https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN38489-ARMY_DIR_2023-10-000-WEB-1.pdf
MEMORANDUM FOR SEE DISTRIBUTION
SUBJECT: Army Directive 2023-10 (Administrative Roles, Responsibilities, and
Procedures for Patient Movement)
1. References. See references enclosed.
2. Purpose. This directive prescribes administrative roles, responsibilities, and
procedures for patient movement within the Continental United States (CONUS) and
outside of the Continental United States (OCONUS).
3. Applicability. The provisions of this directive apply to the Regular Army, Army
National Guard/Army National Guard of the United States, and U.S. Army Reserve.
4. Background. This directive provides specific direction to ensure safe and efficient
aeromedical evacuation (AE) movement, mission command (MC), medical
management (M2), and administrative actions required for Soldiers who need medical
care and treatment that is not available at their assigned duty location. This directive
incorporates Defense Health Agency (DHA) procedural instructions published pursuant
to the National Defense Authorization Act for 2016 and delineates the administrative,
MC, and M2 responsibilities between DHA, the U.S. Transportation Command
(USTRANSCOM), and the U.S. Army.
5. Policy.
a. Patient movement procedures for all wounded, ill, or injured (WII) Soldiers (in a
qualifying duty status) who require AE or commercial air due to a lack of required
medical care and treatment where located, including those for non-medical attendants,
will comply with USTRANSCOM guidance. All WII Soldiers will have an approved and
funded travel order prior to leaving on a commercial or military AE flight. Pursuant to
Army Regulation 600–8–105, the Soldier’s assigned unit is responsible for publishing
the travel order unless otherwise indicated; for example, for Soldiers assigned
OCONUS.
b. Pursuant to AR 40–400, military treatment facility (MTF) directors/readiness
element commanders are responsible for the medical management of all inpatient
Soldiers. When an inpatient Soldier is discharged or in an outpatient status (either to
return to unit/duty location or with continuation of care at current MTF), the unit
S E C R E T A R Y O F T H E A R M Y
W A S H I N G T O N
SUBJECT: Army Directive 2023-10 (Administrative Roles, Responsibilities, and
Procedures for Patient Movement)
2
commander resumes responsibility for the discharged or outpatient Soldier. Patient
Movement clerks will communicate the discharge to the Soldier’s host unit.
c. Host unit commanders are responsible for Soldier transportation, lodging, meals,
incidentals, and travel orders once discharged or in an outpatient status (regardless of
Soldier location).
(1) For Regular Army Soldiers (COMPO 1), the host is the assigned unit.
(2) For Army National Guard and Army Reserve Soldiers (COMPOs 2/3), the
host is the unit command that brought the Soldier onto an active-duty order (also known
as the force requestor).
d. Host unit commanders will follow the recommendations of the MTF director and
facilitate required administrative actions. The MTF will assign a case manager (if
needed) to communicate the treatment plan and future location(s) to the host unit
commander if the Soldier requires movement.
e. Once approved for entry, Soldier Recovery Unit (SRU) assignment orders for
COMPO 1 Soldiers will be published by the gaining SRU. Requests for orders for
COMPOs 2/3 will be submitted to the U.S. Army Medical Command (MEDCOM) Soldier
Transition Branch for publication by the SRU after approval for entry into the program.
f. WII Soldiers who are mobilized OCONUS and require commercial air or AE to a
CONUS location will be managed by a contingency cell or Deployed Warrior Medical
Management Center (DWMMC), if operational. If the DWMMC or contingency cell is not
operational, follow paragraphs 5a–5e of this directive. The contingency cell or DWMMC
will manage onward movement for transfer for continuous care or returned-to-duty (RTD)
patients and their non-medical attendants. This includes, but is not limited to, patients
received at Landstuhl Regional Medical Center (LRMC). The Soldier’s command will
provide a letter of release, signed by an O-6 or higher, authorizing evacuation out of the
AOR pursuant to reference 1e. The contingency cell or DWMMC will—
(1) Publish a medical evacuation (MEDEVAC) temporary duty (TDY) order
within the appropriate system, not to exceed 30 days, attaching the Soldier to the
accepting MTF director for duty purpose of medical evaluation and treatment. Soldiers
on a temporary change of station (TCS) order for contingency operations will maintain
their original TCS order status until an MTF provider makes a medical determination
that the Soldier is unable to return to theater and has been appropriately transitioned to
the correct medical administrative order paid status pursuant to references 1j and 1k.
SUBJECT: Army Directive 2023-10 (Administrative Roles, Responsibilities, and
Procedures for Patient Movement)
3
(a) The Soldier Transfer and Regulating Tracking Center (STARTC) will serve in
a consultant role to USTRANSCOM and will ensure Army personnel are relegated to
the MTF with appropriate medical capability and capacity. Priority should be given to
MTFs with an enduring SRU. The MTF selected should be located as close as possible
to the Soldier’s unit of assignment for COMPO 1 and COMPOs 2/3 Title 10 Active
Guard and Reserve (AGR), or to home of record (HOR) for COMPOs 2/3 non-AGR.
