# Presentation: 193987

## US Coast GuardHealth Service SupportAPhA PHS Session16 March 2007

## Mary Fong, RPhCAPT, USPHS Pharmacy Program Coordinator/ConsultantOffice of Health & SafetyUSCG HeadquartersWashington, DC

**Mary Fong, RPh****CAPT, USPHS**** Pharmacy Program Coordinator/Consultant****Office of Health & Safety****USCG Headquarters****Washington, DC**

## US Coast Guard

**USCG in the Armed Forces**
**US Public Health Service**
**History of the USCG**
**Missions of the USCG **
**Vessels/aircraft in the USCG**
**Contingency Operations**
**Contingency Medical Support**
**Health Services Publications**
**Summary**

## The Uniformed Services

**                                           **_**Armed Forces**_
**               **_**DOC **_**  **_**DHHS**_**  **_**DHS**_**  **_**DOD **_

** ****Army   Navy   Marines   Air Force**
** ****Coast Guard**
** ****Public Health Service  (PHS)**
** ****National Oceanographic and Atmospheric Administration (NOAA)**

## Coast Guard Forces

**42,000 Active Duty**
**18,000 Selected Reservists**
**35,000 Auxiliarists**
**8,000 Civilian**

## History of the U.S. Coast Guard

**History of the U.S. Coast Guard**

**Lighthouse Service-1716 (Treasury Dept. in 1789)**
**Revenue Cutter Service-1790 (Treasury)**
**Life-Saving Service-1848 (Treasury)**
**Steamboat Inspection-1838 (Justice, Treasury, Commerce)**
**Bureau of Navigation-1848 (Treasury)**

## History of the USCG (cont.)

**History of the USCG (cont.)**

**United States Coast Guard formed in 1915 **
**Combined Revenue Cutter Svc & Life-Saving Svc**
**Bureau of Navigation & Steamboat Inspection  joined USCG in 1942**
**Became part of Dept of Homeland Security 2003**
**Served under Navy from 1917-19 and 1941-45**
**Currently 60,000 active duty and reserve**

## CG Command Structure

**Commandant (4-star)**
**Vice Commandant, Chief of Staff, Headquarters**
**Maintenance and Logistics Commands (MLCs)**
**Atlantic and Pacific (3-star commands)**
**Districts – Nine 2-star commands**
**Academy – New London, CT**
**Training Centers**
**Cape May, Yorktown, Elizabeth City, Petaluma, Mobile**

## Slide 9

## History of CG and DoD

**CG is part of Dept of Homeland Security**
**Function under Department of the Navy in time of war **
**Last functioned as part of Navy in WWII**
**Has Memorandum of Understanding with Navy**
**CG had significant presence under DOT/DHS but alongside DoD:**
**Korea, Vietnam, Persian Gulf War, OIF**
**Became part of Department of Homeland Security on 1 Mar 03**
**Retained all current missions**
**Expect that Homeland Security missions will increase**

## Coast Guard 

**Military**
**Maritime**
**Multi-mission**
**Authority – on, over, under high seas and waterways under US jurisdiction**
**CG is an agency of Department of Homeland Security**

## Primary Coast GuardAir and Maritime Missions

**Humanitarian**
**Search and Rescue **
**     ****(SAR)**
**Law Enforcement**
**Drug Interdiction**
**Alien Migrant **
**    ****Interdiction Ops (AMIO)**

**Port Security**
**National Defense**
**Ice Operations**
**Aids to Navigation (ATON)**
**Environmental**
**Mishap Investigation**
**Coast Guard Auxiliary**

## Humanitarian

**Humanitarian**

**Flood Relief**
**Hurricane Relief**

## Search and Rescue (SAR)

**Search and Rescue (SAR)**

**Nationwide system of boats, aircraft, cutters, and rescue coordination centers**
**24 hour alert status**
**Minimize loss of life, personal injury and property damage in U.S. waters and on the high seas**
**May risk losing aircraft to save a life**
**May not risk losing aircraft to save property**
**May not risk losing a life to save a life**

## Law Enforcement

**Fisheries**
**Smuggling**
**LEDETs/TACLETs aboard Navy vessels outside US territorial waters**
**UN sanctions/embargo enforcement**
**Drug interdiction**

## Drug Interdiction

**Drug Interdiction**

**Federal agency to limit smuggling of illicit substances into U.S.**
**Aviation and Vessel Operations**
**Jurisdiction extends out of US territorial waters into high seas per UN Charter**
**U.S. Navy-deemed act of war or piracy**
**entering territorial waters foreign country**
**high seas boarding of foreign vessel**

## Alien Migrant Interdiction Operations (AMIO)

**Alien Migrant Interdiction Operations (AMIO)**

**Massive illegal migration of populations over water**
**Haiti, Cuba**
**Exposure to infectious disease**
**Interdict in foreign ports if possible**
**Return to country of origin or transfer to Navy in Guantanemo Bay, Cuba**

