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Air Force Follow-On Review Protecting The Force: Lessons From Fort 

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Standard Form 298 (Rev. 8-98)

Prescribed by ANSI Std Z39-18 
AIR FORCE FOLLOW-ON REVIEW

PROTECTING THE FORCE: LESSONS FROM FORT HOOD

Secretary of the Air Force

The Honorable Michael B. Donley

Chief of Staff of the Air Force

Gen Norton A. Schwartz

Chair Vice-Chair

Gen Stephen Lorenz Lt Gen Richard Newton

Executive Director Director of Staff

Brig Gen Sharon Dunbar Col Joan Garbutt

Headquarters Air Force Team Leads

Col Elizabeth Arledge

Col Dan Charchian

Col Andy Huff

Col Jim Miner

Col Keith Givens

Col Michael Hafer

Mr. Tom Kelly

Major Command and 

Direct Reporting Unit Team Leads

AETC Col Bruce Lovely

PACAF Col James Strickler

NGB Col Ronald Gionta

AFSOC Col Brady Reitz

USAFE Col Carla Gammon

AMC Col Frank Jones

AFSPC Col Gerald Curry

AFGSC Col Peter Ellis

ACC Col Robert LaBrutta

AFRC Col Joseph Vivori

USAFE Col Gus Green

AFSPC Col William Hampton

AFOTEC Col Edgar Vaughan

AFDW Mr. Steve Doss 

AFMC Mr. Dave Taylor

USAFA Mr. Paul Ceciliani

Major Command Vice-Commanders and 

Direct Reporting Unit Commanders

AMC Lt Gen Vern Findley 

AFRC Lt Gen Charles Stenner 

USAFA Lt Gen Michael Gould 

ACC Lt Gen William Rew 

AFMC Lt Gen Janet Wolfenbarger 

AFSOC Maj Gen Kurt Cichowski 

AFOTEC Maj Gen Stephen Sargeant

AETC Maj Gen James Whitmore 

USAFE Maj Gen William Chambers

AFSPC Maj Gen Michael Basla

NGB Maj Gen Patrick Moisio

AFGSC Maj Gen James Kowalski

AFDW Maj Gen Darrell Jones

PACAF Maj Gen Douglas Owens

Headquarters Air Force Representatives

AF/A1 Brig Gen Sharon Dunbar

AF/A2 Maj Gen Jim Poss

AF/A2 Mr. Mark Tapper 

AF/A3/5 Mr. Harry Disbrow 

AF/A4/7 Ms. Trish Young

AF/A4/7 Mr. David Beecroft

AF/A9 Mr. Kevin Williams

AF/A10 Billy Mullins, PhD

AF/RE Brig Gen Maryanne Miller

AF/SE Maj Gen Fred Roggero

AF/SG Brig Gen Michael Miller

AF/HC Chap (Maj Gen) Cecil Richardson

AF/HO Timothy Keck, PhD

AF/JA Mr. Conrad Von Wald

SAF/AQ Maj Gen Mike Skinner

SAF/PA Col Donald Snyder

SAF/GC Mr. W. Kipling At Lee Jr.

SAF/XC Mr. Bobby Smart

SAF/IG Col Kevin Jacobsen

SAF/MR Ms. Sheila Earle

NGB Brig Gen Allyson Solomon

Council of Colonels

AF/A1 Col Jim Miner

AF/A2 Ms. Connie Wright

AF/A3/5 Col Michael Hafer 

AF/A4/7 Col Elizabeth Arledge

AF/A9 Col Dan Charchian

AF/A10 Lt Col Mark Formica

AF/RE Col Michael Ricci

AF/SE Col Earle Thompson

AF/SG Col Angela Thompson

AF/HC Chap (Col) Jerry Pitts

AF/HO Timothy Keck, PhD

AF/JA Mr. Gregory Girard

SAF/AQ Col Becky Weirick

SAF/PA Col Donald Snyder

SAF/XC Col Brian Pierson

SAF/IG Col Keith Givens

NGB Col Ronald Gionta
i AIR FORCE FOLLOW-ON REVIEW

Contents

Chapter Page

EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Air Force Follow-on Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

A New Awareness––Violent Internal Threats . . . . . . . . . . . . . . . . . iv

Commander’s Intent: Preventing Violence through Vigilant 

Wingmen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

Situational Awareness––Sharing Information about Indicators . . . . v

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

Preventing Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

Risk Assessment and Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

Sharing Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii

Preparing the Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

Developing the Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x

Leading the Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi

Responding and Recovering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii

Conclusion: Preventing Violence...Enhancing Response . . . . . . . . . . . xiv

CROSS-REFERENCE TO FINDINGS/RECOMMENDATIONS 

IN THE DOD INDEPENDENT REVIEW RELATED TO 

FORT HOOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii

1 RISK ASSESSMENT AND PREVENTION . . . . . . . . . . . . . . . . . . . . . . 1

Risk Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Prohibited Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Prohibited Markings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Firearms Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Assessing the Potential for Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Workplace Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Religious Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

2 SHARING INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Information-Sharing Forums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Background Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Storing and Transferring Information . . . . . . . . . . . . . . . . . . . . . . . . . 34

Threat Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Installation Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Sharing Health Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Sharing Information on Cyberspace Activities . . . . . . . . . . . . . . . . . . . 49
AIR FORCE FOLLOW-ON REVIEW ii

Chapter Page

3 PREPARING THE FORCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Lead Agent for Force Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Commanders’ Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Operational Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Intelligence Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Joint Basing and Force Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

4 DEVELOPING THE FORCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Officer Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Chaplain Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Care Provider Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Force Protection Training and Education . . . . . . . . . . . . . . . . . . . . . . . 84

5 LEADING THE FORCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Sponsorship Programs ..

Wingman Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

Feedback Discussions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Health-Related Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Health Care Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

Total Force Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

6 RESPONDING AND RECOVERING . . . . . . . . . . . . . . . . . . . . . . . . . . 107

Responsibility for Emergency Response . . . . . . . . . . . . . . . . . . . . . . . . 107

Exercise Evaluation Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

Emergency Management Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

Emergency Communications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

Common Operational Picture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

High-Risk Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119

Mutual Aid Agreements/Memoranda of Understanding . . . . . . . . . . . 123

Casualty Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

Appendices

A Terms of Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

B Best Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

C AFMA Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1

D Team Rosters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1

E Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1
iii AIR FORCE FOLLOW-ON REVIEW

Executive Summary

On 5 November 2009, a tragic shooting allegedly carried out by a military member at 

Fort Hood, Texas, left 13 dead and 43 wounded or injured.1

 Secretary of Defense Robert 

M. Gates subsequently established the Department of Defense Independent Review Related to Fort Hood and appointed former Secretary of the Army Togo D. West, Jr., and 

former Chief of Naval Operations Adm Vern Clark to lead that effort. The review identified possible deficiencies and provided recommendations regarding Department of Defense (DoD) policies, programs, and procedures related to force protection, personnel 

policies, mass casualty response, and sufficiency of care for the health care providers involved in such events. Key concerns included developing a credible process for 

identifying individuals who pose a potential threat to themselves or others, 

providing time-critical information to 

the right people, employing appropriate 

force protection measures, and planning 

for and responding to incidents. The report, Protecting the Force: Lessons from 

Fort Hood, was delivered to Secretary 

Gates on 15 January 2010.2

 It concluded 

force protection measures focused solely 

on external threats are no longer sufficient. Force protection measures must 

now also consider internal threats—

“disaffected individuals within the force 

motivated to violence against the force 

and the nation.”3

The DoD report recommended that 

each of the Services conduct in-depth 

follow-on reviews. In response, Secretary of the Air Force Michael B. Donley 

issued Terms of Reference on 25 January 2010 and directed Gen Stephen R. Lorenz, 

Commander of Air Education and Training Command, to chair an in-depth Air Force 

Follow-on Review (Air Force FOR) to identify and resolve policy, program, and procedural gaps that could create vulnerabilities to the health and safety of Air Force personnel, other supported personnel, and their families.4

 The Office of the Secretary of Defense (OSD) and other Services likewise initiated reviews based on the DoD report 

findings and recommendations. 
AIR FORCE FOLLOW-ON REVIEW iv

Air Force Follow-on Review

Unit leaders must collect isolated bits of information—like disparate points of light—

to concentrate into a single beam focused on preventing violence affecting Air Force 

personnel and installations.

Although the Air Force review emerged as a result of the shootings at Fort Hood in 

November 2009, the study expanded its focus beyond traditional force protection measures by addressing a broader range of violent physical threats and the potential precursors 

or indicators of violence. This attention to indicators sets the conditions for moving toward preventing violence rather than relying on response in its aftermath. This more expansive approach emphasizes integrating existing programs not normally identified within 

the force protection agenda. For example, the terms resiliency and Wingman appear 

throughout our report as desired effects of improving prevention and protection measures.

A New Awareness—Violent Internal Threats

Our review addressed three fundamental force protection shortfalls identified in the 

DoD report related to the internal threat challenge. First, there is no commonly accepted 

list of indicators concerning potential 

violence. Second, outside the medical 

field, there is no centralized process for 

assessing an individual’s potential for 

violence. Third, there is no effective 

means for sharing information about 

those with a history of violence or those 

who may become violent. Our team 

confirmed the DoD findings and concluded that the current means available to 

unit leaders regarding internal threats are 

incomplete and may hinder prevention 

and response efforts. Removing this hindrance requires creating a new force protection culture that incorporates preventive 

measures aimed at internal threats.

Identifying threats from internal 

sources is not an exact science—behavioral indicators for different types of violence do 

exist, but no single set of criteria is sufficient. Specialists are researching and developing 

There is no commonly 

accepted list of 

indicators concerning 

potential violence.
v AIR FORCE FOLLOW-ON REVIEW

Executive Summary

techniques for detecting these indicators. Distinguishing those personnel for whom these 

indicators are precursors of violence from those who cope effectively with life challenges 

defines the essence of the problem confronting our leaders at all levels.

Commander’s Intent: Preventing Violence through Vigilant Wingmen

Our team found that mental health professionals who specialize in treating violent disorders are best prepared to detect and intervene with at-risk individuals. 

However, these professionals are not always available or accessible to individuals 

and unit leaders before the potential for violence becomes reality. To mitigate this, 

all Air Force members should be trained to understand relevant indicators and apply that knowledge in assessing situations. As Wingmen, Air Force members can 

help guide troubled or potentially violent individuals more effectively toward the 

care they need. The overall goal is to move toward an institutional emphasis on 

preventing violence through trained and vigilant Wingmen.

Situational Awareness—Sharing Information about Indicators

Indicators of potentially violent behavior reside among numerous sources. Organizations like the Community Action Information Board (CAIB) and the Threat Working 

Group (TWG) focus on specific kinds of information that may help leaders more effectively address trends of concern. Security Forces and the Office of Special Investigations 

have distinct missions, responsibilities, and restrictions governing the information they 

can collect, record, and make available to unit leaders. Federal, state, and local agencies 

may also have information that could help commanders and supervisors prevent an escalation toward violence. At present, however, there is no universally accessible process for 

sharing information. Further, unless risky or violent behaviors are documented, subsequent commanders and supervisors may not be aware of the potential for violent behaviors. Consequently, the initiative often rests with commanders and supervisors to ask the 

right questions of the right people, analyze the information, and discern trends toward 

violent behavior. Routine sharing of information among various organizations and individuals is a prerequisite for more effective force protection against threats, particularly 

internal threats. We believe that addressing these fundamental challenges is essential to 

preventing violence that may affect our personnel, our installations, and our community.
AIR FORCE FOLLOW-ON REVIEW vi

Methodology

Our review team conducted simultaneous top-down and bottom-up assessments. Major commands (MAJCOM), direct reporting units (DRU), the Air National Guard 

(ANG), and the Air Force Reserve Command (AFRC) provided inputs and reviews. Representatives from across the Headquarters Air Force (HAF) staff formed six cross-functional 

teams—Risk Assessment and Prevention, Sharing Information, Preparing the Force, Developing the Force, Leading the Force, and Responding and Recovering. The HAF also 

drew upon the DoD findings and recommendations as a baseline from which to assess 

relevant Air Force policies, programs, procedures, and practices. A full team roster is provided at appendix D.

More than 2,000 Total Force commanders and civilian directors provided insight into 

practices related to information sharing, training, recognition of internal threats, force 

protection, and mass casualty response and recovery through a survey conducted by the 

Air Force Manpower Agency (AFMA). Selected survey results are integrated throughout 

the report and provided at appendix C.

The team reviewed 160 Air Force publications comprised of 11,386 pages, 111 DoD 

documents totaling 3,827 pages, 40 publications from other Services totaling 1,565 pages, 

33 federal laws and regulations totaling 946 pages, 12 executive orders at 99 pages, and 

233 other documents totaling 2,719 pages. In sum, the team evaluated 589 documents 

comprising 20,542 pages.

Our review developed 118 findings and 151 recommendations focused on preventing 

violence and enhancing response. A summary of our recommendations appears at appendix E. The terms of reference for both the DoD and the Air Force reviews requested notation of best practices to be shared across the DoD. Those identified during our review are 

provided in appendix B.

Preventing Violence

The desired effect of our review is to help our leaders anticipate, prevent, and respond 

to violence. Preventing violence from internal threats requires aligning policies, programs, 

procedures, and practices. The following chapters recommend ways to augment traditional force protection measures with processes to counter emerging internal threats. 

Risk Assessment and Prevention

Risk Assessment and Prevention focuses on identifying indicators of violent behavior, 

refining guidance on prohibited activities, standardizing tools that address prohibited 
vii AIR FORCE FOLLOW-ON REVIEW

Executive Summary

body markings, assessing the potential for violence, clarifying firearms policies, and promoting consistent application of policies related to workplace violence and religious issues.

Preventing violence is preferable to responding to, and recovering from, tragedies and 

requires the ability to assess indicators of violent behaviors. Traditional threat assessments 

do not focus on internal threats that might arise from military personnel, DoD civilians, 

contractors, and family members. Our team found the Air Force Leader’s Guide for Managing Personal Distress an available reference tool for assessing potentially violent behavior, 

but its use is not widespread. 

Mental health professionals have requisite knowledge and experience to assist with violence risk assessments; however, traditional clinical roles do not foster close working relationships among mental health 

professionals, commanders, unit 

leaders, and supervisors. Accordingly, our team developed 

recommendations for policies, 

programs, and procedures to 

facilitate regular consultancy 

between credentialed mental 

health providers and unit leaders to discuss difficult personnel issues, exchange information, and develop trust.

Our review confirmed the 

DoD report finding that ambiguities exist in policies governing prohibited activities (e.g., 

association with gangs and subversive groups). Current policies are not sufficient to provide 

unit leaders adequate guidance for acting on potential internal threats to good order and 

discipline. The DoD Interim Recommendations of the Fort Hood Follow-on Review tasked the 

Under Secretary of Defense for Personnel and Readiness to ensure guidance on prohibited 

activities is actionable, includes examples of inappropriate behavior, describes how to respond to uncertain situations, and updates DoD policies as appropriate.5

 We recommend 

close coordination with DoD to accomplish this review and update applicable Air Force 

instructions consistent with forthcoming policy changes.

The DoD report and the Interim Recommendations identified deficiencies in pre- and 

post-deployment health assessments as a potential source of vulnerability.6

 We found that 

Air Force policies removed requirements for personal interviews during post-deployment 
AIR FORCE FOLLOW-ON REVIEW viii

health assessments. We recommend reinstituting these interviews with credentialed mental 

health care providers to help redeploying Airmen develop healthy coping strategies for 

stress. Interviews with trained and experienced personnel should be routine practice to 

develop resilient Airmen and address self-reported violence risk factors. Coupling postdeployment interviews with partnerships between unit leaders and mental health providers should assist commanders with early intervention of the compounded effects of stress.

The DoD report recommended evaluating the need for a DoD policy on privately 

owned weapons to align Service policies.7

 Our review discovered a gap in Air Force policy 

and recommends updating Air Force instructions to comply with the Lautenberg Amendment (18 USC 922), which prohibits possession of firearms by persons convicted of domestic violence offenses.

Sharing Information

Sharing Information addresses force protection-related policies, programs, and procedures concerning commander support forums, background investigations, storing and 

transferring information, threat reporting systems, protected health information, and information sharing related to cyber activities. A key theme of our review is the need for 

greater information sharing from the national level to the installation level.

Within the Air Force, several organizations are responsible for elements of the force 

protection mission. Consolidating these elements under one force protection focal 

point at the HAF will enable unity of effort from HAF to installation levels. We also 

examined how organizations support unit leaders as they assess the potential for internal 

threats at the installation level. Venues like the Community Action Information Board 

(CAIB) and the Threat Working Group (TWG) inform leaders about specific types of 

information and threats. Engaging to assist individuals at risk for potentially violent 

behavior requires a different focus and membership than those found in either the current CAIB or TWG.

We recommend establishing a new installation-level forum called the Status of Health and 

Airmen Resiliency Exchange (SHARE). Linked to the CAIB, this forum will better support 

commanders as they address those who experience difficulties. The CAIB can then propose 

strategies to promote a more resilient Air Force community. Establishing a full-time installationlevel position to serve as the executive director of the CAIB and SHARE coordinator will enhance integration across community programs.

In line with DoD report recommendations, we reviewed information-sharing-related issues 

to ensure the Air Force will be postured to support forthcoming changes to DoD policies. The 

DoD Interim Recommendations highlighted two areas for prompt action: establishing a con-
ix AIR FORCE FOLLOW-ON REVIEW

Executive Summary

solidated law enforcement database and adopting a common threat-reporting system.8 Our 

recommendations emphasize close coordination with the ongoing DoD efforts.

While constructive engagement is important to preventing violence from those who 

experience difficulty coping with stress, we acknowledge the existence of subversive and 

dangerous threats. We recommend partnering with other Services, DoD, and 

other government agencies to share information—in appropriate and legal 

ways—to protect the force from internal threats. Forging closer relationships 

with agencies that have access to information could better inform unit leaders’ 

decisions. 

Our review team found that current 

background checks may be insufficient 

to disclose risk factors associated with 

non-US citizen accessions. Therefore, 

we recommend more stringent background checks. Other Services have enhanced their screening of alien accessions through the DoD Military 

Accessions Vital to National Interests 

(MAVNI) program. This program expands basic background checks to include National/Intelligence Agency 

checks, a Single Scope Background Investigation, and Automated Continuous Evaluation System. We recommend 

the Air Force participate in the DoD 

MAVNI program.

Preparing the Force

Preparing the Force focuses on organizing for force protection, providing tools for unit leaders to detect and prevent violence, operational reporting procedures, interagency coordination, and joint basing. The Air Force 

does not have an organizational focal point for integrating force protection policy and guidIn order to make 

informed decisions, a 

commander needs all 

the relevant information 

in a case, which means 

more data from care 

providers to build a 

whole-person picture.

—Survey comment, squadron commander
AIR FORCE FOLLOW-ON REVIEW x

ance. Measures to prepare the force to counter internal threats involve a shift from prevention toward active response. Preparation measures involve engaging with appropriate command and control, notification, and response agencies. Timely notification and warning 

procedures ensure that US Northern Command (USNORTHCOM) and its Air Force 

component command (AFNORTH) can assess the threat and coordinate response measures as necessary.

The Air Force should ensure that tenant units and joint partners are included in host 

installation force protection and emergency management exercises and inspections. Some 

installations include joint partners and tenant units in exercises and inspections, but involvement is inconsistent. Conversely, Air Force units located on other Service installations 

must actively participate in exercises and inspections to prepare their personnel for both 

internal and external threats. Our team recommends coordinating with DoD and the 

other Services to establish policies, programs, and procedures to close this gap. 

A critical element of preparation involves establishing relationships and the ability to 

share vital information with other Services and agencies in bodies like the Joint Terrorism 

Task Force (JTTF) and National Counterterrorism Center (NCTC). Both the DoD report and the DoD Interim Recommendations noted the importance of representation 

within the JTTF.9

 We recommend continuing to fill available billets on the JTTF and 

expanding Air Force participation in the JTTF and the NCTC should additional opportunities become available.

Developing the Force

Developing the Force recommends integrating force protection concepts into the continuum of learning that frames force development for all Air Force personnel. Total Force 

training and education programs are among the Air Force’s most effective tools for improving awareness and influencing behaviors. Several MAJCOMs and DRUs reported examples of the value of Air Force training in saving lives in both military and civilian settings. 

Violence from internal threats has many faces, including radicalization, harassment, 

sexual assault, domestic violence, workplace violence, and suicide.10 Despite overlapping 

risk factors, current Air Force training and education programs address most of these topics separately. We recommend synchronizing these training programs to develop awareness of common risk factors and appropriate intervention strategies. 

Our review confirmed the DoD report finding that the Air Force rescinded all requirements for workplace violence training in 2008. AF/A1 has initiated action to reinstitute 

this training to comply with Air Force policy and to improve general awareness of workplace violence indicators and response procedures. 
xi AIR FORCE FOLLOW-ON REVIEW

Executive Summary

The Air Force is just beginning to define and develop concepts and initiatives to 

strengthen the resiliency of Airmen and our Air Force community. The new Tiered Airman Resiliency Program supports Airmen returning from deployments by providing services based on specific groups’ risks of developing post-traumatic stress symptoms, depression, anxiety, suicidal thoughts, or other potentially adverse conditions.11 To facilitate 

early identification of vulnerabilities and awareness of coping tools to manage stressors, 

we recommend emphasizing resiliency and self-care concepts early and throughout specialty training and continuing education. This much-needed focus will also 

enhance force readiness.

Care providers—chaplains, medical 

personnel, mental health providers, and 

family support personnel—often witness 

signs indicating a progression toward violent behavior. We recommend including care providers who have special insights and expertise in violence prevention 

into the continuum of learning to improve the resiliency of the force.

Leading the Force

Individuals who feel isolated or disconnected from their unit, mission, or 

community may be more prone to violent behaviors or may become more 

vulnerable or sympathetic to radical or 

extremist groups. There have been instances when military personnel became violent after being ostracized, harassed, ridiculed, or isolated.12 This 

kind of treatment is unacceptable. 

Leaders at all levels must foster good order and discipline, unit cohesion, identification 

with the Air Force, and a shared sense of community.

Leading the Force recommends improving interaction between unit leaders and their 

subordinates through engaged interaction with Airmen in transition, Wingman initiatives, feedback processes, support for health care providers, and support for Airmen meetViolence from internal 

threats has many faces, 

including radicalization, 

harassment, sexual 

assault, domestic 

violence, workplace 

violence, and suicide.
AIR FORCE FOLLOW-ON REVIEW xii

ing medical and physical evaluation boards. Because unit leaders are often the first and 

most visible line of support for their subordinates, they also need support to cope with the 

stress inherent in leadership responsibilities.

Frequent engagement by leaders at all levels is essential for early intervention to prevent 

risky and violent behaviors. Our team developed several recommendations to enhance 

such engagement. Bolstering existing sponsor programs can foster a greater sense of inclusion as Air Force members transition to new assignments. The Air Force can further instill 

a Wingman culture by improving Wingman Day agendas. Adding force protection strategic messages, themes, activities, and training templates that address potentially violent 

behavior will raise awareness and enhance prevention. Also, revising current feedback 

processes should facilitate interaction and achieve a higher level of familiarity between 

supervisors and subordinates. Increasing the frequency and quality of interpersonal exchanges allows leaders to learn and share information that may better help them support 

their personnel and the mission.13

Providing high-quality health care for the force requires recruiting, caring for, and retaining qualified professionals. The DoD Interim Recommendations directed the Under 

Secretary of Defense for Personnel and Readiness to review and update policies to sustain 

high-quality care and issue a DoD instruction to reverse stigma associated with medical 

providers seeking mental health support.14 Our review confirmed the need for such guidance and developed a parallel finding and recommendation to coordinate with DoD in 

bolstering care provider resiliency initiatives.

Responding and Recovering

Responding and Recovering addresses lead agent responsibilities for emergency-response 

and exercise-evaluation teams, emergency management systems at all levels, including 

emergency communications and common operating picture, high-risk response scenarios, 

mutual aid agreements, and casualty assistance.

Preventing violence is always preferable to responding to its aftermath. Despite the best 

efforts of engaged commanders, unit leaders, supervisors, and Airmen, some violent acts 

will occur. Fortunately, many Air Force emergency preparedness and response policies, 

programs, procedures, and practices are well designed and implemented. However, we 

found opportunities to improve installation emergency management programs, notification systems, and on-scene command procedures. The Fort Hood tragedy focused attention on the importance of active shooter response, but the equally effective actions taken 

by police, emergency services, medical, and casualty affairs personnel helped shooting 

victims, survivors, and families take the first steps on the road toward recovery.
xiii AIR FORCE FOLLOW-ON REVIEW

Executive Summary

Although the DoD report emphasized the strength of some Air Force emergency management programs, we found aspects of our emergency-response program that are not 

institutionalized. At present, there is no HAF-level office of primary responsibility (OPR) 

to oversee the Exercise Evaluation Team (EET) program. For installations to be considered fully prepared, exercises should be 

multifunctional, include tenant units 

and incidental personnel, and involve 

off-base organizations to the greatest 

extent possible. We recommend identifying an OPR to focus and coordinate 

efforts at the HAF level to ensure 

MAJCOMs, DRUs, and installations 

appropriately resource, exercise, and 

inspect vital emergency preparation 

and response programs.

The ability to notify personnel of an 

incident through mass notification and 

provide updates is essential to timely 

and effective response and recovery operations. The DoD report determined 

that the Services do not consistently 

have mass notification system (MNS) 

capabilities. We confirmed this finding 

applies to the Air Force, as MNS capabilities vary from installation to installation. Additionally, DoD and Air 

Force guidance have not defined clear 

standards for installation MNS capabilities. The lack of clear guidance, 

combined with implementation costs, 

complicates installations’ abilities to meet this need. Accordingly, we recommend establishing a formal acquisition program for MNS capabilities, including procurement, sustainment support, and milestones for reaching full operational capability.

An efficient and effective dispatch function is central to getting responders to the scene of 

an incident. The Air Force has not issued policy to ensure effective routing of emergency 

calls, to include Enhanced 9-1-1 (E 9-1-1). Accordingly, we recommend designating a single 

HAF OPR for developing emergency dispatch and response policy. 
AIR FORCE FOLLOW-ON REVIEW xiv

A common operational picture (COP) information-sharing system should be inherent 

to an installation’s emergency-response capabilities. The Air Force has studied and defined 

system requirements for sharing common information at both the tactical and strategic 

levels. The efforts of this research are in the final stages. In the interim, we recommend 

leveraging existing Web-based systems to close short-term gaps.

Conclusion: Preventing Violence...Enhancing Response

Military, civilians, contractors, and family members experience many of the same 

sources of stress. Stressors may lead to violence that affects the entire community. All Air 

Force members must care for those around them and offer support to those who may feel 

isolated or disassociated. In our research, the team members were reminded time and 

again of the importance of engaged leadership at all levels. Unit leaders must instill confidence that they are engaged and accessible to their people. Creating more effective and 

resilient communities, capable of preventing violence from internal and external threats, 

is essential to meeting the complex and evolving force protection challenge leaders face 

today.

The recommendations that follow are intended to strengthen the Air Force community 

through processes that better care for our people, prevent violence, and ultimately protect 

the force from both internal and external threats. We recommend taking the steps contained in this report as soon as practical.

STEPHEN R. LORENZ RICHARD Y. NEWTON III 

General, USAF Lieutenant General, USAF
xv AIR FORCE FOLLOW-ON REVIEW

Executive Summary

Notes

1. Department of Defense, Protecting the Force: Lessons from Fort Hood: Report of the DoD Independent 

Review (Washington, DC: Department of Defense, January 2010), http://www.defense.gov/pubs/pdfs/

DOD-ProtectingTheForce-Web_Security_HR_13Jan10.pdf, 1.

2. Referred to throughout as the DoD report or the DoD IR.

3. Protecting the Force.

4. Full text of Terms of Reference is shown at appendix A.

5. Secretary of Defense Memorandum, Interim Recommendations of the Ft Hood Follow-on Review, 12 

April 2010, 4–5.

6. Ibid., 3.

7. Protecting the Force.

8. Interim Recommendations, 4–6.

9. Ibid., 5.

10. “The process of adopting or promoting an extremist belief system for the purpose of facilitating 

ideologically based violence to advance political, religious, or social change.” HR 1955, Violent Radicalization and Homegrown Terrorism Prevention Act of 2007, http://www.govtrack.us/congress/billtext 

.xpd?bill-h110-1955.

11. Lt Gen Bruce Green, USAF, “Tiered, Targeted and Tracked Interventions,” presentation, 22 February 2010.

12. For example, an Army sergeant was convicted in 2005 for killing two individuals and wounding 

14 others during the opening days of the Iraq war. See “Akbar Convicted of Murder,” 22 April 2005, available at http://www.foxnews.com/story/0,2933,154220,00.html.

13. The Air Force Sponsor, Feedback, and Wingman programs share a common goal of fostering personal and professional success for all Airmen. The three separate programs are not connected to a larger 

Air Force program but could be readily incorporated into the Airman and Family Support pillar in the 

Year of the Air Force Family program.

14. Ibid., 9.
AIR FORCE FOLLOW-ON REVIEW xvi

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xvii AIR FORCE FOLLOW-ON REVIEW

Cross Reference to DoD Report

Finding 2.1  pages 1, 17, 84, 86

DoD programs, policies, processes, and procedures that address identification of indicators for violence 

are outdated, incomplete, and fail to include key indicators of potentially violent behaviors.

Finding 2.2  pages 29, 32, 84, 86

Background checks on personnel entering the DoD workforce or gaining access to installations may be 

incomplete, too limited in scope, or not conducted at all.

Finding 2.3  page 20

DoD standards for denying requests for recognition as an ecclesiastical endorser of chaplains may be 

inadequate.

Finding 2.4  pages 30, 31

DoD has limited ability to investigate Foreign National DoD military and civilian personnel who require access to DoD information systems and facilities in the US and abroad.

Finding 2.5  page 9

The policies and procedures governing assessment for pre- and post-deployment medical risks do not 

provide a comprehensive assessment of violence indicators.

Finding 2.6  pages 12, 14

The Services have programs and policies to address prevention and intervention for suicide, sexual assault, and family violence, but guidance concerning workplace violence and potential self-radicalization 

is insufficient.

Finding 2.7  page 18

DoD policy regarding religious accommodation lacks the clarity necessary to help commanders distinguish appropriate religious practices from those that might indicate a potential for violence or selfradicalization.

Finding 2.8  page 37

DoD Instruction 5240.6, Counterintelligence (CI) Awareness, Briefing, and Reporting Programs, does not 

thoroughly address emerging threats, including self-radicalization, which may contribute to an individual’s potential to commit violence.

Finding 2.9  pages 34, 36

DoD and Service guidance does not provide for maintaining and transferring all relevant information 

about contributing factors and behavioral indicators throughout Service members’ careers.
AIR FORCE FOLLOW-ON REVIEW xviii

Finding 2.10  page 37

There is no consolidated criminal investigation database available to all DoD law enforcement criminal 

investigation organizations.

Finding 2.11  page 124

DoD guidance on establishing information-sharing agreements with Federal, State, and local law enforcement and criminal investigation organizations does not mandate action or provide clear standards.

Finding 2.12  pages 46, 75

Policies governing communicating protected health information to other persons or agencies are adequate at the DoD-level, though they currently exist only as interim guidance. The Services, however, 

have not updated their policies to reflect this guidance.

Finding 2.13  pages 43, 45

Commanders and military health care providers do not have visibility on risk indicators of Service 

members who seek care from civilian medical entities.

Finding 2.14  page 49

DoD does not have a comprehensive and coordinated policy for counterintelligence activities in cyberspace. There are numerous DoD and interagency organizations and offices involved in defense cyber 

activities.

Finding 2.15  page 4

DoD policy governing prohibited activities is unclear and does not provide commanders and supervisors the guidance and authority to act on potential threats to good order and discipline.

Finding 2.16  pages 14, 16

Authorities governing civilian personnel are insufficient to support commanders and supervisors as they 

attempt to identify indicators of violence or take actions to prevent violence.

Finding 3.1  pages 57, 59, 62

● DoD has not issued an integrating force protection policy.

● Senior DoD officials have issued DoD policy in several force protection-related subject areas such 

as antiterrorism but these policies are not well integrated.

Finding 3.2  pages 27, 61

DoD force protection programs and policies are not focused on internal threats.
xix AIR FORCE FOLLOW-ON REVIEW

Cross Reference to DoD Report

Finding 3.3  page 68

DoD’s commitment to support JTTFs is inadequate.

Finding 3.4  page 63

There is no formal guidance standardizing how to share Force Protection threat information across the 

Services or the Combatant Commands.

Finding 3.5  pages 37, 39, 59

DoD does not have direct access to a force protection threat reporting system for suspicious incident 

activity reports.

Finding 3.6  pages 65, 66, 67

There are no force protection processes or procedures to share real-time event information among commands, installations, and components.

Finding 3.7  pages 39, 40

DoD installation access control systems and processes do not incorporate behavioral screening strategies and capabilities, and are not configured to detect an insider threat.

Finding 3.8  pages 8, 9

DoD does not have a policy governing privately owned weapons.

Finding 3.9  page 41

Services cannot share information on personnel and vehicles registered on installations, installation 

debarment lists, and other relevant information required to screen personnel and vehicles, and grant 

access.

Finding 4.1  page 112

Services are not fully interoperable with all military and civilian emergency management stakeholders.

Finding 4.2  pages 113, 114, 115, 116

There is no DoD policy implementing public law for a 911 capability on DoD installations. Failure to 

implement policy will deny the military community the same level of emergency response as those 

communities off base.

Finding 4.3  pages 119, 120, 122

DoD policy does not currently take advantage of successful models for active shooter response for civilian and military law enforcement on DoD installations and facilities.
AIR FORCE FOLLOW-ON REVIEW xx

Finding 4.4  pages 108, 113

Based on Joint Staff Integrated Vulnerability Assessments, many DoD installations lack mass notification capabilities.

Finding 4.5  pages 111, 117, 118

Services have not widely deployed or integrated a Common Operational Picture capability into Installation Emergency Operations Centers per DoD direction.

Finding 4.6  page 107

Stakeholders in the DoD Installation Emergency Management program, including the Under Secretary 

of Defense for Policy; Under Secretary of Defense for Personnel and Readiness; Under Secretary of 

Defense for Intelligence; Under Secretary of Defense for Acquisition, Technology & Logistics; Assistant 

Secretary of Defense for Public Affairs; and Assistant Secretary of Defense for Networks and Information Integration/Chief Information Officer, have not yet synchronized their applicable programs, policies, processes, and procedures.

Finding 4.7  page 123

Mutual Aid Agreements (MAAs) between DoD and civilian support agencies across the Services are not 

current.

Finding 4.8  page 125

DoD has not produced guidance to develop family assistance plans for mass casualty and crisis response. As a result, Service-level planning lacks consistency and specificity, which leads to variation in 

the delivery of victim and family care.

Finding 4.9  page 125

The lack of published guidance for religious support in mass casualty incidents hampers integration of 

religious support to installation emergency management plans.

Finding 4.10  pages 79, 80, 81

Inconsistencies among Service entry level chaplain training programs can result in inadequate preparation of new chaplains to provide religious support during a mass casualty incident.

Finding 4.11  pages 126

DoD has not yet published guidance regarding installation or unit memorial service entitlements based 

on new Congressional authorization to ensure uniform application throughout the Department.
xxi AIR FORCE FOLLOW-ON REVIEW

Cross Reference to DoD Report

Finding 4.12  page 127

● DoD casualty affairs policy, Federal law, and DoD mortuary affairs guidance do not exist regarding injury or death of a private citizen with no DoD affiliation on a military installation within 

CONUS.

● There is no prescribed process to identify lead agencies for casualty notification and assistance or 

to provide care for the deceased, resulting in each case being handled in an ad-hoc manner.

Finding 5.1  pages 128, 129

● DoD installations are not consistent in adequately planning for mental health support for domestic mass casualty incidents to meet needs of victims and families.

● At Fort Hood, advanced treatment protocols developed at our universities and centers were not 

available to the commander prior to the incident.

● Fort Hood developed a Behavioral Health plan that incorporated current practices including a 

“whole community” approach, and a strategy for long-term behavioral health care not reflected in 

any DoD policy.

Finding 5.2  pages 82, 83, 84

● DoD does not have comprehensive policies that recognize, define, integrate, and synchronize 

monitoring and intervention efforts to assess and build health care provider readiness.

● DoD does not have readiness sustainment models, with requisite resources, for the health provider 

force that are similar to readiness sustainment models for combat and combat support forces.

● The demand for support for caregivers in general, and from mental health care providers in particular, is increasing and appears likely to continue to increase due to the stress on military personnel and their families from our high operational tempo and repeated assignments in combat areas.

Finding 5.3  pages 99, 100

The lack of a readiness sustainment model for the health provider force, the unique stressors that health 

care providers experience, and the increasing demand for support combine to undermine force readiness––care for both warriors and health care providers.

Finding 5.4  page 101

Senior caregivers are not consistently functioning as clinical peers and mentors to junior caregivers.
AIR FORCE FOLLOW-ON REVIEW xxii

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1 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

Military risk assessments have traditionally focused on external threats. The DoD report, 

however, addressed the need to also encompass internal threats; now is the time to devote 

more attention to preventing violence while enhancing our response capabilities. Sensing 

whether a person may become violent begins with understanding how to assess indicators 

and knowing how to intervene appropriately as a Wingman.

The Air Force has access to useful tools for assessing internal threats, but knowledge 

of their existence is not widespread, and there is no policy outlining their use. Mental 

health professionals have the knowledge and experience to help with risk 

assessment for violence; however, traditional clinical roles do not foster 

close working relationships between 

mental health professionals and unit 

leaders. A strong mental health consultancy program could help unit leaders 

access collateral workplace information if they have concerns about an 

Airman’s attitude or behavior. Finally, 

resiliency training and multidimensional fitness may decrease overall violence risk by helping Air Force members become more adaptive to stress at 

work and home. Assessing risk and 

preventing acts of violence are not easy. 

Developing appropriate tools such as 

acceptable indicators of violence is an 

essential first step.

Risk Indicators

Finding 1

(This refers to DoD report Finding/Recommendation 2.1.)

● There is no commonly accepted list of indicators for violence among military personnel.

● Current academic research does not concentrate on, and therefore does not address, potential indicators of violence among military personnel.

... now is the time to 

devote more attention to 

preventing violence 

while enhancing our 

response capabilities.
AIR FORCE FOLLOW-ON REVIEW 2

● The Air Force has an existing internal risk-assessment resource designed for Air 

Force leaders; however, Air Force policy does not address it, and awareness of its 

existence is limited.

● The Army’s Criminal Investigation Command and the FBI’s Behavioral Science 

Unit are cooperating to identify motivations and behavioral indicators of violence 

specific to the military population.

Discussion

Research on long-term indicators of violence in the military community is limited 

compared to similar research addressing other populations.1

 Developing long-term behavioral indicators in Air Force populations 

may yield better insight toward progressive indicators of violence and inform 

modifications to the behavioral screening process. This research may also reveal that indicators leading to violence 

differ across the Air Force community. 

According to our survey of unit leaders, 

negative behaviors regularly documented by unit supervisors differed by 

Air Force affiliation (active duty, Guard, 

Reserve, civilian, contractor).2

 Specifically, military leaders were most likely 

to indicate that supervisors regularly 

documented financial problems and alcohol abuse, whereas civilian directors 

were most likely to report documentation of harassing statements, threats of 

violence, displays of violence, and verbal outbursts.3

 Associations with groups 

that advocate violence or extremist ideologies were among the least likely behaviors regularly documented.

The FBI Behavioral Science Unit’s new Comprehensive Analysis of Military Offenders 

(CAMO) project is designed to apply well-tested methodologies such as the perpetratormotive research design (for understanding violent criminals in the US population) to the 

Developing long-term 

behavioral indicators in 

Air Force populations 

may yield better insight 

toward progressive 

indicators of violence ... 
3 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

military population.4 The FBI has offered to assist DoD efforts to develop immediate 

tactical deliverables (training and consultation) as well as long-term strategic deliverables 

(predictive analysis). In turn, Air Force participation would help improve FBI interview 

protocols by including Air Force issues of concern while improving the quality of research.

The DoD report recommended that DoD develop a risk assessment tool. At present, 

the Air Force provides limited information to help Air Force members detect signs of potential harm. Instruction on other signs of internal threats is directed primarily at organizations that manage risk as a part of their profession (e.g., law enforcement, mental health 

professionals, and clergy). Although these professionals are trained to address the complexities involved in identifying and preventing potential violence, providing useful and 

relevant information to all Air Force personnel will better prepare them to identify indicators and alert unit leaders (or support agencies) about behaviors of concern.

Uncertainty about the seriousness of risk factors may be a barrier to reporting concerns. 

Unit leaders surveyed indicated the most common reason they might be hesitant to report 

personnel concerns was “not sure there’s anything worth reporting” (45 percent). When 

asked why people in their unit might be hesitant to report possible risk factors for violence, more than 60 percent chose “not sure there’s anything worth reporting,” and just 

under 60 percent chose “concern that they might be over-reacting,” and/or “concern that 

they might be wrong.”5

One available Air Force resource is The Air Force Leader’s Guide for Managing Personnel 

in Distress, an online resource to help leaders identify and respond to Air Force members 

who may pose a risk to themselves or others.6

 Developed by the Air Force Medical Service 

(AFMS) as a guide for Air Force leaders, this tool contains material related to risks associated with many forms of violence, including terrorism and workplace violence, typically 

managed by other communities. Sections of this tool were updated in 2009 to address 

new challenges. Further expansion of this resource—to include guidance specific to contractors, members of other Services, National Guard members, and Reservists—would 

markedly increase its utility. Air University’s Guidelines for Command references the 

AFMS’s leadership guide, but it is not referenced in official Air Force policy, and promotion of its use remains limited.7

The Air Force must routinely update risk assessment tools in response to changes in the 

threat environment, advances in behavioral research, and revisions to Air Force, other 

Service, and DoD policy.
AIR FORCE FOLLOW-ON REVIEW 4

Recommendations

1.1 Develop Air Force policy addressing how risk assessment tools can be used to improve care and overall force protection for Air Force members. (OPR: SAF/IG)

1.2 Develop a risk assessment reference available for all Air Force members. (OPR: 

AF/SG)

1.3 Partner with the FBI’s Comprehensive Analysis of Military Offenders project to 

ensure that its research approach reflects Air Force concerns and its products are 

applicable to Air Force populations. (OPR: SAF/IG)

1.4 Continue to update assessment tools as the state of knowledge and policy develop 

and include appropriate courses of action and resources for active-duty, National 

Guard, Air Force Reserve, civilians, contractors, and dependents. (OPR: SAF/IG)

1.5 Sponsor research to develop long-term behavioral indicators that may point to 

progressive indicators of violence among Air Force personnel. (OPR: SAF/IG)

Prohibited Activities

Finding 2

(This refers to DoD report Finding/Recommendation 2.15.)

● Department of Defense Instruction (DoDI) 1325.06, Handling Dissident and Protest Activities among Members of the Armed Forces, does not provide clear guidance 

on extremist and prohibited activities.

● Unit leaders need sufficient guidance to act on potential threats to good order and 

discipline.

● DoD and the Air Force do not have adequate training tools to support official guidance regarding extremist and other prohibited activities.

Discussion

Organizations, networks, and individuals who advocate hatred and violence present a 

dynamic challenge for leaders. Only half of the Air Force military leaders and 30 percent 

of civilian directors surveyed believe they have the means to verify whether groups and/or 

networks their personnel are associated with pose a threat to the Air Force community.8
5 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

DoDI 1325.06 is the overarching publication pertaining to prohibited activities.9 It 

defines prohibited activities, discusses active participation, and outlines corrective actions 

for commanders to address such concerns. Commanders have broad authority to employ 

the full range of administrative and disciplinary actions in addressing active participation 

in prohibited activities or association with extremist organizations.10

Although DoDI 1325.06 governs policies on prohibited activities, it does not clearly 

define “extremism” and “supremacist,” explain what constitutes active participation in 

extremist organizations, or provide indicators of such involvement. Coordinating with 

DoD to address these issues in the instruction will enhance Service policies and procedures on identifying extremist and supremacist individuals or organizations.

Air Force Instruction (AFI) 51-903, Dissident and Protest Activities, is the overarching 

Air Force policy regarding prohibited activities for military personnel.11 It prescribes policy on detecting individuals who engage in supremacist behaviors as outlined in DoDI 

1325.06, Handling Dissident and Protest Activities among Members of the Armed Forces.

