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United States Public Health Service Commissioned Corps

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62-838: The United States Public Health Service Commissioned Corps ( USPHSCC ; also referred to as the Commissioned Corps of the United States Public Health Service ) is the uniformed service branch of the United States Public Health Service and one of the eight uniformed services of the United States (along with the Army , Navy , Marine Corps , Coast Guard , Air Force , Space Force , and NOAA Commissioned Officer Corps ). The commissioned corps' primary mission

124-470: A Ready Reserve Corps for the PHSCC, but technical errors in the legislation prevented it from being implemented until the errors were corrected in the 2020 CARES Act . According to 5 U.S.C.   § 8331 , service in the U.S. Public Health Service Commissioned Corps after 30 June 1960, is considered military service for retirement purposes. Under 42 U.S.C.   § 213 , active service in

186-532: A group augmenting those units. PHS officers must be prepared to deploy within 48 hours of receipt of deployment orders. Rapid deployment units include Rapid Deployment Force (RDF) teams that are made up of over 100 officers with multiple specialties, and are focused on providing acute clinical care of disaster-exacerbated chronic conditions. Officers who do not work as a clinical care provider on one of these teams are often in support roles, such as logistics, administration/finance, or planning. Tier 2 teams are composed of

248-484: A major role in fulfilling the Service's commitment to prevent disease from entering the country. As the nation grew, the scope of Marine Hospital Service's duties grew to include domestic and foreign quarantine and other national public health functions. Over time, the hospitals of the service were also expanded to include research and prevention work as well as the care of patients. Aside from merchant seamen, members of

310-646: A number of officers to support the Coast Guard throughout the country, including within the Coast Guard's senior leadership: The Coast Guard's chief medical officer is a rear admiral in the Public Health Service Commissioned Corps. Commissioned corps officers also may be detailed to other U.S. Government agencies, including the Department of Defense , TRICARE , the Department of Justice ( Federal Bureau of Prisons ),

372-936: A smaller, more specialized workforce. Other rapid deployment units include the Applied Public Health Team (APHT), the Mental Health Team (MHT), and the Services Access Team (SAT). PHS officers not already assigned to one of the rapid deployment units are used to augment the other teams in the event of staffing shortages due to availability, or the need to scale up a response. Commissioned Corps personnel are trained and equipped to respond to public health crises and national emergencies, such as natural disasters, disease outbreaks, or terrorist attacks. The teams are multidisciplinary and are capable of responding to domestic and international humanitarian missions. Some notable deployments involving

434-756: A two-star rank flag. Other Commissioned Corps rear admirals use a two-star assistant surgeon general flag, and Commissioned Corps officers at the rank of rear admiral (lower half) use a one-star assistant surgeon general flag. The members of the Commissioned Corps number over 6,000 officers in 11 professional categories: The Health Services Officer (HSO) category comprises over 50 allied health specialties, including audiology , social workers, physician assistants , optometrists , statisticians, computer scientists , dental hygienists , medical records administrators, medical technologists and others. Commissioned Corps officers wear uniforms similar to those of

496-606: A two-week officer basic course (OBC) before entering active duty. Commissioned corps officers receive the same pay and benefits as other members of the uniformed services . They cannot hold a dual commission with another uniformed service but inter-service transfers are permitted via 10 U.S.C.   § 716 . The commissioned corps is authorized to use warrant officer ranks W-1 to W-4 but does not currently use these ranks. Unlike their United States Armed Forces counterparts, Commissioned Corps officers do not require their rank appointments and promotions to be confirmed by

558-540: Is a Commissioned Corps admiral, he or she is authorized use of the flag of the Assistant Secretary for Health as a four-star rank flag. The Commissioned Corps vice admiral serving as Surgeon General of the United States uses the flag of the Surgeon General as a three-star rank flag, while the Commissioned Corps rear admiral serving as deputy surgeon general uses the deputy surgeon general's flag as

