16 fam 100 
MEDICAL PROGRAM

16 FAM 110

authorities and organization

(CT:MED-25;   08-20-2012)
(Office of Origin:  MED)

16 fam 111  AUTHORITY

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

The regulations and procedures in 16 FAM are issued pursuant to:

(1)  Section 904 of the Foreign Service Act of 1980, as amended, and codified at 22 U.S.C. 4084 (Health Care Program);

(2)  Section 901 of the Foreign Service Act of 1980, as amended, 22 U.S.C. 4081 (Travel); and

(3)  42 CFR 493, implementing the Clinical Laboratory Improvement Amendments of 1988, as amended.

16 FAM 112  office of medical services (med)

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

a. The Office of Medical Services (MED) is a bureau that is responsible for managing the worldwide medical program, including hiring Foreign Service medical professionals, advising the Secretary of State on the Medical Program, and addressing global health-care issues for the State Department.

b. The Medical Program provides access to primary care services to eligible employees and family members assigned abroad.  Regional medical officers (RMOs), regional medical officer/psychiatrists (RMO/Ps), and Foreign Service health practitioners (FSHPs) provide direct patient care services at health units abroad, manage medical evacuations, assess local health risks, evaluate local medical services, and manage health-care delivery at posts within their region.  Regional medical managers (RMMs) provide managerial oversight to RMOs, FSHPs and other medical personnel in their region.  Regional medical laboratory scientists (RMLSs) are assigned abroad and within MED to provide laboratory support to healthcare providers and to monitor the quality of local laboratory services.

c.  The Medical Program provides occupational health services for employees located in the United States and abroad as well as to the locally employed staff abroad.  Occupational health services differ from primary care services in that the Occupational Health Program is responsible for OSHA-mandated pre-placement exams; medical surveillance for employees exposed to hazardous work conditions; immediate initial care for accidents and injuries; and provision of basic emergency care for medical issues that occur in the workplace.

d. The Medical Program establishes standards, evaluates medical conditions at post, and evaluates the health of employees and eligible family members to ensure that the assignment abroad matches the health-care needs of the employee and family members, provides medical consultations for security clearance issues, and provides other services as required by statute.

e. The Medical Program authorizes health units to provide emergency medical assistance to persons not otherwise eligible for medical care in unusual circumstances (e.g., natural disasters, terrorist attacks, transportation accidents).  The determination to provide emergency medical assistance considers the unavailability of suitable care, the capability of the medical providers and embassy medical facilities, and when providing assistance is in the best interest of the U.S. Government.

16 FAM 113  medical components of the office of medical services

(CT:MED-12;   01-12-2010)
(Applies to Civil Service and Foreign Service Employees)

See 1 FAM 360, Office of Medical Services (MED).

16 FAM 113.1  Medical Director

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

a. The Medical Director is the equivalent of an Assistant Secretary and the senior medical advisor to the Secretary of State.  The Medical Director is also the Designated Agency Safety and Health Official (DASHO), providing coordination between MED and operational components on safety and health issues for the Department.   The Medical Director is an experienced Foreign Service physician with a current, valid, and unrestricted license to practice medicine in a State, the District of Columbia, or a territory of the United States, and board-certified in a specialty recognized by either the American Board of Medical Specialties or the American Osteopathic Association with a minimum of three overseas tours and experience with the staff of the Office of Medical Services.  To the extent authorized by law, the Medical Director may authorize payment for medical expenses and medical travel in unusual or unforeseen circumstances.  MED must maintain appropriate documentation each time the Medical Director exercises his or her discretionary authority.  The executive office of MED will issue an authorizing memorandum which will be retained in the patient’s medical file with a copy of the memorandum maintained in a special authorizing file located in the Medical Director’s office.

b. The Medical Director and designee’s responsibilities are described in 1 FAM 360.

16 FAM 113.2  Deputy Medical Director

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

The Deputy Medical Director is equivalent to a principal deputy assistant secretary who acts as the Medical Director/DASHO in the absence of the Medical Director.  The deputy is an experienced Foreign Service physician with a current, valid, and unrestricted license to practice medicine in a State, the District of Columbia, or a territory of the United States and board-certified in a specialty recognized by either the American Board of Medical Specialties or the American Osteopathic Association with a minimum of three overseas tours and experience with the staff of the Office of Medical Services.  The Deputy Director’s responsibilities are described in 1 FAM 360.