12 A 

comparison with corresponding Navy, Marine Corps, and Army policies reveals areas for 

potential improvement to AFI 51-903, including:

● definitions of supremacist and extremist individuals and groups,

● a definition of active participation,

● guidelines for commanders with respect to addressing Air Force members’ participation in such groups,

● a list of potential indicators of violent behavior, and

● Total Force training responsibilities.

Our team drafted these changes to AFI 51-903 into a proposed Air Force Guidance 

Memorandum, currently pending Air Force Judge Advocate (AF/JA) and General Counsel (SAF/GC) review.

The Department of the Army published Pamphlet (DA PAM) 600-15, Extremist Activities, to provide guidance for Soldiers, commanders, and others in implementing Army 

policy on extremist activities and organizations.13 The pamphlet explains general societal 

influences affecting members of the Army and underscores that countering extremism is 

every Soldier’s responsibility. It describes supremacist and extremist activities, clarifies 

rules governing active participation by members with such individuals or groups, and 

provides commanders, Soldiers, and Army leaders with a training tool to address and educate others on related behaviors. It also lists proactive steps for unit leaders to evaluate and 

prevent extremist activities and provides instructions for commanders to address extremist 

behaviors in accordance with Army Regulation (AR) 600-20, Army Command Policy.

14 In 
AIR FORCE FOLLOW-ON REVIEW 6

concert with proposed changes to AFI 51-903, publishing a related AF pamphlet would 

provide Total Force leaders with an accessible reference from which to train, identify, 

mitigate, and address behaviors or activities of concern.15

Recommendations

2.1 Coordinate with the Under Secretary of Defense for Personnel and Readiness to 

review and update DoDI 1325.06, Handling Dissident and Protest Activities among 

Members of the Armed Forces, to ensure guidance is actionable and includes behavior examples as well as guidance on how to respond to uncertain situations, and 

revise AFI 51-903 accordingly. (OPR: AF/JA, SAF/GC)

2.2 Revise AFI 51-903, via an Air Force Guidance Memorandum, to improve identification of potential threats and clarify how commanders may determine which 

activities, including group participation, are disruptive to good order and discipline. (OPR: AF/JA, SAF/GC)

2.3 Update The Military Commander and the Law by adding resources on addressing 

extremist behaviors, including information or actions that indicate personnel may 

be engaged in extremist or other prohibited activities. (OPR: AF/JA)

2.4 Ensure unit leaders are aware of DA PAM 600-15, Extremist Activities, and consider publishing a similar Air Force document and associated training material to 

improve current awareness of extremist and prohibited activities. (OPR: AF/JA, 

SAF/IG)

Prohibited Markings

Finding 3

● DoD and Service programs, policies, processes, and procedures are insufficient to 

address the full range of prohibited markings, including tattoos, that may indicate 

affiliation with groups or organizations prone to violence or radicalization.

Discussion

Permanent body markings such as tattoos, branding, and piercings are becoming increasingly common. One 2006 survey found that 36 percent of Americans between 18 

and 29 have at least one tattoo, more than twice as many as 40- to 50-year-olds (15 percent).16 Body art can signify commitment to a group or set of beliefs and therefore can be 
7 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

an important indicator of an individual’s evolving belief systems. Specific types of body art 

may indicate to unit leaders a propensity or potential for violence.17

Although DoD and the Services prohibit certain types of body markings, the limits and 

sanctions vary based on recruiting needs, demographic changes, and other factors. AFI 

36-2903, Dress and Personal Appearance of Air Force Personnel, addresses Air Force policy 

on body markings and 

specifically prohibits 

tattoos and brands that 

are obscene; advocate 

sexual, racial, ethnic, 

or religious discrimination; are commonly associated with gang affiliations; or are 

“prejudicial to good 

order and discipline.”18

The Army, Navy, and 

Marine Corps policies 

explicitly prohibit tattoos that are “extremist,” although governing policies do not define the term.19 Those involved in the accessions 

process, commanders, and supervisors have wide latitude to determine which markings 

may exceed standards but do not have a readily accessible tool to provide current information on markings that signify extremist beliefs.

Revising AFI 36-2903 is a major step toward providing guidance on tattoos for the Total 

Force. While additional tools like an online tattoo database will take more time, revising the 

instruction and distributing the Air Force Office of Special Investigation’s (AFOSI) Criminal Intelligence Bulletin “Visual Iconography: Gang and Right-Wing Hate Group Affiliated 

Symbols and Body Art” to unit leaders should clarify and standardize identifying and handling tattoos within the Air Force.20 Additionally, unit leaders need a centralized means of 

tracking previously approved body markings to inform their decisions.

Recommendations

3.1 Update AFI 36-2903, Dress and Personal Appearance of Air Force Personnel, to address prohibited tattoos, brands, and body art and to reference acceptable tools for 

unit leaders and other Airmen to identify prohibited markings. (OPR: AF/A1)
AIR FORCE FOLLOW-ON REVIEW 8

3.2 Disseminate AFOSI’s “Visual Iconography: Gang and Right-Wing Hate Group 

Affiliated Symbols and Body Art” to commanders as an initial reference tool, followed by the AFI update. (OPR: SAF/IG)

3.3 Establish a comprehensive reference tool of prohibited body markings for recruiters, trainers, commanders, and supervisors. (OPR: SAF/IG)

3.4 Develop a centralized tracking tool to inform commander decisions of previously 

approved body markings. (OPR: AF/A1)

Firearms Policies

Finding 4

(This refers to DoD report Finding/Recommendation 3.8.)

● Air Force policies and procedures with respect to privately owned weapons are current and consistent with other Service policies but do not address policies for transporting firearms, for personal firearms storage in privatized housing on Air Force 

installations, or disseminating notice of policies.

Discussion

AFI 31-101, Integrated Defense, does not outline firearm policy for occupants of privatized housing. To correct this deficiency, paragraph 8.2.4.2 should be amended to read:

Use AF Form 1314, Firearms Registration, to register privately owned firearms maintained in a 

government facility or in military family housing (to include public/private venture [PPV] or 

privatized housing) with the installation security forces.

Forthcoming DoD guidance will also specify minimum procedures for registering, 

transporting, using, and storing privately owned weapons on DoD installations as well as 

guidance on communicating policy to installation personnel to include employees, residents, and visitors.21

Recommendations

4.1 Amend current Air Force policy and procedures contained in AFI 31-101, Integrated Defense, to govern privately owned weapons in all Air Force housing. In 

doing so, consider whether effective as well as constructive notice is provided to 

individuals who enter installations but do not live on them. (OPR: AF/A4/7)
9 AIR FORCE FOLLOW-ON REVIEW

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4.2 Coordinate with the Under Secretary of Defense for Intelligence to prepare a 

department-wide interim guidance message and interim guidance that will be incorporated into a revision of DoD 5200.08-R, Physical Security Program. (OPR: AF/A4/7)

Finding 5

(This refers to DoD report Finding/Recommendation 3.8.)

● AFI 31-101, Integrated Defense, does not require individuals who register privately 

owned weapons on Air Force installations to certify they have not been convicted 

of domestic violence in accordance with the provisions of the Lautenberg Amendment (18 USC 922).

Discussion

Current Air Force policy does not require compliance with the Lautenberg Amendment to the 1968 Gun Control Act (18 USC 922).22 The amendment makes it a 

felony for those convicted of misdemeanor crimes of domestic violence, including 

members of the Armed Forces, to ship, transport, possess, or receive firearms or ammunition. DoDI 6400.06, Domestic Abuse by DoD Military Members and Other Designated Persons, specifies DD Form 2760, Qualification to Possess Firearms or Ammunition, for Service members to certify they have not been convicted of an applicable 

offense.23 A requirement to complete DD Form 2760 when registering firearms on 

base is not codified in Air Force instructions.

Recommendation

5.1 Revise AFI 31-101, Integrated Defense, to require individuals to sign DD Form 

2760, Qualification to Possess Firearms or Ammunition, when firearms are registered 

in accordance with DoDI 6400.06 and 18 USC 922. (OPR: AF/A4/7)

Assessing the Potential for Violence

Finding 6

(This refers to DoD report Finding/Recommendation 2.5.)

● Post-deployment interviews with properly trained and experienced health care professionals to detect risk for violence are no longer required unless an Airman indicates 

a problem on his or her post-deployment health reassessment (PDHRA) survey.
AIR FORCE FOLLOW-ON REVIEW 10

● Personal behavioral screenings are not required before deployment. Specifically, 

Airmen with current periodic health assessments (PHA) and no subsequent dutylimiting conditions are presumed fit to deploy unless otherwise noted in their 

medical or personnel records.

● Current methods for assessing pre- and post-deployment risk rely extensively on 

self-reported concerns without the benefit of collateral information from coworkers, immediate supervisors, or family members.

Discussion

The Air Force primarily relies on Airmen self-reporting their pre- and post-deployment 

health concerns through various questionnaires prescribed by DoD. Individual interviews 

supplement the post-deployment health assessment (PDHA), and originally were included 

in a PDHRA six months later.24

In late 2009, the Air Force requested a waiver to the policy of including interviews for 

PDHRAs in which Airmen didn’t identify health concerns. The acting Deputy Assistant 

Secretary of Defense for Force Health Protection and Readiness granted this temporary 

waiver. Interviews are, however, a clinical standard in violence risk assessment. A closer 

working relationship between unit leaders and mental health professionals may be an avenue for unit leaders to relay additional pre- or post-deployment behavioral or health 

concerns to mental health staff. This information flow may include direct observations 

from coworkers and supervisors. The Fort Lewis Soldier Wellness Assessment Program 

sets a higher standard for clinical assessment by including personal interviews by a credentialed mental health provider for all redeploying personnel.25 The use of only credentialed 

mental health professionals distinguishes the Fort Lewis program from other behavioral 

PDHA and PDHRA interviews. This initiative emphasizes assessment and preventive care 

over more traditional mental health clinic-based treatment. Finally, the Air Force should 

promote greater awareness and acceptance of Airmen raising pre- and post-deployment 

behavioral concerns to unit leaders. Doing so would be consistent with initiatives to develop resilient Airmen.26

Recommendations

6.1 Train health care providers who conduct pre- or post-deployment interviews to 

assess non-mental-health-related risks for violence (e.g., potential for radicalization, gang involvement). (OPR: AF/SG)
11 AIR FORCE FOLLOW-ON REVIEW

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6.2 Expand deployment risk assessment methods to include reliable, accessible collateral information. (OPR: AF/SG)

6.3 Encourage Airmen to share with leadership or support service providers 

pre- and post-deployment concerns about themselves as well as others. 

(OPR: AF/SG)

6.4 Consider adopting a program similar to the Fort Lewis Soldier Wellness Assessment Program, which requires all deploying personnel to meet personally with 

credentialed mental health providers. (OPR: AF/SG)

Finding 7

● Mental health professionals do not, as a matter of routine, serve as expert advisors 

for commanders and supervisors as they evaluate concerns with personnel or situations in their chain of command.

Discussion

Mental health factors are significant to identifying risk for many types of violence. 

Ready access and direct consultations with mental health professionals would help commanders and supervisors gain perspective on stress levels and other potential concerns 

affecting their personnel and ensure they receive timely, expert advice on possible courses 

of action.

Aligning mental health providers to units in manners similar to chaplains or 

flight surgeons could facilitate more frequent interaction and help identify concerns. Mental health providers could help unit leaders identify disconcerting behavior or signs of distress and recommend whether evaluation or intervention is 

warranted. They could also provide commanders with on-site monthly to quarterly 

consultations to maintain lines of communication, foster discussion of behavioral 

and leadership issues, and provide an avenue for mental health providers to address 

unit challenges through training and broader discussions with unit personnel.

Recommendation

7.1 Develop appropriate changes to policy, programs, and procedures to establish mental 

health consultancy to help unit leaders more effectively address the risks for violence, 

similar to the manner in which unit leaders consult with chaplains. (OPR: AF/SG)
AIR FORCE FOLLOW-ON REVIEW 12

Workplace Violence

Finding 8

(This refers to DoD report Finding/Recommendation 2.6.)

● There is no overarching DoD policy governing workplace violence prevention and 

response.

Discussion

The Occupational Safety and Health Administration (OSHA) promotes a set of voluntary guidelines to underpin voluntary workplace violence prevention. The Office of Personnel Management (OPM) also recommends all employees know how to report incidents of violent, intimidating, threatening, or other disruptive behavior.27 Without 

overarching DoD policy guidance, the Services and DoD may not be addressing workplace violence sufficiently, effectively, or consistently. The Air Force should work with 

DoD to develop policy addressing workplace violence.

Recommendation

8.1 Coordinate with DoD to develop workplace violence and internal threat prevention and response policies, programs, and procedures. (OPR: AF/A4/7)

Finding 9

(This refers to DoD report Finding/Recommendation 2.6.)

● Air Force policy addressing violence in the workplace or potential for selfradicalization is inadequate.

Discussion

Effectively addressing workplace violence requires sufficient focus on prevention, training, and response. Prevention efforts should focus on eliminating circumstances associated with workplace violence, such as abuse or marginalization by unit members. Personnel must also be trained to understand indicators of workplace-specific violence and 

proper reporting of indicators to appropriate agencies. Should prevention efforts fail, swift 

and appropriate response is paramount to limit the trauma that accompanies violent attacks. Current Air Force workplace violence policy lacks enforcement mechanisms similar 
13 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

to those outlined in AFI 36-2706, Military Equal Opportunity (MEO) Program, which 

requires immediate response to unacceptable behavior.28

Although chapter 6 in Air Force Manual (AFMAN) 31-201, vol. 4, High-Risk Response, focuses on workplace violence, its two paragraphs on this subject include vague 

and outdated information.29 These 

gaps could result in insufficient 

workplace violence prevention programs. As a minimum, AFMAN 31-

201, vol. 4, should be revised to emphasize engaging unit leaders, 

contacting Security Forces or OSI 

for concerns involving workplace 

violence or potential criminal conduct, or contacting the Equal Employment Opportunity (EEO) Program office for concerns involving 

discrimination. Additionally, the 

manual should be revised to reference AFI 44-154, Suicide and Violence Prevention Education and Training, as the primary policy document on training and prevention, with reference to OPM violence 

prevention materials as an additional resource.

The Air Force is currently developing a chapter for inclusion in AFMAN 31-201, 

vol. 4, on active shooter response based on lessons learned from the Columbine and 

Virginia Tech shootings.30 This new material is timely and should support established 

guidance on countering high-risk threats.

Recommendations

9.1 Revise AFMAN 31-201, vol. 4, High Risk Response, to establish policy and procedures on reporting indicators of violence and enable swift and appropriate response to prevent escalation. (OPR: AF/A4/7)

9.2 Update AFI 44-154, Suicide and Violence Prevention Education and Training, to 

include internal threat exercise requirements. (OPR: AF/SG)
AIR FORCE FOLLOW-ON REVIEW 14

Finding 10

(This refers to DoD report Finding/Recommendation 2.6.)

● Air Force policies, programs, and procedures do not address comprehensive workplace violence prevention and response.

Discussion

The DoD report identified a shortfall in policies and programs governing preventing and 

responding to workplace violence.31 According to OSHA, workplace violence is violence or 

the threat of violence against workers, occurring at or outside the workplace; it can range 

from threats and verbal abuse to physical assaults and homicide.32 The Air Force derives 

prevention and response policies and programs from this broad definition. For example, AFI 

44-154, Suicide and Violence Prevention Education and Training, establishes the Suicide and 

Violence Prevention and Education Program; AFI 40-301, Family Advocacy, establishes the 

program for family advocacy and domestic violence prevention; and AFI 36-6001, Sexual 

Assault Prevention and Response (SAPR) Program, establishes the SAPR Program.33

Currently, separate Air Force functional communities manage policies and programs 

addressing specific subsets of violence. But they do not identify or link the subset to an 

overarching focus toward more effective violence prevention and response. Without integrating policies addressing the full spectrum of violence education and training, the Air 

Force may miss important opportunities to link and reinforce violence prevention, detection, and response capabilities. The same concern exists with current DoD policies.34

Creating DoD bridge policy similar to that proposed for the Air Force should reduce gaps 

inherent in separate, functionally managed policies and programs.35

Recommendation

10.1 Coordinate with DoD to draft an instruction, followed by a 90- or 40-series AFI 

integrating the full spectrum of violence into a comprehensive prevention and response program. (OPR: AF/A1)

Finding 11

(This refers to DoD report Finding/Recommendation 2.16.)

● DoD and Air Force contract language do not fully address inappropriate contractor behavior and potential indicators of violence.
15 AIR FORCE FOLLOW-ON REVIEW

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Discussion

The Air Force holds contractors responsible for the conduct of their employees. Under 

current legal and regulatory frameworks, the Air Force can enhance indicator visibility 

and flexibility for action for contractor behaviors off base only under specific authorities 

such as determining suitability for access to classified information.

Many contractors sit side by side with members of the Air Force workforce, and they should 

be held to the same standards. Behavior accountability can be added to current contract language. 

There is a contract clause addressing business 

conduct which applies to contracts over $5 million and performance periods of 120 days or 

greater. However, this does not produce a standard result as each company provides a plan with 

the language applying to its workforce.36 For 

lesser-value contracts, there is no requirement for 

a clause to address business conduct. A requirement could be drafted and included in the performance of work statement requiring each contractor to submit an employee mitigation plan 

(code of conduct) detailing how the contractor 

will handle problem employees if a need arises.37

Defense acquisition regulations could be changed 

to include a standard behavior clause in contracts to 

address the behavior of contractors who work in 

government facilities. The intent should be to ensure the government can take appropriate action if contract employees exhibit violent or potentially violent behavior or are found to be 

engaging in prohibited activities such as associating with hate groups. DoD must develop associated legal justification to effect changes to defense acquisition regulations.

Recommendation

11.1 Coordinate with DoD to establish standard contract language regarding prohibited activities, inappropriate or high risk behavior related to violence in the DoD 

workplace. If feasible, the standard language should be required for inclusion in all 

DoD contracts and should parallel standards set for government civilian employees on potential indicators of violence in the workplace. (OPR: SAF/AQ)
AIR FORCE FOLLOW-ON REVIEW 16

Finding 12

(This refers to DoD report Finding/Recommendation 2.16.)

● Air Force policies regarding civilian behaviors do not address all potential indicators of violence in the workplace.

Discussion

Supervisors of civilian employees are expected to act when they perceive indicators of 

potentially violent behavior or receive a report of such an indicator. Appropriate response 

may be as basic as showing concern and helping the individual find assistance, or as complex as contacting law enforcement or 

investigative agencies for threat assessment or intervention. Authority for acting on potential indicators is predicated 

on requirements such as ensuring a safe 

and healthy workplace and proper personnel management.38

AFI 36-703, Civilian Conduct and 

Responsibility, provides little guidance 

on violent behavior indicators.39 Disciplinary and adverse actions could apply 

for behaviors exhibited at work, offduty behaviors having a connection to 

official duties, or actions falling into the 

category of egregious off-duty misconduct.40 The basic framework for addressing inappropriate behaviors is 

sound even though AFI 36-704, Discipline and Adverse Actions, was cited in 

the DoD report as an example of Service guidance being inadequate for addressing civilian behaviors that may be 

associated with violence in a timely 

manner.41 We found, however, that AFI 36-704 provides administrative procedures allowing supervisors to take appropriate action to protect the safety and well being of employees. In cases of imminent threat, the employee can immediately be removed from the 

Authority for acting on 

potential indicators is 

predicated on 

requirements such as 

ensuring a safe and 

healthy workplace ... 
17 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

work site; the person would remain in a pay status according to his or her work schedule—but not be physically present at work until the matter is investigated and appropriately resolved.

Further clarification regarding workplace violence in AFI 36-703 should clearly address 

violent behavior indicators, but it will not be available until administrative staffing, including AF/JA and SAF/GC review, is complete. Federal labor-management relations requirements, including union involvement in the pre-decisional phase, also apply.42

Recommendation

12.1 Revise AFI 36-703, Civilian Conduct and Responsibility, to more clearly address violence in the workplace. (OPR: AF/A1)

Finding 13

(This refers to DoD report Finding/Recommendation 2.1.)

● The Air Force has no risk assessment tool or program to identify personal risk factors, recommended courses of action, and associated support resources.

Discussion

Formalized resiliency programs could encourage personnel to discuss work, family, and 

life concerns, as well as improve awareness and access to support resources. The resiliency 

training developed for medics, security forces, and explosive ordnance disposal personnel 

could serve as a model. Another model may be the Comprehensive Airman Fitness (CAF) 

Program, which Air Mobility Command and Air Combat Command are currently testing.43

Recommendation

13.1 Address personal resiliency and risk management through formalized programs 

that provide an overarching approach to identifying and managing stressors. (OPR: 

AF/A1)

Finding 14

● Current Integrated Delivery System (IDS) community outreach and prevention 

programs do not integrate information on detecting and preventing internal threats.
AIR FORCE FOLLOW-ON REVIEW 18

Discussion

AFI 90-501, Community Action Information Board (CAIB) and Integrated Delivery System (IDS), requires a comprehensive, coordinated plan for integrating and implementing 

community outreach and prevention programs (e.g., violence awareness, intervention, 

and prevention; sexual assault, suicide, and domestic violence prevention).44 These programs are vital to reaching all personnel and providing persistent violence awareness messages throughout the year.

When surveyed, commanders and directors identified threats from disgruntled personnel, alcohol abuse, and mass casualty incidents involving firearms among their top five 

internal concerns.45 These internal threats affect safety, security, force readiness, and quality of life for the entire base community; the CAIB is the primary forum for addressing 

these issues and their impacts.46 The IDS allows commanders to focus awareness campaigns as necessary, based on the specific climate and culture at the installation. An integrated program for preventing and responding to the full range of violence, including 

internal and external threats, strengthens overall force protection, readiness, and quality 

of life.47

Recommendation

14.1 Integrate information on internal threats and workplace violence into IDS community outreach and prevention programs. (OPR: AF/A1)

Religious Issues

Finding 15

(This refers to DoD report Finding/Recommendation 2.7.)

● The lack of consolidated Air Force policy concerning religious accommodation 

complicates consistent application by unit leaders.

Discussion

The Air Force is committed to recognizing and accommodating religious practices in 

accordance with the standards provided in the Religious Freedom Restoration Act of 

1993. DoDI 1300.17, Accommodation of Religious Practices within the Military Services, 

specifies that decisions related to religious accommodation will reside with military commanders.48 Accommodation requests are approved by commanders based on review of the 
19 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

duty and mission impact, safety, unit location, and other relevant factors. Although requests are considered on an individual basis, consistent accommodation of religious practices can reduce perceptions of inequities. Consistent application can be difficult to 

achieve; commanders must refer to several Air Force policies to evaluate whether to grant 

an accommodation and may not be aware of their option to consult with chaplains and 

judge advocates general for advice.49 An AFI consolidating collective guidance on religious 

accommodation would provide commanders consistent guidance to address issues related 

to religious accommodation in a fair and informed manner.

Training on religious accommodation should also be consistent and comprehensive. This 

training is not currently formalized across the Air Force, which may diminish awareness of 

policies, programs, and procedures as well as consistency in their application. Prospective Air 

Force wing and group commanders receive training on religious accommodation at their 

respective pre-command courses at Air University.50

Squadron commander course content is developed by each MAJCOM. There is no standardized 

curriculum addressing religious accommodation 

policies and procedures or the particular challenges 

of religious accommodation in joint locations 

where other Service policies and practices may differ. Although not a specific curriculum item, religious accommodation is generally discussed during 

the MAJCOM chaplain’s module.51 To ensure clarity and consistency in training, the Air Force Chief 

of Chaplains, Plans and Programs Division has 

agreed to annually review, validate, and disseminate to MAJCOMs religious accommodation 

training resources presented in the wing and group 

pre-command courses.

Inconsistent responses to requests for religious accommodation may be perceived as discriminatory. 

In addition, religious-based threats, harassment, 

jokes or slurs, marginalization, and exclusionary behaviors are other actions that may cause individuals 

to isolate themselves from the Air Force community. 

Those individuals may lose their sense of belonging within the organization and build resentment toward those they believe responsible. Air Force personnel may even become violent because of perceptions that they have been treated unfairly based on their religious be-
AIR FORCE FOLLOW-ON REVIEW 20

liefs or practices. Greater transparency about how accommodation requests are evaluated 

may help allay concerns of inequity over requests granted in one set of circumstances but 

denied in another.

Effective in late 2010, all Air Force personnel will be required biennially to complete Total 

Force awareness computer-based training (CBT) on free exercise of religion as approved by 

the Secretary of the Air Force.52 A five-minute supervisory module will supplement the standard 15-minute training. This standardized training will improve overall awareness of policies, programs, and appropriate procedures related to religious practice.

Recommendations

15.1 Consolidate guidance related to religious accommodation (e.g., dress, religious 

observance, immunization) in a single 52-series AFI. (OPR: AF/HC)

15.2 Revise policy to recommend leaders consult chaplains and legal counsel when 

making decisions about religious accommodation requests and to guide leaders on 

the challenges of such decisions in joint environments. (OPR: AF/HC)

15.3 Revise AFI 52-101, Planning and Organizing, to include procedures for religious 

accommodation. After AFPD 52-1 coordination is complete, ensure that the prevention, identification, and response to religious-based disrespect, harassment, and 

discrimination are sufficiently addressed in relevant training (e.g., equal opportunity training, free exercise of religion training, Wingman training, and commander 

courses). (OPR: AF/HC)

Finding 16

(This refers to DoD report Finding/Recommendation 2.3.)

● DoD and Air Force policies do not address approving or removing religious organizations as ecclesiastical endorsers of chaplains or processes for investigative bodies 

that become privy to adverse information on religious organizations and their endorsing agents.

Discussion

The Armed Forces Chaplains Board (AFCB) must have the ability to make informed 

recommendations to the Under Secretary of Defense for Personnel and Readiness 

(USD[P&R]) to approve or remove ecclesiastical endorsers of military chaplains. DoDI 

1304.28, Guidance for Appointment of Chaplains for the Military Departments, requires 
21 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

military chaplains to be sponsored by an authorized endorsing agent of a recognized religious organization.53 Endorsing agents certify that prospective military chaplains are professionally qualified to perform all offices, functions, sacraments, ordinances, and ceremonies required of a DoD chaplain for a particular religious organization and are capable and 

authorized to counsel as required within a pluralistic environment.54

DoDI 1304.28 requires religious organizations (e.g., the Roman Catholic Church, the 

American Muslim Armed Forces and Veterans Affairs Council, the Central Conference of 

American Rabbis) to provide background information on the authorized endorsing agent 

they wish to act on their behalf.55 If approved by USD(P&R), the authorized endorsing 

agent can represent the religious organization and has authority to grant or withdraw ecclesiastical endorsements of military chaplains on the organization’s behalf.

DoDI 1304.28 requires that USD(P&R) take appropriate steps to verify with DoD 

components and other federal agencies that religious organizations comply with stated 

requirements such as not engaging in practices that are illegal or contrary to defined public policy.56 However, DoD and other federal agency information is generally not available 

to the AFCB in determining whether to recommend approval or removal of religious organization endorsing agents.

There is no requirement for security checks of endorsing agents (e.g., national agency 

check with local agency check [NACLC], special background investigation [SBI]).57 Since 

religious organizations with malicious intent are unlikely to select an endorsing agent easily identified by adverse information in a background check, the Air Force Judge Advocate 

General and Chief of Chaplains see little value in conducting background checks on endorsing agents. Instead, potential concerns with adverse ecclesiastical endorser background 

and influence can be more effectively and affordably mitigated by requiring DoD investigative agencies to share adverse information with the AFCB via the Deputy Under Secretary of Defense for Military Personnel Policy (DUSD[MPP]). 

Should investigative functions verify a threat or criminal activity, sharing this information with the DUSD(MPP) will enable DoD to take appropriate action. Although some 

members of these investigative bodies may already share information in practice, it is not 

specifically required by DoD or Air Force policies. Air Force Policy Directive (AFPD) 

52-1, Chaplain Service, should therefore be revised to incorporate forthcoming changes to 

DoDI 1304.28 addressing ecclesiastical endorsers.

Recommendations

16.1 Coordinate with the DUSD(MPP) to develop procedures for investigative bodies 

to convey pertinent information to the Armed Forces Chaplains Board on reli-
AIR FORCE FOLLOW-ON REVIEW 22

gious organizations and their endorsing agents that may affect their status to endorse military chaplains. (OPR: AF/HC)

16.2 Following revisions to DoD policy, update AFPD 52-1, Chaplain Service, to reflect any 

revised roles and responsibilities of the Air Force Chief of Chaplains. (OPR: AF/HC)

Notes

1. Jeffrey W. Swanson et al., “Violence and Psychiatric Disorder in the Community: Evidence from the 

Epidemiologic Catchment Area Surveys,” Hospital Community Psychiatry 41 (July 1990): 761–70; Henry 

J. Steadman et al., “Violence by People Discharged from Acute Psychiatric Inpatient Facilities and by Others in the Same Neighborhoods,” Archives of General Psychiatry 55, no. 5 (May 1998): 393–401; and 

Randy Borum, “Improving the Clinical Practice of Violence Risk Assessment: Technology, Guidelines, 

and Training,” American Psychologist 51, no. 9 (September 1996): 945–56.

2. AFMA Survey, appendix C.

3. Ibid., 20.

4. Laura Miller, PhD, interviewed by Gregory M. Vecchi, PhD (Chief, Behavioral Science Unit, FBI 

Academy, Quantico, VA), December 2009.

5. AFMA Survey, appendix C.

6. The document provides overviews on the types of problems, information on resiliency, checklists of 

behavioral indicators of distress, and advisable leadership courses of action (including care, additional inquiry, referrals, disciplinary action, and follow-up). Air Force and DoD policy related to those problems, 

responses, and corresponding resources (e.g., the Family Advocacy Program and the Web site for the National Institute of Mental Health) are also included. Air Force Medical Service, Air Force Leader’s Guide for 

Managing Personnel in Distress, http://airforcemedicine.afms.mil/leadersguide.

7. Air University (AU)-2, Guidelines for Command (Maxwell AFB, AL: Air University Press, February 

2008), 216, 227, 232–33, 235–38.

8. AFMA Survey, appendix C.

9. DoDI 1325.06, Handling Dissident and Protest Activities among Members of the Armed Forces, 27 

November 2009.

10. AFI 51-903 defines such organizations as those that advocate supremacist doctrine, ideology, or 

causes; attempt to create illegal discrimination based on race, creed, color, sex, religion, ethnicity, or national origin; advocate the use of force, violence, or criminal activity; or otherwise engage in efforts to 

deprive individuals of their civil rights. AFI 51-903, Dissident and Protest Activities, 1 February 1998.

11. AFI 51-903, Dissident and Protest Activities, 1 February 1998.

12. DoDI 1325.06, Handling Dissident and Protest Activities among Members of the Armed Forces.

13. DA PAM 600-15, Extremist Activities, 1 June 2000.

14. AR 600-20, Army Command Policy, 30 November 2009.

15. AFI 51-903, Dissident and Protest Activities.

16. Elizabeth Crown, “Tattoos and Piercings Go Mainstream, but Risks Continue,” Northwestern University NewsCenter, 12 June 2006, http://www.northwestern.edu/newscenter/stories/2006/06/tattoos.html.

17. Air Force Office of Special Investigations (AFOSI), Criminal Intelligence Bulletin, “Visual Iconography: Gang and Right-Wing Hate Group Affiliated Symbols and Body Art” (U), AFOSI Criminal Analysis 

Special Report, 5 March 2010, 2.

18. AFI 36-2903, Dress and Personal Appearance of Air Force Personnel, 6 August 2007, 86–88.
23 AIR FORCE FOLLOW-ON REVIEW

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19. Marine Corps Order (MCO) P1020.34G, Marine Corps Uniform Regulations, 31 March 2003, 

1–6; Marine Administrative Message (MARADMIN) 198/07, Announcement of Changes to the Marine 

Corps Tattoo Policy, 19 March 2007; Navy Administrative Message (NAVADMIN) 110/06, Navy Uniforms, 21 April 2006, 1; AR 670-1, Wear and Appearance of Army Uniforms and Insignia, 3 February 2005, 

5–6; and All Army Activities Message (ALARACT) 017/2006, Wear and Appearance of Army Uniforms and 

Insignia, 25 January 2006.

20. AFOSI, Criminal Intelligence Bulletin, “Visual Iconography: Gang and Right-Wing Hate Group 

Affiliated Symbols and Body Art” (U), AFOSI Criminal Analysis Special Report, 5 March 2010.

21. Secretary of Defense, to all DoD activities, draft memorandum, subject: Privately Owned Weapons, 25 March 2010.

22. Omnibus Consolidated Appropriations Act, 1997, Public Law 104-208, 104th Cong., 2d sess., 30 

September 2006, 369–72.

23. DoDI 6400.06, Domestic Abuse Involving DoD Military and Certain Affiliated Personnel, 21 August 

2007, 10.

24. Air Force, Post-Deployment Health Reassessment Application Users Guide, http://www.pdhealth.mil/

dcs/downloads/PDHRA_AUG.pdf. 

25. Gregory A. Gahm et al., “History and Implementation of the Fort Lewis Soldier Wellness Assessment Program,” Military Medicine 174, no. 7 (July 2009): 721–27.

26. AFI 10-403, Deployment Planning and Execution, 13 January 2008, 133–41; AFI 44-153, Traumatic Stress Response, 13 March 2006, 4; Col John Forbes, USAF, “Airmen Resiliency Training” (presentation, 22 February 2010); and Lt Gen Bruce Green, USAF, “Tiered, Targeted and Tracked Interventions” 

(presentation, 22 February 2010).

27. Office of Personnel Management, Dealing with Workplace Violence: A Guide for Agency Planners, 

OWR-09, February 1998, 19.

28. AFI 36-2706, Military Equal Opportunity (MEO) Program, certified current 17 February 2009, 40, 60.

29. AFMAN 31-201, Security, vol. 4, High-Risk Response, 20 March 2002, 37.

30. Draft AFMAN 31-201, Security, vol. 4, High-Risk Response.

31. Department of Defense, Protecting the Force: Lessons from Fort Hood: Report of the DoD Independent Review (Washington, DC: Department of Defense, January 2010), http://www.defense.gov/pubs/pdfs/DOD

-ProtectingTheForce-Web_Security_HR_13Jan10.pdf, 15–16. (Subsequently referred to as Protecting the Force.)

32. OSHA, “OSHA Fact Sheet: Workplace Violence,” US Department of Labor, http://www.osha 

.gov/OshDoc/data_General_Facts/factsheet-workplace-violence.pdf.

33. AFI 44-154, Suicide and Violence Prevention Education and Training, 3 January 2003; AFI 36-6001, 

Sexual Assault Prevention and Response (SAPR) Program, 29 September 2008; and AFI 40-301, Family 

Advocacy, 30 November 2009.

34. For example, Department of Defense Directive (DoDD) 6495.01, Sexual Assault Prevention and 

Response (SAPR) Program, 6 October 2005, establishes guidance for the SAPR, and DoDD 6400.1, Family Advocacy Program, 23 August 2004, establishes guidance for the family advocacy program, but there is 

no current policy directive on suicide prevention.

35. AFI 44-154, Suicide and Violence Prevention Education and Training, 3 January 2003; AFI 36-6001, 

Sexual Assault Prevention and Response (SAPR) Program, 29 September 2008; AFI 40-301, Family Advocacy, 30 November 2009; Air National Guard Instruction (ANGI) 52-154, Suicide Prevention and Violence 

Awareness Education and Training, 28 July 2003; Air Force Pamphlet (AFPAM) 44-160, The Air Force 

Suicide Prevention Program, April 2001; AFI 10-245, Antiterrorism (AT), 30 March 2009; AFI 90-501, 

Community Action Information Board and Integrated Delivery System, 31 August 2006; and AFI 91-301, 

Air Force Occupational and Environmental Safety, Fire Protection, and Health (AFOSH) Program, 1 June 1996.
AIR FORCE FOLLOW-ON REVIEW 24

36. Federal Acquisition Regulation (FAR) 52.203-13, Contractor Code of Business Ethics and Conduct, 

December 2008.

37. Ibid.

38. Occupational Safety and Health Act of 1970, Public Law 91-596, 91st Cong., 29 December 1970; 

and Delegation of Authority, US Code, vol. 5, sec. 302.

39. AFI 36-703, Civilian Conduct and Responsibility, 17 February 2009.

40. Cause and Procedure, US Code, vol. 5, sec. 7513; and Peter Broida, Guide to Merit System Protection 

Board Law and Practice, 26th ed. (Arlington, VA: Dewey, 2009).

41. Protecting the Force, 23.

42. Labor-Management Relations, US Code, vol. 5, secs. 7101-7135; and Executive Order 13522, Creating Labor-Management Forums to Improve Delivery of Government Services, 9 December 2009.

Sample language for the change in AFI 36-703, Civilian Conduct and Responsibility, as a new Section 

E—Violence in the Workplace, follows:

9. Supervisors. Violent behavior is not acceptable in the Air Force workplace. Supervisors manage 

their work centers in a way that promotes good order, implement a violence response plan in their work 

area, and make sure staff members are familiar with the plan.

9.1. When a supervisor receives a report of an indicator of potential violence, he or she will assess 

the situation and take appropriate action. The supervisor will receive the support of Security 

Forces, the Civilian Personnel Office, the Legal Office, and base medical staff, as appropriate.

10. Employees. While supervisors play a key role in recognizing potentially violent situations and 

taking proactive measures to reduce the negative impact of these situations, employees can contribute to 

maintaining a safe work place. If employees observe any of the following indicators, or sense that something is not right, they will report the concern to their supervisor or other appropriate authority identified at their work location.

A list of indicators will be developed by OSD and incorporated into Air Force instructions.

43. Developed after the Army’s comprehensive Soldier fitness initiative, CAF is an approach that targets four pillars of physical, social, mental, and spiritual health of our Airmen. The overarching CAF 

philosophy is to care for people based on the “five Cs”: care, connect, communicate, commit, and celebrate. See US Army, Comprehensive Soldier Fitness, http://www.army.mil/csf/.

44. AFI 90-501, Community Action Information Board and Integrated Delivery System, 31 August 2006, 3.

45. AFMA Survey, appendix C.

46. AFI 90-501, Community Action Information Board and Integrated Delivery System, 31 August 2006, 2.

47. Ibid., 3–6.

48. DoDI 1300.17, Accommodation of Religious Practices within the Military Services, 10 February 2009, 4.

49. AFPD 52-1, Chaplain Service, addresses the rights of Air Force members to observe the tenets of their 

respective religions and the role of chaplains to assist and advise commanders regarding such observations. 

This directive is being updated; estimated completion date is 1 July 2010 (AFPD 52-1, Chaplain Service, 2 

October 2006, 1–2). AFI 52-101, Planning and Organizing, provides guidance for accommodating religious 

practices, including the role of chaplains in religious accommodation (and further recognition of chaplains 

as leadership advisors in such matters). AFI 52-101 will be revised following the update to AFPD 52-1 (anticipated date of revision and coordination for AFI 52-101 is 1 October 2010) (AFI 52-101, Planning and 

Organizing, 14 March 2008, 6, 8). AFPD 36-29, Military Standards, outlines policies regarding uniform 

standards and presentation (AFPD 36-29, Military Standards, 29 October 2009, 2). AFI 36-2903, Dress and 

Appearance of Air Force Personnel, addresses specific procedures regarding religious apparel and items (AFI 

36-2903, Dress and Appearance of Air Force Personnel, 6 August 2007, 89–91, 93). AFPD 36-27, Equal Opportunity (EO), covers issues of equal opportunity, including protections from discrimination and harassment 

based on religion and the resolution of related complaints (AFPD 36-27, Equal Opportunity [EO], 22 May 
25 AIR FORCE FOLLOW-ON REVIEW

Chapter 1  Risk Assessment and Prevention

2009). AFI 36-2706, Military Equal Opportunity (MEO) Program, further outlines general guidelines and 

procedures for religious accommodation (AFI 36-2706, Military Equal Opportunity [MEO] Program, 17 

February 2009, 69–70). Air Force Joint Instruction (AFJI) 48-110, Immunizations and Chemoprophylaxis, 

addresses exemptions from immunization requirements to accommodate doctrinal religious belief (AFJI 

48-110, Immunizations and Chemoprophylaxis, 29 September 2006, 3–4).

50. Commanders’ Professional Development School, Wing Commanders’ Seminar, http://www.au 

.af.mil/au/ecpd/cpds/Wing_CC_Curriculum.html.

51. Chaplains generally explain the role of the base chaplain in relation to day-to-day wing activities and 

the expeditionary environment and summarize current religious guidelines, initiatives, and policy changes.

52. The 15-minute training module will include scenarios and address various religious issues including religious accommodation, public prayer outside worship settings, individual sharing of religious faith, 

and good order and discipline. Thomas Mahoney, program manager, Air Force Equal Opportunity (presentation, Air Force Learning Committee Working Group, 17 March 2010).

53. DoDI 1304.28, Guidance for Appointment of Chaplains for the Military Departments, 7 August 

2007, 3–4.

54. Ibid., 11.

55. Ibid., 13. DoDI 1304.28 requires that the religious organization provide the name, title, mailing 

address, telephone number, electronic contact, employer identification number as assigned by the Internal 

Revenue Service, and the telephone number of the representative it is authorizing to represent it. To avoid 

any conflict of interest, endorsing agent candidates are not permitted to be serving as a military chaplain 

(i.e., active duty, National Guard, Reserve). 

56. Ibid., 12–13.

57. The Air Force general counsel advised against pursuing security checks of endorsing agents because 

attorney-general policy does not authorize non–law enforcement officials, such as the DUSD(MPP) or the 

AFCB, to request and obtain information concerning ongoing investigations of nongovernment officials. 

See also, DoD Inspector General, Evaluation Report on the DoD Chaplain Program, Report No. IE-2004-001, 

10 November 2004.
AIR FORCE FOLLOW-ON REVIEW 26

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27 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

Sharing information is one of the pivotal issues discussed within the DoD report. As 

Secretary West and Admiral Clark testified before the House Armed Services Committee, 

“Robust information sharing is essential, along with the accompanying command and 

control structures converting active 

information gathered by different 

agencies into decisions and actions, 

to include disseminating the analysis and assessments to the appropriate levels of command.”1Our review 

identified several interagency, DoD, 

and Air Force processes that, if better connected, could improve the 

overall capability of leaders to protect personnel. Forging these relationships is critical.

Better coordination with organizations outside the Air Force could 

improve a number of processes designed to identify personnel who 

may pose a threat to themselves or others. Likewise, internal to the Air Force, information 

sharing must be improved; for example, unit leaders, care providers, law enforcement, and 

investigative services should communicate on a regular basis.

Information-Sharing Forums

Finding 17

(This refers to DoD report Finding/Recommendation 3.2.)

● The Air Force lacks integrated policy, programs, and procedures to ensure installation commanders have a comprehensive means to identify and assist Airmen and 

members of the Air Force community who may exhibit behaviors of concern.

Discussion

Tragedies like the incident at Fort Hood are reminders of the need to remain aware of 

indicators of concern and prepare to respond to threats within the Air Force community. 

Left unaddressed, seemingly innocuous indicators could become precursors of potentially 
AIR FORCE FOLLOW-ON REVIEW 28

violent behavior. Unit leaders are responsible for supporting their personnel but have no 

formally established forum within which to discuss personnel concerns, share information 

and support options, and determine best courses of action.

Several existing forums partially address issues of concern that affect Air Force personnel, the most comprehensive being the Community Action Information Board (CAIB), a 

venue for cross-organizational discussions of quality of life, health and readiness, good 

order and discipline, morale, and climate issues experienced by individuals, organizations, 

and families.2

 A threat of immediate and serious harm to family members activates the 

High Risk for Violence Response Team (HRVRT), which provides support.3

 Additionally, 

the Threat Working Group (TWG) meets to assess internal and external threats to the Air 

Force community and provide installation leaders with proactive threat assessments.4

None of these organizations have a charter that encourages routine discussions among 

unit leaders about individuals’ behavior that may or may not rise to the level of requiring 

immediate action.

Unit leaders would benefit from an opportunity to share relevant information in a forum that could improve their ability to assess issues more holistically and to mobilize 

professional and unit support appropriately, thereby averting additional concerns. By better understanding issues affecting their personnel, care provided, and availability of additional support, unit leaders can develop more effective support strategies. Early engagement with professional care providers is essential. Capitalizing on existing capabilities 

resident in the CAIB, HRVRT, and TWG could bolster individual resiliency and enhance 

force protection measures.5

Headquarters Air Force (HAF), major command (MAJCOM), and direct reporting 

unit representatives expressed a need for an information-sharing forum linked to the 

CAIB.6

 Since the installation commander chairs the CAIB, executive sessions of the board 

would provide an opportunity to conduct a more individually focused executive forum 

named Status of Health and Airmen Resiliency Exchange (SHARE).7

 Primary SHARE 

attendees would include the wing commander, vice-commander, command chief, or senior enlisted adviser; staff judge advocate (SJA); group, squadron, and detachment commanders; chaplain; health care providers; mental health personnel; and TWG members. 