620-612: Is difficult due to the remote locations of many of its jobs. In addition, the commissioned corps provides officers (medical officers, dental officers, therapists, environmental health officers, etc.) to other uniformed services, primarily the United States Coast Guard and the National Oceanic and Atmospheric Administration Commissioned Officer Corps (NOAA Corps), which do not commission their own medical or dental officers. The Commissioned Corps provides

682-414: Is known the world around In research and in treatment no equal can be found In the silent war against disease no truce is ever seen We serve on the land and the sea for humanity The Public Health Service Team Uniformed services Uniformed services is an abstract term that are generally bodies of people in employment of a state who wear a distinct uniform that differentiates them from

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744-482: Is led by the surgeon general , who holds the rank of vice admiral ( O-9 ). The surgeon general reports directly to the Department of Health and Human Services Assistant Secretary for Health . The assistant secretary for health may be appointed to the rank of admiral (O-10) if they are also a serving uniformed officer of the commissioned corps. The Public Health Service Commissioned Corps had its beginnings with

806-488: Is now known as the Commissioned Corps of the U.S. Public Health Service . The scope of activities of the Marine Hospital Service began to expand well beyond the care of merchant seamen in the closing decades of the nineteenth century, beginning with the control of infectious disease . Starting in the mid-14th century, ships entering harbors were quarantined when any of the crew was sick. This practice

868-487: Is the protection, promotion, and advancement of health and safety of the general public. Along with the NOAA Commissioned Officer Corps , the Public Health Service Commissioned Corps is one of two uniformed services that consist only of commissioned officers and has no enlisted or warrant officer ranks, although warrant officers have been authorized for use within the service. Officers of

930-599: The National Institutes of Health , and multiple programs now incorporated into the Health Resources and Services Administration . The origins of the system of Marine Hospitals can be traced to the passage, by the 5th Congress of the United States , of " An Act for the Relief of Sick and Disabled Seamen " in 1798. This act created Marine Hospitals to care for sick seamen. The Marine Hospital Fund

992-638: The National Leprosarium operating. The system was abolished in 1981, with the last eight general hospitals transferred to other organizations, and the remaining functions of the Bureau of Medical Services merged into the present Bureau of Primary Health Care within the Health Resources and Services Administration (HRSA). PHS would however continue to operate the National Leprosarium until 1999. Other pre-1912 divisions of

1054-659: The State Department , the Department of Homeland Security , and the Department of the Interior ( National Park Service ). Commissioned Corps officers may develop individual memoranda of understanding (MOUs) with other organizations, including state and local health agencies and non-governmental organizations (NGOs). The commissioned corps is often called upon by other federal, state, and local agencies to aid and augment in times when those agencies' resources are overwhelmed. These responses are designated as deployments by

1116-549: The United States Navy and the United States Coast Guard with special Public Health Service insignia. Their service dress blues, summer whites, and service khakis are modeled after the Navy's, and their operational dress uniform was modeled after the Coast Guard's. When attached to another uniformed service, a Commissioned Corps officer is subject to the grooming standards of that service for uniform appearance. Because of

1178-475: The United States Senate , and only require approval from the president. Officers serving as assistant secretary for health and the surgeon general however, do require senatorial confirmation due to their status as senior federal officials. Flag officers of the Commissioned Corps are authorized to use rank flags. When the Department of Health and Human Services Assistant Secretary for Health

1240-746: The military , immigrants, Native Americans , other federal beneficiaries, and people affected by chronic and epidemic diseases found a source for health care in the MHS and its hospitals. In 1899, the Marine Hospital Service first formed internal divisions: the Division of Marine Hospitals and Relief, Division of Domestic (Interstate) Quarantine, Division of Insular and Foreign Quarantine and Immigration, Division of Personnel and Accounts, Division of Sanitary Reports and Statistics, Division of Scientific Research and Sanitation, and Miscellaneous Division, although there were minor name changes after this time. In 1902,

