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DEFENSE HEALTH PROGRAM

FISCAL YEAR (FY) 2012 BUDGET ESTIMATES

OPERATION AND MAINTENANCE PROCUREMENT RESEARCH, DEVELOPMENT, TEST AND EVALUATION Volume 1: Justification of Estimates Volume 2: Data Book February 2011

The Defense Health Program spans the globe in support of the Department of Defense's

most important resource--active and retired military members and their families.

CLEARED For Open Publication

JAN 2 6 2011

10

Office of Security Review Department of Defense

II

-c -O(fQP

Defense Health Program

Fiscal Year (FY) FY 2012 Budget Estimates

Table of Contents

Volume I - Justification of O&M Estimates for Fiscal Year (FY) 2012

Page No. Section I

Section II

Section III

Section IV

Section V

Section VI

* PBA-19 - Introductory Statement......................................................................... 0-1 O&M Funding ............................................. ·............................................... ......... OP-32 Summary of Price and Program Growth Summary..... ........ ........... ...... ....... 1

11

12

13

15

18

31

42

54

65

74

83

PB-31R Personnel Summary................................................................................................... PB-31D - Summary of Funding Increases and Decreases ...................................... OP-5 Part 2 In-House Care ......................................................... '" ........ .... ............ OP-5 Part 2 Private Sector Care .......................................... '" .,. ........ .... ...... ........ OP-5 Part 2 Consolidated Health Support......... .................. .................. ............... OP-5 Part 2 Information Management..... ........... .......................... ............ ...... ........ OP-5 Part 2 Management Activities..... ....... ... ... ...... ...... ...... ...... ......... ... ...... .... ...... OP-5 Part 2 Education and Training.................................................................... OP-5 Part 2 Base Operations/Communications...................................................... OP-5 Part 2 Facilities Sustainment, Restoration, Modernization and

Demolition... ..... ....... ...... ...... ...... ... ... ...... .... ........ ...... .... ........ ... ... ...... ...

93

*

OP-32s follow each OP-5

i

Defense Health Program Fiscal Year (FY) FY 2012 Budget Estimates Table of Contents Volume I - Justification of O&M Estimates for Fiscal Year FY 2012 (Continued)

Page No.

Section VII PB-11 - Cost of Medical Activities - DHP Summary ........................................... 100

PB-11A - Personnel- DHP Summary ......................................................................... 105

PB-11B - Medical Workload Data - DHP Summary .................................................. 108

Volume II - Data Book

Section I - Special Analyses

PB-31Q PB-15 OP-34 PB-28 Manpower Changes in FTEs .................................................................................................... 111

Advisory and Assistance Services ............................................................................................... 112

Appropriated Fund Support for MWR Activit s ...................................................... 113

Summary of Budgeted Environmental Proj ects ...................................................................... 115

ii

Defense Health Program

Fiscal Year (FY) FY 2012 Budget Estimates

Table of Contents

Volume II - Data Book (Continued)

Page No. Section II P-1 P-40 Procurement

Procurement Program........................... .................................... ............................... Procurement Budget Item... ... ...... ... ..... .... ... ...... ......... .............. .... ....... ..... ....... ......... 120

121

Section III - Research, Development, Test, and Evaluation (RDT&E) R-1 R-2 RDT&E Programs............... .......................................................... ............ .................. RDT&E Project Justification ................................................................................. (OCO)

Funding.............................................. 177

123

124

Section IV - Overseas Contingency Operations 0-1 OP-32

Overseas Contingency Operations (OCO)

Overseas Contingency Operations (OCO) Summary of Price and

Program Growth............................. .................................... .................. ................... Overseas Contingency Operations (OCO) Det 1 by SubActivity......................

178

179

OP-5

iii

Defense Health Program

Fiscal Year (FY) 2012 Budget Estimates

Defense Health Program

Appropriation Highlights

($ in Millions)

Appropriation Summary:

ion & Maintenance 4 RDT&E Procurement

FY 2011 Annual CR Total 5

FY 2010 1 Actuals

28,423.7 1,443.6

Price Growth

719.3 20.2 11. 8

Program Growth

772.3 -963.9 -16.6

FY 2011 2 Estimate

29,915.3 499.9 519.9

Price Growth

785.7 7.5 12.1

Program Growth

201. 6 156.3 100.5

FY 2012 3 Estimate

30,902.5 663.7 632.5

30,534.3

30,392.0

7

Total, DHP MERHCF Receipts 6 Total Health Care Costs

751. 3

-208.2

30,935.1

805.3

458.4

32,198.7 9,448.0

38,418.7

39,934.0

41,646.7

II Fy 2010 actuals include Operation and Maintenance (O&M) funding of $1,289.2 million for Overseas Contingency Operations (OCO) under the FY 2010 Department of Defense Appropriations Act, Public Law 111-118 and $33.4 million for Department of Defense Supplemental, FY 2010, Public Law 111-212. Additionally, FY 2010 includes $132.0 million O&M and $8.0 million RDT&E funding transferred from Health and Human Services for H1Nl in the Supplemental Appropriations Act of 2009, Public Law 111-32. u FY 2011 President's Budget Request estimate excludes $1,398.1 million for OCO.

3/ FY 2012 request excludes $1,228.3 million for OCO.

~ The Department of Defense projects $132.2 million O&M funding should transfer in FY 2011, and $135.6 million in FY 2012 to the Joint

Department of Defense - Department of veterans Affairs Medical Facility Demonstration Fund established by section 1704 of Public Law

111-84 (National Defense Authorization Act for FY 2010).

5/ Fy 2011 reflects DHP annualized Continuing Resolution funding.

& Reflects Departmental DoD Medicare-Eligible Retiree Health Care Fund (MERHCF) for FY 2010, FY 2011, and FY 2012 O&M only. FY 2012

MERHCF includes Department of Defense healthcare reform initiatives.

Exhibit PBA-19, Appropriation Highlights (Page 1 of 10)

001

Defense Health Program

Fiscal Year (FY) 2012 Budget Est~ates Defense Health Program

Appropriation Highlights

Description of Operations Financed:

The medical mission the Department of Defense (DoD) is to enhance DoD and our Nation's security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care. The Defense Health Program (DHP) appropriation funding provides for worldwide medical and dental services to active forces and other eligible beneficiaries, veterinary services, medical command headquarters, cialized services for the training of medical personnel, and occupational and industri health care. Included are costs associated with provisions of the TRICARE benefit which provides for the health care of eligible active duty family members, retired members and their family members, and the eligible surviving family members of decea active duty and retired members. The FY 2012 Defense Health Program budget request of $32,198.7 million includes realistic cost growth for pharmacy, managed care support contracts, and other health care services either provided in the Military Treatment Facility or purchased from the private sector. This budget includes funding for continued support of Traumatic Brain Injury and Psychological Health (TBI/PH) and Wounded, III and Injured (WII) requirements. It also complies with Congressional mandate related to support of Centers of Excellence (COE) and Secretary of Defense's initiative for operations efficiencies. Operation and Maintenance (O&M) funding is divided into seven major areas: In-House Care, Private Sector Care, Information Management, Education and Training, Management Activities, Consolidated Health Support, and Base Operations. The DoD Medicare Eligible Retiree Health Care Fund (MERHCF) is an accrual fund to pay for DoD's share of health care costs for Medicare-eligible retirees, retiree family members and survivors. MERHCF receipts fund applicable In-House and Private Sector Care operation and maintenance health care costs. The Defense Health Program appropriation also funds the Research, Development, Test and Evaluation (RDT&E) program for medical Information Management/Information Technology (1M/IT), medical laboratory research, and the Armed Forces Radiobiological Research Institute (AFRRI). The Defense Health Program appropriation Procurement program funds ion of capital equipment in Military Treatment Facilities and other selected care activities which include equipment for initial outfitting of newly

Exhibit PBA-19, Appropriation Highlights (Page 2 of 10)

002

Defense Health Program

Fiscal Year (FY) 2012 Budget Est~ates Defense Health Program

Appropriation Highlights

constructed, expanded, or modernized health care facilities; equipment for modernization and replacement worn-out, obsolete, or uneconomically reparable items; equipment supporting programs such as pollution control, clinical investigation, and occupational/environmental health; and Military Health System information processing requirements. Narrative Explanation of FY 2011 and FY 2012 Operation and Maintenance (O&M) Changes: The Defense Health Program O&M funding reflects an overall increase $987.3 million between FY 2011 and FY 2012, consisting of $785.7 million in price growth and net program increase of $201.6 million. Program increases include: $379.1 million for Federal Ceiling Pricing revised reimbursement projections; $205.9 million for increased healthcare provided in Military Treatment Facilities; $151.1 million for Facilit s Sustainment, Restoration and Modernization (FSRM); $137.8 million for initial outfitting in support of MILCON and Restoration and Modernization projects; $137.4 million for TRICARE Reserve Select enrollment increase; $87.2 million for Warrior Transition Command (WTC) transfer and other Wounded Warrior support; $83.8 million for readiness enhancements for bio-defense vaccines, pandemic influenza and surveillance; $71.6 million for fact of life funding realignment and adjustments; $66.3 million for medical education collocation, Tri-Service Nurse Academic Partnership, and other programs enhancements; $50.2 million National Interagency Bio-Defense Campus (NIBC) Central Utility Plan project and lease costs increases; $40.7 million for Navy Individual Augmentees; $30.6 million for collocated medical headquarters transition and sustainment; $29.9 million for Military Health System innovation, strategic communications, and other headquarters and oversight activities; $14.3 million for Hearing and Vision Centers of Excellence enhancements; $6.5 million for Non- Electronic Health Record (EHR) information systems support; $4.6 million for EHR planning, acquisition and oversight activities; and $2.3 million for West Point Medical Facilities transfer from Army Installation Command (IMCOM). Program decreases include: $511.9 million for Private Sector Care net changes in benefits and utilization; $316.8 million for Secretary of Defense Efficiencies which include: Pharmacy Co-Pay for Non-Medicare Eligible ($95.0 million); Reducing Reliance on DoD Service Support Contractors ($67.6 million); TMA Baseline Review to Consolidate

Exhibit PBA-19, Appropriation Highlights (Page 3 of 10)

003

Defense Health Program

Fiscal Year (FY) 2012 Budget Estimates

Defense Health Program

Appropriation Highlights

Headquarters' Activities ($51.4 million): Prime enrollment fees increase ($31.4 million): Medicare reimbursement rates for Critical Access Hospital services ($31.0 million); Reports, Studies, Boards and Commissions Review to reduce reliance on Advisory and Assistance Service ($27.4 million): Medical Supply Chain Sourcing Optimization ($12.9 million): DFAS Baseline Review ($0.9 million), and net Civilian Manpower Freeze and Exceptions (+$0.8 million): $146.7 million for Civilian in-sourcing and other civilian pay adjustments to include one less pay day in FY 2012; $81.6 million for installations transfer to Army Installation Command (IMCOM) and Network Enterprise Technology Command (NETCOM); $68.7 million for military to civilian conversions restoral; $62.0 million for medical installation transfer to Navy; $31.1 million for Army Substance Abuse Program (ASAP) transfer to Army Installation Command (IMCOM); $25.6 million for Patient Centered Medical Home investment's net impact on private sector care requirements; $21.8 million for Military Health System savings initiatives: $14.6 million for Fraud, Waste and Abuse cost savings initiatives; $9.1 million for State Directors of Psychological Health Transfer to Army National Guard; and $7.6 million for Managed Care Support Contract (T3 version) automated eligibility systems support. Continuing in FY 2012, the Department projects $135.631 million should transfer to the Joint Department of Defense (DoD) - Department of Veterans Affairs (VA) Medical Facility Demonstration Fund established by section 1704 of Public Law 111-84, (National Defense Authorization Act for FY 2010). This fund combines the resources of DoD and VA to operate the first totally integrated Federal Health Care Facility in the country by the total integration of the North Chicago VA Medical Center and the Navy Health Clinic Great Lakes. Narrative Explanation of FY 2011 and FY 2012 Research Development Test & Evaluation (RDT&E) Changes: The Defense Health Program RDT&E Program reflects a net increase of $163.8 million between FY 2011 and FY 2012. This includes price growth of $7.5 million and a net program increase of $156.3 million. Program increases include: $46.6 million for medical research to reduce capability gap requirements; $44.4 million for Electronic Health

Exhibit PBA-19, Appropriation Highlights (Page 4 of 10)

004

Defense Health Program

Fiscal Year (FY) 2012 Budget Estimates

Defense Health Program

Appropriation Highlights

Record (EHR) funding that will support enhanced speed, reliability, and user interface, as well as improve security of protected information and data integrity; $19.5 million for initial outfitting and transition the new US Army Medical Research Institute of Infectious Disease (USAMRIID) and the US Army Medical Research Institute of Chemical Defense (USAMRICD); $15.6 million for Hyperbaric Oxygen (HB02) Therapy for Traumatic Brain Injury (TBI) clinical trial support: $15.2 million for the development of new injury metr related to Underbody ast; $11.9 million for Defense Occupational and Environmental Health Readiness-Industrial Hygiene (DOEHRS-IH) RDT&E associated with enhancements to improve data sharing across DOEHRS modules, ergonomics, hazmat product hazard data, interface with current 000 EHR applications, risk assessment, and the completion of veterinary: $7.7 million increase for operations support for the Pacitlc Based Joint Information Technology Center - Maui (JITC- Maui); $7.1 million increase to research programs in support of high-interest projects and enhance competitiveness; $4.0 ilion clinical trial laboratory support at CONUS laboratories and Military Treatment Facilities: $3.1 million for Army medical overseas research laboratory support of existing OCONUS laboratories and the new laboratory in the Republic of Georgia; $2.2 million for continued testing and evaluation of Patient Safety Record (PSR) System evaluations and system refresh; $2.0 million increase associated with the Theater Medical information Program-Joint (TMIP-J) associated with AHLTA Theater enhancements for aeromedical evacuation and pharmacy functionality, continued performance improvements of administrative functions within the TMIP-J framework and interfaces with the Services Joint Theater Trauma Registry (JTTR) applications; $0.9 million for improving testing protocols related to hard body armor; $0.4 million for information technology support related to the trans of the US Army Warrior Transition Command (WTC) to the DHPi and $1.6 million in miscellaneous enhancements/realignments (net of increases and decreases). Program decreases include: $10.1 million for the planned completion of medical logistics capabilities and evolving wireless technology in FY 2011 offset by continued migration of Defense Medical Logistics Standard System (DMLSS) into net-centr , service oriented architecture and development of enhanced functionality to include federated medical logistics capabil s and evolving wireless technology; $4.6 million decrease associated th information management and technology development within the DHP Components; $2.9

Exhibit PBA-19, Appropriation High1ights (Page 5 of 10)

005

Defense Health Program

Fisoal Year (FY) 2012 Budget Estimates

Defense Health Program

Appropriation Highlights

llion e due to the completion of spiral development of Wounded Warrior requirements in support of Traumatic Brain Injury and Psychological th (TBI/PH) specifically the Neuro Cognitive Assessment Tool (NCAT) allowing data to be available to the Bi-Directional Health Information Exchange (BHIE) network which 11 assist the Services in ing, evaluating, and monitoring all TBI cases; $2.5 million for decreases in AHLTA associated with the current timeline for patient safety enhancements; $2.3 million for reductions in e-Commerce development; $2.0 million decrease due to the completed integration required r development of two new blood management COTS products in FY 2011; $0.6 for the Secretary of Defense Ef ciency to reduce iance on 000 Service Support Contractors; and $0.9 million in miscellaneous enhancements/realignments (net of increases and decreases) .

Narrative Explanation of FY 2011 and FY 2012 Procurement Changes: The Defense Health Program Procurement Program has a net increase of $112.6 million between FY 2011 and FY 2012. This consists of $12.1 million in price growth and an increased program growth of $100.5 million. Program increases include: $90.4 million for the Electronic Health Record (EHR) to support enhanced speed, reliability, and user interface, as well as, improve security of protected information and data integrity; $18.0 million due to replacement cycles of End User Devices (EUDs) and Local Area Network (LAN) Upgrades; $10.3 million initial outfitting of military construction (MILCON) projects due to one-time Congressional adds, Base Realignment and Closure (BRAC) , Amer Recovery and Re stment Act (ARRA), and Supplemental funding increases; and $0.8 million in mi laneous enhancements/realignments (net of increases and decreases) . Program decreases include: $7.0 million decrease due to completed implementation of COTS solutions providing donor and transfusion tracking for blood management; $3.8 million due to completion of the Defense Occupational and Environmental Health Readiness-Industrial Hygiene (DOEHRS-IH) Mobile PC tablets deployment to the Air Force and Navy in FY 2011 offset by increased requirements server storage associated with DOEHRS data warehouse

Exhibit PBA-19, Appropriation Highlights (Page 6 of 10)

006

Defense Health Program

Fiscal Year (FY) 2012 Budget Estimates

Defense Health Program

Appropriation Highlights

in FY 2012; $3.6 million associated with the completion of hardware refresh for the inical Information System initiative in FY 2011; and $4.6 million in miscellaneous enhancements/realignments (net of increases and decreases).

President's Management Plan - Performance Metrics Requirements: The Defense Health Program continues to refine existing performance measures and develop specific criterion to determine and measure outputs/outcomes as compared with initial goals. Over the past year the DHP has transitioned to the Quadruple Aim that is focused on a balanced approach to overall performance to include not only production but outcome measures related to medical readiness, a healthy population, positive patient experiences and responsible management of health care costs. · Individual Medical Readiness - This measure provides operational commanders, Military Department leaders and primary care managers the ability to monitor the medical readiness status of their personnel, ensuring a healthy and fit fighting force medically ready to deploy. This represents the best-available indicator of the medical readiness of the Total Force, Active Components and Reserve Components prior to deployment · TRICARE Prime Enrollee Preventive Health Quality Index - The National Committee for Quality Assurance (NCQA) established the Healthcare Effectiveness Data and Information Set (HEDIS) to provide the health care system with regular statistical measurements to track the quality of care delivered by the nation's health plans with a goal of improving the overall health of the popUlation. This composite index scores Prime enrollee population for compliance with HEDIS like measures on seven treatment protocols related to: Appropriate Asthma Medication Use; Breast Cancer Screening; Cervical Cancer Screening; Colorectal Cancer Screening; and Diabetic Care. The selected measures support an evidence-based approach to population health and quality assessment. It also provides a direct comparison with civilian health plans and a means of tracking improvements in disease screening and treatment. Improved scores in this measure should translate directly to a healthier beneficiary

Exhibit PBA-19, Appropriation Highlights (Page 7 of 10)

007

Defense Health Program

Fiscal Year (FY) 2012 Budget Estimates

Defense Health Program

Appropriation Highlights

population, reduced acute care needs, and reduced use of integrated health system resources. · Beneficiary Satisfaction with Health Plan - An increase in the satisfaction with the Health Plan indicates that actions being taken are improving the overall functioning the plan from the beneficiary perspective. Improvements represent positive patient experiences with the health care benefit and services they receive through the system. The goal is to improve overaLl satisfaction level to that of civilian plans using a standard survey instrument. · Medical Cost Per Member Per Year - Annual Cost Growth - The medical cost per member per year looks at the overall cost of the Prime enrollees for the DHP. This tracks all costs related to care delivered to enrollees. The objective is to keep the rate of cost growth for the treatment of TRICARE enrollees to a level at or below the civilian health care plans rate increases at the national level. Currently the measure provides insight to issues regarding unit cost, utilization management, and purchased care management. The metric has been enhanced to properly account for differences in population demographics and health care requirements of the enrolled population. Since enrollment demographics can vary significantly by Service, and across time, it is important to adjust the measure. For example, as increasing numbers of older individuals enroll, the overall average medical expense per enrollee would likely increase. Conversely, as younger, healthy active duty enroll, the overall average would likely decrease. Through the use of adjustment factors, a comparison across Services and across time is made more meaningful. Output related measures that influence Medical Cost Per Member Per Year: · Inpatient Production Target (Relative Weighted Products, referred to as RWP) Achieving the production targets ensures that the initial plan for allocation personnel and resources are used appropriately in the production of inpatient workload. · Outpatient Production Target (Relative Value Units, referred to as RVU) Achieving the production targets ensures that the initial plans for allocation of personnel and resources are used appropriately in the production of outpatient workload.

Exhibit PBA-19, Appropriation Highlights (Page 8 of 10)

008

Defense Health Program

Fiscal Year (FY) 2012 Budget Est~ates Defense Health Program

Appropriation Highlights

Below is final reporting for 2010 related to the prior performance measure goals. The next reporting period will focus on the measures related to the Quadruple Aim, and two output measures ated to production plan targets. The overall success of area measured is discussed below along with information related to continuation of reporting future documents:

· Beneficiary Satisfaction with Health Plan - Satisfaction with Health Care Plan performance FY 2010 exceeded the goal of 58 percent during each quarter for the year, with an aggregate score of 64 percent for the Continuous increases in enrollment and improvement in the score demonstrates real progress for the program with respect to satisfying our beneficiaries. This measure will continue to be reported in support of the Quadruple Aim. · Inpatient Production Target (Relative Weighted Products) - For the most recent reported monthly data for FY 2010, MHS produced 214 thousand RWPs against a target of 215 thousand RWPs. These numbers are based on the records reported to date, and will increase slightly as all records are completed. While care for Active Duty continues at high levels due to care for Wounded Warriors, there was a drop in the. overall uti zation from prior years that was not properly accounted for in the plan. This measure will continue to be reported as an output measure for the DHP. · Outpatient Production Target (Re ive Value Units) - With an increased emphasis on paying r performance, the system has seen a renewed focus on production of outpatient care. For FY 2010, the system produced 71.2 million relative value units versus a goal of 67.0 million relative value units. The MHS achieved the goal for the year. This measure will continue to be reported as an output measure for the DHP. · Medical Cost Per Member Per Year - Annual Cost Growth - Through the most recent reporting t frame the Military Health System achieved the goal for the annual cost growth related to Medical Cost per Member per Month. For FY 2010, the annual cost

Exhibit PBA-19, Appropriation Highlights (Page 9 of 10)

009

Defense Health Program

Fiscal Year (FY) 2012 Budget Est~ates Defense Health Program

Appropriation Highlights

growth rate was 5 percent, compared with the goal for the year of 6 percent. The primary reason for the improvement is related to changes made with respect to the outpatient prospective payments in Purchased Care. Performance improved with each quarter, and should continue into FY 2011 where the measure will continue to be reported.

Exhibit PBA-19, Appropriation Highlights (Page 10 of 10)

010

Oef""se Health I?roqram

Fiscal Year CFY) 2012 Budget Estimates

Operation and Maintenance

Budget Years

Total Obligational Authority (Dollar. 1n Thousan<ls) FY 2010 01300

In' 2011 Ii'B Requ·· t

oefense Heal th Program

11 Bal..... OC0

llML

without CR Miuat;mont

Ql;Q

21

l'2Ul

n

2011 Annualized CR Base3/

llML

=

rx

llML

2012 R.agu·· t

l'2Ul

30,912,606

30(912,606

=

l'2Ul

32,130,834

BUDGET ACTIVITY 01'

OPERATION' MAINTENANCE

0130D

DE:E'ENSE HEALTH PROGRAM

28,423,679

29,915,277

1,39B,092

1,398,092

31.313,369

29,514,514 29,514,514

1,398,092

30,902,546 30,902,546

1,228,280 1,228,288

TOTALJ BA 01:

OPERATION" MAINTENANCE

28,423,679

29 / 915,277

31,313.369

1,398,092

32,130,834

~T

ACTIViTY 02'

01300

ROT'S DEFENSE HEALTH PROGRAM

1,443~630

499,913

499,913

499,913

499,913 499,913

499,913

663,706 663,706

663,106

TOTAL I

BA 02:

RD'Z',g

1,443,630

o

499,913

o

499,913

o

663,706

BUDGET ACTIVITY 03'

PROCUREMENT

0130n

DEfENSE HEAt.TH PROGRAM

524 / 7.37

519,921

519,921

519,921 519,921

519,921

519,921

519,921

519 1 921

632,518

632,518

632,518 632,518

TOTAL, SA 03:

PROC'tJREMENT

524,737

Total Def.nse Heal th Program

30,392,046

30,935,111

1,398 s 05l2

32,333,203

30,534,348

1,398,092

31,932,440

32,198,770

1,228,288

33,427,058

11 FY 2010 actual:!Sl include and Maintenance funding of $l,289.2M for Overseas contingency Operation.a (oeO) under the Department of Defense Appropriation:!Sl Act for n 2010 Public Law 111-116; includes Operation and Maintenance funding of for Supplemental Appropriations Act, 2010 Public Law 111-212; includes $l32.0H for Operation and Maintenance and $8.0M for Re:!Slearch, Development" Test and Evaluation transferred from Health and Human services {HHS)for HINl in the Supplemental Appropriation:!Sl Act of 2009, Public Law 111-32~

2/ Reflects the FY 2011 President's Budget Request. 3/ Adjusts the Operdtions and Maintenance budget line included in the IT 2011 President I s Budget request to match the Annualized

continuin~

Resolution funding level.

Exhibit. 0-1 1 iUn4inq by BAlAS/SAG (Bud9.t. Years)

(P_ 1

ot 1)

011

DEFENSE HEALTIf PROORAM FISCAL YEAR(FY) lOll IruOOET ESTIMATES OPERATiON AND MAIlffEWANcE SUMMARY OF PRJCE AND PROGRAM CHANGE

($ in TbouHtld~)

u..

TrdVlfl

ot

Pen-mrl"

-."

9,ZZO

TULd Tra"el

- - -Pril.'t<Ciwwth

DEfENSE HEALTH PROGRAM

FlSCAL YEAR (f"Y) 2011 tllIIX1ET ESllNATES

OPERATION AND MAllll'EHANCJ:i

SUMMARY or PRICE AND PROORAM CHANGE

(Sin Tbo\l$:Utds)

"'

FYlOtl

Ilw!lh

.....

401 DF'SC Fu",l

......."

Travel I?,,!·sor.s Total T,,'llivel

Fuel Army SUp" Hat Navy Sup & Mat AF Sup .. H;,t

DLA Sup, Mat

1.40\

-3A,911

~lS,H1

-

fY10li

;l07 201

--.

1,S,Oll 3,936 3,936 L'!fi'l 1.99' 1.JH

PrioeeJrowUt

P.,....,

- --

FYl<l1l

10,92e

nO,5H

10,92S'

210,514

Service- F\lno ruel

411 41<!

114

"!'lIlY Sup' Mat

~avy

4.51111

3,lH

S Hat

f,;

3,(,1,

'" '"

91

-;,535 -9 1,1'10 f>,056 3,1A5

6,291

1,270 6,OSS 3,185

191

-1,099

3"

6,8n

120

Af Sup

!o!;It

&

o

5,113

.. Hat

O,OOt

o

101

415

417

DlA

Sup 'Mat

Lo<:;al Pr""

1.07%

12,SSO H,ES!i

l.4n.

1.40'

~3,./I00

."

Hl

1,694

~'!1;

He Ail: FOj"<:.. Retail Supply ." Army fund Equipt

N;wy f'1111rl

o

5~,

15,9n o

4fI,73S

412 414 ~ 15 416 411

4 is

0.63'

"

m

9l

6,326 3,902

1,4U

LSD ..

9,

o

-334

556

~5,

:'02.

