1 FAM 360†

Bureau OF MEDICAL SERVICES (MED)

(CT:ORG-402;†† 11-29-2016)
(Office of Origin:† MED/DIR)

1 FAM 361 †MEDICAL DIRECTOR / Designated safety and health official (dASHO) FOR THE BUREAU OF MEDICAL SERVICES (MED)

1 FAM 361.1 †Responsibilities

(CT:ORG-402;†† 11-29-2016)

a. The Medical Director is responsible for the worldwide medical program for the Department and other participating Federal Agencies. †The Medical Director reports directly to the Under Secretary for Management. †The Medical Director position is equivalent to Assistant Secretary. †He or she advises the Secretary through the Under Secretary for Management on all health issues, and provides international and domestic medical support to members of the Foreign Service and other eligible U.S. Government employees, and to eligible family members.

b. The Departmentís worldwide health program provides medical support through policy and planning to members of the Foreign Service and other eligible U.S. Government employees, and to eligible family members.  Responsibilities of this Bureau include:

(1)† Operation of a worldwide and domestic health program for eligible beneficiaries;

(2)† Administration of medical claims, reimbursements, and expenditures for the medical program;

(3)† Oversight of recruitment, hiring, assignments and staffing of medical professionals;

(4)† The overall substantive responsibility for Volume 16 of the Foreign Affairs Manual (Medical Program);

(5)† Oversight of preventive medicine programs;

(6)† Provision of medical intelligence and technical advice to the Department on natural disasters, epidemics, and terrorist acts against the U.S. Government;

(7)† Provision and direction of medical support to the Departmentís security and protective operations;

(8)† Technical review of contracts and other agreements designed to provide medical care to eligible Government employees and contractors, and ongoing quality assurance support through the contractís period of performance.

c.† The Medical Director also serves as the Designated Agency Safety and Health Official (DASHO). Along with the Bureau of Overseas Buildings Operations Managing Director for Operations (OBO/OPS) and the Deputy Assistant Secretary for Operations (A/OPR), he/she assists the Secretary of State in coordinating the Department's Safety and Health Program to meet the intent of Executive Order 12196 and the Occupational Safety and Health Administration (OSHA) standards in 29 CFR, in accordance with 1 FAM 211.2, 1 FAM 213, and 15 FAM 921.

1 FAM 361.2 †Organization

(CT:ORG-402;†† 11-29-2016)

An organizational chart of the Bureau of Medical Services is found in 1 FAM Exhibit 361.2.

1 FAM 361.3 †Authorities

(CT:ORG-402;†† 11-29-2016)

The Bureau of Medical Services derives its authority from:

(1)† The Foreign Service Act of 1980, as amended, 22 U.S.C. 3901 et seq., particularly sections 901 (Travel, Leave, and Other Benefits) (22 U.S.C. 4081) and 904 (Health Care) (22 U.S.C. 4084) of the Act;

(2)† The State Department Basic Authorities Act of 1956, as amended, 22 U.S.C. sections 2651a et seq., particularly sections 1-4;

(3)† The Occupational Safety and Health Act of 1970, as amended, 22 U.S.C. 651 et seq., particularly at 29 U.S.C. section 668, and implementing regulations at 29 CFR section 1960.6;

(4)† The Privacy Act of 1974, as amended, 5 U.S.C. 552a;

(5)† The Freedom of Information Act of 1966, as amended (FOIA), 5 U.S.C. 552, and implementing regulations at 22 CFR Part 171;

(6)† The Omnibus Diplomatic Security and Anti-Terrorism Act of 1986, as amended, 22 U.S.C. 4802, section 103 (Responsibility of the Secretary of State).

