Systemic issues with the AMEDD MEDCASE procurement process

Curlee

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The medical care support equipment (MEDCASE) program is a centralized funding program providing the capital investment equipment required to support Army health care activities at fixed Army medical treatment facilities (MTFs) throughout the world. The Army uses Defense Health Program Other Procurement, Defense (OPD), OMD, or DOD MILCON funds to acquire equipment through the MEDCASE program and it is managed by The Surgeon General and staffed by the U.S. Army Medical Materiel Agency (USAMMA). The focus of the program is to procure equipment using the following priorities: (1) Meets medical emergencies; (2) Supports AMEDD health care programs; (3) Supports approved construction projects; (4) Completes phased equipment replacement through structured 5-year replacement and modernization programs and acquisition of new medical technologies (AR 40-61).

The program is utilized to purchase equipment in excess of $100,000 throughout the Army Medical Department. As an AMEDD comptroller this program allows for budgetary formulation without having to deal with purchases that would significant degrade the organization’s core funding. The steps in the program, though by no means perfect, are not any more bureaucratic than other major equipment purchase in the military and require input from the end user level, through the resource management and logistics divisions and approval by the organization’s commander prior to eventually being forwarded to USAMMA.

However, there are drawbacks to the system. The main one that I have come across is ensuring all the periphery requirements are included with the equipment purchase or, at the least, ensuring proper communication between USAMMA and the requesting organization occurs when contracts are altered. Recently we purchased a major piece of radiology equipment using the MEDCASE program. The cost of the equipment was approximately $155,000. When the equipment arrived the training portion of the contract had been excluded. The cost was negligible (less than $10,000) for this requirement; however it has been deleted out for reasons that are unclear. It is possible that USAMMA believed that this training should be the responsible of the receiving organization. Additionally, the organization’s logistics division was unaware that this portion of the contract has been voided until after the equipment had arrived. Whatever the reason, the cost was significantly more than $10,000 as the organizations was unable to utilize the equipment until the training was complete. Additionally, instead of simply being able to provide a line of accounting to the original contract, utilizing core funding, an entirely new contract had to be created for the training requirement. This time consuming process added to the delay in utilizing the new equipment.

As a comptroller I do not purport to understand the system as well as the medical logisticians. However, it appears that there are significant systemic issues with an acquisition process that spends millions of dollars on equipment procurement but can line item veto certain aspects of a contract that basically renders the procured equipment useless for a significant amount of time.

The views expressed in this blog are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.

MAJ Matthew Curlee
CGSC 10-002 (Fort Lee, VA) SG C
 
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