!;SA ,'1up " Hat L<.>c.tc) P1'[Ji; Ai!: For"'" Total

1.'19\\

Supply

46,132

0.00\

"9

10)

-nil

·1,1)62

·

16,lS9

o

46,412

4,85)

:;:18

3.16'1

O.O()t

-4,754

501

21,1184 56,lM) 4$6 503

505

,~06

51)6

!'lmd DlJ>. Fund GSA F'JIld

pJ'

685 996

o

24,611

-6,7S8 13,:'46

1.26'

O.SH

_0.9H'

J11

~9,

_545

6DS

o

lH

Total

Al

~\y

S,620 65,;]4

emd Ha1t)t

1.5~'

'"

1

l.HI

-:)1,;{

,

22,361>

1 ,'iI'i3

SO,AIO

NaviII,l suaa.::. Wa! ell

Ctr

Naval PuP..

Nav Puh Wrks Ctn

4l 14,1U

-J,SiH

Svc

Wc;"!!

<:.96*

21,4(,7 124,ll25

~53,

-12

634 .. av PUP \lir)::::: (;tr', OtlHties DISA Bnt"'rpt'isE Computer CentErs

C<:>mmunJ,;:qtions 5vc

~t

,

o

11,033 t.,625

23,651

n,A~6

" ..

"

39.96!

18 15

~1,

Depot Cl:r.<J Ha.l.nt

H

631 (3)

S2B

o

6,;Z(12

i),OIH

m

101

l.OM

o

,

f)~1

6,691

3~.orn

£71

£13

rtn"l'Ice

&

S",~lces

:n,H'I

10,S'n 1.39*

4,H16 -9,1)):

Dlspo!Jilhm

1i71

61~

(>xm;

SVCI1l Ti"r 1

l,OZ1

C:o"t R",lmhursibl" Purr:;hases from Bullt:li"'l P",inlJ&nanCi! F Tet.. l PUtcr.!l.SS""

J'lAC

!;a~o

4,5]]

o

O,orn

" "

.1,1H

4,596

,

'"

679

5,6:'3

~61.

654

160,BIH

Suchc.. ;mr etc N;'tval Civil 8nqrll Ctr Nav~l PUP" Plot 5vc Nav PlIb Wct:ll etc: UtUitia", !>Iav Fub Wrko; Ctn Pur Wds orSA Enr.. t'pci3e Complitf;lr Ceoteco COIm1ur>t<;dtio03 Def "1'I,o\'1C5 " Ac(:r ,'lvc OLA Dispmdtiou 5eJ:vlo.es COIIIIU SVf;;\l Tia" t ('.ost Rail!\bUC!libl .. Purch"",es frQln '!Iundir>" HOJint"'l'IilflCe Tot.. l PUJ:cha3.. s

HAC

~arqo

..

,

~lLJ9t

~L55'-

Z3,flS1 12,1H6

6,1)~Z

5. ,,6~ O,!:I.O' 3,311

~B,OU ~5-'R ~5,

391

-122

m

-9,9Sl'l

H,tS?

b4,2l"17

o

-17.69'

Z .08~ ll.fiH 1.50\

o

6, "lJ2 32,062 .1,2S1

32,(1)1

662

111

5,711

1,114

t,59£

-19

"

~4,Z3J

HO,6Sl

0.00' 0.00'" 0.00'26.61. 26.91it I.f91

-4,959

151,5S9

AMC 'ruining r; ar9 c MTMC PCl't nilndlin'j

7~9

£ll

~ 1,28 3 42,47l

0,00' 150.33' 15,tEU

: ,(Ot

107 111 41,382 '2,15.1

23,550 :24,04,

199

JI.HC Training MSr: Cacgo HTMC Port tlJH~dl1n9 COIlIIlel'ci"l Tr.tcnsp<:u:tll.r.jon Tot.l run~ct.tcUQn

ely Pay J:t.. Jmhucs HO!lt f"on,i9n N.. t rnti Hin. $epilJ:ation Liability

o

190

fl,3S2 H,153

4,156,185 1'13,985 .,936

'"

'" '"

-It _11

Sib

m

~158,411

PillY Relmbu:.s Host

4,109,188

,,01

'JCZ

For&i<:l" N.. t

rod Hir..

1.43{' 30,463 22\',403 61,023

912

Sepa:ratlun Liability Rental p.. y GSr.

Purchaserl

l~nic~

'"

915

1.40% 1.4(1, l.Hn

m

3,169 "OS

HU -1,192

-19,025

19,493 10,094 1,061 129,S()4 -4,231

~H,820

35,955

1,11)!f,2Ofi lO, 1 ~9 143.790

710,28('

"

1

1\'1~

1.40t 1.34'1 2.16,

1.1~\

]0,-662

".

n

4,15fi,le5 a3, Aa~ 1,93Q 29,691 210,541 90,372 t6.629 2, H6 t,no,pO

0.00'

4,:'98,509

o.oln

O.O()~

-2,11'11 21

3.1se

l.50t

,,,

910

91l 914

210,547

PUl'Challad COrmTlUr>.\.C4

AO,J71

~1I,409

-"

Bl,&04 1,9G3

1.SOt 1. 50~ t.45\

4.9Jt

1,206

6'19

-1,063

'"

1 45

2,525

1,381,021

3'1,271

o sa

641

1,4(1\

1.40'

924

Phd.lIldCY

3,633,711 492,<;71

o

2,02l 9,951 1l9,'H2

12,

~33

921 922

1'01.059 3,tJO,069 370,533 350

925

9)0 931

93:'.1

f'z.int:Jng ~ i<.epro-iuct £quipt H..o.l.nt Contr,oct Pad] i ty Maint CQI,t,ra>:t E'hallllilcy Equ1..pt PULchar""" o..pot Hillirtt CmltLilct eQ!'\l'f"ltants M<Jmt " f'r<:lt .<:p!: SVf; Stlldles AMlY"'!$ &val Engineeril>g T..ch $'1C

OtM~"

l£,Zf;

1.4'1'

I.S0t

'"

10,397

13,2S(\ 27(1

~613

16,1El 15E,509

3,91"'.970 4!i2,21J 2,.45

1.SiH 3,(,30,069 :PO,533 2,410

3.5o,

2.13n 1.4ll 1.45\

O.O(Ht

11, iii3

OVerseas p'lfch'Hlt!S Olher O..pot Maint

931 Contl'act COf>Jllultants

Ktj!J;t & Prot Hpt Svc

2,864

'"

o

35

<0

-4:04

o

:ICS,581 5S,416 4,600 1.S60

0,00\

1,40\

1,40t

o

4,615 1,755 167, ;56

:H2

o

4,354

o

-49,886 ~.'4, 256

-49

932 933

1,50t

StudiES

An~lysis:

L50t

4,"15 1,155 l,H.i

l,GU

(J

Tec:h

934

l1.1S\\;

J,~44

535. '110

(Sllbslst.. m:otl ann SlIP)cx!{t Contracts ~v.. tol"m~nt c:ontr;..;:t"

Q

:21,584

1.41\

l.H~

20£,590

"

F',,,d

()the( Gost3 964

~H4

L52:t 1.411\

n,913

5

353 1(),328

()

-8,a53

1,619

I;)

Catoe) \!ntere,.,t an;:( 01lildel\ts) Other CO:(lt, ISubl'fi:(ltcnc. ar;d Support'

(Hedic~l

359.Hi4

-,.

4,636 1, ,42 ),1('0,49G

1.4st

o

0.1)(l~

n,nO,326 997 989 Intra-Gov.. mwH).t Purdn$#l$ nth"r Contract", IT ("'.onlu,ct Suppod Total f>lIcch"ses

1.415,()15 656,290 n,75:',HS 3.S62 0 'iI.207

3.3(lt

443,;2.03

L40*

t.iOt 1.40\ 1,4(1,

'"

572 456 1",859

15,011.431 33,664

15,06A

-417,265 ii5? ,023 1(j2,B6J

990

9,19.0

105,104

1,011,111 114,849 19, n6. 1!)1 29,915,211

'''1,1 aell'elopment Contuets Hente.1Il CAL"' Col'ttL'act", Ot.her Intra-('o<,YIH'n_nt P'nc!lIls.' 98S (kllint, 9fl9 Othac Cont,!4<:tll 990!T Contract $upPOr!:. Services 999 Total E'urch6ses

995 986

1$,011,431 33,664 15,069

O.OOt 0.00\ 3.5(Ji

"

525,610 15,Hi4 11,624 'S4.6bZ 1iiS.£24

o

1,643

o

·.99,91& 4,39-2: 11,5-62 122,511) 1.5,053,063 3a.561 23,B5G 1,148,919

1. ~O'

1,Oil,lil

T14,~49

29, 32/;, 152

;19,915,.<:71

1,161

l,36~

9999 TOTA!.

28,413,679

9,340

1l9,B5

200,2P

30,902,5(6

~U~U."-q'

U'wI"1of U

012

Defense Health Program

Fiscal Year (FY) 2012 Budget Est~ates Exhibit PB-31R, Personnel Summary

Change FY 2010 FY 2011 FY 2012 FY 2011/2012 Active Mili Officer Enlisted Reserve Drill Strength (E/S) Officer Enlisted (Total) 84,085 31,244 52,841 84,946 31,392 53,554 86,007

31,843

54,164

1,061 451 610

o o

o o

o

o

o

o

o

o

(Total)

o o o

o

61,792 59,307 758 60,065 1,727 438 84,516 31,318 53,198

o

o

Reservists on Full Time Active Duty (E/S) Officer Enlisted

o

o

o

64,236 61,676 783 62,459 1,777 421 82,225 30,758 51,467

o o

o

60,187

57,782

713

o o

-1,605 -1,525 -45 -1,570 -35

Civilian End Strength (Total) U.S. Direct Hire

Foreign National Direct Hire

Total Direct Hire Foreign National Indirect Hire (Reimbursable Civilians Included Above (Memo» Active Military Average Strength (A/S) Officer Enlisted Reserve Drill Strength (A/S) Officer Enlisted (Total) (Total)

58,495

1,692

438

85,477

31,618

53,859

o

961 300 662

o o o

(Total)

o

o

o o o

o

o

o o o o

o o o o

o

Reservists on Full Time Active Duty (A/S) Officer Enlisted

o o o

o o

Exhibit PB-31R, Personnel Summary (Page 1 of 2)

013

Defense Health Program Fiscal Year (FY) 2012 Budget Estimates Exhibit PB-31R, Personnel Summary

Change FY 2010 FY 2011 FY 2012 FY 2011/2012 Civilian FTEs (Total) U.S. Direct Hire. Foreign National Direct Hire Total Direct Hire Foreign Natiorial Indirect Hire (Reimbursable Civilians Included Above (Memo) ) Contractor FTE's (Total) 59,839 57,389 757 58,146 1,693 645 19,710 60,100 57,680 736 58,416 1,684 618 19,238 58,369 56,033 686 56,719 1,650 619 17,725 -1,731 -1,647 -50 -1,697 -34 1 -1,513

Exhibit PB-31R, Personnel Summary (Page 2 of 2)

014

Oefense Heal th Proqram Fiscal Year (F'l) 2012 Budqat Estimates Summary of Increases and Decreases (Dollars in Thousands)

O&M (01)

Budqe t Activi ty ROT&E (02)

DHP Total Procurement (03)

FY'" 2011 President's Budqet Requestll

29,915,277

499,913

519,921

30,935,111 7,781,877 16,034,745 2,122,483 1,452,330 293,698 632,534 1,597,610 499,913 519,921

In-House Care Private Sector Care Consolidated Health Support Information Management Management Activities Education and Training Base Operations/Communications

l<DT&E

7,781 / 977 16,034,745 2,122,483 1,452,330 293,696 632,534 1,597,610

499,913 519,921

Procurement 1. Congressional Adjustments a} b) c) d, Distributed Adjustments Undistributed Adjustments Adjustments to Meet Congressional Intent General Provisions

o

o

0

0

o

o o

29,514,514 29,915,277

7,761,877 16,034,745 2,122,483 1,452,330 293,698 632,534 1,597,610

0

° 0

0 519,921

o o

°

499,913

IT 2011 Annual CR Total'l F'l 2011 Appropriated Amount

30,534,348 30,935,111

7,781,877 16,034,745 2,122,483 1,452,330 293,698 632,534 1,597,610 499,913 519,921

499,913

519,921

In-House Care Private Sector Care Consolidated Health Support Information Management Management Activities Education and Training Base Operations/Communications

l<DT&E

499,913

Procurement 2. 3. CCO and Other Supplemental Appropriations Fact-of-Life Changes

<1)

519,921 1,398,092

o o o

o

1,398,092

°

o

o

Functional Transfers 1) Transfers In 2) Transfers Out Technical Adjustments 1) Increases 2) Decreases Emergent Requirements 1) One-Tiroe costs 2} Program Growth 3) Program Reductions

o o

o o

o

o o

o

b)

°

o

° o

o

o

o o

o

o o

c}

o o

o

o

°

o

° o

o o

EXhibit IIB-31n. SUlIIIDo&ry of

ln~ ···

and. n.tcn.... IP"lI" 1 of 3)

015

Defense Health Program

Fiscal Year (FY) 20.12 Budget Estimates

Summary of Incraa.es and Decreases

(Dollars in Thousand.)

O&M (all

Budget Acti vi ty RDTliE (02)

OHP Total Procur......nt (03)

FY 2011 Baseline Funding In-House Care Private Sector Care

31,313,369 8,490,881 16,573,121 2,250,895 1,454,616 294,216 650,595 1,599,045

499,913

519,921

32,333,203 8,490,881 16,573,121 2,250,895 1,454,616 294,216 650,595 1,599,045 499,913 519,921

Consolidated Health Support

Information Management Management Activities Education and Training Base Operations/Communications

RDT&E

499,913 519,921

Procurement

I}.

Reprogrammings/supplemental a) Anticipated War-Related and Disaster Supplemental Appropriations Reprogrammings 1) Increases 2) Decreases

31,313,369 499,913 519,921 32,333,203

bl

Revised FY 2011 Estimate In-HOUse Care Private Sector Care Consolidated Health Support Information Management Management Acti vi ties Education and Training Base Operations/Communications

RDT&E

8,490,881 16,573,121 2,250,895 1,454,616 294,216 650,595 1,599,045

499,913 519,921

Procurement

5.

a, 490, sal 16,573,121 2,250,895 1,454,616 294,216 650,595 1,599,045 499,913 519,921

-1,398,092

Less: War-Related and Disaster Supplemental Appropriations and Reprograrronings (Items 2 and 4)

-1,398,092 29,915,277 1,781,877 16,034,745 2,122,483 1, 452, 330 293,698 632,534 1,597,610 499,913 519,921 785,684 -147,061 44,625 -191,686 7,499 12,575 499,913 519,921

Normalized Current Estimate for FY 2011 In-House Care Private Sector Care Consolidated Health Support Information Management Management Activities Education and Training Base Operations/Communications

RDT&E

30,935,111 7,761,877 16,034,745 2,122,483 1,452,330 293,696 632,534 1,597,610 499,913 519,921 805,758 -147,061 44,625 -191,686

Procurement

6,

7.

price Chang'e Transfers a) Transfers In b) Transfers Out

o

o

bhibit n-:UD,

s~

of

lru:n~·.a ···

and.

0-0:'· · · ·

CPa.p 2 of 3)

016

Defense Health Proqram

F1.0al Year (FY, 2012 Budget Estimates

Summary of Increases and Decreases (Dollars in Thousands)

0&1>1 (01,

Budget Activity RDT&E (02'

DHP Total

Procurement (03)

S.

Program Increases a) Annualization of New FY 2011 Program b) One-Time FY 2012 Costs c) Program Growth in FY 2012 Program Decreases a) One-Time IT 2012 Costs b) Annnalization of FY 2011 Program Decreases c) Program Decreases 1n IT 2012

2,453,469 0 90,912 2,362,557 -2,104,823 0

-2 / 104,823

182,293

0

123,445 0 123,445 -23,313 0 -23,313

2,759,207

o

90,912 2,668,295 -2,154,135

182,293 -25,999

0

9.

o

-2,154# 135

-25,999

FY 2012 Budget Raqu·· t

In-House Care Private Sector Care Consolidated Health Support Information Management Management Activities Education and Training Ease Operations/Communicatio:

RDT&E

30,902,546

8,148,856 16,377,272 2,193,821 1, 422, 697 312,102 705,347 1,742/451

663,706

632,628

32,198,880

8,148,856 16, 377,272 2,193,821 1,422,697 312,102 705,347 1,742,451 663,706 632,628

663,706 632,628

Procurement

11 Reflects the FY 2011 Fresident! s BUdget nque:3t.

21 Adjusts the Operation and Maintenatlce budqet line included in the F'f 2011 Pretlident' s Budget reqtle.st to matc::h the Annulllized Continuing Resolution funding level.

hhibi t pa...310 # sUlI··ny of Inc:r.a.e. and o.c::re&···

(Pap: 3

of 3)

017

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates In-House Care

I. Description of Operations Financed: This Budget Activity Group provides for the delivery of patient care in the Continental United States (CONUS) and Outside the Continental United States (OCONUS). This program includes the following: Care in Department of Defense Medical Centers, Hospitals and Clinics: Resources medical care in CONUS and OCONUS facilities which are staffed and to provide and care for both and non surgical conditions for Military Health System beneficiaries. Dental Care: Resources dental care and services in CONUS and OCONUS for authorized personnel through the operation of hospital departments of dentistry, installation dental clinics, and Regional Dental Activities. Pharmaceuticals: Resources pharmaceuticals specifically identified and measurable to the provision of pharmacy services in CONUS and OCONUS facilities.

II. Force Structure Summary: The In-House Care Budget Group (BAG) includes staffing to medical and dental care in military facilities which provide the full range of and ambulatory medical and dental care services. In addition to medical and dental care this BAG also includes medical center laboratories, alcohol treatment facilities, clinical investigation activities, facility on-the-job training/education programs and federal sharing agreements. This BAG excludes operation of management headquarters for TRICARE Regional Offices, deployable medical and dental units and health care resources devoted exclusively to teaching.

Exhibit OP-S, In-House Care (Page 1 of 12)

018

Defense Health Proqram

Operation and Maintenance

Fiscal Year (FY) 2012 Budqet Estimates In-House Care

I I I . Financial Summary ($ in Thousands):

FY 2011 Congressional Action

A.

1.

Subactivities:

FY 2010 Actua1s

Budget Re9:!:!est

Amount

Percent

Current AEEroEriation

Current Estimate

FY 2012 Estimate

MEDCENs, Hospitals & Clinics (CONUS) MEDCENs, Hospitals & Clinics (OCONUS) Pharmaceuticals (CONUS) Pharmaceuticals (OCONUS) Dental Care Dental Care Total (CONUS) (OCONUS)

5,588,633 489,193 1,303,743 120,827 464,545 60,637 8,027,578

5,317,643 420,786 1,341,241 114,183 521,537 66,487 7,781,877

0 0 0 0 0 0 0

0% 0% 0% 0% 0% 0% 0%

5,317,643 420,786 1,341,241 114,183 521,537 66,487 7,781,877

5,317,643 420,786 1,341,241 114,183 521,537 66,487 7,781,877

5,529,998 436,149 1,455,142 143,687 523,222 60,658 8,148,856

2. 3. 4. 5. 6.

Notes: 1. FY 2010 actuals include $603.900M for Overseas Contingency Operations (OCO) under the Department of Defense Appropriation Act, FY 2010, Public Law 111-118. FY 2010 actuals include $5.192M for Department of Defense Supplemental, FY 2010, Public Law 111-212. (Total FY 2010 OCO is $609.092M). 2. FY 2011 President's Budget Request excludes $709.004M for OCO. 3. FY 2012 Request excludes $641.996 M for OCO. 4. Does not reflect Department of Defense Medicare-Eligible Retiree Health Care Fund (MERHCF) for FY 2010 of $l,244.2M, FY 2011 of $1,388.7M and FY 2012 of $I,437.3M O&M only.

Exhibit OP-5, In-House Care (Page 2 of 12)

019

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~tes In-House Care

B. Reconciliation Summary: Baseline Funding Congressional Adjustments (Distributed) Congressional Adjustments (Undistributed) Change FY 2011/2011

Change

FY 2011/2012

7,781,877

7,781,877 0 0 0 0 7,781,877 709,004 0 8,490,881 0 0 -709,004 7,781,877

n/a n/a n/a n/a

n/a

Adjustments to Meet Congressional Intent Congressional Adjustments (General Provisions) Subtotal Appropriated Amount OCO and Other Supplemental Appropriations Fact-of-Life Changes Subtotal Baseline Funding Anticipated Supplemental Reprogrammings Less: OCO and Other Supplemental Appropriations Revised Current Estimate Price Change Functional Transfers Program Changes

n/a n/a

n/a

n/a n/a n/a

n/a 141,004 -2,857 228,832 8,148,856

n/a n/a n/a

7,781,877

Current Estimate

Exhibit OP-S, In-House Care (Page 3 of 12)

020

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates In-House Care

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional Adjustments a. Distributed Adjustments b. Undistributed Adjustments c. Adjustments to meet Congressional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life Changes a. Functional Transfers b. Technical Adjustments c. Emergent Requirements FY 2011 Baseline Funding

4. Reprogrammings (Requiring 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Appropriations

( $ in Thousands) Totals Amount

7,781,877 0

0 0 0 0

7,781,877 709,004 0

0 0 0

8,490,881

0 0 0 -709,004

Current Estimate for FY 2011 6. Price Change 7. Transfers a. Transfers In b. Transfers Out 1) Transfer from DHP to Secretary of the Army: Transfer of funding and personnel from In-House Care Budget Activity

Group for Army Substance Program (ASAP) from Army Medical Command

(MEDCOM) to Army Installation Command (IMCOM) (-33FTEs, -$2.9M) . .

7,781,877 141,004 -2,857

0 -2,857 -2,857

Exhibit OP-S, In-House Care

(Page 4 of 12)

021

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

In-House Care

( $ in Thousands) Amount Totals

C. Reconciliation of Increases and Decreases

8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs 1) Navy Individual OCO Augmentees: Realigns 3,836 temporary Navy Individual Augmentees and funding from FY 2012 OCO request to the FY12 base budget request. c. Program Growth in FY 2012 1) Healthcare Provided In Military Treatment Facilities: Resources to support delivery of inpatient and outpatient care including Prospective Payment System (PPS) for increased workload ($33.3M), Ground Force Augmentation ($32.6M), United States Forces Korea Tour Normalization ($1.5M), Patient Centered Medical Home (PCMH) (+1,694 FTEs; $66.2),Behavioral Health (+307 FTEs; $37.2M), Comprehensive Pain Management ($10M); and, demolish, expand and renovate Walter Reed National Military Medical Center (WRNMMC) as outlined in the Comprehensive Master Plan (funds transition costs: $25M). FY 2011 Hea1thcare Funding Baseline: $5,738.4M. 2) Initial Outfitting: Resources for initial outfitting requirements for restoration and modernization and programmed MILCON projects including Fort Riley ($53.6M) and Fort Sam Houston ($38.2M). FY 2011 Funding Baseline: $352.5M. 3) Wounded Warrior Support: Resources to support healthcare delivery to Wounded Warriors including Traumatic Brain Injury and Psychological Health (TBI/PH) ($11.5M), Wounded, III and Injured (WIl) ($7.6M) and the realignment of enduring OCO requirements to base ($4.2M). Includes funding for congressionally-directed changes in Combat Related Retiree travel (Sec. 1632, FY08 NDAA, $0.7M) and an increase in Physical Exam Board Liaison Officers (Sec. 597, FY07 NDAA, $10M) for Wounded, III and Injured warriors.

474,127

o

26,470 26,470

447,657 205,904

137,773

33,998

Exhibit OP-5 , In-House Care (Page 5 of 12)

022

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

In-House Care

( $ in Thousands) Amount Totals

C. Reconciliation of Increases and Decreases

4) Funding Realignment: Realigns funding from Private Sector Care Budget Activity Group (BAG) to In-House Care BAG for Patient Centered Medical Home ($25.6M) and Clear and Legible Reports ($20.1M). Realigns funding from various BAGs (3,4,5,7) to In-House Care BAG to align civilian pay execution to correct BAG ($6.2M). FY 2011 Healthcare Funding Baseline: $5,738.4M. 5) Centers of Excellence: Provides resources for Vision (Sec. 722, FY 2009 NOAA) and (Sec. 721, FY 2009 NOAA) Centers of Excellence. FY 2011 Baselines: Vision $9.4M; Hearing $5.0M. 6) Secretary of Defense Efficiencies, Front End Assessment-Personnel, Pharmacy Co-Pay Adjustment (Non-Medicare Eligible): Provides resources to support ected increased utilization in the direct care (Mi Treatment Facilities) pharmacies due to proposed changes in retail pharmacy co-pays. FY 2011 In-House Care Pharmacy Funding Baseline: $l,455.4M. 9. Program Decreases a. One-Time FY 2011 Costs b. Annualization of FY 2011 Program Decreases c. Program Decreases in FY 2012 1) Civilian Personnel Adjustment: Reflects funding realignment due to changes in civilian personnel FTEs from in-sourcing (contract to civilian) (-381 contractor FTEs, -$30.1M in contracts). In addition, realigns execution to correct program elements (-1,154 civilian FTEs, -$59.2M in civilian pay). FY 2011 Funding Baselines: Other Contracts $2,082.0M; Civilian Pay $2,738.3M. 2) Reversal of Military to Civilian Conversions: Incremental funding transfer to MILPERS accounts to restore mi

51,856

6,705

11,421

-245,295

o o

-245,295 -89,275

-54,047

Exhibit OP-S, In-House Care (Page 6 of 12)

023

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

In-House Care

$ in Thousands)

C. Reconciliation of Increases and Decreases authorizations previously programmed as military to civilian conversions, as required by Sec.721 of the FY 2008 NDAA(-202 FTEs) Funding Realignment: Reflects funding realignment from In-House Care Budget Activity Group for restoration and modernization projects and Facilities Sustainment Model execution to 100% (-$30.2M). Also includes a joint bas realignment of medical functions between Army and Air Force Defense Health Program activities. Implements agreements on installation support services that MTFs provide at joint-base sites (10 civilian FTEs, $IM). Funding Realignment: Reflects funding realignment from In-House Care Budget Activity Group to Consolidated Health Care Activity Group for DoD-VA Joint Incentive Fund. One Less Day Paid: usts for one less civilian pay day in FY 2012. FY 2011 Funding Baseline: $2,738.3M. Military Health System Initiative - Initial Outfitting and Transition (IO&T): FY 2012 IO&T savings achieved through better management, standardization of equipment buys and increase in equipment re utilization for MILCON projects. FY 2011 Funding Baseline: $352.5M. Military Health System Initiative - Patient Centered Medical Horne (PCMH) : Achieved savings optimal internal ratios (-263 FTEs). FY 2011 Healthcare Funding Baseline: $5,738.4M. Secretary of Defense Efficiencies, Front End Assessment-Logistics, Medical Supply Chain Sourcing Optimization: Approves the Logistics Efficiency to optimize medical supply chain sourcing. FY 2011 Funding Baselines: In-House Care Pharmacy $1,455.4M; Supply $736.0M. Amount Totals

3)

-31,181

4)

-15,000

5)

-12,810 -9,187

6)

7)

-12,639

8)

-12,113

Exhibit OP-S, In-House Care

(Page 7 of 12)

024

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates In-House Care

C. Reconciliation of Increases and Decreases

( $ in Thousands) Totals Amount

of Defense Efficiencies - Reducing Reliance on DoD Service Support Contractors: Directs the components to reduce funding used to acquire service support contracts by 10% per year over the next three years from their reported FY 2010 levels. FY 2012 reduction is 20% and FY 2013 reduction is 30%. These efficiencies will have no impact on direct healthcare delivery. FY 2011 Funding Baseline: $19.3M. 10) Secretary of Defense Efficiencies Reports, Studies, Boards and Commissions Review: Directs the Components to reduce funding for advisory studies by 25% below the FY 2010 levels. Reductions are based upon self-reported "Advisory and Assistance Service" data and are from "Studies Analysis and Evaluation" activities. These efficiencies will have no impact on direct healthcare delivery. FY 2011 Funding Baseline: $11.4M. 11)Secretary of Defense Efficiencies - TMA Baseline Review: Directs the Director for TRICARE Management Activity (TMA) to streamline operations by consolidat activities into a follow-on Military Health System Support Activity consisting of four divisions: 1) Uniformed Services University of the Health Sciences (USUHS), 2) TRICARE health plan, 3) Health Management Support, and Shared Services and to reduce 364 Contractor ions beginning in FY12. Directs the USD (P&R) to reduce redundancy, capitalize shared services efficiencies and to better align similar missions across the P&R enterprise and to eliminate 24 civilian full-time equivalents beginning in FY 2012. These efficiencies will have no impact on direct healthcare delivery. FY 2011 DHP Contract Services Funding Baseline: $3,00S.6M.