(b) The MTF director will maintain medical management of the MEDEVAC
Soldier until returned to duty, transferred to another MTF, or released from active
duty (REFRAD) pursuant to reference 1f. If a Soldier is unable to return to duty at the
OCONUS location, the MTF director will maintain medical management and ensure the
Soldier is administratively transitioned to the appropriate medical status pursuant to
reference 1f. The accountability of Soldiers hospitalized outside of an MTF is covered in
reference 1k.
(c) Once a diagnosis indicates that the Soldier will not return to theater, the host
unit will complete an SRU packet and follow-on orders (TDY for COMPOs 2/3 and
permanent change of station (PCS) for COMPO 1) for redeployment and backfill
options. The host unit is responsible for movement of the Soldier to the provider’s
recommended discharge disposition (such as HOR or RTD).
(2) Verify outpatient moves for patient care with the accepting MTF patient
administration, the Tricare Operations and Patient Administration (TOPA) Office, and/or
the AE noncommissioned officer in charge when there is no confirmation of an
accepting medical service at the designated MTF. MTF point-of-contact information will
be provided to the sending USTRANSCOM Theater Patient Movement Requirement
Center (TPMRC).
(3) Monitor validation of flight movement in the TRANSCOM Regulating and
Command Control Evacuation System (TRAC2ES).
(4) Verify patient information by using the Armed Forces Health Longitudinal
Technology Application (AHLTA) or the theater equivalent (AHLTA-T), Composite
Health Care System (CHCS), Medical Protection System (MEDPROS), Defense
Eligibility Enrollment Reporting System (DEERS), and Military Health System (MHS)
Genesis.
6. Proponent. The Assistant Secretary of the Army (Manpower and Reserve Affairs)
has oversight responsibility for this policy. The Deputy Chief of Staff, G-1 will
incorporate its provisions into AR 600–77 within 2 years of the date of this directive.
SUBJECT: Army Directive 2023-10 (Administrative Roles, Responsibilities, and
Procedures for Patient Movement)
4
7. Duration. This directive is rescinded on publication of the revised regulation.
Encl Christine E. Wormuth
DISTRIBUTION:
Principal Officials of Headquarters, Department of the Army
Commander
U.S. Army Forces Command
U.S. Army Training and Doctrine Command
U.S. Army Materiel Command
U.S. Army Futures Command
U.S. Army Pacific
U.S. Army Europe and Africa
U.S. Army Central
U.S. Army North
U.S. Army South
U.S. Army Special Operations Command
Military Surface Deployment and Distribution Command
U.S. Army Space and Missile Defense Command/Army Strategic Command
U.S. Army Cyber Command
U.S. Army Medical Command
U.S. Army Intelligence and Security Command
U.S. Army Corps of Engineers
U.S. Army Military District of Washington
U.S. Army Test and Evaluation Command
U.S. Army Human Resources Command
U.S. Army Corrections Command
Superintendent, U.S. Military Academy
Commandant, U.S. Army War College
Director, U.S. Army Civilian Human Resources Agency
Executive Director, Military Postal Service Agency
Director, U.S. Army Criminal Investigation Division
Director, Civilian Protection Center of Excellence
Superintendent, Arlington National Cemetery
Director, U.S. Army Acquisition Support Center
CF:
Principal Cyber Advisor
Director of Enterprise Management
Commander, Eighth Army
Enclosure
REFERENCES
a. Department of Defense (Joint Travel Regulations (JTR)), 1 May 2022
b. Department of Defense Instruction 5154.6 (Armed Service Medical Regulating),
20 October 2013
c. Department of Defense Instruction 6000.11 (Patient Movement), 22 June 2018
d. U.S. Transportation Command Handbook 41–1 (Global Patient Movement
Operations), 3 May 2016
e. U.S. Transportation Command general administration message (Through Regulating
Patients From USCENTCOM), 121555 Z JUL 21
f. Defense Health Agency Procedural Instruction 7000.01 (Patient Travel), 6 July 2021
g. Army Regulation (AR) 40–58 (Army Recovery Care Program), 12 May 2020
h. AR 40–400 (Patient Administration), 8 July 2014
i. AR 600–8–105 (Military Orders), 22 March 2019
j. AR 600–77 (Administrative Management of Wounded, Ill, or Injured Soldiers),
5 March 2019
k. U.S. Army Medical Command Policy Memo 21-027 (Medical Accountability of
Active-Duty Service Members Admitted to Non-Military Medical Treatment
Facilities (MTFs)), 13 May 2021