1302-607: The public and private sector . Their purpose is to maintain the Equality , security , safety , and health of the people they serve. Examples include military personnel, police officers, corrections and firefighters . Some uniformed services carry weapons and ammunition on duty. They include: Depending on role and assignment, members of: Unarmed uniformed services carry or operate other equipment to perform their duty. Such uniformed services may include: Marine Hospital Service The Marine Hospital Service

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1364-1421: The ACA failed to include statutory authority for pay and benefits, preventing the Ready Reserve Corps from being activated. Efforts to pass legislation to correct these errors picked up in late 2019. Funding was finally approved through the CARES Act , passed on 18 March 2020, in response to the COVID-19 pandemic . The first officers were expected to be commissioned in the first half of 2021. The Ready Reserve has three main components. The Selected Ready Reserve (SELRES) consists of officers who are required to train periodically and must be prepared for voluntary or involuntary active duty mobilization within 24 hours to respond to an urgent or emergency public health care need. The Individual Ready Reserve (IRR) consists of officers who have had military and/or USPHS Commissioned Corps training; they are not required to participate in training or other USPHS Commissioned Corps activities, but are subject to involuntary recall to active duty under certain circumstances. The Retired Reserve consists of members who accumulate 20 or more years of qualifying service and have reached age 60. The Commissioned Corps adopted naval ranks to impose military discipline on

1426-513: The Commissioned Corps, if the deployment is outside of the officer's normal duties, and coordinated through the Commissioned Corps's Readiness and Deployment Branch (RDB) in Commissioned Corps Headquarters (CCHQ). Deployments may be for technical needs in standard settings, or in the event of disasters, in austere environments. The commissioned corps may be militarized by an act of Congress or by executive order by

1488-631: The Framework for various needs to other federal agencies, states, local governments, or even to aid foreign governments. Like all other federal-level responses, commissioned corps officers are deployed only upon request, and upon the recommendation of the surgeon general and permission of the Assistant Secretary for Health . During deployments, commissioned corps officers may report to regular office spaces, such as coordinating responses at state-of-the-art emergency operations centers, or into

1550-627: The Marine Hospital Fund. In 1869, Dr. John Shaw Billings , a prominent Army surgeon, was appointed to head an investigation of the Marine Hospital Fund. Dr. Billings found the hospital fund to be inadequate and completely disorganized. In June 1870 the 41st Congress formally converted the loose network of locally controlled marine hospitals, the Marine Hospital Fund, into a centrally controlled Marine Hospital Service, with its headquarters in Washington, D.C. This reorganization made

1612-671: The Marine Hospital Service have descendants that operate to the present day: Today, the records for these institutions sit in storage at the National Library of Medicine in Bethesda, Maryland and the National Archives in College Park, Maryland. The hospitals themselves were, by the middle of the 19th century, fairly imposing and architecturally grand structures in many cases. As long as ample federal funding

1674-538: The Marine Hospital Service into its own bureau within the Department of the Treasury. Dr. John Maynard Woodworth was subsequently appointed to the Service as "Supervising Surgeon." He transformed the service into a disciplined organization based on his experience in the Union Army as a surgeon. Dr. Woodworth required his physicians to be a mobile work force stationed where the service was in need, and he mandated

1736-423: The Marine Hospital Service medical personnel along Army military structure in 1889 to facilitate a mobile force of health professionals that could be moved for the needs of the service and country. He established appointment standards and designed the Marine Hospital Service herald of a fouled anchor and caduceus . Later that year of 1889, President Grover Cleveland signed an Act into law that formally established

1798-541: The Marine Hospital Service was renamed the "Public Health and Marine-Hospital Service." In 1912, as the emphasis of its responsibilities shifted from sailors to general public health, the name was changed again to the "Public Health Service" to encompass its diverse and changing mission. The Division of Hospitals, which contained the Marine Hospital system, became part of the Bureau of Medical Services in 1943, and

1860-548: The Navy and Coast Guard, along with corresponding in-service medical titles. Commissioned corps officers typically receive their commissions through the commissioned corps's direct commissioning program . As with its parent division, the Public Health Service, the commissioned corps is under the direction of the United States Department of Health and Human Services . The commissioned corps

