United States Army Reserve Aeromedical Evacuation Update

By MAJ Shawn Kirby

Credit to Army Aviation Magazine, March 31, 2023

An HH-60M Blackhawk helicopter from Charlie Company, 7-158th GSAB provides MEDEVAC support from an undisclosed location in the Operation Inherent Resolve (OIR) Combined-Joint Operations Area (CJOA)

Aeromedical evacuation has undergone transformation since its re-integration into the United States Army Reserve (USAR) with a single Medical Company Air Ambulance in 2009. The USAR has grown to four 15-ship air ambulance companies, split between two general support aviation battalions (GSAB) and two expeditionary combat aviation brigades (ECAB). The MEDEVAC companies operate from Joint Forces Training Base (JFTB) Los Alamitos, California; Fort Carson, Colorado; Ft. Knox, Kentucky; and MacDill Air Force Base (AFB), Florida. All four companies are continually recruiting Officer and Warrant Officer Pilot, Critical Care Flight Paramedic, and Black Hawk Helicopter Mechanic/Crew Chief positions. Contact a United States Army Recruiting Command (USAREC) recruiter for additional information on the process to become a member of Army Reserve DUSTOFF.


Charlie Company of 7-158th General Support Aviation Battalion recently returned from a mobilization in support of Combined Joint Task Force – Operation Inherent Resolve (CJTF-OIR) and Operation Spartan Shield (OSS). C/7-158th GSAB (Saint Dustoff) is one of two air ambulance companies assigned to the 11th Expeditionary Combat Aviation Brigade. 11th ECAB assumed the Task Force Eagle mission of aviation support to the CJTF-OIR campaign to advise, assist and enable regional partners in their military defeat of the Islamic State of Iraq and Syria, also known as IS or ISIS. Saint Dustoff provided aeromedical evacuation coverage to over 6,000 Coalition Service Members supporting the mission. They conducted 335 medical evacuations and flew over 1,200 hours during their nine-month deployment. The mission requirements of OIR/ OSS provided a challenge to the timely and efficient medical evacuation we have become accustomed to during the Global War on Terrorism. Greater distances between medical treatment facilities necessitated prolonged enroute care and a change to the MEDEVAC battlefield geometry utilized in Operations Iraqi Freedom and Enduring Freedom. With a modification table of organization and equipment (MTOE) designed to operate four forward support MEDEVAC platoons and one area support MEDEVAC platoon across four, possibly five locations, C/7- 158 adapted to the mission requirement and was able to successfully con[1]duct MEDEVAC operations between seven different sites spread across three countries.

Future MEDEVAC Technology

Saint Dustoff deployed with three new Medical Interior Upgrades (MIU) to the HH-60M Black Hawk Patient Handling System (PHS) to conduct a user assessment of the prototype equipment in an austere, combat environment. The MIU was developed to address capability gaps and design deficiencies of the original HH-60M PHS while maximizing the incorporation of commercial medical equipment and accessories, providing for the stowage and access of all required equipment, reducing safety concerns by providing equipment access during inflight medical treatment, and allowing the PHS configurability, flexibility, modularity, and adaptability necessary to support current and future MEDE[1]VAC mission requirements. After their return to home station, flight paramedics and crew chiefs of C/7-158 participated in an after-action review with Program Executive Office Aviation, Utility Helicopters Project Office, and MEDEVAC Product Office to give their opinions on the pros/cons, likes/dislikes, and preferred configurations of the modular medical interior. The user assessment and AAR will aid PD MEDEVAC in their determination of upgrade component usability, production feasibility, and identification of potential modifications to prototype design.

Medical Equipment Fielding

A high operations tempo of support to Operations Iraqi Freedom, Enduring Freedom, Inherent Resolve, and Spartan Shield, as well as homeland defense and contingency operations over the past thirteen years has thoroughly degraded the stockpile and modernization of USAR air ambulance medical equipment sets (MES). Using Congressional National Guard and Reserve Equipment Appropriations (NGREA), the USAR air ambulance companies will finally be replenished to full capability starting with the first twelve sets in July 2023.

Critical Care Flight Paramedic

The fiscal year 2013 National Defense Authorization Act (NDAA) directed that all Army Flight Medics (MOS 68WF2) be Critical Care-Nationally Registered Paramedic (CCNRP) certified by the end of FY16, later extended to the end of FY23. The USAR is authorized one-hundred Critical Care Flight Paramedics (CCFP) split evenly between the four air ambulance companies. Training to become a 68WF2 includes a 42-week program of instruction that consists of three individual courses run in sequence at Joint Base San Antonio-Ft. Sam Houston, Texas and Ft. Rucker, Alabama. Individual courses are waivable depending on an applicant’s civilian qualifications. With this deadline looming, the USAR is on glideslope to recruit, train, and sustain the needed CCFPs to meet the NDAA 2013 requirement. The benefit of the USAR and Army National Guard (ARNG) is that many, if not most of our 68WF2s leverage medical experience and qualifications from their civilian careers to augment the extensive training they receive to operate as an Army CCFP. To retain these very essential Soldiers, the United States Army Reserve Command (USARC), Army Reserve Aviation Command (ARAC), and Reserve Personnel Management Directorate (RPMD) of Human Resources Command (HRC) are working closely to develop a sustainable career model that will retain combat power, knowledge, and experience at the MEDEVAC company level while allowing for maximum career progression.

Aeromedical Evacuation Officer

In December 2015, the Army Chief of Staff directed the formation of the Holistic Army Aviation Task Force (HAATF) to review all aspects of Army aviation. HAATF conducted an analysis of the Aeromedical Evacuation Officer (AOC 67J) lifecycle career model, and the findings of that assessment informed the requirement for 67Js to attend both Army Medical Department and Aviation Captains Career Courses. The requirement was codified in HQDA EXORD 232- 16 and implemented in FY19. HRC RPMD is actively working to increase Troop Program Unit (TPU) and Active Guard Reserve (AGR) quotas in both career courses to meet the requirement for the eligible USAR 67J population. HRC AGR talent managers will enroll AGR 67Js, while HRC Reserve Officer Schools Branch will enroll TPU 67Js after submission of an application through your chain of command.

Unique Army Reserve MEDEVAC Challenges

Due mostly to their Title 10 status, USAR air ambulance companies lack the same stateside mission opportunities of ARNG MEDEVAC units. Mainly as a result of their reserve manning composition, they lack the same stateside mission opportunities of Active Component (COMPO 1) MEDEVAC units. With the transition of the OIR/OSS mission to COMPO 1 and lack of foreseeable Global Force Management Allocation Plan (GFMAP) missions, the USAR will need to determine viability for and then maximize real-world training opportunities to ensure our four air ambulance companies maintain combat power, knowledge, and experience. The regional alignment of the two USAR ECABs to Geographic Combatant Commands as an additional theater enabling aviation capability could provide a suitable substitution for a recuring stateside mission. Consolidated stationing of the four air ambulance companies has undoubtedly increased mission command but has also potentially exacerbated recruitment and retention challenges due to the inability of certain population centers to support the sustainment of critical positions. An analysis will need to be conducted to determine suitability and feasibility of moving MEDEVAC detachments to additional regions within the United States that can expand the potential recruitment population.

MAJ Shawn Kirby is the Aviation Training and Standardization Chief and USAR MEDEVAC Proponent for the United States Army Reserve Command, headquartered at Ft. Bragg, NC.


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