Nearly 30 partner nations are participating alongside the U.S. during Air Mobility Command's Mobility Guardian, which runs across Washington State through Aug. 12.

The exercise aims to enhance the U.S. military's global response force by integrating in complex, realistic mobility training with partner nations.

Fully-integrated events during the exercise will allow for strategic interoperability in support of real-world operations, said Maj. Thomas Rich, Joint Task Force director of operations for Mobility Guardian.

"We're pushing the tactical edge," said Rich. "We're putting aircraft from different nations close together in a tight air space in a dynamic threat environment. There's a little bit of inherent risk in that, but that's what we want to do here so that everybody is ready when we do it for real."

More than 650 international military personnel and 3,000 U.S. military servicemembers will focus on AMC's four core competencies during the exercise, which include airlift, air refueling, aeromedical evacuation and air mobility support, said Col. Clinton Zumbrunnen, the international observer mission commander for Mobility Guardian.

Zumbrunnen hopes Mobility Guardian, which is planned to be held biennially, will attract additional allies to attend and will encourage observers to return as participants in the future.

Col. Jose Antonio Morales, Brazilian air force's 5th Wing training commander, mirrors this hope for his own country.

"We are trying to arrange a lot of new exercises and interchanges between our countries," said Morales. "We are all so proud to represent our country and our air force and participate in this very important exercise."

Some of the scheduled events include formations between the U.S., Brazil and Colombia, and a joint forcible entry from an intelligence alliance comprised of the U.S., Australia, the United Kingdom, New Zealand and Canada.

Capt. Patrick Rodrigue, Canadian Forces Aeromedical Evacuation Unit flight nurse, offered his take on the upcoming exercise upon arrival at Joint Base Lewis-McChord.

"It's very important for us to get out there and actually practice our mission and get to practice our capacity as well as joint interoperability," said Rodrique.

Those nations observing also play a vital role by strengthening partnerships with the U.S. and becoming familiarized with U.S. training, tactics and procedures. Zumbrunnen said observers will be paired with U.S. crew members to see as much of the air mobility process as safely and securely as possible.

It's a test of how we operate with interoperability and also gives us the opportunity to build relationships, he said.

Mobility Guardian will focus on training both junior and senior Air Force airmen to operate alongside international servicemembers. To Rich, this maximizes the efficiency of the entire Air Force and its interoperability during real-world contingencies.

For Zumbrunnen the effort to enhance unrivaled power projection capabilities is not possible without the help of U.S. allies.

"I have not deployed anywhere or gone anywhere in my duty as an airlift pilot where there was not an international presence," said Zumbrunnen.

Zumbrunnen believes the ability for the U.S. to gain and fight alongside its allies is an unrivaled asset.

Mobility Guardian offers an avenue for testing the full spectrum of AMC capabilities. It also incorporates opportunities to exchange mobility expertise with international counterparts to create world-wide impact.

The U.S. does not go to war without allies, said Rich, so it's important that Mobility Guardian develops our ability to power project when and where needed.

Train like we fight is the focus of the inaugural iteration of the largest scale exercise that Air Mobility Command has ever undertaken.

Mobility Guardian features over 3,000 personnel, including 25 international countries through Aug. 12 at Joint Base Lewis-McChord.

"Our ability to move national power to any location is key to the security of the United States," said Gen. Carlton D. Everhart, II, Air Mobility Command commander. "Mobility airmen are often the first to arrive and the last to depart. They provide continuous support to the joint warfighter. Simply put, success requires our Total Force team of mobility airmen to work together with joint and international partners. Exercising our capabilities together is critical, so when we are called upon, we can deliver quickly and precisely."

Exercise Mobility Guardian is designed to enhance the capabilities of mobility airmen by preparing them to succeed in the dynamic threat environments of today and tomorrow.

"We're creating an exercise that will encompass everything AMC does," said Lt. Col. Jeremy Wagner, Mobility Guardian director. "We basically took every skillset from AMC and said, ‘what would the ideal exercise for each of our different mission sets look like?' Then we combined them all into one."

