DOD INSTRUCTION 6200.03
P
UBLIC HEALTH EMERGENCY MANAGEMENT (PHEM)
W
ITHIN THE DOD
Originating Component: Office of the Under Secretary of Defense for Personnel and Readiness
Effective:
Releasability:
Reissues and Cancels:
Approved by:
March 28, 2019
Cleared for public release. Available on the DoD Issuances Website at
https://www.esd.whs.mil/DD
DoD Instruction 6200.03, “Public Health Emergency Management within
the Department of Defense,” March 5, 2010, as amended
James N. Stewart, Assistant Secretary of Defense for Manpower and
Reserve Affairs, Performing the Duties of the Under Secretary of Defense
for Personnel and Readiness
Purpose: In accordance with DoD Directive (DoDD) 5124.02, this issuance:
• Establishes policy, assigns responsibilities, and provides direction to ensure mission assurance and
readiness for public health emergencies caused by all-hazards incidents.
• Defines a public health emergency within the DoD to include the occurrence or imminent threat of
an illness or health condition that poses a high probability of a significant number of deaths, serious or
long-term disabilities, widespread exposure to an infectious or toxic agent, overwhelmed health care
resources, or severe degradation of mission capabilities.
• Provides DoD policy for management of public health emergencies, in accordance with DoD
Instruction (DoDI) 6055.17, through integration with the DoD Emergency Management (EM) Program.
• Outlines the public health emergency health powers, roles, and responsibilities of the military
installation commander, including the authority for restriction of movement.
• Details procedures for internal and external notifications of DoD-declared public health
emergencies.
• Clarifies the PHEM roles and responsibilities of the medical treatment facility (MTF) commander or
director, the public health emergency officer (PHEO), and the medical emergency manager (MEM).
DoDI 6200.03 March 28, 2019
TABLE OF CONTENTS 2
TABLE OF CONTENTS
SECTION 1: GENERAL ISSUANCE INFORMATION .............................................................................. 4
1.1. Applicability. .................................................................................................................... 4
1.2. Policy. ............................................................................................................................... 4
1.3. Information Collections. ................................................................................................... 6
SECTION 2: RESPONSIBILITIES ......................................................................................................... 7
2.1. Under Secretary of Defense for Personnel and Readiness (USD(P&R)). ........................ 7
2.2. Assistant Secretary of Defense for Health Affairs (ASD(HA)). ....................................... 7
2.3. Director, DHA................................................................................................................... 8
2.4. Under Secretary of Defense for Acquisition and Sustainment. ........................................ 9
2.5. Assistant Secretary of Defense for Sustainment. .............................................................. 9
2.6. ASD(HD&GS). ................................................................................................................. 9
2.7. ASD(SO/LIC). .................................................................................................................. 9
2.8. DoD Component Heads. ................................................................................................... 9
2.9. Secretaries of the Military Departments. ........................................................................ 10
2.10. GCCs. ............................................................................................................................ 12
2.11. Chief, National Guard Bureau. ..................................................................................... 12
SECTION 3: DOD PUBLIC HEALTH EMERGENCY DECLARATIONS AND EMERGENCY HEALTH
POWERS ......................................................................................................................................... 14
3.1. Declaration of a Public Health Emergency. .................................................................... 14
3.2. Emergency Health Powers and Restriction of Movement. ............................................. 18
a. Applicability. ................................................................................................................ 18
b. Military Commander Emergency Health Powers. ....................................................... 19
c. Restriction of Movement.............................................................................................. 19
3.3. Notification Procedures. ................................................................................................. 24
3.4. Reporting of Potential PHEICs. ...................................................................................... 27
3.5. Implementation Outside the United States. .................................................................... 29
SECTION 4: PHEM ROLES AND PROCEDURES ............................................................................... 30
4.1. Command Responsibilities. ............................................................................................ 30
a. Military Commander. ................................................................................................... 30
b. MTF Commander or Director. ..................................................................................... 33
4.2. PHEO and APHEO. ........................................................................................................ 34
a. Qualifications. .............................................................................................................. 34
b. Requisite Training. ....................................................................................................... 34
c. Responsibilities. ........................................................................................................... 35
d. PHEO Procedures. ....................................................................................................... 36
4.3. MEM and AMEM. .......................................................................................................... 38
a. Qualifications. .............................................................................................................. 38
b. Requisite Training. ....................................................................................................... 38
c. Responsibilities. ........................................................................................................... 39
d. MEM Procedures. ........................................................................................................ 40
4.4. Veterinary Personnel. ...................................................................................................... 40
4.5. DMHR Teams. ................................................................................................................ 41
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TABLE OF CONTENTS 3
SECTION 5: SURGE CAPABILITIES AND PROCEDURES FOR HEALTH CARE IN DOD PUBLIC HEALTH
EMERGENCIES ................................................................................................................................ 43
5.1. General. ........................................................................................................................... 43
5.2. Prioritizing Delivery of Medical Care and Authorizing Situational Standards of Care
During Public Health Emergencies Involving Mass Casualties. ...................................... 43
5.3. Use of Volunteers to Supplement Health Care Personnel. ............................................. 46
GLOSSARY ..................................................................................................................................... 47
G.1. Acronyms. ...................................................................................................................... 47
G.2. Definitions. ..................................................................................................................... 48
REFERENCES .................................................................................................................................. 52
FIGURES
Figure 1. Public Health Emergency Decision Algorithm ............................................................ 16
Figure 2. Suggested Template for Written Declaration of a Public Health Emergency .............. 17
Figure 3. Suggested Template for Written Notice of Quarantine ................................................ 22
Figure 4. Suggested Template for Written Notice of Isolation .................................................... 23
Figure 5. Notification Routing Procedures (Overview) ............................................................... 26
Figure 6. Notification Routing Procedures (Command and Overseas Notification) ................... 26
Figure 7. Explanatory Text for Figures 5 and 6 ........................................................................... 27
Figure 8. Conceptual HPCON Framework .................................................................................. 37
DoDI 6200.03 March 28, 2019
SECTION 1: GENERAL ISSUANCE INFORMATION 4
SECTION 1: GENERAL ISSUANCE INFORMATION
1.1. APPLICABILITY.
a. This issuance applies to:
(1) OSD, the Military Departments (including the Coast Guard at all times, including
when it is a Service in the Department of Homeland Security (DHS) by agreement with that
Department), the Office of the Chairman of the Joint Chiefs of Staff and the Joint Staff, the
Combatant Commands (CCMDs), the Office of the Inspector General of the Department of
Defense, the Defense Agencies, the DoD Field Activities, and all other organizational entities
within the DoD (referred to collectively in this issuance as the “DoD Components”).
