DTM 24-003, "Military Health System Manpower Requirements Determination, Resourcing, and Assignment" June 28, 2024

OFFICE OF THE UNDER SECRETARY OF DEFENSE

4000 DEFENSE PENTAGON

WASHINGTON, D.C. 20301-4000

PERSONNEL AND

READINESS

June 28, 2024

MEMORANDUM FOR SENIOR PENTAGON LEADERSHIP

DEFENSE AGENCY AND DOD FIELD ACTIVITY DIRECTORS

SUBJECT: Directive-Type Memorandum 24-003 – “Military Health System Manpower

Requirements Determination, Resourcing, and Assignment”

References: See Attachment 1

Purpose. In accordance with the authority in DoD Directive 5124.02 and the

December 6, 2023 Deputy Secretary of Defense Memorandum, this directive-type memorandum

(DTM):

• Incorporates and cancels Deputy Secretary of Defense Memorandum,

“Managing Military Personnel Resources in the Defense Health Program and

the Special Operations Command,” June 22, 2006.

• Establishes policy, assigns responsibilities, and provides procedures for:

o Planning and programming the uniformed medical and dental

workforce within military medical treatment facilities (MTFs) and dental

treatment facilities (DTFs).

o Documenting military medical authorizations allocated to the

Defense Health Agency (DHA).

o Assigning uniformed medical and dental personnel on orders to

DHA MTF/DTFs and other DHA organizational units.

o Providing availability of uniformed medical and dental personnel

to the Military Departments and Military Services when such personnel

are assigned on orders to DHA MTF/DTFs and other DHA organizational

activities.

o Providing accountability for the Secretaries of the Military

Departments to provide military manpower to DHA MTF/DTFs and other

DHA organizational units.

DTM-24-003, June 28, 2024

o Providing accountability for the Director, DHA to report on

civilian employee hiring to the Under Secretary of Defense for Personnel

and Readiness (USD(P&R)) and the Secretaries of the Military

Departments through the Assistant Secretary of Defense for Health Affairs

(ASD(HA)) at least quarterly, and effectively and efficiently use its

workforce (i.e., military, civilian, and contractor personnel) to carry out its

assigned missions.

o Establishing that a single military officer will be dual-hatted and

serve as the MTF/DTF Director, under the authority, direction, and control

of the Director, DHA, and the Service commander, under the command

and control of the Military Department concerned.

• Is effective June 28, 2024; it must be incorporated into other appropriate DoD

issuances. This DTM will expire effective June 28, 2025.

Applicability. This DTM applies to OSD, the Military Departments, the Office of the

Chairman of the Joint Chiefs of Staff and the Joint Staff, the Combatant Commands, the Office

of Inspector General of the Department of Defense, the Defense Agencies, the DoD Field

Activities, and all other organizational entities within the DoD.

Definitions. See Glossary.

Policy.

• DHA MTF/DTFs are the keystone component of the Military Health System

(MHS).

• Service members, civilian employees, and contract personnel at DHA

MTF/DTFs support the wellness, health, and medical readiness of the total force.

• DHA MTF/DTFs educate, train, maintain, deploy, and retain ready medical

forces, in addition to delivering timely and effective care for legally defined

beneficiaries.

• DoD estimates and reports provided through the MHS governance process,

medical operations deputies group, or other governance body as directed, will

include and address specific DHA MTF/DTF capacity in crisis or conflict to treat

wounded, ill, and injured Service members. Maximizing the patient care within

DHA MTFs/DTFs improves the effectiveness of the MHS in meeting Military

Department and joint medical requirements.

DTM-24-003, June 28, 2024

• The transfer of responsibility for all MTFs/DTFs from the Military

Departments to the DHA, pursuant to Section 1073c of Title 10, United States

Code, requires realignment of processes, roles, and responsibilities to assure a

uniformed medical workforce is available at DHA MTF/DTFs.

Responsibilities. See Attachment 2.