The exercise is about strengthening partnerships, discovery, learning and improving together as an integrated team, according to officials. Mobility Guardian will provide mobility airmen an opportunity to work with joint services, international partners and industry.

This exercise is being conducted with mobility aircraft heavily involved in the war against the Islamic State and employed worldwide to deliver hope to those in need. The Combat Air Forces are supporting the exercises with an array of fighter and bomber capability to include F-35s, F-16s, A-10s, F-15Es, F-15Cs, B-52s and the B-2.

"We're trying to challenge mobility airmen to improve skillsets that they either may have not worked on recently or have experienced at all," said 1st Lt. Michael McCarthy, Mobility Guardian planner. "Any Combat Air Forces involvement is to simulate what we would see real-world but really push these members to the limits within the safe parameters of what they're capable of."

Training in preparation for the exercise has been left to individual units. Unlike AMC Rodeo, a competition, Exercise Mobility Guardian is less about showcasing skills and rather creating a comprehensive, realistic and complex training environment.

This exercise is about developing new skills and spreading knowledge among airmen as they work alongside our international partners, said McCarthy.

Throughout the exercise, teams will make observations and gather metrics that will be passed to AMC leadership to develop an appropriate site picture of the MAF's capabilities. They will also compile lessons learned for areas that need improvement, post-exercise.

Planning and coordination has taken roughly two years and has involved the work of several career fields to include all core functions of AMC.

Interest for the exercise has completely exceeded expectations as registration closed July 11 due to an overwhelming response.

"We've built something really fantastic and I think people are responding to that," said Wagner. "We're getting people calling all of the time saying that they want to be a part of this."

The second half of Exercise Mobility Guardian began at Joint Base Lewis-McChord Aug. 6 and will focus on training aircrew on advanced tactical air operations. The exercise ends Saturday.

Following the successful execution of the joint forcible entry, ground forces established control over Moses Lake, which enabled the transition to sustainment operations.

"Mobility Guardian has tested our ability to prepare and deliver the force," said U.S. Air Force Gen. Carlton D. Everhart II, Air Mobility Command commander. "Now it will test our ability to sustain the force and, after the mission is over, ensure the joint force returns home."

The 62nd Medical Brigade enabled the first step in the sustainment phase, said U.S. Air Force Lt. Col. Jeremy Wagner, Mobility Guardian director. The brigade executed humanitarian relief operations after the 82nd Airborne Division accomplished a joint forcible entry and seized the airfield at Moses Lake. From there, components of the 7th Infantry Division, Stryker Brigade Combat Team, took over the airfield and established their power projection.

These movements enabled the 621st Contingency Response Wing to begin air base opening operations at Fairchild Air Force Base, Moses Lake and Yakima.

International teams working with ground forces will also provide force protection during the sustainment phase. The Number 2 Squadron Royal Air Force Regiment, one of the international teams, will provide airfield security for the 621st CRW.

"They are force multipliers," said Wagner. "They've been very involved and have shown how capable they are as our partners."

International teams will remain integrated during the 500-plus flights that were planned in support of Mobility Guardian, said Wagner. During the sustainment phase, aircraft will continue to deliver materials to support the ground forces' humanitarian efforts, but the air operations are expected to become more difficult.

"We've been airdropping an incredible amount of equipment to some of the displaced humanitarian relief operations," said Wagner. "Now it mostly focuses on getting advanced tactical training for our aircrews. When we're done with that, we can start heading home."

This training includes air drops in difficult locations, opportunities to test practice threat systems that detect ground enemies, and C-130 wet-wing defueling, Wagner added.

For Everhart, this advanced exercise is a testament of the abilities that U.S. and international servicemembers provide the global response force.

"Global reach is not a birthright for America; it requires hard work, preparation, investment and training," said the AMC commander. "Mobility Guardian offers our airmen vital experience to excel in any environment, applying lessons learned from years of war to deliver a realistic and challenging training environment for not only the Air Force but our joint and international partners as well."