FY 2012 Budget Request

9)

-3,806

-3,707

-1,530

8,148,856

Exhibit OP-S, In-House Care (Page 8 of 12)

025

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

In-House Care

IV. Performance Criteria and Evaluation

Summa~:

Population by Service Obliqation - World Wide*

FY 2010 Actual

FY 2011

FY 2012

Chanqe

Chanqe

i§Umll.:te

is:t1mll.:te

Jll 2010l2!U1

Jll 2011l2Q12

Average Eligible Population Catchment Area Army Coast Guard Air Force Marine Corps Navy Navy Afloat Other/Unknown Subtotal Non-Catchment Area Army Coast Guard Air Force Marine Corps Navy Navy Afloat Other/Unknown Subtotal Total Average Army Coast Guard Air Force Marine Corps Navy Navy Afloat Other/Unknown Subtotal Population

1,806,893 60,548 853,829 467,223 818,169 267,752 10,947 4,285,360

1,832,959 60,854 852,323 468,138 813,107 273,890 4,312,247

1,821,299 60, 498 827,901 467,591 806,676 272,945 4,267,874

26,066 306 -1,506 915 - 5,062 6,138 26,887

-11,660 -356 -24,422 -547 -6,431 -945 -44,373

2,084,789 143,952 1,731,332 288,780 957,611 56,770 20,700 5,283,932

2,113,570 145,312 1,729,925 290,876 958,692 59,044 20,779 5,318,197

2,132,974 147,390 1,757,916 293,310 966,766 58,060 20,933 5,377,348

28,781 1,360 -1,408 2,097 1,082 2,274

!Ul.

34,265

19,405 2,078 27,992 2,434 8,074 -984 154 59,151

3,891,682 204,500 2,585,161 756,003 1,775,780 324,522 31,646 9,569,292

3,946,528 206,166 2,582,248 759,014 1,771,799 332,934 9,630,444

3,954,273 207,888 2,585,817 760,901 1,773,442 331,005 9,645,221

54,847 1,666 -2,914 3,011 -3,981 8,412 111 61,152

7,745 1,722 3,570 1,887 1,643 -1,929 14,778

*Note: The data are derived from the Managed Care Forecasting and Analysis System (MCFAS) -- Data Version FY2009.0. Numbers may not sum to totals due to rounding.

Exh1bit OP-Sr In-House Care (Page 9 of 12)

026

Defense Health Program

Operation and Maintenanoe

Fisoal Year (FY) 2012 Budget Est~ates In-House Care

IV. Performance Criteria and Evaluation Summary:

DHP Requirements ($OOOIS) Beneficiaries (OOOIS) Enrollees (OOOIS)

'1 2010 28,423,679 9,569 3,286

'1 2011 29,915,277 9,630 3,391

'1 2012 30,902,546 9,645 3,447

Change II 2Q1QL2Qll 1,491,598 61 105

Change II 2QllL2Q12 987,269 15 57

Exhibit OP-S, In-House Care

(Page 10 of 12)

027

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates In-House Care

V. Personnel Summary

FY 2010 Active Mil Officer Enlisted Total Military Active

Militaryl\,v:~rage

FY 2010 19,806 57,286

FY 2012 20,225 38,104 58,329

Change FY 2010/FY 2011

57 684

Change FY 2011/FY 2012

419 1,043

19,749 36,853 56,602

Strength (A/S) Officer Enlisted Total Military

19,425 55,453

19,778 56,945

20,016 37,792 57,808

353 1,492

238 863

U.S. Direct Hire National Direct Hire Total Direct Hire National Indirect Hire Total Civilian (Reimbursable Included Above-memo) Average Civilian Salary ($OOO's) Contractor FTEs (Total)

42,552 558 43,110 1,105 44,215 574 79.039 14,018

41,255 41,796 1,086 42,882 577 79.034 13,888

40,251 512 40,763 1,060 41,823 578 79.065 12,617

-1,297 -1,314 -1,333 3

-1,004 -1,033 -1,059 1

-130

-1,271

Exhibit OP-5 , In-House Care (Page 11 of 12)

028

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

In-House Care

*Outyear contractor FTEs are baselined to FY 2012, however, reductions may be applied to comply with Secretary of Defense required reductions to Service Support Contractors and Reports, Studies, Boards and Commissions review. Note 1 Military Personnel ustment: Data includes Air Force combat support personnel assigned to the DHP. The change in active military end strength is explained as follows--Change from FY 2010 to FY 2011 (+684): includes programmatic changes to FY 2011 from POM-2010 (restoral of MILCIV conversions +286), and PBR-2011 (restoral of MILCIV conversions (+228); miscellaneous manpower reprogramming/adjustments (+170) requested by field activities). Change from FY 2011 to FY 2012 (+1,043): includes programmatic changes to FY 2012 from POM-2010(restoral of MILCIV conversions, +348), from PBR-2011 (restoral of MILCIV conversions, +206), and from POM-2012 (Grow the Army, +393); miscellaneous manpower reprogramming/adjustments requested by field activities (96). Note 2 Civilian Personnel Adjustment: contract to civilian in-sourcing (+381 FTEs) , execution ustments (-1,154 FTEs), military to civilian conversion restoral (-202 FTEs) and miscellaneous mission and function realignment and changes (-84 FTEs).

VI. Outyear Summary: N/A

VII. OP 32 Line Items as Applicable (Dollars in thousands - see next page) :

Exhibit OP-S, In-House Care (Page 12 of 12)

029

DEFENSE HEALTH PROGRAM FISCAL YEAR {FY} 2(l 11 BUOOETf.S11MATES OPERATION AND MAIN11lNANCE SUMMARY OF PRICE AND PROGRAM CHANGE

(SmThuIl-m)

DEFENSEUF..ALTH PROGRAM ASCAL YEAR (FY) 2012 BUDOET ESTlMATfS

OPERATION ANOMAIN1ENANCE

SlJMMARY Of' PRICE AND PROGRAM CHANG£

($ in ThnulWtdll)

f ......

Fom,:n

Program !lJlll!<Ih

1.40\ 1,629

~25.954 ~~5,

u...

:;Oil

J.... thllbll"C n ..

FY10IO -..

lU,240

Q1~

_

MOll _

Uno

Cum!l'lL"y

w...uo..IICln

Travel ot Per!'o!ls Total "1,960 91,960

&WI

Price CJI'O'Mh _6mwuu

l.~Ol

Proaram

~

1''YlOll _

'"

4)1 U2

H4 415

416

116,240

4'\ 45

954

91,960

2U1

;,971

1,182 1,182

'"

12<1

'" o

AfllIY Sup t; Kat Navy Sup Ii Hat

At' , M.ot , Kat

Sup " M~t

269 4:

.~lW

DFS(: ruel

rund !'\lOll

,

5,901

1<

2.97' 1.3'"

D.liU

o

6,17J

1,611:4

J.Z)i

-2, L:'4 -Ie

5,901 4H

3,26%

At"'Y Sup" Mat liIavy Sup" Mat AF Sup' Hat

DLA SUfl ,

o

o

3,2;)5 "1, !lJ U,ll95

:'<1,020

-O.9H

2,OH 1.40'

, Mat

H,6f1

Hat

-3,103 (05

~911

Ht

13,095.

GSA Sup " ~t

1.0.::... 1 I'r<><;

70td Sup

~

Retili 1 Supply

,

1. 4()~

1.40~

411

41f1

1.46' 1.50' 1,50\

"

-H7 -218

2,936 ;,;';'1 14,10J 11,052

o

'04

~4.

o

5iUI

0

Mat

J6,815

4,4B~

'"

24,l!5J 21,536 56,1£0

(I

'"

1. 34~

0.64:~

-Uti

!U'l'tlY

EqIJipt

Equl~t

4.S11

(;14

503

50~

.Ll,S]6

136

~545

.'I"d

Eq.upt

j(!,3!Si

33] 3(0,605

o

",353 59,02i)

SUfi

1,9.11

-LSS~

50? S!:I'9

GSA Equipt T<1td rund E<:J'llpt .41_"'y D.. pot Nav.. l l;Ul·f .. c .. W",1.

Nillval Civ:!.l Eng'"

m

,7,932

1.50i

-H'J 0-11.65'

-3.t'i:H:

~0.3n

39,911>

117,H7

Cln<1t-\dlflt Naval ::;'.11:£;0.".. ~r Ctr Ittval Civil Ctl

1.11]

A,.."

641 (,71

'".. V Put> Wt'ks etc; Utilitiell Wr~s (:tr: PUP W.ks DISA S"terprise COlmlul'll"<ltior,s ::;vc

1,851 o

Nillva1 Pub' Pn<t th.v Pllb Wrk.s Ctr: UtiHt.i<ts

1,ilS!

llO

1,906

o

o

C

1.4\1'0 -14 .1)(1~

OJ 67S

~P9

De! Firilnce " 01/\ Disposition S"rvlces

C<'IMI Svcs t:l II! 1

o

'" o

'"

on

(I

2.un

D 10.601:

1.4i)1I

H.16~

"

It1

~.17.

Def Fi1)ilnr.f! & ",,:ct DLA Oi1'Jpt''ilition Ser'Hr.f!S

o

J, 17~

o

°

o

() -12.99'

~l:l.06~

~11.69'

· "

-,

...

· o

o

2,()H

J,251

Tier 1

Rei.mi:)Ur~ib1. Sve Pun;hasp.s tv,,*, Bui)d1nq Mli.lnt."""n<:" F Tot..1 P1H"hil!l<tS

12,6H l.50'

COEt Reimburl<ti'Je P'I[Ch,UHiS fmm El1111dlnq H.ilntp.ll",,,;e 1ot~1 Purcha"es

Cargo l\HC 7raioin9

",

l4.16'

4.9!>1)

'"

5,569

5,5£8

l.1(a

107

nl

MEC Cargo

M'J}If; Port !hotllll>9 Commerclal Tt'allsporratton 70tal 'fr"nspol·tation

o

<'. 5)~

"

10. 70~ IS. 40~ \5.401 1 "40~

~C

,." Carqo

5,989 5,9B9

19Si

6,516 3,)9(,,717

0,50'1<

"

O.SD'"

121 111 7(09

MTMC ~'ort CDl"II'\''''ci"l Transl'O;;tatio/\ Tnt«l Tl"a!l!lpnlt"Uo/\

-2. eo~

26.90\

2(:,:10,

1.SOl

" "

o

~SO, 7'1~ ~l,696

['<lY

~I)l

Relmbllr!<

Nell. I11n ,HIe

!>2,H7

J,J91,JJ3 51,I()J Hi'S -25 3,.349

'" "

o

14.033

~

1.4010

912 913 914

Clv P"y R>l'trnbu"" !lost lonu9fl "at Jnd 1111·... S"p,in'atlot; U.dbility R.. nul Pay tn f'lU:chased Utll1ti~s .....ad,"$lld COiM!\.1I11ca

1,2:'<1,33)

0.001

<'l,HH

J, 21{), 538 49,407 1,tO,}

o

H6 1.:'01

6.J

"

o

49 .H14

1. 50~

).4011

3,

30~

15

J,102 21,810

"195,154 't.80S 114,6A6

')~4

925

n~

Kail;,- Cnntr!lct. f'har:macy £qllipt. Purchases OVtH">l'aS Purf.,hase3 Other Depr>t' Kaint (;o"triu:t. Consultantll

110,::Sl 1,

~ 2~. ~10

1.40. 1.40. 1.401

3.~0\I

13R l. 606 1,549

"

ell?

-16,15f;

~1l5,BD5

'!In. 7%

1<),0,0

'"'

10, BO

111,253

,11.038

l.5()' 1.<'0% LSOt 1.50,* 1.50'1

H,en

156 1,159

,

-11,611 )I 98

~nO,962

.

10,595 119,110

o

164

"',010

H1,<l6S

3.3011 ) ,40\ 1.40' 1.40\

1.455,424 241,916

1,455.424 241,911\

\"".. ,,,,,,illl

.1.5(1.

.1,50~ 1.~0'

"

<I

o

PUlr:hllt.eH

"o

15,301 1,153

"c

1,253 -?Hil 0 1il4,110

",

15,522 ',Ui3

IB4. TlO

°

8,468 0

(I

~9.360

0

309,14>6 0

1.50%

1.50\

1.4\111

L~O'

2H 100

-1,661 -4,251

13,892 1,l05

EM)iheerin9 'feet.

Other Costs lMed1c~1 Ca ..... j ether r.osts lIotetellt and olv;lIi<'llts) Other CO!!lts lS'lP!'istenclI Support &quipment r:Otltr~ct~ Re',!"lIrr,h lI"d D<Nel~nt Contr""j $ Merlh..lll "an3 Ottll'!C Intr«-Covernment: Purchillses

,

o

182.)P

C

j,3H ()

11

,:W,

0

1>,1::0 2

o

m

'"

o

).10t L401 1.401 1.40'1 1.40' 3,10\

'"

10

Other Coste (Moldiesl Care) Other r,,'iI~S llntere'!t "f1d Dlvtcien1;l!) Othet Cmlts (suhsist ..n"", "'lid SUPP".I:t c Cnnl,'..ct,. <lind Oeve1opmef<t Contracts

1,161 1.50t 1. 50\-

)I~5

'"

38,747 -210,10]

'"

14 l

6.494 2 iO

265,291

451,1l6 143 656

1.50'

1,OD2.519 4: 38

0

0

35,091

~Hif.2n

1,l7,1,9fl) J,3h 7

o

2,445 11,55<, 7,B03,951

He

91l"'

9Hij

9R~

Oth"'r Intn-Govllc/\ment P'a'coases

Grants

o

t.50'

l,50i

811,426 445 t90,594 lO.Jl5 "1,B94,872

Other Cor,tract.s Contract $'1PPOtt Services Total Ptl1:cha'les

~~99

o

7,198

2,U6 162 Pi:. 359 156,916

"

990 -:',94,050 -409,fl15

99~

Othe! Cnl'llcacts rr Support S.. ~'vlr~" Tota 1 P11r'dl"S';>S

155. 7~3

1.501

15"1

1,liI\

7, 7Bl. 571

139, Ul

:L.41,004

32,505 -255 Hl4.912

TOTAL

il,O;.'?!>18

1. J(JH

B,146,!t56

~\OJ"U,

r.::

( ' ' ' ' 3. ., 11

030

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Private Sector Care

I. Description of Operations Financed: This Budget Activity Group provides for all medical and dental care plus pharmaceuticals received by DoD-eligible beneficiaries in the private sector. This includes the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Program, the TRICARE Managed Care Support Contracts (MCSC), the Uniformed Services Family Health Program (USFHP), the TRICARE Overseas Program, the Supplemental Care Program, TRICAREMail Order Pharmacy, the National Retail Pharmacy, TRICARE Reserve Select (TRS) which is a premium based program for Reserves and their family members, and various support activities. Pharmaceuticals: Purchased Health Care: Includes pharmaceutical costs associated with contractual pharmacy services providing authorized benefits to eligible beneficiaries via the TRICAREMail Order Pharmacy Program (TMOP) . National Retail Pharmacy: Includes pharmaceutical costs associated with contractual pharmacy services providing authorized benefits to eligible beneficiaries via the TRICARE Retail Pharmacy (TRRx) program. TRRx provides network pharmaceutical prescription benefits for medications from local economy establishments. TRlCARE Managed Care Support Contracts (MCSC): The TRICARE Managed Care Support Contracts provide a managed care program which integrates a standardized health benefits package with military medical treatment facilities and civilian network providers on a regional basis. With the full deployment of TRICARE, all but a small portion of the standard Civilian Health and Medical Program of the Uniformed Services benefits have been absorbed into the MCSC. Includes health care costs provided in civilian facilities and by private practitioners to retired military personnel and authorized family members of Active Duty, retired, or deceased military service members. Military Treatment Facility (MTF) Enrollees Purchased Care: Includes underwritten costs for providing health care benefits to the Military Treatment Facility Prime enrollees in the private sector as authorized under the Civilian Health and Medical Program of the Uniformed Services. Dental Purchased Care: Includes the government paid portion of insurance premiums which provides dental benefits in civilian facilities and by private practitioners for the beneficiaries who are enrolled in the Dental Program. Beneficiaries eligible for enrollment are: (a) Active Duty family members; and, (b) Select Reservists or Individual Ready Reservist (IRR) and their family members.

Exhibit OP-5 , Private Sector Care (Page 1 of 10)

031

Defense Hea1th Program

Operation and Maintenance

Fisca1 Year (FY) 2012 Budget Estimates

Private Sector Care

Uniformed Services Family Health Program (USFHP): Provides TRICARE-like benefits authorized through contracts with designated civilian hospitals in selected geographic markets to beneficiaries who reside in one of these markets and who are enrolled in the program. Supplemental Care - Health Care: This program provides the TRICARE Prime benefit to Active Duty Service Members and other designated eligible patients who receive health care services in the civilian sector and non-DoD facilities either referred or non-referred from the MTF including emergency care. This program also covers health care sought in the civilian sector or non-DoD facilities due to Active Duty assignments in remote locations under TRICARE Prime Remote. Care to Active Duty members stationed overseas who receive health care in the private sector paid under this program will appear in the Overseas Purchased Health Care program element. Supplemental Care - Dental: Provides for uniform dental care and administrative cost for Active Duty members receiving dental care services in the civilian sector to include Veteran Administration facilities. All dental claims are managed, paid and reported by the Military Medical Support Office (MMSO) or through contractual services. Continuing Health Education/Capitalization of Assets (CHE/CAP): Provides for support of graduate medical education and capital investment within civilian facilities that provide services to the Military Health Care System and Medicare. Overseas Purchased Health care: Includes coverage for delivery of TRICARE Prime benefits in civilian facilities by private practitioners to eligible Active Duty and Active Duty family members through the TRICARE Overseas and Global Remote Overseas programs. The program also includes health care provided to retiree and retiree family members residing overseas who are el under the TRICARE Standard option and Medicare programs. The Supplemental Care program which funds health care provided in the private sector to Active Duty members and other designated eligible patients records costs for the overseas beneficiaries in this program element. Miscellaneous Purchased Health Care: Provides for payments of health care services in civilian facilities by private practitioners not captured in other specifically defined elements. Includes administrative, management, and health care costs for Alaska claims, Custodial Care, Continuing Health Care Benefits Program, Dual-Eligible Beneficiaries Program, TMA managed demonstrations and congressionally directed health care programs, and the TRICARE Reserve Select program which is a premium based option available to Selected

Exhibit OP-S, Private Sector Care (Page 2 of 10)

032

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Private Sector Care

Reservists and their family members. The qualifying Dual-Eligible Beneficiaries claims are paid by the Medicare-Eligible Retiree Health Care Fund (MERHCF). Miscellaneous Support Activities: Provides for payments of costs for functions or services in support of health care delivery not actual health care. Contracts for marketing and education functions, claims auditing, eCommerce and the National Qual Monitoring Service are reflected in this program element.

II'. Force Structure Summary: Approximately 9.6 million DoD beneficiaries are eligible to receive care under private sector care programs, including approximately 2.1 million Medicare eligible beneficiaries. Excluded from the budget figures presented are health care costs for military retirees, retiree family members and survivors who qualify and receive benefits through the Medicare program. These costs are paid from the Medicare-Eligible Retiree Health care Fund (MERHCF). The MCSCs provide a uniform, triple-option health care plan to eligible beneficiaries, allowing them to enroll in the health maintenance organization (HMO) type plan known as TRICARE Prime, or utilize a civilian preferred provider network (TRICARE Extra), or remain with the Standard Civilian Health and Medical Program of the Uniformed Services benefit (TRICARE Standard).

Exhibit OP-S, Private Sector Care (Page 3 of 10)

033

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Est~ates Private Sector Care

III. Financial Summary ($ in Thousands)

FY 2011

Congressional Action A. Subactivities

1. Pharmaceuticals Purchased Health Care 2. National Retail Pharmacy 3. Managed Care Support Contracts

FY 2010 Actuals

323,953 1,885,198 6,663,455 2,321,367 334,546 365,014 1,314,300 170,840 318,320 272,799 291,604

Budget

Re~est

Amount

0 0 0 0 0 0 0 0 0 0 0 0 0

Percent

0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Current ApJ2roJ2riation

320,885 1,853,760 7,376,503 2,977,883 354,505 423,380 1,573,663 144,021 336,156 302,044 261,825 110,120 16,034,745

Current Estimate

320,885 1,853,760 7,376,503 2,977,883 354,505 423,380 1,573,663 144,021 336,156 302,044 261,825 110,120 16,034,745

FY 2012 Estimate

391,514 1,984,627 7,203,021 2,947,481 403,540 455,714 1,642,260 207,082 341,764 313,650 404,609 82,010 16,377,272

320,885 1,853,760 7,376,503 2,977,883 354,505 423,380 1,573,663 144,021 336,156 302,044 261,825 nO,120

4. MTF Enrollee Purchased Care

5. Dental Purchased Care 6. Uniformed Services Family Health Program 7. Supplemental Care - Health Care 8. Supplemental Care - Dental 9. Continuing Health Education/Capitalizatio 10. Overseas Purchased Health care 11. Miscellaneous Purchased Health Care 12. Miscellaneous Support Activities

Total

14,325,010

16,034,745

Notes: 1. FY 2010 actuals include $530.567 for Overseas Contingency Operations (OCO) under DoD Supplemental Appropriations Act of 2010, Public Law 111-118, and $28.175M from DoD Supplemental Appropriations Act of 2010, Public Law 111-112 2. FY 2011 President's Budget Request excludes $538.376M for OCO. 3. FY 2012 Request excludes $464.869M for OCO. 4. Excluded from the figures above are the receipts from the DoD Medicare Eligible Retiree Health Care Fund, in the amount of $6,777.565M in FY 2010. Excluded are ections for MERHCF in FY 2011 of approximately $7,597.400M and in FY 2012 $7,997.411M to pay for purchased health care.

Exhibit OP-S, Private Sector Care (Page 4 of 10)

034

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Private Sector Care

Change FY 2011/FY 2011 16,034,745 Change FY 2011/FY 2012 16,034,745

B. Reconciliation Summary Baseline Funding

ustments ( Congressional ustments ( Adjustments to Meet Congressional Intent Congressional ustments (General Provisions) Subtotal Appropriated Amount OCO and Other Supplemental Appropriations Fact-of-Life Changes Subtotal Baseline Funding Anticipated Less: OCO and Other Supplemental Appropriations Revised Current Estimate Price Change Functional Transfers Program Current Es timate

0 0 0 0 16,034,745 538,376 0 16,573,121 0 0 -538,376 16,034,745 n/a n/a

16,034,745

n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a

n/a 16,034,745

561,217 -7,600 -211,090 16,377,272

Exhibit OP-S, Private Sector Care (Page 5 of 10)

035

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Private Sector Care

C. Reconciliation of Increases and Decreases

FY 2011 President's Budget Request

($ in Amount

16,034,745

1. Congressional Adjustments a. Distributed Adjustments b. Undistributed ustments c. Adjustments to meet Congressional Intent d. General Provisions

FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life a. Functional Transfers b. Technical Adjustments c. Emergent FY 2011 Baseline Funding 4. Reprogrammings ( 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Current Estimate for FY 2011

0 0 0 0 0

16,034,745 538,376 0

0 0 0

16,573,121 0

0 0 -538,376

16,034,745

6. Price Change 7. Transfers a. Transfers In b. Transfers Out 1) Third Generation of TRICARE Contracts (T3) Support: -7,600 of funding to support programming revisions under T3 versions of MCSC within the automated el systems used by the Health System.

561,217 -7,600 0 -7,600

Exhibit OP-S, Private Sector Care (Page 6 of 10)

036

Defense Hea1th Program Operation and Maintenance Fisca1 Year (FY) 2012 Budget Estimates Private Sector Care

($ in Thousands)

C. Reconciliation of Increases and Decreases

8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs 1) OCO to Base - Transfer of Navy Individual Augmentees: Realigns 3,836 temporary Navy Individual Augmentees and funding from FY 2012 OCO request to the FY 2012 base budget request. c. Program Growth in FY 2012 1) Utilization of Managed Care Support Contracts: Cost increases are the result of 1.04% growth in health care users and 5.62% increased utilization of health care benefits by all users as well as sustaining the increased users from Active Duty end-strength growth, additional retirees and their family members who are now using TRICARE as their primary health care plan. 2) Federal Ceiling Pricing: Revised estimates for cost savings projections under initiative enacted for achieving reimbursement paid to the government from prescriptions filled by civilian pharmacies implementing maximum rates per Federal Ceiling Pricing standards. FY 2011 Retail Pharmacy Funding Baseline: $1,853.8M. 3) Pharmacy: Cost increases are the result of 1.93% growth in new users and 3.74% increased utilization of the pharmacy benefits by all users as well as sustaining the increase in users resulting from active duty end-strength growth, additional retirees and their family members who are now using TRICARE as their primary health care plan. FY 2011 PSC Pharmacy Funding Baseline: ,174.6M. 4) TRICARE Reserve Select (TRS): Increase in government costs due to rise in enrollment above previous projections. FY 2011 TRS Funding Baseline: $201.0M.

Amount

Totals

1,402,548

o

14,253 14,253

1,388,295 743,114

379,052

128,771

137,358

Exhibit OP-Sf Private Sector Care (Page 7 of 10)

037

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Est~tes Private Sector Care

($ in Thousands)

C. Reconciliation of Increases and Decreases

Amount

Totals

9. Program Decreases a. One-Time FY 2011 Costs b. Annualization of FY 2011 Program Decreases c. Program Decreases in FY 2012 1) Change in Growth Projections: Decrease in requirements resulting from lower baseline costs per claim and slower growth pattern of eligibles as retirees age into Medicare at age 65 with claims paid by the Medicare-Eligible Retiree Health Care Fund (MERHCF) . 2) Patient Centered Medical Home: Reduction to PSC requirements for assumed increases in workload within the In-House Care BAG under the Patient Center Medical Home concept. 3) Clear and Legible Reporting: Transfer of requirement to In-House Care BAG for oversight of Clear and Reporting duties. 4) Fraud, Waste and Abuse Activities: Additional incremental estimated savings over FY 2011 from initiatives designed to improve identification and verification of waste, fraud and abuse within the TRICARE pharmacy and health care programs. 5) Secretary of Defense Efficiencies - Front End Assessment (FEA)-Personnel, Pharmacy Co-Pay adjustment: Assumed savings resulting from proposal to ust pharmacy co-pays for working age retirees and families at retail establishments to incentivize use of Mi Treatment Facility pharmacy locations and mail order. FY 2011 PSC Pharmacy Funding Baseline: $2,171.6M

-1,613,638 0 0 -1,613,638 -1,383,777

-25,574

-20,071

-14,620

-106,421

Exhibit OP-5 , Private Sector Care (Page 8 of 10)

038

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates Private Sector Care

($ in Thousands)

C. Reconciliation of Increases and Decreases

Amount

Totals

6) Secretary of Defense Efficiencies - FEA-Personnel, Enrollment Fees: Assumed savings resulting from proposal to increase current enrollment fees. The fees will apply to working age retirees and families. 7) Secretary of Defense Efficiencies - FEA-Personnel, Medicare Rates at Sole Community Hospitals: Projected savings resulting from proposal to adhere to Medicare reimbursement rates for inpatient and outpatient services rendered at Sole Community Hospitals. 8) Secretary of Defense Efficiencies - FEA-Logistics, Medical Supply Chain Sourcing Optimization: Approves the logistics efficiency to optimize medical supply chain sourcing; adjusts TRICAREMail Order Pharmacy based on these optimization initiatives. FY 2011 Pharmaceuticals (Mail Order) Funding Baseline: $320.9M.