Procedures. See Attachment 3.

Releasability. Cleared for public release. Available on the Directives Division Website

at https://www.esd.whs.mil/DD/.

Ashish S. Vazirani

Performing the Duties of the Under Secretary of

Defense for Personnel and Readiness

Attachments:

As stated

DTM-24-003, June 28, 2024

4 Attachment 1

ATTACHMENT 1

REFERENCES

Deputy Secretary of Defense Memorandum, “Stabilizing and Improving the Military Health

System,” December 6, 2023

DoD 7000.14-R, Volume 11A, “DoD Financial Management Regulation: Reimbursable

Operations Policy,” current version

DoD Directive 5124.02, “Under Secretary of Defense for Personnel and Readiness

(USD(P&R)),” June 23, 2008

DoD Instruction 1100.22, “Policy and Procedures for Determining Workforce Mix,” April 12,

2010, as amended

DoD Instruction 1120.11, “Programming and Accounting for Active Component (AC) Military

Manpower,” March 17, 2015

DoD Instruction 4000.19. “Support Agreements,” December 16, 2020

DoD Instruction 7000.14, “Department of Defense Financial Management Policy,” August 10,

2020

DoD Instruction 7730.64, “Automated Extracts of Manpower and Unit Organizational Element

Files,” December 11, 2004

United States Code, Title 10

DTM-24-003, June 28, 2024

5 Attachment 2

ATTACHMENT 2

RESPONSIBILITIES

1. USD(P&R). The USD(P&R):

a. Analyzes the total force structure as related to quantitative and qualitative military and

civilian employee personnel requirements, use, readiness, and support.

b. Administers and implements controls over military and civilian employee personnel

strengths and compositions for all DoD Components.

c. Establishes and issues guidance to be used by all DoD Components regarding

manpower management, including manpower mix criteria.

2. ASD(HA). Under the authority, direction, and control of the USD(P&R), the ASD(HA):

a. Manages military authorizations allocated to the Defense Health Program (DHP).

b. Authorizes adjustments to military authorizations aligned to the DHP.

c. Coordinates all adjustments to military authorizations aligned to the DHP with the

Military Departments during the programming and budgeting processes.

d. Develops and maintains business rules to execute the procedures outlined in this

issuance in coordination with the Secretaries of the Military Departments and the Director, DHA.

e. Reviews and approves the Director, DHA’s Human Capital Distribution Plan.

3. DIRECTOR, DHA. Under the authority, direction, and control of the USD(P&R), exercised

through the ASD(HA), the Director, DHA:

a. Acts as the privileging or scope of practice authority for health care personnel in an

MTF/DTF.

b. Coordinates with each Secretary of a Military Department on a Military Service

manpower document that identifies military medical personnel authorized at DHA MTFs/DTFs

and other DHA organizational units by location, grade, and skill set to align with DHA’s unit

manning document (UMD).

c. Identifies the capacity of each DHA MTF/DTF to sustain clinical readiness and force

development of military health care personnel.

DTM-24-003, June 28, 2024

6 Attachment 2

d. Determines the clinical product lines and their respective scope at each DHA

MTF/DTF to support both operational readiness and quality, access, and continuity in the

delivery of health care services to Service members and other eligible beneficiaries.

e. In coordination with the Secretaries of the Military Departments, plans for and

accommodates the absence of military medical personnel from the DHA MTF/DTF and other

DHA organizational units, to meet validated operational and training requirements.

f. Is responsible for overseeing civilian employee manning and contractor personnel in

the DHA MTFs/DTFs, and other DHA organizational units and effectively and efficiently using

the workforce (i.e., uniformed, civilian employees, and contractor personnel) assigned to, or

otherwise working in, the DHA to carry out DHA’s assigned missions. The Director, DHA, will

report on DHA civilian employee hiring to the ASD(HA) and the Secretaries of the Military

Departments at least quarterly.