For the 446th Aeromedical Evacuation Squadron, Mobility Guardian is an opportunity to train and sharpen battlefield skills for medical troops from around the nation and world.

A majority of the AES participation from the 446th Airlift "Rainier" Wing for Mobility Guardian will be as ground members who will support flying crews going up on exercise missions, said Capt. Virginia Aguilar, 446th AES healthcare administrator.

"We will primarily have people running the Aeromedical Evacuation Operations Team," said Aguilar. "Their job will be to organize crews to get on missions and then tag those crews for specific flying missions once alerts come down."

As Capt. April Telan, 446th AES flight nurse, continued to explain, the crews will also be charged with maintaining the equipment and medications needed for Aeromedical Evacuation missions to be flown, as AEOT members will also be responsible for coordinating with the Aeromedical Staging Squadron members to coordinate the transportation of patients to the En Route Patient Staging System (ERPS).

"The people running the AEOT in deployed locations are usually kept very busy working in shifts 24 hours a day to prepare for medical alerts that need to be responded to immediately," said Telan.

The members running the AEOT have to ensure the ability for crews to respond around the clock by maintaining crew-rest schedules and ensuring that crews are always prepared and available.

Tech. Sgt. Gabriel Itaya, 446th AES AEOT non-commissioned officer in charge for Mobility Guardian, explained that part of the challenge in addition to the multitude of tasks the AEOT is charged with normally, has been setting up their AEOT capabilities from the ground up.

"When we came out here we had to learn to set up the whole area," said Itaya. "This has entailed unpacking and doing inventory of equipment as well as creating mission boards for use during the exercise."

Of the 12 members running the AEOT for the Mobility Guardian exercise, four of them are from the Rainier Wing.

In addition to the multitude of tasks AEOT members are charged with organizing, they are also present on the flight line to launch and recover every mission that goes out to ensure that the proper equipment is loaded and unloaded from planes.

"It's been a learning process as we've all had to learn to make adjustments on the fly," said Itaya, "Over the course of the exercise so far, we've already gotten a lot smoother in our process."

Mobility Guardian is a new exercise intended to enhance Mobility partnerships and test the full spectrum of capabilities AMC provides the nation. It began July 31 and is scheduled to conclude Aug. 12. The exercise involves participation from more than 3,000 U.S. military personnel from the Air Force, Army, Navy and Marine Corps in addition to participants from nearly 30 international countries.

Crews flew approximately 1,200 hours in eight days, executing nearly 650 sorties during Exercise Mobility Guardian, July 31 to Aug. 12.

During those missions, refueling aircraft offloaded roughly 1.2 million pounds of fuel; aerial port personnel processed 3,676 passengers and 4,911 tons of equipment; and crews airdropped 356 paratroopers, 33 heavy platforms and nearly 300 Container Delivery System bundles.

"I think (Mobility Guardian) was very beneficial because it was the first exercise in a long time where the sole focus was on the desired learning objectives of the Mobility forces across the spectrum: contingency response, aeromedical evacuation, air mobility liaison officers, air refueling, airlift, airdrop and much more," said U.S. Air Force Col. Johnny Lamontagne, Mobility Guardian combined forces air component commander.

Mobility Guardian included 54 aircraft from 11 nations and enabled personnel from 25 nations to enhance interoperability.

"It was great for them to be able to see how we operate and for us to see how they operate," said Lamontagne. "When the United States goes into combat, we go with our international partners, but we rarely get to train together.

"This was a great opportunity to integrate so when we go into combat, it's not the first time we've worked together; we already have some experience and understand each other's capabilities," he added.

The exercise included more than 3,000 U.S. servicemembers and international partners who worked to measure the effectiveness of the Mobility Air Forces in contingency and humanitarian response operations.