Others may be invited to attend as the installation commander deems necessary, based on 

current installation composition, issues, resources, and personnel.

The SHARE forum would offer commanders an opportunity to discuss potential at-risk 

members and seek assistance and feedback. It also would foster sharing of information 

between commanders and other support professionals outside of the SHARE forum to 

more effectively address concerns. Furthermore, the forum would benefit from a full-time 

civilian community support director position at each installation. This director would 
29 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

continuously monitor community wellness through the CAIB and individual wellness 

through SHARE. In doing so, the director would integrate community, family, and resiliency programs. Specific duties would include leading the installation resiliency program, 

serving as the permanent CAIB executive director, integrating information in support of 

monthly SHARE meetings, developing and executing the Community Action Plan, and 

administering the Integrated Delivery System. Establishing a full-time position to direct 

installation CAIB and resiliency efforts would add permanence and procedures to program efforts that currently have no dedicated staff but remain vital to the Air Force community. Air Force Instruction (AFI) 90-501, Community Action Information Board and 

Integrated Delivery System, will need revision to reflect these changes.

Recommendations

(Relevant best practices are identified in appendix B.)

17.1 Revise AFI 90-501, Community Action Information Board and Integrated Delivery 

System, to incorporate a forum geared to support Air Force members who need 

assistance or intervention to preclude more serious issues. (OPR: AF/A1)

17.2 Fund a full-time, installation-level civilian position to oversee and integrate community, family, individual support, and resiliency programs. (OPR: AF/A1)

Background Checks

Finding 18

(This refers to DoD report Finding/Recommendation 2.2.)

● Current background investigation policies and procedures provide adequate screening for granting access to classified material.

Discussion

Even the most stringent background investigations have, in some cases, failed to identify potential threats. The cost and time required to conduct in-depth background checks 

must be weighed against the risk that may be mitigated. Security clearance background 

checks validate information provided by respondents, with the ultimate goal of certifying 

a predetermined level of trust for handling classified information. The system is a riskbased model. Background checks for secret clearances average 64 days while those for top 
AIR FORCE FOLLOW-ON REVIEW 30

secret average 110 days.8 Current investigative procedures are sufficient for evaluating an 

individual’s eligibility for access to classified information.

AFI 31-501, Personnel Security Program Management, and DoD 5200.1R, Information 

Security Program, establish policy for background checks. Homeland Security Presidential 

Directive–12, Policy for a Common Identification 

Standard for Federal Employees and Contractors, requires all employees to have a national agency 

check with inquiries for local area networks and 

unescorted access to federal installations.9

 These 

instructions result in an annual average of 149,400 

Air Force background checks.10

Background checks for higher levels of security clearances include interviews with applicants, select coworkers, and acquaintances. 

Some checks also involve personal interviews 

with investigators and polygraph interviews. 

In-depth interviews may be impractical for 

the larger Air Force population. Adapting 

these techniques to validate potential risk indicators, when coupled with other available 

information sources, could provide unit leaders additional insight with which to make informed assessments.

Recommendation

18.1 Consider the feasibility of adapting current background investigation processes 

and techniques to improve identification of internal threats. (OPR: SAF/AA)

Finding 19

(This refers to DoD report Finding/Recommendation 2.4.)

● Department of State (DoS) and status of forces agreements (SOFA) determine clearance procedures for installations outside the continental United States (OCONUS).
31 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

Discussion

DoD has limited ability to investigate foreign national military and civilian personnel 

who require access to overseas DoD installations and information systems. Further, the 

Air Force has little control over procedures for granting clearances to foreign national 

military and civilian personnel who require access to OCONUS Air Force installations. 

DoS and SOFAs govern clearance procedures for foreign national access to overseas installations.11 The SOFA and the executive agency for each host nation enable access to military installations on foreign soil. Clearance requests are processed through host nation law 

enforcement, and US personnel do not have the ability to validate associated information. 

Combatant commands are ultimately responsible for force protection in their respective 

areas of responsibility and for coordination with supporting host nations.

Ensuring that host nations adequately assess individuals before granting access to 

OCONUS installations with Air Force personnel is key to overseas force protection. Coordination between combatant commands and host nations may help to increase host 

nation vigilance. Personal relationships between commanders and local military and law 

enforcement agencies may also aid in improving installation security. Ultimately, the Office of the Secretary of Defense (OSD) must work with the DoS to make permanent security improvements.

Recommendation

19.1 Coordinate with DoD, DoS, and combatant commands to ensure foreign nationals working on OCONUS installations are subject to stringent investigation standards and procedures. (OPR: SAF/IA)

Finding 20

(This refers to DoD report Finding/Recommendation 2.4.)

● Continental United States (CONUS) clearance procedures for foreign national visits are governed by the Department of Homeland Security’s (DHS) passport and 

visa process and are administered by SAF/IA through Air Force instructions.

Discussion

Permanent exchange officers and visiting foreign nationals are currently cleared for access to CONUS facilities and information systems through reciprocal agreements executed through host nation embassies and DHS’s passport and visa process.12 The Air Force 

Assistant Secretary for International Affairs relies on the OSD Foreign Visit System for 
AIR FORCE FOLLOW-ON REVIEW 32

visit and clearance information. Foreign clearance information is provided through the 

host embassy with no additional DoD or Air Force checks. Improving coordination with 

DHS for foreign national clearance will help installation commanders balance the legitimate mission of hosting foreign nationals against the imperatives of force protection.

Recommendation

20.1 Coordinate with DHS to ensure that foreign nationals granted access to CONUS 

installations are subject to the most stringent investigation standards and procedures possible. (OPR: SAF/IA)

Finding 21

(This refers to DoD report Finding/Recommendation 2.2.)

● Background checks on foreign personnel who have been granted citizenship and 

security clearances are limited to immigration, Social Security, criminal, and national agency checks (law enforcement and credit).

Discussion

The DoD developed expedited processes for citizenship and clearances to fill operational requirements for linguists, interrogators, cultural advisors, and related specialties. 

Of the 1,399 registered immigrants accessed into the Air Force since 1971, 1,128 have 

entered since 2007.13 Expedited processes for citizenship and clearances are currently limited to background checks related to immigration, Social Security, criminal, and national 

agency checks (law enforcement and credit).14 However, these procedures may not disclose 

risk factors associated with non-US citizen accessions.

Air Force participation in the 

DoD Military Accessions Vital to 

National Interests (MAVNI) program would enable more stringent 

background checks on individuals 

who will have routine access to Air 

Force installations and personnel. 

The MAVNI program expands background checks for those qualifying 

under the expedited citizenship program.15 These background checks in-
33 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

clude national/intelligence agency checks, a single scope background investigation (SSBI), 

and DHS automated continuous evaluation system (ACES) typically associated with top 

secret clearances.16 The increased rigor involved in the higher-level security investigation 

process would help reduce the vulnerability inherent in current practices. The Army and 

Navy have both implemented pilot MAVNI programs.

The original MAVNI program was due to expire 31 December 2009, but was extended 

two months to 28 February 2010. It has subsequently been extended to 31 December 

2010. 

Recommendation

21.1 Adopt the DoD MAVNI program expanding background checks to include national/intelligence agency checks, SSBI (interviews), and automated continuous 

evaluation checks. (OPR: AF/A1)

Finding 22

● Air Force Reserve Command (AFRC) and Air National Guard (ANG) commanders have limited visibility over members’ law enforcement information unless members voluntarily report the information.

Discussion

Unit leaders may be unaware of potentially violent indicators among their members. By 

monitoring criminal databases, ACES would identify potentially adverse incidents and report them to the appropriate military authority. ACES continuously monitors 40 criminal 

and financial databases for anomalies and reports of activity.17 It can alert commanders of 

incidents which would not be officially reported to the military unless the individual voluntarily reports the information. For example, there is currently no official way for commanders to become aware of members who are arrested for a driving while intoxicated incident off 

base. They may learn of such incidents because of local news reports, court dates, or incarceration that cause an Airman to miss training, but these do not constitute official reports. 

Recommendation

22.1 Examine the feasibility of implementing ACES checks on AFRC and ANG members. (OPR: AFRC, NGB)
AIR FORCE FOLLOW-ON REVIEW 34

Storing and Transferring Information

Finding 23

(This refers to DoD report Finding/Recommendation 2.9.)

● Commanders do not have consistent access to relevant information on personnel 

with potential for violent behavior.

● Air Force policies and procedures allow access to an Unfavorable Information File 

(UIF); however, contents of the UIF may be too limited in scope and duration and 

access to the UIF is limited.

Discussion

Air Force policies and procedures allow the use of a UIF to document administrative, 

judicial, or non-judicial censures concerning Airman performance, responsibility, and behavior. Despite mandatory documentation, the UIF contents may be too limited and each item or entry is only 

retained for two years.18 These procedures also do not track adverse behaviors across assignments and thus may 

hinder a commander’s ability to detect a 

potentially violent individual and possibly prevent violent acts.

Additional research is required to determine and document potential indicators of violence. Personnel must then be 

trained on how to use this information. 

This research is essential to inform future 

revisions to Air Force policies prescribing 

what information should follow personnel throughout their careers.

The Judge Advocate’s Automated Military Justice Analysis and Management System 

(AMJAMS) is a tracking tool used to collect detailed information on offenses, processing timelines, and demographic information on judicial and nonjudicial punishment.19

As such, it may represent one option for information storage and sharing.20 Information 

entered into AMJAMS remains indefinitely. The system does not track personnel acAdditional research is 

required to determine and 

document potential 

indicators of violence.
35 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

tions such as UIFs, Officer and Enlisted Performance Reports, control roster, selection 

record actions, etc., but it does contain copies of completed Article 15 actions and 

court-martial orders. Thus, we found that the system may represent a model upon which 

to base a more comprehensive tracking system. It would, however, need to track a wider 

range of behaviors documented by different sources across an Airman’s career.

The Air Force owns the source code for AMJAMS, and it is currently maintained 

through a contract vehicle. The AMJAMS software could be modified to collect data of 

this nature, which could be a cheaper alternative than developing a new database. Resource requirements to modify AMJAMS would involve contract costs to modify the 

software and manpower support for entering and analyzing the data.21

Recommendations

23.1 Coordinate with the OSD Military Personnel Records Information Management 

Task Force (MPRIMTF) study that focuses on what information is appropriate to 

maintain in military personnel records over the course of a career. (OPR: AF/A1)

23.2 Develop procedures for storing and transferring information that includes possible 

indicators of violent behavior. (OPR: AF/A1)

23.3 Consider developing a system similar to the Air Force Judge Advocate’s AMJAMS 

to track information that may indicate a potential for violent behavior. (OPR: AF/

A1)

Finding 24

● Best practices for force protection and internal threat prevention and response are 

not being identified, maintained, or distributed.

Discussion

The Air Force best practice clearinghouse is a repository for documenting and accessing 

best practices that contribute to informing process improvements.22

Information sharing on best practices related to internal threat prevention and response is 

limited. Our review of the best practices database (1,791 total submissions) and the Air 

Force A9 internal review of joint lessons learned yielded only 42 indirectly related practices 

based on a search of 36 Fort Hood–related terms (e.g., “emergency response,” “force protection,” “deployment”).23 Making best practices a priority IG inspection item will help unit 

leaders and their personnel access the most effective practices for force protection.24
AIR FORCE FOLLOW-ON REVIEW 36

The Air Force does not disseminate details of force protection, internal threat, or suicide 

incidents. Unlike flight safety, there is no system for commands not directly involved to 

learn from the incident. When force protection incidents occur, details on lessons learned 

should be sent to MAJCOM and HAF OPRs for Air Force-wide dissemination.25

Recommendations

24.1 Revise AFI 90-201, Inspector General Activities, to make assessment of force protection, internal threat prevention, and response mandatory inspection items. (OPR: 

SAF/IG)

24.2 Develop a Force Protection Response Bulletin to disseminate best practices identified by IG inspections related to force protection, internal threats, and suicides. 

(OPR: SAF/IG)

Finding 25

(This refers to DoD report Finding/Recommendation 2.9.)

● There is no consolidated Air Force policy, program, or procedure to convey potentially adverse behavioral indicators between commanders during transitions (e.g., 

permanent change of station [PCS], deployments, training).

Discussion

AFI 36-2608, Military Personnel Records System, does not identify formal mechanisms for 

informing gaining commanders that members have potentially adverse behavioral indicators.26 The stress of training, deployments, or PCS may exacerbate existing behaviors. DoD 

established the Military Personnel Records Information Management Task Force 

(MPRIMTF) to address “what additional or existing information should be maintained 

throughout Service members’ careers as they change duty locations, deploy, and reenlist.”27

This includes examining DoD and Service guidance on collecting, maintaining, and transferring relevant information about contributing factors and behavioral indicators throughout a Service member’s career. The Air Force has three representatives participating on the 

MPRIMTF; their report is due to the Secretary of Defense on 1 June 2010.

Recommendation

25.1 Review and incorporate findings of the ongoing MPRIMTF into Air Force policy. 

(OPR: AF/A1)
37 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

Finding 26

(This refers to DoD report Finding/Recommendation 2.10 and 3.5.)

● Air Force Office of Special Investigation’s (AFOSI) Investigative Information Management System (I2MS) is a consolidated criminal and counterintelligence investigative case file database; however, this database is not linked with other military 

criminal investigative organizations (MCIO).

Discussion

DoD recognizes the need for a consolidated criminal investigation database available 

to all DoD law enforcement and criminal investigation elements.28 As a result, in August 2008, the Secretary of Defense directed that the Defense Law Enforcement Exchange (D-DEx) be implemented. The D-DEx is based on an existing Naval Criminal 

Investigative Service (NCIS) system that includes the Department of Justice (DoJ) and 

DHS.29 Each of the 13 DoD law enforcement agencies participates in D-DEx development and implementation.

All MCIO subjects are entered into the Defense Index of Investigations. This system 

only lists individuals who have been or are under investigation, but provides no further 

detail. Instead, it is incumbent upon investigators to contact the MCIO case file “owner” 

to obtain a more detailed report.

AFOSI, NCIS, Criminal Investigation Division, and Office of the Under Secretary of 

Defense for Personnel and Readiness have signed a MOU to cooperate on developing D-DEx 

with complete development, including funding requirements, due in FY2011.30 AFOSI 

and NCIS will begin submitting data to the D-DEx as soon as it is operational.31

Recommendation

26.1 Integrate AFOSI I2MS case file database into D-DEx, the DoD consolidated 

criminal investigations database. (OPR: SAF/IG)

Threat Reporting

Finding 27

(This refers to DoD report Finding/Recommendation 2.8.)

● Current AFIs are consistent with DoD policies and directives on counterintelligence awareness.
AIR FORCE FOLLOW-ON REVIEW 38

● DoD Instruction (DoDI) 5240.6, Counterintelligence (CI) Awareness, Briefing, and 

Reporting Programs, does not thoroughly address emerging threats, including selfradicalization.

Discussion

Counterintelligence involves “information gathered and activity conducted to protect 

against espionage, other intelligence activities, sabotage, or assassinations conducted on 

behalf of foreign powers, organizations, persons, or international terrorist activities, but 

does not include personnel, physical, document, or communications security programs.”32

Current intelligence oversight policy restricts DoD counterintelligence agencies, such as 

AFOSI, from collecting information on behaviors not having a direct nexus to foreign 

intelligence or terrorist activities.33 Current AFIs governing collection activities are consistent with DoD policies and directives on counterintelligence.34

Many indicators related to potential internal threats are behavioral-based (e.g., disassociation from friends and acquaintances, religious, or political affiliations).35 These indicators cannot be collected or retained by AFOSI, either within its law enforcement authority (when there is no crime 

committed) or its counterintelligence 

authority (when there is no foreign 

nexus).36 AFOSI can, however, collect 

information when movement of large 

sums of money or purchases of bombmaking material is indicated.37

The Under Secretary of Defense for 

Intelligence (USD[I]) is addressing this 

potential gap by coordinating procedural changes to address behaviors linking individuals to foreign terrorist organizations or activities.38 These changes 

will specify procedures for coordinating 

between law enforcement, force protection, and command officials to ensure 

that appropriate authorities receive information reported to domestic intelligence elements.39

Many indicators 

related to potential 

internal threats are 

behavioral-based ...
39 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

Recommendation

27.1 Coordinate with the USD(I) to review DoDI 5240.6, Counterintelligence (CI) 

Awareness, Briefing, and Reporting Programs. (OPR: SAF/IG)

Finding 28

(This refers to DoD report Finding/Recommendation 3.5.)

● The DoD has not established a common threat reporting system.

Discussion

The DoD report identified the FBI’s eGuardian system as a possible solution to the need for 

a single reporting system.40 AFOSI successfully participated in field testing of eGuardian at 

four detachments. The only problem identified was access to the DoJ/FBI’s Law Enforcement 

On-line which is required to establish an eGuardian account.41 According to the DoD report:

After two years of analysis and a successful pilot program completed in June 2009, the Department has selected the FBI’s eGuardian system for DoD unclassified threat reporting. The 

eGuardian system, which is FBI-owned and maintained, provides an unclassified, secure Webbased, capability to report suspicious activity and will contribute to our overall force protection 

threat information structure. . . . The eGuardian system will appropriately safeguard civil liberties, while enabling information sharing among federal, state, local, and tribal law enforcement 

partners, including interagency fusion centers. By no later than 30 June 2010, the Under Secretary of Defense for Policy will establish a plan and issue policy and procedures for the implementation of the eGuardian system as DoD’s unclassified suspicious activity reporting system. 

. . . Use of eGuardian will begin no later than September 2010.42

Recommendation

28.1 Coordinate with the DoD and the other Services to define requirements for a 

common threat reporting system similar to the DoJ/FBI eGuardian system. 

(OPR: SAF/IG)

Installation Access

Finding 29

(This refers to DoD report Finding/Recommendation 3.7.)

● The Air Force can benefit from ongoing research related to threat detection, assessment and management programs, processes, and technologies.
AIR FORCE FOLLOW-ON REVIEW 40

Discussion

The Technical Support Working Group (TSWG) of the Combating Terrorism 

Technical Support Office (CTTSO) is an effective forum for collaborating with 

other agencies on state-of-the-art threat prevention technologies and procedures. 

The CTTSO partners with more than 100 government agencies, state and local 

governments, law enforcement, and first responders to leverage technical expertise, 

operational objectives, and interagency sponsor funding for antiterrorism initiatives. The Air Force can remain informed about state-of-the-art access control procedures and technologies used within and across multiple organizations by engaging with the CTTSO.43 Ongoing collaboration through the CTTSO will also 

provide an avenue to further inform, direct, update, and refine Air Force access 

control policies, programs, and technologies.

Recommendation

29.1 Continue participation in the TSWG of the CTTSO to collaborate with other 

Services, government agencies, academia, and civilian organizations on threat detection, prevention, and management efforts. (OPR: AF/A4/7)

Finding 30

(This refers to DoD report Finding/Recommendation 3.7.)

● Air Force participation in the Physical Security Equipment Action Group (PSEAG) 

provides a formalized means for evaluating leading-edge tools and technologies to 

augment physical inspections at entry control points.

Discussion

Installation access control points are critical defenses for deterring and detecting internal and external threats and should involve more than just credential checks. While 

current tactics, techniques, and procedures require personnel engaged in access control 

duties be trained in “verbal and behavioral assessments,” no enterprise-wide program 

exists to develop this capability.44 The Air Force has also not deployed technologies to 

augment verbal and behavioral assessments. Leveraging existing and evolving state-ofthe-art access control procedures and technologies can reduce access control vulnerabilities at Air Force installations.

The Air Force, the PSEAG executive agent for access control, participates in and leads the 

Defense Installation Access Control (DIAC) working group (WG). The DIAC WG is tasked 
41 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

to standardize physical access control procedures to enhance security and protect personnel 

and resources by developing DoD-wide and federally interoperable access control capabilities.

The PSEAG and DIAC WG recently provided a $250,000 grant to study how behavior pattern recognition screening procedures and entry-point technologies can 

help detect persons motivated to deceive, conceal, or act with malicious intent. This 

study, will run from 1 May through 31 October 2010 to review and evaluate entry 

control point best practices and state-of-the-art entry control technologies, focusing 

on behavior pattern recognition screening.45 Results from the PSEAG/DIAC WG 

study should inform Air Force decision making related to force protection systems by 

presenting options for developing and fielding leading-edge access control policies, 

programs, and technologies.

Recommendation

30.1 Continue participation in the PSEAG and the DIAC WG behavioral analysis 

study. (OPR: AF/A4/7)

Finding 31

(This refers to DoD report Finding/Recommendation 3.9.)

● Lack of information sharing on debarments from military installations may jeopardize force protection.

● The Air Force, like the other Services, lacks policies and programs for sharing information on personnel and vehicles registered on installations, contained on installation debarment lists, or other relevant information to thoroughly screen personnel 

and vehicles before granting installation access.

● The Defense Biometric Identification System (DBIDS) has the greatest potential 

for sharing vehicle registration, debarment lists, and other relevant information 

required to screen personnel and vehicles and grant access.

Discussion

Installation commanders require relevant information before granting individual requests 

for access to the installation. Current policies and supporting procedures do not include sharing all available information on Air Force or other Service registration, debarment lists, and 

vehicle information. Modifying the instructions followed by instituting supporting programs 

and procedures will increase the quantity and quality of information available to commanders.
AIR FORCE FOLLOW-ON REVIEW 42

DoDI 5200.08, Security of DoD Installations and Resources, establishes policy governing 

commanders’ authority to bar individuals from military installations.46 Air Force Manual 

31-201, vol. 7, Security Forces Administration and Reports, provides further guidance on 

debarment actions.47

AFI 31-201, Security Forces Standards and Procedures, addresses sharing law enforcement 

data but does not adequately discuss sharing debarment information.48 Debarment actions 

only apply to the issuing installation and do not preclude a barred individual from entering 

other military installations. As a result, an individual identified by one commander as a potential threat may pose a threat at other installations.

Directive-type memorandum (DTM) 09-12, Interim Policy Guidance for DoD Physical 

Access Control, dated 8 December 2009, defines DoD policy for installation access, including specific databases to query.49 This policy does not provide for a database to share 

information between installations. The HAF Security Forces Center uses DBIDS, a Defense Manpower Data Center product, to close this gap.50

DBIDS is an identity authentication system that supports installation access control 

measures using a networked client/server database. The program supports adding, retrieving, updating, and displaying information for individuals seeking access to installations. While DBIDS is not limited to accommodate common 

access card (CAC) holders, implementation for non-CAC holders 

remains limited. DoD-wide adoption of a DBIDS-like system, with 

an associated database, would 

greatly increase the effectiveness 

of the system and allow for information sharing among the Services. DoD adoption may also 

lead to supplemental funding for 

the remaining Air Force installations awaiting DBIDS.51

When installation commanders make debarment decisions, the identities of barred individuals are maintained only in local databases. If the information is entered into DBIDS, 

or a DBIDS-like database, it can be shared with other installations for use by installation 

commanders in making debarment decisions. The database could also serve as a tool to 

alert registration personnel and installation gate guards that an individual was barred from 

another installation.52 However, even if DBIDS is modified to meet Air Force needs, it 
43 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

will not identify individuals barred from other Service installations unless they make similar commitments. 

DBIDS installation is currently complete at 32 bases and in progress at two Air Force bases. 

Fifteen bases are scheduled to receive the system by October 2010.53 Thirty-seven active duty 

bases, 12 Air Force Reserve bases, and 77 ANG bases have yet to fully deploy the system.

Recommendations

31.1 Coordinate with DoD and the other Services to share vehicle registration, debarment lists, and other relevant information required to screen personnel, vehicles, 

and grant access. (OPR: AF/A4/7)

31.2 Update AFI 31-201, Security Forces Standards and Procedures, to govern how debarment information is shared. (OPR: AF/A4/7)

31.3 Revise Air Force policy to require installation commanders to enter debarment 

information into a central database and to review Air Force debarments when 

making decisions to grant individuals base access. (OPR: AF/A4/7)

31.4 Fully fund and continue to install DBIDS at all Air Force installations to improve 

communications between installations. (OPR: AF/A4/7)

31.5 Modify the DBIDS database to reflect debarment actions. (OPR: AF/A4/7)

31.6 Support DoD-wide implementation of DBIDS. (OPR: AF/A4/7)

Sharing Health Information

Finding 32

(This refers to DoD report Finding/Recommendation 2.13.)

● The Air Force follows DoD policy requiring civilian health care providers to provide documentation of TRICARE patient encounters to military treatment facilities; however, civilian medical entities may not fully recognize or report to military 

leaders the range of indicators of the risk for violence to self or others.

Discussion

The absence of current DoD policies addressing information sharing between military 

and civilian health care providers creates a potential vulnerability because providers, institutions, and mental health professionals have little guidance on how and when to report 
AIR FORCE FOLLOW-ON REVIEW 44

specific risk indicators to the military. There is also no requirement to convey medical 

information to military treatment facilities (MTF) when Service members procure civilian medical care without MTF referral at their own expense. Sharing such protected health 

information is discretionary for civilian providers. Laws must be changed if DoD and the 

Services wish to request information from civilian providers beyond what is already allowed by the Privacy Act of 1974 and the Health Insurance Portability and Accountability 

Act (HIPAA) of 1996.

Four DoD-managed care support contractors (MCSC) obtain information for MTFs 

from TRICARE network providers who treat military members referred to them.54 In addition, referring MTF providers should review the results of all off-base referrals to ensure 

continuity of patient care and communication with the patient’s commander as appropriate. 

TRICARE network providers are held accountable by the MCSC to fulfill requirements for 

timely, complete consultation reports.55 If enforced, these two accountability measures 

should preclude the need for additional policies, programs, and procedures related to 

TRICARE network provider consults and referrals of military members on active duty.56

Sharing information about potential vulnerabilities within legal constraints will require 

coordination between the TRICARE Management Activity, DoD, and the Services. 

HIPAA considerations, potential due process issues, and managed care support contract 

issues may preclude implementing a broader requirement for sharing additional details 

beyond what is currently permitted by law.57

The DoD report noted that Service policies do not reflect the most current DoD-level 

guidance with regard to sharing protected health information found in DTM 09-006, 

Revising Command Notification Requirements to Dispel Stigma in Providing Mental Health 

Care to Military Personnel.

58 The DTM focuses on directing providers when and how to 

report specific military patient information to commanders while appropriately preserving confidentiality. A clear articulation of the need to know—based in operational requirements such as force protection, installation security, or mission-related safety—

would support arguments for changes in law, policy, and procedure.

Recommendation

32.1 Coordinate with DoD to establish standardized contract procedures and practices 

for TRICARE providers to recognize and report, within legal limits, potential indicators of violent behavior for active duty, ANG, and Air Force Reserve members 

who receive treatment through TRICARE providers. (OPR: SAF/MR)
45 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

Finding 33

(This refers to DoD report Finding/Recommendation 2.13.)

● There are no specific DoD or Air Force policies, programs, procedures, or practices 

that provide commanders, supervisors, and military health care providers visibility 

on risk indicators for ANG and Air Force Reserve members who seek care from 

civilian medical institutions when not on active duty orders.

● Air Force and DoD policies do 

not require civilian health care 

providers to provide documentation of patient encounters for 

ANG and Air Force Reserve personnel who seek care while in civilian status, or notify ANG or 

Reserve leaders when they identify a member who may exhibit 

indicators of violence.

Discussion

Receiving warning from civilian 

health care professionals who deem 

Air Force personnel a potential risk 

to themselves or others is especially 

pertinent for ANG and Air Force Reserve members who obtain civilian 

medical treatment while not on orders. HIPAA-covered entities, including civilian providers, can provide protected health information 

(PHI) to commanders for fitness for 

duty and mission-related purposes.59

Some providers require military 

members to sign HIPAA-compliant 

authorizations before forwarding the 

information to military authorities. 

However, the Air Force Legal OperaThere has to be a way 

to comply with HIPAA 

and still ensure 

commanders/first 

sergeants get the 

information they need 

to ensure the health, 

morale, welfare and 

safety of all...

—Survey comment, wing commander
AIR FORCE FOLLOW-ON REVIEW 46

tions Agency, Military Justice Division, would need to evaluate whether military 

members could lawfully be ordered to provide this information to the MTF, including when the military member seeks and pays for care if not referred by the MTF. 

If the care affects the member’s readiness to perform duties, an order to report such 

care would have a strong influence on military service and would thus likely be 

enforceable.

Recommendations

33.1 Coordinate with DoD to develop policies, programs, and procedures for military 

medical personnel, commanders, and supervisors to receive and review indicators of 

potentially violent behavior for ANG and Air Force Reserve members who seek care 

from civilian medical institutions when not on active duty orders. (OPR: SAF/MR)

33.2 Coordinate with DoD to develop policies and procedures for civilian health care 

providers to alert military leaders when they believe active duty, ANG, and Air 

Force Reserve members whom they treat pose a threat to themselves or others. 

(OPR: SAF/MR)

Finding 34

(This refers to DoD report Finding/Recommendation 2.12.)

● Air Force policies correctly refer to, and follow, OSD/Health Affairs policies regarding handling of PHI.

● Air Force policies with respect to mental health do not reference the interim guidance found in DTM 09-006, Revising Command Notification Requirements to Dispel 

Stigma in Providing Mental Health Care to Military Personnel, issued in July 2009.

Discussion

AFIs are consistent with DoD policies regarding safeguarding PHI.60 However, DTM 

09-006, Revising Command Notification Requirements to Dispel Stigma in Providing Mental 

Health Care to Military Personnel, provides interim guidance for sharing PHI.61 While the 

DTM is not primarily concerned with PHI, a term normally discussed in the context of 

the HIPAA of 1996, it does provide guidance on thresholds for notifying commanders of 

Service members’ mental health treatment. The memorandum directs when and how providers report specific military patient conditions or circumstances to unit leaders and how 

to balance confidentiality with providing mental health information.
47 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

The Air Force must revise AFI 44-109, Mental Health, Confidentiality and Military 

Law, paragraph 6, to reference DTM 09-006 or the forthcoming DoDI. AFI 41-210, 

Patient Administration Functions, 

may also require revision with release of this DoDI since it will 

require health care providers to 

report previously protected mental health information. For example, paragraph 2.5.6.2 states: 

“Access, however, must be balanced with the recognized sensitivity of medical records, which 

often contain information of a 

very private nature. Therefore, 

before a commander or designee gains access to an individual’s protected health information, he or she must establish a need for those records IAW DoDR 6025.18-R, DoD 

Health Information Privacy Regulations, paragraph C7.11 and receive the concurrence of 

the SJA.”62 Changing this paragraph to align Air Force policy with the DTM and the 

forthcoming DoDI removes potentially conflicting guidance for providers and allows 

commanders to access more complete information about potential indicators of violent 

behaviors. Once these two AFI updates occur, training programs for providers, commanders, and supervisors must be updated to reflect the new reporting guidance.

Recommendations

34.1 Revise AFI 44-109, Mental Health, Confidentiality and Military Law, paragraph 6, 

to reference DTM 09-006, Revising Command Notification Requirements to Dispel 

Stigma in Providing Mental Health Care to Military Personnel, or follow-on DoDI 

guidance currently in coordination. (OPR: AF/SG)

34.2 Revise AFI 41-210, Patient Administration Functions, paragraph 2.5.6.2. to add exceptions for commanders establishing need for and obtaining concurrence with the 

SJA before obtaining patient information on a military member. (OPR: AF/SG)

34.3 AF/SG incorporate reporting guidance IAW AFI 44-109, Mental Health, Confidentiality and Military Law, and AFI 41-210, Patient Administration Functions,

into all levels of health care provider training, beginning with medical school at the 

Uniformed Services University of the Health Sciences through the chief of medical 

staff. (OPR: AF/SG)
AIR FORCE FOLLOW-ON REVIEW 48

Finding 35

● AFRC and ANG commanders have limited ability to identify indicators of potentially violent behavior due to limited close personal observation and interaction 

with AFRC and ANG members.

Discussion

The ANG has permission to hire 35 psychologists for high-risk (two or more 

suicides since 2005 or high levels of deployments) wings.63 The 2012 program objective memorandum is expected to support filling the remaining 54 openings and 

the conversion of all 89 positions to the general schedule.64 The directors of psychological health (DPH) at each wing will provide the continuity necessary to identify 

behavioral indicators that is currently lacking due to the limited close personal contact that ANG commanders have with their personnel. They will manage the CAIB 

and will be able to report on the pulse of the wing. The DPHs will also be able to 

complete the increased DoD-directed suicide reporting.65

The DPH66 will work directly for the 89 ANG wing commanders and coordinate the 

following programs:

● suicide prevention

● CAIB

● Wingman programs

● Air Force resiliency programs

● automated neurocognitive assessment metric testing

● pre-/post-deployment assessments

● mental health referral management

● suicide event reporting.67

The AFRC program is designed around seven regional advocates instead of unitlevel psychologists.68 The Reserve is also manning their positions with uniformed 

psychologists instead of contractors. Combining the Reserve and ANG assets is a 

consideration; however, it would be difficult and is not currently viewed as being feasible.69 Yellow Ribbon Reintegration Program (YRRP) funds have been leveraged to 

hire three four-person regional teams that cover 50 states and four territories. The 

responsibilities of the DPH program, as outlined by the 2007 DoD Task Force referenced above, is much broader than the YRRP mandate. More effective and sustainable solutions require standardizing training and oversight, removing barriers between 
49 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

Service components, and allowing for tailored implementation approaches. Refer to 

appendix B for YRRP information.

Recommendation

(Relevant best practices are identified in appendix B.)

35.1 Continue deploying and expand the ANG DPH and AFRC regional psychological 

health advocates programs. (OPR: AFRC, NGB)

Sharing Information on Cyberspace Activities

Finding 36

(This refers to DoD report Finding/Recommendation 2.14.)

● Draft DoDI 5420.xxx, Counterintelligence Activities in Cyberspace, contains guidance on immediately providing threat information obtained from DoD counterintelligence (CI) activity in cyberspace to affected commands, components, installations, or activities.

Discussion

Revisions to Air Force policy required upon publication of DoDI 5420.xxx, Counterintelligence Activities in Cyberspace, must adhere to strict statutory limitations on CI collection and follow DoD procedures for coordinating with other intelligence organizations.

Recommendation

36.1 Publish derivative Air Force guidance upon release of DoDI 5420.xxx, Counterintelligence Activities in Cyberspace, to include when the coordinated offices involved 

in defense cyber activities should alert leaders to potential threats in their command. (OPR: SAF/IG)

Notes

1. Opening Statement, DoD Independent Review Congressional Hearing Conference, House Armed 

Services Committee, 20 January 2010, 5. http://armedservices.house.gov/pdfs/FC012010/Joint_Testimony 

012010.pdf.

2. Air Force Instruction (AFI) 90-501, Community Action Information Board (CAIB) and Integrated 

Delivery System (IDS), 31 August 2006, 2. Air Force Follow-on Review (FOR) team leads reviewed policies governing the CAIB program during two conferences held at Andrews AFB and during the Compre-
AIR FORCE FOLLOW-ON REVIEW 50

hensive Airman Fitness Summit hosted by Air Mobility Command (AMC). Headquarters Air Force, 

major command (MAJCOM), and direct reporting unit (DRU) Air Force FOR representatives agreed 

that the current CAIB structure did not meet the comprehensive requirements for protecting the force 

against potential internal and external threats. Air Force FOR team leads prefer a forum separate from the 

CAIB to facilitate discussions among unit leaders to improve awareness of circumstances affecting their 

personnel and available support options. However, an executive session of the CAIB may be a suitable 

compromise; the intended purpose of the executive session would involve assisting installation and unit 

commanders in discussing issues of concern that affect their personnel as well as examining potential indicators of violence. AFI 90-501, Community Action Information Board (CAIB) and Integrated Delivery 

System (IDS), could be revised to discuss the executive session purpose, meeting frequency, and linkage of 

issues raised in the executive session for broader CAIB awareness and action.

3. AFI 40-301, Family Advocacy, 30 November 2009, 24, par. 4.4.2. The High Risk for Violence Response Team (HRVRT) focuses internally on members of the base community. Trained members of the 

HRVRT activate at the discretion of the family advocacy officer (FAO), based on the advice of the members (the FAO; the Family Advocacy Program [FAP] clinician who works with the family; members’ unit 

commander; mental health provider; domestic abuse victim advocate; and appropriate representatives 

from organizations that have legal, investigative, or protective responsibilities). Addressing safety issues 

and risk factors, the HRVRT develops a coordinated plan for immediate implementation to manage risk 

to the individual presenting a potential threat, intended victims, and community at large.

4. AFI 10-245, Antiterrorism, 30 March 2009, 19, par. 2.11. The Threat Working Group (TWG) reviews, coordinates, and disseminates threat warnings, reports, and summaries. Members include the antiterrorism officer; commanders or designated representatives; appropriate representatives from tenant units 

and the intelligence community; direct-hire contractor; and members of local, state, federal, or hostnation law enforcement agencies. Depending upon the threat information, subject-matter experts meet to 

provide information needed to develop predictive intelligence and recommend courses of action to counter threats and reduce risk.

5. The proposal to establish a separate forum for addressing this issue was discussed among HAF, 

MAJCOM, and DRU representatives at two Air Force FOR conferences (March and April 2010) and the 

Comprehensive Airman Fitness Summit hosted by AMC and Air Combat Command (ACC) in March 

2010. Conference attendees agreed that such a forum is vital to improving information sharing among 

commanders, civilian directors, support agencies (e.g., chaplain, mental health, medical, family advocacy, 

equal opportunity, inspector general, sexual assault response coordinator, etc.), as well as investigative and 

law enforcement entities. Air Force FOR Conference, 30–31 April 2010, Andrews AFB, MD; and Addressing Fort Hood Independent Review Report and Air Force Findings Comprehensive Airmen Fitness 

Summit, Scott AFB, IL, 16–17 March 2010.

6. ACC proposed its force protection intelligence fusion cell (FPIFC) concept as a recommendation to 

fill this gap. The FPIFC provides a mechanism whereby intelligence, Air Force Office of Special Investigations (AFOSI), and security forces representatives meet to identify and address DoD threats and hazards 

and collaborate to conduct intelligence preparation of the operating environment. The goal of FPIFC is to 

leverage and support timely identification of indicators and warnings of emerging localized threats. The 

FPIFC and its products are the primary information sources that directly support the installation commander, TWG, defense force commander, emergency management working group, and other organizations in making immediate planning decisions regarding force protection. Air Force Tactics, Techniques, 

and Procedures (AFTTP) 3-10.X, Force Protection Information Fusion Cell Operations, 1–2 (draft). Air 

Force Space Command (AFSPC) noted that the same Airmen were often appearing in forums such as 

status of discipline, cross-functional oversight committee, and central registry board, among others. 

AFSPC voiced concern about missed opportunities to integrate information and help Airmen before their 
51 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

actions elevated to the level of having these post-incident response forums address them. Based on the 

desire to intervene before an Airman commits a harmful act, an AFSPC wing commander created a coordinating venue entitled “status of care” (SOC) that brings together each month the wing commander, 

vice-commander, group commanders, command chief, staff judge advocate, and senior enlisted advisers to 

review at-risk Airmen. Group commanders submit names, situations, and supervisors to the vice wing 

commander, who integrates and redacts identifying information before group members review the list. As 

each individual situation is briefed, the SOC discusses potential strategies and options to assist the member and unit. The forum is designed to assist the commander with avenues and tools that may not have 

been considered; it is not a substitute for supervisory and commander responsibilities. “Air Force FOR 

Best Practice Submission, Status of Care Concept,” 1, 22 March 2010.

7. Air Force FOR team leads at the HAF, MAJCOM, and DRU levels recommend the following as 

initial objectives for the Status of Health and Airmen Resiliency Exchange (SHARE):

a. Implement a secure, comprehensive mechanism for the timely exchange of information;

b. Make an early identification of behaviors suggestive of potential violence and aberrant activity, to 

include potential criminal or terrorist activity;

c. Promote awareness of internal threat indicators and priority intelligence requirements; and

d. Provide commanders with a comprehensive picture of Airmen/community members with a coordinated plan of action to get AF members well.

The wing commander would chair the SHARE discussion with the proposed rules of engagement. The 

group would meet monthly, quarterly at a minimum, and ad hoc if necessary. Squadron/unit commanders 

submit their at-risk individuals to group commanders, who in turn forward to the SHARE administrator, 

who contacts trusted representatives from the base functional community. Attendees share additional supporting information at the SHARE. Group commanders present the individual with current context to 

SHARE attendees who, in turn provide amplifying information if available. The group discusses support 

options, and the commander is responsible for individuals and is accountable for follow-on actions.

8. Specifically, 15,134 top secret (TS)/special compartmental information (SCI), 73,353 secret, 5,000 

Periodic TS/SCI reinvestigations, 10,000 Phased TS/SCI periodic reinvestigations, 7,927 Access National 

Agency Check and Inquiries (ANACI), 15,718 NACI, 1,746 NAC, and 20,477 other checks were conducted during 2009. Defense Security Service, Statistical Data, 6 March 2010.

9. AFI 31-501, Personnel Security Program Management, 27 January 2005, 8, http://www.af.mil/shared/

media/epubs/AFI31-501.pdf; DoD 5200.1R, Information Security Program, 14 January 1997, 8, http://

www.dtic.mil/whs/directives/corres/pdf/520001r.pdf; and “HSPD-12: Policy for a Common Identification 

Standard for Federal Employees and Contractors,” 27 August 2004, http://www.dhs.gov/xabout/laws/

gc_1217616624097.shtm.

10. Defense Personnel Security Research Center, “PERSEREC,” http://www.dhra.mil/perserec/past 

achievements.html#project21.

11. AFI 31-501, Personnel Security Program Management, 8; and William K. Henderson, Security 

Clearance Manual (Pacific Grove, CA: Last Post Publishing, 7 April 2010).

12. DoD Directive (DoDD) 5530.3, International Agreements, 11 June 1987, certified current as of 21 

November 2003, 21–27; Department of Homeland Security (DHS), “US-VISIT What to Expect When 

Visiting the United States,” 11 April 2010, http://www.dhs.gov/files/programs/editorial _0525.shtm; and 

AFI 16-201, Air Force Foreign Disclosure and Technology Transfer Program, 1 December 2004, incorporating change 1, 11 August 2009.

13. Col Bruce Lovely, AETC/A1, result of query on Air Force Military Personnel System, 3 March 

2010.
AIR FORCE FOLLOW-ON REVIEW 52

14. DoD Inspector General, Report D-2008-104, DoD Implementation of Homeland Security Presidential Directive-12, 23 June 2008, 4, http://www.dodig.mil/Audit/reports/fy08/08-104.pdf.

15. Lt Gen Thomas P. Bostick, Deputy Chief of Staff G-1, US Army, Testimony before the Military 

Personnel Subcommittee of the House Armed Services Committee, 111th Cong., 2nd sess.,17 March 

2010, 5; and DoD, Military Accessions Vital to National Interest (MAVNI) Recruitment Pilot, 29 March 

2010, http://www.defenselink.mil/news/mavni-fact-sheet.pdf.

16. DoDD 5220.6, Defense Industrial Personnel Security Clearance Review Program, 20 April 1999, 

16–18, http://www.dtic.mil/whs/ directives/corres/pdf/522006p.pdf.

17. Defense Personnel Security Research Center, Automated Continuing Evaluation System (ACES) 

(Washington, DC: 7 April 2010), http://www.dhra.mil/perserec/currentinitiatives.html#ACES; Joint Security and Suitability Reform Team, Security and Suitability Process Reform (Washington, DC: 17 December 2008).

18. AFI 36-2907, Unfavorable Information File (UIF) Program, 17 June 2005, 6. Officer UIFs may last 

longer than two years and may transfer with the member to new assignment.

19. Automated Military Justice Analysis and Management System (AMJAMS) provides a Web-based, 

“cradle-to-grave” real-time, statistical history of military justice. AFI 51-201, Administration of Military 

Justice, 21 December 2007, interim change 1, 3 February 2010, 215; “Information Technology,” fact 

sheet, http://hqja.jag.af.mil/factsheet.pdf.

20. AFI 51-201, Administration of Military Justice, 21 December 2007, interim change 1, 3 February 

2010, 215; “Information Technology,” fact sheet, http://hqja.jag.af.mil/factsheet.pdf.

