates going directly into the program. The fact that two billets is worth mentioning, is probably the best indication of how really small the program is. A much smaller pre-World War II Coast Guard probably had more people working on breaking German and Japanese codes. 

Marine Inspection was addressed. The Commandant noted the increased demand for Inspections because 6,000 tugs have been added to inspection program. He noted a need for more stringent oversight of 3rd party inspectors, who in some cases have not been as meticulous as they should have been. He also noted that the US flag merchant fleet, notably the MSC’s Afloat Prepositioning Fleet, will need replacement, which will also raise demand for marine inspectors.

The Commandant also voiced his support for the Jones Act. He noted, we only have three shipyards building Jones Act ships in the US, and their loss would be short-sighted.

There was much discussion about the Arctic and the Icebreaker Fleet. Looks like follow-on funding for icebreaker program (at least after the first) will have to come from CG AC&I rather than the Navy budget. This may be difficult, but it is the way it should be. The chair of committee expressed his reservations about attempting to fund such big-ticket items through the DHS budget. The Commandant stated that the Coast Guard is still considering the acquisition of the commercial Icebreaker Aiviq (but apparently they are doing it very slowly–the chairman of the committee seemed a bit irritated about this).

The committee members seemed to latch onto the idea that the USCG, rather than the Navy, would be responsible for enforcing US sovereignty in the Arctic (which by US definition includes the Aleutians), and seemed to be asking if the Coast Guard was prepared to fight the Russians and/or Chinese in the Arctic. The Commandant suggested instead, that our role was to provide presence in the pre-conflict phase in order assert US sovereignty. He acknowledged that the National Security Cutters are only armed defensively and are not suitable for conventional naval warfare against an enemy combatant.

The Commandant acknowledged that, at some point it may be desirable to arm Polar Icebreakers, meaning they should be built with space, weight, and power reservations for additional weapons.

(I am all for keeping open the option of arming our icebreakers, so that they can defend themselves and do their part, if there is a conflict in a polar region, but there did not seem to be recognition among the Congression Representatives, that an Arctic conflict is most likely to be determined by submarines and aircraft. The icebreakers’ role is likely to be primarily logistical.)

The Commandant apparently does expect that there may be disagreements with regard to the extent of the US authority over certain areas of the Arctic.

In discussing the need for land based Unmanned Air Systems, there was a curious note at minute 40 about go-fast boats going south. Where are they going?

Alien Migrant Interdiction (AMIO). We have gone for seven weeks without a single Cuban Migrant being interdicted. This is because of the end of Wet Foot/Dry Foot Policy. This has allowed reallocation of resources to drug interdiction South of Cuba and human trafficking from the Bahamas

A Congressional Representative, from Texas pointed out there is no CG presence on the Rio Grande River, in spite of it being an international waterway. There was no mention of it, but perhaps he was thinking of the Falcon Lake incident in 2010 when an American was allegedly shot in the head by Mexican drug runners. Maybe something we should reconsider.

The Commandant promised the CG would have an unfunded priority list for FY2018.