16 FAM 113.3  Regional Medical Manager (RMM)

(CT:MED-12;   01-12-2010)
(Applies to Civil Service and Foreign Service Employees)

The regional medical manager (RMM) is an experienced senior regional medical officer who provides clinical and managerial oversight to regional medical officers (RMOs), Foreign Service health practitioners (FSHPs), and other medical personnel in his or her region.  RMM responsibilities are described in 1 FAM 360.

16 FAM 113.4  Regional Medical Officer (RMO)

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

a. The regional medical officer (RMO) is a physician with a current, valid, and unrestricted license to practice medicine in a State, the District of Columbia, or a territory of the United States, and board-certified in family practice, internal medicine, or emergency medicine by either the American Board of Medical Specialties or the American Osteopathic Association, in addition to a minimum of 5 years of experience in primary care.  The RMO must be able to provide primary care to all age groups.

b. The RMO provides clinical services, oversees the operation of the health unit, and supervises Foreign Service health practitioners (FSHPs) and regional medical laboratory scientists (RMLSs) at the post where assigned and posts within his or her assigned region.

16 FAM 113.5  Foreign Service Health Practitioner (FSHP)

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

The Foreign Service health practitioner (FSHP) is a family nurse practitioner or family medicine/primary care physician assistant licensed to practice medicine in a State, the District of Columbia or a territory of the United States, and has current national certification as a family nurse practitioner (FNP) or the physician assistant-equivalent from the American Nurses Credentialing Center, American Academy of Nurse Practitioners, or the National Commission on Certification of Physician Assistants, in addition to a minimum of 2 years of experience in primary care.  The FSHP must be able to provide care to all age groups.  The FSHP provides clinical services and supervises the operation of the health unit at post.

16 FAM 113.6  Regional Medical Officer/Psychiatrist (RMO/P)

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

a. The regional medical officer/psychiatrist (RMO/P) is a physician with a current, valid, and unrestricted license to practice medicine in a State, the District of Columbia, or a territory of the United States, and board-certified in psychiatry by either the American Board of Medical Specialties or the American Osteopathic Association Board of Psychiatry, in addition to a minimum of 5 years experience in general or childhood psychiatry.  The RMO/P must be able to provide psychiatric care to all age groups.

b. The RMO/P provides psychiatric care and oversight of mental health programs at assigned post and within his or her region.

16 FAM 113.7  Regional Medical Laboratory Scientist (RMLS) (Formerly Regional Medical Technologist)

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

The regional medical laboratory scientist (RMLS) must have a bachelor’s degree in medical technology, clinical laboratory science, microbiology, or chemistry from an accredited college or university program.  The RMLS must have 4 years of experience in an accredited laboratory, 2 of those years as a generalist, and 2 additional years training as a specialist or generalist in a laboratory discipline.  The RMLS must possess current certification with a U.S. certifying agency for laboratory medical technologists and scientists, and be able to demonstrate proof of continuing education.  The RMLS provides laboratory support to the regional medical officers (RMOs) and Foreign Service health practitioners (FSHPs) and oversees laboratory services at posts within their region, and performs special projects as assigned.

16 FAM 113.8  Post Medical Advisor (PMA)

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

A post medical advisor (PMA) is a medical practitioner selected from the local medical community at the discretion of the management officer at post and in consultation with the regional medical officer (RMO) or the Foreign Service health practitioner (FSHP).  The PMA is not a salaried position and does not provide direct-patient care services unless under contract.  The PMA assists in identifying local medical practices, hospitals, or clinics that could be utilized by mission personnel.

16 FAM 113.9  Locally Hired Medical Staff

(CT:MED-25;   08-20-2012)
(Applies to Civil Service and Foreign Service Employees)

Posts, in consultation with the regional medical officer (RMO) or Foreign Service health practitioner (FSHP), may hire local medical staff to provide medical services at posts abroad.  The RMO or FSHP must verify the medical credentials of locally employed medical staff (see MED ISO9001 Document #1401, “Hiring Providers Overseas”).

16 FAM 114  through 119 UNASSIGNED