1922-467: The Navy's commissioned hospital ships ( USNS  Mercy  (T-AH-19) and USNS  Comfort  (T-AH-20) ), though other ships, such as the amphibious assault ship USS  Bataan  (LHD-5) , have also been used. The command staff of the PHS deployed team(s) is deployed for the entire mission duration (often three months), while operational personnel serve one month aboard, meeting and departing

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1984-474: The President of the United States, not only in time of war, but also in "an emergency involving the national defense proclaimed by the President." . 42 U.S.C.   § 217 states: In time of war, or of emergency involving the national defense proclaimed by the President, he may by Executive order declare the commissioned corps of the Service to be a military service. Upon such declaration, and during

2046-543: The Public Health Service Commissioned Corps include: In addition to disaster response, the commissioned corps frequently partners with the United States Navy on health diplomacy missions. Commissioned Corps officers have been part of the Navy's Pacific Partnership (in the Pacific basin ) and Operation Continuing Promise (in the Caribbean and western Atlantic ) since 2007. Such missions are often carried out on one of

2108-681: The Public Health Service and presented it to the PHS during their centennial.  At the Washington gala celebrating the event in January of 1989, the Coast Guard Band played and Senior Musician King conducted, for the premier of the fanfare. The only Coast Guardsman so honored, Senior Musician King was presented the PHS Citation by Surgeon General Koop for his special service. The lyrics are as follows: The mission of our service

2170-829: The Service except to the extent that the President may direct as Commander in Chief. Major militarization of the Commissioned Corps occurred during World War II (1941–1945) and the Korean War (1950–1953). Should it be called into active duty again, it would constitute a seventh branch of the United States Armed Forces . The commissioned corps is often deployed as part of the National Response Framework Emergency Support Function No. 8 – Public Health and Medical Services, but can be deployed outside of

2232-504: The U.S. Public Health Service Commissioned Corps is considered active military service for the purposes of most veterans' benefits and for anti-discrimination laws. The stated mission of the commissioned corps of the U.S. Public Health Service is "Protecting, promoting, and advancing the health and safety of the Nation" in accordance with the commissioned corps's four Core Values: Leadership, Excellence, Integrity, and Service. Officers execute

2294-615: The United States . Woodworth created a cadre of mobile, career service physicians, who could be assigned as needed to the various Marine Hospitals. The commissioned officer corps was established by legislation in 1889, and signed by President Grover Cleveland . At first open only to physicians , over the course of the 20th century, the Corps expanded to include veterinarians , dentists , physician assistants, sanitary engineers, pharmacists , nurses , environmental health officers , scientists , and other types of health professionals . It

2356-722: The boundaries of the United States expanded , and harbors were built on other coasts, so too were marine hospitals. In the 1830s and 1840s they were built along inland waterways, the Great Lakes , and the Gulf of Mexico . After the acquisition of the Oregon Territory (1846) and California (1848) hospitals were built in 1850s at Pacific Coast harbors. Following the Civil War , public outcry and scandal surrounded

2418-415: The close relationship between the Commissioned Corps and the Coast Guard, a Commissioned Corps officer on assignment with the Coast Guard is required to wear the same service uniforms as commissioned Coast Guard officers, although still wearing the insignia of the Commissioned Corps to identify them. Senior Musician George King III, U.S. Coast Guard (Retired) composed the "U.S. Public Health Service March" in

2480-510: The commerce and health of America. One such role was quarantine . John Maynard Woodworth , a famous surgeon of the Union Army who served under General William Tecumseh Sherman , was appointed in 1871 as the Supervising Surgeon. Woodworth's title was later changed to "Supervising Surgeon General", which later became the surgeon general . Woodworth is credited with the formal creation of the commissioned corps. Woodworth organized

2542-409: The commissioned corps are classified as noncombatants , unless directed to serve as part of the military by the president or detailed to a service branch of the military. Members of the commissioned corps wear uniforms modeled after the United States Navy and the United States Coast Guard , with special Public Health Service Commissioned Corps insignia, and hold naval ranks equivalent to officers of