1 FAM 362 †Principal DEPUTY MEDICAL DIRECTOR (MED/DMD)

(CT:ORG-402;†† 11-29-2016)

a. The Principal Deputy Medical Director for the Bureau of Medical Services (MED/DMD):

(1)† Assists in formulating and implementing worldwide medical program policies for the Department of State and other participating U.S. government agencies;

(2)† Serves as the Director of Medical Program Operations, providing oversight to the operating elements responsible for administering the domestic and overseas medical programs for the Department;

(3)† Supervises the Managing Director for Operational Medicine (MED/DMD/OM) and the Regional Medical Managers;

(4)† Provides managerial oversight to the Office of the Executive Director; Medical Specialists Staff Office; Office of Medical Informatics; and Quality Management Staff Unit;

(5)† Reports to the Medical Director/DASHO and participates fully in the operation and management of MED;

(6)† When designated, serves as Acting Medical Director/DASHO.

b. The Principal Deputy Medical Director must be familiar with all major functions of MED. He or she is responsible for representing MED, serving as liaison with Department Bureau heads, Chiefs of Mission, and staff members abroad. The Principal Deputy Medical Director position is equivalent to that of a Principal Deputy Assistant Secretary.

1 FAM 362.1 †Managing Director of Operational† Medicine (MED/DMD/OM)

(CT:ORG-402;†† 11-29-2016)

a. The Managing Director of Operational Medicine has primary responsibility for formulating, directing, and implementing policies that provide medical support to covered personnel in high threat environments, and is responsible for planning, resourcing, and executing health support activities in such environments outside normal Health Unit activities.

b. The Managing Director of Operational Medicine directly supervises the Director of the Office of Strategic Medical Preparedness and the Director of the Office of Protective Medicine, and retains responsibility for the management, direction, and development of functions administered by the Office of Strategic Medical Preparedness and the Office of Protective Medicine.

c.† The Directorate of Operational Medicine (MED/DMD/OM):

(1)† Directs liaison activities with medical support counterparts within other U.S. government departments and agencies as the Departmentís focal point medical contingency planning and response;

(2)† Directs and oversees the Department's bio-containment medical evacuation assets, to include the provision of all program office management functions;

(3)† Provides medical direction for a program for qualified Emergency Medical Technicians in the Bureau of Diplomatic Security and other participating Bureaus, in consultation with MEDís credentialing executive; and

(4)† Directs interagency strategic medical planning fellowship programs with the Department of Defense and other partner organizations.

d. The Managing Director of Operational Medicine represents MED on medical security issues, serving as liaison with Department and interagency leaders. He or she reports directly to the Principal Deputy Medical Director.

1 FAM 362.1-1 †Office of Strategic Medical Preparedness (MED/DMD/OM/SMP)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Strategic Medical Preparedness is responsible for developing strategic medical contingency plans, managing the Departmentís strategic stockpiles of medical equipment and pharmaceuticals, and developing and executing mass casualty training programs for high threat posts.

b. The Office of Strategic Medical Preparedness (MED/DMD/OM/SMP):

(1)† Conducts collaborative efforts with DS/C/WMD to identify emerging biological and chemical threats to Department operations; directs program office planning, resourcing, and the logistical management of centrally administered MED emergency response kits, and MEDís Medical Counter-Measures Program for biological/ nuclear/ chemical warfare agents, pandemic illness, HIV, and other highly infectious pathogens, including stockpiles of personal protective equipment.

(2)† Develops and directs medical planning and support for Department responses to natural and man-made disasters.

(3)† Ensures the quality of the Departmentís emergency medical response education programs; develops and directs medical training, sustainment, and integration for Chief of Mission personnel deploying to non-permissive environments; and develops and directs a mass casualty mobile training program to serve high threat posts.

c.† The Director of the Office of Strategic Medical Preparedness reports directly to the Managing Director of Operational Medicine.

