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Commander's Corner

David Lipin - Unit Commander

Hello all, and welcome to the May edition of our newsletter. I've got quite a lot to cover this month, and it's as challenging as last month's message. So let's dig in.

NDMS Re-alignment

We've learned a lot more about the pending NDMS re-alignment. To start, if you didn't read my segment from last month, I'd strongly encourage you to scroll down and read that one first because it will provide a lot of context for this continuation article. My other recommendation is to come to the May team meeting if you can, because we'll go into the details there and have plenty of time to answer questions and address concerns.

As I mentioned in last month's article, NDMS is about to undergo a broad realignment. As of the publication of this newsletter, it hasn't yet been approved and we don't have specifics as to dates and deadlines. But we expect it to begin soon, and we expect the roll-out to take place over many months to make the transition as smooth as possible.

The overall concept is not new; we've been talking about it for many months now -- smaller DMATs capable of fielding smaller, more nimble teams, a more modular footprint and cache, etc. But we now have some further details to expand upon.

One of the items I discussed last month was a consolidation to fewer types of positions. For example, instead of having a spectrum of RN positions, there will now be only one. Ditto for every other position. This means that as we consolidate into these single positions, some people will have their GS level reduced (which will be automatic and not require any effort on your part). If you are one of these individuals, we will notify you by email in the next few days.

Others will have their GS level increased, but this will not be automatic -- you will have to re-apply for your position; basically, you'll be "starting over" and have to go to USAJobs.gov and apply for your position. We're not ready for this yet, but it will be coming relatively soon. If you are one of these individuals, we will notify you by email in the next few days, and we encourage you to go to the USA Jobs website now, create your account/profile, update and upload your resume as well as a current copy of your medical license, and begin the process of acquiring your transcript from your medical school following the instructions on the USA Jobs website. Unfortunately, this will impact roughly 35% of our members. We'll review this in more detail at the upcoming meeting in May.

One of the upsides of this is that some of you will be able to apply for position changes to match your current licensure; we have several members who were hired into one position (e.g., nurse) but have advanced their careers and are now a different position (e.g., nurse practitioner). This will give those individuals an opportunity to "upgrade" to match their current licensure.

One of the new requirements is an increase in the number of clinical hours required to hold a medical position on the team. Since NDMS will be smaller, it wants to focus on clinically-active people. The number being bounced around is 32 hours per month of clinical work (on average), including paid and/or volunteer work. It's not approved yet, so this may change. But if you're not clinically active, we encourage you to start looking into opportunities to increase your clinical hours. We believe that this requirement will impact about 15% of members, and we will email you in the coming days if you're one of the members potentially impacted by this new requirement.

Another of the new requirements is the set of physical/health "fitness to deploy" criteria. These are not new, and we've been working on these as a team for many months now. But safety is an increasing concern for us (none of us is getting any younger!), and all of our members must be physically capable of deploying into an austere environment -- none of us wants to be a burden on the team or put the team's mission at risk. So it's important for everyone to work on being fit and healthy! But we should all be realistic about this, and accept that not every member is going to meet this criteria.

Now for the really bad news: the team will need to shrink in size, and some positions will be eliminated entirely. Mostly these are in areas where there is an overlap in federal service, where some other federal position can cover the position or function served by these individuals (i.e., reduction in overlapping services). Some of this may happen through attrition, but we don't expect attrition alone will suffice. There surely will be members that we have to let go from the team. We'll discuss this in greater detail at the team meeting, but we don't think it's fair to surprise anyone at the meeting so if you are (or might be) one of the members impacted by this part of the re-organization, I or someone from the command staff will call you over the next few days.

Note that we will be hiring soon, and anyone (including current members) can apply for any opening that we may have. So some people whose positions are being reduced or eliminated may be interested in applying for different positions on the team where we have vacancies. We'll review the new roster and our vacancies at the meeting, but we should not have the unrealistic expectation that every impacted member will be able to find a new position, due to the changes in requirements and overall reduction in total team size.

Overall, we estimate that just shy of 85% of our members will be impacted in some way. We can't predict the impact of the physical/health requirements, but for all of the other requirements we will reach out either by email or phone over the next few days to everyone that we think will be impacted. So if you don't hear from us soon, you're one of the roughly 15% or so that isn't impacted by these changes and you won't have to do anything through this transition other than meet the physical/health requirements. (See the next segment below for more information on that.)

This will be a tough transition for us, especially for those whose "DMAT career" will get cut short. But at the very least we should remember that we don't have a timeline on this, so it very well might take many months (or even longer) to complete, and it's not yet approved so we don't know what the final picture will look like. We hope to synchronize this transition with new hiring, so that we can maintain our capability as we work through this over time -- and give current members the opportunity to change to a different position if they need or want to.

The NDMS plan is to get this information out in the very near future, so I am planning on spending extra time at the May meeting to review this in greater detail, explain the strategy and reasoning, and help all of our members understand the impact on them and on the team. So please plan on attending the May meeting if you can.

Responder Health

Many of you have already had the experience of completing your Responder Health Statement (RHS) online, if you were on one of the rosters last year where we trialed that HQ-based system. Now they are rolling it out system-wide during on-call months, so I expect that our team will have to submit their RHS online during our June on-call month. They have been iterating to improve it based on their experience from the previous month, so I can't really say what it will look like when our turn comes. Expect one or more email messages directly from HQ with instructions -- I will send out an email to the team when I see those emails go out, so you know it's "for real". Note that this is a mandate. It doesn't matter whether you're available for on-call in June or not, you will still have to complete the RHS during the specified period (whatever that turns out to be). Keep track of your actual time spent (how much time on what day or days), because you'll be paid for that time. HQ estimates an average of 30-45 minutes to complete this, but some people will be able to complete it more quickly (especially if you've previously gone through it), and some may take longer due to IT or other issues. Just be patient, thoroughly read and follow the instructions you're provided, and keep track of your time. We'll provide what assistance we can when this process begins.

Thanks for the Help!

San Francisco sends its thanks to Ron Shuman and Mark Caplin for helping out at their recent disaster exercise. Over 20 clinic staff from the three-clinic system of Northeast Medical Services in San Francisco were trained in various disaster medical skills as primary care clinicians using the SF DPH curriculum, and then they participated in a tabletop and functional MCI exercise with an earthquake scenario guided by the instructors. Pictured in the photo (left to right) are Bob Goodnough and Karla Canseco (Emergency Medicine Residents at ZSFG/UCSF), Cindy Lambdin (SF DPH), John Brown (SF DPH and CA-6 member), Kenpou Saelee (SF DPH), Eric Silverman (EMS/Disaster Medicine Fellow at ZSFG/UCSF), Mark Caplin (CA-6 member) and Ron Shuman (CDMSA SF member). Also participating (but missing from the photo) was Josephine Valenzuela, another EM Resident (ZSFG/UCSF).



CAL-MAT Program Launch

As I mentioned in last month's article, the California EMS Authority assumed responsibility for the CAL-MAT program effective May 1, so that CAL-MAT members will now be state emergency hires, be paid by the state on deployments, and have liability, worker's compensation and other protections from the state. We will have someone from EMSA at our May meeting to describe the new program and how it will work. If you just can't wait, you can click here to read about the CAL-MAT program and even start the application process (but we'll also explain it at the May meeting).

So for several reasons, I'm looking forward to seeing everyone at our May meeting!

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