g. Is responsible for the absence or lack of availability of the civilian workforce in DHA

MTFs/DTFs and other DHA organizational units.

h. Through the DHA MTF/DTF Director, exercises authority, direction, and control of

DHA MTF/DTF operations and of all personnel assigned, allocated, or detailed, to perform

duties and functions associated with DHA MTF/DTF operations, including the delivery of health

care services and business operations.

i. Selects, after considering nominations from the Secretaries of the Military

Departments, DHA MTF/DTF directors.

j. Creates the Human Capital Distribution Plan. This includes:

(1) Revalidating DHA MTF/DTF staffing for projected Military Service

vacancies of authorized billets, as outlined in the program objective memorandum (POM)

manpower requirements process, and determines prioritization by military occupational specialty

and location.

(2) Submitting staffing requests to the Military Services, according to the

Secretary of the Military Department’s manning guidance and distribution processes, to ensure

sufficient time for planning and response to such requests.

4. SECRETARIES OF THE MILITARY DEPARTMENTS. The Secretaries of the Military

Departments:

a. Exercise administrative control of uniformed medical and dental personnel assigned to

DHA MTFs/DTFs and other DHA organizational units, including as such control pertains to

personnel assignments and the issuance of military assignment orders.

b. Nominate the highest quality candidates to serve as a DHA MTF/DTF director to the

Director, DHA in accordance with Military Department policies and procedures.

DTM-24-003, June 28, 2024

7 Attachment 2

c. After consultation with the Director, DHA, may remove a Service commander, who is

also dual-hatted as an MTF/DTF director, or relieve them of the authority to act as a Service

commander, in accordance with Military Department policies and procedures.

d. Primarily assign uniformed medical and dental personnel on orders to DHA

MTFs/DTFs absent:

(1) Specific, validated operational and training requirements identified by the

Secretaries of the Military Departments; or

(2) Exigent circumstances.

e. Have access to their uniformed medical and dental personnel for all validated Military

Service duties, including both planned and unplanned deployments, military operations, training,

and exercises.

f. Are responsible for the absence or lack of availability of the programmed uniformed

medical and dental workforce in DHA MTF/DTFs and other DHA organizational units because

of Military Service duties.

g. Will identify and notify the Director, DHA of operational and training requirements to

be accomplished by military personnel assigned on orders to a DHA MTF/DTF.

h. In support of the Director, DHA’s Human Capital Distribution Plan, will review

vacant authorized Military Service billets to inform assignments for uniformed medical and

dental personnel for the upcoming fiscal year in a mutually beneficial timeline that aligns with,

and facilitates, Military Department assignment cycles. In support of this process, the Secretaries

of the Military Departments will:

(1) Determine availability of staffing to meet DHA requirements based on their

respective distribution processes.

(2) Provide their feedback and ability to fill the DHA MTF/DTF staffing

requirements to the Director, DHA.

(3) Provide documentation outlining their projected ability to fill the Director,

DHA’s authorized military vacancies.

i. Through their respective Service commander:

(1) Exercise administrative control of uniformed medical and dental personnel on

assignment orders to DHA MTFs/DTFs.

(2) Ensure that uniformed medical and dental personnel assigned to a DHA

MTF/DTF obtain and maintain clinical currency and readiness at, or above, established

thresholds, and provide venues and opportunities for uniformed medical and dental personnel to

meet non-clinical readiness standards and career-enhancing Military Service training, as

prescribed by the Military Department.

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8 Attachment 2

(3) Communicate to the Director, DHA, Military Department contingency and

operational requirements, including both planned and unplanned deployments, and Military

Service operations and exercises, thereby enabling the Director, DHA to plan for, and

accommodate, the absence of uniformed medical and dental personnel from duty at the DHA

MTF/DTF.