1 FAM 362.1-2 †Office of Protective Medicine (MED/DMD/OM/PM)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Protective Medicine is responsible for the development and execution of medical support to security, protective, and crisis response operations.

b. The Office of Protective Medicine (MED/DMD/OM/PM):

(1)† In collaboration with DS, develops and directs medical support programs for the Bureau of Diplomatic Security including medical planning and MED personnel detailed to support Diplomatic Security protective details, crisis response, and re-entry operations;

(2)† Develops and executes comprehensive medical support to travel by the Secretary and other designated officials, including in-transit direct medical support during OCONUS travel by the Secretary;

(3)† Provides supplemental medical support to high threat posts at the direction of the Medical Director;

(4)† Develops and directs medical support for Foreign Emergency Support Team deployments; and

(5)† Provides medical direction for a program for qualified Emergency Medical Technicians in the Bureau of Diplomatic Security and other participating Bureaus, in consultation with MEDís credentialing executive.

c.† The Director of the Office of Protective Medicine reports directly to the Managing Director of Operational Medicine.

1 FAM 362.2 †Office of the Executive Director (MED/DMD/EX)

(CT:ORG-402;†† 11-29-2016)

a. The Office of the Executive Director is responsible for management and administrative operations to ensure policies and programs of the Bureau are efficiently and effectively implemented. The Office of the Executive Director:

(1)† Provides fiscal management of the Bureauís budget;

(2)† Formulates, coordinates and submits Bureau resource plans and requests;

(3)† Handles claims from Department of State personnel covered by the medical program for reimbursement of covered medical expenses;

(4)† Provides general services support, including medical supplies procurement, to the domestic operations of the Bureau;

(5)† Provides Human Resources support to Bureau personnel either directly or through a HR shared services provider;

(6)† Interfaces with Executive Offices of Regional Bureaus and outside Agencies whose personnel are participants in the medical program;

(7)† Liaises with the central ICASS council as needed.

b. The Executive Director serves as the Bureauís Management Control Coordinator in accordance with 2 FAM 022.8. †He or she directly supervises the Deputy Executive Director and reports directly to the Principal Deputy Medical Director.

1 FAM 362.3 †Medical Specialists Staff Office (MED/DMD/MS)

(CT:ORG-402;†† 11-29-2016)

a. The Medical Specialists Staff Office is responsible for providing professional, medical administrative and training support to medical specialists employed by the Bureau and to overseas Health Unit personnel. The Medical Specialists Staff Office:

(1)† Oversees the medical professional development and training for medical specialists;

(2)† Defines and develops the curriculum for continuing medical education programs provided by the Bureau for its professional staff;

(3)† Oversees on-going medical training and continuing education for locally employed medical personnel employed in overseas Health Units;

(4)† Coordinates the Bureau orientation process for new Foreign Service medical personnel;

(5)† Manages the Medical Provider (MP) program assignment process;

(6)† Oversees mentoring processes and programs for the medical specialists staff;

(7)† Develops nursing protocols utilized in overseas health units;

(8)† Participates in MEDís credentialing process and assists in determining clinical privileges of medical specialists through reviews of clinical performance and competencies;

(9)† Manages staffing support for Health Units abroad through deployment of rovers, re-employed annuitant (REA) personnel, and other resources;

(10) Liaises with the Bureau of Administration Logistics Management Acquisitions (A/LM) on procurement support for overseas Health Units; and

(11) Liaises with Human Resources Career Development and Assignments Office (HR/CDA) on all Foreign Service medical specialist assignments.

b. The Director of the Medical Specialists Staff Office reports directly to the Principal Deputy Medical Director. †He or she supervises the MP Program Manager, the Director of Overseas Nursing, the Training and Professional Development Coordinator Officer, and the MP rovers.