21. Greg Girard, AF/JAA, to Dr. Anthony C. Cain, e-mail, 9 April 2009, concerns with Finding 2.9.

22. Air Force Manpower Agency, “AF Best Practices Clearinghouse,” https://afkm.wpafb.af.mil/ 

community/views/home.aspx?Filter=AF-DP-00-30.

23. Ibid., “Crosstalk.”

24. AFI 90-201, Inspector General Activities, 19 July 2007.

25. Air Force Manpower Agency, “AF Best Practices Clearinghouse,” https://afkm.wpafb.af.mil/ 

community/views/home.aspx?Filter=AF-DP-00-30.

26. AFI 36-2608, Military Personnel Records System, 30 August 2006.

27. DoD, Military Personnel Records Information Management Task Force Charter, 10 March 2010, 2.

28. Protecting the Force, 19.

29. Col Keith Givens, AFOSI, Andrews AFB, MD, interview with special agent (SA) Jon S. Stivers, 

Deputy Director/CTO, AFOSI/XI, Andrews AFB, MD, 22 February 2010.

30. Ibid.

31. Office of the Secretary of Defense (OSD), “Interim Recommendations of the Ft. Hood Follow-on 

Review,” memorandum, 12 April 2010, 4.

32. DoD Instruction (DoDI) 5240.6, Counterintelligence (CI) Awareness, Briefing, and Reporting Programs, 7 August 2004, 11, http://www.dtic.mil/whs/ directives/corres/pdf/524006p.pdf.

33. DoDD 5240.1-R, Procedure Governing the Activities of DoD Intelligence Components that Affect 

United States Persons, December 1982, http://www.dtic.mil/whs/directives/corres/pdf/524001r.pdf; executive order 12333, US Intelligence Activities, 4 December 1981, http://www.fas.org/irp/offdocs/eo/ 

eo-12333-2008.pdf; and Defense Personnel Security Research Center, Counterintelligence Reporting Essentials (CORE), May 2005, http://www.dhra.mil/perserec/reports/core_brochure.pdf.

34. AFI 71-101, vol. 4, Counterintelligence, 1 August 2000, http://www.e-publishing.af.mil/shared/

media/epubs/AFI71-101V4.pdf; and AFOSI Manual 71-144, vol. 1, Counterintelligence and Security Services, 8 April 2009.
53 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

35. Paul Davis and Kim Cragin, Social Science for Counterterrorism, Putting the Pieces Together (Arlington, VA: Rand Corporation, 2009), xxxvi, http://www.rand.org/pubs/monographs/2009/RAND 

_MG849.pdf.

36. Assistant to the Secretary of Defense for Intelligence Oversight, Policy Guidance for Intelligence 

Support to Force Protection, 18 November 1998, 2.

37. AFI 71-101, vol. 4, Counterintelligence.

38. DoDD 5148.11, Assistant to the Secretary of Defense for Intelligence Oversight, 21 May 2004, http://

atsdio.defense.gov/documents/51481p.pdf.

39. Paul Stockton, Assistant Secretary of Defense Homeland Defense and America’s Security Affairs, 

Coordination Package 03152010, Consolidated Summary of Recommendations, draft 3, 15 March 2010, 1.

40. Protecting the Force, 30.

41. Col Keith Givens, AFOSI, Andrews AFB, MD, interview with SA Matthew Simmons, Director, 

ICON, Andrews AFB, MD, 15 April 2010.

42. OSD, “Interim Recommendations of the Ft. Hood Follow-on Review,” memorandum, 12 April 

2010, 5–6.

43. www.cttso.gov.

44. AFTTP 3-31.1, Entry Control, 29 May 2007, para. 2.4.4.3, 15.

45. Scott Petrowski, office of the Under Secretary of Defense for Intelligence and member of the DoD 

follow-on review team of the Fort Hood report, stated the PSEAG/DIAC WG study is the “perfect vehicle” for answering recommendation 3.7 to the SECDEF and is requesting updates for later briefings and 

recommendations. The PSEAG/DIAC WG study will interview subject matter experts throughout the 

DoD, federal and civilian agencies, and academia. The study will also evaluate operational threat detection/management programs such as the US Secret Service’s Exceptional Case Study project and the Transportation Security Administration’s Behavior Detection Officer and Screening of Passengers by Observation Techniques Programs. Research projects, to be evaluated by the study, consist of projects within DHS, 

to include the Future Attribute Screening Technology project which combines multiple physiologic sensor 

technologies to assist operators in detecting hostility and/or malicious intent, and the Hostile Intent DetectionAutomated Prototype project which uses automated intent detection using noninvasive, culturally-neutral 

behavioral indicators such as facial micro-expressions.

46. DoDI 5200.08, Security of DoD Installations and Resources, 10 December 2005, 2, http://www

.fas.org/irp/doddir/dod/i5200_08.pdf.

47. Air Force Manual 31-201, vol. 7, Security Forces Administration and Reports, 28 August 2009, 10, 

http://www.e-publishing.af.mil/ shared/media/epubs/AFMAN31-201V7.pdf.

48. AFI 31-201, Security Forces Standards and Procedures, 30 March 2009, 28–30, http://www.af

.mil/shared/media/epubs/AFI31-201.pdf.

49. DTM 09-012, Interim Policy Guidance for DoD Physical Access Control, 8 December 2009, 10–11.

50. As the DoD’s human resource information source, Defense Manpower Data Center (DMDC) 

manages databases including identity management systems like DBIDS, Defense Cross-Credentialing 

Identification System, Defense National Visitors Center, and the Real-time Automated Personnel Identification System card program.

51. The Biometric Task Force is reviewing requirements for an enterprise architecture that gathers and 

shares data. The DoD Biometric Enterprise Architecture (DBEA) supports the DoD Biometric Enterprise 

Strategic Plan and will be implemented through guidance in a DoDI to ensure the US government and its 

allies can share biometric data and operate within a common information structure. The DBEA will establish 

procedures for inserting and using biometric technologies to support the DoD warfighter and business operations. It will resolve biometric capability gaps, guide biometric system-of-systems development, and align 

DoD biometric resources. See DoDD 8320.02, Data Sharing in a Net-Centric Department of Defense, 23 
AIR FORCE FOLLOW-ON REVIEW 54

April 2007, http://www.dtic.mil/whs/directives/corres/pdf/832002p.pdf; and DoD—Biometrics Task Force, 

“Architecture,” http://www.biometrics.dod.mil/CurrentInitiatives/architecture.aspx.

52. DMDC, Defense Biometrics Identification System (DBIDS)/Installation Control Access System

(ICAS) Privacy Impact Assessment (PIA).

53. Col Keith Givens, AFOSI, Andrews AFB, MD, interview with Lt Col Scott Ulrich, USAF, deputy 

commander, Air Force Security Forces Center, 24 February 2010.

54. Some contracts will not pay if the civilian treatment facility fails to provide documentation. The 

situation is complicated because each contract may be worded differently and processes are not standardized. Standardized wording and contracts would ensure the information is consistently provided to the 

medical treatment facility (MTF).

55. AFI 41-210, Patient Administration Functions, 22 March 2006, 40; Marcia L. Kurtz (legal advisor, 

Procurement and HIPAA, AFMSA/SG5J), e-mail to Lt Col Kevin P. Seeley, Chief, Enterprise Technology 

Services, Air Force Medical Support Agency, 22 February 2010; AFI 44-109, Mental Health, Confidentiality, and Military Law, 1 March 2000, 1, 6–8; AFI 44-154, Suicide and Violence Prevention Education and 

Training, 3 January 2003, 4. For urgent matters that cannot wait for written communication, disclosure 

authorization from the patient is not required per DoDI 6025.18-R, DoD Health Information Privacy 

Regulations.

56. National Guard and Reserve members only receive medical care through local MTF and TRICARE providers while on active duty orders.

57. Health Insurance Portability and Accountability Act (HIPAA) of 1996, Public Law 104-191, 

104th Cong., 2nd sess., 21 August 1996.

58. Protecting the Force, 20–21.

59. AFI 41-115, Authorized Health Care and Health Care Benefits in the Military Health System (MHS), 

28 December 2001, 6.

60. AFI 44-109, Mental Health, Confidentiality, and Military Law, 1 March 2009, 9, http://www

.e-publishing.af.mil/shared/media/epubs/ AFI44-109.pdf.

The following policies govern Air Force PHI procedures:

•	 AFI 41-210, Patient Administration Functions, 22 March 2006, 14, http://www.af.mil/shared/

media/epubs/AFI41-210.pdf, references DoDI 6025-18R, Privacy of Individually Identifiable 

Health Information in DoD Health Care Programs, 22 March 2006, http://www.dtic.mil/whs/

directives/corres/pdf/602518r.pdf.

•	 AFI 44-109 references DoDI 6490.4, Requirements for Mental Health Evaluations of Members of 

the Armed Forces, 28 August 1997, 6–12, http://www.dtic.mil/whs/directives/corres/pdf/ 

649004p.pdf; and DoDD 6490.1, Mental Health Evaluations of Members of the Armed Forces, 24 

November 2003, http://www.dtic.mil/whs/directives/corres/pdf/649001p.pdf.

•	 AFI 44-154, Suicide and Violence Prevention Education and Training, 24 November 2003, 5, 

http://www.af.mil/shared/media/epubs/AFI44-154.pdf; also references DoDI 6490.4, and 

DoDD 6490.1.

•	 AFPD 36-60, Sexual Assault Prevention and Response Program (SAPR), 28 March 2008, 2, 5, 

http://www.e-publishing.af.mil/shared/media/epubs/AFPD36-60.pdf, references DoDD 6495.01, 

Sexual Assault Prevention and Response Program, 7 November 2008, http://www.dtic.mil/whs/

directives/corres/pdf/ 649501p.pdf.

61. DTM 09-006, Revising Command Notification Requirements to Dispel Stigma in Providing Mental 

Health Care to Military Personnel, 2 July 2009, 5–6, http://www.dtic.mil/whs/directives/corres/pdf/DTM

-09-006.pdf.

62. AFI 41-210, Patient Administration Functions, 22.
55 AIR FORCE FOLLOW-ON REVIEW

Chapter 2  Sharing Information

63. Dale Hamby (Air Force Fort Hood Review) interview by Peter Koeppl (ANG DPH Coordinator), 

9 April 2010.

64. Ibid.

65. AFI 44-154, Suicide and Violence Prevention Education and Training, 28 August 2006.

66. National Guard Bureau, Presentation to Warrior Resiliency Conference, National Guard Psychological Health (Washington, DC: 3 November 2009); AFI 40-301, Family Advocacy, 30 November 2009, 14.

67. AFI 90-501, Community Action Information Board and Integrated Delivery System, 31 August 2006; 

AFI 44-154, Suicide and Violence Prevention Education and Training, 3 January 2003; HAF, Memorandum 

for ALMAJCOM/CC, Automated Neuropsychological Assessment Metric (ANAM), Pre-deployment 

Automated Neuropsychological Assessment Metric Baseline Testing, 18 November 2009.

68. An Achievable Vision: Report on the Department of Defense Task Force on Mental Health, June 2007. 

See especially Recommendations 5.4 and 5.4.1.16.

69. Hamby, interview.
AIR FORCE FOLLOW-ON REVIEW 56

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57 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

The Air Force faces a broad array of threats in an uncertain operating environment. 

To enable appropriate responses, the Air Force must clearly define the term force protection and appoint an office of primary 

responsibility for integrating currently 

disparate force protection efforts. Only 

then can we clarify responsibilities, command and control relationships, and reporting procedures.

Emerging technologies will improve 

timely information sharing. We must also 

partner with DoD and other government 

agencies to improve timely threat and incident reporting procedures. For example, 

participation with the Joint Terrorism 

Task Force is an important opportunity to 

strengthen partnerships. Appointing an 

office of primary responsibility for force 

protection will be key to forging these 

partnerships.

Lead Agent for Force Protection

Finding 37

(This refers to DoD report Finding/Recommendation 3.1.)

● Geographic combatant commander (GCC) and military department force protection responsibilities are clear.

● Neither DoD nor Air Force publications include a clear and consistent definition 

of the term force protection.

Discussion

The DoD report implies a degree of misunderstanding regarding the scope of the GCCs’ 

force protection responsibility and that of the military departments, particularly within 

the continental United States (CONUS).1

 From an Air Force standpoint, GCC responsibilities are clear. United States Northern Command (USNORTHCOM) is assigned tactical control (TACON) for force protection of all US forces in its area of responsibility.2

 As 
AIR FORCE FOLLOW-ON REVIEW 58

the Air Force component to USNORTHCOM, Headquarters First Air Force (AFNORTH), 

is assigned force protection responsibilities for the Air Force.3

 These policies and the Unified Command Plan’s assignment of force protection responsibilities to USNORTHCOM 

and AFNORTH are sufficiently clear.

One concern, however, involves the lack of a clear and consistent definition of the term 

force protection. Joint Publication (JP) 1-02, Department of Defense Dictionary of Military and 

Associated Terms, and JP 3-0, Operations, define force protection as preventive measures taken 

to mitigate hostile actions against DoD personnel (including family members), resources, 

facilities, and critical information.4

 Defining force protection as actions taken to mitigate 

hostile threats rather than all threats and hazards potentially limits the GCC force protection 

mission assigned by the Unified Command Plan. In contrast, USNORTHCOM Instruction 10-222 (U), USNORTHCOM Force Protection (FP) Mission and Antiterrorism (AT) 

Program, identifies force protection as an 

all-hazards mission.5

 Defining force protection in this manner enhances the 

GCCs’ ability to protect the force even 

though it conflicts with definitions in 

JP 1-02 and JP 3-0.

The current definition of force protection also does not consider the full spectrum of threats unit leaders must address for mission assurance. In fact, the 

same systems and assets required for 

planning, preparation, and response for 

terrorist incidents are also used for natural disasters, pandemic diseases, and 

other non-hostile threats. This is particularly true in CONUS, where national command-level response plans 

encompass an all-hazards approach.

A revised definition of force protection should enable commanders at all levels to 

protect DoD personnel, facilities, and information from internal as well as external 

threats. This definition must remain broad enough for commanders to address missionspecific concerns and be appropriately integrated into force protection policies, programs, and procedures.

Current efforts to better define force protection are converging toward an all hazards 

scope: (1) the Office of the Secretary of Defense (OSD) and Joint Chiefs of Staff (JCS) 

The current definition of 

force protection does not 

consider the full 

spectrum of threats ...
59 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

are discussing changing the definition of force protection to emphasize all hazards; (2) 

USNORTHCOM now defines force protection as all hazards;6

 and (3) a working group 

at the Air Force Doctrine Center is updating Air Force Doctrine Document (AFDD) 

2-4.1, Force Protection, to incorporate an all-hazards approach.7

 Additionally, US Pacific 

Command has issued a combined Antiterrorism and Defense Critical Infrastructure 

Program (DCIP) operations order merging the threat-based antiterrorism program with 

the all-hazards-based DCIP program.8

Recommendation

37.1 Engage with the OSD to better define the term force protection. (OPR: AF/A3/5)

Finding 38

(This refers to DoD report Finding/Recommendation 3.5.)

● No single agency manages DoD’s force-protection-related common reporting system as the counterintelligence and human intelligence (HUMINT) authority.

Discussion

There is no agency that integrates force protection information among DoD agencies. 

Also, each Service operates criminal and counterintelligence agencies that often compile 

force protection-related information. Without a DoD-wide integrating agency focused on 

force protection, unit leaders may not receive required critical information.9

Recommendation

38.1 Coordinate with the DoD to identify a single executive agent to manage force 

protection-related common reporting systems. (OPR: SAF/IG)

Finding 39

(This refers to DoD report Finding/Recommendation 3.1.)

● The Air Force does not have an organizational focal point for integrating force protection policy and guidance.
AIR FORCE FOLLOW-ON REVIEW 60

Discussion

The Air Force has no policy document from which to derive force protection doctrine 

and policy guidance. Moreover, no Air Force office or agency has responsibility for integrating and synchronizing the efforts of the multiple staff agencies that develop force 

protection policies. The following organizations at Headquarters Air Force (HAF) address 

elements of force protection:

● AF/A2 provides policy for force protection intelligence;

● AF/A3/5 is responsible for homeland defense and civil support, continuity of operations (COOP), operations security (OPSEC), antiterrorism, protection of critical infrastructure, and information assurance and security;

● AF/A4/7 offers guidance for air provost and law enforcement operations; integrated 

defense; chemical, biological, radiological, nuclear, and high-yield explosives 

(CBRNE); and installation emergency management;

● SAF/AAP issues guidance for personnel security, information security, and industrial security;

● SAF/IG provides policy and guidance for intelligence oversight, counterintelligence, and investigations;

● AF/SE develops policies for occupational safety;

● AF/SG offers policy and guidance for force health protection; and

● Other staff agencies supply specific policy guidance that may be theater dependent.

The Air Force has no integrating policy document to link the myriad functional areas 

related to force protection and to promote unity of effort in developing and disseminating 

policy guidance on force protection. Gaps and seams in force protection may develop if 

various staff agencies responsible for promulgating policy and guidance within their functional areas fail to coordinate closely.

To establish unified force protection policy and better clarify roles and responsibilities, 

the Force Protection Steering Group should recommend an appropriate HAF office as 

lead for integrating and synchronizing force protection policy.10 The force protection lead 

should chair a HAF Force Protection Summit and oversee the HAF Force Protection 

Working Group and steering groups. This lead should also revise the charters of these forums to reflect new responsibilities and draft an Air Force policy directive (AFPD) to 

clarify and establish various roles and responsibilities within the Air Staff on force protec-
61 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

tion efforts. In addition, this lead office would coordinate with applicable DoD and Service agencies and address the requirements of multiple Air Force stakeholders.

Recommendations

39.1 Task the Force Protection Steering Group to develop options for appointing a 

HAF force protection lead. (OPR: AF/A4/7)

39.2 Develop an AFPD to establish and clarify roles and responsibilities within the 

HAF for the force protection mission. (OPR: AF/A4/7)

Commanders’ Tools

Finding 40

(This refers to DoD report Finding/Recommendation 3.2.)

● Force protection programs do 

not provide multidisciplinary capabilities focused on predicting 

and preventing insider threats.

Discussion

The Air Force’s primary efforts to 

identify and mitigate internal threats 

focus on counterintelligence and espionage. Our force faces a variety of internal threats. In most instances, we find 

early indicators of potential acts of violence associated with internal threats—

after the fact.11 However, even if unit 

leaders are aware of indicators of potential violence, programs for assessing and 

reporting those indicators are lacking, 

increasing the likelihood of gaps in reporting and responding.

As a means of addressing this issue, 

the Air Force has partnered with the 

OSD Force Protection Working Group, 

In most instances, we 

find early indicators of 

potential acts of 

violence associated with 

internal threats— 

after the fact.
AIR FORCE FOLLOW-ON REVIEW 62

which commissioned the Defense Science Board (DSB), to review DoD documents and 

analytical findings related to workplace violence.12 The DSB will also evaluate existing 

threat-assessment programs for success and best practices, including those used by other 

government agencies, private industry, and academia.13

The review will evaluate existing training and education programs to assist DoD personnel in identifying aberrant behavior exhibited by potentially violent actors. Remaining 

engaged with this effort, the Air Force will gain insight into broader issues related to assessing, protecting against, and countering internal threats.

Recommendations

40.1 Participate in the DSB multidisciplinary group to develop assessment programs 

for internal threats. (OPR: AF/A4/7)

40.2 Provide commanders with a multidisciplinary capability focused on detecting and 

neutralizing internal threats, based on recommendations from the DSB independent study. (OPR: AF/A4/7)

Operational Reporting

Finding 41

(This refers to DoD report Finding/Recommendation 3.1.)

● Air Force command and control relationships related to force protection are unclear.

● AFI 10-206, Operational Reporting, Attachment 2, “OPREP-3 and Reports Matrix,” does not require notifying AFNORTH or USNORTHCOM for certain incidents, despite their force protection implications.

Discussion

Current reporting procedures for CONUS Air Force installations require operational 

reports (OPREP-3) from the unit of origin to the appropriate MAJCOM and, if required, 

to the Air Force Service Watch Cell located in the Pentagon.14 Based on the nature of the 

event, reports must meet strict timelines to ensure that appropriate organizations are sufficiently informed.

AFI 10-206 addresses required reporting, but inconsistencies in prescribed reporting 

procedures could lead to incorrect notifications. For example, current procedures under 

Rule 2M for “deliberate discharge of a firearm resulting in a death” do not demand noti-
63 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

fication to AFNORTH or USNORTHCOM.15 However, Rule 3B for “serious crimes/

incidents that may involve exercise of domestic or foreign jurisdiction over Air Force personnel or dependents or that may result in extensive news media or congressional interest” 

requires notification to USNORTHCOM but not AFNORTH.16 Updating reporting 

requirements in AFI 10-206, Operational Reporting, will improve notification of appropriate entities regarding important incidents that affect Air Force personnel, property, or 

information.

Further, because AFI 10-206, Attachment 2, does not clearly specify that AFNORTH 

or USNORTHCOM must be notified when events having implications for force protection occur, reporting may be delayed. Specifically, eight events (death of an active duty Air 

Force member, death of a civilian, criminal activity, bomb threat, sabotage, change in 

force protection condition, civil disturbance, and malicious acts) do not require reporting 

either to AFNORTH or USNORTHCOM; however, any of these occurrences could 

have serious force protection implications. Adding AFNORTH and USNORTHCOM 

as minimum essential addresses for force protection-related events will help prevent delays 

in future reporting and will mitigate subsequent risks.

Recommendations

41.1 Revise AFI 10-206, Operational Reporting, to ensure incidents related to force protection within the CONUS are reported according to prescribed timelines to 

USNORTHCOM, AFNORTH, and appropriate Air Force and DoD agencies. 

(OPR: AF/A3/5)

41.2 Revise AFI 10-206, Operational Reporting, Attachment 2, to ensure AFNORTH 

and USNORTHCOM are notified for all incident types having force protection 

implications. (OPR: AF/A3/5)

Finding 42

(This refers to DoD report Finding/Recommendation 3.4.)

● Air Force policies adequately address reporting requirements to share threat information with internal Air Force entities and with external counterparts; however, no 

DoD-wide standardized reporting procedures exist for sharing threat information.

Discussion

Counterintelligence agents throughout DoD need to share threat information across 

organizational boundaries. Without standardized processes, agents rely on ad hoc proce-
AIR FORCE FOLLOW-ON REVIEW 64

dures to share information. Lack of standardized processes may create gaps in details and 

timeliness of information, causing recipients to miss important data and preventing vital 

information from flowing to operational commanders. AFOSI Manual 71-121, Processing 

and Reporting Investigative Matters, and AFI 10-206, Operational Reporting, give clear 

guidance on following notification procedures as well as elevating threat information.17

AFOSI detachments create a suspicious activity report (SAR) when an incident meets 

criteria outlined in AFOSI Manual 71-121. SARs must fall within one of eight categories: 

specific threats, surveillance, elicitation, tests of security, repetitive activities, suspicious activities, suspicious incidents, or bomb threats. SARs are reported to 

the AFOSI Global Watch Center to advise counterpart 

DoD, local, regional, and federal law enforcement and 

intelligence agencies as needed. This assists other agencies in identifying and thwarting related suspicious incidents.18 Though standard practice for AFOSI, these 

procedures are not standardized among the Services.

The Air Force should participate in DoD efforts to 

develop specific guidance that improves the timely flow 

of actionable threat information. DoD plans to establish a principal staff agency for force protection to work 

with combatant commanders, military departments, 

defense intelligence agencies, investigative organizations, and counterintelligence organizations to identify 

sources of required threat information. After defining 

the threat information and sources, the OPR will establish policies and processes for sharing information with pertinent organizations and 

agencies. The OSD has set October 2010 as its deadline for developing draft guidance.19

Recommendation

42.1 Coordinate with DoD to develop standardized threat-reporting procedures and 

incorporate any new policies and procedures into existing AFIs as necessary. (OPR: 

SAF/IG)
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Chapter 3  Preparing the Force

Finding 43

(This refers to DoD report Finding/Recommendation 3.6.)

● Current DoD reporting and alerting systems based on phone calls and e-mail can 

delay the transmission of critical incident reports and limit capacity for simultaneous dissemination, both horizontally and vertically.

Discussion

Legacy communication technology using telephone calls and e-mails may constrain 

rapid, simultaneous incident reporting. AFI 10-206, Operational Reporting, establishes 

the goal to provide an incident voice report within 15 minutes with a hard copy report 

following within an hour. A national-level interest event must be reported by telephone to 

the responsible MAJCOM and combatant command, the Air Force Watch, and the National Military Command Center (NMCC).20 This reporting process is time-consuming, 

occurring simultaneously with efforts to coordinate local responses. Current reporting is 

vertical, to higher levels of command only; other installations and MAJCOMs that may 

be affected by the incident have to be informed by other means.

Innovative communications, data storing, and sharing options using the Internet could 

provide Air Force users with near real-time force protection information, trend data, and 

background sources. Users could potentially see information as it is posted and could access other sites for additional data. Command centers could maintain a constant watch of 

ongoing events within their communities. 

Recommendation

43.1 Participate with the Joint Staff to explore and research technology to improve legacy 

OPREP-3 reporting systems. (OPR: AF/A3/5)

Finding 44

(This refers to DoD report Finding/Recommendation 3.6.)

● Installation command posts often do not meet the 15-minute requirement to transmit OPREP-3 initial voice reports.
AIR FORCE FOLLOW-ON REVIEW 66

Discussion

According to Air Force Service Watch Cell representatives, OPREP-3 initial voice reporting goals of 15 minutes are often not met.21 If the voice report is not timely, subsequent notifications are delayed.

Command posts responsible for submitting reports must also communicate information 

between local responders and installation leaders. Responding to incidents is the first priority 

and installation commanders typically approve all reporting to include initial voice reports. 

The initial hard copy reports are frequently delayed as a result. 

To improve incident reporting timeliness, command post controllers could be certified to 

generate initial voice reports on behalf of the installation commander. Controllers should also 

monitor information and reporting sources outside the installation. All those involved in the 

reporting process must be well trained, exercised, and inspected to ensure proficiency.

Recommendations

44.1 Ensure those involved in the installation reporting process (e.g., command post 

representatives, command chain, etc.) are properly trained and proficient in their 

tasks and have appropriate resources, tools, checklists, and guidance to accomplish 

them. (OPR: AF/A3/5)

44.2 Evaluate the need for command post controllers to be certified to monitor external 

information sources, approve, and submit initial voice reports on behalf of the 

installation commander. (OPR: AF/A3/5)

Finding 45

(This refers to DoD report Finding/Recommendation 3.6.)

● Policies governing operational reporting procedures do not provide specific examples of incident types that are of national-level interest.

Discussion

None of the primary directives governing event notification provide details of the 

types of incidents meriting national-level response.22 For example, PINNACLE requirements in AFI 10-206, Section 3.2.1, explain what external factors justify a PINNACLE 

response (i.e., for national media attention) but do not explain in detail what security 

breaches merit a PINNACLE designation.23 Without specific examples, the OPREP-3 

PINNACLE reporting might be improperly executed.
67 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

Air Force representatives should partner with JCS staff and the other Services to develop and incorporate specific examples of national-interest-level events into policy directives to ensure timely notification of events affecting force protection.

Recommendation

45.1 Coordinate with appropriate DoD, joint, and Service representatives to revise operational reporting policies to include specific examples of incident types that 

should trigger an OPREP-3 PINNACLE report. (OPR: AF/A3/5)

Finding 46

(This refers to DoD report Finding/Recommendation 3.6.)

● Policies that govern operational 

reporting procedures do not 

specify how the National Military Command Center (NMCC) 

or the GCCs will disseminate incident information.

Discussion

The NMCC or GCCs must disseminate incident information to subordinate 

units to ensure unity of effort and to synchronize response and recovery actions. 

Current policies do not provide adequate 

guidance for this critical phase of the reporting and notification process. Notification from the NMCC and the GCCs 

to subordinate units could be delayed, 

especially if an incident involves a coordinated or nearly simultaneous attack 

against several installations.

AFI-10-206, Operational Reporting,

clearly defines information flow from 

the reporting unit to the upper command structure, but it does not provide guidance 

on horizontal notification of units within the same geographic region. There are no 

There are no 

standardized 

procedures for rapidly 

sharing incident 

reporting with nearby 

installations ...
AIR FORCE FOLLOW-ON REVIEW 68

standardized procedures for rapidly sharing incident reporting with nearby installations 

should an attack occur at multiple DoD installations. 

Recommendations

46.1 Coordinate with Joint Staff and USNORTHCOM representatives to revise 

CJCSM 3150.05C, Joint Reporting Structure (JRS) Situation Monitoring Manual, 

and US Northern Command Instruction 10-211, Operational Reporting, to include instructions on how to disseminate incident reports, including rapid horizontal notification. (OPR: AF/A3/5)

46.2 Revise AFI 10-206, Operational Reporting, to reflect Joint and GCC policies on 

disseminating information. (OPR: AF/A3/5)

Intelligence Coordination

Finding 47

(This refers to DoD report Finding/Recommendation 3.3.)

● The Air Force Office of Special Investigations (AFOSI) serves as the focal point for 

Air Force participation in Joint Terrorism Task Forces (JTTF).

● The current MOU that incorporates AFOSI participation in JTTFs is sufficient.

● Air Force has fully manned its JTTF authorizations in 13 of 103 JTTFs (14 total 

positions).

Discussion

The DoD report indicated that DoD’s commitment to the JTTFs is inadequate. On 

7 August 2009, the Federal Bureau of Investigation (FBI) and DoD signed a memorandum of understanding (MOU) formalizing the partnership for AFOSI, Naval Criminal 

Investigative Service, and Army Military Intelligence participation in JTTFs.24 This MOU 

assigns AFOSI as the functional manager for the Air Force role in JTTFs. There are no 

open issues requiring a change to this relationship or the MOU.25

The current MOU between the DoD and FBI, establishing JTTF participation requirements for the counterintelligence agencies within the Services, is sufficient for addressing AFOSI participation. Although DoD does not have an MOU formalizing 

JTTF participation for all agencies, the current DoD MOU with the FBI meets current 

Air Force intelligence-sharing requirements.26 SAF/IGX should coordinate with appro-
69 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

priate DoD agencies to maintain Air Force representation within JTTFs as DoD revises 

the existing MOU.

To preserve unity of effort and concentrate key resources and expertise at high-priority 

locations, AFOSI maintains oversight of Air Force participation at high-priority JTTFs 

nationwide. The Air Force currently has 14 AFOSI civilian criminal investigators assigned 

at 13 JTTFs and the National Joint Terrorism Task Force (NJTTF).27 Of these positions, 

13 are funded by the Director National Intelligence (DNI) and one is funded by the 

AFOSI.28 Expanding AFOSI participation at other JTTFs will require additional manpower and funding; however, AFOSI maintains a prioritized list for assigning additional 

personnel should resources become available from DNI and the FBI approves Air Force 

placement at specific locations.

Recommendations

47.1 Participate in DoD revision of MOUs governing participation in JTTFs. (OPR: 

SAF/IG)

47.2 Coordinate with the FBI and DNI to determine the feasibility of expanding Air 

Force representation on priority JTTFs. (OPR: SAF/IG)

Finding 48

● There are currently no Air Force personnel assigned to the National Counterterrorism Center (NCTC) or the associated Defense Intelligence Unit (DIU) in Air 

Force-sponsored billets to support Air Force counterterrorism (CT) analysis.

Discussion

An AFOSI liaison officer (LNO) currently works in the NJTTF, providing valuable 

law enforcement and counter intelligence collaboration with national investigative 

agencies.29 The NCTC is co-located with NJTTF and the Joint Intelligence Task 

Force-Counterterrorism (JITF-CT) to analyze and assess emerging counterterrorism 

and counterintelligence threats.30 The synergy created by these organizations enhances 

national force protection awareness. NCTC/DIU has offered to host Service intelligence analysts and LNOs.31

At present, there are no Air Force-sponsored intelligence analysts working within 

the DIU. The Air Force should consider the potential benefits of placing an intelligence analyst in the NCTC/DIU to improve CT information sharing and situational 

awareness of the national counterterrorism picture.32 Improved collaboration may 
AIR FORCE FOLLOW-ON REVIEW 70

enhance the Air Force’s ability to thwart or mitigate the effects of those intent on 

causing harm.

Recommendation

48.1 Establish an MOU with NCTC/DIU to establish an Air Force intelligence analyst 

position and assign an Air Force liaison officer. (OPR: AF/A2)

Finding 49

● The AF does not have real-time signals intelligence (SIGINT) support for counterintelligence investigations and operations.

Discussion

AFOSI Investigations, Collections, and Operations Nexus (ICON) has a demonstrated 

need to shape SIGINT support to meet current mission needs and could do so more effectively with an embedded national tactical integration (NTI) element. NTI elements 

provide time-sensitive, near-real-time SIGINT indications and warning support for 

CONUS-based air operations centers, numbered Air Forces, and regional cryptology centers. An embedded NTI element in the ICON would enhance AFOSI’s indigenous analytic capability against foreign targets and emerging intelligence indicators. Other potential benefits include improving threat information fusion within the force protection 

community and enhancing situational awareness for unit leaders and regional AFOSI 

headquarters. The capability would not involve supporting AFOSI’s law enforcement 

mission, except where authorized by DoD Instruction 5240.1-R, Procedure Governing the 

Activities of DoD Intelligence Components That Affect United States Persons.

33

Recommendation

49.1 Embed a national tactical integration element in the AFOSI Investigations, Collections, and Operations Nexus (ICON) organization to ensure timely signals intelligence (SIGINT) indications and warning support. (OPR: AF/A2)

Joint Basing and Force Protection

Finding 50

● Force Protection exercises and inspections at joint bases may not consistently include all tenant units and joint partners.
71 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

Discussion

Force Protection programs are most effective when they are clearly understood and 

routinely trained, exercised, and inspected. The safety and security of Air Force communities hinge on the vigilance of all personnel who work and live within them. Allowing 

people to not participate in force protection and emergency management exercises creates 

potential gaps in awareness of prevention, response, and recovery measures.34

AFI 90-201, Inspector General Activities, directs compliance inspections to 

“[e]valuate whether the base exercise program complies with AFI 10-2501 AF Emergency Management (EM) Program Planning and Operations. The installation, unit, 

or activity shall demonstrate the tasks and/or technical operations required to comply with exercise and evaluation program by conducting a base-wide exercise.”35 This 

policy directs the evaluation of 

emergency responders but does 

not require the general populace 

to participate in force protection. 

Exercising emergency responders 

is important but does not sufficiently stress prevention and mitigation measures.

Emergency management concepts vary between the Services 

and can slow development and 

implementation of a common approach to force protection. To 

this end, the Joint Staff (J3/4) Defense Threat Reduction Agency (DTRA) is addressing joint base inspection standards. DTRA produces Joint Service Integrated 

Vulnerability Assessment Standards (JSIVA) and benchmarks which the Air Force 

Vulnerability Assessment Team (AFVAT) uses to create Air Force vulnerability assessment benchmarks.

To overcome gaps between the Services, Joint Base McGuire-Dix-Lakehurst, NJ, established a joint base control center (JBCC). This benchmark structure provides command and control connectivity during crises between the emergency operations cell 

(EOC) and over 80 tenant units and joint partners. The JBCC maintains direct communication with the host installation EOC and serves as the conduit to distribute information. Doing so allows the EOC to focus on crisis response, while ensuring affected 

units and personnel receive timely updates.36
AIR FORCE FOLLOW-ON REVIEW 72

Recommendations

50.1 Review requirements and coordinate with joint partners and the Defense Threat 

Reduction Agency for including tenant and joint organizations in base exercises 

and inspections. (OPR: AF/A4/7)

50.2 Update AFI 90-201, Inspector General Activities, to address inspections at joint base 

locations. (OPR: SAF/IG)

50.3 At joint base locations where the Air Force is lead, the joint base commander must 

include tenant units in emergency management exercises. (OPR: AF/A4/7)

50.4 At locations where the Air Force is supported by another Service, the senior Air 

Force commander should ensure Air Force personnel are aware of emergency management procedures and exercise accordingly. (OPR: AF/A4/7)

Notes

1. Protecting the Force, 26.

2. Message 071901ZMAY04 (U), chairman, Joint Chiefs of Staff, subject: EXORD [execution order] 

for Standup of USNORTHCOM CONUS AT-FP [United States Northern Command continental 

United States antiterrorism/force protection] Responsibility.

3. HQ USAF/CC Message 261834ZMAR09 (U), subject: Designation of 1 AF (AFNORTH) [First 

Air Force (Air Forces Northern)] as POC [point of contact] for USAF Force Protection Issues. This message also rescinded AF/XO message 012247ZDEC04 (U), subject: Designation of NORTHAF POC for 

Force Protection (FP) Issues.

4. Protecting the Force, 25. See Joint Publication 3-0, Joint Operations, 13 February 2008, III-25, http://

www.dtic.mil/doctrine/dod_dictionary/data/f/623.html.

5. USNORTHCOM Instruction 10-222, USNORTHCOM Force Protection (FP) Mission and Antiterrorism (AT) Program, 17 February 2010, 5, par. 1.2.1.

6. Ibid.

7. The revised document, to be listed as Air Force Doctrine Document (AFDD) 3-10, Force Protection,

is currently in technical coordination prior to four-letter coordination.

8. USPACOM OPORD [United States Pacific Command operations order] 5050-08, 18 March 

2008, FRAGO [fragmentary order] 1, 23 July 2009, 1, par. 1.a.; and 2, par. 1.c.

9. The Counterintelligence Field Activity preceded the Defense Counterintelligence and Human Intelligence Center (DCHC). The latter was created in 2008 to manage the DoD’s counterintelligence and 

HUMINT operations. A suborganization of the Defense Intelligence Agency, it nevertheless has no classic 

intelligence function and is more closely aligned with the Air Force Office of Special Investigations 

(AFOSI) than with the AF/A2. Defense News Release, no. 651-08, “DoD Activates Defense Counterintelligence and Human Intelligence Center,” 4 August 2008, http://www.defense.gov/releases/release 

.aspx?releaseid=12106.

10. We explored three possible courses of action in an effort to identify an appropriate Air Force integration office for force protection: (1) designate AF/A3/5 as the office for integrating force protection 

policy via a matrix organization, (2) designate AF/A4/7 for that function, or (3) establish a special staff to 

integrate force protection policy (e.g., SAF/FP) with assigned and matrix personnel. Major commands 
73 AIR FORCE FOLLOW-ON REVIEW

Chapter 3  Preparing the Force

(MAJCOM) and direct reporting units (DRU) firmly rejected the third option due to concerns about 

manpower and cost but favored having the Headquarters Air Force (HAF) Force Protection Steering 

Group analyze the first two options for the HAF FP Summit and approval by the Secretary of the Air 

Force. The force protection office of primary responsibility (OPR) should develop an Air Force policy 

directive to define force protection efforts by staff agencies and provide overarching policy to support an 

Air Force doctrine document on force protection.

11. “Air Force Follow-on Review (FOR) Background Materials,” tab 3, Air Force Research Institute 

(Maxwell AFB, AL: Air University, 2010), 1.

12. The Defense Science Board task force is sponsored by the Under Secretary of Defense for Acquisition, Technology, and Logistics; the Chairman of the Joint Chiefs of Staff; and the Under Secretary of 

Defense for Policy. “Terms of Reference” (draft), in Defense Science Board (DSB) Study on Behavioral Indicators of Potential Insider Threats to the Department of Defense and Violence in the Work Place (Washington, 

DC: Defense Science Board, 1 May 2010), 2.

13. The DSB will interview DoD and civilian officials (threat-assessment professionals and first responders, as well as those in academe, private business, health affairs, law enforcement, force protection, 

and intelligence), peer and subordinate groups, witnesses, and others to identify behavioral indicators of 

potential violence. The DSB plans to assess the adequacy of suitability criteria conducted in periodic 

checks and those provided to coworkers and supervisors. If the current criteria are inadequate, the DSB 

will suggest possible alternatives that are more effective, given the large number of people involved and the 

range of activities requiring suitability determinations.

14. AFI 10-206, Operational Reporting, 15 October 2008, 9, par. 1.3.2; 18, par. 3.4.

15. Ibid., 73.

16. Ibid., 74.

17. AFOSI Manual 71-121, Processing and Reporting Investigative Matters, chap. 6; and AFI 10-206, 

Operational Reporting, sec. 3.2, 14.

18. Ibid., chap. 6.

19. Alan Gorowitz, team lead, “OSD [Office of the Secretary of Defense] Fort Hood Follow-on Review Information Sharing Team Meeting Notes,” 1 April 2008.

20. AFI 10-206, Operational Reporting, 15 October 2008, 14, par. 3.2.1.

21. Air Force Service Watch Cell representatives; interview, 3 February 2010.

22. Chairman of the Joint Chiefs of Staff Manual 3150.03C, Joint Reporting Structure Event and Incident Reports, 1 February 2009; and United States Northern Command Instruction 10-211, Operational 

Reporting, 16 April 2009.

23. For example, does someone firing a single round at a person on an installation constitute nationallevel interest? What about exposing an improvised explosive device on an installation? See AFI 10-206, 

Operational Reporting, 15 October 2008.

24. DoD/Federal Bureau of Investigation (FBI) Joint Terrorism Task Force Memorandum of Understanding (JTTF MOU), 7 August 2009, 2, sec. I, par. A.

25. The 12 April 2010 Secretary of Defense Interim Report for the OSD Follow-on Review Related to Fort 

Hood indicates that the Under Secretary of Defense for Policy (USD[P]) will serve as the DoD lead for 

providing policy guidance and developing DoD-wide goals and objectives for JTFF collaboration. By 

September 2011, USD(P) will begin drafting and coordinating a consolidated MOU between the FBI and 

DoD, including the DoD Inspector General’s Defense Criminal Investigative Service, to clarify responsibilities and ensure consistency among all agencies. USD(P) will review personnel and data from a resource 

study provided by the Under Secretary of Defense for Intelligence (USD[I]) to ensure that the commitment of resources to JTTFs meets DoD requirements. Resource and organizational requirements, including requests for additional manpower, will be determined no later than October 2010. A realignment 
AIR FORCE FOLLOW-ON REVIEW 74

plan, if required, will be completed by October 2012. SecDef [Secretary of Defense], memorandum, subject: Interim Recommendations of the Fort Hood Follow-on Review, 12 April 2010, 5.

26. SAF/IGX and HQ AFOSI representatives, Mr. Jude Sunderbruch, AFOSI HQ XRC, interview by 

Preparation Team, HAF OSI HQ, 9 March 2010.

27. The FBI has 103 JTTFs nationwide. Air Force JTTF billets are located in Boston, Colorado 

Springs, Las Vegas, Los Angeles, Miami, New York City, Omaha, Orlando, Salt Lake, San Antonio, Tampa, 

Tucson, and the National JTTF in Washington, DC. These locations were selected based on personnel 

levels, resources, and Air Force interests.

28. SAF/IGX and HQ AFOSI representatives, Mr. Jude Sunderbruch, AFOSI HQ XRC, interview.

29. Federal Bureau of Investigation and the Department of Defense, standard memorandum of understanding, 21 July 2009, par. 4.

30. Executive Order 13354, National Counterterrorism Center, 27 August 2004, sec. 3.

31. Dustin Gard-Weiss, “DIA/JITF-CT Mission Management,” e-mail memorandum, 4 December 

2009.

32. Meeting between Connie Wright, Chief, Force Protection Intelligence Integration and Capabilities 

Division, Headquarters Air Force; Thory Wolfe, Director, Operations Center; and John Sinisko, Chief/

SIO, Information Sharing Division, JITF-CT-DIU, National Counterterrorism Center, 11 February 

2010; Executive Order 13356, Strengthening the Sharing of Terrorism Information to Protect Americans, 27 

August 2004, sec. 2; and Executive Order 13388, Further Strengthening the Sharing of Terrorism Information to Protect Americans, 25 October 2005, sec. 2.

33. Air Force Intelligence, Surveillance, and Reconnaissance Agency, “Bullet Background Paper on Air 

Force National Tactical Integration Support to OSI,” 8 April 2010. See also DoD Instruction (DoDI) 

5240.1-R, Procedure Governing the Activities of DoD Intelligence Components That Affect United States Persons, December 1982, 56.

34. See appendix C. The AFMA survey confirmed that tenant units are not routinely integrated into 

force protection exercises and inspections.