"Mobility Guardian was about learning, discovery and the opportunity to work as a part of a joint and coalition team," said U.S. Air Force Gen. Carlton D. Everhart II, Air Mobility Command commander. "This exercise was an investment in ensuring our airmen are prepared to succeed in the most challenging environments and deliver desired results across the globe."

Mobility Guardian offered international, partner-nation opportunities including exposing aircrews to critical aeromedical evacuation patient stabilization training.

For the 446th Aeromedical Evacuation Squadron, the opportunity to train with a Brazilian air crew in their Casa 295 to share knowledge about how to stabilize and transport patients using the smaller Brazilian aircraft was one of the highlights of the exercise.

"We've had a lot of international participants for Mobility Guardian," said Capt. Virginia Aguilar 446th AES healthcare administrator, "and Brazil was one we really enjoyed working with."

While the Brazilian air crew had previously performed casualty evacuation using their aircraft, they did not have experience with aeromedical evacuation that involved patient stabilization.

"The goal was to see if their aircraft could be used for future aeromedical evacuation missions based on some of the standards that we use," said Aguilar.

The 446th AES loaded their own equipment onto the aircraft to attempt to simulate an aeromedical evacuation as realistically as possible.

"We were trying to work with the Brazilians to share with them what resources they would need to transport patients," said 1st Lt. Kyoung Craddock, 446th AES flight nurse.

Working on a different airframe from the C-17 Globemaster III, AES was able to simulate operating on a Brazilian aircraft.

"We brought along our own oxygen and our own electrical equipment to try and see how we would be able to operate within their aircraft," said Capt. Grace De La Alas, 446th AES Flight Nurse.

Once the 446th AES loaded their equipment and simulated patients onto the aircraft, they flew to Fairchild Air Force Base to attempt at Engine-Running On-load (ERO).

"The goal was to be able to off-load and on-load as quickly as possible," said Alas, "to show them what we would do in an emergency situation."

EROs require a lot of oversight, including safety.

"There's much more safety oversight required to perform and ERO," said Craddock. "We do it to simulate what might need to happen in a combat environment if the pilot tells us we need get out of their as quickly as possible."

Although there were no Brazilian medical personnel on the flight, the Brazilian air crew was able to document and record much of what AES was able to share.

"It was a great experience for us," said Aguilar. It was a good brainstorming opportunity for us and we feel like both sides benefited a lot."

The opportunity to train with new equipment and exchange best practices for the purposes of advancing the readiness of U.S. allied partners has been one of the central components of Mobility Guardian.

Mobility Guardian included 54 aircraft from 11 nations and enabled personnel from 25 nations to enhance interoperability.

Crews flew approximately 1,200 hours in eight days, executing nearly 650 sorties during Exercise Mobility Guardian, July 31 to Aug. 12.

During those missions, refueling aircraft offloaded roughly 1.2 million pounds of fuel; aerial port personnel processed 3,676 passengers and 4,911 tons of equipment; and crews airdropped 356 paratroopers, 33 heavy platforms and nearly 300 Container Delivery System bundles.

Constantly on high alert, and not knowing when or where an attack might occur, serving in a deployed environment can test even the most experienced airmen. For 16 members of the 446th Aeromedical Staging Squadron, a recent deployment to Afghanistan was anything but routine.

Shortly after arriving at Craig Joint Theater Hospital at Bagram Airfield, Afghanistan, in mid-October 2016, citizen airmen of the 446th ASTS participated in a mass casualty exercise to help prepare them for what they might encounter during their deployment.

"The mass casualty exercises are good because it keeps us familiarized with our equipment and roles," said Senior Airman Paul Whatley, an aerospace medical technician assigned to the 446th ASTS. "It also helps with working with other branches of service in building that trust of working together."

The exercise occurred at the beginning of a new rotation of deployed medics. The purpose of this type of drill is to create a realistic scenario of an incident that may occur during a deployment to prepare each team in handling their roles.

But what they couldn't prepare for was putting those skills to the test less than two weeks later.