## Ice Operations

**Ice Operations**

**Polar Ice operations**
**International Ice Patrol**
**Since 1912 due to sinking of the *****Titanic***
**Large Icebreakers with helo support**
**Deploy for 6 month missions**
**Domestic Ice Operations**
**Facilitates transportation through ice-laden domestic shipping lanes**
**Use Icebreaker Tugs, 1 large icebreaker**

## Environmental ProtectionCG National Strike Teams

**Environmental Protection****CG National Strike Teams**

**Minimize damage caused by pollutants released in the coastal zone**
**Reduce threats posed by potential spills of oil hazardous materials**
**Assist in national and international pollution response planning**
**Anthrax cleanup in Florida and DC**
**Ricin cleanup in DC**
**Expeditionary role w/DoD for HAZMAT/oil response, etc.**

## Environmental ProtectionPort Safety

**Detection of oil/hazardous substance spills**
**Safeguard ports/vessels/waterways/personnel from accidental damage, injury, or destruction**
**Vessel/cargo inspection**

## Mishap Investigation

**Mishap Investigation**

**Investigation of all USCG aviation and vessel mishaps**
**Investigation of civilian mishaps which occur on U.S. waterways**
**Exxon Valdez**
**Amtrak train crash in Mobile waterway**
**TWA Flight 800**
**Barge collision with I 40 bridge in Oklahoma**

## Aids To Navigation (ATON)

**Maintenance of buoys in US coastal and shipping waterways**
**Maintenance of ~90% of US lighthouses-automated and manned**
**LORAN stations**

## Port Security and Safety Operations

**Marine Safety Offices**
**Responsible for US and territories**
**Interact with local and state law enforcement**
**Increased Marine Security (MARSEC) in response to military out loads at certain ports**
**Captain of the Port**
**Marine Safety and Security Teams (MSSTs)**
**Port Security Units (PSUs)**
**120 man units**
**Security in foreign ports in DoD operations**

## Captain of the Port (COTP)

**Broad authorities to manage maritime safety & security at US ports**
**Enforces International & National Regulatory standards**
**Leads efforts with the Harbor Safety Committee & Industry Associations **
**Designated CG Incident Commander for Port Wide Emergencies**

## Marine Safety and Security Teams(MSSTs)

**Maritime SWAT teams for US ports**
**Currently 12 teams (1****st**** activated in summer 2002).  Project to have 16 teams total.**
**Required to be deployable anywhere in US in 24 hours**
**76-84 person teams **
**6 high performance boats with M-60 machine guns and M-16s/shotguns for personnel**
**CBR operations capable**

## Security Response Team (SRT)

**1****st**** activated for mission response – June 2004**
**Combines MSST Boat ops with Special Ops aviation**
**Designed to use maritime insertion teams**
**Maritime equivalent of FBI Hostage Rescue team**
**Will have ready team for immediate deployment**

## US Coast Guard Auxiliary

**US Coast Guard Auxiliary**

**Non-military; Coast Guard civil function**
**Must own at least 25% interest in a boat, aircraft or marine radio station**
**35,000 members**
**Missions:**
**Vessel exams (Courtesy Marine Exam)**
**Public education**
**Operations (SAR)**
**Fellowship**

## National Defense Expeditionary

**Port/Littoral Security**
**PSUs**
**Patrol Boats**
**Buoy Tenders**
**Law Enforcement**
**LEDET/TACLETs**
**Cutter Ops**
**Transport: C-130**
**Intelligence gathering**
**Cutters, fixed and rotary wing assets**
**SAR/MEDEVAC**

## National Defense Homeland Security

**Cutter Ops**
**	****- ****378’, 270’, 210’ Cutters, Ice Breakers-offshore support**
**Patrol Boat Ops**
**	****- ****110’ shore patrol boats – port/littoral**
**PSU/MSST/SRT Ops**
**	****- ****Port/shore/offshore – based security/response**
**Buoy Tenders**
**	****- ****Provide ATON support for navigable waterways**
**Aviation Ops**
**	****- ****C-130 transport**
**	****- land-based fixed wing Intel/Search platforms**
**	****- cutter-based rotary wing Intel/Search platforms**

## CG Response Assets Afloat

**High endurance/Medium endurance cutters**
**Ice Breakers**
**Patrol Boats**
**Small Boats**
**Deployable Pursuit Boats**
**Port Security Boats**

## USCG Cutters: 399’ Ice Breaker

## USCG Cutters: WHEC-378’

**Interdiction/law enforcement/defense operations**
**Platform/hanger on fantail to accommodate CG helicopter**

**Weaponry:**
** ****76 mm gun**
** ****2 x 25 mm guns**
** ****2 x 50 caliber machine guns**
** ****Phalanx CIWS (Close-In-Weapon System)**
** ****SRBOC launchers (Chaff and Decoy system**)