35. AFI 90-201, Inspector General Activities, 17 June 2009, 31, par. 3.3.7.2.3.

36. “Joint Base Control Center Concept Briefing,” 87th Air Base Wing, 16 April 2009 [POC, Lt Col 

David Searle (87th Mission Support Group/CONS)]. Joint bases at Charleston, SC, and McGuire-DixLakehurst, NJ, have also conducted tabletop exercises in concert with joint partners on their installation.
75 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

Force development relies on a continuum of learning that provides competency development across members’ careers. Integrating prevention and force protection concepts into this continuum represents a necessary step for securing the force against violence and internal threats. As such, providing training and education to all military, 

civilian, and contractor personnel on potential threats, across a spectrum of violence, 

can increase Total Force protection. The Air Force must collaborate with DoD on violence education and training policies, 

programs, and procedures. These programs will better equip Air Force members to identify possible indicators of 

violence, and as vigilant Wingmen, to 

mitigate associated risks and take appropriate actions. The majority of these 

issues and programs are appropriate 

for the Force Management Development Council (FMDC) to address.

Currently, most Air Force violence 

prevention training does not adequately 

prepare personnel to handle the full 

spectrum of violence. Violence-related 

training and education should capture 

all types of threats with specific emphasis on detecting, preventing, or minimizing injury from both internal and 

external threats. Failing to address all 

aspects of force protection can severely 

compromise the safety and well-being 

of Air Force members and ultimately 

jeopardize the mission.

Officer Development

Finding 51

(This refers to DoD report Finding/Recommendation 2.12.)

● Air Force training for commanders on protected health information (PHI) is not 

consistent.

The Air Force must 

collaborate with DoD on 

violence education and 

training policies, 

programs, and 

procedures.
AIR FORCE FOLLOW-ON REVIEW 76

Discussion

Health Insurance Portability and Accountability Act (HIPAA) guidelines prohibit disclosing PHI. In addition to HIPAA, health information is protected by numerous laws 

including the Privacy Act, Freedom of Information Act, Drug Abuse Offense and Treatment Act, and Comprehensive Alcohol Abuse amendments.1

 However, exceptions are 

permitted in accordance with DoD 6025.18-R, DoD Health Information Privacy Regulation, to allow unit leaders to access PHI when necessary for mission accomplishment. 

Commanders and civilian directors frequently cite improved health information sharing and relaxation of HIPAA as most needed to ensure the health and safety of their unit 

personnel.2

 Sixty-two percent of unit leaders surveyed perceived that HIPAA constrains 

information sharing on personnel concerns between Air Force leaders and care providers.3

HIPAA is a topic of discussion addressed by the Surgeon General during wing, group, 

and squadron precommand training courses; however, there is no standardized HIPAA 

curriculum across these courses. To ensure clarity and consistency in commander training, 

the Air Force Surgeon General should annually review, validate, and disseminate HIPAA 

training resources presented in these courses. 

New Air Force commanders receive the Air Force Judge Advocate General’s School 

(AFJAG) publication, The Military Commander and the Law. This publication discusses 

HIPAA along with permissible disclosures, minimum necessary standards, and commander access to information.4

 In addition, military treatment facility (MTF) leaders are 

required to meet with all new commanders and first sergeants to provide a TRICARE 

Commander’s Tool Kit including a section outlining HIPAA rules and identifies the privacy officer (PO) for the relevant MTF.5

 MTF POs are experts on PHI issues and are a 

valuable resource for commanders.6

 Therefore, to solidify commander understanding of 

PHI issues and to establish working relationships, POs should meet with all new commanders whom they support.

Recommendations

51.1 Annually review, validate, and disseminate HIPAA training resources to wing, 

group, and squadron commander courses. (OPR: AF/SG)

51.2 Revise AFI 41-210, Patient Administration Functions, paragraph 1.4.2.2, HIPAA 

Privacy Officer Responsibilities, Education, Training, and Communication, to 

provide commanders initial patient privacy orientation within 90 days of their assignment. (OPR: AF/SG)
77 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

Finding 52

● Separate accession programs for line officers and direct commission officers (e.g., 

medical, chaplain, and legal) may create an unintended gap in leadership, officership, and military professionalism.

Discussion

AFI 36-2013, Officer Training School (OTS) and Enlisted Commissioning Program 

(ECPS), establishes two separate programs within OTS: Basic Officer Training (BOT) 

and Commissioned Officer Training (COT). Of the officers trained at OTS, 38 percent 

are trained via BOT while 62 percent are trained via COT.7

To ensure a common foundation for all officers, AFI 36-2014, Commissioning Education Program, establishes a standard list of core competencies taught at all commissioning 

venues, including COT. 8 Although the standards are common and annual reviews aim to 

ensure equivalency, course length for direct commission officers is significantly shorter 

than for all other officers. The four-and-a-half week COT course differs from the 12-week 

BOT course in the depth of instruction available to officers and opportunities for students 

to demonstrate professional competence as part of the course.9

Given these significant differences in initial training, COT and BOT officer candidates 

do not begin their Air Force careers with a common training experience or similar depth 

of military professional and Air Force–specific knowledge. This initial training difference 

may contribute to leadership perceptions of inequity or inadequate preparation of direct 

commission officers to be military professionals within the Air Force officer corps.

The Air Force should review BOT and COT curricula to ensure the programs provide 

required leadership, officership, and military professionalism competencies. This review 

should assess the potential for combining COT and BOT courses, as well as whether certain aspects of direct commission officer training could be more effectively conducted in 

phases over time or via distance learning. The goal is to ensure that all Air Force officers 

are afforded the same officership and leadership training upon entering the Air Force.

Recommendation

52.1 Assess the requirements for, and implications of, conducting separate officer training courses within OTS to ensure common military professionalism competencies 

among competitive categories. (OPR: AF/A1)
AIR FORCE FOLLOW-ON REVIEW 78

Finding 53

● Inconsistent support of Air Force personnel in nontraditional developmental positions (e.g., advanced academic degrees [AAD], foreign professional military education [PME], education with industry [EWI], etc.) may create vulnerabilities in accountability and support.

Discussion

Nearly 1,000 Air Force members attend various nontraditional programs (greater than 

six months) throughout the world. Participants include active duty Airmen involved in 

endeavors such as AADs at civilian institutions, foreign PME, EWI, foreign exchange fellowships, and medical education programs.10 The majority of these Air Force members are 

assigned to programs under the purview of Air University (AU) (for Air Force Fellows) 

and the Air Force Institute of Technology’s Civilian Institution (AFIT CI) Program.

AFI 36-2639, Education with Industry Program; AU Instruction (AUI) 36-2213, Support of Air University Education Program Personnel Attending Civilian Institutions by Air 

Force Reserve Officer Training Corps (AFROTC) Detachments; and AFIT Instruction 

(AFITI) 36-105, Civilian Institution Programs, address management and oversight responsibilities for program participants.

AFIT assigns liaison officers (LO) to serve as campus representative for the AFIT commandant at each civilian school where two or more students are enrolled. LOs maintain 

contact with assigned students and communicate with them weekly to ensure personal 

issues affecting their military or academic performance are dealt with appropriately.11

Individuals who attend programs in foreign countries fall into two categories: the Military Personnel Exchange Program (MPEP) and foreign PME. AFI 16-107, Military Personnel Exchange Program, directly assigns day-to-day management of MPEP-assigned personnel to the Air Force International Airmen Division (SAF/IAPA) and regional air 

component commands through regional program management offices.12 The sponsoring 

host-nation military supervisor and the servicing personnel function at the nearest US 

installation provide continuous support to MPEP personnel and their families.13

AFI 16-107 does not apply to members enrolled in foreign education/PME.14 Current 

guidance establishes oversight roles and responsibilities only at the programmatic level but 

falls short when it comes to day-to-day management of individuals in these programs. 

This lack of leadership oversight and personnel accountability can isolate PME personnel 

and may make them susceptible to negative influences.
79 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

Recommendation

53.1 Revise AFI 16-109, International Affairs Specialist (IAS) Program, to include specific command oversight duties within SAF/IA and AU for members attending 

academic or PME programs in foreign countries. (OPR: SAF/IA)

Chaplain Development

Finding 54

(This refers to DoD report Finding/Recommendation 4.10.)

● Advanced and refresher Chaplain Corps training does not adequately address mass 

casualty and workplace violence response. 

Discussion

Air Force chaplains now receive mass casualty training at their basic course and more 

detailed mass casualty training upon arrival at their first duty station.15 The DoD report

identified the Army’s Chaplain 

Basic Officer Leadership Course’s 

(CBOLC) comprehensive training for religious support as a possible best practice for other Services to consider.16

Based on this recommendation, 

the Air Force Chaplain Corps 

College (AFCCC) incorporated 

this training into the Basic Chaplain Course (BCC) curriculum effective 10 April 2010.17 This revised training will comply with 

new DoD policy guidance.18

The Air Force Chaplain Corps Education Oversight Board, which provides curriculumoriented recommendations, will recommend updates to advanced chaplain and chaplain 

assistant training programs, building on curriculum revisions incorporated in the BCC. 

Upon approval by the Chief of Chaplains, the AFCCC will develop relevant instructional 

materials and programs.19
AIR FORCE FOLLOW-ON REVIEW 80

Recommendation

54.1 Revise advanced chaplain and chaplain assistant training and refresher courses to 

include mass casualty and workplace violence response familiarization training. 

(OPR: AF/HC)

Finding 55

(This refers to DoD report Finding/Recommendation 4.10.)

● AFI 52-104, Chaplain Service Readiness, does not address the need for chaplains to 

provide spiritual support in response to workplace violence.

Discussion

AFI 52-104 includes procedural checklists and required training for chaplains to provide spiritual support for deployed operations, humanitarian support, and response to 

natural disasters and national emergencies, but does not address workplace violence.20

Updating the AFI to include mass casualty response resulting from workplace violence 

will align policy with the recently revised curriculum at the AFCCC and will improve the 

corps’ ability to respond to all types of traumatic events.21

Recommendation

55.1 Revise AFI 52-104 to address training and provide guidance on the requirement 

for chaplains to provide spiritual support in response to incidents involving workplace violence. (OPR: AF/HC)

Finding 56

(This refers to DoD report Finding/Recommendation 4.10.)

● The Civil Air Patrol (CAP) Chaplain Corps Region Staff College does not include 

training on mass casualty response.

Discussion

Responding to emergencies is a critical aspect of the CAP Chaplain Corps mission. CAP 

provides chaplain support, when available, in response to emergencies such as disasters, aircraft accidents, or acts of terrorism involving the CAP, the Air Force, or local communities.22
81 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

CAP Regulation 50-17, CAP Senior Member Professional Development Program, establishes a formal, in-residence training program at the Chaplain Corps Region Staff 

College.23 This program covers the main CAP mission areas and includes critical incident stress management and disaster response; however, it does not include training 

on mass casualty response. The DoD report highlighted the value of having welltrained chaplains who responded during the Fort Hood incident.24 Without mass 

casualty training, CAP chaplains may not be as effective in meeting emergencyresponse mission requirements.

Recommendation

56.1 Air Force Chief of Chaplains and the CAP should review and update Chaplain 

Corps Region Staff College training to ensure CAP chaplains are prepared to respond to the full range of emergencies, to include mass casualties. (OPR: AF/HC)

Finding 57

(This refers to DoD report Finding/Recommendation 4.10.)

● Contract clergy may not be prepared or permitted to provide 

spiritual support in the aftermath 

of mass casualty incidents.

Discussion

AFI 52-105, volume 4, Chaplain 

Service Contracts, provides for contracted clergy to meet religious needs 

within the Air Force community, and 

AFI 52-104, Chaplain Service Readiness, requires installations to maintain 

liaisons with civilian clergy in the community to prepare for emergencyresponse scenarios.25

The Air Force contracts with civilian 

clergy to meet specific faith group requirements (e.g., lead worship services, 

Installations may rely 

on contracted clergy in 

circumstances when Air 

Force chaplains and 

civilian clergy are 

unavailable ...
AIR FORCE FOLLOW-ON REVIEW 82

hear confessions), but the contract statement of work does not require the full range of 

military chaplain duties such as general counseling or Airman visitations.26 Specifically, 

contract clergy are not required to respond to mass casualty incidents despite requirements specified in AFI 52-104.27

Installations may rely on contracted clergy in circumstances when Air Force chaplains and civilian clergy are unavailable to respond adequately to mass casualty incidents. Workplace violence is also not identified as a contingency response scenario in 

AFI 52-104.28 Finally, there is no apparent requirement for contract clergy training, 

to include training concerning workplace violence and mass casualty incidents.

Air Force installations depending on contract clergy for spiritual support require 

clergy with comprehensive capabilities; lack of workplace violence training for contracted clergy presents a potential gap in pastoral care for Air Force communities in 

times of crisis.

Recommendation

57.1 Evaluate training requirements and appropriately resource contracted clergy to 

provide support during mass casualty incidents on military installations. 

(OPR: AF/HC)

Care Provider Development

Finding 58

(This refers to DoD report Finding/Recommendation 5.2.)

● The Air Force has no policies, programs, or procedures specific to health care provider resiliency.

Discussion 

The Air Force has policies and programs addressing generic issues of readiness and resiliency, including the Airman Resiliency Program (ARP) established in 2010.29 The intent 

of the ARP is to provide tailored support based on risk of developing post-traumatic stress 

symptoms, depression, anxiety, suicide, or other adverse conditions.30 However, certain 

care provider specialties (e.g., chaplains, trauma center professionals, mental health specialists, mortuary affairs personnel) may require additional resiliency support to cope with 

stressful or traumatic events.31 As noted in the DoD report, current readiness and resil-
83 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

iency programs do not provide adequate support to care providers needing to recover 

from occupational stress.32

The Air Force’s Warrior Resiliency Program Senior Review Group is reviewing resiliency issues within the Air Force.33 The group is evaluating readiness issues specific to care 

providers (e.g., compassion fatigue, secondary trauma) to determine how to integrate 

these issues into a tiered ARP.34 Under the ARP, risk for stress is categorized into three tiers 

based on severity of risk. Ultimately, appropriate tier placement for care providers should 

adequately address the need for additional policies, programs, or procedures specific to 

care provider resiliency. 

The Army, Navy, and various civilian organizations are likewise addressing the issue of 

provider resiliency.35 Awareness of their work should continue to contribute to developing 

successful Air Force resiliency training, program development, and delivery.

Recommendation

58.1 Incorporate provider-specific resiliency care in the ARP. (OPR: AF/A1)

Finding 59

(This refers to DoD report Finding/Recommendation 5.2.)

● There are no current mechanisms for the Air Force to collaborate with civilian resources on resiliency matters.

Discussion

Because no data or outcome trials exist for resiliency in military settings, the Air Force 

may benefit from forming partnerships with civilian entities to develop ARPs and procedures. Research groups such as the Defense Centers of Excellence for Psychological Health 

and Traumatic Brain Injury specializing in post-traumatic stress disorder have gained great 

synergy by combining military and civilian resources.36

Recommendation

59.1 Develop a process to collaborate with civilian entities in addressing resiliency issues. (OPR: AF/SG)
AIR FORCE FOLLOW-ON REVIEW 84

Finding 60

(This refers to DoD report Finding/Recommendation 5.2.)

● Resiliency and self-care education and training have not been integrated into DoD 

and Air Force military medical education and training materials.

Discussion

The Air Force Surgeon General (AF/SG) has a representative on each of the four Uniformed Services University of the Health Sciences curriculum committees charged with 

developing and integrating health care provider skills and readiness concepts into applicable training.

As previously discussed, the Warrior Resiliency Program Senior Review Group is actively reviewing resiliency issues within the Air Force and integrating them into existing 

training and education programs (e.g., suicide awareness) across all education and training venues. Further, the group has begun identifying and addressing the needs of caregiving specialties such as chaplains, mortuary affairs, and medical technicians.37

Each of these career fields is addressed within the tiered system of resiliency care. As the 

ARP develops, providing resiliency and self-care matters early in accession training, as well 

as throughout specialty training (e.g., primary care manager training) and continuing 

education (e.g., Aerospace Medicine Primary Course), will help identify and provide coping tools beneficial to these professional caregivers.38

Recommendation

60.1 Coordinate with Assistant Secretary of Defense for Health Affairs to incorporate 

resiliency and readiness self-care skills into initial and follow-on training and education programs for military health care providers. (OPR: SAF/MR)

Force Protection Training and Education

Finding 61

(This refers to DoD report Finding/Recommendation 2.1 and 2.2.)

● Air Force policies and procedures addressing indicators of potential violence are 

consistent with DoD policy but do not adequately address workplace violence, 

radicalization, and internal threat education and training.
85 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

Discussion

Leadership training on different forms of violence varies in frequency and availability, 

as does the effectiveness of that training. In our survey of commanders and civilian directors, 98 percent indicated they had received Air Force training to prevent suicide and 

sexual assault in the past year. Annual training on these two topics is mandatory for the 

entire Air Force population. Training to prevent other types of violence is not mandatory 

and is less common.

Our survey revealed variations in prevention training. At least 60 percent received training in the past year on internal security threats, family violence, and domestic terrorism. 

Less common is training on hostage-taking, physical fights or assault, shooting sprees or 

mass killings, or homicide. Less than half received training on preventing other abusive 

behaviors that may be linked 

to self-harm or workplace 

violence, such as verbal 

abuse (43 percent) and bullying (23 percent). Current 

research on bullying distinguishes this form of aggression from other negative 

workplace behaviors, particularly in terms of intensity, 

frequency, and duration of 

numerous negative acts, 

which may include harassment but extend beyond it.39

We also surveyed unit leaders on whether they had received Air Force–sponsored 

training in the past year to respond to those same forms of violence. The frequency rates 

for receiving this training were similar to those for prevention training, although training on the response to violence was less common on several items than it was for training on prevention.40 Instruction on how to respond to violence, however, appears to be 

more effective than training guidance on prevention: more than 70 percent of Air Force 

leaders reported that their training provided the skills and tools they needed to respond 

to various forms of violence, with that figure surpassing 90 percent for suicide and 

sexual assault response training.41

The Air Force introduced DoD workplace violence prevention training in 1999 through 

AFI 44-154, Suicide and Violence Prevention Education and Training, which provides guid-
AIR FORCE FOLLOW-ON REVIEW 86

ance for violence awareness training to include common motivations, scenarios, and risk 

factors for violence; targets of and precipitants to violence; and post-incident support. 42

AFI 44-154 further supports force development training and education goals by defining 

annual violence prevention education and training requirements for AU PME courses, 

commander courses, and community education programs.43

In 2008, however, AFI 44-154 requirements for workplace violence awareness training 

were rescinded to streamline ancillary training.44 As a result, accession, military and civilian supervisor, commander, and AU PME courses no longer address workplace violence, 

although related issues are referenced in leadership lessons associated with the Air Force 

Institutional Competencies List (ICL).45

Recommendation

61.1 Reinstitute workplace violence prevention education and training as outlined in 

AFI 44-154, Suicide and Violence Prevention Education and Training, across the 

career-long continuum of learning. (OPR: AF/SG)

Finding 62

(This refers to DoD report Finding/Recommendation 2.1 and 2.2.)

● Current antiterrorism level 1 (AT-1) training does not include information on 

identifying and responding to internal threats or radicalization.

Discussion

AFI 10-245, Antiterrorism (AT), implements DoD Directive (DoDD) 2000.12, DoD 

Antiterrorism (AT) Program, and DoD Instruction (DoDI) 2000.16, DoD Antiterrorism 

(AT) Standards.

46 It establishes responsibilities and guidance for the Air Force AT program 

and integrates security precautions and defensive measures. The primary focus of AFI 

10-245 is on external threats such as terrorism and those associated with chemical, biological, radiological, nuclear, and high-yield explosives.47

DoDI 2000.16 specifies requirements for AT training and is supplemented by requirements in AFI 10-245 that all military and civilian personnel, as well as local, national, or 

direct-hire third-country citizens, must complete regardless of grade or position.48 Given 

that these policies focus on external threats, AT Level 1 training does not address how to 

identify or respond to internal threats or radicalization.

The success of current force protection may be impacted by the effectiveness of formal 

training to detect and respond to potential internal threats. In our survey of commanders 
87 AIR FORCE FOLLOW-ON REVIEW

Chapter 4  Developing the Force

and directors, nearly 80 percent of respondents reported consulting Air Force policies and 

guidance to educate themselves on how to assess indicators of potential violence by a 

member of their unit. Nearly 70 percent report using Commander’s Course guides or 

information, over 65 percent consult Air Force training materials, and 55 percent refer to 

Air Force or DoD Web sites to obtain risk assessment information.49 These findings suggest a revision of AFI 10-245 by the Director of Air Force Security Forces may prove 

beneficial to addressing internal threat identification and response. Further, table 2.2, 

“Minimum AT Awareness Training Requirements,” should be updated to include “indicators and response to internal threats.” These updates should be incorporated into current 

AT training and education programs.

Recommendation

62.1 Revise AFI 10-245 to integrate response procedures for defending the Total Force against 

internal threats (e.g., active shooter) into existing training across the continuum of 

learning. (OPR: AF/A4/7)

Notes

1. AFI 41-210, Patient Administration Functions, 22 March 2006, 13, http://www.af.mil/shared/media/

epubs/AFI41-210.pdf.

2. Air Force Manpower Agency (AFMA), “Follow On Review: Issues from Ft. Hood Survey,” data collection period 22 February–8 March 2010, appendix C.

3. Brig Gen Sharon K. G. Dunbar, USAF, “AF Follow On Review (FOR): Lessons from Fort Hood” 

(presentation, 9 April 2010), 47.

4. AFJAGS, The Military Commander and the Law (Maxwell AFB, AL: AFJAGS Press, 2009), 272–75, 

http://milcom.jag.af.mil/Military_CC_and_Law_2009.pdf.

5. Maj Pell, HQ USAF/SGMA, “Operation Command Champion (OCC), 2001 Campaign,” talking 

paper, 28 June 2001; Lt Gen Paul K. Carlton, Surgeon General, memorandum, subject: Operation Command Champion (OCC), 2001 Campaign; and Lt Gen Charles B. Green, Surgeon General, to ALMAJCOM/SG, memorandum, subject: Operation Command Champion, 25 October 2009. Operation Command Champion supports DoDI 6000.14, Patient Bill of Rights and Responsibilities in the Military Health 

System (MHS), 5 September, 2007.

6. AFI 41-210, Patient Administration Functions, 8.

7. BOT is a 12-week program open to all civilian applicants including Air Force Reserve, Guard, sister 

Service members, and active duty Airmen pursuing the opportunity to become an Air Force commissioned officer. COT is a four-and-a-half-week program that provides initial officership training and leadership developmental education to direct commissioned officers serving in the profession-oriented JAG 

Corps, Chaplain Service, Nurse Corps, Medical Corps, and Dental Corps. AFI 36-2013, Officer Training 

School (OTS) and Enlisted Commissioning Programs (ECPS), 23 October 2008, 65, 85. Dr. Donald Giglio 

(Holm Center Commander’s Action Group) e-mail to Ms. Ladonna McGrew, 12 April 2010.

8. AFI 36-2014, Commissioning Education Program, 22 April 2008, 8–16.
AIR FORCE FOLLOW-ON REVIEW 88

9. Most direct commission officers do not attend in-residence officer developmental education courses 

(e.g., Squadron Officer College and intermediate developmental education). Therefore, for the majority of 

non-line, direct commission officers, COT is the only formal officer training and education they receive 

during their Air Force careers. Capt Je Raley, Holms Center, AETC/CRDL, “Differences between Basic 

Officer Training (BOT) and Commissioned Officer Training (COT) Curriculum,” talking paper, 18 

March 2010.

10. AFITI 36-105, Civilian Instruction Programs, 28 April 2006, 1–2.

11. Ibid., 15.

12. AFI 16-107, Military Personnel Exchange Program (MPEP), 2 February 2006, 7–8.

13. Ibid., 9–27.

14. Ibid., 1.

15. Maj Michael S. Rash, USAF, Chief, Education Division, USAF Chaplain Corps College, to Col 

Jerry Pitts, AF/HCX, e-mail, 26 March 2010.

16. Protecting the Force, 45.

17. On 10 April 2010, the Army chaplain course Religious Support during Mass Casualty Operations 

to Wounded and Dying Soldiers was adapted into the AF Chaplain Corps College’s BCC. This material 

will form the foundation for revisions to the advanced chaplain and chaplain assistant training and refresher courses to address mass casualty and workplace violence response. Rash to Pitts, e-mail.

18. Robert Gates, Secretary of Defense, “Interim Recommendations of the Fort Hood Follow-on Review,” 12 April 10. The interim guidance directs the Under Secretary of Defense for Personnel and Readiness to publish a policy by July 2010 directing that new chaplains get mass casualty incident training at 

the earliest point.

19. USAF Chaplain Corps Education Oversight Board Charter, 27 February 2009.

20. AFI 52-104, Chaplain Service Readiness, 19 August 2009, 45–49, 71–79.

21. Specifically, attachments 2 and 6 of the AFI must be updated to incorporate mass casualty response.

22. Civil Air Patrol Regulation (CAPR) 265-1, The Civil Air Patrol Chaplain Corps, 15 October 2009, 2.

23. CAPR 50-17, CAP Senior Member Professional Development Program, 22 September 2009, 25.

24. Protecting the Force, 44–46.

25. AFI 52-105, vol. 4, Chaplain Service Contracts, 10 April 2008, 4; and AFI 52-104, Chaplain Service 

Readiness, 16. 

26. AFI 52-105, vol. 4, Chaplain Service Contracts, 4. 

27. AFI 52-104, Chaplain Service Readiness, 16.

28. Ibid., 72–83.

29. AFI 10-403, Deployment Planning and Execution, 13 January 2008, 133–41; AFI 44-153, Traumatic Stress Response, 13 March 2006, 4; Col John Forbes, USAF, “Airmen Resiliency Training” (presentation, 22 February 2010); and Lt Gen Bruce Green, USAF, “Tiered, Targeted and Tracked Interventions” 

(presentation, 22 February 2010).

30. Green, “Tiered, Targeted and Tracked Interventions.” 

31. Sharon Rae Jenkins and Stephanie Baird, “Secondary Traumatic Stress and Vicarious Trauma: A 

Validation Study,” Journal of Traumatic Stress 15, no. 5 (October 2002): 423–32; and Amy R. Hesse, “Secondary Trauma: How Working with Trauma Survivors Affects Therapists,” Clinical Social Work Journal 30, 

no. 3 (September 2002): 293–309.

32. Protecting the Force, 51–53.

33. Lt Col Charles Motsinger (Deputy Chief Medical Information Officer, Workflow Integration and 

Business Process Reengineering Division, Air Force Medical Support Agency [AFMSA]/SG6), interview 

with Lt Col William Isler (Chief, Deployment Mental Health, Air Force Medical Operations Agency, 

AFMOA/SGHW), 25 February 2010.
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Chapter 4  Developing the Force

34. Ibid. Secondary trauma, also referred to as compassion fatigue, is the effect on therapists from 

working with traumatized persons. See Jenkins and Baird, “Secondary Traumatic Stress and Vicarious 

Trauma,” 423–32; and Hesse, “Secondary Trauma,” 293–309.

35. LTC Edward Brusher, Transitioning the Provider Resiliency Training (PRT) Program into the Care 

Provider Support Program (CPSP: Program Expansion and Revision) (Falls Church, VA: DASG-HSZ, 10 

December 2009); LTC Graeme Bicknell and LTC Edward Brusher, DASG-HCZ, “Professional Quality 

of Life (ProQOL) Scale Score Comparisons,” information paper, 23 November 2009; Bicknell and Brusher, 

DASG-HCZ, “MEDCOM Provider Resiliency Training (PRT) Program,” information paper, 1 December 2009; Bicknell and Brusher, DASG-HCZ, “Provider Resiliency Training (PRT) provision across Department of Defense,” information paper, 23 November 2009; and Motsinger and Isler, interview.

36. Examples include the “Strong Star” program in San Antonio and the “Home Base” program, a 

collaboration between the Boston Red Sox and Massachusetts General Hospital, working with the Armyfunded Center for Integration of Medicine and Innovative Technology (CIMIT). CIMIT, “Soldier Medicine: Addressing Soldier Care, Disaster Response and National Healthcare Needs,” http://www.cimit.org/

about-soldiermedicine.html. 

37. Col John Forbes, MD, Deputy Director, AFMSA, Crystal City, VA, talking paper, “AF Resiliency 

Program (AFRP),” 25 March 2010; Forbes, “Airman Resiliency Training” (presentation, 22 February 

2010); and Forbes, “Tiered, Targeted and Tracked Interventions” (presentation, 22 February 2010).

38. AF medical training venues include initial and new staff orientation programs conducted at each 

clinic as new providers and staff arrive, primary care manager training, intermediate executive skills 

courses, chief of medical staff (SGH) course, monthly professional staff meetings (conducted by the SGH 

and includes all privileged providers), mandatory monthly training (e.g., Personal Reliability Program 

training), Graduate Medical Education (medical residency training), Aerospace Medicine Primary Course, 

and continuing educational programs that involve AF health care providers. E-mail correspondence provided by Col Angela Thompson, USAF, AF/SG8X, 12 April 2010.

39. AFMA Survey, appendix C. See also for example, one evaluation of the research on workplace bullying operationalizes “bullying as occurring when an individual experiences at least two negative acts, weekly 

or more often, for six or more months in situations where targets find it difficult to defend against and stop 

abuse.” Pamela Lutgen-Sandvick, Sarah J. Tracy, and Jess K. Alberts, “Burned by Bullying in the American 

Workplace: Prevalence, Perception, Degree and Impact,” Journal of Management Studies 44, no. 6 (September 2007): 837–62.

40. AFMA Survey, appendix C.

41. Ibid.

42. AFI 44-154, Suicide and Violence Prevention Education and Training, 3 January 2003, 1, rescinded 

AFI 44-154, 1 July 1999, which introduced violence prevention.

43. Force development involves integrating education, training, and experience through integrated 

competencies—the career-long continuum of learning. See AFI 36-2640, Executing Total Force Development, 16 December 2008, 4; and AFI 44-154, Suicide and Violence Prevention, 4–5.

44. Maj Gen Thomas Loftus, assistant surgeon general, Office of the Surgeon General, AF/SG3, to 

ALMAJCOM/SG, memorandum, 8 April 2008.

45. The Institutional Competencies List identifies the basic, intermediate, proficient, skilled, and advanced levels of knowledge and corresponding officer, enlisted, and civilian grades associated with each 

proficiency level. It serves as the foundational document for the continuum of learning across all training 

venues.

46. AFI 10-245, Antiterrorism (AT), 30 March 2009, 1; DoDD 2000.12, DoD Antiterrorism (AT) 

Program, 13 December 2007; and DoDI 2000.16, DoD Antiterrorism (AT) Standards, 2 October 2006.

47. AFI 10-245, Antiterrorism (AT), 4–10.
AIR FORCE FOLLOW-ON REVIEW 90

48. DoDI 2000.16, DoD Antiterrorism (AT) Standards, standard 25, table E3.T2, 28–30; and AFI 

10-245, Antiterrorism (AT), table 2, 28.

49. Dunbar, “AF Follow On Review.”
91 AIR FORCE FOLLOW-ON REVIEW

Chapter 5  Leading the Force

Aggressive unit leadership is required to accelerate 

the Air Force drive to prevent violence while accomplishing assigned missions. The DoD report identified commanders as our “key assets to identify and 

monitor internal threats.”1

 Commanders and supervisors are responsible for enhancing force protection 

and maintaining situational awareness regarding the 

health, safety, and effectiveness of their personnel. 

With this in mind, we’ve identified initiatives that 

should improve unit leader abilities to support subordinates and prevent violence.

Sponsorship Programs

Finding 63

● Guidance regarding the Air Force Sponsor Program appears in two AFIs.

● The benefits of the Sponsor Program do not consistently reach all Air Force 

personnel.

Discussion

Moving to any new location is stressful for individuals and their families. Sources of 

stress include the ability to sell one’s house, find renters, and find a new home; they also 

include the need for a spouse to secure employment, for children to transition into new 

schools, and for individuals to adjust to their new work environment. Some of these activities can present financial difficulties and pose uncertainties. Children may face adjustment challenges, leading to behavioral and academic problems. New assignments may 

take Airmen and their families to unfamiliar or even foreign cultures that may be frustrating to understand. Moves may also disrupt many of the social networks individuals rely 

on for friendship and support. 

The Air Force’s Sponsor Program was designed to help lessen the stresses associated with 

these moves by assisting Air Force personnel and their families as they transition during a 

permanent change of station. This program is a component of the Air Force Individualized Newcomer Treatment and Orientation (INTRO) Program, governed by AFI 36-2103, 

Individualized Newcomer Treatment and Orientation Program. Additional requirements 
AIR FORCE FOLLOW-ON REVIEW 92

regarding sponsor training are currently found in AFI 36-3009, Airman and Family 

Readiness Centers. 

When notified of a new assignment, Airmen have an opportunity to request a sponsor 

to help ease the transition to the new location.2

 In 2009, 77.4 percent of Airmen who had 

a permanent change in duty assignment requested and were assigned a 

sponsor; 22.6 percent elected not to 

have a sponsor.3

 Sponsors are normally 

assigned to newcomers based on similar demographics (e.g., family, grade, 

unit) and help them adjust to their 

new unit and Air Force community by 

quickly establishing relationships with 

peers and superiors. These relationships and acceptance in a new environment build resiliency. 

Recommendations

63.1 Incorporate Sponsor Program guidance found in AFI 36-3009, Airman and Family Readiness Centers, into AFI 36-2103, Individualized Newcomer Treatment and 

Orientation Program, to consolidate Sponsor Program policy. Cross-reference consolidated policy appropriately. (OPR: AF/A1)

63.2 Require sponsors for all first-term Airmen and new officer accessions to support relocation to first duty stations, and update AFI 36-2103 accordingly. (OPR: AF/A1)

Finding 64

● The Air Force does not consistently track sponsor training, sponsor actions, or 

feedback from sponsored Airmen and their families.

Discussion

Airman and Family Readiness Center (A&FRC) staffs currently provide sponsor training. AFI 36-3009 states, “First-time sponsors and those who have not been trained as a 

sponsor during the past year must receive sponsorship training.”4

 A&FRC coordinates to 

make sponsor training available. Although the sponsor checklist found at table 1 in AFI 

36-2103 provides detailed recommendations for sponsor actions, training and feedback 
93 AIR FORCE FOLLOW-ON REVIEW

Chapter 5  Leading the Force

are not standardized.5 Consequently, commanders do not have adequate insight into the 

effectiveness of their unit’s Sponsor Program.

The OSD/Office of Communications, Military Community, and Family Policy (OSD/

MC&FP) initiated a program to develop a Web-based program called electronic sponsorship application and training (e-SAT) to provide standardized sponsorship training to all 

appointed unit sponsors.6

 A sponsor can use this program to create an online record for 

the newcomer to include a needs assessment, a customizable welcome letter, and a welcome package.7

 The entire process between sponsor and newcomer can be tracked online, 

establishing e-SAT as the first system to provide metrics on customer satisfaction with the 

quality of sponsor support.8

 Surveys generated 30 days after newcomer arrival will afford 

both the newcomer and the sponsor an opportunity to rate e-SAT and their experience 

with the sponsorship process.

Recommendations

64.1 Incorporate forthcoming DoD e-SAT into the Air Force Sponsor Program to standardize sponsor participation, training, and customer feedback available to commanders. (OPR: AF/A1)

64.2 Make feedback available to commanders from the forthcoming reports function of 

e-SAT to assist program effectiveness. (OPR: AF/A1)

Finding 65

● Air Force IG inspection checklists do not require comprehensive assessment of the 

Sponsor Program.

Discussion

At present, eight of 12 MAJCOMs inspect some aspect of the Sponsor Program even 

though it is not an Air Force–level inspection item listed in AFI 90-201, Inspector General 

Activities.

9

 Requiring sponsorship for first-term Airmen and officer accessions and implementing e-SAT will strengthen the Sponsor Program. We recommend including requirements covering sponsor training, newcomer assignment, and feedback tracking in MAJCOM 

IG inspection checklists.

Recommendation

65.1 Revise the SAF/IG inspection checklists to include Sponsor Program metrics. 

(OPR: SAF/IG)
AIR FORCE FOLLOW-ON REVIEW 94

Wingman Initiatives

Finding 66

● The Air Force Wingman Program does not provide unit leaders consistent and 

standardized content to conduct Wingman Day activities that address specific concerns to include force protection and resiliency. 

Discussion

In 2004 the Chief of Staff of the Air Force (CSAF) established the Wingman Program 

to encourage Airmen to look out for their teammates’ emotional, physical, social, and 

professional well-being. Wingman Day also serves as a vehicle for Airmen to get to know 

one another better and devise coping strategies for difficult times. Today our Chief of Staff 

uses this tool to engage by personally providing Airmen information, resources, and strategies to help them be more effective. 

Commanders have the latitude to tailor Wingman Day activities to address their units’ 

particular challenges, rather than being required to implement a standardized program 

designed by Air Force headquarters. However, guidance should be provided at all levels 

(e.g., PME, commanders’ courses) to ensure successful Wingman Day planning and to 

help embed the Wingman concept into Air Force culture 

more thoroughly.10 For example, unit leaders indicate they 

could benefit from access to 

MAJCOM statistics related to 

suicide, violent crimes, and 

other concerns.

Interactive training scenarios 

should emphasize realistic leadership situations to enhance 

communication skills. Adding 

awareness training on indicators of violence and radicalization to Wingman Day training 

templates will help Airmen identify at-risk individuals. A range of off-the-shelf training 

templates would also allow unit leaders to select standardized content to address the needs 

of their personnel. 
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Chapter 5  Leading the Force

A “Knowing Your Airmen” guide, modeled after the one developed by the Air Force 

Special Operations Command (AFSOC), would prompt leaders to ask about life stressors and circumstances.11 This would facilitate leader involvement and help resolve potentially volatile situations. The guide would also provide leaders with tools such as 

real-world scenarios, case studies, counseling approaches, and information about available resources (e.g., health and wellness programs, financial services, sexual assault response coordinators).

AFI 90-501, Community Action Information Board (CAIB) and Integrated Delivery System (IDS), provides the authority and criteria for establishing a cross-functional team to 

address individual, family, and community concerns. AFI 90-501 is currently being revised to incorporate the Wingman Day program. Examples of successful and unsuccessful 

practices should be shared with the CAIB/IDS and with leaders who organize Wingman 

Day so that future events benefit from lessons learned.12

Recommendations

66.1 Communicate the importance and value of the Wingman concept and development of Wingman Day through focused messages from senior Air Force leaders to 

all AF members (e.g., recommended strategic messages, themes, activities, and 

training templates that address a wide range of behaviors related to violence risk). 

(OPR: AF/A1)

66.2 Provide unit leaders statistics and background information that MAJCOMs can 

tailor for installation-level Wingman Days. (OPR: AF/A1)

66.3 Include strategies for executing Wingman Day events in appropriate PME, commanders’ courses, and other training venues. (OPR: AF/A1)

66.4 Publish a “Knowing Your Airmen” guide for leaders’ use on Wingman Day. (OPR: 

AF/A1)

Feedback Discussions

Finding 67

● The current Air Force Performance Feedback Program incorporates guidance for 

personal interviews and written feedback; however, commanders and supervisors 

do not have consistent methods for meeting program objectives.
AIR FORCE FOLLOW-ON REVIEW 96

Discussion

The current Air Force Performance Feedback Program, as described in AFI 36-2406, 

Officer and Enlisted Evaluation System, facilitates interaction between commanders 

and Airmen with respect to performance of assigned duties. The underlying philosophy of the process relies on establishing goals and setting standards to provide individual members with a confidential, qualitative framework within which to measure 

progress and performance.

Although effective when implemented correctly, the Performance Feedback Program is 

often not fully utilized as a leadership tool. It is beneficial not only to professional success 

but also to the early identification of stressors. Surveyed leaders also indicated that high 

operations tempo and mission requirements restrict the time they can devote to conducting feedback, thus degrading program effectiveness.13

An Air Force Guidance Memorandum (AFGM) to AFI 36-2406 is in development to 

support increased automation and accountability in the Performance Feedback Program. 

The AFGM recommends automating the feedback process. A system such as Virtual MPF 

could provide automatic notification to the rater that feedback is due, with follow-up 

notifications if it is not performed on time. Increased visibility at various steps in the process can provide greater accountability for the feedback process as a whole. We recommend modifying the current program to accommodate input from the ratee prior to 

scheduled feedback sessions. 

Recommendation

67.1 Revise AFI 36-2406, Officer and Enlisted Evaluation System, via an AFGM, to incorporate greater accountability and automation into the feedback process. (OPR: 

AF/A1)

Finding 68

● The formal feedback processes can be improved to facilitate greater interaction between rater and ratee during initial and follow-on feedback sessions.

Discussion

AFI 36-2406 prescribes the military feedback process, which is designed to facilitate “private, formal communication” for supervisors to discuss pertinent issues (e.g., work performance, professionalism, professional goals) with their subordinates at regular intervals. 
97 AIR FORCE FOLLOW-ON REVIEW

Chapter 5  Leading the Force

Feedback tools should also be used to increase interaction between Air Force members 

at all levels. As an example, the Marine Corps’ Honor, Courage, and Commitment assessment includes the following:

● The critical role of the ratee supporting unit and higher command missions.

● Individual unit readiness index, including assessment of ratee’s deployment and 

medical requirements.

● Supervisor-conducted performance feedback.

● Ratee’s assessment of their performance and opportunities to discuss their personal 

and professional goals.

Recommendation

68.1 Form an integrated process team to evaluate and refine officer, enlisted, and civilian feedback tools and processes. (OPR: AF/A1)

Health-Related Feedback

Finding 69

● Air Force policy does not specify that Physical Evaluation Board liaison officers 

(PEBLO) update commanders and first sergeants on Medical Evaluation Board 

(MEB) and Physical Evaluation Board (PEB) results affecting Airmen in their units.

Discussion

AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, consolidates 

guidance for the complex, lengthy, and often stressful MEB and PEB processes.14 Although the 

instruction contains a section on “control of member during PEB processing,” it lacks guidance on how and when PEBLOs should notify impacted Airmen and their commanders and 

first sergeants (e.g., in person, by e-mail, by phone call, in writing via mail or distribution—

during the duty day, not on a Friday). The 61-page PEBLO Guide also lacks guidance on the 

importance of communicating information to Airmen as well as their unit leaders.15 A gap exists in both policy and practice: at present, Airmen may be notified of MEB results––potentially life-changing events––without commander, first sergeant, or supervisor awareness.

Coping with the potential loss of a military career can challenge an Airman’s resiliency 

and may lead to behavior that puts the Airman or others at risk. At the conclusion of an 
AIR FORCE FOLLOW-ON REVIEW 98

MEB or a PEB, PEBLOs should notify commanders and first sergeants as soon as reasonably possible so they can ensure adequate support for affected Airmen. Likewise, Airmen 

should have time to arrange for a supervisor, first sergeant, or commander to participate 

in the medical board discussion to provide Wingman and unit support as 

needed. PEBLOs are enablers of this 

unit-leadership support. Revised guidance should thus ensure that adverse information is not passed to an Airman at 

the end of the duty day or end of a work 

week, as squadron support may be less 

available compared to the time when 

notifications occur during normal duty 

hours within a regular work week. Timing should also afford Airmen the opportunity to immediately ask the PEBLO 

important follow-up questions. 

PEBLOs must therefore be well 

trained and must coordinate information among the primary medical care 

provider, local MEB, Airman and his/

her commander and first sergeant, 

public health flight, PEB, and force 

support squadron. Modifying AFI 36-

3212 will clarify important pre- and 

post-notification procedures for 

health care providers, unit leadership, 

and Airmen.

Recommendations

69.1 Modify AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, 

to include PEBLO duties to relay MEB/PEB processes and timely updates to affected Airmen and their commanders and first sergeants. (OPR: AF/SG)

69.2 Revise the Disability Counseling Guide for Physical Evaluation Board Liaison Officers 

(PEBLO) to incorporate material from the updated AFIs. (OPR: AF/SG)

Coping with the 

potential loss of a 

military career can 

challenge an Airman’s 

resiliency and may lead 

to behavior that puts the 

Airman or others at risk.
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Chapter 5  Leading the Force

Health Care Leadership

Finding 70

(This refers to DoD report Finding/Recommendation 5.3.)

● Sustaining high-quality health care requires balancing operational demands, compensation, and quality of life for the number of Air Force health care professionals 

available.

Discussion

Compassion and caregiver fatigue attracted significant attention in the DoD report.16

Today’s elevated operations tempo often magnifies stress associated with these phenomena.17 Similar stressors are also experienced by medical professionals in garrison, who often maintain the same level of patient care. Fully implementing the Family Health Initiative/Medical Home concept and addressing some of the critical shortfalls that exist in 

many Air Force Medical Service (AFMS) career fields may mitigate some of these issues.18

Recommendation

70.1 Review AFMS force management, and consider changes to compensation, qualityof-life factors, operations tempo, and deployment issues to sustain high-quality 

health care. (OPR: AF/SG)

Finding 71

(This refers to DoD report Finding/Recommendation 5.3.)