1 FAM 362.4 †Office of Medical Informatics (MED/DMD/MI)

(CT:ORG-402;†† 11-29-2016

a. The Office of Medical Informatics is responsible for developing, maintaining, and adapting medical information management systems and tools to meet the needs of the Departmentís medical program. †The Office:

(1)† Manages electronic health record systems utilized by the Department for the provision of medical care and medical program administration;

(2)† Oversees the development and maintenance of telemedicine support services;

(3)† Develops and supports medical information databases maintained by the Bureau that detail local medical resources at overseas posts;

(4)† Supports other information management needs of Bureau Offices; and

(5)† Provides technical support to the Bureau on all information technology needs including computer and telephonic systems.

b. The Director of the Office of Medical Informatics reports directly to the Principal Deputy Medical Director.

1 FAM 362.5 †Quality Management (MED/DMD/QM)

(CT:ORG-402;†† 11-29-2016)

a. The Quality Management (QM) Staff Unit is responsible for administering the Bureauís quality management system, to ensure health care is delivered at high standards by properly credentialed medical personnel. The Quality Management Staff Unit:

(1)† Maintains and updates MEDís Quality Manual;

(2)† Monitors Bureau adherence to ISO 9001:2008 Quality Management processes through internal and external quality process audits, Corrective Action Plans and other risk management programs;

(3)† Ensures Bureau operations and personnel comply with provisions of the Privacy Act;†

(4)† Directs clinical quality initiatives and peer review processes to promote standardization of provided care, data collection, and measurement of outcomes;

(5)† Verifies the existence and proper maintenance of professional credentials, including licensure and professional board certification for direct-hire MED providers, and other employees/ personal services contractors assigned domestically or overseas by other Bureaus who provide emergency medical support and treatment to personnel under Chief of Mission (COM) authority;

(6)† Ensures the management and retention of Bureau documents and records comply with ISO and Department standards and schedules; and

(7)† Facilitates and provides responses to Freedom of Information Act (FOIA) requests and EEO processes.

b. The Chief of the Quality Management staff unit reports directly to the Principal Deputy Medical Director.

1 FAM 362.6 †Regional Medical Managers (RMM)

(CT:ORG-402;†† 11-29-2016)

a. Regional Medical Managers (RMMs) are responsible for providing MED-specific oversight and direction to medical personnel in their assigned geographic region. RMMs:

(1)† Provide guidance on medical program management issues to Foreign Service Medical Specialists located in their region;

(2)† Provide direct clinical supervision to Foreign Service Regional Medical Officers (RMOs) and Medical Providers (MPs) assigned within their regions.

(3)† Coordinate Bureau response to medical crises in their region;

(4)† Oversee the development of staffing plans for their assigned regions;

(5)† Ensure newly hired medical employees in their assigned regions have appropriate mentorship;

(6)† Participate in the quality assessment process for Health Units and medical staff; and

(7)† Report directly to MED senior leadership on issues regarding the medical program at posts and on the performance of medical professionals in their regions.

b. RMMs are supervised by the Principal Deputy Medical Director.

1 FAM 363 †Deputy medical dIRECTOR For CLINICAL ProgramS (MED/CP)

(CT:ORG-402;†† 11-29-2016)

a. The Deputy Medical Director for Clinical Programs is responsible for overseeing all clinical functions, services, and programs provided by the Bureau to Department of State employees, their eligible family members and others participating in the medical program. †The Deputy Medical Director for Clinical Programs:

(1)† Has primary responsibility for formulating and implementing clinical care policies for the Departmentís worldwide medical program;

(2)† Supervises the Managing Director for Clinical Services, and the Directors of the Office of Foreign Programs and the Office of Occupational Health and Wellness;

(3)† Through the Managing Director, provides oversight and supervision to the Office of Medical Clearances and the Office of Examinations;

(4)† Reports to the Medical Director/DASHO and participates fully in the operation and management of MED; 

(5)† When designated, serves as acting Medical Director/DASHO.

b. The Deputy Medical Director for Clinical Programs must be familiar with all major functions of MED.† He or she is responsible for representing MED, serving as liaison with Department Bureau heads, Chiefs of Mission, and staff members abroad. †The Deputy Medical Director for Clinical Programs position is equivalent to that of a Deputy Assistant Secretary.

