16 fam 100
MEDICAL PROGRAM
16 FAM 110
authorities and organization
(CT:MED-25; 08-20-2012)
(Office of Origin: MED)
16 fam 111 AUTHORITY
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
The regulations and procedures in 16 FAM are issued
pursuant to:
(1) Section 904 of the Foreign Service Act of 1980, as
amended, and codified at 22 U.S.C. 4084 (Health Care Program);
(2) Section 901 of the Foreign Service Act of 1980, as
amended, 22 U.S.C. 4081 (Travel); and
(3) 42 CFR 493, implementing the Clinical Laboratory
Improvement Amendments of 1988, as amended.
16 FAM 112 office of medical services
(med)
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
a. The Office of Medical Services (MED) is a bureau
that is responsible for managing the worldwide medical program, including
hiring Foreign Service medical professionals, advising the Secretary of State
on the Medical Program, and addressing global health-care issues for the State
Department.
b. The Medical Program provides access to primary care
services to eligible employees and family members assigned abroad. Regional medical officers
(RMOs), regional medical officer/psychiatrists (RMO/Ps),
and Foreign Service health practitioners (FSHPs) provide direct patient care
services at health units abroad, manage medical evacuations, assess local
health risks, evaluate local medical services, and manage health-care delivery
at posts within their region. Regional medical managers (RMMs) provide
managerial oversight to RMOs, FSHPs and other medical personnel in their
region. Regional medical laboratory scientists (RMLSs) are assigned abroad and within MED to
provide laboratory support to healthcare providers and to monitor the quality of local laboratory services.
c. The Medical Program provides occupational health
services for employees located in the United States and abroad as well as to
the locally employed staff abroad.
Occupational health services differ from primary care services in that the
Occupational Health Program is responsible for OSHA-mandated pre-placement
exams; medical surveillance for employees exposed to hazardous work conditions;
immediate initial care for accidents and injuries; and provision of basic
emergency care for medical issues that occur in the workplace.
d. The Medical Program establishes standards, evaluates
medical conditions at post, and evaluates the health of employees and eligible
family members to ensure that the assignment abroad matches the health-care
needs of the employee and family members, provides medical consultations for
security clearance issues, and provides other services as required by statute.
e. The Medical Program authorizes health units to
provide emergency medical assistance to persons not otherwise eligible for
medical care in unusual circumstances (e.g., natural disasters, terrorist
attacks, transportation accidents). The determination to provide emergency
medical assistance considers the unavailability of suitable care, the
capability of the medical providers and embassy medical facilities, and when
providing assistance is in the best interest of the U.S. Government.
16 FAM 113 medical components of the
office of medical services
(CT:MED-12; 01-12-2010)
(Applies to Civil Service and Foreign Service Employees)
See 1 FAM 360,
Office of Medical Services (MED).
16 FAM 113.1 Medical Director
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
a. The Medical Director is the equivalent of an
Assistant Secretary and the senior medical advisor to the Secretary of State. The Medical Director is also the Designated Agency
Safety and Health Official (DASHO), providing coordination between MED and
operational components on safety and health issues for the Department. The
Medical Director is an experienced Foreign Service physician with a current,
valid, and unrestricted license to practice medicine in a State, the District
of Columbia, or a territory of the United States, and board-certified in a
specialty recognized by either the American Board of Medical Specialties or the
American Osteopathic Association with a minimum of three overseas tours and
experience with the staff of the Office of Medical Services. To the
extent authorized by law, the Medical Director may authorize payment for
medical expenses and medical travel in unusual or unforeseen circumstances.
MED must maintain appropriate
documentation each time the Medical Director exercises his or her discretionary
authority. The executive office of MED will issue an authorizing memorandum
which will be retained in the patients medical file with a copy of the
memorandum maintained in a special authorizing file located in the Medical
Directors office.
b. The Medical Director and designees responsibilities
are described in 1
FAM 360.
16 FAM 113.2 Deputy Medical
Director
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
The Deputy Medical Director is equivalent to a principal deputy
assistant secretary who acts as the Medical Director/DASHO in the absence of
the Medical Director. The deputy is an
experienced Foreign Service physician with a current, valid, and unrestricted
license to practice medicine in a State, the District of Columbia, or a
territory of the United States and board-certified in a specialty recognized by
either the American Board of Medical Specialties or the American Osteopathic
Association with a minimum of three overseas tours and experience with the
staff of the Office of Medical Services. The Deputy Directors
responsibilities are described in 1 FAM 360.