● Air Force health care providers are afforded the same post-deployment programs 

and opportunity for post-deployment recovery time as combat and combat support 

personnel. 

Discussion 

The DoD report highlighted as potentially detrimental to caregiver readiness the Army 

policy of requiring caregivers assigned to Brigade Combat Teams to remain in their assigned teams for a minimum of 90 days after return from deployment. Air Force health 

care providers are currently afforded the same post-deployment programs and opportunities for recovery as all other Airmen, operational or support. 
AIR FORCE FOLLOW-ON REVIEW 100

Recommendation

71.1 None.

Finding 72

(This refers to DoD report Finding/Recommendation 5.3.)

● The DoD and Air Force do not address issues of stigma and confidentiality for 

members who seek treatment for stress or other mental health concerns. 

Discussion

The Office of the Under Secretary of Defense for Personnel and Readiness (OUSD[P&R]) 

has announced plans to convert DTM 09-006, Revising Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Military Personnel, into a 

DoD instruction (DoDI) addressing stigma concerns among Service members who seek 

mental health treatment.19 The new instruction will clarify information communicated 

to commanders when a member seeks mental health care.20 AFI 44-109, Mental Health, 

Confidentiality and Military Law, addresses issues referenced in the DTM at the Air 

Force level.21

DTM 09-006 and AFI 44-109 do not address treatment sought by health care providers. Clarifying and communicating proper uses of mental health treatment information 

should reduce perceived stigmas associated with treatment. This could encourage Airmen, 

including mental health care providers, to seek mental health care, when needed, by reducing their concerns over possible personal and career impacts.

Clarifying and consolidating policy related to all aspects of mental health care, including treatment, can reduce overall concerns (and associated stigmas) by reducing inconsistencies in how commanders interpret and apply policy. The Air Force is in the process of 

centralizing policy with respect to mental health issues through a comprehensive mental 

health AFI, which will incorporate guidance on mental health issues currently found 

throughout multiple AFIs, policy letters, and memoranda. It will also implement Air 

Force Policy Directive (AFPD) 44-1, Medical Operations, and establish guidance for Air 

Force mental health services.22

Publishing a comprehensive mental health AFI, including guidance on reducing stigmas for health care providers who seek treatment, will benefit the Air Force health care 

community.
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Chapter 5  Leading the Force

Recommendations

72.1 Coordinate with OUSD(P&R) to integrate existing policies and provide appropriate guidance to sustain high-quality care, as well as publish an anti-stigma DoDI 

based on DTM 09-006. (OPR: AF/SG) 

72.2 Address health-care-specific stigma concerns as part of the ongoing biennial review 

process for AFI 44-109, Mental Health, Confidentiality and Military Law. (OPR: 

AF/SG) 

72.3 Consolidate Air Force mental health guidance into a 40-series AFI. (OPR: AF/SG)

Finding 73

(This refers to DoD report Finding/Recommendation 5.4.)

● Air Force policy does not consistently allow senior (O-6) physicians to remain 

clinically active and regularly available to serve as clinical peers and mentors to junior caregivers.

Discussion

Senior clinicians typically serve in command and administrative roles, removing them 

from regular patient care.23 This often leaves junior clinicians without the benefit of mentoring from more seasoned clinicians.24 In 2008, the AFMS launched a pilot initiative—

the Senior Clinician Billet Program—that returns O-6 physicians to full-time practice, 

enabling them to serve as mentors during clinical practice.25

AFMS officers are encouraged to sustain clinical activity across the duration of their 

careers.26 Officers are expected to step into career-enhancing leadership positions (e.g., 

command, departmental chair, chief of the medical staff), as annotated in the Medical 

Corps Officer Career Path.27 Placing senior physicians in clinical mentoring roles maintains high-quality health care and preserves the breadth of experience and expertise within 

the AFMS. 

Recommendation

73.1 Augment chiefs of medical staff by continuing the current Senior Clinician Billet 

Program pilot project, and evaluate the program within six months of implementing the 2010 O-6 assignment plan. (OPR: AF/SG)
AIR FORCE FOLLOW-ON REVIEW 102

Total Force Leadership

Finding 74

● Air Force leaders lack knowledge about how best to manage Total Force personnel 

who might pose a threat to themselves or others. 

Discussion

Air Force operations increasingly require unit leaders to serve with Total Force personnel: active duty, reserves, National Guard, DoD civilians, contractors, dependents, as well 

as personnel from other Services. Our survey of commanders and civilian directors asked 

whether they were aware of their authority to address various types of personnel who may 

pose credible threats to themselves or others. Results indicate gaps in understanding that 

may impair leaders’ ability to ensure a safe working environment. Closing this gap should 

present a stronger, more resilient Total Force.

All active duty commanders surveyed indicated they are aware of their authorities for 

active duty personnel, while only 79 percent report awareness of their authorities with 

DoD civilians. Further, and surprisingly, active duty commanders are more familiar with 

their authorities with regard to dependents (74 percent) than they are with reserve personnel (65 percent). In fact, these commanders indicated the same knowledge in addressing 

reserve personnel as they did other Service personnel (also 65 percent). Active duty commanders reported being least familiar with their authorities with respect to DoD contractors (60 percent) and ANG members (58 percent). 

Civilian directors also conveyed levels of disparity in their awareness of Total Force personnel. Although 93 percent are aware of their authorities for potentially dangerous DoD 

civilians, 83 percent reported the same awareness for active duty personnel and 75 percent 

for contractors. Only 45 percent indicated familiarity with authorities to address dependents or Reservists, compared to 42 percent for other Service personnel. Similar to active 

duty commanders, civilian directors are least familiar with their authority for Air National 

Guard members (34 percent). Responses from ANG and AFRC commanders reflected 

patterns similar to active duty and civilian leaders.28

Uncertainty regarding authorities may lead to hesitant, ineffective, or diminished responses. Unit leaders appeared most likely to understand, document, and refer or report 

personnel within their affiliation.29 Gaps in understanding may be rooted in training; only 

40 percent believe their commander training sufficiently addressed sharing information 

on civilian employees, dependents, and contractors.30 Knowledge gaps on authorities, 

procedures, and information sharing for Total Force personnel may lead to inaction or 
103 AIR FORCE FOLLOW-ON REVIEW

Chapter 5  Leading the Force

slow response even when leaders are concerned about individuals. When asked why they 

might be hesitant to report personnel concerns to official agencies or individuals, “unclear 

guidance” and “unclear lane of authority” were among the most common reasons indicated by roughly one-third of respondents. 

As the Air Force continues to integrate Total Force operations and operate in joint environments, training and education must provide leaders with greater awareness of how to 

address all members of the force. 

Recommendations

74.1 Revise applicable professional military education and professional continuing education programs to include learning outcomes focused on authorities, procedures, 

and programs that support Total Force teaming and leadership. (OPR: AF/A1)

74.2 Revise reference materials for officer, enlisted, and civilian members to clarify authorities, procedures, and programs that support Total Force teaming and leadership. (OPR: AF/A1)

Notes

1. Protecting the Force, 3.

2. The Checklist for Sponsor Guidance says the sponsor’s role is to provide information and assistance 

and to help the newcomer’s move be as smooth as possible. AFI 36-2103, Individualized Newcomer Treatment and Orientation Program, 3 June 1994, 9.

3. Department of the Air Force, “Air Force Sponsorship Program,” Airman’s Roll Call, 23 July 2008. Of 

the 105,317 Airmen who changed duty locations in 2009, 97,173 were eligible for sponsorship. More 

Airmen request sponsors when assigned outside the continental United States due to a lack of understanding of lawful requirements, currency, culture, traffic, utilities, and so forth.

4. AFI 36-3009, Airman and Family Readiness Centers, 18 January 2008, 15.

5. AFI 36-2103, Individualized Newcomer Treatment and Orientation Program, 3–4.

6. According to the A&FRC policy chief, e-SAT will officially be announced in May 2010 at the Joint 

Services Agency Relocation Training Conference. DoD, “e-Sponsorship Application & Training,” https://

apps.mhf.dod.mil/esat.

7. Gretchen Shannon, Chief, Airman and Family Readiness Policy, AF/A1S, to Lt Col Janice Langer, 

Associate Director, Medical Corps, AF/SG, e-mail, 22 March 2010.

8. A forthcoming report feature will allow commanders to generate feedback reports based on the 

newcomer’s rating of his/her experience with his/her sponsor or a sponsor’s experience with the training. 

Pam Cunningham, program manager, Relocation Program, OSD/Military Community and Family Policy, to Thomas A. Kelly, Deputy Chief, Personnel Readiness Division, AF/A1PR, e-mail, 26 March 2010. 

See also Lorraine M. Neuser, Deputy Chief, Airman and Family Readiness Policy, AF/A1DF, to Thomas A. 

Kelly, e-mail, 24 March 2010.

9. AFI 90-201, Inspector General Activities, 17 June 2009.

10. Examples of effective Wingman programs include a Wingman Familiarization Tool developed organically within a unit through the use of focus groups. The tool involves programs centered around 
AIR FORCE FOLLOW-ON REVIEW 104

positive choices with regard to relationships, alcohol and drugs, financial matters, and negative emotions; 

and a Wingman Tool Kit comprised of games that pose questions related to suicide prevention, financial 

and family readiness, physical fitness, chaplaincy, and other programs involving Airmen taking care of 

Airmen. Maj Gen Kurt Cichowski, vice-commander, Air Force Special Operations Command, to Lt Gen 

Richard Newton, Deputy Chief of Staff, Manpower and Personnel, AF/A1, e-mail, 10 April 2010; and 

Theresa D. Gardiner, “Wingman Tool Kit” (best-practice document, 7 December 2005).

11. Cichowski, e-mail. 

12. Air Force Public Affairs Strategy and Assessment Division (SAF/PAX), “Identification as Airman, 

Wingman, Warrior,” Communication Research Bulletin 31 (7 February 2008). See also Husna Mirza (AF/

A1S), “2008 Wingman Day Feedback” (information paper, February 2009.)

Academic studies cite means to facilitate psychological commitment from individuals and influence 

long-term behavior, including making short public statements in a small-group forum (e.g., oath of office, 

change of command, promotion, marriage ceremonies) and publically signing a contract. Robert B. 

Cialdini, Influence: Science and Practice, 4th ed. (Needham Heights, MA: Allyn & Bacon, 2001), 52–97. 

Incentives such as quarterly, annual, or “best Wingman” awards have proven their value in enhancing Airmen’s positive impression of the Wingman program. Mirza, “2008 Wingman Day Feedback.” 

13. AFMA Survey, appendix C.

14. AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, 2 February 2006, Incorporating Through Change 2, 27 November 2009. The USAF Physical Disability Division’s PEBLO 

Guide includes 12 references, five of which are lengthy Air Force instructions.

15. AFI 48-123, Medical Examinations and Standards, 24 September 2009; AFI 10-203, Duty Limiting 

Conditions, 25 October 2007; AFI 41-210, Patient Administrative Functions, 22 March 2006; AFI 36-3212, 

Physical Evaluation for Retention, Retirement, and Separation.

16. Protecting the Force, 52–53.

17. Charles R. Figley, Treating Compassion Fatigue (New York: Routledge, 2002).

18. Lt Col Timothy J. Kosmatka (AFMOA), “FHI Implementation: The Road to a Medical Home” 

(presentation, 19 January 2010); and Capt Joe Lupa (AFPC/DPAPA), “Medical Corps: Career Field 

Data” (presentation, 31 January 2006).

19. The DTM was disseminated to MAJCOM mental health consultants in July 2009 and will remain 

in effect until its conversion into a DoDI. Lt Col Catherine A. Bobenrieth, Chief, Mental Health Branch, 

Psychiatry Consultant to Air Force Surgeon General, to author, e-mail, 7 April 2010.

20. Concerns about stigmas often center on a Service member’s worry that shared details about mental 

health treatment will result in unfavorable command perception, negative career impact, and the potential 

for being ostracized. DTM 09-006, Revising Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Military Personnel, 2 July 2009.

21. The AFI is currently undergoing biennial review, and a discrepancy relating to confidential substance evaluations will be addressed as part of the process. AFI 44-109, Mental Health, Confidentiality and 

Military Law, 1 March 2000; and Lt Col Catherine A. Bobenrieth, interview, 7 April 2010.

22. The proposed 44-series AFI—developed over the past year with inputs and reviews from all MAJCOM 

mental health consultants, a Tiger Team of mental health professionals, and the AFMOA Mental Health 

Division staff—is expected to be forwarded for coordination by May 2010. Bobenrieth, e-mail.

23. Col Arnyce Pock (Chief, Medical Force Management, AF/SG1), interview, 9 April 2010.

24. Col Arnyce Pock (presentation, Clinical Systems Program Assessment Review Conference, 5 December 2008); and Pock (presentation, Medical Corps Developmental Team Meeting, 16 September 2008).

25. Pock (presentation, 5 December 2008); and Pock (presentation, Medical Corps Pre-Game Plan 

Conference, December 2008).
105 AIR FORCE FOLLOW-ON REVIEW

Chapter 5  Leading the Force

26. AF/SG1M and AFPC/DPS, “Career Counseling Tool,” 29 January 2010; and Lt Col Janice 

Langer (AF/SG1M), “Talking Paper on Medical Corps (MC) Career Progression,” information paper, 

9 February 2010.

27. AF/SG1M and AFPC/DPS, “Medical Corps Office Career Path Guide,” chart, 22 January 2010; 

and AF/SG1M and AFPC/DPS, “Office Career Time with Projections,” chart, 22 January 2010.

28. AFMA Survey, appendix C.

29. Ibid., 9.

30. Ibid.
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Many Air Force emergency preparedness and response policies, programs, and practices 

are well designed and well implemented. However, we found room for improving installation emergency management programs, notifications system, and on-scene command 

procedures. Although Air Force 

policies address “high-risk situations,” including active shooter 

response, our approach to traumatic stress response is not fully 

integrated into the emergencyresponse program. 

Currently, no Air Force–level 

working group exists to synchronize emergency management functions, and there is no 

appointed office of primary responsibility for mass-notification systems. Also, there is no 

Air Force–level office with primary responsibility to oversee and codify the exercise evaluation team (EET) program. 

This lack of senior management and oversight leads to redundancy and gaps in programs 

where the seams and responsibilities have not been resolved. It also leads to a proliferation 

of nonstandard systems in lieu of a best-practices approach.

We also recognize the important role of a common operational picture (COP) to respond effectively to an emergency. Although the DoD has not established standards, 

requirements, and capabilities for a COP, we recommend that the Air Force continue to 

define its needs through its Emergency Response Operations Community of Interest. 

These policies and associated programs will require updates as DoD policy requirements emerge.

Responsibility for Emergency Response

Finding 75

(This refers to DoD report Finding/Recommendation 4.6.)

● No Air Force-level working group exists to synchronize emergency management 

functions.
AIR FORCE FOLLOW-ON REVIEW 108

Discussion

Air Force instructions require MAJCOMs and installations to establish working groups 

to foster discussions and synchronize efforts of emergency-response organizations.1

 AFI 

10-2501, Air Force Emergency Management (EM) Program Planning and Operations, requires all tasked agencies to coordinate on the Comprehensive Emergency Management 

Plan (CEMP) 10-2.2

 Installations are also required to convene an emergency management 

working group (EMWG) semiannually to synchronize plans and programs.3 

Although there is no specific requirement for an Air Force–level EMWG, AF/A4/7 recently identified the need for a HAF working group to synchronize policy efforts to support the Installation EM program.4

 AF/A4/7 held an initial working group meeting in 

April 2010.

Recommendation

75.1 Establish and chair a HAF-level working group to synchronize Air Force Emergency Management policy and programs. (OPR: AF/A4/7)

Finding 76

(This refers to DoD report Finding/Recommendation 4.4.)

● The Air Force has no appointed OPR for mass notification systems.

Discussion

Timely, accurate notification of an impending threat and appropriate response can reduce 

the risk of mass casualties. Installations may not have the most effective means for notifying 

personnel in the event of emergencies because there is no HAF OPR for mass notification 

systems (MNS). In the event of an incident on or near an Air Force base, the installation 

command post (CP) is responsible for mass notification.5

 Draft AFI 10-221, Installation 

Command and Control, defines the duties of CP controllers as initiating “base control procedures via sirens, klaxon, telephone and network alerting systems, Giant Voice or Installation Notification and Warning System (INWS), and other mass notification systems.”6

Most Air Force installations employ an MNS; however, the absence of Air Force–wide 

standards results in varied capabilities across installations. Net-Centric Alert Systems, 

which include such measures as pop-up alerts on computers and text messages to mobile 

phones can be used to activate Giant Voice notification systems. In March 2008, AF/A3O 

identified the need for MNS requirements, and the “Air Force–Wide Network Centric 

Emergency Notification Management System” is in draft.7

 Air Mobility Command devel-
109 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

oped a performance work statement for an integrated system that was delivered to SAF/

CIO A6 in February 2010.

Some installations remain limited to Giant Voice capability while others do not even 

have access to Giant Voice capabilities.8 Several MAJCOMs have incorporated state-ofthe-art systems into their emergency-response plans. Available advanced systems include integrated capabilities, Giant Voice in populated areas, pop-up messages on network computers, e-mail messages, text messages, and television and radio messages, as 

well as notification on land-mobile radios and on land or mobile telephones. Total 

Force commanders and civilian directors reported on the quality of alert procedures, 

rating e-mail alerts, telephone recall, and Giant Voice as primarily “good” more than 

“very good.” Figure 1 highlights variations in ratings within and outside the continental 

United States (CONUS).9

Air Force policies, programs, and procedures should be updated to reflect current technologies such as text messaging and e-mail to alert personnel who may or may not be 

physically located on the installation. 

Figure 1. Comparisons of alert procedures

Alert Procedures: CONUS vs OCONUS

The following Installation alert procedures for ongoing threats are:
AIR FORCE FOLLOW-ON REVIEW 110

Recommendations

(Relevant best practices are identified in appendix B.)

76.1 Appoint the Director of Operations (AF/A3/5) as the OPR for the MNS. (OPR: 

AF/A3/5)

76.2 Evaluate mass notification technologies and recommend viable, tailored solutions 

for installation use. (OPR: AF/A3/5)

Exercise Evaluation Team

Finding 77

● There is no Air Force–level office with primary responsibility to oversee the EET 

program.

Discussion

Exercise evaluations are critical commanders’ tools for assessing installation emergency 

management capabilities and practices. Inspector general (IG) checklists, installation-level 

EETs, Joint Staff Integrated Vulnerability Assessments, and Air Force Vulnerability Assessment Teams are used to evaluate the effectiveness of the Air Force Incident Management 

System (AFIMS).10

Although AFIs require exercises for emergency response, the EET program should have 

Air Force–level oversight to ensure that program and mission requirements are properly 

updated, exercised, and evaluated. The Air Force Inspector General (SAF/IG) is currently 

leading a working group of key stakeholders to identify the appropriate Air Force–level 

OPR for EET and to better define the Air Force EET program.

Recommendation

77.1 Determine the appropriate HAF-level OPR for EET policies, programs, and procedures. (OPR: SAF/IG)

Finding 78

● Tenant units are often not included in installation emergency management exercises.
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Chapter 6  Responding and Recovering

Discussion

AFI 10-2501, Air Force Emergency Management (EM) Program Planning and Operations, provides guidance on the installation emergency management program and requires 

installations to include tenant units in base exercises. Our survey of unit commanders and 

civilian leaders confirmed that tenant units are much less involved in installation emergencyresponse exercises than required.11 Approximately 20 percent of field operating agencies 

(FOA) and direct reporting units (DRU) report they were “not sure” if their organization 

practiced emergency response in the past year. 

Air Force and MAJCOM IGs should assess tenant participation in emergency management exercises. Air Force host installation and tenant unit leaders should actively seek 

routine engagement related to emergency management issues.12

Recommendation

78.1 Include tenant units in installation emergency management exercises. (OPR: SAF/IG)

Finding 79

(This refers to DoD report Finding/Recommendation 4.5.)

● Air Force policy includes an operational approach to raise and lower the force protection condition (FPCON) level as needed.

Discussion

The DoD report emphasized that local command and control procedures for responding to FPCON changes should allow commanders flexibility to lower FPCON when appropriate to accelerate recovery efforts. AFI 10-245, Antiterrorism (AT), provides installation commanders the authority to raise and lower the installation FPCON as necessary.13

Commanders may not, however, lower the FPCON below that established by the combatant commander. The instruction requires installations to provide specific details regarding local implementation of each condition.14 FPCON implementation measures are 

required in the installation’s antiterrorism plan.15

To ensure that installations can receive support from off-base responders during an incident, AFI 31-101, Integrated Defense, gives specific guidance requiring local plans to 

include “instructions to allow expedited emergency entry for off-base Fire, Medical, or 

Law Enforcement personnel as identified in mutual aid agreements.”16
AIR FORCE FOLLOW-ON REVIEW 112

Recommendation

79.1 Ensure that installation exercises include situations requiring changes in the 

FPCON. (OPR: SAF/IG)

Emergency Management Systems

Finding 80

(This refers to DoD report Finding/Recommendation 4.1.)

● DoD guidance identifying milestones for accomplishing full operational capability 

of the DoD installation emergency management program will require reassessment 

of the Air Force emergency management program. 

Discussion

In March 2004, the Department of Homeland Security published the National Incident 

Management System (NIMS) in response to Homeland Security Presidential Directive 5.17

In that directive, the President mandated a single, comprehensive system for national 

incident management.18 NIMS outlines core doctrine to enable a “balance between 

flexibility and standardization” in preparation for, response to, and recovery from incidents.19 National preparedness and response activities have grown from this core concept. The National Response Framework (NRF) is the operational guidance 

of NIMS and discusses roles, responsibilities, authorities, and the overall approach to incident management.20

The DoD instituted the installation 

emergency management program to 

align Services’ preparedness, response, 

and recovery actions within national-response guidance. DoDI 6055.17, DoD 

Installation Emergency Management (IEM) 

Program, establishes guidance related to 

the installation emergency management program but does not identify program requirements for initial operating capability (IOC) and full operating capability (FOC). Air 

Force guidance for implementing the installation emergency management program and 

aligning with national-response policies—specifically, the implementation of AFIMS—
113 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

identified milestones for IOC and FOC.21 All installations reached Air Force Installation 

Management System (AFIMS) FOC in February 2010.22 When DoD guidance is updated to include milestones, Air Force installation programs should be assessed to determine the feasibility of reaching FOC by the DoD deadline of 13 January 2014.

Recommendation

80.1 Revise the Air Force emergency management program to comply with the DoD’s 

forthcoming installation emergency management program policy. (OPR: AF/A4/7)

Finding 81

(This refers to DoD report Finding/Recommendation 4.4.)

● Mass Notification System procurement and sustainment currently depend on the 

availability of installation discretionary funds or reprogrammed funds from other 

programs.

Discussion

Although MNS is a costly system, its funding is currently an installation responsibility. 

One installation estimated the cost to upgrade the current MNS at $4.5 million to provide full coverage.23 AFRC estimates the initial cost for its MNS to have been $1.2 million 

in 2007, with a sustainment cost of $600,000 each year.24 A formal acquisition program 

would help standardize MNS capabilities and provide centralized funding for procurement and sustainment.

Recommendation

81.1 Establish a formal acquisition program for MNS capabilities, including procurement and sustainment support. (OPR: AF/A3/5)

Emergency Communications

Finding 82

(This refers to DoD report Finding/Recommendation 4.2.)

● Not all 9-1-1 calls initiated on base are directed to on-base dispatch personnel.
AIR FORCE FOLLOW-ON REVIEW 114

Discussion

Military installations have inherent difficulties related to 9-1-1 emergency phone service. CONUS Air Force bases use 9-1-1 as a universal emergency-response number.25

However, these calls may be routed to an off-base public safety answering point (PSAP) 

or to an on-base dispatch center, depending on the mode of communication used by 

the caller.26 If an Air Force installation is not identified as that region’s PSAP, the commercial provider will route that installation’s 9-1-1 calls to an off-base dispatch center. 

Therefore, even though commercial calls initiated from offices on base generally go 

through an on-base local exchange and 9-1-1 calls are routed to on-base emergencyresponse personnel, private phone lines in base housing and dormitories more likely 

route through off-base local exchanges, and 

9-1-1 calls route to off-base PSAPs. Differences 

in base telephone routing can delay response 

and degrade information sharing between onand off-base responders.

The Air Force has not issued guidance addressing effective 9-1-1 call routing or PSAPs. 

There are 38 Air Force installations identified as 

PSAPs, each with varying technological capabilities.27 Requirements for PSAP capabilities 

and training vary by state. In addition, cell 

phones and Voice over Internet Protocol (VoIP) 

are not routed through local telephone exchanges; these technologies will be addressed in 

Next Generation 9-1-1.28

Recommendation

82.1 Develop policy to ensure effective emergency call routing. (OPR: AF/A4/7)

Finding 83

(This refers to DoD report Finding/Recommendation 4.2.)

● Air Force policy for implementing enhanced 9-1-1 (E9-1-1) gives installation commanders discretion to determine implementation timelines.
115 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

Discussion

DoD has not published guidance requiring E9-1-1 implementation, although various 

Air Force policies discuss implementation of the E9-1-1 technology system. AFI 33-111, 

Telephone Systems Management, states that installations “should” migrate to an E9-1-1 

system.29 The August 2009 emergency communications center’s (ECC) concept of operations lists E9-1-1 enabling technologies as capabilities needed to support successful execution. The Air Force’s on-base telephone exchanges in the CONUS can provide caller information, including location.30 However, only 33 percent of CONUS installations have 

the necessary software and computer terminals at the call-reception point to use the service.31 In addition, for emergency calls directed off base, caller information will not display at the reception point if the local community does not support E9-1-1.

No single Air Force office is responsible for E9-1-1 policy. There are many entities involved in providing E9-1-1 support at various levels:

● The Defense Information System Agency (DISA) is responsible for fielding telephone systems that can support E9-1-1 capability.

● The DoD Emergency Management Working Group is tasked with developing 

DoD E9-1-1 policy.32

● AF/A4/7 is responsible for emergency-response programs, including fire emergency 

services and security forces.

● The Air Force Network Integration Center/Enterprise Capabilities-Voice Networks 

Branch manages telephone switches, including E9-1-1 interoperability.

Recommendations

83.1 Designate a single Air Force office responsible for developing Air Force E9-1-1 

policy. (OPR: SAF/CIO A6)

83.2 Update Air Force policy to comply with DoD E9-1-1 policy guidance. (OPR: 

SAF/CIO A6)

Finding 84

(This refers to DoD report Finding/Recommendation 4.2.)

● On-base emergency dispatch centers do not combine all responder capabilities.
AIR FORCE FOLLOW-ON REVIEW 116

Discussion

Many local communities have a combined dispatch center to answer and dispatch 

responders to fire, police, and medical calls. Civilian communities have found that 

consolidating these services yields more efficient 

use of manpower and resources.33

In September 2009 AF/A4/7 issued guidance 

requiring systematic replacement of Air Force 

installation dispatch centers with a consolidated 

dispatch center.34 This single, integrated ECC 

will meet E9-1-1 standards and improve response capabilities. However, upgrading base 

response centers (fire and security forces) requires replacing existing hardware. Costs for installing new consoles range up to $500,000 per 

location, excluding costs associated with combining dispatch functions.35

Recommendation

84.1 Ensure the ECC enabling concept approved in August 2009 is fully developed and 

funded. (OPR: AF/A4/7)

Finding 85

(This refers to DoD report Finding/Recommendation 4.2.)

● On-base dispatch capability cannot generally provide emergency medical dispatch 

(EMD) information, including pre-arrival instructions.

Discussion

Air Force installations as a general rule do not have an EMD program. Security forces 

and fire emergency services receive most 9-1-1 calls. Few installations have advanced ambulance and life-support services. As a result, medical calls are routed to local community 

9-1-1 service for ambulance dispatch.

Some civilian communities have implemented EMD programs, which include trained 

and certified emergency medical dispatchers who provide pre-arrival instructions to 9-1-1 

callers using protocols established by the local emergency medical director.36
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Chapter 6  Responding and Recovering

Without an EMD program, personnel on base who answer 9-1-1 calls cannot provide 

pre-arrival medical-care instructions to callers. This deficiency increases response times 

to provide basic emergency medical care. The Air Force civil engineer and medical communities are collaborating to develop a basic life support response so on-base fire personnel can respond immediately to medical calls and provide basic assistance until advanced care arrives.

Recommendation

85.1 Evaluate the feasibility of providing an EMD program on Air Force installations. 

(OPR: AF/SG, AF/A4/7)

Common Operational Picture

Finding 86

(This refers to DoD report Finding/Recommendation 4.5.)

● Although DoD standards, requirements, and capabilities for a COP have not yet 

been established, the Air Force has established an Emergency Response Operations 

Community of Interest (ERO COI) to define Air Force needs.

Discussion

The Air Force established the ERO COI to develop standards and provide the groundwork for Air Force implementation comprised of leaders from security forces, fire and 

emergency services, medical emergency management, and command posts. ERO COI 

participants exchanged information on missions, goals, and processes related to emergencyresponse operations. Through the work of the ERO COI, the Air Force established standards to field a COP consistent with the intent of national response guidance and mission 

considerations.37

DoDI 6055.17, Installation Emergency Management Program, states that an emergency 

operations center (EOC) “uses a common operating picture and information management system in order to execute and support actions listed in the IEM Plan and facilitate 

coordination of incident information.”38 DoDI 6055.17 further defines a COP as “a continuously updated overview of an incident compiled throughout an incident’s life cycle 

from data shared between integrated systems for communication, information management, and intelligence information sharing.”39
AIR FORCE FOLLOW-ON REVIEW 118

In November 2009, the ERO COI analyzed potential COP solutions. The analysis of 

alternatives identified 42 required capabilities and two mandatory compliance capabilities 

to meet requirements from the field.40 Two systems were found to meet more than 90 

percent of Air Force needs.41 The HAF force protection steering group is scheduled to 

make a selection for fielding in June 2010.

Recommendation

86.1 Field a COP as a mid- to long-term solution to support emergency-response capabilities. (OPR: AF/A4/7)

Finding 87

(This refers to DoD report Finding/Recommendation 4.5.)

● Until a standard COP is fielded, Air Force installations can continue to use the 

virtual operations center (VOC) interim tool to provide COP information.

Discussion

Air Force installations must adapt interim solutions until a long-term COP is fielded. 

Several available Web-based systems provide tactical-level information sharing during 

emergency response. The VOC system uses SharePoint design templates that can be customized to meet an installation’s needs.

Recommendation

87.1 Installations review current COP capabilities and ensure that an interim solution 

is in place and is practiced as part of the installation emergency management program. (OPR: AF/A4/7)

Finding 88

(This refers to DoD report Finding/Recommendation 4.5.)

● DoD guidance for a COP does not identify minimum system requirements.

Discussion

In March 2010, the DoD’s EMWG determined that DoD guidance did not sufficiently 

define required COP capabilities. The EMWG decided that identifying capabilities would 
119 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

be more cost-effective and mission-enabling than implementing a common DoD-wide 

solution. Related efforts by the Air Force and Navy will inform discussions on developing 

required capabilities.42

Recommendation

88.1 Coordinate with DoD to develop minimum system requirements for a COP. 

(OPR: AF/A4/7)

High-Risk Response

Finding 89

(This refers to DoD report Finding/Recommendation 4.3.)

● Air Force policies address “high-risk situations,” including active shooter response.

Discussion

Although DoD policy does not currently provide guidance on the active shooter threat, 

AFI 31-201, Security Forces Standards and Procedures, requires security forces to establish 

policies and procedures for planning, training, and equipping installations to respond to 

high-risk situations, including active shooter scenarios.43 AFI 31-201 applies to Air Force 

military and civilian police responders and directs installations to establish necessary 

memorandums of agreement (MOA) with local civilian agencies to build an effective response capability.44

The Air Force has promulgated specific guidance for preparing, training, and equipping 

to meet the active shooter threat. Draft Air Force Manual (AFMAN) 31-201, vol. 4, High 

Risk Response, includes preliminary tactics, techniques, and procedures (TTP) under the 

heading “Active Shooter.”45 In anticipation of the manual’s publication, the Air Force’s 

Security Forces Deputy Director released “Interim Guidance for Active Shooter Scenarios” on 21 January 2010.46 This guidance provides specific TTPs for security forces 

to prepare for, and respond to, an active shooter incident.

The 21 January 2010 interim guidance directs the installation defense force commander 

(DFC) or the installation antiterrorism officer (ATO) to assist the installation commander 

in developing a training briefing suitable for commander’s calls or similar forums to educate installation personnel on actions to take during an active shooter situation. The interim guidance includes a requirement for combined exercises with civilian counterpart 

agencies with which MOAs or mutual-aid agreements have been established. The interim 
AIR FORCE FOLLOW-ON REVIEW 120

guidance also directs the Air Force to educate all Air Force–affiliated populations on appropriate actions to take when encountering an active shooter.47

Several installations have made notable efforts in this area. For instance, Shaw AFB, 

South Carolina, developed a senior leader seminar focused on responding to an active 

shooter event.48 This forum includes such topics as special considerations for military installations, command and control in a 

dynamic environment, and active 

shooter response by security 

forces. In addition, the workshop 

includes a tabletop exercise and a 

basewide active shooter-training 

presentation for military and civilians.49 This presentation includes 

a “shooting incident threat aid” 

(Figure 2) that can be posted or 

kept in a convenient location.50 To provide consistent information and training, the Air 

Force Security Forces Center (AFSFC) is developing a baseline briefing for MAJCOM 

review and dissemination that will include best practices seen in the field.

As the interservice lead designated for civilian police training, the Army is publishing a 

multiservice regulation with common minimum training standards.51

Recommendation

(Relevant best practices are identified in appendix B.)

89.1 Continue developing security forces and police-response procedures to high-risk 

situations through the use of TTPs. (OPR: AF/A4/7)

Finding 90

(This refers to DoD report Finding/Recommendation 4.3.)

● Training and awareness for active shooter response is not formalized.

Discussion

Unit leaders indicate that personnel need to be trained on active shooter response actions.52 Twenty-five percent of commanders surveyed reported receiving training on how 
121 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

to respond to shooting sprees and mass killings; three quarters of those reported that the 

training provided the skills needed to respond effectively. Additionally, as Figure 3 indicates, fewer than one-half of the surveyed unit leaders believe their personnel are informed 

about actions to take during an active shooter event.53

AFI 10-245, Antiterrorism, does not specifically address active shooter events.54 It does, 

however, mandate annual AT-1 training for all military personnel, civilians, and family 

members over age 14 who accompany Service members overseas on official orders, as does 

DoDI 2000.16, DoD Antiterrorism (AT) Standards.

55 AT-1 is also offered to all contractors 

and is mandatory if specified in the contract.

Chairman of the Joint Chiefs of Staff (CJCS) J-34, Office of Combating Terrorism, 

recently included public reaction to an active shooter event in AT-1 training resources. 

The Air Force Security Forces Center, responsible for AT-1 updates, will incorporate the 

new CJCS J-34 training in the updated Air Force AT-1 computer-based training (CBT) 

course. This will provide a baseline of knowledge, but unit DFCs or ATOs must address 

installation-specific procedures.56

Figure 2. Shooting incident threat aid

SHOOTING INCIDENT

IMMEDIATE DANGER

SEEK COVER / ESCAPE

CALL

911 AND FACILITY HQ > Caller’s Location

> Number of Shooters

> Type of weapons (or explosives)

> Shooter location and direction of movement

> Shooter description

SECURE YOURSELF & LOCATION

SHELTER

IN PLACE

MITIGATE LOCK DOOR, LIMIT MOVEMENT,

TURN OFF LIGHTS

ACCOUNT

FOR PERSONNEL

AND REPORT

WAIT FOR RESPONSE FORCES

OR INSTRUCTIONS

This aid was developed for a threat in a building. Threats to a 

compound or installation may require dierent measures.

Personnel are encouraged to develop specic plans for their location.

Training in preparedness and frequent drills are also recommended.

SHOOTING INCIDENT THREAT AID ·

·

·

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·

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·

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Call 911

Relay info - S-A-L-U-T-E Report or Your location, # of

shooters, type of weapons, shooter location and

description

911 call from a base phone goes directly to LE Desk

911 call from a cell phone goes to Sumter Dispatch--costs

time

911 may be overwhelmed

Can also call 803-895-3669/3668 (LE Desk)

Let dispatcher know you’re on SAFB

Responding SF will yell “Security Forces”

Stay Calm

If unable to escape, secure immediate area

Lock the door

Block the door using whatever is available-desks, le cabinets,

other furniture...

If the shooter enters your room and leaves, lock/barricade the

door behind them

If safe allow others to seek refuge with you

After securing the room, people should be positioned out of

sight and behind items that might oer additional protectionwalls, desks, le cabinets, etc.

Treat the injured

Remember basic rst aid/SABC

For bleeding apply pressure and elevate

Be creative in identifying items to use for this purposeclothing, paper towels, etc.
AIR FORCE FOLLOW-ON REVIEW 122

Recommendations

90.1 Incorporate active shooter response training into Air Force AT-1 training. (OPR: 

AF/A4/7)

90.2 Incorporate best practices and TTPs for active shooter response into recurring 

training for military and civilian personnel. (OPR: AF/A4/7)

Finding 91

(This refers to DoD report Finding/Recommendation 4.3.)

● Air Force capabilities for active shooter response must continue to evolve by including lessons learned and best practices from the Fort Hood incident, civilian law 

enforcement, and such tragedies as the shootings at Columbine and Virginia Polytechnic Institute and State University (Virginia Tech).

Discussion

Several Air Force organizations have implemented procedures based on lessons learned 

from incidents involving internal threats. After the Columbine shooting in Colorado, the 

US Air Force Academy (USAFA), in concert with other Service academies, took deliberate 

steps to improve response capabilities by training cadets and staff on steps to take in the 

event of an active shooter incident.57 USAFA identified other improvements through such 

Figure 3. Preparation for active shooter events by organizational level
123 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

exercises as ensuring the ability to secure classroom doors to deny shooter access.58 Air 

Force agencies are reviewing AFI 10-2501, Air Force Emergency Management (EM) Program Planning and Operations, to include references for lockdown procedures.59

US Pacific Air Forces conducted extensive training and preparation with DoD dependent schools (DODDS) to ensure they have active, well-trained, and rehearsed plans to 

respond to an active shooter event.60 Information gained through these preparation-andresponse efforts should benefit all Air Force installations that host local schools.

Developing appropriate TTPs, incorporating best practices, and implementing relevant 

training will prepare AF members to counter the active shooter threat. Case studies of 

such internal-threat incidents as Fort Hood should be incorporated into incident-response 

courses and precommand training at all levels. Doing so will build awareness with regard 

to leadership accountability and prevention of, preparation for, response to, and recovery 

from internal threats.

Recommendation

91.1 Incorporate a case study based on the Fort Hood shooting and similar incidents 

into wing, group, and incident commander training courses. (OPR: AF/A4/7)

Mutual Aid Agreements / Memoranda of Understanding

Finding 92

(This refers to DoD report Finding/Recommendation 4.7.)

● The Air Force does not have clear guidance addressing emergency management 

mutual aid agreement (MAA) policies, including integrating, tracking, exercising, 

and inspecting MAAs.

Discussion

Guidance for emergency-response MAAs is contained in several DoDIs and AFIs.61

Although most Air Force references to MAAs address aid to the local community instead 

of community aid to installations, several AFIs recognize the need for support from the 

local community or state and federal agencies.62 Similar to DoDI 6055.17, DoD Installation Emergency Management (IEM) Program, Air Force documents referencing MAAs do 

not provide overarching guidance for emergency management program-related agreements.63 Annual review of emergency management agreements is implied, but not specifically stated, as part of the annual review of the CEMP 10-2.
AIR FORCE FOLLOW-ON REVIEW 124

Because MAAs are a critical component of the comprehensive installation emergency 

management plans, these agreements should be reviewed and exercised annually as part of 

a review process. AFI 25-201, Support Agreements Procedures, discusses mutual benefits 

under special support conditions in attachment 6; however, no specific information regarding tracking and coordinating responsibilities exists.64 This section should include 

functional responsibilities for tracking and exercising. Additionally, appropriate AFIs 

should be updated following DoD’s review of the Fort Hood recommendations.

Recommendation

92.1 Update Air Force policy to address the need to integrate, track, exercise, and inspect MAAs. (OPR: AF/A4/7)

Finding 93

(This refers to DoD report Finding/Recommendation 2.11.)

● Security forces squadrons (SFS) and Air Force Office of Special Investigations 

(AFOSI) policies do not specify scope and timeliness for MOUs.

Discussion

The DoD report recommended that information-sharing agreements be required with 

local law enforcement agencies, including standards for scope and timeliness.

Revising AFI 31-101, Integrated Defense, to require MOUs with civilian law enforcement 

agencies will address the gap identified in the DoD report. The updated AFI should specify minimum continuity standards and should provide flexibility for commanders to consider local legal jurisdictions and community relationships for MOUs.65 SFS and AFOSI 

commanders should jointly sign MOUs with civilian law enforcement agencies when appropriate. An annual review of MOUs should further facilitate improved levels of information sharing.66

Recommendation

(Relevant best practices are identified in appendix B.)

93.1 Modify AFI 31-101, Integrated Defense, to require SFSs and AFOSI jointly to establish MOUs with civilian law enforcement agencies to include expectations for 

scope and timeliness. (OPR: AF/A4/7)
125 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

Casualty Assistance

Finding 94

(This refers to DoD report Finding/Recommendation 4.8.)

● Air Force policies governing the Emergency Family Assistance Control Center 

(EFACC) are not synchronized. 

Discussion

AFI 10-2501, Air Force Emergency Management Program Planning and Operations, 

addresses EFACC activation and identifies the EFACC as the focal point for familyassistance services.67 This instruction is consistent with DoDI 1342.22, Family Centers, 

and AFI 34-1101, Assistance to Survivors of Persons Killed in Aviation Mishaps and Other 

Incidents.

68 AFI 10-2501 and AFI 34-1101 are not synchronized with AFI 36-3009, 

Airman and Family Readiness Centers. Specifically, AFI 10-2501 does not cross-reference 

AFI 36-3009 when describing the basic execution of an EFACC.69 AFI 34-1101 and 

AFI 36-3009 do not have consistent exercise requirements related to the EFACC. Moreover, AFI 36-3009 does not refer to the EFACC toolkit. Updating and cross-referencing 

these AFIs for consistency and accuracy will solidify the EFACC within the emergency 

management program.

Recommendation

94.1 Synchronize EFACC-related AFIs to ensure awareness and participation of all pertinent agencies during EFACC execution and sustainment. (OPR: AF/A1)

Finding 95

(This refers to DoD report Finding/Recommendation 4.9.)

● Air Force policy and procedures provide guidance for religious support during mass 

casualty incidents; however, these policies should be updated to improve response 

capability.

Discussion

Air Force policy includes chaplain and religious support in the emergency-response 

framework; however, guidance providing standardized response actions is lacking. The Air 

Force Chaplain Corps (AF/HC) is integral to cultivating and sustaining the spiritual 
AIR FORCE FOLLOW-ON REVIEW 126

health and well-being of military personnel, family members, retirees, and civilian employees. Chaplains are expected to perform ministry for their own faith group and provide 

for the rights and needs of other faith groups in their areas of responsibility, especially 

during mass casualty events. The 

need for spiritual support often intensifies during and following crises.

AFI 10-2501, Air Force Emergency 

Management Program Planning and 

Operations, addresses religious support and lists chaplain roles and responsibilities.70 It does not, however, 

specify a religious-support concept 

of operations that clearly defines the 

provision of religious support during and following incidents of workplace violence, response to mass casualties, or recovery actions. Revisions to AFI 10-2501 should ensure response consistency 

of chaplain support across Air Force installations and inform first-responder training requirements for chaplains.

The guidance in AFI 52-104 includes a sample wing chaplain operation instruction and 

checklists for major accident response, natural disaster response, national emergencies, 

and humanitarian support. However, it does not specify chaplain roles and responsibilities 

following incidents of workplace violence, mass casualty response, and recovery.71

Recommendation

95.1 Revise religious support policies to synchronize mass casualty response efforts. 

(OPR: AF/HC)

Finding 96

(This refers to DoD report Finding/Recommendation 4.11.)

● The Air Force does not have policy or programmed funding to support family attendance at unit memorial services for a deceased military member.