1 FAM 363.1 †Managing Director for Clinical Services† (MED/CP/CS)

(CT:ORG-402;†† 11-29-2016)

a. The Managing Director for Clinical Services is responsible for oversight, execution, and policy development for all aspects and components of the medical clearance process, including physical examination and laboratory services directly provided domestically by the Department, clearance determinations and adjudications, maintenance of required medical records, and appeals of medical clearance decisions.

b. The Managing Director for Clinical Services directly supervises the Director of the Office of Medical Clearances and the Director of the Office of Examinations.

c.† The Managing Director of Clinical Services reports directly to the Deputy Medical Director for Clinical Programs.

1 FAM 363.1-1 †Office of Medical Clearances (MED/CP/CS/CL)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Medical Clearances is responsible for adjudicating and issuing medical clearance determinations based upon established Bureau guidelines, procedures, and Departmental policy. The Office collects and reviews medical information as necessary to issue medical clearances to participants in the Departmentís worldwide medical program, including Department of State employees, their eligible family members, and others as specified in 16 FAM 210.

b. The Director of the Office of Medical Clearances reports directly to the Managing Director of Clinical Services.

1 FAM 363.1-2 †Office of Examinations (MED/CP/CS/E)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Examinations is responsible for performing physical and laboratory examinations as required to issue medical clearances to participants in the Departmentís worldwide medical program, including Department of State employees, their eligible family members and others as specified in 16 FAM 210.

b. The Director of the Office of Examinations reports directly to the Managing Director of Clinical Services.

1 FAM 363.2 †Office of Occupational Health and Wellness (MED/CP/OHW)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Occupational Health and Wellness (MED/CP/OHW) assists the Medical Director in his or her role as the Designated Agency Safety and Health Official (DASHO) through the coordination, development and implementation of program objectives for the Department's worldwide occupational health and safety program affecting domestic Department employees, U.S. Government employees abroad under Chief-of-Mission authority and their eligible family members.

b. The Office of Occupational Health and Wellness:

(1)† Offers expert advice, recommendations, and program implementation on occupational and preventive health services;

(2)† In coordination with HRís Work Life Division, directs the Departmentís Wellness Program activities;

(3)† Liaises with the Departmentís Safety, Health, and Environmental Management Office (OBO/OPS/SHEM) and the Domestic Environmental and Safety Division (A/OPR/FMS/DESD) to reduce workplace injuries and illnesses;

(4)† Provides travel and immunization services necessary to prevent diseases and illnesses related to overseas deployments to eligible medical program participants at domestic sites.

(5)† Assists the Departmentís Human Resources Employee Relations Office (HR/ER) in making disability and reasonable accommodation determinations through review of pertinent medical documents;

(6)† Develops policy on pandemic disease response and represents the bureau in the Departmentís overall pandemic response planning;

(7)† Advises the DASHO and other Department stakeholders on the possible health effects to personnel from air pollution and other environmental hazards;

(8)† Provides medical opinions to the Bureau of Consular Affairs (CA) on visa issues when required; and

(9)† Provides pertinent medical opinions to the Office of the Legal Advisor (L) on extradition issues when required.

c.† The Director of the Office of Occupational Health and Wellness supervises the Occupational Medicine Division Chief, Travel and Immunization Division Chief, and the Wellness Program Manager. He or she reports directly to the Deputy Medical Director for Clinical Programs.

1 FAM 363.3 †Office of Foreign Programs (MED/CP/FP)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Foreign Programs is responsible for authorizing and managing medical evacuations of Department of State employees, their eligible family members, and other participants in the Medical Program to the United States.† The Office also provides guidance and direction to deployed MED staff on medical evacuations to designated overseas medevac centers. It develops and implements policy regarding medical evacuations for the Departmentís worldwide medical program. 

b. The Director of the Office of Foreign Programs reports directly to the Deputy Medical Director for Clinical Programs.