(2) The Service members, U.S. Government civilian employees, dependents of military
or civilian personnel, contractors, and other individuals who are subject to DoD authority and are
present on DoD installations and facilities worldwide.
b. This issuance does not impose additional regulatory requirements on the public.
1.2. POLICY. It is DoD policy that:
a. DoD installations, property, and other assets, as well as individuals working in or residing
on DoD installations, facilities, field operations, and commands, will be protected pursuant to
applicable legal authorities including:
(1) Sections 113, 3013, 5013, and 8013 of Title 10, United States Code (U.S.C.), which
generally provide authority to conduct the affairs of the DoD authorized by the Constitution and
laws of the United States.
(2) Section 2672 of Title 10, U.S.C., which authorizes the protection of buildings,
grounds, and property under DoD jurisdiction, custody, or control as well as the persons on that
property.
(3) Section 797 of Title 50, U.S.C., which provides penalties for violating any lawful
regulation or order for protecting or securing property or places subject to DoD jurisdiction and
administration or in DoD custody. The regulation or order may include ingress or egress or
otherwise provide for safeguarding the same against destruction, loss, or injury, either by
accident or by enemy or other subversive actions.
(4) Section 1382 of Title 18, U.S.C., which authorizes the regulation of entry onto DoD
installations.
(5) Section 301 of Title 5, U.S.C., which authorizes regulations for the custody, use, and
preservation of government property.
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SECTION 1: GENERAL ISSUANCE INFORMATION 5
(6) Sections 243, 248, 249, and 264-272 of Title 42, U.S.C., and Parts 70 and 71 of Title
42, Code of Federal Regulations (CFR), which contain regulations for preventing the
introduction, transmission, and spread of communicable diseases and hazardous substances from
foreign countries into the United States, and from one State or possession into another. These
references also authorize the Director of the Centers for Disease Control and Prevention (CDC),
through delegated authority of the Secretary of the U.S. Department of Health and Human
Services (HHS), to apprehend, detain, and conditionally release individuals with the
quarantinable communicable diseases listed in Executive Order (E.O.) 13295, as amended by
E.O. 13375 and E.O. 13674.
(7) Section 4 of E.O. 13527, which requires the establishment of mechanisms for the
provision of medical countermeasures (MCM) to personnel performing mission-essential
functions following a biological attack for continuity of operations.
(8) Any provision of Chapter 47 of Title 10, U.S.C., also known as the “Uniform Code
of Military Justice” regarding a breaking or breach of medical quarantine.
b. In order to achieve the greatest public health benefit while maintaining operational
effectiveness, DoD military installation commanders, referred to in this issuance as “military
commanders,” may declare a DoD public health emergency and subsequently implement
relevant emergency health powers, in accordance with the procedures in Section 3.
c. All public health emergencies will be managed in accordance with DoDI 6055.17 and this
issuance.
d. Public health and medical preparedness efforts for chemical, biological, radiological,
nuclear, and high-yield explosives (CBRNE) events will meet the standards and capability
requirements provided in DoDI 3020.52. These actions will be integrated and synchronized with
installation CBRNE preparedness activities to support effective and unified response operations.
e. To the extent practicable, military commanders will act in accordance with the applicable
provisions of public health emergency declarations made by U.S. public health officials at the
federal level and at the State, local, tribal, and territorial (SLTT) levels. Overseas military
commanders will act in accordance with host nation (HN) and allied forces public health
emergency declarations as applicable, practicable, and as otherwise defined in relevant
agreements, including status-of-forces agreements, defense cooperation agreements, and base
rights agreements.
f. DoD Components will cooperate closely with the federal and SLTT public health officials,
as appropriate, to provide a unified response regarding public health emergencies.
g. Geographically proximate military commanders, PHEOs, and MEMs will coordinate and
collaborate, to the maximum extent possible, to provide unified representation of the DoD to
SLTT, other federal agencies’ regional offices, and HN EM planners and public health officials.
h. In the event of an all-hazards incident, the military commander ensures personnel at
affected DoD installations will receive access to a pre-identified disaster mental health response
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(DMHR) team and disaster mental health (DMH) services, to include rapid response teams,
regional teams, and other shared resources as necessary.
i. DoD installations in the United States are authorized to serve as receipt, staging, and
storage (RSS) sites for Strategic National Stockpile (SNS) assets that are being deployed to
SLTT public health officials. DoD installations are also authorized to serve as closed points of
dispensing (PODs) capable of distributing SNS assets to their DoD population (as defined in
Military Department planning guidelines). DoD installations are prohibited from serving as open
PODs for the general population.
j. In actual or potential public health emergencies, DoD laboratories that are members of, or
participate in, the CDC-sponsored Laboratory Response Network (LRN) are authorized to
provide diagnostic services pertaining to laboratory specimens of non-DoD health care
beneficiaries referred for analysis, consistent with designated LRN tests, other procedures,
agreements, and the mission of the LRN, pursuant to the authority of Section 1074(c) of Title 10,
U.S.C., and in accordance with DoDI 6025.23.
(1) The authority to perform laboratory diagnostic services for non-DoD health care
beneficiaries will be used very sparingly and will not result in a laboratory incurring significant
incremental costs or limitation of its laboratory operations.
