OFFICE OF MEDICAL SERVICES LONG RANGE PLAN

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP88G01332R001100050001-4
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 27
• Document Creation Date: December 27, 2016
• Document Release Date: January 13, 2012
• Sequence Number: 1
• Publication Date: December 3, 1985
• Content Type: MEMO

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ROUTING AND RECORD SHEET
suamcT: (optional)
CMS FY 86 - FY 91 Plan
FROM:
EXTENSION
NO.
Director of Medical Services
1D4061 Hqs.
DATE
7 November 1985
TO: (Officer designation, room number, and
building)
DATE
OFFICER'S
RECEIVED FORWARDED INITIALS
COMMENTS (Number each comment to show from whom
to whom. Draw a line across column after each comment.)
MA ' p
7
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Attached is OMS FY 86 -
2.
FY 91 Plan.
3.
4.
5.
6.
7.
8.
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10.
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13.
14.
13.
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MEMORANDUM FOR: Director of Medical Services
FROM: Harry E. Fitzwater
Deputy Director for Administration
SUBJECT: Office of Medical Services Long Range Plan
REFERENCE: Office of Medical Services Strategic Plan,
FY 1986,to FY 1991
I have reviewed and approved your long range plan. The plan outlines an
ambitious and well thought-out set' of objectives for medical services for the
coming years. It is exceptionally and commendably people-oriented. I look
forward to meeting with your people quarterly to review the progress of your
important programs to disouss any problem areas.
ORIG: DDA/Pla~
Original - Addressee
1 - DDA Chrono
1 - DDA Subject
1 - DDA/MS Chrono
1 - DDA/MS Subject
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The Director of Medical Services is responsible for
developing and directing the Agency's medical programs, both in
the United States and overseas. These programs are concerned
with promoting and maintaining the physical and mental fitness
of all Agency employees, and dependents when applicable;
providing medical evaluations and psychological assessments for
job suitability; and providing medical and psychological support
to operational and intelligence production activities.
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A. The Office of Medical Services (OMS) provides a broad
range of professional programs that fall into four functional
categories and are as follows:
1. SELECTION AND EVALUATION. This process involves
clinical, psychiatric, and psychological screening of
applicants and evaluation of both employees and dependents
pre- and post-overseas assignment.
2. HEALTH SUPPORT. This is the traditional medical
support plus a potpourri of additional services such as
counseling, training, health lectures, Employee Assistance
Program, Safety Program, etc.
3. SUPPORT OF OPERATIONS AND INTELLIGENCE
PRODUCTION. This support assists the clandestine service
(Agency and Intelligence Community) in the development and
retention of agents and assets, and production of
intelligence.
4. INTERNAL OMS SUPPORT. This represents the
traditional support services such as personnel, budget,
medical administration, etc.
B. The plan establishes one or more objectives in each of
the functional areas and identifies the major challenges facing
OMS during the next five years and provides a general strategy
for meeting these challenges.
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SELECTION AND EVALUATION ASSUMPTIONS AND GOALS FY 86 - FY 91
The Agency's planning emphasis upon increased
technology/automation has an impact upon selection activities.
Increased automation is characteristically accompanied by
increased centralization of information bases; i.e., the more
efficient an information processing system becomes, through
reliance upon technology, the more vulnerable it becomes. (A
single individual, by means of perhaps a computer terminal, may
gain access in a matter of minutes to more information than the
same person, without automation, might ever have been exposed to
over years of routine Agency employment.) Thus, plans for
increased automation of Agency operations points up the
requirement for expanded, more detailed evaluation of applicants
in terms of stability and reliability, but this requirement
cannot be met solely through refined medical evaluation
techniques or methodology.
The ultimate success in refining and improving Agency
selection processing demands abandonment of parochialism among
Agency selection components and collaborative review of tine
evolving social mores of applicants applying for Agency
employment. Expansion of inter-component (OP, OS, and OMS) data
sharing will be critical in pursuing the highest levels of
selection efficiency and effectiveness which are attainable.
Reaching these levels while observing the legal and ethical
constraints associated with selection processing systems will
require development of a creatively complex automated
information management system.
Goal 1 - EXPANSION OF OMS SELECTION METHODOLOGY TO ALL
APPLICANTS. (e.g., CPI TESTING FOR CLERICALS, ETC.)