-31,398

-31,000

-777

FY 2012 Budget Request

16,377,272

IV. Performance Criteria and Evaluation Summary:

Uniformed Services Family Health Services Enrollees (Non-MERHCF, DoD only) Enrollees (MERHCF, DoD only)

FY 2010 Actuals 102,631 65,345 37,286

FY 2011 Estimate 105,616 67,303 38,313

FY 2012 Estimate 110,108 70,771 39,337

Change FY 2010/FY 2011 2,985 1,958 1,027

Change FY 2011/FY 2012 4,492 3,468 1,024

Exhibit OP-S, Private Sector Care (Page 9 of 10)

039

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Est~ates Private Sector Care

V. Personnel Summary:

FY 2010 FY 2011 FY 2012

0

Change FY 2010/FY 2011

0 0 0

Change FY 2011/FY 2012

0 0 0

Active Officer Enlisted Total Military Active

Militar~

0 0 0

0 0 0

0 0

Average Strength (A/S) Officer Enlisted Total Military

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

Civilian FTEs U.S. Direct Hire Foreign National Direct Hire Total Direct Hire Foreign National Indirect Hire Total Civilian Average Civilian Salary (SOOO's) Contractor FTEs (Totall

VI.

0 0 0 0 0 0.000 0

0 0 0 0 0 0.000 0

0 0 0 0 0 0.000 0

0 0 0 0 0

0 0 0 0 0

0

0

Outyear Summary: N/A

VII. OP 32 Line Items as Applicable (Dollars in thousands - see next page) :

Exhibit OP-S, Private Sector Care (Page 10 of 10)

040

DEFENSE HFALTII PROGRAM FISCAL YEAR {FY).1012BUDGETESTIMA'fES OPERATtoN AND MAJN'TENANCE SUMMARY OF PRICE AND PROGRAM CHANGE

LIM

PrtnR< SH:tot Cin

l:'erSN1.~

Tottl

Tr~vcl

(iin

ThOlllill1td~)

fYUtH1

Curren~. y

ll6li!!!l

...

0

1, 42~ l,42S

-

DEFENSE HEALTII PROORAM

FISCAL YEAR {i"'y)2tl12 BUOOET~"TtMATBS

OPERATlON AND MAIN'fENA)K:E.

SUMMARV QfPRK;E AND PROORAM CHANGE

(i ill nw)Usand.oq

forcign

en-

FY2011

LIM

PrivatI! Slodor OIH

'l'l,<,.\lel of 'l'ot...l Tr"",,,l

en-

FYlO11

"""""" l>iIilI!t

0

0 0 0

-I,UfI .399

Ml,UfI

-- - Pril::eGrowth

FY2tl1l

t ,.50t

2.S7'

",9n

1.3H

-O.'f7~

{OJ 411 4.12 414

'"

F'l('l Service f\Jud ru.. l Army ~ Mat W vy .. Mar AF Sup & Hat

S\JP

~

4,Sll

411

S"'A;vice nmM Almy Sup" Hat N"vy S"l'

HoC

'!.:on'

Milt

"

417 416

0

. LA

, Hat

Local S'lP ~ Mat Air FOlee Retail Supply

0

$UI) '!".at

0

1P

UH 499

l.ccal Air Tot-al

Sup' Mat RHail Supply

....,

>

0

1.46'

1.SOt

1.5o,

5.4:n

"50;': Army Ft.H)M £'1u1pt Navy Fund AI" Funri. Equ.:.pl 506 [)l,A Fvnd Equi~A

LSll

3.23%

50~

3.2';"

0

0

;1.01%

t .60'

503

50S All Fund Equi!,t 506 DLA Fund Equipl 507 GSA r'Hld 59~ Tot<ll !:.quirl

o

0

-{l,97~

1.46_

>

1.501

M<llnt

o ,

-1.55\

2,38%

l\rr.>y Depot

'.m;j

M.-t!nt

o flUIt

m

·· 3-3

to.lO\ 1.40\

Comput"'c Centers , Acct Svc O:tsposit 1 (")fl Stlrvi.;es $v,,:< Tle, 1 Co::ot RBilcinus"ilile PUl"ChaSC3 hOl1\ Bul1MiflQ H..lnteflance Total ?ul'chasu

701

I'II\C Cargo AHC 7r;:l1n111,)

E·il"i~n" ...

UUtl

~

.01'1

Wrr.n ctn W, WrKs Ctr: DrS" EntAcDrise G~vt"c COllll\lIJnic<ltlol"ill Svr. Oef Finane;> I> Acct Svc

DI.A DispositLm Sef'"vi.;e

H.~

0

0.501

o nuu

n _il.OIl'

U"tI

o 2.071

12.64*

1.50t

o

I)

l(L60-1:

:.>4.1\;'

Cost Reimbutsible PIJrr.heses ti:;;.lt\ Buildil1(j Total PI.ICCh1ll3"S

701 707

HI

Q

o 24.16'

1. nil..

2('.~Ot

,

o

1.~0~

1O.70t

1~,4M

M!\C Cargo AMC Training

H$G ('~t:90

~(; !'<:>l·t Hd.nd!tng

Comm"qdal Tl'<lflSpOrr.",t.l0 'l'otal Transporletion

0

'711

7'19

HSC HTHC "awI11n'J C;:mn>i'r.;:u1 Tlanspct"l"tl<;m Total Transpcrbtiol1

o

l)

o 0

15. fC~

721

19'?

n

1,W'

1 ,50.

9XX

'"Y

f"ui<)fl Nat

0 0 0

0 0

0

0.5;)'

0,5("

Fotit!')"

h.y R..tl'l\b<lrs llast N~t lnd

LiahlHt:(

0,50' 1.40% 1.41)'0 1.if)'

0

913

\/14

~jlf>

P<lrcful;;,<N1 HtiUtie" PUl'Cfl<lSe<1 (';OIn'!lLlnica Rents nOli GSA

" "

0

0.00\

1. S()~

1.''10'

1.501

1.."';)11

1.40' SUpplH"S

& H/I~.

0

M445

.5,115

0

1.40%

L40~

-5,1117

Faciljty Munt CO[l~r .. r:t 'f!4 £>hermd<.y E:qu1pt ov><rs",as ?utchaslas

0 ),109,151

.3::5 0

"

,

0

,

0

1.40'*

1.50'

1. 50~

1, 50~

1.501

1.50'11

76,llJ

71,902

0

~

101', 40R

2,114,645

0

2,174,64!> aversea,. I?urehl\ses Other Depot M<lint. Contr3..:t (;ollsult."nt' Mg",r. r. .<:pt lOt",ttes AI'1.II1:.',.1s Ev.ol 'l'fI',h SVc Othll<t Cost!! ~Hedtc .. l Cat

nth"'t Costs i Intel'.:1t ~n

(I

'l.~O' !.~Ol

,

125, 3B~

2,37*>,Hl

0

1.40'.1

,

1\6

0 0 0

1 · :>(~ ..

0

1,f01

"

t.401f 1.40.

11.30io

-B,434 -2',S91

;111 ;>32 \/33

1,5o,

L50'

l.SOt

L!;01

1.:>Ot

0

~9,

Othel.' Costs (M,u11cal

C~r",)

and [)i videut.s)

9,HIO 0

Q

4a3

0

,

0

0

1.401 1.40\ 397,645

1,406,345

~6,557

Contra<:ts anM ~vel()p",ent

)l,il60,lOO

D.&"(},~OO

C

H.dlcal Care ContrM;t$

l?G55,~lO

""

~upport SeLvices IT Total ?u!chases

'"'

Intn-Gcve~nt

!''1rc:ha!Jes

6,H6 0 1.40\:

"

176

4"11,74')

0

9117 9119 9<)0

~12,

756

"

1,4tH

-13,S:,u

1,719,411

"

16,034, 74~ 16, O~4. 745

Othel.· Int,a-G<;lv01t·n.rnent r Gnflt,;

Other i"X>fltracts IT t:<;:>Iltl"",,-.t Support Se~V Total f'l1rGl,,,,,es

C

:J..50' l,r,O'

0

C

4B5,104

-.~44,

073

H,OOl,131

c

1.50\

1.50'

~(;.l.111

-21H,690 -218,6\10

16,371.21 2

15,377.27,

tutAL

l~,

325,010

4.71,7!;1

16,0]4, -145

55l,111

lbIhlloU o.~n, t ..... J 14 :1.)

.ac

041

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Consolidated Health Support

I. Description of Operations Financed: delivery of patient care worldwide:

This Budget Activity Group comprises nine functions which support

Examining Activities: Resources required for administering physical examinations and performing evaluations of medical suitability for military service. Includes resources required for Armed Forces Examination and Entrance Stations and the Department of Defense Medical Examination Review Board (DoDMERB). Other Health Activities: Resources required for organizations and functions that support the provision of health care for Military Health System beneficiaries. Examples include central medical laboratories; medical services squadrons; Navy Medicine Regional Commands; public affairs; and the Women, Infants and Children (WIC) Program.

~litary

Public/Occupational Health: Resources required for Military Public Health manpower, supplies, permits, certification and licensure fees, support equipment, and the associated requirements fically identified for management, direction, and operation of disease prevention and control. Examples include epidemiology, medical entomology, drinking water safety, monitoring hazardous waste disposal, food and facility sanitation, wellness/health promotion and education, health surveillance, community health nursing, medical intelligence, disease and climate illness, disease prevention and control, and injury surveillance.

Veterinary Services: Resources required for the management, direction and operation of DoD's worldwide veterinary missions, as well as veterinary support requirements for other specified federal agencies. Includes veterinary care of government owned animals, procedures involving animals in clinical investigation departments, and control of zoonotic and veterinary public health diseases.

~litary

Unique- Other Medical Activities: Resources required for unique military medical functions and activities that have a relationship to the size of the military population supported and are not included in any other program elements. Examples of programs include physiological training units; drug abuse detection labs; optical repair and fabrication laboratories; pandemic influenza preparedness; medical logistics offices; medical support offices; medical materiel activities; and plans, operation and training offices in military treatment facilities. Beginning in FY 2012, funding will support the remaining missions of the Armed Forces Institute of

Exhibit OP-S, Consolidated Health Support (Page 1 of 11)

042

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Consolidated Health Support

pathology (Medical Examiner, DNA Registry and Accident Investigation, Legal Medicine, Clinical Lab, and Patient Safety) . Aeromedical Evacuation System: Resources required for the operation and administration of the Aeromedical Evacuation System and the costs associated with intra- and inter-theater patient transportation. Service Support to Other Health Activities: Support to TRANSCOM. Armed Forces Institute of Pathology (AFIP): Resources required for manpower, equipment, facilities and the associated operation and maintenance of the AFIP. Due to BRAC, the AFIP is closed as of 1 October 2011 (FY 2012) and funding will move to the Joint Pathology Center and Military Unique/Other Medical Activities to support the remaining missions of AFIP (Medical Examiner, DNA Registry and Accident Investigation, and Legal Medicine, Clinical Lab, and Patient Safety). Joint Pathology Center (JPC): NDAA 2008, Section 722 directs establishment of the JPC by FY 2012 as the reference center in pathology for the Federal Government. Resources required for manpower, equipment, facilities, and the associated operation and maintenance of the JPC will move from the AFIP.

II. Force Structure Summary: Consolidated Health Support includes a variety of Program Elements supporting such functions as examining activities, military public and occupational health, veterinary services, aeromedical evacuation, and various activities that have a relationship to the size of the military population supported but that are not included in other program elements.

Exhibit OP-5, Consolidated Health Support (Page 2 of 11)

043

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Consolidated Health Support

III. Financial Summary ($ in Thousands):

FY 2011

Conqressional Action

FY 2010

A. 1.

Subactivities:

Actuals

Budqet Re9!i!est

Amount

Percent

Current !E1?ro1?riation

Current Estimate

FY 2012

Estimate

Examining Activities Other Health Activities Military Public/Occupational Health Veterinary Services Military Unique-Other Med Activities Aeromedical Evacuation System Service Spt to Other Health Activities TRANSCOM Armed Forces Institute of Pathology (AFIP) Joint Pathology Center (JPC) Total

72,757 474,945 379,368 31,772 760,548 67,848 1,018 78,588

74,290 803,380 335,919 37,174 753,278 51,880 1,417 65,145

0 0 0 0 0 0 0 0

0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

74,290 803,380 335,919 37,174 753,278 51,880 1,417 65,145

74,290 803,380 335,919 37,174 753,278 51,880 1,417 65,145 0 2,122,483

77,120 840,083 346,696 32,745 839,467 36,501 1,121 0 20,088 2,193,821

2. 3. 4. 5. 6. 7. 8. 9.

Q

1,866,844

Q

2,122,483

Q

0

Q

2,122,483

Notes: 1. FY 2010 actuals include $124.477M for Overseas Contingency Operations (OCO) under the Department of Defense Appropriations Act, FY 2010, Public Law 111-118. 2. FY 2011 President's Budget excludes $128.412M for OCO. 3. FY 2012 Request excludes $95. for OCO. 4. FY 2012 reflects the BRAC directed closure of the Armed Forces Institute of Pathology (AFIP), with funding realigned to the Joint Pathology Center (JPC) and Military Unique/Other Medical Activities to support the remaining missions of AFIP.

Exh~it

op-S, Consolidated Health Support (Page 3 of 11)

044

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Consolidated Health Support

B. Reconciliation Summary: Baseline Funding Congressional Adjustments (Distributed) Congressional Adjustments (Undistributed) Adjustments to Meet Congressional Intent Congressional Adjustments (General Provisions) Subtotal Appropriated Amount OCO and Other Supplemental Fact-ot-Life Changes Subtotal Baseline Funding Anticipated Supplemental Reprogrammings Less: OCO and Other Supplemental Appropriations Revised Current Estimate Price Change Functional Transfers Program Changes Change FY 2011/2011

Change FY 2011/2012 2,122,483 n/a

2,122,483

0 0 0

0

0

0

2,122,483 128,412

0

0

n/a n/a n/a n/a n/a n/a n/a 2,122,483 28,236 218 42,884 2,193,821

2,250,895

0 0

-128,412 2,122,483 n/a n/a n/a 2,122,483

Current Estimate

Exhibit OP-S, Consolidated Health Support (Page 4 of 11)

045

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Consolidated Health Support

( $ in Thousands)

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional ustments a. Distributed Adjustments b. Undistributed Adjustments c. Adjustments to meet Congressional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life Changes a. Functional Transfers b. Technical Adjustments c. Emergent Requirements FY 2011 Baseline Funding

4. Reprogrammings (Requiring 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Appropriations 0 0 -128,412

Amount

Totals 2,122,483 0

0 0 0 0

2,122,483 128,412 0

0 0 0

2,250,895

0

Current Estimate for FY 2011 6. Price Change 7. Transfers a. Transfers In 1) Transfer from Warrior Transition Command (WTC) to DHP: Transfer manpower and dollars associated with the US Army WTC from Army (OMA) to the DHP. Includes 90 Civilian FTEs.

2,122,483 28,236 218

42,309 42,309

Exhibit OP-5, Consolidated Health Support (Page 5 of 11)

046

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Consolidated Health Support

( $ in Thousands) Amount Totals

-42,091 -28,200

C. Reconciliation of Increases and Decreases

b. Transfers Out 1) Army Substance Abuse (ASAP) Transfer: Transfers Army ASAP responsibilities and resources from the US Army Medical Command (MEDCOM) to the US Army Installation Command (IMCOM). Includes 141 Civilian FTEs. 2) State Directors of Psychological Health Transfer: Transfers funding for the State Directors of Psychological Health program to Army National Guard from the Defense Health 3) Medical Installation Transfers to Commander, Navy Installations Command (CNIC): Transfers resources and for Class 1 and 2 Real Property, Base Operating Management, and funds associated to Commander, Navy Installations Command (CNIC) from the Defense Health Program for six Bureau of Medicine (BUMED) sites. Includes 3 Civilian FTEs. 4) Transfer from DHP to Installation Command (IMCOM): Transfers responsibilities, management, and oversight of operations for the US Garrison, Fort Detrick from the US Army Medical Command (MEDCOM) to the US Army Installation Management Command (IMCOM). Includes one Civilian FTE. 8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs c. Program Growth in FY 2012 1) Sustainment of Biodefense Vacccines: Acquisition, storage, and shipment of anthrax and smallpox vaccines to protect and ensure readiness of military personnel. 2) Funding Adjustments and Includes civilian manpower program transfers and PE realignments to reflect accurate execution.

-9,065

-4,664

-162

149,631

o o

149,631 44,200

34,533

Exhibit OP-S, Consolidated Health Support (Page 6 of 11)

047

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Consolidated Health Support

( $ in Thousands)

C. Reconciliation of Increases and Decreases 3) Pandemic Influenza Medical Materiel and Biosurveillance Readiness:

For purchase of vaccine doses, new anti-virals, and Personal Protective Equipment; to store existing anti-virals; and to expand

the biosurveillance mission of Pandemic Influenza. FY 2011 Funding

Baseline: $51.5M.

4) Joint Incentive Fund (JIF): National Defense Authorization Act (NOAA) 2010, Section 1706 extends

the JIF through September 30, 2015.

5) Hearing Center of Excellence (HCOE): Establish the HCOE and try which tracks the diagnosis, surgical

intervention/operative procedure, other treatment, and follow up for

each case of hearing loss and auditory system injury incurred by a

member of the Armed Forces while serving on active duty. Cost

includes manpower; facility costs for labs, offices, renovation;

outfitting with furniture and equipment; travel; registry support

(software, hardware, site support); and research support for studies,

office supplies, medical supplies. FY 2011 Funding Baseline: $4.951M.

6) Readiness Enhancements: Programmatic increases due to increased execution over prior years in

the following areas: Armed Services Blood Program, Global Emerging

Infectious Disease Surveillance (GElS), Industrial Hygiene Services,

Occupational Health Services, and Force Health Protection items

Flu and Malaria vaccine) . 7) Non-Pay Non-Fuel Purchases Inflation: Adjusts the funding ~or non-pay, non-fuel purchases based on revised

rates.

8) Military Entrance Processing Command (MEPCOM): Funds increased cost to sustain adequate level of staff and

operations (consults and tests) and life cycle replacement of

equipment at Military Entrance Processing Centers. FY 2011 Baseline:

$6.004M.

Amount 33,300

Totals

15,000

7,575

6,255

4,297

2,676

991

Exhibit OP-S, Consolidated Health Support (Page 7 of 11)

048

Defense Health Program

Operation and Maintenanoe

Fisoal Year (FY) 2012 Budget Estimates

Consolidated Health Support

$ in Thousands)

C. Reconciliation of Increases and Decreases 9) Joint Basing Transfer: Transfer of Joint Basing Medical Functions between Army and Air Force Defense Health Program Activities. Implements agreements on specific installation support services that MTFs provide at joint-base sites. Includes 10 Civilian FTEs. 10)Secretary of Defense Efficiencies - Civilian Manpower Freeze and Exceptions: Adds civilian FTEs and associated funding for the Secretary of Defense approved exceptions to the civilian manpower freeze.

9. Program Decreases

Amount

Totals

804

-106,747

a. One-Time FY 2011 Costs b. Annualization of FY 2011 Program Decreases c. Program Decreases in FY 2012 1) Civilian Pay Raise Adjustment Adjusts civilian personnel funding to reflect no pay raise for FY 2011 and FY 2012 consistent with direction to freeze Federal pay at the FY 2010 level for the next 2 years. 2) Budget Activity Group Funding Realignment: Funding realignment to the Management Activities Budget Activity Group to reflect proper execution of Patient Administration Systems and Biostatistics Activity (PASBA) and Medical Expense Performance Reporting Systems. 3) Budget Activity Group Funding Realignment: Funding realignment to the Management Activities Budget Activity Group to reflect proper execution of the Health Insurance Portability and Accountability Act (HIPAA) and Beneficiary Advisory Panel (BAP) programs. 4) One Less Day Paid: Adjusts for one less civilian pay day in FY 2012. FY 2011 Funding Baseline: $802.3M.

o

-106,747 -24,234

-18,000

-12,825

-3,074

Exhibit OP-S, Consolidated Health Support (Page a of 11)

049

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Consolidated Health Support

( $ in Thousands)

C. Reconciliation of Increases and Decreases

5) Wounded Warrior: Realigns funding to multiple Budget Activity Groups (In-House Care

and Base Operations and Communications) for Traumatic Brain

Injury/Psychological (TBI/PH) to reflect actual execution.

6) Civilian to Military Conversion Restoral:

Incremental funding transfer to Service MILPERS accounts to restore military authorizations previously programmed as military to

civilian conversions, as required by Section 721 of NDAA 2008.

7) Secretary of Defense Efficiencies - Reducing Reliance on DoD Service Support Contractors:

Directs the components to reduce funding used to acquire service

support contracts by 10% per year over the next three years from

their reported FY 2010 levels. FY 2012 reduction is 20% and FY 2013

reduction is 30%. These efficiencies will have no impact on direct

healthcare delivery. FY 2011 Funding Baseline: $117.168M.

8) Secretary of Defense Efficiencies - Reports, Studies, Boards and Commissions Review:

Directs the Components to reduce funding for advisory studies by 25%

below the FY 2010 levels. Reductions are based upon self-reported

"Advisory and Assistance Service" data from "Studies Analysis and

Evaluation" activities. These efficiencies will have no impact on

direct healthcare delivery. FY 2011 Funding Baseline: $24.0M.

9) Secretary of Defense Efficiencies - TRICARE Management Activity (TMA) - Baseline Review:

Directs TMA to streamline operations by consolidating activities into

a follow-on Military Health System Support Activity consisting of

four divisions: 1) Uniformed Services University of the Health

Sciences (USUHS), 2) TRICARE health plan, 3) Health Management

Support, and 4) Shared Services. Direction will reduce redundancy,

capitalize shared services efficiencies, and better al similar

missions across the enterprise. As a result, beginning in FY 2012,

-2,641

Amount

Totals

-2,289

-23,110

-12,620

-7,883

Exhibit OP-5 , Consolidated Health Support (Page 9 of 11)

050

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Consolidated Health Support

( $ in Thousands) Amount Totals

C. Reconciliation of Increases and Decreases

24 Civilian FTEs and 364 Contractor positions will be eliminated. FY 2011 DHP Contract Services Funding Baseline: $3,005.6M. 10) of Defense Efficiencies DFAS Baseline Review to Civilian Personnel Positions: to DFAS due to DFAS elimination of beginning in FY 2012 to reduce personnel without impacting mission ishment.

-71 costs

FY 2012 Budget Request

2,193,821

IV. Performance Criteria and Evaluation Summary:

Change

Active Duty Force Structure MEPS Workload (OOO's) Spectacles/Inserts fabricated (OOO's) Veterinary Lab procedures (OOO's)

Ft 2010 1,425,000 333 1,723 185 Ft 2011 1,432,400 387 1,766 220

Change

EX 2212

1,408,300 387 1,816 260

EX 2212£2211

7,400 54 43 35

EX 2211£2212

-24,100 0 50 40

Exhibit OP-5, Consolidated Health Support (Page 10 of 11)

051

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates Consolidated Health Support

V. Personne1 Summary

FY 2010 FY 2010 FY 2012

Change

FY 2010/FY 2011

Change

FY 2011/FY 2012

Active Military End Strength (E/S) Officer Enlisted Total Military Active Military Average Strength(A/S} Officer Enlisted Total Military

2,781 6,376 9,157

2,879 6,608 9,487

2,902 6,595 9,497

98 232 330

23 10

2,642 5,990 8,632

2,830 6,492 9,322

2,891 6,602 9,493

188 5 690

61 110 171

U.S. Direct Hire Foreign National Direct Hire Total Direct Hire Foreign National Indirect Hire Total Civilian Average Civilian Salary ($OOO's) Contractor FTEs

7,527 135 7,662 461 8,123 82.133 1,820

9,052 131 9,183 4 9,645 83.184 1,733

9,009 110 9,119 7 9,576 82.480 1,625

1,525 1,521 1 1,522

-43 -21 -64 -69

-87

-108

VI.

Outyear Summary: N/A

VI. OP 32 Line Items as App1icab1e (Do11ars in thousands - see next page) :

Exhibit OP-5, Consolidated Health Support (Page 11 of 11)

052

DEFENSE Hr:.AL.TfI PROGRAM

FISCAl 'fEAR (F'f) 2011 BUDGET ESTIMATES

OPERATION AND MAINTENANCE

DEFENSE HEALTH PROGRAM

fISCAL YEAR (FY}lOU BUOOf.T P.8TIMATES

OPERATJON AND MAINTENANCE

SUMMARY OF PRICE AND PROGRAM CHANGE

(S in ThOlllillnlill)

SUMMARY OF pR.ICr AND PROORAM CHANGE ($ in 'ThousIInda)

FY'lO I0

Ciurency

~

""""an

Pi'Wt f'JfOw.1h

~

u...

Tora!

COrhKlIWllted Health Support

Travel of P*i"$Cn:s

fmm!!l

69,041 69,041

Ammm!

-494

-494 6'1,546

.....

411

~t" ..

HellhhSqppoI1

'flav<tl of p .. r"ons

Total Trdv..l

DfSC £'utll Stlrvi'~i! fllnd ,uel Army Sup,. Milt

/!Iavy Sup' M<\t

:n

402. S.. rvlce Fund fl,.. l 411 Army SIll? · Mat

~"VY

o

- ----Foreisn

f1'2On

OUT~

J>ri;:lcGroWlb

J>roaram

FYlOJ2

69,54l

L5Dt

69,546

1,OV. l,on

-953 -953

11.]0t:

c

c

m

o

",

o o o

2.9H ;:. 91~

c

o

Sap. /'tIr

411; 417

AP 5>Jp 4. /'tit OJ,)l, Sup' Hat ~ Hat Proc Sup .. Mat: All' ret'CD Retail Sypply

'rct~l

o o

'"

J, l6~

411

2,07%

1J

-414

c

1,1!i90

4 .fit ~

",

415 >06 417 418

Af & Hat. nu. Sup' Milt GSA SlIP" H.<t J,ocal

Air

~O.91i

"

H

Totilll Sup

Rata11 Supply ~ Hat

,""

t.f6. 1.50'

~.

m

o

50i

5,43'

" "

'"

121

Army

o o

3,095

Atmy o.-p'A Cmd Maillt Mav3l Sut'tac"l Wat. Ctl' If<lval civ:d Neval P"b , Prill Sv<:: W,U ct,': Utilifie3 tia'" Pub 'k~.s Ctn Nd"" DIS)!, Entecp,,1s.. Cm",u,micatlorw Svc O.d Firnnclil .. }V",~t Sve Ou. 01S'posnion SlIt'vices R.timbursibl", P>Jrc.:hese:;: ttOJll Buil<ilnq Hainte,HUlce Tot'l'l P'Jrcha!r'l!s

HJ\C Car>-)o

LZJ% ,L:'6t

,,-O"1t

o

·}.(2 41

~2,

'OJ

l6J

no

595

'"'

5(16

° -0,91'

LH'

5\15

o

0.64*

~2, ~,lil

'"

1.501

-1,55t

2.]8'1

631

o

1. 77t ... 99"

10.20%

1.40~

6]1

34.1

2,145

&3:1

Amy tMopot CInd H.lint t.lllval

Nall",l Enqra lhv"l ",'Jb , Pmt I'Ia... Pub Wl'k;$ Ctu Iltilit.\"$

PUb Wl';',:l

°

°

2,14S

o

flUIl

-J.6)\ -0,34\

5,91'0

1,150

6:15 647

o

o

UUU

o

671 673 De! Finill"H~ilI & .a.c:c:t nu. Disposl tion

C:wtlI $ ....;;;$ Tiu' 1

Cost F«d.w.bux$lbl<! Sve

fUl'ct\a"l>e::i ftOlll BuJ.ldilYl Mlliflxenar,ee JOUll Pur.;;;has<ts

o

12

° UUII LeO\ ()

0,50'1;

-1

"

"

"

o

12

C UUu

1,;61

° ° 2LU'

1.40~

10,60%

'"

132

2,1:,!

s,""9

2.1~'1

126

-121

1.40\

}0.70%

o

111

J4,344

mc Tl';;lnln'.)