## USCG Cutters: 225’ Buoy tender

## USCG Cutters: 110’ Patrol Boat

**Law enforcement **
**Interdiction**
**Coastal defense**

**Weaponry:**
** ****25 mm machine gun**
** ****2 x 50 caliber machine guns**

## Transportable Port Security Boat

**MSST/SRT/Port Security for DoD operations**
**Weaponry:**
** ****50 Caliber machine gun (bow)**
** ****2 x M-60 machine guns (port/starboard)**

## CG Response AssetsAviation

**Rotary Wing**
**	****- ****HH-60 (Jayhawk)**
**	****- HH-65 (Dolphin)**
**	****- MH-68 (Hitron****)**
**Fixed Wing**
**	****- ****HC-130**
**	****- HU-25 (Falcon)**
**UAVs (future)**

## USCG Aircraft: HC-130

## USCG Aircraft 

**HH-60  Jayhawk**

**HH-65  Dolphin**

## HITRONMH-68

**Drug interdiction**
**50 caliber machine gun**
**7.62 mm machine gun**
**Used to disable go-fast boats of drug smugglers**

## Average Coast Guard Day

**Average Coast Guard Day**

**Every eight minutes, conducts a SAR = 180 per day (65,700 SAR missions per year)**
**Every two hours a life is saved = 12 lives per day (4380 lives per year)**
**Aid 315 people/day; save $2 million in property**
**Seize 318 pounds of marijuana and 253 pounds of cocaine**
**Interdict 112 illegal immigrants**

## Slide 41

## Medical Structure of the CG

**Health care professionals are PHS officers**
**Physicians: 60**
**Dentists: 55**
**PAs/NPs: 7 (additional 30 CG)**
**Pharmacists: 16**
**Sanitarians/Environmental Health Officers: 18**
**Corpsmen: 675 total**
**Includes dental/pharmacy/x-ray techs **
**71 afloat IDTs/81 ashore IDTs**

## USCG Pharmacists

**Managerial Billets**:                                                                                                Headquarters, Washington , DC - Pharmacy Program Coordinator/ Pharmacy Chief Maintenance Logistics Command, Atlantic in Norfolk , VA – LANT Regional Pharmacy Consultant                                                                                                       Maintenance Logistics Command, Pacific in Oakland , CA – PAC Regional Pharmacy Consultant
**Field Billets: **                                                                                                            Kodiak, AK; Seattle, WA; Petaluma, CA; Alameda, CA; Mobile, AL; Miami, FL; Clearwater, FL; Elizabeth City, NC; Portsmouth, VA; Washington, DC; Cape May, NJ; New London, CT; and Cape Cod, MA.

## Slide 44

## USCG National Defense Medical Support

**Port Security Unit: ****1 Physician’s assistant, 2 corpsmen (1 **_**>**_** E-7), 120 personnel**
**Cutters/Buoy tenders/MSSTs: ****1 independent duty corpsman, EMTs/Combat lifesaver equivalent**
**Patrol Boats: ****1 EMT-B**
**SRT:  ****TBD (proposed: 1 Flight Surgeon, 5-6 HSs)**
**Aircraft**
**Fixed wing - no intrinsic medical support**
**Rotary wing - 1 rescue swimmer (EMT-B) (medevac/SAR)**

## Levels of Care

**Defined for CG in DoD operations**
**JP 4.02 - “Doctrine for Health Service Support in Joint Operations” **
**Level 1 - EMT/possible Corpsman**
**Level 2 - Have no level 2 or above capabilities**
**rely on DoD medical treatment capabilities**
**rely on lifts of opportunity for evacuation**

## US Coast GuardMilitary Medical  Readiness

**HQ responsibilities**
**Policy **
**Information gathering/dissemination**
**MLC responsibilities**
**Deployment oversight**
**Assistance with equipment /supplies/medical readiness immediately predeployment**
**Unit responsibilities**
**Aware of physical readiness deficiencies**
**Aware of equipment/supply deficiencies**

## USCG Health DoctrinePublications

**Medical pubs responsibility of Office of Health**
**Operational deployment pubs per Operations or Logistics offices with input from Office of Health**

## Joint Program Participation

**ASD (HA) Prevention, Safety & Health Promotion Council (PSHPC) and committees**
**Force Health Protection Committee (FHPC)**
**Joint Preventive Medicine Policy Group (JPMPG) **
**Armed Forces Epidemiology Board**
**Anthrax Vaccine Immunization Program (AVIP)**
**Smallpox Vaccine Program (SVP)**
**Joint Health Services Doctrine Board**
**Accession and Induction Standards WG**
**Reserve Health Affairs WG**
**Individual Medical Requirements WG**
**JOMMC, HLSMEC, Joint Med Planners Courses**

## Questions?