Goal 2 - FURTHER REFINEMENT OF RELIABLE MEASURES OF
APPLICANT CHARACTERISTICS SUCH AS INTEGRITY, LOYALTY AND
CAREER COMMITMENT.
Goal 3 - DEVELOP AND IMPLEMENT AN ARTIFICIAL INTELLIGENCE (AI)
SYSTEM (MIDAS) that will significantly enhance the
quality of selection methodology and medical care
through knowledge engineering. Employees, physicians,
and psychologists will enter evaluations and histories
at terminals here and abroad. This information along
with other experience and knowledge factors will be
manipulated and presented in a digested "intelligent"
manner to the examining physicians and psychologists
both at Headquarters and in the field. By 1990 these
types of computer assisted programs will routinely
enhance the quality of medical and psychological
judgment in the U.S. Without this automation, OMS
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medical and psychological programs will be removed from the
usual professional standards associated with a top notch
organization.
Goal 4 - IN COORDINATION WITH OTHER AGENCY COMPONENTS
PILOT STUDIES OF IMPROVEMENT IN SELECTION PROCESSING AS
A FUNCTION OF AN ALL-SOURCE (OMS, OP AND OS ) DATA
SYSTEM. Findings developed will provide guidelines
(where appropriate) to assist in upgrading the selection
screening process.
The development and implementation of an OMS Al System over
the five years will require
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GOAL FY 86: Review and Revise Current Applicant Screening Methods.
OBJECTIVES: Complete Revision of Personal Index Utilizing Data
Obtained from Review of PI, Interview CPI, and ARP
data.
MILESTONES
I Introduction PI Revision 1st Quarter
II Finish Review of OMS, OP, OS Files 2nd Quarter
III Analyze Data 3rd Quarter
IV Final Revision of PI 4th Quarter
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GOALS FY 86: To explore the utility of expanded inter-component
sharing of applicant data for Agency selection
processing.
Project Design. Assembling data,
designating in-house expertise, Preparation
of data collection instruments. Orientation
of raters (drawn from OMS, OP, and OS). 1st Quarter
II Perusal and evaluation of applicant data
by Raters. 2nd Quarter
III Perusal and evaluation of applicant data by
Raters. First level data analysis by PSD 3rd Quarter
IV Final data analyses and preparation of
report of findings by PSD. 4th Quarter
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HEALTH AND SAFETY SUPPORT ASSUMPTIONS AND GOALS FOR
FY 86 - FY 91
While we endorse an Agency-wide goal of attracting and
retaining the best people available, we recognize that the
changing nature of federal service as well as changing economic
conditions make that task difficult. In addition, adjustment
problems of staff and families will continue and increase as the
overseas environment grows more hostile to American presence.
Thus, the currently high levels of demand for psychiatric and
psychological support to the field and preparing staff and
families to go to the field will increase. Therefore, OHS
challenge has, quite appropriately, been the identification and
provision of additional health services as benefits of Agency
employment.
This was done by streamlining those services which can be
considered as direct benefits of Agency employment. For example,
the inclusion of the Fitness Program, Alcohol Program and
Counseling Branch under the general title of Employee Assistance
Program (EAP) centralizes access to these services and emphasizes
their Agency-wide significance. This consolidation, in
conjunction with other programs, provides the general direction
of the development of an increasingly integrated OMS program of
future employee health benefits/services. Extension of these
services to family members provides an additional service and
increasingly recognizes problems as developing within the family
unit with special implications for the employee being assigned
overseas. This type of OMS program provides the prevention and
maintenance, ongoing support and crisis intervention, and
rehabilitation which will be tine hallmarks of OMS comprehensive
program over the next five years.
Demands upon the Safety Division are expected to increase
considerably during the next five years due to continued growth
of Agency in personnel, buildings, and additional operations.
There are currently ::::]agency facilities, not including
activities within the Headquarters building, that should be
inspected annually. Some of these are quite extensive and
require from one to two weeks for the inspection. This figure
will probably increase. For example, it is estimated that at
least one man-year annually will be required for the new
Headquarters Building. Further, with increased activity in the
ordnance field, at least two Safety Division employees must be
trained to be able to comply with regulations covering shipping
and storage of ordnance items.
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Goal 1 - IDENTIFY AND REFLECT THE NEEDS OF THE CURRENT
WORKFORCE.