(4) Establish clinical and non-clinical training requirements applicable to Military

Service medical and dental personnel and provide as much advanced notice to Director, DHA as

practicable of any requirement for Service medical or dental personnel assigned to a position on

a Military Service manpower document but allocated against a manpower requirement on a DHA

MTF/DTF UMD to participate in such training.

(5) Exercise command and control over Military Department medical and dental

personnel executing Military Service duties.

DTM-24-003, June 28, 2024

9 Attachment 3

ATTACHMENT 3

PROCEDURES

1. PLANNING AND OVERSIGHT. The USD(P&R) will conduct an annual review of all

validated and funded military medical and dental requirements, in coordination with the Director,

DHA, and the Secretaries of the Military Departments.

a. The review will be conducted in the first quarter of each fiscal year.

b. The results of the review, which informs risk as to how forces are arrayed, will be

presented to the MHS Executive Review for review and validation. The USD(P&R) may request

this information be briefed at a subsequent Deputy’s Management Action Group or Deputy’s

Workforce Council.

2. MEDICAL MANPOWER REQUIREMENT DETERMINATION.

a. The Director, DHA, will:

(1) In coordination with the Secretaries of the Military Departments, forecast and

identify the capacity of each DHA MTF/DTF to sustain clinical readiness of uniformed medical

and dental personnel consistent with requirements established by the ASD(HA) and the

Secretaries of the Military Departments.

(a) The requirements referenced in Paragraph 2.a.(1) will be established

across the Future Years Defense Plan (FYDP) and take into consideration Military Service

mission changes occurring in future years, and program the resources necessary to meet mission

changes, as part of the annual DoD Planning, Programming, Budget, and Execution process.

(b) Determine and regularly validate total manpower requirements in

accordance with DoD Instruction (DoDI) 1120.11, specifically the number of medical and dental

staff by occupational specialty, at each DHA MTF/DTF, considering Military Service mission

changes in future years.

(2) Forecast and recommend uniformed manpower resourcing requirements to

the Secretaries of the Military Departments across the FYDP as part of the annual DoD Planning,

Programming, Budget, and Execution process, in accordance with DoDI 1120.11.

b. The Secretaries of the Military Departments will determine workforce mix for military

requirements in accordance with DoDI 1100.22 and in coordination with the Director, DHA.

c. Personnel and staffing disagreements (e.g., manpower issues within the year of

execution or requested budget year) will be adjudicated through the MHS governance process.

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10 Attachment 3

d. Programming issues and resourcing gaps will be adjudicated through the DoD

Planning, Programming, Budget, and Execution process annually, in accordance with

DoDI 7000.14. The Director, DHA will submit civilian employee manning issues, and the

Secretaries of the Military Departments will submit uniformed medical and dental personnel

manning issues.

e. The manpower requirements established by this review will be recorded on a DHA

requirements document for every DHA MTF/DTF and will be documented in the Fourth Estate

Manpower Tracking System.

3. RESOURCING.

a. Developing Medical POMs.

(1) The Secretaries of the Military Departments will update and inform the

Director, DHA of potential mission or force structure changes across the FYDP that will drive

changes to DHA MTF/DTF resourcing and staffing requirements.

(2) The ASD(HA) will publish DHP POM guidance no later than the first week

of January each year. This guidance will include a schedule of milestones to meet timelines

established by published DoD program and budget review guidance.

(a) The Director, DHA will validate manpower requirements, informed by

previous POM and fill rates, regardless of type (e.g., uniformed, civilian employee, contractor

personnel) for each DHA MTF/DTF by Military Department occupational specialty.

(b) The Secretaries of the Military Departments will review DHA

manpower requirements identified in the DHA POM baseline and provide the Director, DHA

with their programmed level of support.

requirements using civilian employees or contractor personnel against validated staffing model

requirements at each DHA MTF/DTF. The Director, DHA must program the associated

operations and maintenance funding for civilian or contractor pay as part of the DHP POM

submission.

