Chairman and members of the committee,
thank you for this opportunity to address
the successes and challenges of the Air
Force Medical Service (AFMS).
The year 2001 was a year that
changed our world forever.
The threat we feared – an attack
on the homeland -- became reality on
September 11, 2001.
swiftly rose to the challenge of September
11, and proved, once again, its commitment
to rapidly and effectively meet any
contingency that faces our country.
Within hours, 71 personnel arrived
at the Pentagon site from Andrews Air
Force Base to provide emergency medical
support. Four receiving hospitals were quickly identified within the
National Capital Area to provide support
hours of the attacks, the AFMS deployed
500 medics to McGuire Air Force Base, New
Jersey to respond immediately to any
Federal Emergency Management Agency (FEMA)
tasking for equipment and/or personnel
needed at the New York City disaster.
State-of-the-art medical emergency
facilities were assembled, which included
four Expeditionary Medical Support
packages (light-weight modular systems
that allow added bed sets as needed).
Critical Care Air Transportable
Teams (CCATTs), which provide emergency
medical attention while in-flight, were
quickly established at both the Pentagon
and McGuire Air Force Base.
Critical Incident Stress Management
Teams conducted counseling to personnel
assigned to recovery efforts at both
locations as well.
activation of the National Disaster
Medical System, the AFMS also set up its
aeromedical evacuation assets at both
McGuire Air Force Base and Andrews Air
Overall, while little help was
actually needed from the AFMS, it
responded quickly and proactively with the
help of several Air Force military
Such a response is exactly what
America needs to stand prepared for future
terrorist threats, whether they occur on
our shores or the shores of our allies
around the world.
vision of global engagement supports an
Air Force that is charged with responding
to the full spectrum of contingencies
throughout the world, and at a moment’s
It also supports Joint Vision 2020,
which states that today’s joint force
must be prepared to operate with
multinational forces, government agencies,
and international organizations.
To achieve these ambitious visions,
we know that we must consider our
readiness and peacetime missions to be
inextricably linked, and we must have a
strategy that is durable, comprehensive
This strategy is called the “Long
View is an enterprise-based approach that
emphasizes the realignment of readiness
requirements, clinical currency and best
practices, enabling the AFMS to provide
high quality, cost effective health care
and preventive services in all
environments during peacetime and
Crucial to success is the
acceptance by each member of the
enterprise that the needs of the AFMS
outweigh those of the individual unit. By thinking and acting globally, we will ultimately
strengthen our capabilities at the
grassroots level and be able to respond
effectively to the needs of our nation
anywhere in the world.
is committed to the Air Force Vision 2020
of “Global Vigilance, Reach, and
Our Long View is founded on this
readiness triangle. One of the ways we are
supporting global vigilance (to anticipate
and deter threats) is through the
Institute of Global Health (IGH), located
at Brooks AFB, Texas.
The IGH is a worldwide educational
program for medical providers to develop
and improve their medical response skills.
It develops and executes our
international medical training programs,
under the International Military Education
and Training (IMET) and Expanded IMET (E-IMET)
requirements implemented by the Defense
Security Cooperative Agency.
These medical training programs
support the three components of the AFMS
readiness mission, including humanitarian
and civic assistance (HCA), medical
response to disasters, and support of
traditional wartime operations.
objective of these “train the trainer”
programs is to provide regional leaders a
foundation for building disaster/trauma
systems and improving their health systems
and emergency response systems
infrastructure by acquiring the necessary
concepts and educational tools.
Team training across specialties
within healthcare, emergency response
organizations, and regional partners
(including hands on interactive
educational techniques) have been
tremendously popular with our
At the same time, these mobile
programs help shape the international
environment by supporting the theater
commander-in-chiefs (CINCs) engagement
plans to promote democracy, stability, and
collective approaches to disasters or
medical threats to the region.
Ultimately, we are partnering with
our allies to protect our deployed forces
in remote sites, that our troops might
have the best possible care wherever they
components of these programs are that they
are tailored to the host nation’s
infrastructure and resources and are
Certainly, a primary outcome is the
excellent training and experience the
courses provide our own personnel.
prototype, “The Leadership Program for
Regional Disaster and Trauma System
Management,” was established largely
through initiatives begun at the Air
Force’s Level-One trauma center, Wilford
Hall Medical Center in San Antonio, Texas.