● The Air Force does not have programmed manpower or funding requirements associated with family attendance at unit memorial services for deceased military 

members.
127 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

Discussion

The National Defense Authorization Act for Fiscal Year 2010 authorizes round-trip 

travel and transportation allowances for eligible relatives of members who die while on 

active duty to attend a memorial service for deceased military family members at a location other than the burial site.72 In May 2010, DoD published implementation guidance for this legislation, Directive-Type Memorandum (DTM) 10-008 – Travel and 

Transportation for Survivors of Deceased Members of the Uniformed Services to Attend Memorial Ceremonies.73

AFI 34-242, Mortuary Affairs Program, should be updated to reflect the new DoD 

guidance and address funding family-member travel to attend a unit or installation memorial service.74 With DoD guidance now established, the Air Force Mortuary Affairs 

Operations (AFMAO) Center will implement the program, and provide oversight based 

on the OUSD(P&R) policy memo.75 AFMAO identified a requirement for one program 

administrator position and funding requirements for travel reimbursements for civilian 

family members to attend memorial services.76

Recommendations

96.1 Align Air Force policy with DoD guidance to address memorial service attendance. (OPR: AF/A1)

96.2 Fund one civilian position and provide funding to support civilian family requests 

to attend memorial services. (OPR: AF/A1)

Finding 97

(This refers to DoD report Finding/Recommendation 4.12.)

● Casualty notification and mortuary affairs for private citizens killed on DoD installations or participating in sponsored events are coordinated through MOAs with 

local government agencies.

Discussion

The DoD report found there was no DoD guidance regarding death of a private citizen 

on a military installation.77 This is significant since the death of a private citizen entails 

two facets: notification and mortuary affairs. The Air Force can prescribe policy regarding 
AIR FORCE FOLLOW-ON REVIEW 128

notification of next of kin; however, public law must authorize the use of federal funds 

supporting private-citizen mortuary affairs.

Despite limited DoD guidance, the Air Force provides some guidance in AFI 36-3002,

Casualty Services, with respect to notifying next of kin. The instruction allows commanders “discretion to notify next of kin of non-DoD civilians if they are killed on an 

installation or during an orientation flight or a civic leader tour including airlift. If the 

commander chooses to make notification, the same procedures will be followed as for 

military members.”78

Existing AFIs do not require MOUs with local authorities regarding notification. When 

commanders choose not to notify the next of kin, base support agencies coordinate with 

off-base civilian organizations to ensure proper notifications are made. Each installation 

coordinates with local authorities to comply with applicable county and state laws. Air Force 

policy covering mortuary plans should be updated to include notifications in the MOU.

Unlike casualty notification, mortuary support is an entitlement requiring legislation 

and funding. Public law does not currently authorize mortuary entitlements for private 

citizens with no DoD affiliation. The force support squadron develops MOUs with local 

law enforcement and the coroner’s office to ensure appropriate and timely handling and 

disposition of remains.79

Recommendation

97.1 Coordinate with DoD to develop policies and procedures for casualty notification 

and mortuary support of fatalities involving private citizens on an Air Force installation. (OPR: AF/A1)

Finding 98

(This refers to DoD report Finding/Recommendation 5.1.)

● The Air Force provides a comprehensive, proactive approach to traumatic stress 

response (TSR), but this concept is not fully integrated into the emergency-response 

program.

Discussion

AFI 36-3009, Airman and Family Readiness Centers, offers guidance on the activation of 

an EFACC, tasked with integrating services addressing the practical and emotional needs 

of families of potential DoD casualties and DoD personnel affected by the disaster.80

Given the EFACC’s role in response, it would be logical to include TSR as an organic 
129 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

member of the EFACC; current guidance treats it as a stand-alone team. Guidance covering EFACC and TSR should be updated to clearly identify the relationship between the 

EFACC and TSR during emergency response.

Published in January 2004, the Clinical Practice Guideline (CPG) is a joint Department 

of Veterans Affairs and DoD effort for managing post-traumatic stress.81 A Veteran Affairs / 

DoD Working Group is currently revising the CPG to address appropriate interventions 

in the immediate aftermath of traumatic events. The revised CPG is expected to be released in summer 2010 and should be incorporated into AFI 44-153, Traumatic Stress 

Response, to replace guidelines listed in section IV.82

Recommendation

98.1 Revise Air Force TSR policy to synchronize mental health support services in the 

aftermath of mass casualty incidents. (OPR: AF/SG)

Finding 99

(This refers to DoD report Finding/Recommendation 5.1.)

● Redundancies among crisis response team (CRT) and TSR team missions cause 

confusion and inefficiency.

Discussion

The CRT provides mental health support during hostage negotiations and in the aftermath of incidents.83 CRT and the TSR missions currently overlap. To gain manpower and 

response efficiencies, mental health support to hostage negotiators should move to the 

TSR, and its requirement for CRT should be deleted.

Recommendation

99.1 Add hostage-negotiation consultation to TSR team capabilities outlined in AFI 

44-153, Traumatic Stress Response. (OPR: AF/SG)

Notes

1. AFI 10-2501, Air Force Emergency Management (EM) Program Planning and Operations, 6 April 

2009, 15, 16. At the Air Force level, five working groups and three organizations are involved in emergency management. At the MAJCOM and installation level, three working groups and three organizations are involved. Working groups at MAJCOMs and installation levels review Air Force Incident Management System (AFIMS) and EM training issues; monitor EM operational plans and exercises; review 

readiness issues IAW AFPD 10-2, Readiness, 30 October 2006, and AFPD 10-4, Operations Planning: Air 
AIR FORCE FOLLOW-ON REVIEW 130

& Space Expeditionary Force (AEF), 30 April 2009, 1–13; review staff assistance visit, exercise, and inspector general trends; monitor AFIMS and chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE) defense equipment shortfalls; coordinate new AFIMS tactics, techniques, and procedures 

(TTP) and initiatives; and review CBRNE defense training.

2. AFI 10-2501, Air Force Emergency Management (EM) Program Planning and Operations, 6 April 

2009, 46–48.

3. Ibid., 15, 16.

4. Lt Col Thomas Taylor, Chief, Incident Management, Air Force Readiness Emergency Services 

Branch, AF/A7CXR, and Col Elizabeth E. Arledge, A4/7 reserve advisor, AF/A4/7H, 30 March 2010.

5. AFI 10-207, Command Posts, 4 April 2008, 28.

6. AFI 10-221, “Installation Command and Control,” draft, 11.

7. AF/A3O-AO, “Air Force-Wide Network Centric Emergency Notification Management System,” 

draft, 24 March 2008, 3.

8. There are current Air Force efforts to update and standardize MNS at installations. In a Scope Warrior action item, Air Force Scope Warrior, “Action Item Review” (presentation, 18 November 2009), Air 

Mobility Command was tasked as the Air Force lead for developing a performance work statement for an 

integrated mass notification system that includes integrating Giant Voice with a computer desktop notification and other state-of-the-art capabilities. That statement was delivered to SAF/A6 in February 2010. 

Several MAJCOMs have taken independent steps to standardize MNS capabilities. However, no organization has been named the OPR specifically for MNS. The Air Force FOR team recommends that AF/A3O 

assume responsibility and update its role accordingly in AFI 10-221 and AFI 10-2501. AF/A3O’s continued work in this area, combined with the DoD Emergency Management Working Group’s efforts to further define MNS, will remedy this shortfall.

9. Air Force Performance Management (AFMA/MAP), “Follow On Review: Issues from Ft. Hood 

Survey Results” (presentation, 18 March 2010), 16.

10. See DoDI 6055.17, DoD Installation Emergency Management Program, 13 January 2009; and Lt 

Col Thomas Taylor, Chief, Incident Management, AF/A7CXR, and Col Elizabeth E. Arledge, A4/7 reserve advisor, AF/A4/7H, 30 March 2010.

11. AFMA Survey, appendix C.

12. Source for “FOAs/DRUSs report concerns . . . ” AFOTEC, Col Ed Vaughan and commander, 314 

AW, “Lessons Learned,” briefing, March 2010 AETC Commander’s Conference.

13. AFI 10-245, Antiterrorism (AT), 30 March 2009, 25.

14. Ibid., 49.

15. Ibid., 15.

16. AFI 31-101, Integrated Defense (FOUO), 7 July 2007, 34.

17. NIMS and the Incident Command System, November 2004, http://www.fema.gov/txt/nims/nims

_ics_position_paper.txt.

18. Homeland Security Presidential Directive 5, Management of Domestic Incidents, http://www.fas

.org/irp/offdocs/nspd/hspd-5.html.

19. NIMS and the Incident Command System, November 2004, http://www.fema.gov/txt/nims/nims

_ics_position_paper.txt.

20. United States Department of Homeland Security, National Response Framework, January 2008, 1.

21. Memorandum for ALMAJCOM/CV/FOA/DRU from HQ USAF/A4/7, Force Incident Management System (AFIMS) Full Operational Capability (FOC) Reporting Instructions, 22 April 2009.

22. Col Curt A. Van De Walle, Chief, Readiness & Emergency Management Division, AF/A7CX, to 

AF/A4/7 assistant executive officer, e-mail, 25 February 2010.
131 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

23. RFI 7-05-146, “Emergency Management Gaps, Concerns, & Difficulties,” Air Force Follow On 

Review information paper, 11 April 2010.

24. AFRC, “Best Practice #2 (AFRC)” (presentation, 26 March 2010).

25. In October 1999, the Wireless Communications and Public Safety Act of 1999 (Public Law 106-81) 

declared 9-1-1 the universal emergency number for telephone service (Wireless Communications and Public 

Safety Act of 1999, Public Law 106-81, 106th Cong., 1st sess., 26 October 1999, secs. 3a3). In 2001 Air 

Force installations were directed to implement 9-1-1 as the single emergency-response number for all 

police, fire, and medical emergencies in the continental United States (including Alaska and Hawaii). 

Overseas, Air Force installations were directed to use 9-1-1 unless it conflicts with host nation emergencyresponse numbers or intergovernmental agreements (AFI 33-111, Telephone Systems Management, 25 

March 2005, 20).

26. DISPATCH Magazine On-Line, “911 Information,” http://www.911dispatch.com/911/index.html .

27. Donald Warner, Air Force Fire Chief, AFCESA/CEXF, to MAJCOM/DRU fire chiefs, e-mail 22 

March 2010.

28. National Emergency Number Association, “NG 9-1-1 Project,” http://www.nena.org/ng911-project/. 

Federal Next Generation 9-1-1 policies and procedures are evolving to keep pace with new communication technologies. (The National E9-1-1 Implementation Coordination Office, A National Plan for Migrating to IP-Enabled 9-1-1 Systems, September 2009, 2–3.) VoIP is an emerging communication technology 

challenging conventional E9-1-1 routing mechanisms. VoIP calls are made from traditional phones but 

move over the Internet rather than traditional phone lines. Consumer and Government Affairs Division, 

“VoIP and 911 Service,” FCC, http://www.fcc.gov/cgb/consumerfacts/voip911.html. With VoIP, individuals can use a phone number from any location as long as there is an Internet connection. This portability, among other characteristics, limits the system’s ability to provide location information when a VoIP 

caller makes an E9-1-1 call. This limitation is being addressed in several ways. More broadly, the FCC 

continues to update regulations regarding these protocols and the telecommunication industry is working 

to provide technological solutions. At the local level, users can take several steps users to ensure proper 

location information is passed to E9-1-1-capable dispatch centers. Information campaigns are costeffective means for educating installation personnel on how to ensure that their location information is 

properly displayed on E9-1-1 systems.

29. AFI 33-111, Telephone Systems Management, 20.

30. Lt Col Karl Kraan, Deputy Chief, Warfighting Integration and Command & Control Division, 

SAF/A6WW, phone discussion with Maj Gaycha Robinson and CMSgt Stephen Marotte, Branch Chief, 

Air Force Network Integration Center/Enterprise Capabilities-Voice Networks, 3 March 2010.

31. RFI 7-01-015, “E911, Mass Notification, Common Operational Picture,” Air Force FOR review 

information paper, 1 March 2010.

32. DoD, “Implementation of Recommendations for the Independent Review Related to Fort Hood,”

draft, 8 April 2010.

33. Gary Davidson, “Sheriff’s Office to Dispatch for Daytona and Holly Hill,” Daily News, Volusia 

County Sherriff’s Office, 8 July 2004, http://volusia.org/sheriff/press/2004PressReleases/July/040097.htm.

34. Glenn Eckhardt and Lt Col David Scharf, Emergency Communications Center Enabling Concept, 19 

August 2009, 2.

35. Steven Fuller, AFRC/A7XF, to Donald Warner, Air Force Fire Chief, AFCESA/CEXF, e-mail 19 

March 2010.

36. National Academies of Emergency Dispatch, “Standard Practice for Emergency Medical Dispatch,” http://www.emergencydispatch.org/articles/standardpractice1.htm.

37. Dating back to 2003, policies leading up to the establishment of a COP include Homeland Security Presidential Directive (HSPD)-5, Management of Domestic Operations, 28 February 2003; HSPD-8, 
AIR FORCE FOLLOW-ON REVIEW 132

National Preparedness, 17 December 2003; National Response Framework (NRF) (Washington, DC: 

January 2008); and National Incident Management System (NIMS) (Washington, DC: 18 December 

2008), 23. The NRF is the first to introduce a COP in name as part of its key concept of collection, tracking, and reporting incident information. NRF states, “Information must be gathered accurately at the 

scene and effectively communicated to those who need it. To be successful, clear lines of information flow 

and a common operating picture are essential.” See Department of Homeland Security, National Response 

Framework (Washington, DC: January 2008). HSPD-5 established NIMS as the incident command system to provide a consistent nationwide approach to work effectively and efficiently to prepare for, respond 

to, and recover from domestic incidents at the federal, state, tribal, and local levels. NIMS guidance defines a COP as “an overview of an incident created by collating and gathering information—such as traffic, 

weather, actual damage, resource availability—of any type (voice, data, etc.) from agencies/organizations 

in order to support decision making.” See US Department of Homeland Security, National Incident Management System (Washington, DC: 18 December 2008), 23.

38. DoDI 6055.17, DoD Installation Emergency Management (IEM) Program, 31.

39. Ibid., 39.

40. Of more than 40 systems reviewed, two systems met more than 90 percent of those requirements: 

Integrated Defense Command and Control (IDC2) and the Incident Information Management System 

(IIMS) component of Theater Battle Management Core System (TBMCS) Unit Level-Unit Command 

and Control (UL-UC2). Leveraging existing systems is more cost-effective to the Air Force, and the process of fielding an approved information technology solution can be expedited in what otherwise could be 

a lengthy approval process. The Analysis of Alternatives found IDC2 incorporated and can meet more 

than 93 percent of the requirements and appears to be able to meet the needs of the ERO communities. 

See Michael E. Dickey, Emergency Response Operations Analysis of Alternatives, 18 February 2010, 2, 5. 

Drawbacks, however, still exist. Getting the system fully fielded on the NIPR system is among these problems. Other issues currently being addressed include sustainment and Total Force fielding. Stakeholders 

represented on the ERO COI meet on a regular basis to provide input to the teams developing IDC2 to 

resolve open issues. While IDC2 was the clear leader for use at the tactical level, TBMC’s UL/UC has a 

much larger focus on mission-related decision support. However, these two COP tools can integrate and 

meet all identified requirements.

41. Col Robert K. Mendenhall, Chief, Force Protection and Operations Division, “HAF Force Protection Working Group (FPWG) Meeting Minutes,” draft, 26 March 2010.

42. Col Elizabeth E. Arledge, A4/7 reserve advisor, AF/A4/7H, 2 April 2010.

43. AFI 31-201, Security Forces Standards and Procedures, 30 March 2009, 31–33.

44. Ibid., 32.

45. AFMAN 31-201, vol. 4, High-Risk Response, draft.

46. David R. Beecroft, Deputy Director of Security Forces, DCS/Logistics, Installations and Mission 

Support, to ALMAJCOM/A7S and ALL SF/CC/SFMs, interim guidance memorandum, 21 January 

2010.

47. Ibid., 2.

48. Air Combat Command (ACC), “Best Practice #15 (ACC-Shaw)” (presentation, 26 March 2010).

49. Ibid.

50. Ibid.

51. In response to the DoD recommendation to standardize military law enforcement training and 

incorporate civilian law enforcement best practices, DoD, through the Joint Security Chiefs Council 

(JSCC), is reviewing military law enforcement training curriculum to develop and promulgate minimum 

common training standards for military law enforcement personnel. The JSCC chairman accepted this 
133 AIR FORCE FOLLOW-ON REVIEW

Chapter 6  Responding and Recovering

tasking, which is included in the DoD Follow On Review Interim Report to the Secretary of Defense 

(Dickey, interview by Arledge).

52. AFMA Survey, appendix C.

53. Ibid., 5.

54. AFI 10-245, Antiterrorism (AT), 27–28.

55. DoDI 2000.16, DoD Antiterrorism (AT) Standards, 2 October 2006, 28.

56. Beecroft, memorandum, 2.

57. Paul M. Ceciliani, United States Air Force Academy (USAFA), “Additional information on 

USAFA’s FOR,” information paper, 10 March 2010.

58. Ibid.

59. A7SO, Michael E. Dickey, Chief, Force Protection Branch, Operations, to A7CXR, Lt Col Tom 

Taylor, Chief, Incident Management, AF/A7CXR, e-mail 21 April 2010.

60. Pacific Air Forces, “Best Practice #10 (PACAF)” (presentation, 30 March 2010).

61. Protecting the Force, 42.

62. AFI 10-245, Antiterrorism (AT), 22, 25, 45, 48; AFI 10-2501, Air Force Emergency Management 

Program Planning and Operations, 26 January 2007, 16, 21, 150; and AFI 41-106, Unit Level Management 

of Medical Readiness Programs, 28 July 2009, 9, 20, 33, 46, 136.

63. Ibid.

64. AFI 25-201, Support Agreements Procedures, 28 January 2008, 33.

65. AFOSIMAN 71-122, Criminal Investigations, 29 May 2008, 1.

66. AFI 25-201, Support Agreements Procedures, 28 January 2008, 4–5, http://www.e-publishing.af

.mil/shared/media/epubs/AFI25-201.pdf.

67. AFI 10-2501, Air Force Emergency Management Program Planning and Operations, 41.

68. DoDI 1342.22, Family Centers, 30 December 1992, 3, 6, 7, 11; and AFI 34-1101, Assistance to 

Survivors of Persons Killed in Aviation Mishaps and other Incidents, 1 October 2001, 17.

69. AFI 36-3009, Airman and Family Readiness Centers, 18 January 2008, 26–27.

70. AFI 10-2501, Air Force Emergency Management Program Planning and Operations, table A4.13, 

143, lists the roles and responsibilities of the chaplain as: “1) Determines religious affiliation of victims 

and assists in comforting the afflicted; 2) Assists with control and assurance of family members of deceased 

and injured; 3) Ministers to military personnel, their families, and other authorized personnel during 

contingencies; 4) Serves as OCR for the Mass Care, Housing and Human Services ESF (ESF 6); and 5) 

Serves as OCR for the Public Health and Medical Services ESF (ESF 8).”

71. AFI 52-104, Chaplain Service Readiness, 26 April 2006, 74–79.

72. National Defense Authorization Act for Fiscal Year 2010, Public Law 111-84, 111th Cong., 1st sess., 

28 October 2009, sec. 631, 170.

73. Office of the Under Secretary of Defense, Personnel and Readiness, Directive-Type Memorandum 

(DTM) 10-008—Travel and Transportation for Survivors of Deceased Members of the Uniformed Services 

to Attend Memorial Ceremonies, 11 May 2010.

74. AFI 34-242, Mortuary Affairs Program, 2 April 2008, 1–152.

75. Air Force Mortuary Affairs Operations Center, “Travel, Transportation, and Support to Survivors 

of Fallen Airmen Attending an Installation Memorial Service,” draft memorandum, 22 March 2010.

76. The source for the data is based on a five-year average of historical data from Air Force Casualty 

DCIPs (Defense Casualty Information Processing System) and financial information of travel vouchers 

filed in relation to burial services. This requirement is based on historical data estimating an average of 190 

Air Force active duty deaths per year with an average of 85 percent (or 161) of eligible families expected 

to use the entitlement. The additional manpower requirement is based on an administrator’s duties to re-
AIR FORCE FOLLOW-ON REVIEW 134

ceive, validate, process, and reimburse costs associated with the potential for 966 authorized travelers in 

accordance with the established Air Force implementation policy.

77. Protecting the Force, 47.

78. AFI 36-3002, Casualty Services, 22 February 2010, 52–53.

79. AFI 34-242, Mortuary Affairs Program, 30 April 2008, 17.

80. AFI 36-3009, Airman and Family Readiness Centers, 26–27. The EFACC serves as the staging area 

where families can obtain disaster relief, contingency information, and services. In addition to Airman and 

Family Readiness Center personnel, the EFACC may be staffed with representatives from Mental Health, 

Chapel, Legal, Services, Public Affairs, and the American Red Cross.

81. Department of Veterans Affairs, VA/DoD Clinical Practice Guideline for the Management of Post 

Traumatic Stress (Washington, DC: Department of Veterans Affairs, January 2004).

82. Maj Scott Olech, Chief, Homeland Medical Operations, AFMSA/SGXH, phone conversation 

with Lt Col Randon Welton, Chief, Modernization Division, AFMC/SGR, 19 February 2010. The VA/

DoD Working Group assessed 12 studies that evaluated interventions to prevent post-traumatic stress 

disorder (PTSD). Additionally, the group reviewed six metaanalyses that addressed PTSD. CPG revisions 

will outline two treatment options for PTSD: brief cognitive-behavioral therapy (CBT) and psychological 

first aid (PFA). This update will improve the way clinicians within the DoD and the VA respond to traumatic stress for their patients and therefore obtain more desirable patient outcomes.

83. AFI 41-106, Unit Level Management of Medical Readiness Programs, 123.
A-1 AIR FORCE FOLLOW-ON REVIEW

Appendix A  Terms of Reference

Air Force (AF) Follow-on Review of Issues Relating to Fort Hood

These Terms of Reference (TOR) address the objectives of the Air Force Follow-on Review of the Secretary of Defense-directed DoD Independent Review of circumstances related to the mass shooting at Fort Hood, Texas on 5 Nov 09. The TOR includes background 

information, objectives and scope, methodology, duration and limitations and deliverables.

Introduction:

The purpose of the Air Force Follow-on Review (FOR) is to identify and resolve program, policy, and procedural weakness that may create vulnerabilities to the health and 

safety of Air Force personnel, other supported personnel, and their families. As such, the 

FOR will thoroughly address all findings and recommendations contained in the January 

2010 Report of the DoD Independent Review (DoD IR) relevant to the Air Force. The 

FOR will identify specific changes required to implement DoD IR recommendations, as 

well as address other deficiencies identified during the course of the review, with the objective of better protecting Air Force personnel and family members. 

Background:

The shooting that occurred on 5 Nov 09, at the Fort Hood, Texas, Soldier Readiness Center resulted in the deaths of 12 Soldiers and one Army civilian, and the hospitalization of 30 

victims who sustained gunshot wounds. The President directed a review of intelligence matters related to the Fort Hood shooting, and a military justice investigation is underway. In 

order to maintain the integrity of these investigations, other reviews underway must not 

interfere with either of these activities. Nothing herein should be interpreted as expressing 

any view on the culpability of any individual for the events of 5 Nov 09. 

Objectives and Scope:

The FOR will specifically identify gaps and/or deficiencies in Air Force programs, processes, procedures, and training related to the purpose of this FOR, and will recommend 

improvements. The review will include the following areas: 

● Identifying military and civil service personnel, contractors, and civilians who may 

pose credible threats to themselves and/or others due to internal or external stressors, and consider:

ű Personnel Reliability Programs 

ű Personnel assessments to include documentation, reporting, and coordinating 

pertinent information among appropriate officials 
AIR FORCE FOLLOW-ON REVIEW A-2

ű Medical assessments and/or adverse personnel actions 

ű Recruitment, background investigations, screening, security clearance, hiring, 

and placement, with additional focus on recently modified military accession 

and streamlined civilian hiring authorities 

ű Transition of personnel deemed not fully qualified or suitable for continued 

service 

● Force protection programs related to potential internal and external threats, from 

installation to HAF-level, including Air Force reliance on other Services at locations where the Air Force is a supported Service

● Reporting procedures when personnel may be considered a potential threat to 

themselves and/or others 

● Limitations on the ability to communicate, document, and/or share information, 

to include: 

ű Privacy Act and HIPAA issues 

ű Transparency and accessibility of information 

ű Sufficiency of information sharing between health care providers, helping agencies, commanders, first sergeants, and/or supervisors 

ű Effectiveness of documenting and transferring personnel information, particularly during personnel transitions 

● Training and education related to identifying, preventing, and/or responding to 

individuals who may be in distress and/or potentially pose a threat, to include: 

ű Life skills and work-life balance 

ű Mental health and/or medical concerns/conditions (e.g., PTSD, suicide awareness) 

ű Behavioral concerns on and/or off-duty (e.g., unsatisfactory duty performance, 

isolation, alcohol and/or substance abuse, financial issues, family issues, violent/

aggressive behavior, questionable associations) 

ű Risk factors for violence 

● Readiness for emergency response to internal and/or external threats and mass casualty situations at AF or Joint Base facilities, to include: 

ű Capabilities for responding to alleged perpetrators 

ű Initial alert notifications/warning systems, and subsequent communication updates 

ű First responder training 

ű Memoranda of Agreement with local community and state first responders 

ű Personnel accountability 

ű Frequency of exercises, use of checklist procedures, and readiness assessments 
A-3 AIR FORCE FOLLOW-ON REVIEW

Appendix A  Terms of Reference

● Readiness to care for victims and family members in the aftermath of a mass casualty 

situation, particularly training preparation and periodic assessments, to include: 

ű Helping agency and Crisis Incident Stress Management (CISM) team training 

ű Memoranda of Agreement with local community and state support agencies 

ű Frequency of mass casualty exercises and readiness assessments 

● Support of professional care providers (e.g., chaplains, medical, and mortuary 

professionals) 

● Direct personal support, interface, and feedback, to include: 

ű Selection and assignment of sponsors and unit wingmen to new unit personnel 

ű Training on, and assessment of, sponsor responsibilities 

ű Pre-and post-deployment health assessment programs 

ű Resiliency and reintegration programs 

ű Military and civil service feedback sessions 

ű Responsibilities in support of contractor personnel 

ű Health questionnaires and assessments over the course of service 

Methodology:

● The FOR will entail a Total Force examination of relevant programs, policies, procedures, and best practices ranging from DoD and Air Force levels to MAJCOM, 

DRU and installation levels.

● FOR participants are authorized to use appropriate interviews, focus groups, data 

compilation, and other processes they determine sound and necessary to achieve 

objectives.

● Specific methodology will be established by the AF Lead (AETC/CC).

● MAJCOM/CVs and DRU/CCs will lead their command’s effort, working in concert with HAF 2-digit functional experts and the HAF Lead (AF/A1).

● Functional and cross-functional discussions will be required between subject matter experts at the HAF, MAJCOM, DRU and installation levels to identify seams 

and disconnects among programs, policies, procedures, and training.

● As HAF Lead, the AF/A1 will guide and integrate HAF 2-digit, MAJCOM, and 

DRU functional and cross-functional efforts and results. 
AIR FORCE FOLLOW-ON REVIEW A-4

Duration: 

The Air Force FOR will begin no later than 15 Feb 10 and conclude by 15 May 10, at 

which time the AF Lead will submit the results of the FOR to the Secretary of the Air 

Force and the Chief of Staff. 

Deliverables:

The FOR will deliver a concise presentation of areas requiring attention and recommended courses of action to implement DoD IR recommendations and address other 

gaps and/or deficiencies identified during the course of the review. The FOR will further 

recommend internal controls to minimize risks, reduce the likelihood of future incidents 

and mitigate associated circumstances, and will outline best practices (Air Force and 

otherwise) to improve Air Force policies, programs, procedures, and training. The final 

product will be in a format that is readily accessible and usable by those who will take 

follow-on actions. 

Support: 

Air Force personnel will provide such assistance as required to meet established FOR 

objectives, scope and timeline, to include access to Air Force records, consistent with law 

and regulation. To the extent that needed access is impeded by such law or regulation, it 

will be noted in the report. 
B-1 AIR FORCE FOLLOW-ON REVIEW

Appendix B  Best Practices

The Secretary of the Air Force requested the Air Force Follow-on Review identify best 

practices, Air Force and otherwise, to improve our policies, programs, procedures, and 

training. Accordingly, we assessed a number of programs and processes that have proven 

to be successful, and may be helpful to other installations. Air Force major commands and 

direct reporting units also conducted a comprehensive review of force protection initiatives for the Air Force Follow-on Review. The list below highlights a limited number of 

ongoing programs and practices implemented at various Air Force installations or in support of specific commands. Additional noteworthy programs and practices are mentioned 

throughout the report. 

The following best practices range from improving force protection on the prevention, 

preparation, and response fronts, to improving the resiliency of Airmen and their families. 

Each example illustrates the results of actively engaged leaders from across the Service to 

preserve our Air Force community as the safe, secure, supportive environment we expect 

it to be.

Risk Assessment and Prevention – Collaborative Support

At the 21st Space Wing (21 SW) at Peterson AFB, CO, installation leaders noted that 

the same names repeatedly surfaced in different personnel forums (e.g., Status of Discipline, Central Registry Board, “Cops and Robbers,” Cross Functional Oversight Committee, and Sexual Assault Response Coordinator). Unit leaders realized they may have 

missed prior opportunities to help troubled Airmen before more serious events occurred. 

As a result, 21 SW leaders established a “Status of Care” forum in April 2009 to bring 

appropriate entities (e.g., commanders, medical, legal, chaplains, OSI, etc.) together to 

review a list of at-risk Airmen. Airmen were discussed by rank and situation, not by name, 

to protect their privacy. When appropriate, the group discusses potential success strategies 

for individual situations, assisting squadron and group commanders consider several options for addressing situations. Status of Care is an intervention group rather than a disciplinary forum, although punitive measures may be discussed to assess care. The initiative 

established by the 21 SW serves as model for the Status of Health and Airmen Resiliency 

Exchange (SHARE) initiative proposed in Chapter 2 of this report. (POC: 21 SW/DS)

Risk Assessment and Prevention – Deployment Outreach

The Yellow Ribbon Reintegration Program (YRRP) is congressionally mandated in accordance with Section 582 of Public Law 110-181, 28 January 2008, to support National 

Guard and Reserve members and their families. The YRRP provides information, services, 
AIR FORCE FOLLOW-ON REVIEW B-2

referrals, and outreach opportunities over the course of the deployment cycle. In addition 

to providing a continuum of support, the YRRP provides a high standard of care for 

military members and their families. Specifically, the program supports the Air Reserve 

Components (ARC) with five key events timed during pre-deployment, deployment, and 

post-deployment. Pre-deployment events prepare military members and their families for 

deployment by providing training and resources, and offering support services. During 

deployment, the YRRP provides tailored information and support for families and employers, raising awareness to challenges and stressors associated with deployment. Postdeployment events at the 30- and 60-day points focus on reconnecting military members 

with their families, employers, and communities, as well as providing information and 

access to resources to facilitate successful reintegration. These events include a forum for 

members and their families to address negative behaviors related to combat stress and 

transition. The third post-deployment event occurs 90 days after return and addresses 

specific programs focused on the member’s adjustment and reintegration, to include a 

post-deployment health reassessment (PDHRA). While geared to the ARC, the YRRP 

serves as an important engagement model for building resiliency and a sense of community among deployed Airmen, their families, and even employers. (POC: NGB/A1)

Preparation – Active Shooter Training

After the 2007 Virginia Tech shooting, the US Air Force Academy (USAFA) made active shooter prevention and response a priority. The installation antiterrorism office developed plans and checklists, and then implemented a training program to prepare the installation for an active shooter incident. USAFA updated training to include “key action” 

words. Once USAFA matched actions to the action words of cover, communicate, mitigate, 

personnel found it easier to know what to do when confronting an active shooter. In exercising these concepts, USAFA reduced estimated casualties by 50 cadets during the first 

exercise in 2007, to only 4 during a January 2010 active shooter exercise. The innovative 

planning and training USAFA conducted exemplifies the force protection success that can 

be achieved by heightening awareness and engaging members within the local Air Force 

community. (POC: USAFA/ATO)

Preparation – Active Shooter Lessons Learned

USAFA reviewed lessons learned from the February 2008 active shooter incident at 

Northern Illinois University (NIU) in order to ensure their force protection procedures 

addressed gaps as well as successes. The NIU action assessment revealed that students ran 
B-3 AIR FORCE FOLLOW-ON REVIEW

Appendix B  Best Practices

from the auditorium where the shooter was into other classrooms and auditoriums that 

could not be locked. Students fled in a similar pattern during the April 2007 Virginia 

Polytechnic Institute (Virginia Tech) shooting. Students tried to barricade the doors with 

desks and other items, but the shooter fired shots through the door. Recognizing that 

survivability may be lower among students who fled into classrooms that could not be 

locked, USAFA issued work orders to have locks installed on all classroom and auditorium doors. This initiative is due to be completed by June 2010. (POC: USAFA/ATO)

Preparation – Active Shooter Table Top Exercise

Based on the Fort Hood After-Action Report, the 20th Fighter Wing (20 FW) at Shaw 

Air Force Base, SC tasked its Security Forces to develop a comprehensive active shooter 

scenario for wing leadership to table top exercise a potential event. The 20 FW Plans and 

Inspections Office compiled and conducted training on active shooter profile, special 

considerations for military installations, command and control in a dynamic environment, and active shooter response by security forces members. The scenario was presented 

in a “rapid slide build” format to simulate how quick an active shooter event can unfold 

and to ensure leaders understood they would have little time to develop situational awareness during the event. Follow on discussions addressed site safety by Emergency Ordnance 

Disposal, treatment by medical providers (including Post Traumatic Stress Disorder for 

survivors and family members of victims), Public Affairs interaction with media, and requirements for interacting with local law enforcement and federal agencies. The table top 

exercise scenario conducted by the 20 FW is an effective and low-cost means of testing 

preparedness, response, and recovery to determine gaps in procedures and practice. Consideration of off-base support by local, state, and federal emergency response, medical, law 

enforcement, and investigative entities and the need for supporting MOUs is equally important. (POC: 20 FW/XP)

Response and Recovery – Mass Emergency Notification

In 2007, AFRC deployed the Installation Warning System (IWS) Alerts Emergency 

Notification System (ENS), a commercial off-the-shelf system from AtHoc, Inc. AFRC 

pursued this means of mass notification to address the fact that domicile locations vary 

greatly among Reserve component forces. AFRC plots members’ individual addresses using geospatial information system capabilities. Based on event projections, supportable 

conclusions can be made with regard to the impact on AFRC forces and where to focus 

follow-up contact and support efforts. The IWS-ENS capability enhances command, 
AIR FORCE FOLLOW-ON REVIEW B-4

control, and accountability capabilities and is easily adaptable to any real-world or exercise 

scenario, to include threat events that may occur on as well as off base. (POC: HQ AFRC/A7)

Response and Recovery – Instant Messaging Alerts

The USAFA Command Center implemented an initiative that improved their Installation Notification and Warning System (INWS) while simultaneously adjusting to lower 

manning from single controller operations. USAFA fielded “Falcon Alert,” a local customization of Rave Mobile Safety’s “Rave Alert” system. This particular system delivers broadcast emergency alerts via text messaging, e-mail, voice messaging or Really Simple Syndication (RSS) feed. Narrowcast alerts to specific groups or individuals are also possible. 

User registration requires only 5 minutes; once registered with the system, individuals will 

receive message updates on emergency matters and other notices via their preferred notification method. A single controller has demonstrated the ability to send text, e-mail, 

voice messages, and an RSS alert within three minutes after a standard attack notification. 

USAFA’s initiative is illustrative of the mass communication capability that can be gained 

by leveraging off-the-shelf technology. (POC: USAFA/ATO)

Response and Recovery – Active Shooter Contingency Support

To provide active shooter contingency response for locations with smaller Security 

Forces units, Air Force Materiel Command (AFMC) implemented a Staff Reaction Force 

(SRF). The SRF is comprised of six staff personnel who have been trained and appropriately equipped with weapons and communication capability. These individuals keep their 

equipment readily available and are available to immediately augment any AFMC Security Forces unit in the event of an active shooter situation. (POC: AFMC/IG)

Response and Recovery – Engaging the Community

Representatives from Hickam Air Force Base (AFB) Anti-terrorism, Force Protection, 

Fire Department, Security Forces, and Safety organizations are members of the local 

School Safety Committee (SSC). The SSC establishes school-wide phases of Emergency 

Management (Prevention and Mitigation, Preparedness, Response, and Recovery) efforts. 

The SSC meets quarterly to review the Hawaiian Department of Education Crisis Management and Safety Guide, and to plan mandatory emergency drills (earthquake, lock 

down, off-campus evacuation, and shelter-in-place). Base officials attend emergency drills 

and provide input to after-action reviews conducted by the school. By partnering with the 
B-5 AIR FORCE FOLLOW-ON REVIEW

Appendix B  Best Practices

local community school system, Hickam AFB is heightening emergency-response awareness within the local community and at locations frequented by Hickam AFB families. 

(POC: 15 MSG/CCL)

The practices outlined above are not all inclusive, but reflect efforts to address force 

protection concerns more effectively. Air Force personnel must remain consistently engaged to identify and address issues, heighten community awareness and participation, 

and leverage technology to facilitate rapid and accurate communication. Protecting our 

personnel is not just a concern for unit leaders, but a shared concern within our entire Air 

Force community. We highlight the noteworthy programs and practices above and others 

within our report to encourage leaders Air Force-wide to pursue innovation and to share 

their successes with others. Doing so will better protect and strengthen our communities 

by more effectively training and preparing to prevent, respond, and recover from the inevitable tragedies in life.
AIR FORCE FOLLOW-ON REVIEW B-6

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C-1 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

This is a primary source document 

provided by the Air Force Manpower Agency.

Preventing and Responding 

to Violence Survey

The Air Force Manpower Agency conducted a survey to the Air Force Follow-on Review Related to Fort Hood. Responses from unit leaders were used to assess possible deficiencies in information sharing, training and recognition of internal threats, force protection, mass casualty response, and post-incident support. The survey was administered for 

three weeks to a target population of 4,229 active duty, Guard, Reserve commanders, and 

civilian directors at the wing, group, squadron, and detachment level. Overall, 2,068 participants completed surveys. Survey sample demographics closely reflect Air Force leadership population demographics.

Where AFMA detected statistically significant differences in survey responses by Air 

Force affiliation, MAJCOM, organizational levels, or CONUS/OCONUS, the additional 

results are presented. AFMA conducted further analysis on certain areas where we suspected career field or line/non-line officers’ perspectives might also play a role; where significant, these results are presented as well.

The results indicate approximately 25 percent of unit leaders report receiving training 

in shooting sprees/mass killings of which three quarters report the training provided the 

necessary skills to respond. Less than half of commanders and civilian directors believe 

unit personnel are informed about the potential for an active shooter scenario on base and 

clearly understand what to do during an active shooter situation. Primary and backup 

slides are included in this appendix.
AIR FORCE FOLLOW-ON REVIEW C-2

FOR Survey

● Purpose

● Identify and assess possible deficiencies in information sharing, training 

and recognition of internal threats, force protection, mass casualty response and post incident support

● Data Collection Period: 22 February – 8 March

● Distributed to Commanders and Civilian Directors

● Participation Rate – Overall 49% (2,068 Completed Surveys)

● Active Duty: 55%

● AF Reserve: 43%

● Air National Guard: 40%

● Civilian Directors: 36%

● Agree scales collapsed

Sample Demographics

Survey sample demographics closely reflect population demographics
C-3 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Areas of Interest

● Approximately 25% of commanders report receiving training in shooting 

sprees/mass killings; 75% of those commanders report the training provided 

skills needed to respond

● Less than half of commanders feel personnel are informed or know what to do 

during an active-shooter event

● Top 5 reasons commanders are hesitant to report behaviors

● Not sure there is anything worth reporting

● Lack of documented proof

● Unclear guidance

● Unclear lane of authority

● Lack of authority

● Most documented behavior is financial problems

● Least documented behaviors are associated with extremist groups

● Information sharing is most constrained by HIPAA

I Would Contact

If I suspected that a member of my unit posed a credible threat to themselves or 

others, I would contact:
AIR FORCE FOLLOW-ON REVIEW C-4

Timely Information

I receive timely information from the following agencies when they determine my 

personnel may pose credible threats to themselves or others:

Tools

Other than the agencies previously mentioned, I use the following tools to educate 

myself on how to assess indicators of a potential for violence by a member of my unit:
C-5 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

My Authorities

I am aware of my authorities to deal with personnel in the following categories who 

may pose credible threats to themselves or others: 

Associated Threats

I have the means to verify whether groups and/or networks my personnel are associated with pose a threat to the Air Force community.
AIR FORCE FOLLOW-ON REVIEW C-6

Training to Prevent Violence

In the past year, have you received AF sponsored training to prevent the following 

types of violence?

Training to Prevent Violence

The training I received provided the skills/tools I need to prevent the following types 

of violence:
C-7 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Training to Respond to Violence

In the past year, have you received AF sponsored training to respond to the following 

types of violence?

Training to Respond to Violence

The training I received provided the skills/tools I need to respond to the following 

types of violence:
AIR FORCE FOLLOW-ON REVIEW C-8

Emergency Response Practice

My unit practices emergency response actions:

Emergency Response Practice by Career Family

My unit practices emergency response actions:
C-9 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Alert Procedures: CONUS vs OCONUS

The following Installation alert procedures for ongoing threats are:

Installation Threat Working Group: Actionable Information

The installation Threat Working Group provides commanders with actionable 

information.
AIR FORCE FOLLOW-ON REVIEW C-10

Installation Threat Working Group: Timely Information

The installation Threat Working Group provides commanders with timely information.

Behaviors Documented by Unit Supervisors

All Commanders n= 2068
C-11 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Understanding Procedure 

All Commanders n= 2068

Document Action by Affiliation

When I refer or report personnel concerns to any of the previously mentioned agencies, I understand how to document the action on the following personnel:
AIR FORCE FOLLOW-ON REVIEW C-12

Direct Feedback

When I refer or report personnel concerns, I receive direct feedback on actions taken 

by the appropriate agency.

Hesitant to Report

Please identify to which of the following agencies you would be hesitant to report 

personnel:
C-13 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Hesitant to Report

People in my unit might be hesitant to report personnel’s possible risk factors for 

violence to official agencies/individuals due to the following:

Hesitant to Report

I might be hesitant to report personnel concerns to official agencies/individuals due 

to the following:
AIR FORCE FOLLOW-ON REVIEW C-14

Hesitant to Report

Other commanders might be hesitant to report personnel’s possible risk factors for 

violence to official agencies/individuals due to the following:

My unit personnel clearly understand what to do during an active-shooter situation 

on-base (e.g., direction of evacuation, shelter in place, etc.).

Preparation for Active-Shooter Events by MAJCOM

My unit personnel are informed about the potential for active-shooter scenarios 

on-base.
C-15 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Preparation for Active-Shooter Events by Career Family

My unit personnel are informed 

about the potential for activeshooter scenarios on-base.

My unit personnel clearly understand 

what to do during an active-shooter 

situation on-base (e.g., direction of 

evacuation, shelter in place, etc.).

Commander Training

My commander training sufficiently addressed the following:
AIR FORCE FOLLOW-ON REVIEW C-16

Change to Information Sharing

● “What change to information sharing is most needed to ensure the health and 

safety of your personnel?”

● Background

● 750 responses

● 18 areas of concern with at least 10 responses each

● Top 10 responses accounted for 80% of all responses

● Analysis focused on identifying areas of concern based on Commander 

statements

● Identified responses reflect level of detail provided by Commander statements

Information Sharing

Information sharing between Air Force leaders and service providers about personnel 

concerns is constrained by:
C-17 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Suggested Changes to Information Sharing

● Timely/Complete info on Airman’s medical treatment

● Timely/Complete info on Airman’s medical treatment (with specific reference to 

HIPAA)

● Timely/Complete info from agencies (e.g., OSI, Chaplain, etc.)

● Improve guidelines/processes for sharing information

● Improve training for Commander

● Arrange time to interact with Airmen

● Improve training for all Airmen

● Database of relevant information on Airman incidents/behavior

● Fair application of and adherence to standards/discipline

● Timely/Complete info on Airman’s medical treatment (with specific reference to 

civilian health care providers)

Comments on Information Sharing

● “In order to make informed decisions a commander needs all the relevant 

information in a case, which means more data from care providers to build a 

whole person picture.” Sq CC

● “There has to be a way to comply with [HIPAA] and still ensure commanders/

first sergeants get the information they need to ensure the health, morale, 

welfare and safety of all . . .” Wg CC

● “Unless the Airman self-identifies, there is little I can do until [it is] too late.” 