(3) After the President’s Budget release, each Military Department, Military

Service, and DHA will conduct synchronization of their respective manning or manpower

documents no later than 45 days post release.

b. Manpower Documentation. There will be at least two manpower documents with a

memorandum entry at each DHA MTF/DTF: The DHA MTF/DTF UMD (i.e., the statement of

DHA MTF/DTF total manpower requirements) and the Military Service manpower document.

Military Service authorizations that are aligned to authorizations on the DHA UMD in the Fourth

Estate Manpower Tracking System will remain on the Military Service manpower documents.

DTM-24-003, June 28, 2024

11 Attachment 3

(1) The Director, DHA will generate the DHA MTF/DTF UMD. The DHA

MTF/DTF UMD is the authoritative document for establishing and documenting all DHA

MTF/DTF human resource requirements and authorizations, including uniformed medical and

dental personnel and civilian employees. The UMD includes the personnel and capabilities

required to deliver clinical and health care services and DHA MTF/DTF business operations at

the capacity determined by the Director, DHA.

(2) The Secretaries of the Military Departments will generate their respective

Military Service manpower document (e.g., table of distribution and allowances, activity

manpower document, UMD). The Military Service manpower document is authoritative for

establishing and documenting all Military Service human resources requirements and

authorizations. This document includes both uniformed medical and dental personnel and

civilian employees in the numbers and capabilities required and is associated with the Military

Department’s execution of operational and installation-specific medical functions outside of

DHA MTFs/DTFs. Military Service manpower documents will include personnel not aligned to

the DHA UMD.

(3) The DHA MTF/DTF UMD and Military Service manpower document will be

reconciled a minimum of every 6 months of the calendar year, to include at least one

reconciliation after the President’s Budget is released, to assess DHA MTF/DTF mission and

capacity requirements against Military Department operational medical force readiness

requirements, respectively.

c. DHP Uniformed Medical and Dental Personnel Authorization Management.

(1) The ASD(HA), in coordination with the Secretaries of the Military

Departments, will manage military authorizations allocated to the DHP in accordance with the

December 6, 2023 Deputy Secretary of Defense Memorandum.

(2) The ASD(HA), in coordination with the Secretaries of the Military

Departments:

(a) May adjust military authorizations aligned to the DHP during the

programming and budgeting processes. The annual DoD composite rate will be utilized as the

standard transfer price for adjustments to military authorizations. The ASD(HA) and the

Secretaries of the Military Departments have the authority to negotiate a transfer price that

differs from the annual DoD composite rate.

(b) May alter the mix and specialty of officer and enlisted personnel by

transferring officer and enlisted authorizations to or from the Military Departments in return for

total obligation authority (TOA) at the applicable transfer prices.

Components that do not result in an increase or reduction in military authorizations or a change

in the mix of officer and enlisted personnel.

1. DHP adjustments that result in a shift of military authorizations

on the same Military Department service support program element (PE) must be documented in a

DTM-24-003, June 28, 2024

12 Attachment 3

memorandum of agreement (MOA), in accordance with DoDI 4000.19. No corresponding

adjustments in TOA will be required.

2. DHP adjustments that result in a shift of military authorizations

from one Military Department service support program element (PE) to a different service

support PE must be documented in a MOA, in accordance with DoDI 4000.19. No

corresponding adjustments in TOA will be required.

3. DHP adjustments that do not result in a shift of military

authorizations on a Military Department service support PE to another service support PE in the

same Military Department do not have to be documented in a MOA.

(3) Military Department-initiated reorganizations, transformation initiatives, and

military-to-civilian conversions that adjust military authorizations aligned to the DHP will be

tied to a corresponding adjustment in TOA at the applicable transfer price. All Military

Department-initiated adjustments to DHP military authorizations must be approved by the

ASD(HA) and documented in a MOA, in accordance with DoDI 4000.19.