(2) Laboratory diagnostic services for non-DoD health care beneficiaries that would
result in significant incremental costs will be conducted in accordance with DoDD 3025.18.
k. PHEO, alternate public health emergency officer (APHEO), MEM, and alternate medical
emergency manager (AMEM) designees, as described in this issuance, must be afforded
adequate training and work time to perform all assigned PHEM duties, including preparing and
responding to public health emergencies and all-hazards incidents.
l. The policy changes delineated in this issuance were developed during the transition of
roles and responsibilities, which were historically assigned to the medical components of the
Services, to the Defense Health Agency (DHA). Nothing in this issuance is intended to
supersede future transfers to the DHA of responsibility for health care delivery.
1.3. INFORMATION COLLECTIONS. The budget estimates, referred to in Paragraph 2.9.h.
of this issuance, do not require licensing with a report control symbol in accordance with
Paragraph 10 of Volume 1 of DoD Manual 8910.01.
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SECTION 2: RESPONSIBILITIES
2.1. UNDER SECRETARY OF DEFENSE FOR PERSONNEL AND READINESS
(USD(P&R)). The USD(P&R) provides criteria, guidance, and instruction to incorporate PHEM
requirements into appropriate DoD policy, program, and budget documents.
2.2. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS (ASD(HA)).
Under the authority, direction, and control of the USD(P&R) and in accordance with DoDD
5136.01, the ASD(HA):
a. Oversees the policy, program planning and execution, and allocation and use of public
health, medical, and veterinary resources for activities within the DoD related to public health
emergencies. These activities will be coordinated with other applicable officials such as the
Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs;
Assistant Secretary of Defense for Manpower and Reserve Affairs; Assistant Secretary of
Defense for Homeland Defense and Global Security (ASD(HD&GS)); and the Assistant
Secretary of Defense for Special Operations and Low-Intensity Conflict (ASD(SO/LIC)).
b. Collaborates with federal and other applicable entities to implement this issuance.
c. Issues any necessary DoD public health, medical, veterinary, and mental health guidance
to implement this issuance.
d. Issues any necessary guidance regarding the protection of humans and animals from
environmental health threats.
e. Develops additional policy and updates guidance regarding restriction of movement
(human or animal quarantine, isolation, and conditional release) within the DoD as appropriate
and in consultation, when necessary, with the:
(1) Under Secretary of Defense for Policy (USD(P)) and the ASD(HD&GS).
(2) Joint Staff Surgeon.
(3) Surgeons General (SGs) of the Military Departments.
(4) Medical Officer of the Marine Corps.
(5) SG of the United States.
(6) Director, Coast Guard Health, Safety, and Work-Life.
(7) Director, DHA.
(8) Appropriate joint force commanders.
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(9) HHS Assistant Secretary for Preparedness and Response.
(10) Director of the CDC.
f. Coordinates DoD efforts to review public health emergency of international concern
(PHEIC) declarations from the World Health Organization (WHO) in collaboration with the
ASD(HD&GS), the ASD(SO/LIC), the SGs of the Military Departments, the Joint Staff Surgeon,
and appropriate CCMD(s), to:
(1) Determine the scope and applicability of the PHEIC declaration to DoD personnel
and other beneficiaries, including individuals working on DoD installations or in DoD facilities,
field operations and/or commands, and individuals residing on DoD installations.
(2) Evaluate the impact of the PHEIC on DoD missions, personnel, and other
beneficiaries.
(3) Develop appropriate force health protection (FHP) guidance to achieve the greatest
public health benefit while minimizing disruptions to DoD missions and deployments.
g. Reviews notifications of DoD-declared public health emergencies to:
(1) Identify circumstances suggesting a potential PHEIC. The ASD(HA) provides
approval, as appropriate, to the National Military Command Center (NMCC)/Global Situational
Awareness Facility (GSAF) to notify the HHS Secretary’s Operations Center (SOC) of the
potential PHEIC, pursuant to the WHO International Health Regulations (IHR) (see Paragraph
3.3.).
(2) Ensure notification of DoD public health emergency declarations are made to the
ASD(HD&GS) and the ASD(SO/LIC).
h. Grants exceptions to this issuance consistent with law.
2.3. DIRECTOR, DHA. In addition to the responsibilities in Paragraph 2.8., under the
authority, direction, and control of the USD(P&R), through the ASD(HA), and in accordance
with DoDD 5136.13, the Director, DHA:
a. Supports the Secretaries of the Military Departments PHEM responsibilities and activities
as outlined in this issuance.
b. Provides technical support to the SGs of the Military Departments, geographic Combatant
Commanders (GCCs); appropriate joint force commanders; DoD agencies and other DoD
Components, and the Director, Coast Guard Health, Safety, and Work-Life on coordination of
PHEM as necessary.
c. Ensures that standardized public health and medical training and education programs
associated with implementation of this issuance are regularly offered.
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d. Designates a PHEO and a MEM at the Defense Health Headquarters for effective
integration of PHEM activities within the DHA. The Director, DHA, may designate APHEOs
and AMEMs, as required, to support the PHEO and MEM mission responsibilities.
2.4. UNDER SECRETARY OF DEFENSE FOR ACQUISITION AND SUSTAINMENT.
The Under Secretary of Defense for Acquisition and Sustainment provides criteria, guidance, and
instruction to incorporate PHEM requirements into relevant DoD EM program elements.
2.5. ASSISTANT SECRETARY OF DEFENSE FOR SUSTAINMENT. Under the
authority, direction, and control of the Under Secretary of Defense for Acquisition and
Sustainment, the Assistant Secretary of Defense for Sustainment advocates for resources and
supports planning, programming, and budgeting processes to meet the PHEM requirements of
the DoD EM Program.
2.6. ASD(HD&GS). Under the authority, direction, and control of the USD(P) and in
accordance with DoDD 5111.1 and DoDD 5111.13, the ASD(HD&GS):
a. Coordinates with the ASD(HA) on PHEM policy and guidance to ensure integration and
consistency with policies and programs related to homeland defense; national preparedness;
national or global security; combatting weapons of mass destruction; defense support of civil
authorities; chemical, biological, radiological, or nuclear defense; mission assurance; and
defense continuity.
b. Provides the ASD(HA) assistance when a public health emergency occurs within the DoD
that affects DoD operations; national or global security; or involves the National Security
Council, other federal departments or agencies, HNs, or other non-DoD parties.