1 FAM 364 †DEputy medical director for MENTAL HEALTH programs (MED/MH)

(CT:ORG-402;†† 11-29-2016)

a. The Deputy Medical Director for Mental Health Programs is responsible for mental health services worldwide, and provides direction to all units within the Directorate.† He or she provides guidance to senior Department leaders on sensitive mental health, crisis response, disaster planning/response, and morale issues. †The Deputy Medical Director for Mental Health Programs:

(1)† Oversees the Regional Medical Officer Psychiatrists (MED/RMOPs) assigned abroad, and has overall responsibility for recruiting, hiring, and training all mental health services personnel;

(2)† Serves as the chairperson for the Departmentís Family Advocacy Committee in Washington;

(3)† Supervises the directors of the Office of Overseas Mental Health Services and the Office of Employees Consultation Services, and the director of the Diplomatic Security Support Program;

(4)† Reports to the Medical Director/DASHO and participates fully in the operation and management of MED; 

(5)† When designated, serves as acting Medical Director/DASHO.

b. The Deputy Medical Director for Mental Health Programs must be familiar with all major functions of MED.† He or she is responsible for representing MED, serving as liaison with Department Bureau heads, Chiefs of Mission, and staff members abroad. The Deputy Medical Director for Mental Health Programs position is equivalent to that of a Deputy Assistant Secretary.

1 FAM 364.1 †Office of Overseas Mental Health Services (MED/MH/MHS)

(CT:ORG-402;†† 11-29-2016)

a. The Office of Overseas Mental Health Services is responsible for coordinating medical evacuation, hospitalization, treatment referrals, and the medical clearances system of mental health patients for MED.† Component divisions and programs include the Child and Family Services division, the Alcohol and Drug Awareness Program (ADAP), and the RMO/P rover position.

b. The Director of the Office of Overseas Mental Health Services reports directly to the Deputy Medical Director for Mental Health Programs.   He or she serves as Acting Deputy Medical Director when designated.

1 FAM 364.2 †Office of Employee Consultation Services (MED/MH/ECS)

(CT:ORG-402;†† 11-29-2016)

a. The Employee Consultation Services Office provides crisis intervention, problem assessment, brief counseling, and referral services to eligible employees. Components include the Employee Assistance Program which utilizes licensed clinical social workers to offer confidential services and assistance to all Foreign Service and Civil Service employees and their family members of the Department of State and USAID, and the Deployment Stress Management Program which offers pre- and post-deployment support services for employees in high-threat assignments, and real time support for both employees and families during the deployment period.

b. The Director of the Employee Consultation Services Office reports directly to the Deputy Medical Director for Mental Health Programs.

1 FAM 364.3 †Diplomatic Security Support Program (MED/MH/DSSP)

(CT:ORG-402;†† 11-29-2016)

a. The Diplomatic Security Support Program (DSSP) provides in-depth analysis and recommendations regarding forensic mental health matters and related cases referred to the Medical Director, senior leaders at the Bureaus of Diplomatic Security (DS), the Office of the Legal Advisor (L), and Human Resources.† Functions and responsibilities include:

(1)† Perform and supervise complex expert witness forensic psychological evaluations and consultations relating to diplomatic security concerns, including security clearance issues;

(2)† Provide consultation to DS on Special Agent Fitness for Duty matters;

(3)† Serve as the Departmentís subject matter expert on forensic psychological issues;

(4)† Provide faculty support to the DS Training Center on various topics; and

(5)† Consult as appropriate with other USG entities involved in national security operations.

b. The director of the DSSP reports directly to the Deputy Medical Director for Mental Health Programs.

1 FAM 365 †THROUGH 369† UNASSIGNED


1 FAM EXHIBIT 361.2
BUREAU OF MEDICAL SERVICES ORG CHART

(CT:ORG-402;†† 11-29-2016)

Title: MED Org Chart - Description: MED Org Chart