6lJ

721 771

KI'HC t><;,rt

COII....u·c.:hl

H~ndltl!g

C C

15.40% 15,40'

'"

121

1.70t

~J ,BOt

2fi.'l0t:

o

1<)0

MSC Cdrgo

t<J'MC pon: }I"'lldUn'l CO\MI'H'cl'11 T~arnlr" Tot<tl T[~I,sp..:>rtati"j,

SIC

o

34.144 J5,Or.l

o

()

Total

9)(X

"""",,,""00

34,.Hl 640, 50~ 26,553

"

16.30' 1. 50~

"

132,059 -240

"1"1~.

1>11' Rell\'.b>Jts Host

70;7

Clv Pay R>llmburs

for>eiqn t.lllt

Tl5,1ti7

26,U5

1.B61

1.!,,<iJiI

26,445

1,!lIH

914

SeperaUon L1ability R",nUl Pay to l,;$}\ P'll'("hMleC\ Uti1lti.. ,~ Purr:hIlS<l;t f;omtllJnlC:'1

Separation Liability

o

6,268

1.40'1

-5H1

~ln

i<ental p:!IY

t.40't 1.401

9t3

J,lU

J&4,64"/

Plnchased

Un litlE'S

n.

£.:32)

'"

4,175

o

7

1.4-0~

9)1

L40~

"

""

~J,

-H 224

f<in:hased c,,,,,,,,tmi<iI

no

917

Postal

°

o

(I

1.50' l.5D. L5Ct

",

'l5 -1,

~6

1,907

5,152

~, ~(l9

-.11

224,401

110

1 ,4(j~ L40\ 1.40'

l,14:1

15,990 J,4JS 7,61)"1

"

o

o n

2,94 7

85,2£3

"'

Supplies t H.lt

264,647

ElJ5

"

o

.3,969 ;6,<)04 -I,01S 1

34'l.!i";0 9,486 10,756

,"",elZ

1

1.40'

1,195 1

923 924

39,11~

9,422 10,596 Phu'1r\acy l!%l>Jipt PUtcha5~s 0""'{'5'''IIS i'luc;has>!I'I nth .. , M<lint;. Contl:".!t c(>n!;tnlt~nt",

k<J!fIt "' Prot 5pl

"

159

1

" '"

o

o

5"13

{I (I

",

9:>2

,.

o

-4~,

)4(J

1.40t

LiO~

"

o

6,215

-164 117,4}0 :;;4,014

926

930

(1)1

9)~

,,,

137,410 24,014

L50t

,

-J,518

J ,!;Oi:

1.50'" 1,50t. 1.5011 l.SO' i,501

J.50'll

~24,122

r.onsultant.!l 1,812 1.40\ l1.l01l 3.30\

9B

(IIj,(

o o

22£,363 <:55,950

9.l~

o

'"

Costs lHoJ,Uc,ol Care) Oth"t 1.:osts ~lnt .. rest 'Inn Oiv:b:lilln-ts) ';6.4 !S>Jt:>sist..It!<::e and Su);>t:>ort 984 £quip;:&int Cuntta.;;ts 91:15 Re~3J::<:h and Oevel<>pl"'lfnt (;ontl'd"llf Medl<;dl

Oth!!1: lnt r.;pGc'Y!!rn!l\O!nr Put<e-tl'l""""

'"

"

o

c

t<~m

o o

'" '"

9bO 964

o o

o

°

°

o

C

V C

114,149

fI,701

)61

~15,

5;)

o

il,958 58,3.27 15 0313,235

;Hedieal

;:55,950

922

1.40\

1,40*

3,30\

1'36,51:! 19,;>27 3H.031 16,9JO 1,75(" \14+

1,1J&f,.8·H

£,4F1S 269

~!:;O,

7··

o

Other Cvntr"cts Support S'<lvices l.4('t I .4"0~

l,ni! 1,213

4,187

~·16,

l52,25S 19,456 C

Oth",r costs Ilnt.,cest and 01vid"'nt$; Other iSubslstan.:::o and SliDPOn Contracts "nd Cel;,,dopment H.eriicdl f' ..... Co!)ttact..~ . Other !ntsa-GovIilUrll\lfht P1.i.rc;has<I!s Other Contulcts IT Contnct Suppon. Stlcvices Total PlJrC:\")1ISiill!

"

L50' l.5D'

1.10!

3.50i:

-"

~.3.30

o

'"

225,441

151,2::'5

"

o o

o

o

H,U6

1.5o,

1.50t

H<: 4,0500 258 26,:14::1

UI,319

0

-49,612 U.U5 {3,102

7:'J

9SB 9$9

1.5o,

1.5(l'o

"

23:.1,1'32 2Q,5?6

P,161 2,OH,162

2,1}',Un

l5,826

7, Oli!4, 70D

2,OH,162 2,122,48)

)999 T<trAL

28,2)6

2,193., sa

~nlW-u.

CU

..... 1ol11

053

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Information Management

I. Description of Operations Financed: This Budget Activity Group provides for the Information Management/Information Technology resources dedicated to the operation and maintenance of Defense Health Program (DHP) facilities. This program includes the following: Service Medical IM/IT: Includes funding for non-centrally managed, service medical Information Management/Information Technology (1M/IT) programs in the following functional areas: 1) Service medical funded support for functional area applications (service unique information systems); 2) Communications & computing infrastructure to include long haul/wide area communications, office automation and video teleconferencing; 3) related technical activities, which includes spectrum management, data administration, development of architectures, facilitation of interoperability and technical integration; and 4) Information assurance, which includes all efforts that protect and defend information and information systems by ensuring their availability, integrity, authentication, confidentiality and non-repudiation. DHP 1M/IT Support Programs: Includes funding for 1M/IT services in support of the Military Health system (MHS). These services are in support of the Military Health System Chief Information Officer and can be contracted out or provided by other DoD agencies. Services deliver modifications to contractor owned 1M/IT systems to meet congressional and other mandated changes; changes or modifications to other DoD agencies 1M/IT systems to comply with changes in medical regulatory guidance; commercially purchased 1M/IT related services that enable the Managed Care Support Contracts to meet compliance requirements; and funding to support centrally managed office automation, video-teleconferencing and related technical activities. Excludes funding for centrally managed and service medical 1M/IT systems including acquisition of centrally developed systems. Tri-Service IM/IT: Includes funding for tri-service 1M/IT programs for program management, system and infrastructure sustainment, annual software licensing fees, and software and hardware maintenance fees. Major tri-service initiatives include: 1) AHLTA which is DoD's current Electronic Health Record (EHR) serving as one of the world's largest clinical information systems that provides secure, 24x7, worldwide online access to patients' medical records, making it a key enabler of military medical readiness; 2) Electronic Health Record (EHR) Way Ahead is the proposed Major Automated Information System program designed to replace/sunset the current portfolio of systems providing initial EHR capability (AHLTA and CHCS). EHR Way Ahead will provide a comprehensive, longitudinal, electronic health record that is available anytime anywhere; 3) Theater Medical Information Program - Joint (TMIP-J): Integrates the military health information systems to ensure timely interoperable medical support for mobilization, deployment and sustainment of missions in the theater environment. TMIP-J adapts medical information systems to Theater specific requirements; 4) Defense Medical

Exhibit OP-S, Information Management (page 1 of 10)

054

Defense Health Program

Operation and Maintenanoe

Fisoal Year (FY) 2012 Budget Estimates

Information Management

Logistics Standard Support (DMLSS): Provides integrated supply chain and life cycle management for pharmaceuticals, medical supplies, equipment, health facilities, and services. Additionally, DMLSS enables medical logistics support to the Force Health Protection mission for the MHS; 5) Executive Information/Decision Support (EI/DS): Receives and stores data from MHS systems, processes those data through a variety of business rules, and makes the data available, in various data marts, to managers, clinicians, and analysts for the management of the business of health care; and 6) Defense Occupational and Environmental Health Readiness System - Industrial Hygiene (DOEHRS-IH): Assembles, stores and evaluates data on personnel occupational exposure information, environment monitoring, protective equipment usage, work practices, and health hazard education. Funding for other significant tri-service initiatives include, but are not limited to: Defense Medical Human Resources System (internet); the Patient Accounting System (PAS); Enterprise Blood Management System (EBMS); TRICARE On Line (TOL); Patient Reporting (PSR), and the Joint Electronic Health Record Interoperability (JEHRI) for the 000 portion of the joint DoD/VA sharing initiative. Resources also support MHS communications and computing infrastructure under MHS Cyber Infrastructure Services (MCiS) Division (which includes the previously known Tri-Service Infrastructure Management Program Office (TIMPO)). MCiS manages the associated implementation of three basic components: (1) a wide area network (WAN) deployed to all TRICARE regions, to provide communication support for all medical information systems; (2) a local area network (LAN), to provide unified backbone networks within military treatment facilities; and (3) centralized network management, to include capacity planning, configuration management and security integration.

II. Force Structure Summary: This program funds concept exploration, management and sustainment of automated information systems, communications & comput infrastructure, related technical activities and information assurance supporting military medical readiness and promoting quality healthcare services to members of the armed forces, their families, and others entitled to 000 healthcare.

Exhibit OP-S, Information Management (Page 2 of 10)

055

Defense Health Proqram Operation and Maintenance Fiscal Year (FY) 2012 Budqet Estimates Information Manaqement

III. Financial Summary ($ in Thousands) :

FY 2011

Congressional Action A. Subactivities Service Medical 1M/IT l. Programs 2. DHP 1M/IT 3. Tri-Service 1M/IT

FY 2010 Actuals

Budget Rese:est

Amount

Percent

Current Apl2rol2riation

Current Estimate

FY 2012 Estimate

550,346 98,898 1,345,827

Total

Notes:

521,908 115,624 814,798 1,452,330

0 0 0 0

0% 0% 0%

521,908 521,908 115,624 115,624 7 814,798 1,452,330 1,452,330

536,870 112,960 772,867 1,422,697

1. FY 2010 actuals include $6.124M for Overseas Contingency (OCO) under the Department of Defense

Appropriations Act of 2010, Public Law 111-118.

2. FY 2011 President's Budget Request excludes $2.286M for OCO. 3. FY 2012 excludes $5.548M for OCO. 4. Excludes DoD Medicare-El Retiree Health Care Fund (MERHCF) for FY 2010 of $4.944M, FY

2011 of $12.800M, and FY 2012 of $13.248M.

ExhLbit OP-S, Information Management (Page 3 of 10)

056

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Information Management

B. Reconciliation Summary Baseline Funding Congressional Adjustments (Distributed) Congressional Adjustments (Undistributed) ustments to Meet Congressional Intent Congressional Adjustments (General Provisions) Subtotal Appropriated Amount OCO and Other Supplemental Appropriations Fact-of-Life Changes Subtotal Baseline Funding Anticipated Supplemental Reprogrammings Less: OCO and Other Supplemental Appropriations Revised Current Estimate Price Change Functional Transfers Program Changes Current Estimate Change FY 2011/FY 2011 1,452,330 Change

FY 2011/FY 2012

1,452,330

n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 1,452,330 20,848 -8,794 7 1,422,697

0 0 0 0 1,452,330 2,286 0 1,454,616 0 0 -2,286 1,452,330

n/a n/a 1,452,330

Exhibit OP-S, Information Management (Page 4 of 10)

057

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Information Management

($ in Thousands)

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional ustments a. Distributed ustments b. Undistributed Adjustments c. Adjustments to meet Congressional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life a. Functional Transfers b. Technical c. Emergent FY 2011 Baseline Funding 4. Reprogrammings (requiring 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Appropriations Current Estimate for FY 2011 6. Price Change 7. Transfers a. Transfers In b. Transfers Out 1) Transfer from DHP to Secretary of the Army: Transfer of Army Medical Command manpower and dollar resources to

Installation Management Command and Garrison Operations (-$1.5M)

and to Army Network Enterprise Technology Command(-$5.5M and -40

civilian FTEs) for Fort Detrick.

Amount

Totals 1,452,330 0

0 0 0 0 1,452,330 2,286 0 0 0 0 1,454,616 0 0 0 -2,286 1,452,330 20,848 -8,794 0 -8,794 -7,001

Exhibit OP-5, Information Management (Page 5 of 10)

058

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Information Management

($ in Thousands)

C. Reconciliation of Increases and Decreases

2) Transfer from DHP to of the Navy: Transfer of Naval Bureau of Medicine manpower and dollar resources to Commander, Naval Installations Couunand for Portsmouth, Beaufort, San Diego, Bremerton, Guam, and Bethesda medical facilities (-$1.8M and -3 civilian FTEs). 8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs c. Program Growth in FY 2012 1) Funding Realignment: Realigns funding from other Budget Groups to 1M/IT Budget Activity Group to support proper execution. Realignments include: increased sustainment for critical service military treatment facility network security and web-based applications; Theater Medical Information Program; Defense Medical Human Resource System-internet (single-sign-on); Defense Occupational and Environmental Health Readiness - Industrial Hygiene; Defense Medical ics Standard Theater and service oriented architecture implementation; enhanced capabilities for blood management; tracking of In-House and Private Sector Care workload; accounting, medical surveillance: Business Modernization Program functions ($2.5M); customer rate ustments due to Department's methodology changes from fee-for service to Defense Working Capital Fund (DWCF) rates and DWCF capital reductions ($0.02M); and an increase in customer funding from Defense Information Systems network Subscription Services ($0. 8M) . -1,793

Amount

Totals

40,888

o o

40,888 32,817

Exhibit OP-S, Information Management (Page 6 of 10)

059

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates Information Management

($ in Thousands)

C. Reconciliation of Increases and Decreases 4,580 2) EHR Way Ahead: Provides support for the Analysis of Alternatives for the Department of Defense (DoD) Electronic Health Record to define the preferred alternative; initiate acquisition and program management activities; and continue risk reduction efforts including the Clinical Data Repository Stabilization which allows the DoD and the Veterans Affairs to share electronic health information. FY 2011 Funding Baseline: $120.3M. 3) Wounded Warrior: Provides funding for IT development for the Wounded, III and ured program associated development and implementation efforts for clinical case management; Neuro Cognitive Assessment Tool (NCAT) and behavioral health notes; and access to radiographic supporting infrastructure requirements for .improved data sharing with the Veteran's Administration. 4) AHLTA: Provides funding to transition training for Armed Forces Health Longitudinal Application (AHLTA) block upgrades. 9. Decreases a. One-time FY 2011 Costs b. Annualization of New FY 2011 Program c. Program Decreases in FY 2012 1) Secretary of Defense Efficiencies - TMA Baseline Review: Directs the Director for TRICARE Management Activity (TMA) to streamline operations by consolidating activities into a followon Military Health System Support Activity consis of four divisions: 1) Uniformed Services University of the Health

Amount

Totals

2,881

610

-82,575

o o

-82,575 -33,255

Exhibit OP-S, Information Management (Page 7 of 10)

060

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Information Management

C. Reoonoiliation of Inoreases and Deoreases Sciences (USUHS), 2) TRICARE health plan, 3) Health Management

Support, and 4) Shared Services and to reduce 364 Contractor

positions beginning in FY 2012. Directs the USD(P&R) to reduce

redundancy, capitalize shared services efficiencies and to better

align similar missions across the P&R enterprise and to eliminate

24 civilian full-time equivalents (-$33.3M). FY 2011 DHP Contract

Services Funding Baseline: $3,005.

2) Non-EHR Way Ahead Realignments: Realigns funding from sustainment to Research,

Development, Test and Evaluation and Procurement in support of

systems' capability enhancements including reduction in Composite

Health Care System (CHCS) sustainment for on-site support

transitioning to AHLTA; the completion of sustainment efforts

supporting Enterprise Blood Management System

development/implementation; a decrease of Theater Medical

Information Program - Joint (TMIP-J) sustainment due to

transition of medical logistics support in theater to Defense

Medical ics Standard Support (DMLSS). Also realigns

operations and sustainment funding for Managed Care Forecasting

and Analysis System Data Analysts (-$0.8M) and

Computer/Electronic Accommodations Program (-$1.1 and -7 civilian

FTEs) to the Management Activities Budget Group.

3) of Defense Efficiencies - Reducing Reliance on DoD Service Support Contractors:

Directs the components to reduce funding used to acquire service

support contracts by 10% per year over the next three years from

their reported FY 2010 levels. FY 2012 reduction is 20% and FY

2013 reduction is 30% (-$18.591M). FY 2011 Funding Baseline:

$94.3M.

4) Secretary of Defense Efficiencies Reports, Studies, Boards

($ in Thousands) Amount Totals

-26,946

-18,591

-2,129

ExhLbit OP-S, Information Management (Page 8 of 10)

061

Defense Health Program Operation and Maintenance Fiscal Year .(FY) 2012 Budget Estimates Information Management

($ in Thousands)

C. Reconciliation of Increases and Decreases

and Commissions Review: Directs the Components to reduce funding for advisory studies by 25% below the FY 2010 levels. Reductions are based upon self reported PB-15 exhibit "Advisory and Assistance Service" data and are from "Studies Analysis and Evaluation" activities (-$2.12 FY 2011 Funding Baseline: $40.8M. 5) Civilian to Military Conversions: Incremental funding transfer to service MILPERS accounts to restore military authorizations previously programmed as military to civilian conversions, as required by Sec. 721 of the FY 2008

Amount

Totals

-1,038

NOAA.

6) One Less Pay Day: Adjusts funding for one less civilian pay day in FY 2012. Funding Baseline: $160.811M. -616 FYll

FY 2012 Budget Request

1,422,697

IV. Performance Criteria and Evaluation Summary:

An Electronic Health Record Usability Satisfaction Survey is currently under development using questions from the American Academy of Family Physicians and from customized Military Health Systems focus groups. A future performance baseline will be established upon deployment of this survey from which performance criteria will be reported.

Exhibit OP-S, Information Management (Page 9 of 10)

062

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Information Management

V. Personnel Summary:

IT 2010

~~.·.. ~ ....M.ilita~y

IT 2011

153 354 507

IT 2012

152 505

Change IT 2010/IT 2011

Change

End Strength (E/S) Officer Enlisted Total Mil

158 343 501

-5

11

6

-1 -1

-2

Active Officer Enlisted Total Militarv 488 155 156 349 505 153 507

1

-3

16 17

5

2

U.S. Direct Hire National Direct Hire Total Direct Hire National Indirect Hire Total Ci vi lian Civilian Salary ($OOO's) Contractor FTEs (Total)

1,658 10 1,668 36 1,704 93.222 1,970

1,642

1,601

-16 1 -15 6 -9

-41 0 -41 -45

11 1,653 42 1,695

94.874 1,794

11 1,612

1,650 94.762 1,917

-176

123

VI.

Outyear Summary: N/A

VII. OP 32 Line Items as Applicable (Dollars in thousands - see next page) :

Exhibit OP-5, Information Management (Page 10 of 10)

063

UEI'ENSE HEALTH PROORAM f1SCAL YEAR (FY) 2012 BUOOET ESTIMATES OPERATION AND MAINTENANCE SIIMMARY OF PRICE AND PROGRAM CHANGF, (5: in Th()\)IfIW\d;i)

Fn:reijn

DEFENSE HF.ALTH PROGRAM

FISCAL YEAit (fY) 2011 BUDGETfSTIMATF.s OPERATION AND MAINTENANCE SUMMARY OF PRICE AND PROORAM CHANGE

($ in ThmIlIarnb)

.....

'rrllv~l

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() 11.31H

4,014 4,014

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1,941 2.040 AUlIY Ni.lvd Haint w"t' Ctt r.1v11 £ngru Ctt Nilvd PUb' f'tnl $'11<;

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o

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604,139

l,J,n,7 14 l,"H5,627

1ol9 0 4,41)4 ~t:l,9n lJ.,010 -4:',0]9 20,156 -50,492

10,OtH

"

1,41<-,995

1,~n.G97

l,4~2,H{J

-50,.Sl

~tIW-3l,

(..,."..t 11

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064

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Management Activities

I. Description of Operations Financed: This Budget Activity Group is comprised of Services Medical Headquarters and TRICARE Management Activity (TMA) functions supporting Military Health System (MHS) worldwide patient care delivery. Management Headquarters: Resources required for the U.S. Army Medical Command, the Navy Bureau of Medicine and Surgery, the Command Surgeon's staff at Air Force Major Commands, and TRICARE Management Activity personnel identified as management headquarters staff that coordinate and oversee the provision of health care within the Military Health System. TRICARE Management Activity: Resources required for the operation of the TRICARE Management Activity. These operating costs support delivery of patient care worldwide for members of the Armed Forces, family members, and others entitled to 000 health care. This also includes the TRICARE Regional Offices (TROs), the Military Medical Support Office (MMSO), and the Pharmacoeconomic Center (PEC). Business Management Modernization Program: The Domain structure consists of: Accounting and Finance, Strategic Planning and Budgeting, Human Resource Management, Logistics, Technical Infrastructure, Acquisition, and Installations and Environment. The Domains will perform such functions as Portfolio Management, Business Process Re-engineering, Pilot programs, and Process Coordination amongst the Domains, Services, and Agencies.

II. Force functions MHS, this Bureau of

Structure Summary: Management Headquarters includes resources necessary to support headquarters outlined in 000 Directive 5100.73, Major Department of Defense Headquarters Activities. Within the includes the cost of operating the TRICARE Management Activity, U.S. Army Medical Command, the Navy Medicine and Surgery, and the Command Surgeon's staff at Air Force Major Commands.

Exhibit OP-S, Management Activities (Page 1 of 8)

065

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Management Activities

III. Financial Summary ($ in Thousands) :

FY 2011

Congressional Action A. 1. 2. 3. Subactivities Management Headquarters TRICARE Management BMMP Domain Management & Systems Integration Total FY 2010 Actuals Budget ReSl!:!est Amount Percent Current Current AEEroEriation Estimate

FY 2012 Estimate

118,847 209,054

106,897 184,382

0 0 0 0

0% 0% 0 0%

106,897 184,382

106,897 184,382 2,419 293,698

114,295 197,807 0 312,102

330,300

293,698

293,698

Notes:

1. FY 2010 actuals include $0.823M for Overseas Contingency Operations (OCO) under the Appropriation Act, FY 2010, Public Law 111-118. 2. FY 2011 President's excludes $0.518M for OCO. 3. FY 2012 Request excludes $0.751M for OCO.

of Defense

Exhibit OP-S, Management Activities (Page 2 of 8)

066

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Management Activities

Change FY 2011/FY 2011 293,698 0 0 0 0 293,698 Change FY 2011/FY 2012 293,698 n/a n/a n n/a n/a

B. Reconciliation Summary Baseline Funding

Congressional Adjustments (Distributed) Congressional Adjustments (Undistributed) Adjustments to Meet Congressional Intent Congressional Adjustments (General Provisions) Subtotal Appropriated Amount OCO and Other Supplemental Appropriations Fact-of-Life Changes Subtotal Baseline Funding Anticipated Supplemental Reprogrammings Less: OCO and Other Supplemental Appropriations Revised Current Estimate Price Change Functional Transfers Program Changes Current Estimate

518 0 294,216

0 0

n/a

n/a n/a n/a n/a 293,698 1,996 -363 16,771 312,102

-518 293,698 n/a n/a n/a

293,698

Exhibit OP-S, Management Activities (Page 3 of 8)

067

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Management Activities

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional Adjustments a. Distributed ustments b. Undistributed Adjustments c. Adjustments to meet Congressional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life Changes a. Functional Transfers b. Technical Adjustments c. Emergent Requirements FY 2011 Baseline Funding 4. Reprogrammings (requiring 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Appropriations Current Estimate for FY 2011

($ in Thousands) Amount Totals

293,698

o o o o

o

293,698 518

o o o

o o

o

294,216

o

-518 293,698 1,996 -363

6. Price Change 7. Transfers a. Transfers In b. Transfers Out 1) Transfer from DHP to Secretary of the Army: Transfer of resources for the establishment of the Office of Business Transformation (OBT) to the Office of the Secretary of the Army (2 Civilian FTEs). 2) Transfer from DHP to Secretary of the Army: Transfer of responsibilities and resources of the Army Substance Abuse Program (ASAP) to the Army Installation Command (IMCOM) (1 Civilian FTE).

o

-274

-89

Exhibit OP-5, Management Activities (Page 4 of 8)

068

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Management Activities

($ in Thousands) Amount Totals

51,288

C. Reconciliation of Increases and Decreases 8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs c. Program Growth in FY 2012

1) Funding Realignments:

funding from Consolidated Health Support Budget Activity Group for: Patient Administration Systems and Biostatistics Activity (PASBA), Medical Expense & Performance Reporting (MEPRS) to reflect proper execution (25 Civilian FTEs). 2) Funding Realignments: Realigns from Consolidated Health Support and Education and Training Activity Groups for Health Insurance Portability and Accountability Act (HIPPA) and Bene Advisory Panel (BAP) to reflect proper execution. 3) MHS Reflects funding to various MHS programs to include Component Acquisition Executive Support ($3.5M), Strategic Communications ($3.0M), Innovative Investment Program ($2.5M)and Mission Essential Non-Benefit activities ( 4) MILCON Support: Reflects funding for contract support to various MILCON initiatives including program management of the Capital Investment Decision Model, overhaul of existing planning and design criteria and acceleration of the of new buildings. 5) Funding Realignments: Realigns funding from Information Management Budget Activity Group for Computer/Electronic Accommodations Program (CAP) ($l.lM) and Managed Care Forecasting and System (MCFAS) Data s ($0.

o o

51,288 18,444

14,110

11,421

5,448

1,865

Exhibit OP-S, Management Activities (Page 5 of 8)

069

Defense Health Program

Operation and Maintenanoe

Fisoal Year (FY) 2012 Budget Estimates

Management Aotivities

($ in Thousands)

C. Reconciliation of Increases and Decreases

9. Program Decreases a. One-Time FY 2011 Costs b. Annualization of FY 2011 Program Decreases c. Program Decreases in FY 2012 1) Funding Realignments: Realigns funding to Information Management Budget Activity Group for Business Management Modernization Program (BMMP) to reflect proper execution (1 Civilian FTE). 2) One Less Day Paid: Adjusts for one less civilian pay day in FY 2012. FY 2011 Funding Baseline: $154.0M. 3) Secretary of Defense Efficiencies - Reducing Reliance on DoD Service Support Contractors: Directs the components to reduce funding used to acquire service contracts 10% per year over the next three years from their reported FY 2010 levels. FY 2012 reduction is 20% and FY 2013 reduction is 30%. FY 2011 Funding Baseline: $69.636M 4) Secretary of Defense Efficiencies - Reports, Studies, Boards and Commissions Review: Directs the Components to reduce funding for advisory studies by 25% below the FY 2010 levels. Reductions are based upon self-reported "Advisory and Assistance Service" data and are from "Studies Analysis and Evaluation" activities. FY 2011 Funding Baseline: $27.4M 5) Secretary of Defense Efficiencies - TMA Baseline Review: Directs the Director for TRICARE Management Activity (TMA) to streamline operations by consolidating activities into a follow-on Military Health System Support Activity consisting of four divisions: 1) Uniformed Services University of the Health Sciences (USUHS), 2) TRICARE health plan, 3) Health

Amount

Totals

-34,517

o o

-34,517

-2,539

-591

-13,735

-8,920

-8,732

Exhibit OP-S, Management Activities (Page 6 of 8)

070

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates Management Activities

($ in Thousands)

Amount

Totals

C. Reconciliation of Increases and Decreases

Management Support, and 4) Shared Services and to reduce 364 contractor positions beginning in FY 2012. Directs the USD(P&R) to reduce redundancy, capitalize shared services efficiencies and to better align similar missions across the P&R enterprise and to eliminate 24 civilian full-time equivalents beginning in FY 2012. FY 2011 DHP Contract Services Funding Baseline: $3,005.6M.