"I was heading to a base ‘fun-run' for Veterans Day," said Whatley. "I was running late for the run and when I arrived where the run was supposed to start, all I saw was chaos. As soon as I saw the casualties I ran back to the hospital to get ready to work."

On Nov. 12, 2016, a suicide bomber had penetrated the defenses of Bagram Airfield and blew himself up, killing four people and wounding 17 others.

"You have to be flexible, things always change in a deployed environment," said Capt. Christopher Hamel, a 446th ASTS clinical nurse and serving his fourth deployment. "Most of us in the ASTS are in the medical field outside of the Reserves. We all had to step up and fill in wherever we could."

For some, it was their first deployment and an eye-opening experience.

"It was my first deployment and one of the roles I really wasn't prepared for was providing hospital security," said Staff Sgt. Taleesha Thomas, an aerospace medical technician assigned to the 446th ASTS. "I had my rifle and body armor, but there was a lot of uncertainty. We didn't know what was happening with the attack."

After the casualties were treated, the Rainier Wing ASTS members then had to prepare them for aeromedical evacuations out of Bagram.

"After the patients were stable, a lot of the hospital staff left to go rest," said Hamel. "We had to stay behind and step back into our roles as the ASTS. Most of us ended up working more than thirty hours straight."

While no training can simulate the real thing, it works toward enabling a team to work together.

"Any mass casualty incident is hard to prepare for," said Thomas. "There was a lot of chaos at the hospital during the attack, but we were also well organized."

The 446th ASTS is constantly training at home to provide the best care for patients in a deployed environment, moving them between medical facilities on the ground and aeromedical evacuation flights.

"Our mission is to ensure that every patient that comes through our hands is cared for at the highest level -- medically, physically, professionally and mentally," said Tech Sgt. Tamie Zabroski, an aerospace medical technician assigned to the 446th ASTS. "Then we assist them in getting evacuated through the aeromedical evacuation system to the next higher level of care. We don't treat just the "wounds" but the whole person. We want to ensure that the patient is returned to duty as quickly as possible so that he or she can continue in their mission."

Beginning Monday and continuing through Sept. 22, JBLM's Directorate of Public Works will be conducting a repaving project on Perimeter Road which will prohibit traffic getting either to or from the Spanaway area through Barnes Gate, however, traffic getting to and from I-5 will continue to be able to use Barnes Gate (traveling west) through Sept. 4. Beginning Sept. 5, the city of Lakewood will be making extensive improvements to the sewer network in the American Lakes Garden neighborhood resulting in the closure of 150th Street from Woodbrook Drive to Perimeter Road.

The timeframe these two projects overlap will occur Sept. 5 through Sept. 22 and will require Perimeter Road being closed from Woodbrook Drive to Military Road. Barnes Gate and the McChord Field Commercial Vehicle Inspection Point will be inaccessible to any vehicular traffic.

JBLM's Directorate of Emergency Services will incorporate the following gate schedules during the road improvement project (Aug. 28 - Sept. 22).

McChord Main Gate:  Gate remains open 24-hrs a day, 7 days a week.

McChord Barnes Gate:

Aug. 28 - Sept. 4:   Normal operation (5 a.m. to 7 p.m. / 7 days)

Sept. 5-22:  Closed

Sept. 23: Resume normal hours of operation

McChord North Gate:

Aug. 28 - Sept.1:  5 a.m. - 7 p.m. daily

Sept. 5:  Resume normal hours of operation (5 - 9 a.m. and 3-6 p.m., M-F)

Woodbrook Housing Gate:

Sept. 5-22:  5 a.m.- 7 p.m., M-F

Sept. 25:  Resume normal weekday operations (5-9 a.m. and 3 - 6 p.m., M-F)

Weekend hours will remain unchanged throughout the construction (8 a.m. - 5 p.m., Sat-Sun)

McChord East Gate:

Sept. 5-22: 5 a.m. to 7 p.m. / 7 Days

Sept. 23: Gate will close

McChord Field Commercial Vehicle Inspection Point:

Sept. 3-24: Any commercial vehicle or oversized vehicle requiring access to McChord Field will need to enter the Lewis Main portion of JBLM and cross over to McChord Field via Unity Bridge.  

