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         TOPIC AREA: COMMAND, CONTROL, COMMUNICATION (C3)

         SUBMITTED BY: HQ AFRES/SGXO

         ISSUE: A requirement exists for a single WAES CONOPS coordinated
         and agreed upon by all user commands.

         OBSERVATION: Aeromedical evacuation has supported wartime and
         contingency operations under a variety of major commands and each
         command used its own concept of operations.

        DISCUSSION: Each contingency involving aeromedical evacuation
        has resulted in another unwritten concept of operations for
        aeromedical evacuation and patient regulation. The Air Reserve
        Components, the command having over 95 percent of aeromedical
        personnel, has worked with MAC over the last four or five years
        to attempt to standardize aeromedical evacuation operations.
        Standardization is required so proper training of the younger
        generation of AE personnel can be achieved. Aeromedical
        evacuation is becoming less and less a profession and more and
        more a fly by the seat of your pants operation. It seems that
        whomever is in charge sets up their own concept of how things
        should be accomplished and forces the aeromedical operations to
        bend to the new set of rules. It is in this environment that
        younger aeromedical evacuation members are expected to learn the
        aeromedical evacuation system. Comments are frequently heard
        from aeromedical evacuation personnel such as "we did not do it
        this way in Granada, or Just Cause, or Urgent Fury". U.S. Army
        medical personnel (the primary aeromedical evacuation users) have
        made comments such as "Why can't the Air Force follow its own
        rules in aeromedical evacuation operations? After all, it wrote
        them." this is because there is no aeromedical evacuation system
        accepted by all Air Force commands. This is true even though
        HQ MAC has been designated by the Air Force as the OPR for
        aeromedical evacuation. Sometimes aeromedical evacuation
        personnel are told to "forget the command you came from. You
        belong to our command now and you will do it our way." It is
        essential that a single aeromedical evacuation concept of
        operations be developed and published that is binding on all DOD
        agencies so that proper training can be accomplished. It is
        currently impossible to provide authoritative training in a
 |      system that changes with each operation.

        IMPACT: This would eliminate the confusion of not knowing
        current procedures at any given time. Increase mission
        effectiveness.

        RECOMMENDATION: Publish an approved and in-depth concept of
        aeromedical evacuation operations in either a DOD, tri-service,
        or Air Force level regulation. All services and commands must be
        required to follow the concept. A centralized agency must
        prepare training materials based on the approved concept of
        operations and allow all personnel to become proficient in one
        standardized concept of operations.

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