2.7. ASD(SO/LIC). Under the authority, direction, and control of the USD(P) and in accordance
with DoDD 5111.10, the ASD(SO/LIC):
a. Oversees humanitarian assistance, disaster relief, and global health policy.
b. Oversees program planning and execution, and allocation and use of resources for
activities that the DoD conducts related to humanitarian assistance, disaster relief, and global
health, including international public health emergencies.
2.8. DOD COMPONENT HEADS. The DoD Component heads:
a. Implement this issuance and any supporting PHEM guidance of the ASD(HA).
b. Ensure that the headquarters (HQ), installation, and DoD-leased facility EM programs
identify appropriate public health and medical subject matter experts (SMEs) to advise on public
health and medical issues pertaining to the DoD EM Program. DoD Component heads without
public health and medical resources will ensure that appropriate SMEs are identified (e.g.,
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PHEOs and/or MEMs at nearby DoD installations or local civilian public health officials) to
consult on public health emergency preparedness and response planning activities.
c. Authorize installations and DoD-leased facilities to enter into support agreements with
other DoD Components, SLTT public health officials, mental health providers, or other EM
resources to support effective public health emergency preparedness planning and response
efforts in accordance with DoDI 4000.19.
d. Provide written approval and authorization for DoD installations and DoD-leased
facilities in the United States to make agreements with SLTT public health officials to serve as
closed PODs for SNS assets when requested, and inform the CCMD Surgeon and other relevant
officials at the United States Northern Command or United States Indo-Pacific Command, as
appropriate. Encourage installations and DoD-leased facilities to participate in applicable SLTT
public health emergency planning efforts by serving as closed PODs capable of dispensing SNS
medical materiel to their DoD population.
2.9. SECRETARIES OF THE MILITARY DEPARTMENTS. In addition to the
responsibilities in Paragraph 2.8, the Secretaries of the Military Departments:
a. Designate a PHEO and a MEM at the HQ level for effective integration of all PHEM
activities. The Secretaries may designate APHEOs and AMEMs, as required, to support the
PHEO and MEM mission responsibilities.
b. Ensure execution of PHEM program requirements across all installations, entities, and
activities.
c. Authorize designation of additional individuals at other levels of their organizational
structure to facilitate coordinated PHEM planning among PHEOs and MEMs with SLTT
governments, other DoD Components, other federal agencies’ offices within the United States,
and HNs.
d. Develop and maintain intra- and inter-Service collaborative networks of installation
and/or command PHEOs. Consistent with the DoD EM Program, these networks will coordinate
locally and regionally with other federal agencies and in concert with geographic CCMD in order
to provide unified representation of the DoD to SLTT authorities, other federal agencies’
regional offices, and HN emergency planners and public health officials.
e. Ensure military commanders develop and maintain collaborative relationships with SLTT
authorities, other DoD Components, other federal agencies’ regional offices, and HN authorities
to meet mutual aid and support requirements of public health emergencies and formally
document such agreements.
f. Ensure military commanders provide a public health, medical, and veterinary response
capable of effectively responding to a public health emergency within DoD in accordance with
this issuance, DoDI 3020.52, and DoDI 6055.17. Military commanders will ensure the following
functions are available through installation resources, regional assets, or civilian or HN
providers:
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(1) Patient decontamination.
(2) First-responder and first-receiver care.
(3) Mass casualty response.
(4) Triage.
(5) Patient movement.
(6) Distribution and employment of medical supplies.
(7) Distribution and administration of pharmaceuticals (e.g., MCM such as antibiotics,
antivirals, and vaccines).
(8) Provision of alternate treatment facilities.
(9) Health surveillance, including occupational and environmental health surveillance
and medical surveillance subcomponents.
(10) Psychological support.
(11) Health risk communications and assessment.
(12) Veterinary patient management and zoonotic disease surveillance.
g. Ensure military commanders are prepared to establish, at their discretion, a health
protection framework (referred to in this issuance as the health protection condition (HPCON)
level) during an all-hazards emergency to communicate specific health protection measures to
the affected population, including individuals working in, residing on, or visiting the installation.
The HPCON framework can include any authorized FHP measures that may be applicable to the
emergency and should be coordinated with other affected installations to ensure consistent
messaging across installations and Services.
h. Develop budget estimates and submit program objective memorandum requirements that
cover program establishment; equipment; tactics, techniques, and procedures; training; exercises;
assessments; and sustaining activities to make it possible to execute the responsibilities
prescribed in this issuance.
i. Ensure that required PHEM resources and capabilities are identified and developed (e.g.,
mass notification and recall, command and control elements).
j. Provide written approval and authorization to military installations in the United States to
make agreements with SLTT public health officials to serve as RSS sites and closed PODs for
SNS assets when requested, and inform the CCMD Surgeon and other relevant officials at the
United States Northern Command or United States Indo-Pacific Command, as appropriate.
(1) Maintain comprehensive and up-to-date lists of installations that have signed
agreements with SLTT SNS coordinators to serve as RSS sites.
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(2) Encourage military commanders to participate in the CDC’s Cities Readiness
Initiative and other applicable SLTT public health emergency planning by serving as closed
PODs capable of dispensing SNS medical materiel to their DoD populations.
k. Ensure military commanders of DoD installations meet the requirement outlined in
Section 4 of E.O. 13527 in accordance with Service guidance on mass prophylaxis planning and
ensuring access to MCM for mission-essential personnel.
l. Ensure that appropriate standards for credentialing and certification for MEMs are
established at the Service-level, and issue policy and guidance to implement the standards.
m. Ensure military commanders of DoD installations in HNs oversee execution of PHEM
requirements in accordance with status-of-forces agreements, other applicable U.S. government
and HN agreements, Department of State (DoS) and geographic CCMD guidance, and applicable
HN standards.