Sept. 25: Gate resumes normal operations (5 a.m. to 1 p.m., Mon-Fri)

The JBLM Public Works road improvement project is scheduled to be completed Sept. 22 and the Lakewood sewer improvement project is scheduled to be completed Sept. 30. For more details concerning the Lakewood sewer improvement project, call or email Lakewood Public Works Department at (253) 589-2489, email: sewerproject@cityoflakewood.us.

Beginning Sept. 1, Express Scripts will need annual consent from patients who want to receive automatic refills of their maintenance medications enrolled in TRICARE Pharmacy Home Delivery. This means that just before one of your prescriptions runs out of refills, Express Scripts will reach out to you to know if you would like your doctor to be contacted to renew the prescription and if you'd like to continue in the Automatic Refill program. If not, Express Scripts will not refill your prescription.

"This new process gives beneficiaries more control over their medications and keeps the convenience of automatic refills," said Amy Aldighere, the DoD Program Management Express Scripts senior director. "It also makes it easier to opt out of the Auto Refill program and helps to prevent beneficiaries from receiving medications that they no longer need or shouldn't receive."

What to Expect

When the last refill of a medication enrolled in the Automatic Refill program ships, Express Scripts will reach out to you by telephone and/or email (depending on the preference you indicated) and ask the following:

• Would you like Express Scripts to reach out to your doctor for a new prescription?

• Do you want to keep your medication enrolled in the Auto Refill program?

How to Respond

Express Scripts will not re-enroll your medication unless they hear from you. You have several ways to respond:

• Online at Express-Scripts.com/TRICARE

• Via the automated phone call from Express Scripts

• By calling an Express Scripts patient care advocate (PCA) at 1.877.363.1303

If Express Scripts does not receive your consent within 10 days of reaching out to you, they will remove your medication from the Auto Refill program. However, re-enrolling is simple. You can re-enroll your medication at any time online, or through a PCA.

For more information or if you have questions, go to the Express Scripts website. You can also call Express Scripts at 1.877.363.1303 to speak with a PCA.

Air Force Medicine has a non-stop global readiness mission. Medical airmen must be prepared to deploy on short notice to provide life-saving and performance-enhancing healthcare in diverse, austere, isolated locations, and all airmen must be medically ready to deploy. To achieve this readiness mission, the Air Force Medical Service operates 76 military treatment facilities around the world, which serve as the primary readiness and training vehicles.

The 12 hospitals and 64 clinics within the AFMS serve as dual readiness platforms, ensuring that all airmen meet medical readiness standards to deploy, and that all medical airmen have the training and skills necessary for deployment. The MTFs are the foundation of our expeditionary medical capabilities, providing a population of patients that drives the workload, case diversity and acuity necessary to maintain clinical currency that is essential for readiness.

Every Air Force MTF is aligned with an operational wing to enhance the medical readiness of warfighters and their families. Medical group commanders tailor the care and training offered at their MTF, ensuring the medical readiness of the operational wing they support. No two air bases have exactly the same mission portfolio, so each has unique medical support requirements.

An excellent example of how MTFs support the installation's operational mission is the 19th Medical Group at Little Rock Air Force Base, Arkansas. The 19th Aerospace Medicine Squadron High Altitude Airdrop Mission Support Center is housed at Little Rock, so medics from the 19 MDG are experts in the care of high-altitude operators. This includes unique oxygen monitoring and physiologic performance requirements for these airmen. This type of expertise, like others organic to Air Force Medicine, isn't required at every installation, nor would it be efficient to deploy it at all 76 AFMS facilities.