Gp CC

● “We [don’t] share information now. Thus any change would be an improvement.” Sq CC

● “Most needed is a MAJOR leadership program of mentorship and cross-talk so 

leaders can learn from others experience.” Sq CC
AIR FORCE FOLLOW-ON REVIEW C-18

Top Three Internal Threats

● Disgruntled Airman/civilian employee/contractor

● Alcohol/Drug abuse

● Stress (in general)

● Perimeter defense

● Mass casualty involving firearms

● Emotionally unstable individual

● Terrorist act

● Suicide

● Contractor loyalty

● Family stress (in general)

● Financial stress/poor economy

● Job security

Top Three Internal Threats

● “What top three internal threats to your installation concern you the most?”

● Background

● 2,622 responses

● 53 areas of concern with at least 10 responses each

● Top 10 responses accounted for 51% of all responses

● Analysis focused on identifying areas of concern based on Commander 

statements

● Identified responses reflect level of detail provided by Commander statements
C-19 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Analysis Notes

● Participation Rate – Overall 49% (2,068 Completed Surveys)

● Active Duty: 55%

● AF Reserve: 43%

● Air National Guard: 40%

● Civilian Directors: 36%

● Agree scales are collapsed for ease of reporting

● % Agree = % Strongly Agree + % Agree

● % Disagree = % Strongly Disagree + % Disagree

● Results are not displayed for demographic groups with less than 10 respondents

● Vertical bar charts display a bar for each demographic group

● Horizontal bar charts display a bar for each question
AIR FORCE FOLLOW-ON REVIEW C-20

During My Command

How often do you practice the following?

Training - Prevent Violence by Career Family

In the past year, have you received AF sponsored training to prevent the following 

types of violence?
C-21 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Training – Prevent Violence by Career Family

The training I received provided the skills/tools I need to prevent the following types 

of violence:

Training – Respond Violence by Career Family

In the past year, have you received AF sponsored training to respond to the following 

types of violence?
AIR FORCE FOLLOW-ON REVIEW C-22

Training – Respond Violence by Career Family

The training I received provided the skills/tools I need to respond to the following 

types of violence:

During My Command

How often do you practice the following?

Tabletop mass casualty exercises Mass casualty exercises with local community first responders

Note: Recruiting Services: n=18
C-23 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

During My Command

How often do you practice the following?

Integrated exercise involving on and off-base support Installation only exercises involving local community responders

Note: Recruiting Services: n=18

Behaviors Documented by Unit Supervisors

● Commanders were asked to check all of the behaviors that their supervisors 

regularly document for AD, Guard, Reserves, Civilians, Contractors, and Family

● Minimal differences in behaviors cited by Active Duty, Guard, Reserve commanders

● Military commanders indicate the most documented behavior is “Financial 

problems”

● Military commanders primarily checked behaviors for personnel under 

their same affiliation 

● Civilian Directors are more likely to cite violent behaviors as the top documented behaviors

● Least documented behaviors reported by all leaders are:

● “Affiliation with groups that pose credible threats” 

● “Association with groups known to advocate violence” 

● “Association with groups that advocate extremist ideologies”
AIR FORCE FOLLOW-ON REVIEW C-24

Behaviors Documented by Unit Supervisors

Active Duty Commanders n= 1362

Behaviors Documented by Unit Supervisors

Air National Guard Commanders n= 405
C-25 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Behaviors Documented by Unit Supervisors

AF Reserve Commanders n= 228

Behaviors Documented by Unit Supervisors

Civilian Directors n= 73
AIR FORCE FOLLOW-ON REVIEW C-26

Non-Line Officers

Non-Line officers are held to the same professional standards as Line Officers.

Non-Line Officers

Non-Line officers are held to the same professional standards as Line Officers.
C-27 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Understanding Procedure

● Commanders were asked to check all of the agencies for which they understood the appropriate procedures for referring or reporting their personnel

● Minimal differences in understanding procedures cited by Active Duty, Guard , 

Reserve commanders

● Best understood

● How to refer/report to Chain of Command and Chaplains

● Appropriate procedures for their own personnel

● Civilian Directors best understood appropriate procedures for active duty 

personnel as well as civilians

● Least understood procedures by all leaders

● Local community agencies 

● Off-base mental health provider

● Few leaders report understanding procedures on how to refer contractor 

personnel

Understanding Procedure

Active Duty Commanders n= 1362
AIR FORCE FOLLOW-ON REVIEW C-28

Understanding Procedure

Air National Guard Commanders n= 405

Understanding Procedure

AF Reserve Commanders n= 228
C-29 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Understanding Procedure

Civilian Directors n= 73

Preparation for Active-Shooter Events by Affiliation

My unit personnel are informed 

about the potential for activeshooter scenarios on-base.

My unit personnel clearly understand 

what to do during an active-shooter 

situation on-base (e.g., direction of 

evacuation, shelter in place, etc.).
AIR FORCE FOLLOW-ON REVIEW C-30

Preparation for Active-Shooter Events by Organizational Level

My unit personnel are informed 

about the potential for activeshooter scenarios on-base.

My unit personnel clearly understand 

what to do during an active-shooter 

situation on-base (e.g., direction of 

evacuation, shelter in place, etc.).

Preparation for Active-Shooter Events by CONUS/OCONUS

My unit personnel are informed 

about the potential for activeshooter scenarios on-base.

My unit personnel clearly understand 

what to do during an active-shooter 

situation on-base (e.g., direction of 

evacuation, shelter in place, etc.).
C-31 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Commander Training by Career Family

My commander training sufficiently addressed the following:

Commander Training

My commander training sufficiently addressed the following:
AIR FORCE FOLLOW-ON REVIEW C-32

Commander Training

My commander training sufficiently addressed the following:

Sources of Stress

I have a good understanding of whether the below sources of stress are currently 

affecting personnel within my unit.
C-33 AIR FORCE FOLLOW-ON REVIEW

Appendix C  AFMA Survey

Assessment of Programs

Assessment of programs/procedures available to mitigate stressors affecting 

unit personnel.

All Active Duty, Reserve Commanders 

and Civilian Directors Air National Guard Commanders
AIR FORCE FOLLOW-ON REVIEW C-34

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D-1 AIR FORCE FOLLOW-ON REVIEW

Appendix D  Team Rosters

Risk Assessment and Prevention 

Col Andy Huff

Col Belinda Morrone

Ms. Connie Wright

Lt Col James Bachinsky

Lt Col Mark Bell

Lt Col Mark DiCarlo

Lt Col Mark Formica

Lt Col Clifford Gyves

Maj Jason Knudsen

Maj Brian Musselman

Mr. Peter Koeppl, Contractor

Sharing Information

Col Keith Givens

Ms. Connie Wright

Lt Col Angel Olivares

Lt Col Bridgette Arnold

Lt Col Eric Obergfell

Lt Col Kevin Seeley

Maj Reid Novotny

Maj Renae Hilton

Preparing the Force

Col Michael Hafer

Lt Col Lowell Sensintaffar

Lt Col Aaron Benson

Lt Col Mark DiCarlo

Lt Col Mark Formica

Lt Col Marshall S. Furr

Lt Col Gary Hayward

Lt Col Frederick Helmer

Lt Col Tara Morrison

Maj Jason Knudsen

Capt Carl Cook

Developing the Force

Col James Miner

Lt Col Amy Asher

Ms. Ladonna McGrew

Lt Col Charles Motsinger

Maj Thomas Hoskins

Mr. Christopher Merlo

Chap (Maj) Abner Valenzuela

CMSgt Saint Carter

CMSgt Lawrence Chang

Ms. Pamela Friend

DS Staff

Col Joan Garbutt

Laura Miller, PhD

Lt Col John Giles

Lt Col Jason Knight

Maj Chad Schrecengost

Maj Tracy Maza

Capt Marissa Carlton

Capt Tracy Barnett

Capt Shane Blevins

HAF Teams
AIR FORCE FOLLOW-ON REVIEW D-2

Leading the Force

Mr. Tom Kelly

Chap (Col) Jerry Pitts

Col Annette Sanks

Lt Col Mark Formica

Lt Col Janice Langer

Lt Col Roger Neumann

Lt Col Jeff Puckett

Mr. Mike Dickey

Ms. Carmen Livoti

Chap (Maj) Matthew Franke

Capt Thomas Oziemblowsky

Responding and Recovering

Col Elizabeth Arledge

Chap (Col) Jerry Pitts

Lt Col John Conaway

Lt Col Elizabeth Demmons

Mr. Mike Dickey

Lt Col Karl Kraan

Ms. Gretchen Shannon

Lt Col Tom Taylor

Maj Gary Byrd

Maj Dan Janning

Maj Scott Olech

Capt Ian Phillips

SA Brian Alexander

Other HAF Contributors

Mr. Jim Neighbors

Col Gregory Cate

Col James Byrne

Col John Forbes

Lt Col James DeLong

Mr. Gary Brisbane

Mr. Dan Stanton

Mr. Dan Cipra

Ms. Jessica Pezzaro

Ms. Ellen Campana

Ms. Mercedes Greene

Red Team

Col Dan Charchian

Frank Wondolowski, PhD

SA James Cangialosi

Reachback Advisor

Lt Gen Richard T. Swope, USAF (Ret.)
D-3 AIR FORCE FOLLOW-ON REVIEW

Appendix D  Team Rosters

Major Command and Direct Reporting Unit Teams

ACC

Col Bob LaBrutta

Col Howard Stendahl

Col Alan Metzler

Col Victoria Bowens

Col David Crow

Col Mike Dwyer

Col Jeff Yocum

Lt Col Tim Wagoner 

Lt Col Joseph Piasecki

Lt Col David Schobel

Lt Col Erik Fegenbush

Lt Col John D. Smith

Lt Col Mitzi Thomas-Lawson

Mr. Jean Michel

Ms. M. Eileen Jones

Mr. Michael Hassan

Maj Joel Fenlason

Ms. Jill Gibson

Mr. Mark Salisbury

Mr. Angelo Dart

Capt Justine Iacono

SMSgt Bryan Vibert

AETC

Col Bruce Lovely

Chap (Col) Bobby Page

Col Gerard Jolivette

Col Lee Pittman

Col Tal Metzgar

Col John Lopardi

Mr. Chip Manning

Ms. Bonnie Molina

Mr. Byron Cotton

Lt Col Christopher Alonzo

Lt Col Cheryl Scaglione

Lt Col Sonya Collins

Lt Col Kristine Blackwell

Lt Col Christopher Oleksa

Lt Col Matthew McConnell 

Chap (Lt Col) Charles Cornelisse

Mr. Gerard Kinane

Mr. Charles Wyatt

Mr. David Smith

Capt Johanna Jaboneta

CMSgt William Dambacher

CMSgt Michael Young

SMSgt Ulanda Isaaks

AFDW

Mr. Steve Doss

Col June Gavron

Col David Timm

Col Brian Bellacicco

Col Wally Vaughn

Mr. Ryan Ferrell

Ms. Wanda Jones-Heath

Ms. Marsha Johnson
AIR FORCE FOLLOW-ON REVIEW D-4

AFGSC

Brig Gen Ed Walker

Col Pete Ellis

Col Charles Campbell

Col Jon Stovall

Col Mike Kelly

Col Annette Foster

Col Jimmy Sterling

Col Ronald Grove

Col Lynden Skinner

Col Michael O’Connor

Col Dewey Little

Mr. Kelvin Bowen

Mr. John Good

Mr. Robert Thomson

Lt Col Lori LaVezzi

Lt Col Paul Cairney

Lt Col Paul Gardetto

Lt Col Michael Saylor

Lt Col John Thomas

Lt Col Carl Wright

Maj Adam Curtis

Maj Christopher Karns

Maj Ryan Wheeler

1Lt Daniel Minnocci

SMSgt Eric Hein

TSgt Carl Koester

SA Michael Allen

SA Melody Mitchell

AFMA

Col Brian Norman

Mr. Grover Lindsey

Ms. Bernadette Oncale

Mischell Navarro, PhD

Mr. Louis Datko

AFMC

Mr. David Taylor

Col Kenneth Andersen

Col Joan Cunningham

Col Rick Hyland

Col Steven Merrill

Lt Col David Dusseau

Lt Col Michael Miles

Lt Col Roger Scott

Maj Franklin Swayne

Mr. Bill Klosterman

Mr. Russell Kofoed

Mr. Jeff Kirklighter

Ms. Libby Van Hook

Jeff Paddock, PhD

Mr. Mike Hall

Ms. Sharon Williams

AFOTEC

Col Edgar Vaughan

Ms. JoAnn Stringfield

Lt Col Carolyn Patrick

Mr. Roderick Earl

Barron Oder, PhD

Mr. Douglas Miles

CMSgt Kelly Branscom

Mr. Gerald Trujillo

SMSgt Peter Padilla

Mr. Timoteo Torrez

Mr. William Horst

MSgt Lonnie Allen

Ms. Jessica Leisey
D-5 AIR FORCE FOLLOW-ON REVIEW

Appendix D  Team Rosters

AFRC

Col Joseph Vivori

Col Mike Kozak

Col Connie Hutchinson

Col Max Mendoza

Col Allen Gilbar

Mr. Jefferey Ippolito

AFRI

Chris Cain, PhD

Mr. Robyn Read

Lt Col Kristal Alfonso

AFSPC

Brig Gen John Raymond

Col Gerald Curry

Col Mary Fleurquin

Col Thomas French

Mr. Jonathan Grammer

Col Bill Hampton

Col Dawn Harl

Col Beverly Plosa-Bowser

Col Susan Rhodes

Chap (Col) Gregory Tate

Col Ralph Thompson, Jr.

Col Stephen Whiting

Ms. Nancy Brewer

Chap (Lt Col) Michael Grubbs

Lt Col Mark McCullohs

Lt Col Alexis Sotomayor

Mr. Al Strait

Mr. Al Brodecki

Maj Scott Bullis

Ms. Kathy Latzke

Capt Joy Tredway

MSgt June Geter 

SA Steven Aguilar

AFSOC

Col Brady Reitz

Lt Col Chris Simpson

Lt Col Bill Marsh

Lt Col Chris Holton

Maj Charles Love

Maj Roy Frierson

Mr. David Charitat

CMSgt William Posey

Ms. Jeanne Haun

AMC

Col Diane Ritter

Col Wilkins Urquhart

Col Frank Jones

Col Barbara Jacob

Col Steven Ehlenbeck

Chap (Col) Gary Linsky

Mr. Tony Joyner

Lt Col John Jorgensen

Mr. John Hoercher

Mr. Paul Zabbo

Ms. Patti Sizemore

Capt Jonathan Stock

Capt Sandra Bannan

Mr. Stephen Pak

MSgt Mark Miller

SA Kim Gaestel

NGB/ANG

Col Ronald Gionta

Lt Col Anthony Lanuzo

Mr. Jerry Bivins
AIR FORCE FOLLOW-ON REVIEW D-6

PACAF

Col James Strickler

Col Steve Hatfield

Col Mark Kling

Col Judith Hughes

Mr. Jeff Allen

Mr. Cliff Hogue

Mr. Johnny Bland

Lt Col James Tims

Lt Col Wendy Sherman

Lt Col Ron Gray

Lt Col Marie Colasanti

Lt Col Robert Lilke

Maj Cotina Jenkins

SMSgt Charlie Johnson

USAFA

Col Rick LoCastro

Col Ronald Nelson

Lt Col Edward Werner

Mr. Paul Ceciliani

Mr. James Rowell

Mr. J. Lance Matzke

USAFE

Col Carla Gammon

Col Gus Green

Col Joseph Mastrianna

Col Mike Johnson

Col Robert Moriarty

Col David Hocking

Col Rod Dorsey

Col Pamela Moxley

Col John Jordan 

Mr. Perry D. Sell

Mr. Billy Trevino

Mr. Roger Davis

Lt Col Aubrey Burkel

Lt Col Craig Hess

Lt Col Victor Moncrieffe

Lt Col David Klaus

Maj Catherine Gambold

Maj Steve Smith 

Maj Debra Shock

Maj Kevin Mares

Capt Lorena Venegas

Capt Christopher Smith

MSgt Sam Miller
E-1 AIR FORCE FOLLOW-ON REVIEW

Appendix E  Recommendations

1.1 Develop Air Force policy addressing how risk assessment tools can be used to improve care and overall force protection for Air Force members. (OPR: SAF/IG)

1.2 Develop a risk assessment reference available for all Air Force members. (OPR: AF/SG)

1.3 Partner with the FBI’s Comprehensive Analysis of Military Offenders project to 

ensure that its research approach reflects Air Force concerns and its products are 

applicable to Air Force populations. (OPR: SAF/IG)

1.4 Continue to update assessment tools as the state of knowledge and policy develop 

and include appropriate courses of action and resources for active-duty, National 

Guard, Air Force Reserve, civilians, contractors, and dependents. (OPR: SAF/IG)

1.5 Sponsor research to develop long-term behavioral indicators that may point to 

progressive indicators of violence among Air Force personnel. (OPR: SAF/IG)

2.1 Coordinate with the Under Secretary of Defense for Personnel and Readiness to 

review and update DoDI 1325.06, Handling Dissident and Protest Activities among 

Members of the Armed Forces, to ensure guidance is actionable and includes behavior examples as well as guidance on how to respond to uncertain situations, and 

revise AFI 51-903 accordingly. (OPR: AF/JA, SAF/GC)

2.2 Revise AFI 51-903, via an Air Force Guidance Memorandum, to improve identification of potential threats and clarify how commanders may determine which 

activities, including group participation, are disruptive to good order and discipline. (OPR: AF/JA, SAF/GC)

2.3 Update The Military Commander and the Law by adding resources on addressing 

extremist behaviors, including information or actions that indicate personnel may 

be engaged in extremist or other prohibited activities. (OPR: AF/JA)

2.4 Ensure unit leaders are aware of DA PAM 600-15, Extremist Activities, and consider publishing a similar Air Force document and associated training material to 

improve current awareness of extremist and prohibited activities. (OPR: AF/JA, 

SAF/IG)

3.1 Update AFI 36-2903, Dress and Personal Appearance of Air Force Personnel, to address prohibited tattoos, brands, and body art and to reference acceptable tools for 

unit leaders and other Airmen to identify prohibited markings. (OPR: AF/A1)

3.2 Disseminate AFOSI’s “Visual Iconography: Gang and Right-Wing Hate Group 

Affiliated Symbols and Body Art” to commanders as an initial reference tool, followed by the AFI update. (OPR: SAF/IG)

3.3 Establish a comprehensive reference tool of prohibited body markings for recruiters, trainers, commanders, and supervisors. (OPR: SAF/IG)
AIR FORCE FOLLOW-ON REVIEW E-2

3.4 Develop a centralized tracking tool to inform commander decisions of previously 

approved body markings. (OPR: AF/A1)

4.1 Amend current Air Force policy and procedures contained in AFI 31-101, Integrated Defense, to govern privately owned weapons in all Air Force housing. In 

doing so, consider whether effective as well as constructive notice is provided to 

individuals who enter installations but do not live on them. (OPR: AF/A4/7)

4.2 Coordinate with the Under Secretary of Defense for Intelligence to prepare a 

department-wide interim guidance message and interim guidance that will be incorporated into a revision of DoD 5200.08-R, Physical Security Program. (OPR: AF/A4/7)

5.1 Revise AFI 31-101, Integrated Defense, to require individuals to sign DD Form 

2760, Qualification to Possess Firearms or Ammunition, when firearms are registered 

in accordance with DoDI 6400.06 and 18 USC 922. (OPR: AF/A4/7)

6.1 Train health care providers who conduct pre- or post-deployment interviews to 

assess non-mental-health-related risks for violence (e.g., potential for radicalization, gang involvement). (OPR: AF/SG)

6.2 Expand deployment risk assessment methods to include reliable, accessible collateral information. (OPR: AF/SG)

6.3 Encourage Airmen to share with leadership or support service providers 

pre- and post-deployment concerns about themselves as well as others. 

(OPR: AF/SG)

6.4 Consider adopting a program similar to the Fort Lewis Soldier Wellness Assessment Program, which requires all deploying personnel to meet personally with 

credentialed mental health providers. (OPR: AF/SG)

7.1 Develop appropriate changes to policy, programs, and procedures to establish mental 

health consultancy to help unit leaders more effectively address the risks for violence, 

similar to the manner in which unit leaders consult with chaplains. (OPR: AF/SG)

8.1 Coordinate with DoD to develop workplace violence and internal threat prevention and response policies, programs, and procedures. (OPR: AF/A4/7)

9.1 Revise AFMAN 31-201, vol. 4, High Risk Response, to establish policy and procedures on reporting indicators of violence and enable swift and appropriate response to prevent escalation. (OPR: AF/A4/7)

9.2 Update AFI 44-154, Suicide and Violence Prevention Education and Training, to 

include internal threat exercise requirements. (OPR: AF/SG)
E-3 AIR FORCE FOLLOW-ON REVIEW

Appendix E  Recommendations

10.1 Coordinate with DoD to draft an instruction, followed by a 90- or 40-series AFI 

integrating the full spectrum of violence into a comprehensive prevention and response program. (OPR: AF/A1)

11.1 Coordinate with DoD to establish standard contract language regarding prohibited activities, inappropriate or high risk behavior related to violence in the DoD 

workplace. If feasible, the standard language should be required for inclusion in all 

DoD contracts and should parallel standards set for government civilian employees on potential indicators of violence in the workplace. (OPR: SAF/AQ)

12.1 Revise AFI 36-703, Civilian Conduct and Responsibility, to more clearly address violence in the workplace. (OPR: AF/A1)

13.1 Address personal resiliency and risk management through formalized programs 

that provide an overarching approach to identifying and managing stressors. (OPR: 

AF/A1)

14.1 Integrate information on internal threats and workplace violence into the Integrated 

Delivery System community outreach and prevention programs. (OPR: AF/A1)

15.1 Consolidate guidance related to religious accommodation (e.g., dress, religious 

observance, immunization) in a single 52-series AFI. (OPR: AF/HC)

15.2 Revise policy to recommend leaders consult chaplains and legal counsel when 

making decisions about religious accommodation requests and to guide leaders on 

the challenges of such decisions in joint environments. (OPR: AF/HC)

15.3 Revise AFI 52-101, Planning and Organizing, to include procedures for religious 

accommodation. After AFPD 52-1 coordination is complete, ensure that the prevention, identification, and response to religious-based disrespect, harassment, and 

discrimination are sufficiently addressed in relevant training (e.g., equal opportunity training, free exercise of religion training, Wingman training, and commander 

courses). (OPR: AF/HC)

16.1 Coordinate with the Deputy Under Secretary of Defense for Military Personnel Policy 

to develop procedures for investigative bodies to convey pertinent information to the 

Armed Forces Chaplains Board on religious organizations and their endorsing agents 

that may affect their status to endorse military chaplains. (OPR: AF/HC)

16.2 Following revisions to DoD policy, update AFPD 52-1, Chaplain Service, to reflect any 

revised roles and responsibilities of the Air Force Chief of Chaplains. (OPR: AF/HC)

17.1 Revise AFI 90-501, Community Action Information Board and Integrated Delivery 

System, to incorporate a forum geared to support Air Force members who need 

assistance or intervention to preclude more serious issues. (OPR: AF/A1)
AIR FORCE FOLLOW-ON REVIEW E-4

17.2 Fund a full-time, installation-level civilian position to oversee and integrate community, family, individual support, and resiliency programs. (OPR: AF/A1)

18.1 Consider the feasibility of adapting current background investigation processes 

and techniques to improve identification of internal threats. (OPR: SAF/AA)

19.1 Coordinate with DoD, DoS, and combatant commands to ensure foreign nationals working on OCONUS installations are subject to stringent investigation standards and procedures. (OPR: SAF/IA)

20.1 Coordinate with the Department of Homeland Security to ensure that foreign 

nationals granted access to CONUS installations are subject to the most stringent 

investigation standards and procedures possible. (OPR: SAF/IA)

21.1 Adopt the DoD Military Accessions Vital to National Interests program expanding background checks to include national/intelligence agency checks, single scope 

background investigation (interviews), and automated continuous evaluation 

checks (ACES). (OPR: AF/A1)

22.1 Examine the feasibility of implementing ACES checks on AFRC and ANG members. (OPR: AFRC, NGB)

23.1 Coordinate with the OSD Military Personnel Records Information Management 

Task Force (MPRIMTF) study that focuses on what information is appropriate to 

maintain in military personnel records over the course of a career. (OPR: AF/A1)

23.2 Develop procedures for storing and transferring information that includes possible 

indicators of violent behavior. (OPR: AF/A1)

23.3 Consider developing a system similar to the Air Force Judge Advocate’s Automated 

Military Justice Analysis and Management System to track information that may 

indicate a potential for violent behavior. (OPR: AF/A1)

24.1 Revise AFI 90-201, Inspector General Activities, to make assessment of force protection, 

internal threat prevention, and response mandatory inspection items. (OPR: SAF/IG)

24.2 Develop a Force Protection Response Bulletin to disseminate best practices identified by IG inspections related to force protection, internal threats, and suicides. 

(OPR: SAF/IG)

25.1 Review and incorporate findings of the ongoing MPRIMTF into Air Force policy. 

(OPR: AF/A1)

26.1 Integrate AFOSI Investigative Information Management System case file database 

into Defense Law Enforcement Exchange, the DoD consolidated criminal investigations database. (OPR: SAF/IG)
E-5 AIR FORCE FOLLOW-ON REVIEW

Appendix E  Recommendations

27.1 Coordinate with the Under Secretary of Defense for Intelligence to review DoDI 

5240.6, Counterintelligence (CI) Awareness, Briefing, and Reporting Programs. 

(OPR: SAF/IG)

28.1 Coordinate with the DoD and the other Services to define requirements for a 

common threat reporting system similar to the DoJ/FBI eGuardian system. 

(OPR: SAF/IG)

29.1 Continue participation in the Technical Support Working Group of the Combating Terrorism Technical Support Office to collaborate with other Services, 

government agencies, academia, and civilian organizations on threat detection, 

prevention, and management efforts. (OPR: AF/A4/7)

30.1 Continue participation in the Physical Security Equipment Action Group and the 

Defense Installation Access Control behavioral analysis study. (OPR: AF/A4/7)

31.1 Coordinate with DoD and the other Services to share vehicle registration, debarment lists, and other relevant information required to screen personnel, vehicles, 

and grant access. (OPR: AF/A4/7)

31.2 Update AFI 31-201, Security Forces Standards and Procedures, to govern how debarment information is shared. (OPR: AF/A4/7)

31.3 Revise Air Force policy to require installation commanders to enter debarment 

information into a central database and to review Air Force debarments when 

making decisions to grant individuals base access. (OPR: AF/A4/7)

31.4 Fully fund and continue to install Defense Biometric Identification System 

(DBIDS) at all Air Force installations to improve communications between installations. (OPR: AF/A4/7)

31.5 Modify the DBIDS database to reflect debarment actions. (OPR: AF/A4/7)

31.6 Support DoD-wide implementation of DBIDS. (OPR: AF/A4/7)

32.1 Coordinate with DoD to establish standardized contract procedures and practices 

for TRICARE providers to recognize and report, within legal limits, potential indicators of violent behavior for active duty, ANG, and Air Force Reserve members 

who receive treatment through TRICARE providers. (OPR: SAF/MR)

33.1 Coordinate with DoD to develop policies, programs, and procedures for military 

medical personnel, commanders, and supervisors to receive and review indicators of 

potentially violent behavior for ANG and Air Force Reserve members who seek care 

from civilian medical institutions when not on active duty orders. (OPR: SAF/MR)

33.2 Coordinate with DoD to develop policies and procedures for civilian health care 

providers to alert military leaders when they believe active duty, ANG, and Air 
AIR FORCE FOLLOW-ON REVIEW E-6

Force Reserve members whom they treat pose a threat to themselves or others. 

(OPR: SAF/MR)

34.1 Revise AFI 44-109, Mental Health, Confidentiality and Military Law, paragraph 6, 

to reference DTM 09-006, Revising Command Notification Requirements to Dispel 

Stigma in Providing Mental Health Care to Military Personnel, or follow-on DoDI 

guidance currently in coordination. (OPR: AF/SG)

34.2 Revise AFI 41-210, Patient Administration Functions, paragraph 2.5.6.2. to add exceptions for commanders establishing need for and obtaining concurrence with the 

SJA before obtaining patient information on a military member. (OPR: AF/SG)

34.3 AF/SG incorporate reporting guidance IAW AFI 44-109, Mental Health, Confidentiality and Military Law, and AFI 41-210, Patient Administration Functions,

into all levels of health care provider training, beginning with medical school at the 

Uniformed Services University of the Health Sciences through the chief of medical 

staff. (OPR: AF/SG)

35.1 Continue deploying and expand the ANG directors of psychological health and 

AFRC regional psychological health advocates programs. (OPR: AFRC, NGB)

36.1 Publish derivative Air Force guidance upon release of DoDI 5420.xxx, Counterintelligence Activities in Cyberspace, to include when the coordinated offices involved 

in defense cyber activities should alert leaders to potential threats in their command. (OPR: SAF/IG)

37.1 Engage with the OSD to better define the term force protection. (OPR: AF/A3/5)

38.1 Coordinate with the DoD to identify a single executive agent to manage force 

protection-related common reporting systems. (OPR: SAF/IG)

39.1 Task the Force Protection Steering Group to develop options for appointing a 

HAF force protection lead. (OPR: AF/A4/7)

39.2 Develop an AFPD to establish and clarify roles and responsibilities within the 

HAF for the force protection mission. (OPR: AF/A4/7)

40.1 Participate in the Defense Science Board (DSB) multidisciplinary group to develop assessment programs for internal threats. (OPR: AF/A4/7)

40.2 Provide commanders with a multidisciplinary capability focused on detecting and 

neutralizing internal threats, based on recommendations from the DSB independent study. (OPR: AF/A4/7)

41.1 Revise AFI 10-206, Operational Reporting, to ensure incidents related to force protection within the CONUS are reported according to prescribed timelines to 
E-7 AIR FORCE FOLLOW-ON REVIEW

Appendix E  Recommendations

USNORTHCOM, AFNORTH, and appropriate Air Force and DoD agencies. 

(OPR: AF/A3/5)

41.2 Revise AFI 10-206, Operational Reporting, Attachment 2, to ensure AFNORTH 

and USNORTHCOM are notified for all incident types having force protection 

implications. (OPR: AF/A3/5)

42.1 Coordinate with DoD to develop standardized threat-reporting procedures and incorporate any new policies and procedures into existing AFIs as necessary. (OPR: SAF/IG)

43.1 Participate with the Joint Staff to explore and research technology to improve legacy 

OPREP-3 reporting systems. (OPR: AF/A3/5)

44.1 Ensure those involved in the installation reporting process (e.g., command post 

representatives, command chain, etc.) are properly trained and proficient in their 

tasks and have appropriate resources, tools, checklists, and guidance to accomplish 

them. (OPR: AF/A3/5)

44.2 Evaluate the need for command post controllers to be certified to monitor external 

information sources, approve, and submit initial voice reports on behalf of the 

installation commander. (OPR: AF/A3/5)

45.1 Coordinate with appropriate DoD, joint, and Service representatives to revise operational reporting policies to include specific examples of incident types that 

should trigger an OPREP-3 PINNACLE report. (OPR: AF/A3/5)

46.1 Coordinate with Joint Staff and USNORTHCOM representatives to revise 

CJCSM 3150.05C, Joint Reporting Structure (JRS) Situation Monitoring Manual, 

and US Northern Command Instruction 10-211, Operational Reporting, to include instructions on how to disseminate incident reports, including rapid horizontal notification. (OPR: AF/A3/5)

46.2 Revise AFI 10-206, Operational Reporting, to reflect Joint and GCC policies on 

disseminating information. (OPR: AF/A3/5)

47.1 Participate in DoD revision of MOUs governing participation in Joint Terrorism 

Task Forces (JTTF). (OPR: SAF/IG)

47.2 Coordinate with the FBI and the Director National Intelligence to determine the 

feasibility of expanding Air Force representation on priority JTTFs. (OPR: SAF/IG)

48.1 Establish an MOU with the National Counterterrorism Center/Defense Intelligence Unit to establish an Air Force intelligence analyst position and assign an Air 

Force liaison officer. (OPR: AF/A2)
AIR FORCE FOLLOW-ON REVIEW E-8

49.1 Embed a national tactical integration element in the AFOSI Investigations, Collections, and Operations Nexus organization to ensure timely signals intelligence 

indications and warning support. (OPR: AF/A2)

50.1 Review requirements and coordinate with joint partners and the Defense Threat 

Reduction Agency for including tenant and joint organizations in base exercises 

and inspections. (OPR: AF/A4/7)

50.2 Update AFI 90-201, Inspector General Activities, to address inspections at joint base 

locations. (OPR: SAF/IG)

50.3 At joint base locations where the Air Force is lead, the joint base commander must 

include tenant units in emergency management exercises. (OPR: AF/A4/7)

50.4 At locations where the Air Force is supported by another Service, the senior Air 

Force commander should ensure Air Force personnel are aware of emergency management procedures and exercise accordingly. (OPR: AF/A4/7)

51.1 Annually review, validate, and disseminate Health Insurance Portability and Accountability Act (HIPAA) training resources to wing, group, and squadron commander courses. (OPR: AF/SG)

51.2 Revise AFI 41-210, Patient Administration Functions, paragraph 1.4.2.2, HIPAA 

Privacy Officer Responsibilities, Education, Training, and Communication, to 

provide commanders initial patient privacy orientation within 90 days of their assignment. (OPR: AF/SG)

52.1 Assess the requirements for, and implications of, conducting separate officer training courses within Officer Training School to ensure common military professionalism competencies among competitive categories. (OPR: AF/A1)

53.1 Revise AFI 16-109, International Affairs Specialist (IAS) Program, to include specific command oversight duties within SAF/IA and AU for members attending 

academic or PME programs in foreign countries. (OPR: SAF/IA)

54.1 Revise advanced chaplain and chaplain assistant training and refresher courses to 

include mass casualty and workplace violence response familiarization training. 

(OPR: AF/HC)

55.1 Revise AFI 52-104 to address training and provide guidance on the requirement 

for chaplains to provide spiritual support in response to incidents involving workplace violence. (OPR: AF/HC)

56.1 Air Force Chief of Chaplains and the Civil Air Patrol (CAP) should review and 

update Chaplain Corps Region Staff College training to ensure CAP chaplains are 
E-9 AIR FORCE FOLLOW-ON REVIEW

Appendix E  Recommendations

prepared to respond to the full range of emergencies, to include mass casualties. 

(OPR: AF/HC)

57.1 Evaluate training requirements and appropriately resource contracted clergy to provide 

support during mass casualty incidents on military installations. (OPR: AF/HC)

58.1 Incorporate provider-specific resiliency care in the ARP. (OPR: AF/A1)

59.1 Develop a process to collaborate with civilian entities in addressing resiliency issues. (OPR: AF/SG)

60.1 Coordinate with Assistant Secretary of Defense for Health Affairs to incorporate 

resiliency and readiness self-care skills into initial and follow-on training and education programs for military health care providers. (OPR: SAF/MR)

61.1 Reinstitute workplace violence prevention education and training as outlined in 

AFI 44-154, Suicide and Violence Prevention Education and Training, across the 

career-long continuum of learning. (OPR: AF/SG)

62.1 Revise AFI 10-245 to integrate response procedures for defending the Total Force against 

internal threats (e.g., active shooter) into existing training across the continuum of 

learning. (OPR: AF/A4/7)

63.1 Incorporate Sponsor Program guidance found in AFI 36-3009, Airman and Family Readiness Centers, into AFI 36-2103, Individualized Newcomer Treatment and 

Orientation Program, to consolidate Sponsor Program policy. Cross-reference consolidated policy appropriately. (OPR: AF/A1)

63.2 Require sponsors for all first-term Airmen and new officer accessions to support relocation to first duty stations, and update AFI 36-2103 accordingly. (OPR: AF/A1)

64.1 Incorporate forthcoming DoD electronic sponsorship application and training 

(e-SAT) into the Air Force Sponsor Program to standardize sponsor participation, 

training, and customer feedback available to commanders. (OPR: AF/A1)

64.2 Make feedback available to commanders from the forthcoming reports function of 

e-SAT to assist program effectiveness. (OPR: AF/A1)

65.1 Revise the SAF/IG inspection checklists to include Sponsor Program metrics. 

(OPR: SAF/IG)

66.1 Communicate the importance and value of the Wingman concept and development of Wingman Day through focused messages from senior Air Force leaders to 

all AF members (e.g., recommended strategic messages, themes, activities, and 

training templates that address a wide range of behaviors related to violence risk). 

(OPR: AF/A1)
AIR FORCE FOLLOW-ON REVIEW E-10

66.2 Provide unit leaders statistics and background information that MAJCOMs can 

tailor for installation-level Wingman Days. (OPR: AF/A1)

66.3 Include strategies for executing Wingman Day events in appropriate PME, commanders’ courses, and other training venues. (OPR: AF/A1)

66.4 Publish a “Knowing Your Airmen” guide for leaders’ use on Wingman Day. (OPR: 

AF/A1)

67.1 Revise AFI 36-2406, Officer and Enlisted Evaluation System, via an Air Force Guidance Memorandum, to incorporate greater accountability and automation into the 

feedback process. (OPR: AF/A1)

68.1 Form an integrated process team to evaluate and refine officer, enlisted, and civilian feedback tools and processes. (OPR: AF/A1)

69.1 Modify AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, 

to include Physical Evaluation Board liaison officers (PEBLO) duties to relay Medical Evaluation Board (MEB)/Physical Evaluation Board (PEB) processes and 

timely updates to affected Airmen and their commanders and first sergeants. 

(OPR: AF/SG)

69.2 Revise the Disability Counseling Guide for Physical Evaluation Board Liaison Officers 

(PEBLO) to incorporate material from the updated AFIs. (OPR: AF/SG)

70.1 Review Air Force Medical Service (AFMS) force management, and consider 

changes to compensation, quality-of-life factors, operations tempo, and deployment issues to sustain high-quality health care. (OPR: AF/SG)

71.1 None.

72.1 Coordinate with Office of the Under Secretary of Defense for Personnel and Readiness (OUSD[P&R]) to integrate existing policies and provide appropriate guidance to sustain high-quality care, as well as publish an anti-stigma DoDI based on 

DTM 09-006. (OPR: AF/SG) 

72.2 Address health-care-specific stigma concerns as part of the ongoing biennial review 

process for AFI 44-109, Mental Health, Confidentiality and Military Law. (OPR: 

AF/SG) 

72.3 Consolidate Air Force mental health guidance into a 40-series AFI. (OPR: AF/SG)

73.1 Augment chiefs of medical staff by continuing the current Senior Clinician Billet 

Program pilot project, and evaluate the program within six months of implementing the 2010 O-6 assignment plan. (OPR: AF/SG)
E-11 AIR FORCE FOLLOW-ON REVIEW

Appendix E  Recommendations

74.1 Revise applicable professional military education and professional continuing education programs to include learning outcomes focused on authorities, procedures, 

and programs that support Total Force teaming and leadership. (OPR: AF/A1)

74.2 Revise reference materials for officer, enlisted, and civilian members to clarify authorities, procedures, and programs that support Total Force teaming and leadership. (OPR: AF/A1)

75.1 Establish and chair a HAF-level working group to synchronize Air Force Emergency Management policy and programs. (OPR: AF/A4/7)

76.1 Appoint the Director of Operations (AF/A3/5) as the OPR for the mass notification systems (MNS). (OPR: AF/A3/5)

76.2 Evaluate mass notification technologies and recommend viable, tailored solutions 

for installation use. (OPR: AF/A3/5)

77.1 Determine the appropriate HAF-level OPR for exercise evaluation team (EET) 

policies, programs, and procedures. (OPR: SAF/IG)

78.1 Include tenant units in installation emergency management exercises. (OPR: SAF/IG)

79.1 Ensure that installation exercises include situations requiring changes in the force 

protection condition (FPCON). (OPR: SAF/IG)

80.1 Revise the Air Force emergency management program to comply with the DoD’s 

forthcoming installation emergency management program policy. (OPR: AF/A4/7)

81.1 Establish a formal acquisition program for MNS capabilities, including procurement and sustainment support. (OPR: AF/A3/5)

82.1 Develop policy to ensure effective emergency call routing. (OPR: AF/A4/7)

83.1 Designate a single Air Force office responsible for developing Air Force enhanced 

9-1-1 (E9-1-1) policy. (OPR: SAF/CIO A6)

83.2 Update Air Force policy to comply with DoD E9-1-1 policy guidance. (OPR: 

SAF/CIO A6)

84.1 Ensure the emergency communications center (ECC) enabling concept approved 

in August 2009 is fully developed and funded. (OPR: AF/A4/7)

85.1 Evaluate the feasibility of providing an emergency medical dispatch (EMD) program on Air Force installations. (OPR: AF/SG, AF/A4/7)

86.1 Field a common operational picture (COP) as a mid- to long-term solution to support emergency-response capabilities. (OPR: AF/A4/7)
AIR FORCE FOLLOW-ON REVIEW E-12

87.1 Installations review current COP capabilities and ensure that an interim solution 

is in place and is practiced as part of the installation emergency management program. (OPR: AF/A4/7)

88.1 Coordinate with DoD to develop minimum system requirements for a COP. 

(OPR: AF/A4/7)

89.1 Continue developing security forces and police-response procedures to high-risk situations through the use of tactics, techniques, and procedures (TTP). (OPR: AF/A4/7)

90.1 Incorporate active shooter response training into Air Force antiterrorism level-1 

(AT-1) training. (OPR: AF/A4/7)

90.2 Incorporate best practices and TTPs for active shooter response into recurring 

training for military and civilian personnel. (OPR: AF/A4/7)

91.1 Incorporate a case study based on the Fort Hood shooting and similar incidents 

into wing, group, and incident commander training courses. (OPR: AF/A4/7)

92.1 Update Air Force policy to address the need to integrate, track, exercise, and inspect MAAs. (OPR: AF/A4/7)

93.1 Modify AFI 31-101, Integrated Defense, to require security forces squadrons (SFS) 

and AFOSI jointly to establish MOUs with civilian law enforcement agencies to 

include expectations for scope and timeliness. (OPR: AF/A4/7)

94.1 Synchronize Emergency Family Assistance Control Center (EFACC)-related AFIs 

to ensure awareness and participation of all pertinent agencies during EFACC execution and sustainment. (OPR: AF/A1)

95.1 Revise religious support policies to synchronize mass casualty response efforts. 

(OPR: AF/HC)

96.1 Align Air Force policy with DoD guidance to address memorial service attendance. (OPR: AF/A1)

96.2 Fund one civilian position and provide funding to support civilian family requests 

to attend memorial services. (OPR: AF/A1)

97.1 Coordinate with DoD to develop policies and procedures for casualty notification 

and mortuary support of fatalities involving private citizens on an Air Force installation. (OPR: AF/A1)

98.1 Revise Air Force traumatic stress response (TSR) policy to synchronize mental 

health support services in the aftermath of mass casualty incidents. (OPR: AF/SG)

99.1 Add hostage-negotiation consultation to TSR team capabilities outlined in AFI 

44-153, Traumatic Stress Response. (OPR: AF/SG)
Executive Writing Team

Editor-in-Chief

Chris Cain, PhD

Co-Chiefs Content Integration

Capt Marissa Carlton

Capt Johanna Jaboneta

Editing Team

Col Joan Garbutt

Col Bruce Lovely

Lt Col Scott Peel

Maj Tracy Maza

Laura Miller, PhD

Mr. Jim Howard

Mr. Robyn Read

Technical Writers

Mr. Ben Bryant

Ms. Cheryl Hackley

Mr. Dale Hamby

Mr. Tom Zamberlan

Mr. Michael Arnone

Mr. Mike Ivey

Mr. Gilbert Mendez

Ms. Karen Roberts-Gaither

Mr. C. Boyd Norwood

Content Editors Technical Editors

Richard Bailey, PhD Ms. Carolyn Burns

Marvin Bassett, PhD Mrs. Sandi Davis

Mrs. Belinda Bazinet Ms. Tammi Long

Mr. Jerry Gantt Ms. Catherine Parker

Ms. Demorah Hayes Mrs. Sherry Terrell

Ms. Jeanne Shamburger Mr. Andrew Thayer

Graphic Designers

Mr. Daniel Armstrong

Ms. Susan Fair

Printing Specialists

Ms. Ann Bailey

Mrs. Nedra Looney

Mrs. Vivian O’Neal