The task of the next five years is to determine,
given the changing nature of the Agency workforce, the
areas of greatest employee need and the most effective
and efficient way of providing appropriate services.
For example, the Employee Counselling Branch/EAP,
in keeping with the injunction to do more with stable
resources, has increasingly relied on support groups as a
means of assisting employees with a wide variety of
problems. Support groups for the newly separated and
divorced as well as support groups for single parents
(both currently in the planning process) are an
indication of the OMS response to the needs of a changing
workforce.
Goal 2 - TO IDENTIFY STRESSORS ON FAMILIES AND STAFF OVERSEAS,
PERSONAL TRAITS THAT CAN BEST HANDLE THEM, THE MEASURES
OF SUCH STRESSORS AND TRAITS, AND CONDUCT A NEEDS
ASSESSMENT OF STAFF AND FAMILY IN THE FIELD.
Goal 3 - THE ALCOHOL BRANCH IS IN THE PROCESS OF EXPANDING
ITS EFFORTS TO INCLUDE ALL FORMS OF SUBSTANCE ABUSE.
For several years increasing numbers of Agency
employees have experienced difficulties with drug abuse
problems among dependents. To educate employees about
the prevalence of these problems and to assist them in
the identification of drug difficulties in their
youngsters, the Alcohol Branch has initiated a drug
education and parent referral services. The parent
referral service was the suggestion of a group of parents
who have experienced drug problems in their own
families. The wisdom of encouraging employee
participation as well as the advantage of using
experienced volunteers determined this approach. It is
an approach which we expect to use to good advantage with
other problems in the future.
Goal 4 - EXPAND INDIVIDUAL FITNESS EVALUATIONS, EXERCISE
PRESCRIPTIONS AND FEEDBACKS.
The Fitness Branch has been increasingly integrated
into other OMS health promotion activities, a role which
will expand during the next five years as opportunities
are identified. This year, for example, our Exercise
Physiologist was an integral part of the Clinical
Activities Division's Stop Smoking Clinic. Participation
of the Fitness Branch in health promotion activities is
not only desirable, but will inevitably increase as the
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number of employees actively involved in individual
fitness activities increasingly request this kind of
integration. It is worth noting that the greatest
expression of interest during OMS briefings on OMS
employee services invariably involves the fitness area
facilities, equipment and personnel.
Goal 5 - INCREASED COMMUNICATION AND TRAINING.
In addition to providing a host of counselling,
rehabilitation, and fitness services to employees, OMS
has a significant training task. Beyond the
responsibility to inform Agency employees of OMS employee
services, OMS has the opportunity to inform employees of
the broader commitment of the Agency. The function is a
critical one of communicating Agency concern for the
employee population and its focus on people as our most
significant resource.
Goal 6 - ESTABLISH A FAMILY HEALTH FACILITY where families
assigned PCS will be evaluated and counseled on their
assignment as a unit that also includes the employee.
addition to the usual medical/psychiatric processing,
elements of the FELO and EAP (overseas support network)
will be contiguous and will coordinate their activities
to provide the care and concern the employee and family
deserve.
Goal 7 - CONDUCT AN OCCUPATIONAL HEALTH PROGRAM TO PROVIDE
AGENCY EMPLOYEES HEALTHY ENVIRONMENTS FREE OF RECOGNIZED
OCCUPATIONAL HAZARDS. This will be accomplished througn
implementation of environmental health, industrial
hygiene, radiation, asbestos, and noise programs.
Goal 8 - FURNISH TO EMPLOYEES PLACES AND CONDITIONS OF
EMPLOYMENT THAT ARE FREE OF RECOGNIZED SAFETY HAZARDS.
This is to be accomplished through periodic inspections
of Agency facilities, training in all categories of
employees, maintaining an effective motor vehicle
program, investigation of accidents, maintaining
statistics regarding accidents, and keeping top
management advised of the status of the program.
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OFFICE OF MEDICAL SERVICES
GOALS FY 86: Develop a program where families assigned PCS will
be evaluated arid counseled on their PCS assignment
as a unit.
OBJECTIVE: Establish a Family Health Facility
I Locate space and obtain approval to lease
5000 square feet for covert Family Health
Facility.
II Lease, design and furnish 5000 square feet
and make operational. 3rd Quarter
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OFFICE OF MEDICAL SERVICES
GOALS FY 86: Since employees are the single most important Agency
resource, the EAP's primary goal is to expand those
services which enhance their well-being and
productivity and which constitute an additional
benefit of their Agency employment.