(a) Secretary of Defense-directed mission transfers between DHP and the

Military Departments necessitating an adjustment in DHP military authorizations will require

only a transfer of military authorizations. Unless specifically directed by the Secretary of

Defense, no corresponding adjustment in TOA will be required.

(b) The annual DoD composite rate will be used as the standard transfer

price for adjustments in military authorizations. The ASD(HA) and the Military Departments

have the authority to negotiate a transfer price that differs from the annual DoD composite rate,

provided that all military authorization adjustments aligned to the DHP are documented in

MOAs.

a signed MOA, in accordance with DoDI 4000.19. The MOAs will be submitted in time to be

reflected in the Military Department’s POM and budget estimate submissions and in accordance

with published DoD program and budget review guidance.

1. All manpower issues will be resolved according to established

MHS governance policies and procedures.

2. If consensus cannot be reached on a proposed change and a

MOA cannot be executed, the ASD(HA) or Secretary of the concerned Military Department may

submit an issue proposal following the President’s Budget request procedures and timelines.

(4) The Secretaries of the Military Departments are responsible for reporting their

prior-year actual DHA-allocated authorizations in the Next Generation Resource Management

System as part of the annual end-of-Fiscal-Year reporting according to issued Program/Budget

Review Guidance timelines.

(5) The Secretaries of the Military Departments will update the Director of Cost

Assessment and Program Evaluation and Under Secretary of Defense (Comptroller)/Chief

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13 Attachment 3

Financial Officer, Department of Defense on current-year DHA-allocated authorization

execution detailing actual allocations through mid-year and projected allocations through the end

of the fiscal year as part of the Fiscal Year Mid-Year Execution Review according to provided

timelines.

4. ASSIGNING UNIFORMED MEDICAL AND DENTAL PERSONNEL.

a. Categorization of Military Billets and Assignment to DHA MTF/DTFs.

(1) DHA MTF/DTF Assigned Uniformed Medical and Dental Personnel. This

category includes all uniformed medical and dental personnel assigned on orders to a DHA

MTF/DTF, to include a subset who are also aligned with an operational billet. Generally,

personnel will be assigned to the MTF/DTF on orders to the MTF/DTF for 36 months.

(a) Evaluations: The Director, DHA and the Secretaries of the Military

Departments will develop a performance evaluation process within 180 days of the date of this

DTM and maintain such performance evaluation process for assigned personnel.

(b) Orders: Uniformed medical and dental personnel will be assigned to

the DHA MTF/DTF on orders to the DHA MTF/DTF pursuant to the respective Military

Departments’ permanent change of station orders process.

1. The Director, DHA and the Secretaries of the Military

Departments will develop notification timelines to provide standardized awareness of availability

of uniformed medical and dental personnel assigned on order to a DHA MTF/DTF and enable

the DHA and Military Departments to best ensure stability of staffing at the DHA MTFs/DTFs to

render patient care.

2. The dual-hatted DHA MTF/DTF director or Service

commander will have discretion and delegated authority to balance health care delivery and

career-enhancing opportunities when approving temporary additional duty and temporary duty.

(2) Military Service-assigned Uniformed Medical and Dental Personnel. This

category includes uniformed medical and dental personnel in billets with specific validated and

funded operational and training requirements identified by the Secretaries of the Military

Departments. Personnel assigned to these authorizations fall under the command and control of

their unit or command and are referenced as borrowed military manpower or operational medical

forces as noted in subsequent business rules.

(a) The Military Department chain of command and the Service

commander exercise administrative control of uniformed medical and dental personnel who

perform duties at DHA MTF/DTF facilities.

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14 Attachment 3

(b) Evaluations: The Military Services will utilize existing performance

evaluation schemes for assigned personnel, updated as appropriate to reflect the requirements of

this issuance.

Military Service operational units, pursuant to the respective Military Departments’ permanent

change of station orders process. These assignments constitute validated Military Service

requirements.

(d) Accessibility:

1. Military Service commanders will have discretion and authority

to balance the Military Service missions with ability to support DHA MTF/DTF operations.