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2604-403: The commissioned corps is under the United States Public Health Service (PHS), a major agency now of the U.S. Department of Health and Human Services (HHS), established by Congress in 1979 and 1980. It was previously established in 1953 as the U.S. Department of Health, Education and Welfare (HEW), and it is still led by the surgeon general . The commissioned corps allocates officers to all of

2666-489: The creation of the Marine Hospital Fund in 1798, which later was reorganized in 1871 as the Marine Hospital Service . The Marine Hospital Service was charged with the care and maintenance of merchant sailors, but as the country grew, so did the ever-expanding mission of the service. The Marine Hospital Service soon began taking on new expanding health roles that included such health initiatives that protected

2728-431: The daily wear uniforms. This eventually led to the creation of the modern-day Public Health Service Commissioned Corps . Dr. Woodworth, using Army-style heraldry, created the Marine Hospital Service fouled anchor and caduceus seal which is used to this day by the Public Health Service. In 1873, Dr. Woodworth's title was changed to "Supervising Surgeon General," a forerunner of the modern-day office of Surgeon General of

2790-551: The doctors of the service, and their medical titles correspond with their service rank and pay grade . The service uses officer ranks and service titles interchangeably when referring to the grades of its officers. The commissioned corps uses the same commissioned officer rank structure as the United States Navy and Coast Guard : from ensign to admiral (O-1 through O-10). Commissioned corps officers are typically appointed via direct commission and must complete

2852-425: The field in extremely austere environments, such as when responding to a natural disaster. In addition, deployments may either be on an individual basis, such as when specific skill sets are needed, or as part of a team, when large-scale responses are needed. The commissioned corps organizes PHS officers into units for rapid deployment. PHS officers are either assigned to a pre-configured rapid deployment unit (RDU) or

2914-827: The former Reserve Corps, which had active and inactive components. All former Reserve Corps officers who were serving on extended active duty on 23 March 2010 were converted to Regular Corps officers. The same legislation also abolished the Inactive Reserve Corps (IRC) on 23 March 2010, and consequently the commissions of the existing 10,000 commissioned corps IRC officers. The IRC had consisted of inactive reservists voluntarily activating to provide over 3,000 active-duty days annually for routine and public health emergencies including during Hurricane Katrina and other emergency response missions, and in providing surge capacity for numerous shortages in isolated and hardship underserved areas. Inactive reservists also played roles in

2976-582: The humanitarian shipboard training missions with other uniformed services . A Ready Reserve Corps Working Integrated Project Team was convened in April 2010 to propose policy concepts, a strategic framework, and a budget. It submitted its final report in June 2010. As of late 2010, the directives and policies to implement the Ready Reserve awaited Secretarial decisions. However, due to a technical error,

3038-683: The late 1980s, and presented the copyright to the PHS Surgeon General, by whom it is still held. The PHS is the only one of the uniformed services in which the copyright is held by the titular head of the Corps. In addition, King composed the Centennial Fanfare, "Anchor and Caduceus", for the PHS Corps Centennial event in 1989. The U.S. Coast Guard Band recorded both the PHS March and Centennial Fanfare for

3100-666: The mission of the commissioned corps in the following ways: As of 2019, the most common agency for commissioned corps officers was the Indian Health Service , followed by the Food and Drug Administration , and then the Centers for Disease Control and Prevention . The increased benefits and pay of commissioned corps officers is considered especially beneficial for the Indian Health Service, where recruitment

3162-502: The modern Public Health Service Commissioned Corps (then the Marine Hospital Service ) under the Supervising Surgeon (later Surgeon General). At first open only to physicians, over the course of the 20th century, the Corps expanded to 11 careers in a wide range of specialties to include veterinarians, dentists, occupational therapists , physical therapists, engineers, pharmacists, nurses, environmental health specialists, scientists, dietitians, and other allied health professionals . Today,