These initiatives included a trauma
refresher course for surgeons, a field
surgery training course, Ecuador trauma
symposiums, and clinical and field
training for the new Air Force modular
The huge success of our prototype
(taught to 25 countries since 1999; 16
scheduled for 2002) and the identified
need for similar courses on other medical
topics, such as the new
“Hospital-Focused Approach to Biological
Weapons and Toxins Course,” has led to
the requirement for a sustainable
infrastructure to support our global
medical initiatives – thus the Institute
for Global Health.
National Guard and Air Force Reserve have
partnered with us to support these
In addition, we have partnered with
the Joint Commission for Accreditation of
Healthcare Organizations (JCAHO),
universities and international
organizations in developing the IGH.
We are excited about the future of
the IGH and the opportunities it offers to
enhance global health.
former Air Force Chief of Staff Michael
Ryan stated that, “to meet the
needs of a complex global
environment, Air Force officers would need
specialized skills to operate in coalition
with partners in the contingency arena.” In response to this call, we developed the International
Health Specialist (IHS) program.
The program’s focus is to build
partnerships with other countries in
peacetime, before disasters occur or
assistance is needed.
Then when disaster strikes, the
medical networking is already in place and
a more rapid and efficient response can
members should be culturally aware and
language proficient when deploying to
increase mission effectiveness and force
protection as we serve as instruments of
This is important in the areas of
Humanitarian Assistance (HA) and Disaster
Response (DR) as well as in war winning
Clearly in the current Operation
Enduring Freedom, coalition support and
interoperability will grow best with cross
cultural understanding and clear
In fact, we learned just how
effective our IHS program really was when
two French-speaking members of our
Critical Care Air Transportable team
worked successfully with French colleagues
in response to the bombing of USS Cole in
October 2000, providing the best possible
care for the casualties.
there are four fully capable IHS teams,
and they are aligned under Unified
European Command, Pacific Command,
Central Command, and Southern Command.
There are also IHS team members
located at the Uniformed Services
University of Health Sciences and the U.S.
Air Force School of Aerospace Medicine,
and some serve as Special Operations
To ensure the AFMS Total Force
synergy is optimized, the IHS program
partners with the Air National Guard and
Air Force Reserve.
The IHS also has partnered with the
Air Force Foreign Area Officer Branch to
explore numerous language-training options
with the goal of having our medics meet
and sustain the Air Force goal of 10
percent of all officers proficient in a
second language by 2005.
Our language training opportunities
do not stop at the officer level, however.
The IHS Program has extended its
language training opportunities to
enlisted personnel as well through the
Base Education Office Tuition Assistance
Program and an IHS-funded enlisted
opportunity for Language Area Studies
is composed of medics of all ranks and Air
Force Specialty Codes.
Its members are cultural and
language experts in their Area of
Responsibility (AOR) and have humanitarian
assistance/disaster relief and interagency
and joint operations experience.
In addition to the Unified
Command-aligned teams, the IHS program
office maintains a database of 300 AFMS
members with varying degrees of cultural
and regional medical experience who can
serve as valuable assets for future
missions. The language expertise represented by AFMS members includes
more than 36 different languages.
We are very excited about this
The potential for IHS involvement
and the return on its investment in the
international arena is immeasurable:
Today’s commanders must be able
to appraise health-related information and
resources in a multi-national,
Reach and Overwhelming Power
are striving to support global vigilance,
we are also thoroughly preparing our
nation’s ability for both strategic
reach (to curb crises) and overwhelming
power (to prevail in conflict and win
Part of this thorough preparation
involves our continual development of
state-of-the-art equipping and training
We continue to fine-tune our crisis
response by ensuring we have the smallest,
lightest, most flexible, and mobile system
We have nearly completed the
transition from the Cold War legacy air
transportable hospital to the
Expeditionary Medical Support (EMEDS).
The EMEDS system is a light-weight
modular system that allows the AFMS to
tailor our response to each situation,
adding bed sets as needed and offering
services that range from prevention and
basic primary care to aerospace medicine
support and sustained surgical operations.