OBJECTIVE: Identify and develop programs which reflect tiie
changing nature and needs of the Agency workforce.
I Identify and develop appropriate support groups
for employees (such as groups for newly
separated or divorced individuals; single
parents, etc.) within the Counseling
Branch. lst Quarter
II Expand Alcohol Branch into Alcohol and
Substance Abuse Branch to deal with
dependent drug problems; develop
education and referral services.
III Conduct a comprehensive conditioning
program for as many employees as possible
which includes individual evaluation,
monitoring and feedback.
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GOALS FY 86: Develop a health program that will evaluate the
employee and dependents as a family unit.
OBJECTIVE: Identify stressors, personal traits that can best
handle them, the measures of such stressors and
traits; and conduct a needs assessment of staff
and families in the field.
I Design a study of risk factors in illnesses
overseas and a needs assessment for
field.
II Continue risk factor and needs assessment
study designs, design a measure of
environmental stressors.
III Begin data analysis in risk factor study,
begin data collection in needs assessment,
continue design of measure of environmental
stressors.
IV Complete data analysis of risk factor data,
begin collecting new data set for validation
of risk factor study results, complete data
collection for needs assessment, begin
data collection in environmental stressors
study.
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OPERATIONAL MEDICAL SUPPORT ASSUMPTIONS AND GOALS FY 86 - FY 91
Because of a continual increasing recognition for the use of
operational medicine, OMS will face demands for an increased and
improved medical support to operations. This will require a
cadre of medically/operationally experienced people and a
long-term covert medical action program.
Goal 1 - PROMOTE THE GROWTH OF AND MAINTAIN CONTACTS WITH
OTHER BEHAVIORAL SCIENTISTS INTERNAL AS WELL AS
EXTERNAL. Since Behavioral Analysis Branch (BAB) and
Psychiatric Operations Division (POD)/OMS attempt to
accomplish similar goals, OMS believes a good case could
be made for closer coordination and "pooling" of
behavioral activities particularly in combating
terrorism.
Goal 2 - IMPROVE AND EXPAND AGENT MEDICAL DATA BASE
INFORMATION.
Goal 3 - MAINTAIN AND EXPAND GEOGRAPHICALLY A NATIONWIDE LIST
OF PHYSICIANS CLEARED TO HANDLE SENSITIVE CASES. This
activity is now undergoing significant expansion in
cooperation with the National Collection Division. It
is anticipated that a corps of 25 consultants in 11
states will be in place within the next year.
Goal 4 - DEVELOP A TWO-PHASE MEDICAL TRAINING PROGRAM FOR
THOSE AGENCY PERSONNEL GOING ON HIGH RISK OPERATIONS
WITHOUT MEDICAL SUPPORT.
Goal 5 - DEVELOP A STANDARD INDIGENOUS MEDICAL TRAINING PROGRAM
DIVIDED INTO FOUR LEVELS OF PROFICIENCY AND TRANSLATED
INTO VARIOUS LANGUAGES, E.G., SPANISH, FRENCH, ETC.
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INTERNAL OMS SUPPORT ASSUMPTIONS AND GOALS FY 86 - FY 91
OMS will be tasked with more medical administrative
functions because of increased recruitment, larger Agency
population, and increased worldwide operational requirements.
Advances in computer technology will continue to soar, while
the cost of equipment and software will drop. Terminal devices
will gradually be converted to or replaced by multi-functional
work stations incorporating personal computing,
telecommunications, word processing and graphics, with the
capacity for interchanging specific-purpose peripherals as
needed. Medical software applications will be readily available
in the marketplace for use on microcomputers.
There will be increased requirements for space for
automation equipment and for the automation support personnel.
Widespread use of automation and the Corporate Data concept
(shared data based among Agency components) will encourage
inter-Office cooperation in the Directorate and discourage
parochialism.
As more employees obtain access to the different computer
systems, the records management officer will have to insure that
the medical confidentiality is maintained and that security
procedures meet the Agency's standards.
Increased missions and functions, employee mobility, the
technology explosion, a high number of OMS employees eligible for
retirement, the increase in covert action operations and the
possible end of the PCA benefit after FY 89 (FY 87 for new hires)
will severely challenge OMS recruitment, position staffing, TDY
and retention capabilities over the next five years.