FY 2012 Budget Request

312,102

IV. Performance Criteria and Evaluation Summary: N/A

Exhibit OP-5, Management Activities (Page 7 of 8)

071

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Management Activities

V. Personnel Summary:

FY 2010 FY 2011 FY 2012

Change

Change

FY 2010/FY 2011

FY 2011/FY 2012

Active

Officer Enlisted

Total Military 525 214 739 545 213 758 547 2

759 20

19

2

-1

1

Officer Enlisted

Total Military

533 214 747

535 749

546 759

2

0

2

11

10

U.S. Direct Hire National Direct Hire

Total Direct Hire Foreign National Indirect Hire Total Civilian

Average Civilian Salary ($OOO's) Contractor FTEs (Total)

1,245 0 1,245 5 1,250 119.188 1,519

1,249 0 1,249 5 1,254 122,904 1,447

1,268 0 1,268 5 1,273 114.490 1,160 -72

4

0

4

0

4

19

19

0

19

-287

VI .

Outyear Summary: N / A

VII. OP 32 Line Items as Applicable (Dollars in thousands - see next page):

Exhibit OP-5, Management Activities (Page 8 of 8)

072

DEFF.NSE HEALTH PROGRAM FlSCAL YEAR {t'Y)2012 BUDGETF~'ITlMATES OPERATION AND MAINTENANCE SUMMARY OF PRICE AND PROGRAM CHANGE

($inThUl.lsundili) f10reign

OEfENSE HEALTH PROGRAM FISCAL YEAR (FY) lOl2 BUDGe! ESTIMATES OPERATION AND MAINTENANCE SUMMARY OF PRICf. AND PROGRAM CHANGE

($ in Tbouands)

.....

4HZ

~ll

Managemmt Activities

Tf lIvel of Persons

MOIO

PrWc Growth

~

Progrum

fY2011

~!Jnl.I!!lIl

Iii -3,105 -:':1,105

£Dimm

.....

'" .02

Ul

M .....gennnt Activities

Tr" ...",l of Pel'sons Total 1'l'a ...e1

10,1196 10,139-G

is;!

- -

FY2011

~)(

PriI:c Growth

rS,I),l!

I),Dll

FY2012

7,

.l

llG

1,90

t20

2,S11O 0 Navy

S.nvice FYI'",l 'liel ArntySup' Mat 3.26*

2,QI-%

1,34\

412

0 0

1,10'

L40~

'"

411

0 0 Tot"l SliP" M<lt.

L50~

SU['141'

0

1.40%

m

5.43%

50:; 503

A'my f'\ma Equ1pt N<lvy Fynd Eq\.d pt AF Fund £qllil>t. OtA f'Jnd f\l1l1"t GSA fund rqlllr'>;

Army Oepot ,"md Ma\nt Naval SYda ce Wa r Naval Nallal

War I:tl'

o unu o -j,ljJII

()

ut.

0

)(L;tDl

1.'!~

0

0

-0.34' 5,9Jt 0.5(1'1; LBO\

0

o

J ,40\ _14.001

'"

iDS

fl4? 671

615

PLA Dl,.$['0S .. t"Of\ :;...1.'"1",,, ... C<4ml ;;'1<:$ Ti&t 1 Cost. R,,!JU.llr$!ble SVG PUX"Ghases fn>m It,d Idll1q Total PYr,h"s""~

MAC rdr9"

,

o

0

2.0H

HJ.60~

1.4(t.

N/IV r"b Wd;.s etc: Puh WrI::s DISA £n~",cpris", Computer r;entets: C''II\\I!!'mications Svc D... r f;1fj,ance " Acct :;"cDlJ\. Cisvc,sitioT' services CDIml SVGS T1"!r 1 Cost fi",im~"'.rslhli(! SV(

PU[Thil",flS

"

(j

o

a ,

U

lUlU -e.06" UUU

2.01'1'

12.&U

1,50\

24,16;'

H~ j "t"'I'''l1c"

"LIMo

139

0 L70'l:

Tot.al

PUlGrMSiI!$

N'1wdl1flg

Tr~nsport~tlofl

-20 -20

14~,HfI

5'

"

qOl

Handling

1:00000000eL"clal 1'ranspDrtiltior;.

"ftallSpOl tation Pey ""imburs Hose r<>t'&i,]fl Nat II'.1 Hire

5' OJ

1 ~ ',3('2

tlU

129 144,!W;

4'1

"

0

0.5!H: 0.501 1.40,.

1.~O1-

,,,

4, ]93 0

.,

D

"

0 0

fLOO"

'"

0

]~1

L50t 1.50,.

1.50% 1.50%

1,40" 915

i<... "t,. non GsA Post-d ;>ves

Sllppl j

"l~

".~

1.4()t

,

HAL

1,o:n

0

0

f'Unrj"i> ,

f,qlli"t M;dHt

'"

1,094

1.40,. 1.40\ 1.40'

0 0

142

<:,lH7

-1,139

-40 -ll

5.9B? 159

0

t. ~O.

1 ,~O,

1.!iO~

12,924

0

0

P"ctltty Mdflt

rt,;Io.HMCY

L50\ 1,571 l.40t 1.10'

J..40~

,

Depo~

Hall'll lOS, IilO

<)),942

" "

1.50'

1.50't

'"

~17. 614 -11,741

"

75,109 3,012

17,210

a

o

(,

L40l 11.30"

:'\,.101

~5, 20~

)4,545

241

fmd

0

LSD' 1.50,.

1.50.

0 0

..,

a

202

J,609

0

-5,205

lO,aJS

15,450

1.40\

1.~0t

LSr:a

1 ,50\ },70' ), 50~

'" 9B5

0 0 0

1,{0' J.JOI/r

J()

"

1,10* 1.404

1.401

1.4{H

" -.,'3)

-521

()ttwr Intt·a-<'".oyernmellt ?t.ll'chi!l.'!::<!!s

Gr~nt " nth.. , Cuntc.acts T'l' C(Jntr.. ct .$uppurt Tut.. l purd,as",,,

0

1. so~

l.SO' 1.50' ),50\

I

a

0

("OlO

~a!l,

"

TOTAL ;:130,300

237 -7,1;;5 100 -1,19j 3,213 -36,1146 3, ,1.70

"

"

~t

j90

0

5£3

1,A67

293,698

Hi,40B

H2.102

IbI3IUIUl.'II'-lit,-. 1 ..... 1 of 1)

073

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Education and Training

I. Description of Operations Financed: This Budget Activity Group is comprised of three primary categories that provide support for education and training opportunities for personnel within the Defense Health Program. Health Professions Scholarship Program: Resources required for the Armed Forces Health Professions Scholarship Program (HPSP), the Financial Assistance Program (FAP) , Health Professions Loan Repayment Program (HPLRP), and other pre-commissioning professional scholarship programs. These funds are used for educational expenses including tuition, fees and reimbursed expenses (e.g., books, supplies, and equipment). Uniformed Services University of the Health Sciences (USUHS): Resources required for operation and maintenance of the Uniformed Services University of the Health Sciences (USUHS). USUHS is a Department of Defense-funded medical school that produces an average of 165 medical doctors annually, advanced education for nurses in the Graduate School of Nursing, and graduate programs leading to a masters or doctoral degree in the biological sciences. Other Education and Training: Resources required for specialized skill training and professional development education programs for health care personnel at the Medical Education and Training Campus (METC), U.S. Army Medical Department Center and School, Navy Bureau of Medicine and Surgery sponsored schools, and Air Force medical professions education and training programs. Includes formal educational programs for health care personnel at civilian academic institutions, civilian medical facilities and facilities of non-DoD governmental agencies. Professional development provides officer, enlisted, and civilian medical personnel with the skills and knowledge required to perform highly technical health services jobs. II. Force Structure Summary: Education and training resources provide tuition and other educational expenses for the Armed Forces Health Professions Scholarship Program, Financial Assistance Program residencies, and the Health Professions Loan Repayment Program. USUHS resources fund operation and maintenance requirements necessary to operate a DoD-funded medical school that trains doctors, as well as offering graduate programs for nurses and professionals in the biological sciences. The remaining resources are required for professional development education, training programs, and skills training to match medical job requirements.

Exhibit OP-S, Education and Training (Page 1 of 8)

074

._--_.

_ ._._-- . _ - - - - - .

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Education and Training

III. Financial Summary ($ in Thousands) :

FY 2011

Congressional Action A. Subactivities 1. Health Professions Scholarship Program 2. Uniformed Services University of the Health Sciences 3. Other Education and Training FY 2010 Actuals 223,151 Budget ReSl:!:!:est 240,746 Amount 0 Percent 0% Current Current AEEroEriation Estimate 240,746 240,746

FY 2012 Estimate 259,998

131,540

105,529

0 0

0% 0% 0%

105,529 28 632,534

105,529

112,313

Total

Notes:

655,338

632,534

0

632,534

705,347

1. FY 2010 actuals include $16.848M for Overseas Contingency Operations (OCO) under the ion Act, FY 2010, Public Law 111-118. 2. FY 2011 President's Budget Request excludes $18.061M for OCO. 3. FY 2012 Request excludes $16.859M for OCO.

of Defense

Exhibit OP-S, Education and Training (Page 2 of 8)

075

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Education and Training

B. Reconciliation Summary Baseline Funding Change FY 2011/FY 2011 632,534 Change

FY 201l/FY 2012

632,534 n/a

n/a n/a n/a n/a

Congressional Adjustments Congressional Adjustments (Undistributed) Adjustments to Meet Intent Congressional Adjustments (General Provisions) Subtotal Appropriated Amount OCO and Other 1 ations Fact-of-Life Changes Subtotal Baseline Funding Anticipated Supplemental Reprogrammings Less: OCO and Other Revised Current Estimate Price Change Functional Transfers Program Changes Current Estimate Appropriations

0 0 0 0 632,534 18,061 0 650,595 0 0 -18,061 632,534

n/a n/a n/a 632,534

n/a

n/a n/a n/a

n/a 632,534 17,798

0

705,347

Exhibit OP-S, Education and Training (Page 3 of 8)

076

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Education and Training

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional ustments a. Distributed Adjustments b. Undistributed Adjustments c. Adjustments to meet Congressional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life Changes a. Functional Transfers b. Technical Adjustments c. Emergent Requirements FY 2011 Baseline Funding 4. Reprogrammings (requiring 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Appropriations Current Estimate for FY 2011 6. Price 7. Transfers a. Transfers In b. Transfers Out

($ in Thousands) Amount Totals

632,534

o o o o

o

632,534 18,061

o o o o o

o

650,595

o

-18,061 632,534 17,798

o o

o

Exhibit O,p-5, Education and Training (page 4 of 8)

077

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Est~ates Education and Training

($ in Thousands)

C. Reconciliation of Increases and Decreases

8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs c. Program Growth in FY 2012 1) Funding Realignments: Funds programmatic increases supported by historical execution in various educational and training programs including enhancement of Army and Air Force medical distance learning programs ($3.0M), AMEDD Center and School's Master in Social Work program ( .OM), student travel for Army and Air Force medical enlisted training ($5.0M), the Inter-Service Physician Assistant Program ($2.0M), Navy Family Support and psychological health training programs ($19.7M), and other Navy Wounded III & Injured Programs ($10.6M). FY 2011 Other Education and Training Funding Baseline: $286.3M. 2) Medical Education and Training Campus (METC): Funding support for purchase of equipment, student books, and supplies required for the co-location of medical enlisted technical training in METC, San Antonio. FY 2011 Other Education and Training Funding Baseline: $286.3M. 3) Health Professions Scholarship Program (HPSP): Funding to support scholarships for the Tri-Service Nurse Academic Partnership program (TSNAP; $4.7M) as directed by FY 2010 NDAA, Sec.525, and other HPSP students ($2.5M). FY 2011 HPSP Funding Baseline: $240.7M. 4) Uniformed Services University of Health Sciences (USUHS): Total funding support for enhancements to various USUHS programs to include the curriculum reform for the School of Medicine ($2.7M), Tri-Service Nursing Research Program ($0.2M), Student Travel for Medical Clerkships ($0.02M), Medical Effects of Ionizing Radiation ($0.02M), Regenerative Medicine Center of Excellence ($0.02M), Recruitment & Retention efforts ($0.9M), the Tri Service Center for Oral Health Studies ($0.003M), and funding adjustments for transferred programs that include Patient Safety (-$1.3M), and the In-house Laboratory Independent Research ( $0.01). FY 2011 USUHS Funding Baseline: $105.5M.

Amount

Totals

66,980

o o

66,980 47,475

7,400

7,208

4,211

Exhibit OP-S, Education and Training (Page 5 of 8)

078

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates Education and Training

C. Reconciliation of Increases and Decreases

($ in Thousands) Amount Totals

5) Manpower Reprogramming: Reinvestment of BRAC and converts Foreign Indirect hires (FIH) to US Direct hires. 6) Wounded Warrior Programs: Funds enhancements to various Wounded III and Injured and Traumatic Brain ury!Psychological Health programs to include Army Physical Evaluation Board Liaison Officer Training, Re-Engineering Systems of primary care treatment in the military (Respect-Mil; a system of primary care designed to enhance the recognition and high-quality management of post-traumatic stress disorder and depression). FY 2011 Other Education and Training Funding Baseline: $286.3M. 9. Program Decreases a. One-Time FY 2011 Costs b. Annualization of FY 2011 Program Decreases c. Program Decreases in FY 2012 1) Military to Civilian Conversions and Restorals: Incremental funding effect of previously programmed mi1itary-to-civilian conversions ($1.5M), and restoral of these conversions ($-7.4M) as required Sec. 721 of the FY 2008 NDAA. FY 2011 Other Education and Training Funding Baseline: $286.3M. 2) Civilian Pay Adjustment: Adjusts for one less civilian pay day in FY 2012. FY 2011 Baseline: $171.7M. 3) Secretary of Defense Efficiencies-Reducing Reliance on DoD Service Support Contractors: Directs the components to reduce funding used to acquire service support contracts by 10% per year over the next three years from their reported FY 2010 levels. FY 2012 reduction is 20% and FY 2013 reduction is 30%. FY 2011 Funding Baseline: $27.6M

412

274

-11,965

o o

-11,965

-5,861

-658 -5,439

Exhibit op-S, Education and Training (Page 6 of 8)

079

Defense Health Program Operation and Maintenance Fiscal Year (FY) 2012 Budget Estimates Education and Training

($ in Thousands) Amount Totals

C. Reconciliation of Increases and Decreases

4) Secretary of Defense Efficiencies- DFAS Baseline Review to Eliminate Civilian Personnel Positions Reduced payments to DFAS due to DFAS elimination of multiple positions beginning in FY 2012 to reduce personnel and budget costs without impacting mission accomplishment.

-7

FY 2012 Budget Request 705,347

IV. Performance Criteria and Evaluation Summary: N/A

Exhibit OP-S, Education and Training (Page 7 of 8)

080

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Education and Training

V. Personnel Summa£Y:

FY 2010 FY 2011 FY 2012

Change

FY 2010/FY 2011

Change

FY 2011/FY 2012

7,433 Enlisted Total Military

7

7,448

7,466 7,207 14,673

15

6

18 65 83

14,584

7 14,590

Officer Enlisted Total Military

7,408

7

7,441

33 14,632 132

16 28 44

7

7

14,456

14,588

U.S. Direct Hire Foreign National Direct Hire Total Direct Hire Foreign National Indirect Hire Total Civilian (Reimbursable Included Above-memo) Civilian Contractor FTEs (Total) ($OOO's)

1,927

1

2,004

1

2,022

77

18

1

2,023

o

77

o

18

1,928

1

2,005

1

1,929

71

2,006 41 87.406 65

1 2,024

41 87.231 63

o

77

-30

o

18

o

87.956 65

o

-2

VI. Outyear Summa£Y: N/A VII. OP 32 Line Items as Applicable (Dollars in thousands - see next page) :

Exhibit OP-S, Education and Training (Page 8 of 8)

081

DEfENSE Hf.ALTIl: PROGRAM

($ iSTIttMUlII.d:<)

FGfel8fl

Fnrejs"

FYlO1{}

Un<

EducAtion&:

G'unem:y

PriccGrowth

~

FY2011

FY20tJ

CurTll'IIiJ)'

TrlllnioJ

fmmm

I~, I~,

Mil!.l!!.

AIlli!Ym

I, 052 1, 052

~6,

fmlW!m

~6,

Unr

Edundcm &; Tnlninl

fm&wn

69,903 69,50J

M!!.!!1

&i!&I:Il

PriQ'O(ftoW1h Program &nQ!!!ll ~

1,04S

1,0411

FYl012

tnw:Atn

196 196

345 345

69,903 69,901

11,748 11,7411

4010rscrucl 402 SerY1Ce nmd ~uel 411 ....l·my 412 Navy Sup' Mat 414 ....r Sup· & Mat D1). c~>Jp & Hat 416 GSA sup, Mat:

91

o

~,

'1

402 HI Send"e ¥\.nd f\; 1 Army Sup {, Hat ~avy Sup {, Hat Af' Sup (, Mat

-17

11.Jm

.L2.:I'I' 3,.26\ 2,(]1\ 102

(1

15f1

"'

o o

3,2(,0

Q

2.97%

l.JH

£14

(} -0.97\ 1.S0l 1.5(;'s 5.431

3,365

1,2'18

o

414

o

m

Local ?ro;:; Sup (, Mat f'O!;ce R.,tai1 Supply

o

H&

>,65<;

4,51\

°

o

(}

'''''

f;md Eq'lipt

1.3H

navy rm,d Equipt

o . .;U

-Q.SO~

Af F"nd E'f.l1pt

1511

C 1.60\

5'l"!

DLA f'",d &luipt

m

l,D""!

D

1.4U l.SO",

GSA ["I'n

~ulpt

'"

1,069

"" .. ,,1 fund Eq"lpt

I'wny D-PI''-'' (:tml H"'lnt

60J

w.,

Na....al Ciy.ll EH)lIr 1:tr Naval ~\lh ~ >'nlt !:y,;

Sa....

~\lb

' '1'fOy

°

1,046

G

2,

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6\1

1.77t

11

Webl Cl

~;

,

~4

3

1, Cl;l4

~

6]3

Nav Pub Wrk,~ l~lC: I'hks DISA Ent"rpll.'1H Co~rULar 671

COmmUrliGdtloll~

o 1.40~ o HUll

{,J5 1,47

r,7~

D,,! FJnan,.'"

I>

Ar;r;t

,;13

DLA IHsp!'~il l"ll

D#pot Cmd Halnt )oI"Yal S"rf<lc" WaJ: ClL" )oI"Y"] C~ vll Eng". Ct [ N"Y<ll P"b , Prnl SVG Nav Pub WrKS err; Urlli) 1",.. Nav Pub WtKs etl'; Pull- W,b, OISA Ent.,rpdse \..<JtRrut .. r Cel1t"1s Cortllnunic1Itions SVG De! FiadnCp. 1 A"ct Sv" DLA DiaposltiolL S...Vj'7""

......

°

o o o

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.3,63'1i

1,0:14

6

0.5o, 1.8f"

-}l 1

"

1,01;>5 7

o

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-A,O£'

55

UUtl

,

Comm Svr;s TIHI 1

Cost. R.. irol-nJts'lble

Purdiat,ols fl")~

1,1 1

)8

Pu."h"s~s

fl"Vm BUlldir.q

!iMC

'rc~atnlr,q

10,'10* 15,40*

!~~'<:'l<ll

lfalHilillq

Transpt.Jct1ltlN\

Telal ",l"rlln2pcl'tation

o o

C.SOi

ely

34

0.5011

C.SO'

PUICCllase<:i COft1!l\ur,ica R"nts nor. GSA Sl.:pplie:s · K:!It Pnnt1n'~ · R<>product 922 Equipt Maillt Cor.uact 92J racility Haint Cur.Cl'act 924. ~h~rmacy Equipt ~ulcra:;:",s Ov"rseas Purchases ~30 OtheL Depot Honnt Gontu.ct Consultants Mqmt ~ Prot Spt ~dj Studies Analysis Eval ')34 Enqi:,eerll"l Tech

921

" '"'

,}1),99;! 1,355

~11

l?~y Relmr>IJt·s Host F()J:oei<;l11 H<lt Ir,d Hi1e ';"'pu·ati.:>l\ Ll<1hil1ty R"nt"l P,;y to GSA P"lchd2f'!\ Utllities

"o

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o o o

o

0,001<

0.(1)1

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112,94<>

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o

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40~

914

11 -474 342

~Jl'i

P"tchi'lsed Corwnuni ..a

R"'HI.:!II nOll GSA

()

-6.754

1.~IH

911

""0

P"sl;d Svc,

Slll'pU . !! & Mat PdFl'.ilfr,1 i R P loduct /i;qulpt Maint Ccntr<l .. t fll ..ility H".iJ,t CantLact I'haL'lllll"y

()

1,374

286

19 1 -3::l

Cl -7,22B

~;n

1.40\ 1.40i

'"

I)

f)

$6

"

o

o

14,2!:1.l

1.50" 1. <;O~ l.S()' 1.50% 1.504; LSO.. 1.50.. 1.501

3.50+

1.50'

l,SOi

21»)1

369

20

500 1

15,54l

zn

1,J9;

7,500

14,812

o

(j

o

I

,O:;l~

1.'0' 1.40t 1.4[,.

1.40+

t. ... O'l

o

"

4,1.)-/1

o

11,158

o

L'.\(l1I

14,445 0

4,607 -6

)5'1,991;1 0

1. JOli

~fll

(),h ! '

twdir:al [;aJil't r,.:>)ltcacts In1::n-{;ove.wm.,nt l:'uccM.!:es n,lJ9h

COFlla"<I,~t·.!! IT Contra.. t SIJppoct Setvices Tot.<:I1 ~\a:dla.!!S

(l

3.51)\

7J

2,295

o

Q

JS7 -D.!>:.!l

1,40]

-19,~69

o

1. 40~ 14,65G -J4,H41 IS, 810

~JB,

11,a9f1 fl2,OB6 199

~54.(d2

~a9

(n.h ! '

o o

554,6J" t.J2,SJ4

999

l.<;I)' 0 1.51)11 17a l. 51)% 1, ~30 1.<;0\:3 1£,61fl lI,7!}B

0 3,225 25,921

43,~lO

15,301 10:1,231 202 614,4.60 10S.H7

b ~4

tJ2, [,)4

Tm'At.

55,015

bldhi.t. 0'-", ad 1 .... "011)

082

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Base Operations/Communications

I. Description of Operations Financed: Base (BASOPS)/Communications refers to the resources dedicated to the operation and maintenance of Defense Health Program (DHP) facilities. BASOPS for facilities and services at military medical activities (CONUS and OCONUS) supporting active duty combat forces, reserve and Guard components, training, eligible beneficiaries. The program consists of eight components: Facility Restoration and Modernization: Resources for facilities restoration and modernization. Restoration includes repair and replacement work to restore facilities damaged by lack of sustainment, excessive age, natural disaster, fire, accident, or other causes. Modernization includes alteration of facilities to implement new or higher standards (including changes), to accommodate new functions, or to building components that typically last more than 50 years (such as foundations and structural members) . Facility Sustainment: Resources required for maintenance and repair activities necessary to keep facilities in working order. It includes regularly scheduled ustments and inspections, preventive maintenance tasks, emergency response and service calls for minor Sustainment also includes major repairs or replacement of components (usually accomplished by contract) that are expected to occur periodically throughout the life cycle of facilities. This work includes regular roof replacement, refinishing of wall surfaces, repairing and replacement of heating and cooling systems, tile and carpeting, etc. Faoilities Operations: Resources required for fire and protection including crash rescue, emergency response, and disaster preparedness; engineering readiness: utilities to include plant operation and of commodity; refuse collection and disposal to include operations; pavement clearance including snow and ice removal from,roads: lease costs for real off-base facilities; grounds maintenance and ; real property management and engineering services including special inspections of facilities and master planning; pest control; and custodial services. The title of this Program Element (PE) was changed from Real Property Services in FY 2005. Base Communications: Resources required to provide base communication resources to DHP medical activities. includes non-tactical, non-DCS (Defense Communications , base communication facilities and that provide local communications worldwide. This

Exhibit OP-S, Base Operations/Communications

(Page 1 of 9)

083

Defense Hea1th Program

Operation and Maintenance

Fisca1 Year (FY) 2012 Budget Estimates

Base Operations/Communications

Base Operations Support: Resources required to provide comptroller services, data process services, information activities, legal activities, civilian personnel administration, military personnel administration, printing and reproduction, facility safety, management analysis/engineering services, retail supply operations, supply activities, procurement operations, storage activities, transportation activities, physical security and police activities, laundry and dry cleaning, food services, and morale, welfare and recreation activities. Environmental: Resources required to comply with environmental laws, regulations, criteria, and standards. includes manpower, training, travel, and supplies.

This

Visual Information Systems: Resources required to provide manpower, travel, contractual service, procurement of supplies and materials, expense equipment, necessary facilities and the associated services specifically identifiable to visual information productions, services, and support. Demolition/Disposal of Excess Facilities: Resources required for demolition and/or disposal costs associated with excess facilities, including buildings or any other permanent or temporary structure as well as pavements, utility systems, and other supporting infrastructure. Includes environmental costs directly attributable to demolition/disposal to include inspection and removal of hazardous material {such as lead-based paint or asbestos.

II. Force Structure Summary:

Inpatient Facilities Medical Clinics Dental Clinics Veterinary Clinics

IT 2009 Actual 59 364 282 288

IT 2010 Estimate 59 365 281 255

IT 2011 Estimate 56 363 274 253

Exhibit OP-S, Base Operations/Communications (Page 2 of 9)

084

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Base Operations/Communications

III. Finanoial Summary ($ in Thousands) :

FY 2011

Congressional Action

FY 2010

A.

l.