Collective protection has also been
designed and is being fielded.
we were asked to take our EMEDS to Houston
to assist the flood-ravaged hospital
system there. Our EMEDS treated over 1,000 patients, and our contribution
was recognized by the mayor of Houston,
the governor of Texas and the director of
the Federal Emergency Management Agency (FEMA). As I noted previously, on September 11 we also
activated four EMEDS upon the request from
our Chief and Secretary to deploy EMEDS
teams to McGuire Air Force Base, N.J., to
provide additional medical capability to
the medical group there in support of
local authorities in New York City.
Our strategy envisions placing
EMEDS throughout the country to offer a
regional quick response capability.
partnership with our Army counterparts,
the U.S. Air Force Medical Evaluation
Support Activity (AFMESA) at Fort Detrick,
MD., recently activated EMEDS-XTI
(Experimental, Exercises, and Technology
Insertion) as a “test bed” for
expedited fielding of medical technologies
and processes. EMEDS-XTI will help to
better equip our medical providers for
dealing with the medical challenges
resulting from attacks on our homeland as
well as the medical requirements to
support our expeditionary forces.
Using EMEDS-XTI, AFMESA will
immediately focus on assessing, acquiring
and fielding several key technologies,
which include deployable medical oxygen
equipment, chemical and biological
decontamination, and biohazard
surveillance systems. EMEDS-XTI also serves as an available response unit in the
region in case of disaster.
September 11 attacks, the concern
regarding the threat of Weapons of Mass
Destruction (WMD), particularly chemical
and biological warfare attacks, has come
to the forefront of our nation’s most
For the AFMS, however, WMD has been
a critical issue of concern and planning
for the past few years – proof-positive
of our carefully prepared detection and
response technologies and programs.
A primary example of our latest
technology is a state-of-the-art disaster
response system called Lightweight
Epidemiological Advanced Detection and
Emergency Response System (LEADERS), which
was designed to enhance the current
medical surveillance process and provide
the earliest possible detection of covert
biological warfare incidents or
significant outbreaks of disease.
also in use by some civilian
organizations, such as the Centers for
Disease Control and Prevention (CDC), is a
modular web-based application that
supports the collection, storage and
analysis and distribution of critical sets
of medical data to aid with rapid,
effective response to natural disease
outbreaks or overt/covert biological
attacks within civilian populations or
LEADERS is very deployable – it
is based on an application model that
requires little or no additional
infrastructure for deployment.
LEADERS system is organized into three
primary customer modules, which include
(1) Critical Care Tracking to facilitate
the communication of bed availability
between hospital departments and emergency
response teams; (2) Medical Surveillance
to detect and identify disease outbreaks
using medical information stored in a
database; and (3) Incident Management to
enable a coordinated response of medical
and non-medical personnel to potential or
confirmed emergencies through a collection
of command and control tools for
situational awareness and response
Together, these three modules allow
multiple civilian and military
applications, including identifying
disease outbreaks, medical forensics,
public health analysis, monitoring and
improving clinical practice, monitoring
medical fraud, improving infection
control, and comprehensive outbreak
management and response.
We will continue working with our
civilian counterparts on development and
fine-tuning of this technology over the
efforts underway to improve the AFMS’s
ability to respond to weapons of mass (WMD)
destruction include the First Responder
Pilot Program, which consists of 10 pilot
bases that maintain a medical equipment
list to support nuclear bio-chemical
detection and provide decontamination
capability at the MTF if appropriate.
MTFs are required to scale
requirements based on their local threat,
vulnerabilities, mission capabilities and
manpower, deliberate plans, and agreements
with local first responders and providers
to develop credible, supportable first
recent WMD initiative is the National
Laboratory Response Network (NLRN), which
provides an early warning network to
detect covert release of pathogenic
Collaborators include local and
state departments of health, Department of
Defense medical laboratories, and the
Federal Bureau of Investigation.
The Air Force currently has 54
laboratories participating in this
addition to this network of laboratories,
the AFMS has also assembled and trained 35
Biological Assessment Teams (BATS) that
identify pathogen agents through the use
of a commercial product called a
Ruggedized Advanced Pathogen
Identification Device (RAPID). RAPID quickly and accurately identifies a variety of
pathogens, including conventional
biological agents; it can accomplish tests
in less than two hours from the time of
the sample being received, a marked
improvement over current pathogen
identification technologies, which require
the culturing of biological agents –
taking as much as 48 hours for results.
October, we responded to a request to send
Air Force medics as part of joint
Microbiology Augmentation Teams to New
York City and the U.S. Capitol to assist
staff from the Centers for Disease Control
and Prevention and local authorities in
the testing of samples for anthrax.