Goals FY 86 - FY 91
Goal 1 - PROVIDE A FULLY AUTOMATED SYSTEM. This will enable
OMS components to call up and track medical files, track
requests for medical evaluation (Form 259b), maintain and
monitor medical appointment schedules, process
cancellations and separation notices and transfer medical
records to archives.
Goal 2 - STRIVE TO KEEP ABREAST OF AUTOMATION ADVANCES WITH
MAXIMUM ECONOMY. This will be done by investing in
equipment that is currently state-of-the-art and which
can wherever possible be modularly upgraded rather than
replace. We will succeed only by close interaction with
OIT, relying on their projections and benefiting from
their technical expertise.
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Goal 3 - DEVELOPMENT OF PROJECT MIDAS WILL CONTINUE THROUGH THE
PERIOD IN COOPERATION WITH OIT. The plan to integrate
OMS data bases has been incorporated under MIDAS,
beginning with conversion of MEDSIGN and CLINSTAT to IDNI;
in FY 86. The work will be performed by a contractor
whose production will be monitored by IMB and the OIT
representative on TDY to OMS.
Goal 4 - THE ACCOUNTABLE AND PERSONAL APPEAL PROPERTY WILL BE
AUTOMATED ON THE ASAP system in FY 86. This will give
the office a tighter control of its property. It will
also assure a more accurate record keeping system and
provide easier updates and deletions.
Goal 5 - RECRUITMENT OF PHYSICIANS. OMS will explore new
ideas and procedures to insure the continuing access to
the best qualified professionals for our organization.
OMS will be faced with a critical space problem before the
new building is ready. We need to find added space, preferably
contiguous, to accommodate two more people and for the use of the
Project MIDAS team from OIT, probably a maximum of three
persons. For security and control of our automated systems and
hardware, the entire first floor component of ONIS at Headquarters
should be vaulted. In addition to space, three positions will be
required to support the increase of medical processing and
automation. Resource implications for MIDAS are listed under
Selection and Evaluation Functions.
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OFFICE OF MEDICAL SERVICES
GOALS FY 86: Establish a fully automated medical records system
to provide authorized OMS personnel ready access to
medical data in order to respond to consumer
requests.
OBJECTIVE: Provide the capability to order up Form 259b
requests for medical evaluation, medical
appointment schedules, cancellations or
separation notices, and transfer
medical records to archives.
I Automation of cancellation and separation
notices. lst Quarter
II Automated transfer of medical records to
archives. lst Quarter
III Automated tracking of Form 259b. 2nd Quarter
IV Automated call-up and tracking of
medical files throughout OMS. 3rd Quarter
V Automated appointment scheduling.
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GOALS FY 86: Development of Project MIDAS (Medical Information,
Diagnosis and Artificial Intelligence System) will
continue through the period in cooperation with OIT.
The plan to integrate our data bases has been
incorporated under MIDAS, beginning with conversion
of MEDSIGN and CLINSTAT to an IDMS prototype.
OBJECTIVE: To complete the Initiation and System Definition
Phases of a long-range plan to develop and
implement an integrated data base management
system for OMS which interacts with one or more
expert systems.
I Complete System Feasibility Report. 1st Quarter
II Progress Report on the MEDSIGN and
CLINSTAT IDMS prototype. 4th Quarter
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OFFICE OF MEDICAL SERVICES
GOALS FY 86: Automation of Accountable and Personal Appeal
Property to include all equipment in our newly
acquired Safety Division. Assist in the planning
and procurement of new gym and stress equipment
for our new building.
OBJECTIVE: To provide tighter controls and better record
keeping procedures of our accountable property
and to provide our employees with the finest
facility to promote their physical fitness and
well being.
II Planning and Procurement of gym
fitness equipment. 4th Quarter
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GOALS FY 86: To explore the utility of expanded inter-component
sharing of applicant data for Agency selection
processing.
I Project Design. Assembling data,
designating in-house expertise, Preparation
of data collection instruments. Orientation
of raters (drawn from OMS, OP, and OS). 1st Quarter
II Perusal and evaluation of applicant data
by Raters. 2nd Quarter
III Perusal and evaluation of applicant data by
Raters. First level data analysis. 3rd Quarter
IV Final data analyses and preparation of
report of findings. 4th Quarter
CONFIDENTIAL
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