Subactivities: Facility Restoration/Modernization - CONUS Facility Restoration/Modernization - OCONUS Facility sustainment - CONUS Facility Sustainment OCONUS

Actuals 438,714 34,198 470,195 58,653 413,980 33, 648 39,544 5,555 316,088 21,899 657 5 28,986 10,660

Q

Budget ReSl!!est 305,728 49,691 288,389 89,399 380,340 29,470 41,499 5,717 340,621 21,029 955 3,628 28,371 12,773

Q

~

Percent 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Q

Current Appr!:2riation 305,728 49,691 288,389 89,399 380,340 29,470 41,499 5,717 340,621 21,029 955 3,628 28,371 12,773

Q

Current Estimate 305,728 49,691 288,389 89,399 380,340 29,470 41,499 5,717 340,621 21, 029 955 3,628 28,371 12,773 0 1,597,610

FY 2012

Estimate 370,888 70,985 380,867 61,927 366,818 29,937 36,809 4,908 362,9ll 21,638 0 255 24,160 7,648 2,700 1,742,451

0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

2. 3. 4. 5. 6. 7. 8. 9. 10. ll.

Facilities Operations - Health Care (CONUS) Facilities Operations - Health Care (OCONUS) Base Communications - CONUS Base Communications - OCONUS Base Operations - CONUS Base Operations - OCONUS Environmental Conservation

12. Pollution Prevention 13. Environmental Compliance 14. Visual Information Systems 15. Demolition Total

1,872,782

1,597,610

0

1,597,610

actuals inCludes $6.439M for Overseas Contingency Operations (OCO) under the Department of Defense Appropriation Act, FY 2010,

Public Law 111-118.

2. FY 2011 President's Budget Request excludes $1.435M for OCO. 3. FY 2012 Request excludes $2.271M for OCO.

Exhibit OP-S, Base Operations/Communications (Page 3 of 9)

085

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Base Operations/Communications

B. Reconciliation Summary: Baseline Funding

Congressional Adjustments Congressional Adjustments (Undistributed) ustments to Meet Congressional ional Intent

Change FY 2011/2011 1,597,610

0 0 0 0

Change FY 2011/2012 1,597,610

n/a n/a n/a n/a

ustments (General Provisions

Subtotal Appropriated Amount

OCO and Other Fact-of-Life Changes

1,597,610

1,435

0

n/a n/a

n/a

Subtotal Baseline Funding

Anticipated Supplemental Reprograrnrnings Less: OCO and Other Appropriations

1,599,045

0 0

n/a

n/a n/a

-1,435

n/a 1,597,610

14,585 -127,665 257,921

Revised Current Estimate

Price Change Functional Transfers Program Changes

1,597,610

n/a n/a

Current Estimate

1,597,610

1,742,451

Exhibit OP-S, Base Operations/Communications (Page 4 of 9)

086

Defense Hea1th Program

Operation and Maintenance

Fisca1 Year (FY) 2012 Budget Est~ates Base Operations/Communications

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional Adjustments a. Distributed Adjustments b. Undistributed Adjustments c. Adjustments to meet ional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life Changes a. Functional Transfers b. Technical Adjustments c. Emergent Requirements FY 2011 Baseline Funding

4. Reprogrammings a. Increases b. Decreases 5. Less: OCO and Other 1415 Actions)

( $ in Thousands) Amount Totals

1,597,610 0

0 0 0 0

1,597,610 1,435 0

0 0 0

1,599,045

0 0 0

-1,435

Current Estimate for FY 2011 6. Price Change 7. Transfers a. Transfers In 1 ) Transfer from IMCOM to DHP:

Transfer resources and command responsibilities of the Keller Community Hospital and associated medical treatment facilities at

West Point from the Army Installation Command (IMCOM).

b. Transfers Out 1) Transfer from DHP to IMCOM: Transfer of responsibilities, management and oversight of

1,597,610 14,585 -127,665

2,316 2,316

-129,981

-71,178

Exhibit OP-5, Base Operations/Communications (Page 5 of 9)

087

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Base Operations/Communications

( $ in Thousands) Amount Totals

C. Reconciliation of Increases and Decreases

operations at Fort Detrick to IMCOM (435 Civilian FTEs and 11

Military Personnel). 2) Transfer from DHP to Commander, Navy Installations Command (CNIC):

Transfer resources and responsibility for Class 1 and 2 Real

Property, Base Operating Support, and Installation Management for six

Bureau of Medicine sites to the Commander, Navy Installations Command

(145 Civilian FTEs and 64 Military Personnel). 3) Transfer from DHP to NETCOM and IMCOM:

Transfer of resources and responsibilities of Fort Detrick

Directorate of Information Management to the Army Network Enterprise

Technology Command (NETCOM) (15 Civilian FTEs) (-$2.lM), and the

transfer of resources for the Army Civilian Human Resources Agency

from MEDCOM to Army Installation Management Command (-$1.

8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs 1) National Interagency Bio-Defense Campus (NIBC): Reflects funding adjustments from prior year due to one-time Central

Utility Plan project and lease costs increase.

c. Program Growth in FY 2012 1) Facilities Sustainment, Restoration and Modernization (FSRM): Reflects funding realignment from In-House Care ($30.2M) and Private

Sector Care ($146.6M) Budget Activity Group for restoration and

modernizations projects and Facilities Sustainment Model execution to

100%. FY 2011 Funding Baseline: $733.207M.

2) Colocated Medical Headquarters: Reflects funding for lease costs (Lease $19.6M + $ll.OM Transition

Costs) associated with the colocation of the Medical Headquarters in

the Northern Virginia area. FY 2011 Funding Baseline: $10.4M

3) Wounded Warrior:

Realigns funding from multiple Budget Activity Groups for Traumatic

Exh~it

-55,560

-3,243

268,007

o

50,189 50,189

217,818 176,798

30,600

10,420

OP-5, Base Operations/Communications (Page 6 of 9)

088

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Base Operations/Communications

( $ in Thousands) Amount Totals

C. Reconciliation of Increases and Decreases Brain (TBl/PH) to reflect actual execution.

9. Program Decreases a. One-Time FY 2011 Costs b. Annualization of 2011 Program Decreases c. Program Decreases in FY 2012 1) Military to Civilians conversions: Incremental transfer to Service MlLPERS accounts to restore military authorizations previously as Military to Civilian conversions, as required by Section 721 of the FY 2008 NOAA. 2) One Less Day Paid: usts for one less civilian pay day in FY12. Baseline: $210.0M. FY 2011 Funding

-10,086

o

o

-10,086 -5,466

-805

3) Secretary of Defense Efficiencies - Reducing Reliance on 000 Service Support Contractors: Directs the components to reduce funding used to acquire service support contracts by 10% per year over the next three years from their reported FY 2010 levels. FY 2012 reduction is 20% and FY 2013 reduction is 30%. FY 2011 Funding Baseline: $14.9M. 4) Secretary of Defense Efficiencies - DFAS Baseline Review to Eliminate Civilian Personnel Positions: Reduced payments to DFAS due to DFAS elimination of multiple positions beginning in FY 2012 to reduce personnel and budget costs without impacting mission accomplishment.

-2,945

-870

FY 2012 Budget Request

1,742,451

Exhibit OP-S, Base Operations/Communications (Page 7 of 9)

089

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates Base Operations/Communications

IV. Performance Criteria and Evaluation Summary: See performance criteria located with Exhibit OP-5 Facilities

Sustainment, Restoration and Modernization.

Exhibit OP-5, Base Operations/Communications (Page 8 of 9)

090

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budqet Estimates

Base Operations/Communications

V. Personnel Summary FY 2010

Active

Militar~

FY 2010

561 2,318

FY 2012

551 1,693 2,244

Change FY 2010/FY 2011

-37 -147 -184

Change FY 2011/FY 2012

-10 -64 -74

End Strength (E/S) Officer Enlisted Total Military

598 1,904 2,502

Active

Militar~

Average Strength (A/S) Officer Enlisted Total Military

596 1,855 2,451

580 1 2,411

556 1,725 2,281

-16 -40

-24 -106 -130

Civilian FTEs U.S. Direct Hire Foreign National Direct Hire Total Direct Hire Foreign National Indirect Hire Total Civilian Average Civilian Salary ($OOO's) Contractor FTEs (Total)

2,480 2,533 85 2,618 79.276 318

2,478 52 2,530 8 2,618 80.247 311

1,883 1,935 88 2,023 77.364 343

-2 -3 3

a

-595 0 -595 0 -595

-7

32

VI. Outyear Summary: N/A

VII. OP-32 Line Items as Applicable (Dollars in thousands - see next page)

Exhibit OP-5, Base Operations/Communications (Page 9 of 9)

091

DEFENSE HEALTH PllOORAM fISCAL YFAR (FY) WI2 BUDGET ESTIMATES OPERATIDN AND MAINTE'.NANct SUMMARY OF PRIG'E AND PROGRAM CHAlliCE

($mTbtlWtMdll)

Foreilln

DEFENSE HEALTH PROGRAM

FlSCAL YEAR (FY) 2012 BUOO£T ESTTMATF..S

OI>ERATION AND MAl'N'Tb"NANCE

SUMMARY OF PRK:E AND PRt:XJ1\.AM OIANGE

($ in ThOUl'Bll<i,)

FYlall

FYlOIO

Curmft(,y

~

:'40+

fl!!mIll FY10II "Travel 1"ta1 T1.a_l

B~

Cum:lwy

Full:i,," _ _ _ _ PrieeGNwth Prosrwn

_., FYlUJl

12.,321'1

Un<

jut... ! TI:'1Y'fl 401

4flJ

~

DaM Opentlont

fu!imm

fl!!mIll

12,141 12,141

~,

Orn'attm.

o

1",H7

::.., ~!ii 1, ~69 1

1. SO~

lR2

'"

l.JH

-1

12,

]~8

S,Ul

F\1flti FUIIl , Mdt

1154

6.401 -1,099

l'

leo

1.233 3.16* 2,OH

L~Oi

"

4.5U

-z,

l,2fj9

o

19z

411 412 414

ServIce rUIlQ i\lel AnlW Sup { M<ll

~av~' Sup , ~.al 1\f S\lp ;; ~lat

o

5

192

1,087

1,1'1.0;.

o

0,,,4'1

-0,97'11

m

411 L,;;,c;a!

."

o

k"t.. i 1 Supply

Q

& Mdt

1.40'" 1. ~!)\

150

1,il54

417

o

HE

Total SllP

~

'"o

C

1.46' 1.50'

1.'50\'

5.41\

263

-?1~

1,fH>l

o

Toul

!f,R03

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W, 6~~

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o

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3.231

503

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634 N,w f'ubWrK!':

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1.50\

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-4,51H

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Handling T!'anspoj'tdtlon TOt.41 Tplnsportatio[\

1,ZU

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lO.1(J'!. IS,40l 15,1M

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21,594 209,876 50,914 20,524 1,617

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Rents "on GSA

Sllppli... ~ , Mat

:n,lf.f

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SupplJ >!s .. Met Faflting" !Wp.:cduct

20,5)4 1,637 .016,513 3,070 603,294

30'

o o o o o o

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1.50-11 1.50-11 3.501

45

H,OiiEl

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M.."L1'1t Contl'Jct

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11,155

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1 ,40~

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o

1,6H -l< -fl,853

o

1,723 I fI, 1·n

1,iU nUl"l Costs (Medic"l C"r.. )

othe]' C(),'Ots [lnt'!\J;:.. st and [J.ivident!l)

°

lA,191

(r

1.50' 1.5011 -33

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6,245 21,555

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ami [m"'I'lnpment ('"ontrar;:t!l Me'iin'!l Cat" r.onlritGts lrltn.-Gov"l-n""""r. rUJ;:C;h~'HlS

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1,421,511 1,597,610

2,9~3

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l21,4::l 0

11'1,530 14,585

3H.9!1::l 3.113 1,51:",185

1,741,451

bhUoit Of-U, ft..., 1 of 11

to.

092

Defense Hea1th Program

Operation and Maintenance

Fisca1 Year (FY) 2012 Budget Est~ates

Faci1ities Sustainment, Restoration and Modernization (FSRM) , and Demo1ition (Attachment 4)

I. Description of Operations Financed: Base Operations (BASOPS)/Comnlunications refer to the resources dedicated to the operation and maintenance of Defense Health Program (DHP) facilities. The DHP's BASOPS provides for facilities and services at mili medical activities supporting active duty combat forces, reserve and guard components, training, eligible beneficiaries. Facility Restoration and Modernization: Resources required for facilities restoration and modernization. Restoration includes repair and replacement work to restore facilities damaged by lack of sustainment, excessive age, natural disaster, fire, accident, or other causes. Modernization includes alteration of facilities to implement new or higher standards (including regulatory changes), to accommodate new functions, or to replace s that typicallY last more than 50 years (such as foundations and structural members) . Facility Sustainment: Resources required for maintenance and repair activities necessary to keep facilities in good working order. It includes regularly scheduled adjustments and inspections, preventive maintenance tasks, emergency response and service calls for minor Sustainment also includes major repairs or replacement of facility components (usually accomplished by contract) that are expected to occur periodically throughout the life cycle of facilities. This work includes roof replacement, refinishing of wall surfaces, and replacement of heating and cooling systems, replacing tile and carpeting, etc. Demolition/Disposal of Excess Facilities: Resources required for demolition and/or costs associated with excess facilities, including buildings or any other permanent or temporary structure as well as utility , and other supporting infrastructure. Includes environmental costs attributable to demolition/disposal to include inspection and removal of hazardous material (such as lead-based paint or asbestos) .

Exhibit OP-5, Facilities Sustainment, Restoration and Modernization (FSRM), and Demolition (Page 1 of 7)

093

Defense Hea1th Program

Operation and Maintenance

Fisca1 Year (FY) 2012 Budget Estimates

Faci1ities Sustainment, Restoration and Modernization (FSRM), and Demo1ition (Attachment 4)

II. Force Structure Summary: FY 2010 Actual FY 2011 Estimate FY 2012 Estimate

Inpatient Facilities Medical Clinics Dental Clinics Veterinary Clinics

59 364 282 288

59 365 281 255

56

363

274

253

III. Financial Summary ($ in Thousands) :

FY 2011 FY 2010

A.

1.

Subactivities:

Actuals

Budget ReSl!:!est

Congressional Action Percent ~

Current Approl2riation

Current Estimate

FY 2012

Estimate

Facility Restoration/Modernization

CONUS

438,714 34,198 470,195 58,653 0 1,001,760

305,728 49,691 288,389 89,399 0 733,207

0 0 0 0 0 0

0% 0% 0% 0% 0 0%

305,728 49,691 288,389 89,399 0 733,207

305,728 49,691 288,389 89,399 0 733,207

370,888 70,985 380,867 61,927 2,700 887,367

2.

3.

4.

Facility Restoration/Modernization - OCONUS Facility Sustainment - CONUS Facility Sustainment - OCONUS Demolition Total

5.

1. FY 2010 actuals include $0.248M for Overseas Contingency Operations (OCO) under the Department of Defense Appropriation Act, FY 2010, Public Law 111-118. 2. FY 2011 President's Budget Request excludes $0.422M for OCO. 3. FY 2012 Request excludes $O.184M for OCO.

Exhibit OP-S, Facilities Sustainment, Restoration and Modernization (FSRM), and Demolition (Page 2 of 7)

094

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Facilities Sustainment, Restoration and Modernization (FSRM), and Demolition (Attachment 4)

Change B. Reconciliation Summary: Baseline Funding Congressional Adjustments (Distributed) Congressional ustments (Undistributed) FY 2011/2011 733,207

0 0 0 0

Change FY 2011/2012 733,207

n/a n/a n/a n/a

Adjustments to Meet Congressional Intent Congressional ustments (General Provisions)

Subtotal Appropriated Amount OCO and Other Supplemental Appropriations Fact-of-Life Changes Subtotal -Baseline Funding Anticipated Supplemental Reprogrammings Less: OCO and Other Supplemental Appropriations Revised Current Estimate Price Change Functional Transfers Program Changes

733,207

422 0

n/a

n/a n/a

733,629

0 0 -422

n/a

n/a n/a n/a

733,207

733,207

10,925 -28,872 172,200

n/a n/a

733,207

Current Estimate

887,367

Exhibit OP-S, Facilities Sustainment, Restoration and Modernization (FSRM), and Demolition (Page 3 of 7)

095

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Facilities Sustainment, Restoration and Modernization (FSRM) , and Demolition (A t tachment 4)

( $ in Thousands)

C. Reconciliation of Increases and Decreases FY 2011 President's Budget Request 1. Congressional Adjustments a. Distributed Adjustments b. Undistributed Adjustments c. Adjustments to meet Congressional Intent d. General Provisions FY 2011 Appropriated Amount 2. OCO and Other Supplemental Appropriations 3. Fact of Life Changes a. Functional Transfers b. Technical Adjustments c. Emergent Requirements FY 2011 Baseline Funding 4. Reprogrammings (requiring 1415 Actions) a. Increases b. Decreases 5. Less: OCO and Other Supplemental Appropriation Current Estimate for FY 2011 6. Price Change 7. Transfers a. Transfers In 1) Transfer from IMCOM to DHP: Transfer resources and command responsibilities of the

Keller Army Community Hospital and associated medical

treatment facilities at West Point from the Army

Installation Management Command (IMCOM).

0 0 -422 733,207 10,925 -28,872 1,382 1,382

0 0 0 0 733,207 422 0 0 0 0 0 733,629 0 Amount Totals 733,207 0

Exhibit OP-5, Facilities Sustainment, Restoration and Modernization (FSRM), and Demolition (Page 4 of 7)

096

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates

Facilities Sustainment, Restoration and Modernization (FSRM) , and Demolition (Attachment 4)

( $ in Thousands)

C. Reconciliation of Increases and Decreases

Amount

Totals

b. Transfers Out 1) Transfer from DHP to IMCOM: Transfer of responsibilities, management and oversight of

garrison operations at Fort Detrick to Army Installation

Management Corr~and.

2) Transfer from DHP to Commander, Navy Installations Command (CNIC) : Transfer resources and responsibility for Class 1 and 2

real property, base operating support, and installation

management for six Bureau of Medicine sites to the

Commander, Navy Installations Command (CNIC).

8. Program Increases a. Annualization of New FY 2011 Program b. One-Time FY 2012 Costs c. Program Growth in FY 2012 1) Facilities Sustainment, Restoration and Modernization: Reflects funding realignment from In-House Care ($30.2M)

and Private Sector Care ($138.4M) Budget Activity Group

for Restoration and Modernizations Projects and Facilities

Sustainment Model execution to 100%. FY 2011 Funding

Baseline: $733.207M

2) One Less Day Paid:

usts for one less civilian pay day in FY 2012. FY 2011 Funding Baseline: $32.0M.

-30,254 -22,223

-8,031

172,200

o

172,200 168,589

3,611

Exhibit OP-S, Facilities Sustainment, Restoration and Modernization (FSRM) , and Demolition (Page 5 of 7)

097

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Estimates

Facilities Sustainment, Restoration and Modernization (FSRM) , and Demolition (Attachment 4)

( $ in Thousands) Amount Totals

-93

C. Reconciliation of Increases and Decreases

9. Program Decreases a. One-Time FY 2011 Costs b. Annualization of FY 2011 Program Decreases c. Program Decreases in FY 2012 1) Wounded Warrior: Realigns funding from multiple Budget Activity Groups for TrauTIlatic Brain Injury/Psychological (TBI/PH) to reflect proper execution.

o o

-93 -93

FY 2012 Budget Request

887,367

IV. Performance Criteria and Evaluation Summary: Funding Levels Facility Sustainment funding Facility Sustainment Model requirement Sustainment Rate (MILPERS excluded)

*Note: FY 2012 Sustainment Rate does not reflect 100% of the model requirement due to the transfer of $12.2M for DHP installation transfers to Army Installation Management Command and Commander, Navy Installations in FY 2012 after the model was run.

FY 2010 Actual 528,848 393,577 134.4%

FY 2011 Estimate 377,788 375,673 100.6%

FY 2012 Estimate 442,794 455,435 97.2%*

Change FY 2010/2011 -151,060 -17,904 -11.0%

Change FY 2011/2012 65,006 79,762 -3.3%

Exhibit OP-S, Facilities Sustainment, Restoration and Modernization (FSRM), and Demolition (Page 6 of 7)

098

Defense Health Program

Operation and Maintenance

Fiscal Year (FY) 2012 Budget Est~ates

Facilities Sustainment, Restoration and Modernization (FSRM) , and Demolition (Attachment 4)

V. Personnel Summary: FY 2010 Active

Militar~

FY 2011 9 6 15 10 6 16 FY 2011 343 13 356 5 361 88.188 0

FY 2012 9 6 15 10 6 16 FY 2012 258 13 271 5 276 87.551 0

Change FY 2010/FY 2011 -1 -4 -5 0 0 0 Change FY 2010/FY 2011 -63 0 -63 2 -61

Change FY 2011/FY 2012 0 0 0 0 0 0 Change FY 2011/FY 2012 -85 0 -85 0 -85

End Strength (E/S)) Officer Enlisted Total Military

10 10 20 10 6 16 FY 2010 406 13 419 3 422 87.100 0

Active

Militar~

Average Strength(A/S)

Officer

Enlisted Total Military

V. Personnel Summary: U.S. Direct Hire Foreign National Direct Hire Total Direct Hire Foreign National Indirect Hire Total Civilian Average Civilian Salary ($OOO's) Contractor FTEs (Total

0

0

VI. Outyear Summary: N/A

VII. OP 32 Line Items as Applicable (Dollars in thousands): See OP-32 information included on the OP-5 Base Operations/Communications Exhibit.

Exhibit OP-S, Facilities Sustainment, Restoration and Modernization (FSRM) , and Demolition (Page 7 of 7)

099

o.,t.nse a.al th Frogram

J'h(Jal Year (I'Y) 2012 Bud.pt Estimat··

Cost o,t Med!cal Aot!vit1··

Defense Heal th Program Funding by Subac:ti vi ty Group (Dollars in Thou!iands)

iT 2010

11

n

2011;111

n

2012

n

20] q

..

2011

~

~

~

I

Chapp ill

rx 29" - 2QU; Q.'XJA

I

ill

IN-HOWIE

CARli

Defense Medical Centers, Hospitab and Medical Clinics - OCONUS Defense Medical Pharmaceutica13

Centers~

Oe01?OOHP oe07900HP Oa07701HP 0807901HP 08077l5HP OS0791SHP

5,588. Q33 469,193 1.303.743 120,827 464,545

~

5,317,643 420,78Q 1.341,241 114,1$3 521,531

~

5,529,998 43E,149 1,

455~

-270,990 -68,407 37,498 -6,644 56,992

~

-4.8% -14.0% 2.9% -5.5% 12.3% 9.6% -3.U

212,355 15,363 113,901 29,504 1,685

4.0% 3.7%

8.5%

Hospitals and Medical Clinics - OCONUS

Pharmaceutica13 - CONUS OCONUS Dental Care Activities - CONUS Dental Care Activities - OCONUS

142

143# 687 523,222

~

25.8% 0.3t -8.8'

=.hW

366 t l19

SUbtotal In-House Care

8.027,578

7.781#811

8,148,856

-245 / 701

4.7t

PRIVATE

S!ICTQR

CANt

Purchased Health Care 323,953 320,8$S 1,853.760 7,376,503 2,977,883 354,505 423,380 1,573,663 144,021 336,156 302,044 261,825 110,120 16,034# 745 391.514 1.984,621 7,203.021 2.947,481 403,540 455,714 1,642,260 207.082 341,764 313,650 404,609 82,010 16,377,212 -3,068

-0.9%

0807102HP oe07703HP 0801723HP OB0773SHP Oe01141HP 0807742HP oa07?43HP 0807745HP OS07747HP Oa07749HP 0807751HP 0807'752HP

Pharmaceuticals

10 t 629

130,867

22.0%

Pharmaceuticals - National Retail Pharmacy TRICARt Managed Care Support (MCS} Contracts MTF Enrollees - Purchased Dental Purcha.. ,ed Care

car~

1,885 1 198 6.663,455

2,321,361 334,546 365,014 1,314,300 170,840 318.320 272,199 291, E04 63,614 14,32.5 1 010

-:U,438

713,048 656,516 19,959 56,366 259,363 -26,819 17,836 29,245

-1.7% 10.7t

28.3% 6.0%

7.1% -2.4% -1.0%

-173,482

-30,402 49.035 32,334 68,597 63,061 5,608

llt 606

13 .8'

7.6' 4.4% 43.8% 1. 7%

Uniformed Services Family Health Program (OSFHP) Supplemental Care - Health Care Supplemental Care - Dental Continuing Health Education/Capitaliz.ation of Assets Program (CHE/CAP) OVersel\$ Purcha..,ed Health Care Miscellaneous Purchased Health Care Miscellaneous support Activities

16.0% 19.7% -15.7% 5.6' 10.7% -10.2%

3.8%

54.5%

-25~5%

-29,779

142,784

!l.f!..Jl!lJi

1,70g j 735

73.1%

11.9'

=l.!L..UJl

342,527

Subtot.l Private bator e.re

2.1'1

a:x:h.U:.t1t rB-1l. coat of Ma<U.ccl. Mt1v1U. . «I'~ 1 of 5}

100

o · .t.n·· a..l th PX'09X'U\

Fi.cal Y.ar (N) 2012 Budq.t Zatimat··

Co.t of MedLeal Activiti··

Defense liealth Program Funding by Subactivity Group (Dollar" in Thou"and,l3)

rY 2010

~

ry 2011

~

IT 2012

~

n

2Q10 ..

aQn

Ch.anqe

n

2011

..

2012

Change

1

.w.

a

.w.

CQNSOI.tDAnp HEAl TH supPORT

OS0I720HP 080?714HP OS07705HP OSO//60HP oeO/124H? OSO??Z5HP 0807730HP OS071S5HP 0607766HP

Examining Activities Other Health Activitie$ Military Public/Occupational Health Veterinary Service::! Military Unique Requirement" - Other Medical Aeromedical Evacuation Sy"tem service Support to Other Health Activities Armed Forces Institute of Pathology (AFIP) Joint Pathology Center {JPC) TRi\NSCOM

72.757 474,945 379,368 31,772 760,548 61,848 1,018 78,588

74.290

803.380 335,919 31 1114 753 , 278 51,880 1,411

77 1 120 840,083 346,696 32,745 839,467

1. S33

328,435 -43.449

2.1%

2,830 36 f 703

3.8% 4.6% 3.2% -11.9% 11.'%

-29.6% -20.9% -100.0%

69.2% -11.5%

17 .0%

-1.0%

10,171

-4,429 a6,189

5.402

-1,270

-15,968

36.501

1,121 20,088

-23.5% 39.2%

-15.379 -296

-65,145

399 -13,443

65,145

-lI.n

0.0%

!l.

255,639

ZJl.Jl.II.Jl

71,338

100.0%

Subtotal Con.ol idat..d a.a1 th Support

1,866,844

2,122,493

2,193,821

13. "

3.n

INFORMATION MANAGEMENT

08077S1HP OS0778JHP 080779JHP Non-Central Infoxmation Manaqement/Information Technoloqy DHP Information ManagementlInformation Technology Support progralM MHS Tri-Service Information Management/Information Technology 550,346 98,898 521., 908 115,624 814,798

536,810

112.960 772.867 1,422,697

-28,436 16,726

-5.

2~

14,962

-2,664

2.9%

16.9ft 17.0%

-2.3'

-5.1%

696, S83

1,345,821

ll.L.ll:i.

106.503

::U...n.l

-29,633

subtotal Infermat10n Manaqement

1 / 452,330

, .9'

-2.0'

~

aCTIVITIES

OaO??96HP 0807709HP 0901200HP

Management Acti vi ties TRICARE'. Management Activity BMMP Domain Management and System Integration

118,847 209,054 2.399 330,300

106,891

164~

114,295 197,607

0

-11 / 950

-24.672

-10.1% -11.6% 0.8%

7,396

13,425

6.9%

382

7.3'

-100.0%

2,419 29-3,69-S

Zl!