We were delighted when our
preliminary results completely correlated
with the definitive cultures.
Along with our sister Services, we
are offering our services in whatever
capacity is needed by local, state, and
federal authorities during these
on Terrorism in the United States will
test the effectiveness of our technologies
and training in many areas.
To ensure we have the best the
health care industry has to offer, we are
partnering with our civilian counterparts
whenever and wherever it makes sense.
At the same time, we are sharing
with them what we have to offer as well.
One of our biggest milestones over
the past year is the development of two
Centers for Coalition Sustainment of
Trauma and Readiness Skills – or CSTARS.
The CSTARS concept creates unique
learning opportunities in which civilian
academic medical centers serve as training
platforms to provide clinical experience
to help sustain necessary readiness skills
for our providers.
The evolving strength of the CSTARS
program is that it allows for the
development of synergistic relationships
and familiarity between academic medical
centers and military medical assets
(active, Guard, and Reserve), while
simultaneously improving wartime readiness
and homeland defense capability.
centers in Baltimore and Cincinnati have
begun classes this year and will consist
of full-time military medical personnel
integrated into the facility of an
academic medical center. Our partners are the University of Maryland School of
Medicine and the University of Cincinnati.
The faculty will coordinate the
rotation of military medical teams into
the academic health center using patient
care and didactic teaching sessions as the
means of sustaining readiness skills.
Additional CSTARS programs are
being considered to ensure geographical
distribution across the United States,
with the goal of shortening the response
time in homeland defense efforts.
way we are seeking to partner with the
civilian community to reach our mutual
goals is through a new partnership with
the University of Pittsburgh Medical
Center Health System to collaborate on the
development of sophisticated telemedicine
technology that will ultimately link
specialists in pathology, radiology and
dermatology with outposts at distant
locations around the globe.
Our goal is to strengthen the
AFMS’s expeditionary capability and
provide state-of-the-art health care to
our personnel everywhere.
examples have shown, the face of medical
readiness has changed drastically in the
Therefore, so too have our training
Today Air Force medics are asked to
provide a full spectrum of medical
support, from caring for refugees
requiring treatment for measles,
dehydration or starvation to providing
state-of-the-art trauma care in a disaster
or wartime environment. Admittedly, until recently, few Air Force personnel have had
the necessary experience in these or many
other readiness-based care requirements.
In support of our readiness case
analysis and skills currency case analysis
goals, we designed the Readiness Skills
Verification Program (RSVP).
will define the clinical tasks required of
our deployable medics and build training
programs targeted to keep our medics
Individuals assigned to mobility
positions are required to maintain
currency in RSVP tasks through attendance
in formal training programs, ongoing
clinical practice, and individual study.
The RSVP consists of training task
lists for every Air Force specialty.
Today, all deployable medics
– and soon, all Air Force medics –
will focus their clinical training upon
specific, measurable goals.
do we go from here?
The Long View
Long View, when we have built a solid
foundation for readiness case analysis
(RCA) and currency case analysis (CCA), we
must then ensure a strong business case
analysis (BCA) occurs in our
We are doing this through an
effective corporate structure that reviews
every major AFMS resourcing decision
through a standardized process using the
RCA-CCA-BCA model that allows input from
every applicable party and measures each
decision against objective criteria.
This maintains the enterprise
strategic view of a comprehensive plan,
preventing local or urgent decisions from
adversely affecting the AFMS.
We are now planning far beyond the
standard Program Objective Memorandum (POM)
cycle to 10 years out and beyond.
Our Primary Care Optimization (PCO)
development and rollout was the first use
of this model.
to the AFMS Population Health Plan is the
reengineering of our primary care services
under PCO. Sixty-five of our 75 Air Force medical treatment facilities (MTFs)
focus almost exclusively on offering
primary care services.
The goal of PCO is to vastly
improve the efficiency, effectiveness and
quality of care delivered through our
primary care platform.
An important strategy within PCO is
to recapture care from the private sector
so that all enrollees can benefit and also
to better manage the total financial risk
of our health care system.
Efficiencies are gained by
improving clinical business processes, by
enhanced partnerships with civilian and
other federal healthcare partners, by
effectively utilizing support staff
skills, and through robust information
management that supports evidence-based
health care decision-making.