16 FAM 113.3 Regional Medical
Manager (RMM)
(CT:MED-12; 01-12-2010)
(Applies to Civil Service and Foreign Service Employees)
The regional medical manager (RMM) is an experienced
senior regional medical officer who provides clinical and managerial oversight
to regional medical officers (RMOs), Foreign Service health practitioners
(FSHPs), and other medical personnel in his or her region. RMM responsibilities
are described in 1
FAM 360.
16 FAM 113.4 Regional Medical
Officer (RMO)
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
a. The regional medical officer (RMO) is a physician with a current, valid, and unrestricted license to
practice medicine in a State, the District of Columbia, or a territory of the
United States, and board-certified in family practice, internal
medicine, or emergency medicine by either the
American Board of Medical Specialties or the American Osteopathic Association,
in addition to a minimum of 5 years of experience in primary care. The
RMO must be able to provide primary care to all age groups.
b. The RMO provides clinical services, oversees the
operation of the health unit, and supervises Foreign
Service health practitioners (FSHPs) and
regional medical laboratory scientists (RMLSs)
at the post where assigned and posts within his or her assigned region.
16 FAM 113.5 Foreign Service Health
Practitioner (FSHP)
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
The Foreign Service health practitioner (FSHP) is a family nurse practitioner or family medicine/primary
care physician assistant licensed to practice medicine in a State, the District
of Columbia or a territory of the United States, and has current national
certification as a family nurse practitioner (FNP) or the physician assistant-equivalent
from the American Nurses Credentialing Center, American Academy of Nurse
Practitioners, or the National Commission on Certification of Physician
Assistants, in addition to a minimum of 2 years of experience in primary
care. The FSHP must be able to provide care to all age groups. The FSHP
provides clinical services and supervises the operation of the health unit at
post.
16 FAM 113.6 Regional Medical
Officer/Psychiatrist (RMO/P)
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
a. The regional medical officer/psychiatrist (RMO/P) is
a physician with a current, valid, and
unrestricted license to practice medicine in a State, the District of Columbia,
or a territory of the United States, and board-certified in psychiatry by
either the American Board of Medical Specialties or the American Osteopathic
Association Board of Psychiatry, in addition to a minimum of 5 years
experience in general or childhood psychiatry. The RMO/P must be able to
provide psychiatric care to all age groups.
b. The RMO/P provides psychiatric care and oversight of
mental health programs at assigned post and within his or her region.
16 FAM 113.7 Regional Medical Laboratory Scientist (RMLS) (Formerly Regional Medical Technologist)
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
The regional medical laboratory scientist (RMLS) must have a bachelors degree in medical
technology, clinical laboratory science, microbiology, or chemistry from an accredited college or university program.
The RMLS must have 4 years of experience
in an accredited laboratory, 2 of those years as a generalist, and 2 additional
years training as a specialist or generalist in a
laboratory discipline. The RMLS must
possess current certification with a U.S.
certifying agency for laboratory medical technologists
and scientists, and be able to demonstrate proof of continuing
education. The RMLS provides laboratory
support to the regional medical officers (RMOs) and Foreign Service health
practitioners (FSHPs) and oversees laboratory services at posts within their
region, and performs special projects as assigned.
16 FAM 113.8 Post Medical Advisor
(PMA)
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
A post medical advisor (PMA) is a medical practitioner
selected from the local medical community at the discretion of the management
officer at post and in consultation with the regional medical officer (RMO) or
the Foreign Service health practitioner (FSHP). The PMA is not a salaried
position and does not provide direct-patient care services unless under
contract. The PMA assists in identifying local medical practices, hospitals,
or clinics that could be utilized by mission
personnel.
16 FAM 113.9 Locally Hired Medical
Staff
(CT:MED-25; 08-20-2012)
(Applies to Civil Service and Foreign Service Employees)
Posts, in
consultation with the regional medical officer (RMO) or Foreign Service health
practitioner (FSHP), may hire local medical staff to provide medical services
at posts abroad. The RMO or FSHP must
verify the medical credentials of locally employed
medical staff (see MED ISO9001 Document
#1401, Hiring Providers Overseas).
16 FAM 114 through 119 UNASSIGNED