Availability of such uniformed medical and dental personnel to the DHA MTF/DTF will be

determined by the operational mission. The amount of expected use within the DHA MTF/DTF

for these personnel will be developed by the Director, DHA and the Secretaries of the Military

Departments to provide maximum predictability for both the uniformed medical and dental

personnel and the DHA MTF/DTF.

2. These uniformed medical and dental personnel may not be able

to meet all DHA MTF/DTF policy requirements due to their operational responsibilities. Such

requirements include, but are not limited to, opening schedules for booking several months in

advance and the number of enrolled patients to a provider.

3. Uniformed medical and dental personnel working in the DHA

MTF/DTF will follow all DHA clinical quality management policies. Uniformed medical and

dental personnel will adhere to applicable DHA clinical and administrative guidelines to ensure a

consistent standard of care. The Director, DHA exercises operational control over such personnel

when they provide health care services in DHA MTFs/DTFs.

b. Accountability. The desired outcome of this directive-type memorandum is to provide

a holistic view of the entire DHA MTF/DTF workforce (i.e., uniformed, civilian employees, and

contractor personnel), assess risk, and identify future actions to mitigate risk and optimize the

direct care system.

(1) The Director, DHA, in coordination with the Secretaries of the Military

Departments, will conduct a periodic assessment and report the number of Military Service

manpower hours executed in a DHA MTF/DTF compared to planned manpower and the

resources required, to mitigate any Military Service manpower shortfall and measure and report

Military Service performance to the ASD(HA). The metrics included in the report will be

identified in business rules established by the ASD(HA).

(2) The Director, DHA is accountable for periodic reporting on DHA civilian

employee hiring to the USD(P&R) and the Secretaries of the Military Departments through the

ASD(HA) at least quarterly. The Director, DHA is accountable for the effective and efficient use

of their total workforce (i.e., uniformed, civilian employee, and contractor personnel) to carry out

the DHA’s assigned missions.

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15 Attachment 3

(3) The Secretaries of the Military Departments will review each report and, in

coordination with the Director, DHA, provide mitigation strategies for identified gaps to include

adjustments to personnel and budgetary resources.

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16 Glossary

GLOSSARY

PART I. ABBREVIATIONS AND ACRONYMS

CRONYM

EANING

ASD(HA)

Assistant Secretary of Defense for Health Affairs

DHA

Defense Health Agency

DHP

Defense Health Program

DoDI

DoD instruction

DTF

dental treatment facility

DTM

directive-type memorandum

FYDP

Future Years Defense Plan

MHS

Military Heath System

MOA

memorandum of agreement

MTF

military medical treatment facility

program element

POM

program objective memorandum

TOA

total obligation authority

UMD

unit manning document

USD(P&R)

Under Secretary of Defense for Personnel and Readiness

PART II. DEFINITIONS

Unless otherwise noted, these terms and their definitions are for the purpose of this issuance.

ERM

EFINITION

administrative

control

Direction or exercise of authority over subordinate or other

organizations in respect to administration and support. Applies to

uniformed medical and dental assigned on official military

assignment orders to a DHA MTF/DTF. Administrative control

constitutes the delivery of routine Military Department administration

and support functions (e.g., leave, promotion, family care plans) and

exercising authority over such uniformed medical and dental

personnel for purposes of applying Chapter 47 of Title 10, United

States Code (also known as the “Uniform Code of Military Justice”)

and other disciplinary and adverse administrative actions.