2.10. GCCS. In addition to the responsibilities in Paragraph 2.8., the GCCs:
a. Designate a PHEO at the HQ level to ensure effective integration of all PHEM activities
with the DoD EM Program. The GCC may also designate APHEOs, as required, to support the
PHEO mission responsibilities.
b. Designate additional individuals as needed at other levels of their organizational structure
(e.g., local, regional, and theater) to facilitate coordinated PHEM planning among PHEOs and
MEMs (within their area of operations) and with SLTT governments and other federal agencies’
regional offices within the United States and with HNs.
c. Ensure unity of effort in the implementation of PHEM at DoD installations within the
CCMD area of responsibility and compliance with status-of-forces agreements, other applicable
U.S. Government and HN agreements, DoS guidance, and applicable HN standards.
d. In collaboration with the appropriate chief of mission (COM), engage each HN’s public
health officials regarding respective roles for reporting and notification of potential PHEICs
within the HN’s territory in accordance with the WHO IHR notification requirements.
2.11. CHIEF, NATIONAL GUARD BUREAU. The Chief, National Guard Bureau:
a. Serves as the principal advisor to the Secretary of Defense, through the Chairman of the
Joint Chiefs of Staff, on matters involving non-federalized National Guard and has the specific
responsibility to address matters relating to the Army National Guard, the Army National Guard
of the United States, Air National Guard, and the Air National Guard of the United States.
b. Serves as the channel of communications for matters pertaining to the use of National
Guard personnel and resources between DoD Components and the States, to include planning for
and responding to public health emergencies.
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c. In coordination with the Adjutants General of the States, and consistent with State and
local EM plans, ensures National Guard units not collocated on active duty military installations
communicate identified health threats to the DoD installation PHEO in their catchment area.
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SECTION 3: DOD PUBLIC HEALTH EMERGENCY DECLARATIONS AND
EMERGENCY HEALTH POWERS
3.1. DECLARATION OF A PUBLIC HEALTH EMERGENCY.
a. Public health emergencies can appear and progress rapidly, leading to widespread health,
social, and economic consequences. Their causes can be diverse, and they may result from
natural disasters, industrial accidents, or intentional CBRNE events, including the release of a
novel or reintroduced infectious agent, biological toxin, zoonotic disease, or radiological agent.
They may also result from a cyberattack on critical infrastructure with cascading consequences
that endanger the public’s health.
b. Military commanders must be prepared to make timely decisions to protect lives,
property, and infrastructure and enable DoD installations and/or military commands to sustain
mission-critical operations and essential services.
(1) Military commanders should expect a level of uncertainty during the decision-
making process, especially during early stages of a public health emergency.
(2) The PHEO and staff judge advocate (SJA) or command judge advocate (CJA) should
be prepared to provide relevant guidance relating to the military commander on authorized
actions, powers, and limits of authority.
(3) Efforts that strengthen lines of communication with civilian decision makers at the
community level will greatly enhance the response’s effectiveness.
c. Circumstances suggesting a public health emergency should be evaluated according to the
Public Health Emergency Decision Algorithm (see Figure 1). Situations that may be public
health emergencies include the occurrence or the imminent threat of an illness or health
condition with a high probability of any of the following:
(1) A significant number of deaths.
(2) A significant number of serious or long-term disabilities.
(3) Widespread exposure to an infectious or toxic agent that poses a significant risk of
substantial future harm.
(4) Health care needs that exceed available resources.
(5) Severe degradation of mission capabilities or normal operations.
d. The military commander will direct the PHEO to determine the existence of cases
suggesting a public health emergency affecting the installation’s population, ensure that sources
of the health hazard (e.g., infection or contamination) are investigated, define the distribution of
the illness or health condition, and recommend implementation of proper mitigation and/or
control measures. Appropriate actions by the PHEO may include:
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(1) Initiating actions to collect and analyze data on the health hazard causing the public
health emergency, particularly when the source or hazard is unknown or novel, in coordination
with applicable installation units.
(2) Evaluating the health threat as a potential PHEIC (see Paragraph 3.4.). A public
health emergency may require notification to the WHO as a potential PHEIC pursuant to the
WHO IHR through the procedures outlined in Paragraph 3.3. Some diseases, such as smallpox
or severe acute respiratory syndrome, require immediate notification to the WHO.
(3) Ensuring identification, interviewing, and tracking of all individuals or groups
suspected to have been exposed to the health hazard to characterize the source and spread of the
health hazard and estimate the impact on critical and mission essential personnel.
(4) Advising the military commander on appropriate health protection measures for
personnel; the examination, closing, evacuation, or decontamination of a facility; or the
decontamination or destruction of any material contributing to the public health emergency.
(5) Sharing information gathered during the investigation of a potential public health
emergency with federal and SLTT public health and public safety officials to the extent
necessary to protect public health and safety and for reporting potential PHEICs, pursuant to the
WHO IHR. Shared information may include personally identifiable health information in
accordance with DoD 6025.18-R.
(6) Notifying, directly or through applicable DoD channels, the appropriate defense
criminal investigative organization concerning information indicating a possible terrorist incident
or other crime. Notifications to other law enforcement authorities (e.g., Federal Bureau of
Investigation, SLTT police) are as made as necessary. Without compromising efforts to preserve
life and minimize risk to health, the PHEO should seek to cooperate with law enforcement
efforts to prevent terrorist or other adversary attacks, ameliorate their effects, and to apprehend
and prosecute their perpetrators.
e. Public health emergencies may be declared in the United States by the Secretary of HHS
at a national level (pursuant to Section 247d of Title 42, U.S.C.) and by SLTT government
authorities in their respective jurisdictions according to applicable SLTT law.
(1) In these circumstances, the PHEO will assist the military commander in determining
the impact of the emergency on the installation and what actions are necessary and practicable
for the installation to act with the relevant declaration(s) (see Paragraph 1.2.e.).
(2) Military commanders whose installations fall in the jurisdiction of an SLTT public
health emergency declaration may declare a public health emergency on the installation to
facilitate coordination with civilian authorities.