Critical to PCO success is Primary
Care Manager by Name, which provides
patients with continuity of care and
allows providers and their teams to better
manage their practice by knowing who their
began our “Quick Start” training for
PCO two years ago, we have seen some
important returns on investment.
Where teams are fully staffed, they
are performing exceptionally well, and
with great patient and staff satisfaction.
Primary Care Manager by Name
enrollment has been accomplished in 100
percent of our facilities.
MTFs are proactively contacting
patients regarding needed clinical
other objective measurements continue to
Population health preventive
measures are on a positive slope along
with provider productivity. AFMS clinical quality measures, such as cervical cancer
screening, breast cancer screening, and
HbA1C annual testing for diabetics, are
all above the 90 percent level for the
Health Plan Employer Data and Information
Set (HEDIS) national measures in all our
There are very few health care
organizations in the United States that
can claim that type of preventive care
continue to improve PCO, our next step
will be to pursue specialty care
We are reviewing a limited number
of AFMS product lines associated with
surgical specialties in larger, bedded
ophthalmology, otolaryngology, and
As we implement our primary and
specialty care optimization programs, the
resourcing decisions arising from the work
of various functional panels will have
full visibility at all levels of our
corporate structure to ensure the Long
View is the ultimate focus.
a crucial factor in optimization is the
ability to man our mission effectively,
with the right number and mix of
appropriately trained personnel at the
right place and at the right time.
We are working hard to do this, but
it’s been a very challenging time for
medical force management in the Air Force.
Many issues have been brought to
the forefront, most importantly recruiting
and retention and a high operations tempo
with substantial deployment needs.
Shortages in the Medical Corps,
Dental Corps, Nurse Corps, Biomedical
Sciences Corps, and Medical Service Corps
have reached all-time highs and are
expected to dramatically increase private
sector health care costs as we are forced
to shift health care downtown.
staffing shortfalls led to our largest
recruiting requirements in AFMS history
for Fiscal Years 2000 and 2001.
Centering our efforts around our
RCA-CCA-BCA model, we’ve sought
solutions, such as addressing promotion
concerns, exploring special pay and
investing additional resources in health
professions scholarships for better and
more stable long-term staffing growth.
The success of these force
management initiatives will enhance the
future of our clinical capabilities and
ultimately improve our readiness posture.
our health care involves many factors,
from training and equipping our providers,
to modernizing our facilities, to
effectively manning our mission. It also
means educating our patients to take
responsibility for their health and giving
them the tools to make it easier.
This is a key tenet of
population-based health care.
current chairman of the DoD Prevention,
Safety and Health Promotion Council (PSHPC),
I want to praise the personnel serving on
the council for their outstanding efforts
in many areas, but particularly in
reducing tobacco use and alcohol abuse.
In fact, our Tobacco Use Reduction
Plan is nearly 80 percent complete.
We still have a problem in the
armed services, but proactive initiatives
such as sensible pricing of tobacco and
alcohol products in the commissaries and
exchanges, better education of our troops,
and research studies that will help us
focus our efforts better are all means to
reducing the problem.
pleased to say that the PSHPC has now
chartered the Suicide Prevention and Risk
Reduction Committee to develop an action
plan that will address suicide prevention
across the DoD enterprise.
The creation of both a DoD strategy
and the national strategy developed under
the United States Surgeon General are
important steps in addressing this
significant public health issue.
Force Suicide Prevention Program has made
a difference in the number of suicides in
the Air Force, but, unfortunately, we
continue to lose valuable personnel who
needlessly take their own lives.
As we move forward with our
program, and in support of the DoD
program, our primary goal within the Air
Force is to better understand the
causative factors involved with suicide
and thus be able to implement the critical
ingredients for effective suicide
recent implementation of “TRICARE for
Life” provided one of the missing links
to our population-based health care
Now we truly have the foundation to
provide “whole life” care to our
Fiscal Year 2001 was a year of
preparation and implementation of this and
other significant health care provisions
in the Fiscal Year 2001 National Defense
TRICARE Senior Pharmacy Benefit, which
started Apr. 1, 2001, brought a robust
pharmacy benefit to our senior patriots.
The expanded pharmacy benefit was
deployed with minimal problems and has
been a tremendous success story for DoD
and our beneficiaries.
