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Ensuring readiness for 3,000 Marines: How H&S Bn does it

18 Feb 2016 | Eve A. Baker Marine Corps Base Quantico

If you find it difficult to keep track of your own family’s medical and dental appointments on top of work, school, sports practices and other family activities, be glad you are not in the shoes of Headquarters and Service Battalion’s commanding officer, Col. Todd J. Oneto. Marine Corps Base Quantico’s H&S Bn is the largest battalion in the Marine Corps, with approximately 3,000 Marines and Sailors, and Oneto is responsible for ensuring the medical and dental readiness of every member of the command.

According to Oneto, when he took command of the battalion on May 29, 2015, Col. Robin Gallant, the previous CO, told him achieving the Department of Defense mandated minimum readiness levels of 75 percent for medical and 95 percent for dental was “a tough nut to crack.” Accepting the challenge, Oneto decided to make medical and dental readiness his number one priority and has been working steadily towards achieving that goal since last May.

On Feb. 1, Oneto said “We’re making good headway, but it could be a lot better.” Medical readiness for H&S Bn stood at 60.2 percent when Oneto first took command, and it peaked at 71 percent in December. Readiness has dipped slightly since then to 67 percent, due to the year-end requirement for everyone to receive flu shots, but Oneto believes it will rebound within a few weeks.

Capt. Robert Alonso, executive officer for Naval Health Clinic Quantico, said it is particularly difficult for units at MCBQ to achieve the 75 percent medical readiness level because “there are a lot of training and support commands with a lot of turnover, and it’s hard for them to get a lot of people together in one place at one time.”

However, one tool that has proven effective in increasing medical readiness is the Mobile Medical Readiness Team, a concept pioneered by NHCQ in the second half of 2015. According to Cmdr. Han Bui, director of the Public Health section at the clinic, the “Mobile Medical Readiness Team comprises six to eight corpsmen and a clinician. The team will come to a unit’s physical location to provide the following services: PHA [periodic health assessment], immunizations, medical readiness labs, and any required PDHRA/MHA [post-deployment health reassessment/mental health assessment] screenings post-deployment.”

Alonso said the turnout will range from 15-80 percent of required personnel when the MMRTs go to the various unit sites. H&S Bn has hosted 16 MMRT visits since June 2015, and both Oneto and Alonso feel that the visits have helped bring readiness up in the battalion.

“While medical readiness for The Basic School and Officer Candidates School is handled by their respective clinics, any other unit can request an MMRT visit by calling the clinic,” said Bui.

The one readiness issue the MMRT cannot address is dental readiness, because service members need to visit the clinic for an exam and X-rays, said Alonso.

Dental readiness for the battalion stood at 85.4 percent when Oneto took command, and as of Feb. 1, it stands at 91.1 percent. Oneto said the dental figures are much higher than for medical because “all it takes is a dental exam to be considered ready.”

Lt. Brent Zastrow, the dental readiness officer for Naval Health Clinic Quantico, said that there are four dental class ratings, but “only Class 3 and 4 affect readiness.” Class 4 patients are those who have not had the required annual exam. Simply by receiving the exam, provided the patient does not need major dental work (which would put him or her at Class 3), the patient moves to Class 2 and no longer affects readiness levels. A patient can move to a Class 1 rating by having a recommended, though not required, dental cleaning.

As of Feb. 4, there were 197 service members listed as Class 4 within H&S Bn, said Zastrow. To bring readiness numbers up, Zastrow and other dental clinic staff have been e-mailing patients directly on a daily basis, both those who are already Class 4 and those whose exams are due in the next couple months.

“In the e-mail we provide them with the clinic phone number and location,” Zastrow said. The clinic does approximately 35 dental exams per day, and service members can usually get an appointment within one to two days of calling and frequently, even a same-day appointment. “Cleanings take longer, and we only have four hygienists,” said Zastrow, so sometimes service members may have to wait for up to a month before getting an appointment for a cleaning.

Zastrow also e-mails Oneto and other commanders on a weekly basis to make them aware of the current readiness status, and he updates the units’ status regularly on a board displayed in the clinic waiting area. Oneto said the public display of readiness levels at the clinic “inspires a little competition and encourages units to raise their stats.”

Oneto believes the biggest obstacle to achieving the DoD-mandated levels of readiness in both the medical and dental categories is individual accountability or personal responsibility. “There were 330 missed dental appointments from October through December, which means the patients and those on the waiting list both miss out on a chance to be seen. The clinic requires at least a 24-hour notice for cancellations.”

“I understand everyone’s busy, but I’m busy too and still get my requirements taken care of.” With the cooperation of the medical and dental staff and the general officers and other senior leaders in the battalion, Oneto said H&S Bn can be fully compliant with DoD standards in the next few months.

NHCQ, which houses both the dental and medical clinics, is located at 3259 Catlin Ave. and can be reached by phone at 703-784-1725.


Marine Corps Base Quantico