(3) In situations where there are potential conflicts with SLTT declarations, the military
commander and PHEO will consult their SJA/CJA for guidance, particularly in cases where the
installation has concurrent federal and State jurisdiction. SLTT public health laws vary between
jurisdictions, and the SJA/CJA may be required to provide a legal opinion on the installation’s
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legal obligations to comply with the SLTT requirement. When possible, efforts should be made
to resolve issues with SLTT authorities before legal action is required.
Figure 1. Public Health Emergency Decision Algorithm
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f. When the military commander and PHEO determine that a public health emergency
declaration is necessary to respond to a suspected or confirmed incident, the military commander
will complete a written declaration within the scope of their authority with the support and
guidance of the SJA/CJA and in consultation with the public affairs office (PAO). The
declaration must outline the situation and relevant actions that will be taken (see Figure 2).
Figure 2. Suggested Template for Written Declaration of a Public Health Emergency
{LETTERHEAD}
{DATE}
MEMORANDUM FOR ALL SUBORDINATE COMMANDS AND TENANT UNITS
SUBJECT: Declaration of a Public Health Emergency on {Installation Name}
I have been notified by my Public Health Emergency Officer (PHEO) of a possible public
health situation on our installation involving {agent/disease name or description of the qualifying
incident} that requires immediate action. Based on the PHEO’s recommendations and the results
of a preliminary investigation, I am declaring a public health emergency in accordance with DoD
Instruction (DoDI) 6200.03, “Public Health Emergency Management (PHEM) Within the DoD,”
and {applicable Service Instruction}. This declaration will terminate automatically 30 days from
the date of this memorandum unless it is renewed and re-reported or terminated sooner by me or
a senior commander in the chain of command.
The installation PHEO {and public health personnel} are hereby directed to identify,
confirm, and control this public health emergency utilizing all the necessary means outlined in
DoDI 6200.03 and {applicable Service Instruction}. To implement my direction, the PHEO may
issue guidance that affects installation personnel and property, and other individuals working,
residing, or visiting this installation (e.g., steps to protect personnel health, closing base facilities,
restricting movement, or implementing quarantine for select individuals). We will establish the
Health Protection Condition (HPCON) level framework that will provide specific actions
specific to this emergency that each person should take to protect his or her health.
The installation command and the PHEO will coordinate activities and share information
with {list which of the following are applicable to the current situation: federal, State, local,
tribal, territorial, and/or host nation. For overseas commands, replace “Federal, State, and local”
with “host nation”} officials responsible for public health and public safety to ensure our
response is appropriate for the public health emergency. Shared information may include
personally identifiable health information only to the extent necessary to protect the public health
and safety.
Any person who refuses to obey or otherwise violates an order during this declared public
health emergency may be detained. Those not subject to military law may be detained until civil
authorities can respond. Violators of procedures, protocols, provisions, or orders issued in
conjunction with this public health emergency may be charged with a crime under the Uniform
Code of Military Justice and under Section 271 of Title 42, United States Code (U.S.C.).
Pursuant to Section 271 of Title 42, U.S.C., violators are subject to a fine up to $1,000 or
imprisonment for not more than one year, or both.
{Installation Commander Signature Block}
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g. A declaration of a public health emergency within the DoD will be immediately reported
through the chain of command to the Secretary of Defense (see Paragraph 3.3.).
h. The declaration will be communicated within 12 hours to all installation personnel,
including those individuals in tenant organizations and commands, and individuals residing on
the installation, with the support of the PAO. Appropriate risk communications (e.g., HPCON)
will be developed and distributed to installation personnel, Military Health System (MHS)
beneficiaries, and guests on the installation to inform all individuals of the situation, actions that
will be taken, and where to get more information. If installation services are curtailed, guidance
should be provided on other service availability, especially in the case of restrictions on medical
care. The PHEO, MTF commander or director, MEM, PAO, and other relevant personnel will
coordinate on the development and distribution of these communications.
i. Public health emergency declarations within the DoD will terminate automatically in
30 days, unless renewed and re-reported, or may be terminated sooner by the military
commander who made the declaration, any senior commander in the chain of command, the
Secretary of the Military Department concerned, or the Secretary of Defense.
j. For zoonotic diseases, PHEO activities and procedures will be conducted in coordination
with other public health and veterinary activities.
k. In coordinating with the Coast Guard, DoD Components should note that the Coast Guard
has designated the Director, Coast Guard Health, Safety, and Work-Life (or designee) to serve as
the PHEO and MEM for the Coast Guard and does not have APHEOs or AMEMs.
l. In areas outside the United States, declarations of a public health emergency may be
limited to U.S. personnel and subject to the requirements of applicable treaties, agreements, and
other arrangements with foreign governments and allied forces, particularly in the case of non-
U.S. installations and field activities (see Paragraph 3.5.).
3.2. EMERGENCY HEALTH POWERS AND RESTRICTION OF MOVEMENT.
a. Applicability.
(1) When a military commander declares a DoD public health emergency within the
scope of their authority due to a suspected or confirmed incident, the military commander is
authorized to take relevant emergency actions to respond to the situation to achieve the greatest
public health benefit while maintaining operational effectiveness.
(2) To the extent necessary for protecting or securing DoD property or places and
associated Service members, emergency health powers may include persons other than Service
members who are present on a DoD installation or other areas under DoD control, including:
(a) Reserve Component installations not collocated with active duty installations.
(b) DoD civilian personnel, contractors, beneficiaries, and other persons within the
scope of the military commander’s authority.
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b. Military Commander Emergency Health Powers. Military commander emergency
health powers include:
(1) Directing Service members to submit to medical examinations or testing as necessary
for diagnosis or treatment. Persons other than Service members may be required as a condition
of exemption or release from restrictions of movement to submit to a physical examination or
testing, as necessary, to diagnose and prevent the transmission of a communicable disease and
enhance public health and safety. Qualified clinical personnel will perform examinations and
testing.