The Air Force continues to work
with the other Services to minimize the
impact of this enhanced benefit to ensure all
of our beneficiaries are served.
for Life, the program that makes TRICARE
second payer to Medicare, and TRICARE
Plus, the program that allows seniors to
enroll in a primary care program at
selected MTFs, both began concurrently on
Oct. 1, 2001.
We are delighted that these
programs will enhance the quality of life
for our retirees.
We are also optimistic that TRICARE
Plus will strengthen our medical readiness
posture by expanding the patient case mix
for our providers while reducing the
government’s cost to provide healthcare
for these great Americans.
grateful to the committee and all of
Congress for your support in adequately
funding these programs. Your efforts have been crucial to their success, and they
will provide the AFMS the ability to
restore its in-house funding expenses
(particularly for equipment, facility
repair, and maintenance) to planned
levels, and it will help ensure that our
patients are provided quality care with
Funding will also allow us to
address numerous infrastructure
requirements in medical facilities,
particularly in the area of
Additionally, we are excited about
the opportunities provided by
congressionally directed optimization
funding, which will help us strike the
balance in maintaining a high state of
readiness, while providing efficient
peacetime healthcare and investing in
imperative modernization for the future.
Healthcare Resource Sharing
relationships continue to move forward as
the VA/DoD Executive Council, which was
reinvigorated in FY 2001 with increased
accountability and leadership oversight,
has established work groups to focus on a
number of policy initiatives.
The Air Force is pleased to
participate in these work groups, which
have achieved significant success in
improving interagency cooperation in areas
such as information management, pharmacy,
medical surgical supplies, patient safety,
and clinical practice guidelines.
The AFMS continues to support the
progress of our
four successful joint ventures in
Albuquerque, New Mexico; Las Vegas,
Nevada; Anchorage, Alaska; and Fairfield,
Albuquerque site, which has operated
effectively for more than 14 years, we
recently established an agreement with the
VA to provide professional VA
oversight to our Air Force mental health
We also recently established an
agreement to reduce the veterans’
colonoscopy procedures backlog while
assisting Air Force personnel in the
retention of critical skills.
Vegas, our joint venture operates under
common medical by-laws, allowing the VA
and Air Force providers to address the
needs of both Departments’
We collaborate with the VA to
manage inpatient pharmacy services, and we
plan to manage the Intensive Care Unit in
the same manner. This management “evolution” capitalizes on the experience
of VA staff in inpatient operation of
medical centers. In addition, the VA and the Air Force at the Las Vegas site
are proposing to expand their existing
emergency room to add a Step Down Unit and
a secure recreation area for psychiatric
Anchorage, approximately 50 VA full-time
employees work in the joint venture
A recently established “Joint
Venture Business Operations Committee (JVBOC)”
was designed to provide structured
communications and organizational
continuity to the planning and
implementation of issues relevant to the
Fairfield, California, a VA outpatient
clinic is located adjacent to David Grant
Medical Center (DGMC) on land leased from
the Air Force.
The VA actually purchases inpatient
care from DGMC as well as other services
that include specialty outpatient,
emergency services, ambulatory surgery,
and ancillary services.
An Executive Management Team (EMT)
manages this VA/DGMC joint venture, which
consists of commanders, directors, and
senior level staff of both agencies. The EMT provides oversight to a Joint Initiatives Working
Group (JIWG), which identifies operational
issues that need to be resolved and
develops recommendations for the EMT.
extremely proud of the collaborative team
efforts that all four joint ventures are
engaged in, and we expect continued
innovations in the areas of resource
sharing in the future.
View is built on metrics that show us how
well we’re doing in supporting DoD’s
Customer satisfaction is one of the
vital indicators of our success or
I’m pleased to report that
customer satisfaction in the Air Force
continues to rise.
According to DoD’s latest
Customer Satisfaction Survey Results, 90
percent of our enrolled beneficiaries
indicate they would enroll or reenroll in
TRICARE Prime if given the option.
The overall satisfaction with
clinics and medical care exceeds national
civilian HMO averages. With the expanded senior benefit, improving access through
primary care optimization, and our many
population health initiatives, it should
be no surprise that we are receiving high
marks from our customers.
task is only begun.
We will be working very hard in the
months and years ahead to ensure we are
ready if and when another “September 11th”
The AFMS must keep the Air Force
fit and healthy and be able to answer our
nation’s call whenever and wherever we