.... 36,602

.::2.....lllt

IB i 404

Subtotal ManagftJUO'nt 1u:tt.,iviti··

312,102

-11."

6."

1Ibcl:'lJ.bit 0-11, Coat

~

Medical Activiti·· (Pap 2 of 5)

101

Def.n·· H.al th P.roqram

Fiscal Y.ar (n) 2012 B u . t a.timat··

Coat of Medioal Activiti··

Defense Health Progl:am Funding by Subactivity Group (Do11al:s in Thousands)

"

2010

n

2011

lIT 2012

~

rx gOlA

2211 Change

n

2011 -

aOl a

Ch,na

.ill

~

I.I.t.l.m&.li!t

1

.ill

II

EDUCATIQN AN[) mAINING

fl8fl6?22HP OS06?21HP 0806?61HP

Armed Forces Health Profe..,sions Scholarship Pt:ogt:am Uniformed Service!! University of tho Health Sciences Other Education and Training

223,151

240,746 105,529 286.259 632,534

259 .. 998 112.313 333,036

131,540

300,641 655,338

17 / 595 -26, all

7.9% -19.8%

19,252 6,784

8.0%

6.4%

::lL.:!ll

-22,804

-4.n

-3.5'

.tL.lll

72,813

16.3%

Subtotal Education and 'l'raining

705,347

11.5<

BASE QPERATIONS/c;g.tmNICATIONS

08062?6HP OS063?6HP Oa062,8HP OBD637SHP 080",9HP ()SO?9?9HP 080??95HP 0807995HP {J8{J,,96HP OBO,996HP OS0'7,S3HP ()8(),,54HP OS07756HP OB07790HP 080B093HI?

Subtotal

Facilitie:'l Restoration and

Modet:nization - CONUS OCONUS

438,714 34,198 470,195 5B ,653 413,980 33,648 39,544 5 t 555 316,088

305,728 49,691 288,389 89,399 380,340 29,470 41,499

370, B88 70,985 380,867 61,92'1 366,81S 29,937

-132,986

15,493 -lBl,806 30, '746

-30.H

45.3%

65,160

21.3%

Facilities Restoration and Modernization Facilities Sustainment - CONUS Facilitie$ Sustainment OCONUS Facilities Operations - Health Care - CONUS

21,294

92 1 478

42.9% 32.1% -30.

-38.H

52.4%

-27,412

-13,522

,%

-33,640

-4 f 178

... 8.1% -12.4% 4.9% 2.9% , .8>!;

-4.0%

"'3.6%

Facilities Operations - Health Cal:tJ - OCONUS Base Communications Base Operations CONUS

BaSe Communications - OCONUS

467

-4,690

1. 6~

-1l.3' -14.2'

6.5% 2.9% -100.0% -93.0% -14.8%

36, S09

4,908 362,911 21 1 638

0

1,955 162 24,533

-870

29.

5,717

340 f 621

-909

22,290

609

CONUS

Base operations - OCONUS Environmental Conservation pollution Prevention Environmental compliance Visual Information sy,stell'lS Demolition/Disposal of Excess Facilities

21.999 657 28,986

10,660

0

21.02. 955

3,628 2S J 371

45.4%

..955

255

24,160 7,64B 2,700

3.623

72460.0. -2.1'

19.8% 0.0*

-3,373

-4~211

-615

2,1ll

Q

12 1 773

-5 r 125

2...2QQ

-40.n

100.0%

~.n

e···

Operations!Communioations

1,&,2,782

1,597.610

1, 142~ 451

-275.172

-14.H

144,841

Subtotal DHP Operation and Maintenanc.

26,423,679

29 J915 ,277

30,902,546

1.491,598

5.2'

987,269

3.3%

'Cxh1bit U·1l. coat of: . .dical AeUviti·· ('ap :1 of 5)

102

o.ten·· B.... lth Prog'ram

Fiuiial Year (FY) 2012 Budgw-t Estimat..

CoU. ot Mediad Aotiviti··

Defense Health Pl:ogram FUnding by Subactivity Group (Dollau in Thousands)

.... 2010

~

i'Y 2011

~

.... 2012

~

rx

2010 - 2011 Changa

n

2011 -

2012

Chang-

ill

I

ill

A

PrOC\,l:t'lNMIn t (P:t'og':tam Elements Oe07720HP 0907721BP)

&

Dental Equipment Food Service, Pl:eVentive Medicine, and Pharmacy Equipment Medical Information system Equipment Medical Patient Care Administrative Eq\lipment Medical/Surgical Equipment Other

Equi~men t

3,IJ00 IS,757 232,402 2,351

1,200

1/672 3 1 291 401 1 264

-2,200 -9,250 76,705

-64.7' -58.7% 33.0%

2.0% 11.6%

472

-3,216 92,157

39.3% -49.4% 29.8% 2.0% 43.2% 34,5% 42.0% 0.3% 21. 7.

6.507

309 / 107 2,IJ04

2.452 33.561

15,837

47

3-,51J -69,545 12,211

.8

10,117 4,063 8,524

19.931 81 , 319

8,080

23.44.

ll,174 20,297

~

-85.5%

151.2% -10.1%

Pathology/Lab Equipment Radiogrdphic Equipment Subtotal P:toourement

28.821

~

ll.l....ill

524,737

.:::.l.!i.d.Q1

-4,816

ill

112/597

519/921

632,518

-O.g,

Ret.earch, o.velopment, Test and Evaluat,ton

0601101HP

0601117HP

In-House Laboratory Independent Research (ILIR) EA::lIic Operational Medical Research Sciences Applied Biomedical Technology Medical Technology (AFRRI) Medical Advanced Technology {AFRRIJ Medical Technology Development Medical Products support and Advdnced Concept Development lnfotmation Technology Development Medical Products and Support Systems Development Small Business Innovative Research {SEIR) Program Medical Program-Wide Activities Medical Products and Capabilities Enhancement Activitiu: Subtotal RDT&E

2,670 88,498

116# 662

2.875

28,658

2,,935

205 -88,498

-89,004

7.7%

60

5,147

2.1%

0.0% 18.DIt 4.0% 2.0% 35.7% 4.6% 28.9% 100.0% 0.0% 250.9% -26.2%

0

:33,805

-100.0% -75."

9.7% 7.6!t -83.0%

0602115HP

0602787HP 060J002HP 0603115HP 06041l0HP o605013HP 0605145HP 0605502Hp 0606105HP 0607100H£'

3.239

3.553 752

133,376 160,168 136,761

3.694 767

181 / 042 167,481

314 53

-649,379 -102,018

141 15

47,666

699

782,755

262~

186

-38.9%

13.0%

-IOO.Oj),

7 / 313

39,584

l2l r 077

176.345

34,559

15,684 -723

-35,952

723

35,952 12,669

13 , 710

ZQ..JL!lJl.

34.559 34.543

~

0 48,313

~

-100.0%

1.101

~

a.7%

21.2% -65.6'

li..2!l.!l

1,443,630

499,913

663.706

-947,217

169,028

33.S.

Total Defense Health

P~09't'am

30 1 392 r 046

30,935,111

32,199,770

539 f 565

1."

1,269,094

3.9'

rY 2011 Continutng Resolution!!

30,5-34,349

1/ FY 2010 aetuah include operation and Maintenance o~erillltl.on and Maintenance funding of $33.4M for Evaluation transferred from Health and liullIan

of $1,289.2M for O'Verseas contingency operations iDeO) under the Department of Defe-nse Appropriations Act for FY Z010 Public Law 111-11B; includes Act, 2010 Public La.... 111-212; includes $132.0M for operation and Maintenance; and includes $a .OM for Picsearch, De"elo~ment, Test and in the Supplemental A~~ro~riations Act of 2009, Public Law 111-32.

2/ Reflects the

n 2011 president's Budget request.

3/ Adjusts the operation and Maintenance budget line included in the FY lOU President's Budget request to match the Annualized Continuing Resolution funding level.

1:xh1b1t 1'9-11, Cost .of *dical AQUv1U·· (,a9' .. of

5.

103

Def'ansa liaal th Pl'()grUl. Fiscal ¥'·· r (FY) 2011 8u4gat Z.ti..."_ Co.t of' Medioal Activiti··

Defense Health Program Funding by subactivity Group (Dollan in Thousands)

IT 2010

~

n

2011

n

2012

rx

2010 -

2011 Chapg_

rx

2011 -

2012 Chang.

I.It.t.i.III&tl

I.It.t.i.III&tl

a

ill.

a

ill.

SPECIAL INTEgS,!, ITEMS

Medicare Eligible Accrual Fund Receipt.

Tot'll Medic<tre Elicjible Accrual Fund Direct Care

Private Sector Care

Military Personnel Accounts

8,429,109 1,253 / 900 6,772, SO!? 402,400 SI,4S7,000 1,401,500 7 f 597,400 458,100 9,916,600

1, 450~ 553 7,997,411 468 I 636

l,027,eu 147 ,600 824 1 591 55 1 700

12.21

11. S% 12.2%

13.S%

4S9 f 600 49,053 400,Oll 10,536

4~9'

3.5% 5.3% 2.3<

a.March, Development, Test &: Evaluation

1 443,630

j

499,913

663,706

-921,00a

-63.8'

47 / S02

9.5"

Congression<1lly Directed prO<Jrams TMA Central Information Technology Development Service Information Technolo(jY Devel0t'tnent Small Business Innovative Research Medical Technology Development Biomedical Technology Armed Forces R<1diobiology Research Institute (AFRRI) In-HOUse Laboratory Independent Re3earch {ILIR) Medical Advanced Technolo9Y (AFRRI, Medical Products support and Advanced Concept Development Medical Products and Support systems Development Medical Program-Wide Activities Medical Products i1,nd Capabilities Enhancement Activities Basic Operational Medical Research sciences GOF Medical Research Enhancement

822,529 102,549 14,448 32,451 10B,319 8B,000 3.239 2,670 699 169,380 723 2,456 16,500 53,568 26,100 232,195 306,051 13.770 15 1 600 40,590 106,613 3.394 3,553 2,875 752 114,245 3,479 3,694 2,935 767

-822,528

-100.0% 18.0% 9,0% -100.0% -1.6% -96.1% 9.7% 7.7% 7,6% -100.0% -100.0% 460.7% -100.0% -100.0% 789.6% 73,856

15 1 60:0

0.0< 43,479 -3, &95 7,632 85 141 60 15 35.9% "24.7% 0.0% 7.2% 2.5% 4.0%

2.1%

121 1 008 15 / 753

164 , 487 11,858

IS,459: 1,305 -32,451 -1,706 -84,606 314 205 53 -169,380 -723 11,314 -16.500 -53,568 206,095

2.0% 0.0% 100.0% 194.8% 0.0% 0.0% 31.8%

26, B20

ltah.1b!t n ..n, cut of liIIad1eal Act.iv1U,·· (f.~ 5 of 5)

104

Defense Health Program

Fiscal Year (FY) 2012 Budget Est~ates Exhibit PB-11A, Personnel Summary

FY 2010 Actual End Avg strength Strength FY 2011 Estimate End Avg Strength Strength

FY 2012 Estimate End Avg Strength Strength

FYII-12 Change End Avg Strength Strength

Active Military Army Total Officers Enlisted Navy Total Officers Enlisted

Assigned to DHP 25,866 11,506 14,360 26,709 8,580 18,129 31,510 11,158 20,352 84,085 31,244 52,841

off~cer

24,816 11,142 13,675 26,351 8,526 17,826 31,058 11,091 19,967 82,225 30,758 51,467

26,207 11,573 14,634 27,220 8,662 18,558 31,519 11,157 20,362 84,946 31,392 53,554

26,037 11,540 14,497 26,965 8,621 18,344 31,515 11,158 20,357 84,516 31,318 53,198

26,748 11,889 14,859 27,715 8,790 18,925 31,544 11,164 20,380 86,007 31,843 54,164

26,478 11,731 14,747 27,468 8,726 18,742 31,532 11,161 20,371 85,477 31,618 53,859

541 316 225 495 128 367 25 7 18 1,061 451 610

441 192 250 503 105 398 17 3 14 961 300 662

/l

Air Force Total Officers Enlisted Total Active Duty Officers Enlisted

I~

Includes one USMC DHP

strength

Active Military Army Total Officers Enlisted Navy Total Officers Enlisted Air Force Total Officers Enlisted Total Active Duty Officers Enlisted

Non DHP Medical 21,705 4,168 17,537 10,852 1,830 9,022 2,040 780 1,260 34,597 6,778 27,819 20,937 3,980 16,957 9,609 1,841 7,768 2,107 790 1,317 32,653 6,611 26,042 21,931 4,266 17,665 12,375 2,392 9,983 1,994 776 1,218 36,300 7,434 28,866 21,818 4,217 17,601 11,614 2, III 9,503 2,017 778 1,239 35,449 7,106 8,343 21,971 4,270 17,701 12,149 2,145 10,004 1,992 774 1,218 36,112 7,189 28,923 21,951 4,268 17,683 12,262 2,269 9,994 1,993 775 1,218 36,206 7,312 28,895 40 4 36 -226 -247 21 -2 -2 0 -188 -245 57 133 51 82 649 158 491 -24 -3 -21 758 206 552

Exhibi t PB-llA, Personnel Summary (Page 1 of 3)

105

Defense Health Program

Fiscal Year (FY) 2012 Budget Estimates

Exhibit PB-11A, Personnel Summary

FY 2010 Actual End Strength FTEs FY 2011 Estimate End Strength FTEs FY 2012 Estimate End Strength FTEs FY11-12 Change End Strength FTEs

I.

Civilian Personnel US Direct Hire Army Navy Air Force TRICARE Management Activity Total

40,092 12,937 7,075 1,572 61,676

37,456 12,019 6,488 1,426 57,389

38,316 12,800 6,808 1,383 59,307

37,480 12,614 6,219 1,367 57,680

36,608 12,452 7,223 1,499 57,782

35,772 12,266 6,512 1,483 56,033

-1,708 -348 415 116 1,525

-1,708 -348 293 116 -1,647

II.

Civilian Personnel Foreign National Direct Hire Army 449 431 227 Navy 219 107 Air Force 107 TRICARE Management Activity o o 757 Total 783

433 236 89

428 213 95

383 236 94

378 213 95

-50

-50

o

5

o

758

o

736

o

713

o

686

o

-45

o o o

-50

III. Civilian Personnel - Foreign National Indirect Hire Army 1,103 1,033 Navy 434 423 Air Force 235 232 TRICARE Management Activity 5 5 1, 777 Total 1,693 IV. Total Civilian Personnel Army Navy Air Force TRICARE Management Activity Total /l

1,032 448 242 5 1,727

1,012 430 237

5

997 448 242

5

977 430 238

5

-35

-35

o o o

-35

o

1

o

-34

1,684

1,692

1,650

41,644 13,598 7,417 1,577 64,236

38,920 12,661 6,827 1,431 59,839

39,781 13,484 7,139 1,388 61,792

38,920 13,257 6,551 1,372 60,100

37,988 13,136 7,559 1,504 60,187

37,127 12,909 6,845 1,488 58,369

-1,793 -348 420 116 -1,605

-1,793 -348 294 116 -1,731

V.

Summary Civilian Personnel U.S. Direct Hire Foreign National Direct Hire Foreign National Indirect Hire Total, Civilians /1

61,676 783 1,777 64,236 421

57,389 757 1,693 59,839 645

59,307 758 1,727 61,792 438

57,680 736 1.684 60,100 618

57,782 713 1. 692 60,187 438

56,033 686 1,650 58,369 619

-1,525 -45 -35 -1,605

-1,647 -50 -34 -1,731

1

o

/1

Includes reimbursable civilians -

memo

Exhibit PB-llA, Personnel Summary (Page 2 of 3)

106

Defense Health Proqram

Fiscal Year (FY) 2012 Budqet Est~ates Exhibit PB-11A, Personnel Summary

FY 2010 Actual End

Strenqth

FTEs FY 2011 Estimate End Strength FTEs

FY 2012 Estimate End Strength FTEs

FYll-12 Change End Strength IT.§..2.

SPECIAL INTEREST MANPOWER TRICARE Regional Offices (TRO) : Military Civilian TRICARE Management Activity (PE 0807798) Military Civilian Army Management Headquarters (PE 0807798) Military Civilian Navy Management Headquarters Military Civilian Air Force Management Headquarters Military Civilian (PE 0807798) 204 192 (PE 0807798) 399 150 399 129 399 119 399 113 399 144 399 138 0 25 0 25 204 166 204 173 204 170 204 173 204 170 0 0 0 0 104 493 104 457 109 462 107 455 110 450 110 443 1 12 3 -12 3 68 6 65 0 69 2 69 0 69 0 69 0 0 -2 0 1 129 1 119 1 143 1 143 1 143 1 143 0 0 0 0

Note: Some numbers do not add due to rounding.

Exhibit PB-llA, Personnel Summary (Page 3 of 3)

107

De~en.e a ...l th Progl:'UJ

Fisc..l Year (FY) 2012 Sudg.t :a::st1maUs

Cost ot. HedicAl Activiti·· - Madic.l Workload Data

(Total Comp Lavel)

o.t.ns. U...l.th Program

Medical WorkloAd and Produativi ty Oata

(Act"al)

fY 2010 FY 2011 rY 2012

EstilnatG

l'Y 2010

~

2011

Actual

ponU]

E:jtlmate

1~ 558, 909 2,245 s 074 1,086 / 209 2,221,739 7,111,931 2,054,973 9 1 166,904

chang_

FY 2011 ~ 2012 Chan.".

itl on

-

Average

Eliaible Bfflaf:i 91 aries

ccmys

1,551,462 2~ 236 1 805 1# 088,780 2,204,498 7. OSl, 545 2,023,280 9,104,825

Active Duty Active Duty Dependents CHAMPUS Eligible Retirees CHAMPUS Eligible Dependents of Retirees Subtotal CRAMPUS Eligible Medicare Eligible Beneficiaries Total Average IUigible Beneficiaries

Population AVerage Eligible BeMfigia.ie, QCQNUS

1,554,695 2,235,334 It 069,510 2,225,557 7(085,096 2,104,178 9 r 189, 273

7 r 447 a,269 -2,571 17,242 30,386 31,693 62,079

-4,214 -9,740 -16,700 3,818 -26,835 49,205 22,370

Active Duty ActiVe Duty Dependents CHP..MPUS Retirees CHP..MPUS Dependents of Retiree,s Subtotal CHAMPUS l igible Medicare Eligible Beneficiaries Total Average Eligible Beneficiaries

Pgpulati.on - Averaae ilig] b l . Beneficiari.es Worldwide

185,459 171,334 21,921 53,597 432,311 32 i 157 464,467

184,941 173,018 21,053 52,045 431,056 32,484 463,540

180 t 805 171,419 20,231 50,662 423,116 32,832 455 / 948

-518 1,684 -868 -1,552 -1,255 326 -927

-4,136 -1.599 -823 -1,363 -7,940 348 -7,592

Active Duty Active Duty Dependents CRAMPUS lUigible Retirees CHAMPUS Elistible Dependents of Retirees Subtotal CHAMPUS Eligible Active Duty Members Guard/Reserve Family Members Retirees Family Members of Retirees survivors Other Total Medicare Eligible Beneficiaries Total Average Eligible Beneficiaries Notes:

l.

L 736 1 921 2,408,139 1,110,701 2,258,094 7,513,855

7/677 2,393 974,559 630,329 438,758 1,721 2 1 055,437 9 , 569,292

1,743,850

2 / 418,091

1,107,262 2$ 273, 784 7,542,987

It 735,500 2; 40(;, 753 1 1 089,740 2,276,219

7,508 t 212

7,741 2,402 1,014,628 649,223 461,289 It 729 2,137,010 9,645,221

6,929 9,952 -3,439 15,690 29,132

-8,350 -11,339

-11 t 522

2,436 -34,775

7,767 2,396 989 f 155 636 f 336 450,072 1,732: 2,087,457 9,630,444

91 14,596 6,007 11,314 11 32,021 61,152

-27

25,473 12,887 11,217

-3 49,553 14,178

2.

3.

The data are derived from the Managed Care Forecasting and Analysis System (MCFAS) -- Data Verl;!:ion FY2009.0. Medicare Eligible total does not include Active Duty Beneficiaries or Activated Guard/Reset've who are identified in DEERS as Medicare 'eligible. For Active Duty, their healthcare Numbers may not sum to totals due to rounding.

Bxhibtt 0-11B, .-cU.o.l Worklo&d. and. Productivity t>.ta n.pi 1 o~ 3)

108

Defense Health frogram

Fisaal Year (FY) 2012 Budget Estimat··

CQst of Mediaal Activi-tie. . . Mediaal Workload Data

(Total COnq> Level)

DEFENSE HEAlo'l'H PROGRAM

Med..iaal WortlQad and Proc:luativ.i.ty Data

F¥ 2010 i\ctual

Enroll.as F'l 2011

f'{ 2012 E$ti'IMh

E$timate

FY 2010 2011 chang.

F'f 2011

- 2012 Change

Di.rect. Ca.ra TRICARE Region TRICARE Reqion TRICARE Region TRICARE Region TRICARE Region TRICARE Region -

North South West

Latin America

Alaska 1 Sub-Total CONUS Regions Sub-Total OCONUS Regions Total Direct Care Enrollees Source: FY2010 = M2; FY 2011-2012

949,195 931,325 1,0132,846 l132 f 110 116,579 1,119 65,931 2,963,366 299, aoa 3,263,174

897,958 1,030,206 1,103,934 171,889 121,281 1,147 66,716 3,032,098 299, BOB 3,331,906

898# 651 1,064,107 l,124,9BO 172,796 121,360 1,147 66,686 3,087,73B 299, B08 3,3S7,546

-51,237 98, ae1 21,Oee -10,221 4,702 28 785 68,732 ISS,966 257,698

693 33,901 21,046 907 79 -30 55,640 188,966 244,606

Service Medical Departments Business Plans as Projected December 2010

tAlaska in the West Contract is not underwritten therefore not included in the total

Enroll... - Managed Car&: Support Contract TRICARE Region North TRICARE Region - South TRICARE Region - West Total MCS Contracts

In'~Ju!tnl~ty;[§; 1b.S=ty~J, ~.~i!l

447 f 672 614,818 375,697 1, 43a, 187

492,486 662,6B3 406,152 It 561, 321

543,166 716,129 440,213 1,699,508

44,814 47 f 865 30,455 123,134

50,6BO 53,446 34,061 138,187

Inpatient Facilities Medical Clinics Dental Clinics Veterinary Clinics

59 364 262 288

59 365 281 255

56 363 274 253

-1

-33

-3 -2 -7 -2

o:tnNSE HEALTH PROGRAM Mediaal Workload and Producti vi ty Data.

FY 2010 Actual Oiregt Care System Workl.gad (frgm 112 FY 2011 E!!Itimate

!'Y 2012

E~timate

n 2010

Change

2011

!'Y 2011

- 2012 Change

and

Business PI ann.'

09'

TOQl)

Inpatient Admissions ~SIDR Dispositions) Occupied Bed Days Inpatient Weighted Workload (MS-DRG RillE's} Average length of stay \ Bed Days/Disposi tions) Total Ambulatory Visits (Aggregate Weight APCs) Outpatient Relative Value Units (Total Enhanced RVUsj

260,055 796,350 215,035 3.06 35,247,219 76,784,818

273,865 B51,910 227,192 3.11 34,276,012 75,449,299

265,B79 807,813 215,347 3.04 34.469,718 75,474,163

13,810 55,620 12,151 0.05 -971,201 -1,335,519

-7,986 -44,157 -11,845 -0.07 193 , 106 24,864

~umber

CONUS

OCONUS

of Scripts

48,104(898

48,613# 506

49,436,495

50a) 606

822,9BB

Dental WorkJ,oad (Pen tal Weighted Values

<PH'Vsl)

13,921,006 2,713,765 16,634,771 14,224,717 2, B57, 090 17,081,807 14,576,11B 2,923,416 17,499,534 303 r 711 143,325 351,401 66,326 0

Total DWVs

=.tlll

Active Duty Non-Active Duty Total CONUS

Q£Qlli!!l. Active Duty Non-Active Duty Total CONUS

12,464,021 1,456,9a5 13,921,006

12,733,082 1,491,635 14,224,717

13,041,712 1,534,406 14,576,118

269,061 34,650 303,711

308,630 42,771 351,401

1,782,080 931,686 2,713,765

1, 87B, 939 97B,151 2,857,090

1,921,716 1,001,699 2,923,415

96, S59 46,465 143,325

42,777 23,548 66,325

Exhibit PS-llB. Hod1oal

Wo~klQU

a.nd Proclvotivity Data

(Pap 2 01 3)

109

Oet'en.. aeal th Program Fiacal Year ("} 2012 B1Jdget E.timatea Coat ot' Medical Ac'Uv1t1 ·· - MedL1cal Workload Data (TotAl Comp x..vel)

DEFENSE B&ALTH PROGRAM Medical Workload and Produot.ivity Data

FY 2010

Actual

t't 2011 Estimate

P''i 2012

El:IItitnate

f'i' 2(HO - 2011

F'i 2011

Ch4tlg:6

2012

Change

Private Sector Workload Managed care Support Contracts (TRICARE Prime) Inpatient Admissions Inpatient Realtive Weighted Product (RWPs} Outpatient Visits outpatient Revaltive Weighted Units (RVU::;) TRlcARE Extra/Standard Inpatient Admissions Inpatient Realtive Weighted Product {RWPs) outpatient Visits Outpatient Revaltive Weighted Units (RVUs) Overseas CHAMPlIS Inpatient Admissions Inpatient Realtive Weighted Product (RWf's) Outpatient Visits outpatient Revaltive Weighted Units (RVUs) Pharmacy

Retail

Number of scripts

Mail Order Number of scripts

280,742 254 t 058 35,648,908 41,567,618

281,865 255,074 38,322,576 44,685,190

282,146 255,330 40,813;544 47,589,727

If 123 1,016 2 ( 673,668 3,117,571

282 255 2,490,967 2,904,537

117,053 128,158 233, 80a 18.168,1t17

15~

117,521 128.671 16¥376,343 19,530, aOl

117,638 12a. aDO 17, 440,fl05 20,800.303

468 513 1,142,536 1,362,614

118 129 1,064.462 1,269,502

14,861 7,911 412,111 322.682

14,647 7,736 421,520 316.753

14,436 7,564 431.143 310,932

-214 -175 9,408 -5,930

-211 -171 9,623 -5,821

33,655,990

35,002,126

35 1 352( 147

1,346,236

350,021

2,371,891

2,537,923

2,664,820

166,032

126,896

TRICARE Dental Program Enrollment - Single Plan Enrollment - Family Plan Enrollment - Survivor Single Plan Enrollment - Survivor Family Plan

302,849 467,982 467 1,040

313,737 '483,441 452 1,181

331,442 496 1 166 442 1,172

16,759 12,967 -10 -10

17,705 13,325 -10 -9

Uniformed Services Family Health Plan Enrollees (Non-Medicare eligible, 000 Only! Enrollees (Medicare eligible, 000 only)

102,631 65,345 37,286

105,616 67 t 303 38,313

110,108 70,111 39,337

4,271 3,275 996

4,492 3 t 468 1,024

Exh.i.bit PB-llB f lil&dic&l

Wo~k10&d

and

P~tivity

J)&ta (Page 3 of 3)

110

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HCFA-1500 1/98