(2) Collecting specimens and performing tests on any property or on any animal or
disease vector, living or deceased, as reasonable and necessary for emergency response.
(3) Using facilities, materials, and services for purposes of communications,
transportation, occupancy (e.g., emergency shelters or quarantine/isolation), fuel, food, clothing,
health care, and other purposes, and controlling or restricting the distribution of commodities as
reasonable and necessary for emergency response.
(4) Taking measures as reasonable and necessary, pursuant to applicable law, to obtain
and control the use and distribution of needed health care supplies.
(5) Closing, directing the evacuation of, or decontaminating any asset or facility that
endangers public health; decontaminating or destroying any material that endangers public
health; or asserting control over any animal or disease vector that endangers public health,
including quarantine and isolation of animals on the installation.
(6) Controlling evacuation routes on, and ingress and egress to and from, the affected
DoD installation or military command.
(7) Taking measures to safely contain and dispose of infectious or contaminated waste as
may be reasonable and necessary for emergency response.
(8) Restricting movement to prevent the introduction, transmission, and spread of
communicable diseases or any other hazardous substances that pose a threat to public health and
safety as outlined in Paragraph 3.2.c.
c. Restriction of Movement.
(1) Quarantine, isolation, and conditional release are types of restriction of movement
that can be imposed in certain circumstances by a military commander for individuals within the
scope of the commander’s authority.
(a) In the case of Service members, restrictions of movement, including isolation,
quarantine, conditional release, or any other measure necessary to prevent or limit transmitting a
communicable disease and enhance public safety may be implemented.
(b) In the case of persons under the commander’s authority other than Service
members, restrictions of movement may include isolation or limiting ingress and egress to, from,
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or on a DoD installation or military command. Coordination with civilian public health officials,
including the CDC, SLTT, and HN public health agencies, may be required.
(2) In the United States, restriction of movement should be considered in coordination
with the local CDC quarantine officer and SLTT public health. These agencies have public
health authorities that may be applicable when the military commander’s authority is limited.
(a) Authority for restriction of movement may vary between civilian public health
officials depending on the situation and scope of applicable law. Civilian public health officials
may provide vocal authorization for the military commander to restrict the movement of
individuals not within the military commander’s scope of authority until a formal written order is
issued by the CDC or SLTT public health official.
(b) In accordance with Parts 70 and 71 of Title 42, CFR, the Director of the CDC
may take public health measures or a combination of measures the Director deems reasonably
necessary to prevent the spread of disease, particularly when involving movement across State
lines or international travel.
(c) Within the borders of their own jurisdictions, SLTT public health officials may
have authority for restriction of movement and can quarantine or isolate individuals under
applicable State, tribal, or territorial law.
(3) Quarantine or isolation will be accomplished through the least restrictive means
available, consistent with protection of public health.
(4) Conditional release is a less restrictive alternative to quarantine and is authorized for
persons who may have been exposed to a communicable disease or hazardous substances and
require continued health monitoring and supervision but have been assessed and determined to
be asymptomatic and present a low risk to public health.
(a) Conditional release is a subjective option and is not appropriate under all
circumstances. The PHEO should advise the military commander on the appropriateness of
conditional release after consultation with the chain of command and relevant DoD and civilian
public health and medical officials.
(b) Persons under conditional release orders may return to their living quarters but
must comply with the terms of the orders, including regular monitoring visits, travel restrictions,
and limited contact with other persons as directed. Additional conditions may be required
dependent upon the circumstances of the exposure. Violations of conditional release may result
in more restrictive measures and charges under applicable law.
(c) Regular monitoring may be accomplished through in-person encounters,
telephone or video calls, or other suitable electronic methods through the incubation period of
the communicable disease, or as determined by medical authorities. The written notice of the
conditional release will detail how monitoring will be accomplished, designated monitors, and
timeframe for monitoring encounters.
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(d) For personnel residing off-installation, the PHEO will coordinate with federal,
SLTT, or HN public health officials. Conditional release may require approval by applicable
civilian public health officials.
(5) The needs of persons quarantined or isolated will be addressed in a systematic and
competent fashion.
(a) Places of quarantine will be maintained in a safe and hygienic manner, designed
to minimize transmission of infection or contamination or other harm to other persons under
quarantine. Adequate food, clothing, medical care, and other necessities will be provided.
(b) Isolating individuals or groups serves to prevent the transmission and spread of a
communicable disease or any other hazardous substances that pose a threat to public health and
safety. Isolation measures may be implemented in health care facilities, living quarters, or other
buildings on a DoD installation or military command. Isolation measures do not lessen the
responsibilities of the MHS to provide medical care to infected or affected persons to the
standard of care feasible given resources available (see Section 5).
(6) In accordance with DoDD 5400.11 and DoD 6025.18-R, personally identifiable
information, including protected health information, will be used and disclosed only as necessary
to safeguard public health and safety.
(7) Quarantine or isolation of any persons will be terminated when no longer necessary
to protect public health.
(8) The PHEO will, as soon as practicable, ensure that every person subject to
quarantine, isolation, or conditional release is provided written notice of the reason for the order
and a plan of examination, testing, and treatment designed to resolve the reason for the
restriction of movement. Figures 3 and 4 are suggested templates to be adapted based on the
circumstances of the public health emergency and with appropriate consultation by the SJA/CJA.
The notice of conditional release can be adapted from the notice of quarantine.
(9) The PHEO will provide an opportunity to any person subject to quarantine, isolation,
or conditional release who contests the reason for restriction of movement to present information
supporting an exemption or release from quarantine. Where possible, technological resources
will be used to support communications and limit the necessity for in-person encounters. The
military commander or designee (who has not been previously involved in any medical
determination concerning the person) will review such information. The reviewing official will
exercise independent judgment and promptly render a written decision on the need for quarantine
or isolation for the person.
(10) A person subject to quarantine or isolation will:
(a) Obey the restrictions and orders established by the military commander.
(b) Remain in assigned quarters.
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(c) Not put themselves in contact with any persons except as specified in the notice
of quarantine.