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3224-527: The other uniformed services depending on the health or medical needs of each service. By the 1980s, the wearing of uniforms on a day-to-day basis was not consistently practiced. In 1987, Surgeon General C. Everett Koop advocated for consistent use of the uniform while on duty, although he allowed individual agencies to determine their own requirements. In 2004, Surgeon General Richard Carmona made uniforms compulsory whenever officers were on duty. The 2010 Patient Protection and Affordable Care Act established

3286-471: The period of such war or such emergency or such part thereof as the President shall prescribe, the commissioned corps (a) shall constitute a branch of the land and naval forces of the United States, (b) shall, to the extent prescribed by regulations of the President, be subject to the Uniform Code of Military Justice , 10 U.S.C.   § 801 et seq., and (c) shall continue to operate as part of

3348-659: The ships at the ports of call during the mission. The Affordable Care Act (ACA), signed by President Barack Obama on 23 March 2010, established the Ready Reserve Corps of the Public Health Service Commissioned Corps as the new surge capacity for the U.S. Public Health Service Commissioned Corps. The ready reserve corps is intended to fulfill the need for additional commissioned personnel on short notice to assist Regular Corps personnel for both routine public health and emergency response missions during involuntary calls to active duty. The Ready Reserve Corps replaced

3410-519: The tax was abolished and in 1906 funds were dispensed by Congress.) The act led to the gradual creation of a network of hospitals along coastal and inland waterways. They were initially located along the East Coast , at the harbors of the major port cities, with Boston being the site of the first such facility, followed later by others including in the Baltimore vicinity at Curtis Bay . As

3472-643: The well-being of these sailors, the hospitals provided a key monitoring and gate-keeping function against pathogenic diseases. As immigration increased dramatically in the late 19th century, the Federal Government also took over the processing of immigrants from the individual states, beginning in 1891 . The Marine Hospital Service was assigned the responsibility for the medical inspection of arriving immigrants at sites such as Ellis Island in New York Harbor . Commissioned officers played

3534-588: Was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the United States Merchant Marine , the U.S. Coast Guard and other federal beneficiaries. The Marine Hospital Service evolved into the U.S. Public Health Service . It was the point of origin for several components of the current Public Health Service, including the Public Health Service Commissioned Corps ,

3596-503: Was available for their construction, these hospitals were impressive examples of government-provided health care. The hospitals of the early 20th century in major port cities such as New Orleans , San Francisco , and Savannah displayed ornate architectural detail and reflected many of the changes sweeping medicine at the time. In addition to the major hospitals, many lower-class hospitals and clinics existed. A chronological gallery of hospitals constructed prior to 1912 follow, showing

3658-558: Was eventually renamed as a different Bureau of Medical Services within the Health Services Administration in 1973. Large new buildings were constructed for many Marine Hospitals in the 1920s and 1930s, and the system reached its peak of 30 hospitals in 1943. A wave of closings in 1944–1953 mainly targeted hospitals that had not been upgraded, and another wave during 1965–1970 closed the remaining hospitals at inland locations, leaving eight general hospitals and

3720-551: Was normal procedure at United States harbors, with quarantine originally a function of the individual states, rather than of the Federal Government. The National Quarantine Act of 1878 vested quarantine authority to the Marine Hospital Service. However, the Public Health Act of 1879 created the National Board of Health , through which quarantine authority was shared with the U.S. Army and Navy; this arrangement

3782-426: Was not reauthorized by Congress in 1883, and its powers reverted solely to the Marine Hospital Service. Over the next half a century, the Marine Hospital Service increasingly took over quarantine functions from individual state authorities. The Marine Hospitals, as their name suggests, were hospitals constructed at key sea and river ports across the nation to provide health care for merchant marine sailors. Aside from

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3844-497: Was placed under the Revenue Marine Service (a forerunner of the present-day Coast Guard ) within the Department of the Treasury . It was the first federal health law. It authorized a tax, which was the deduction of twenty cents per month from the wages of the seamen. This tax raised funds for physicians and to support the network of hospitals. The tax was about 1% of the wages of maritime sailors. (In 1884,

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