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17 Glossary

ERM

EFINITION

allocation

A funded authorization.

annual DoD

composite rate

Provides the timeliest, grade specific estimate of the economic cost of

a military billet. It includes the basic pay, retirement pay accruals,

basic allowance for housing, basic allowance for subsistence,

incentive and special pays, permanent change of station pay,

miscellaneous pay, and the Medicare-Eligible Retiree Health Care

normal cost contribution. The annual DoD composite rate is

established by the Under Secretary of Defense (Comptroller)/Chief

Financial Officer, in accordance with provisions of Volume 11A,

Chapter 6, Appendix G of DoD 7000.14-R.

aligned

The steps taken to ensure the requirements and authorizations on the

DHA manning document are in-line with the positions on the

Military Service manpower document. Military Service manpower

positions aligned to DHA manning document positions are not

duplicative and a single Service member will fill both positions.

assignment

Placement of personnel on orders to DHA MTFs/DTFs where such

placement is relatively permanent for the length of the assignment

and where serving at the DHA MTF/DTF is their primary duty. The

Director, DHA exercises operational control over such personnel for

the primary duties for which they are assigned.

authorization

Total strength authorized by law for internal Military Service

applications only. This includes the sum of personnel in the force

structure and individuals accounts. Synonymous with “manpower

authorizations.”

billet or position

Defined in DoDI 7730.64.

clinical readiness

Clinical practice that is relevant to a provider or provider team’s

ability to perform their assigned deployed role. This would include

MTF-based practice as well as clinical experience gained through

partnerships. Also included are relevant medical education,

licensure, and privileging for providers and team members.

exigent

circumstances

An emergency requiring swift action to prevent imminent danger to

life or operational mission failure that cannot wait to undergo the

normal Secretary of a Military Departments’ defined validation

process to identify and notify the Director, DHA of operational and

training requirements.

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18 Glossary

ERM

EFINITION

funded

Defined in DoDI 7730.64.

manning

The process of staffing requirements with trained personnel, which

can include military, civilian employee, or contractor resources.

manpower

Defined in DoDI 1120.11.

Military Service

duties

Those duties performed by uniformed medical and dental personnel

assigned on-orders to a DHA MTF/DTF that do not fall under the

authority, direction, and control of the Director, DHA that prevents

the uniformed medical or dental personnel from providing the

programmed level of support to DHA.

MHS governance

A governance process composed of three councils, one board, one

joint body, various focus councils, and working groups as

established. The Military Health System Executive Review, chaired

by the USD(P&R), is the highest-level body of MHS governance.

MTF

Any fixed facility of the DoD that is outside of a deployed

environment and used primarily for health care, including dental

care; and any other location used for purposes of providing health

care services as designated by the Secretary of Defense.

MTF/DTF director

and Service

commander

As a general rule, at each MTF there will be a single Military Service

officer who will be dual-hatted as the MTF/DTF director and the

Service commander. For ease of reference, this dual-hatted officer

will be referred to as the “MTF director” except when acting solely in

their capacity as Service commander, in which case, the officer will

so state and will execute documents and issue direction with the title

of “Service commander.”

on orders

The technical process by which the Secretary of a Military

Department places military personnel on official military assignment

orders to a Service manpower document position, which is both a

required and authorized position, and is aligned to a requirement and

authorization on the DHA’s UMD, with a memorandum entry

denoting the alignment. The primary mission of military personnel on

orders is to work in the DHA MTF/DTF under the authority,

direction, and control of the Director, DHA, while receiving

administrative control from the Secretary of the Military Department

concerned.

requirement

Defined in DoDI 7730.64.

DTM-24-003, June 28, 2024

19 Glossary

ERM

EFINITION

transfer price

The standard rate for military authorizations adjustments that are

based on the annual DoD Composite Rate.

UMD

The DHA’s manpower document that identifies the positions, and

enumerates the requirements, that have been validated by the

Director, DHA for the DHA MTF/DTF for a specific fiscal year

(authorization year), and authorized through coordination with the

Secretaries of the Military Departments for planning and

programming purposes for the 4 subsequent fiscal years (program

years), with a memorandum entry aligning the requirement and

authorization to an aligned position on the Military Service

manpower document.

validated operational

and training

requirement

An operational or training requirement established pursuant to a

Secretary of a Military Department’s defined validation process.