The knowledge, skills and abilities gained at these fixed facilities translate into outstanding care in a deployed environment. A valuable tool for the AFMS to extend this care downrange is our Expeditionary Medical Support Health Response Teams (EMEDS-HRT). EMEDS-HRT allows medical airmen to rapidly deploy a mobile tent hospital that can provide emergency care within an hour of arrival on the scene of a disaster or other casualty situation. This gives us the capability to deliver surgery and critical care within six hours, and full hospital capability within 12 hours of arrival.

Properly training medical airmen to deploy and operate EMEDS-HRT requires a specialized MTF readiness platform. Four Air Force MTFs are presently staffed to deploy and train EMEDS personnel, including the 633rd Medical Group at Joint Base Langley-Eustis, Virginia, devoting time and resources to a critical deployment platform that other MTFs are not resourced to deliver.

At the 633rd, the Global Response Force coordinates with Air Combat Command to run annual training exercises on EMEDS-HRT. Medics from the 633rd practice rapid deployment and simulated casualty care with a wide assortment of patient scenarios. These well-trained airmen from the 633rd deploy in support of a variety of mission types around the world, from combat operations support to humanitarian assistance and disaster relief.

Once fully operational, EMEDS-HRT can provide surgical and trauma care, prevention, acute intervention, primary care and dental service to a population of more than 3,000. Our expert teams continue to find innovative ways to decrease the size and weight, while increasing the speed of deploying these mobile hospitals. They can also be tailored to a specific mission, adding specialty care such as obstetrics/gynecology and pediatrics for humanitarian assistance, disaster relief or other missions involving populations with special healthcare needs.

Medics at most MTFs rotate through EMEDS training, but may not receive the in-depth training available to airmen at Joint Base Langley-Eustis. This tailored mission support is critical to building and sustaining an agile and flexible force, capable of completing a myriad of health-related missions around the globe at once.

MTFs also serve as platforms to evolve and implement new ways of caring for patients. Most patients interact most often with their health teams in primary care clinics, so these are a key area for readiness and innovation. Air Force MTFs utilize the Air Force Medical Home model, a team-based approach to care that embeds specialty providers into primary care clinics. This removes barriers to care and drives efficiency. Mental health providers, physical therapists, clinical pharmacists, social workers, and others augment or deliver primary care appointments in close coordination with the primary provider and other members of the team.

Our Behavioral Health Optimization Program, which embeds mental health providers in primary care clinics, has been particularly beneficial. Building a mentally resilient force is a key to readiness, but stigma can sometimes create a serious hurdle to seeking mental healthcare. BHOP is an effective way to initiate mental healthcare, starting informal conversations with mental health professionals. Brief meetings in the context of a primary care appointment can lead to earlier treatment of a mental health condition, preventing a more serious problem.

The AFMH model also incorporates the Base Operational Medicine Clinic, an occupational medicine, flight medicine and deployment health-focused clinic. BOMC is separate from primary and family care clinics at MTFs, focusing resources on the readiness mission. Previously, flight and occupational medicine clinics required patients to visit different departments to get their pre-placement exams and exposure assessments. BOMC, centralizes all exam components in one clinic, and use standardized procedures. This model is especially valuable at MTFs that host fighter wings, or other units that call for a high volume of aerospace medicine services.

In our continuous efforts to provide a medically ready and ready medical force of airmen for our nation's defense, the AFMS relies on the remarkable medical airmen who are its providers, nurses, technicians and patients. The people I serve with, men and women of amazing compassion, skill, training and creativity, continually inspire me. My job is to build a system that allows them to succeed to the maximum extent of their abilities, and to create space for them to successfully innovate. The strength of the AFMS is undoubtedly our mighty medical airmen.

In any organization, once change has begun, the biggest challenge is to sustain the change and build on that initial momentum. Our readiness focus is not only for today's requirements, but the new missions we may be called upon to execute tomorrow. As we support the increasingly in-demand, 24/7 mission of our globally engaged Air Force, some of these challenges will be small, while others will be immense. Our MTFs are the backbone of a flexible and resilient AFMS, helping us answer the call to meet any readiness mission we are called on to deliver in the future.