(11) No person may, without authorization, enter quarantine or isolation premises. A
person who, by reason of unauthorized entry, poses a danger to public health and becomes
subject to quarantine.
Figure 3. Suggested Template for Written Notice of Quarantine
{LETTERHEAD}
{DATE}
MEMORANDUM FOR INDIVIDUALS SUBJECT TO QUARANTINE
FROM: {Installation Commander}
SUBJECT: Notice of Quarantine
In response to a declared public health emergency on {installation name}, this is a formal notice that
as the installation commander, I am ordering your quarantine. I am providing you with the following
directions and information regarding the quarantine.
{Name, identifying information or other description of the individual, group of individuals or
geographic location subject to the order. Brief statement of the facts warranting the quarantine.}
{Symptoms of the subject disease and a course of treatment. Instructions on the disinfecting or
disposal of any personal property. Precautions to prevent the spread of the subject disease.}
{Conditions for termination of the order. Specified duration of quarantine. The place or area of
quarantine. Rules for the quarantine. Requirements for contact with non-quarantined individuals.}
Any individual subject to quarantine has the right to contest the reason for quarantine. Information
supporting an exemption or release can be provided to me or one of my designated representatives. I (or a
designated representative) will review the information provided, in consultation with public health,
medical, and legal personnel, for a final determination on the need for quarantine. The total time from
submission to response will not exceed 24 hours.
Procedures for the declaration of a public health emergency, quarantine, and the actions prescribed
above are found in Department of Defense Instruction 6200.03, “Public Health Emergency Management
(PHEM) Within the DoD,” and {applicable Service Instruction}. It is DoD and {Military Service} policy
that military installations, property, and personnel and other individuals working or residing on military
installations will be protected under applicable legal authorities against communicable diseases associated
with biological warfare or terrorism or other public health emergency. Violators of procedures, protocols,
provisions, or orders detailed in this memorandum may be charged with a crime under Section 271 of
Title 42, United States Code, and subject to punishment of a fine up to $1,000 or imprisonment for not
more than one year, or both.
A wide range of professionals are working hard to bring this situation to a resolution that supports
your health and the safety of the general public.
{Installation Commander Signature Block}
Attachment: Declaration of Public Health Emergency
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Figure 4. Suggested Template for Written Notice of Isolation
{LETTERHEAD}
{DATE}
MEMORANDUM FOR INDIVIDUALS SUBJECT TO ISOLATION
FROM: {Installation Commander}
SUBJECT: Notice of Isolation
Due to your diagnosis of {specify communicable disease of concern}, this is a formal notice
that as the installation commander, I am ordering your isolation. I am providing you with the
following directions and information regarding the isolation.
{Name, identifying information or other description of the individual, group of individuals or
geographic location subject to the order. Brief statement of the facts warranting the isolation.}
{Symptoms of the subject disease and a course of treatment. Instructions on the disinfecting
or disposal of any personal property. Precautions to prevent the spread of the subject disease.}
{Conditions for termination of the order. Specified duration of isolation. The place or area
of isolation. Rules/requirements for the isolation, such as no unapproved contact with non-
isolation or protocols for individuals entering isolation premises.}
Any individual subject to isolation has the right to contest the reason for isolation.
Information supporting an exemption or release can be provided to me or one of my designated
representatives. I (or a designated representative) will review the information provided, in
consultation with public health, medical, and legal personnel, for a final determination on the
need for isolation. The total time from submission to response will not exceed 24 hours.
Procedures for the declaration of isolation and the actions prescribed above are found in
Department of Defense Instruction 6200.03, “Public Health Emergency Management (PHEM)
Within the DoD,” and {applicable Service Instruction}. It is DoD and {Military Service} policy
that military installations, property, and personnel and other individuals working or residing on
military installations will be protected under applicable legal authorities against communicable
diseases of public health concern.
Violators of procedures, protocols, provisions, or orders detailed in this memorandum may
be charged with a crime under Section 271 of Title 42, United States Code, and subject to
punishment of a fine up to $1,000 or imprisonment for not more than one year, or both.
A wide range of professionals are working hard to ensure you receive the highest quality
medical care and are released from isolation as soon as possible. These actions are necessary to
safeguard the health of your loved ones and ensure the safety of the general public.
{Installation Commander Signature Block}
Attachment: Declaration of Public Health Emergency
DoDI 6200.03 March 28, 2019
SECTION 3: DOD PUBLIC HEALTH EMERGENCY DECLARATIONS AND EMERGENCY HEALTH
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(12) Submission to vaccination, treatment, or diagnostic testing may be a requirement to
return to work or gain access to a DoD installation or facility or as a condition of exemption or
release from restriction of movement to prevent transmitting a communicable disease and to
protect public health and safety.
(a) Qualified clinical personnel will perform these procedures consistent with
appropriate medical standards, including appropriate exemption criteria.
(b) Service members may be required to participate in certain FHP measures,
including mandatory vaccination, treatment, or diagnostic testing, subject to the applicable laws
and regulations described in DoDI 6200.02.
(c) Persons other than Service members may be required to submit to vaccination,
treatment, or diagnostic testing as necessary as a condition of access to a DoD installation or
facility. During a declared DoD public health emergency, the provisions in DoDI 6205.4
regarding voluntary vaccination for non-Service members do not supersede the requirements in
Paragraph 3.2.c.(12).
(13) Security and enforcement measures should be appropriate to the circumstances.
(14) Individuals and groups subject to quarantine will be advised that violators may be
charged with a crime pursuant to law (including Section 797 of Title 50, U.S.C.; Section 1382 of
Title 18, U.S.C.; or Parts 70 or 71 of Title 42, CFR) and subject to punishment of a fine up to
$1,000 or imprisonment for not more than 1 year, or both.
(a) In the case of Service members, these sanctions are in addition to applicable
military law authorities, to the extent allowed by law.
(b) Those individuals or groups not subject to military law and who refuse to obey or
otherwise violate an order issued in accordance with this issuance may be detained by the
military commander until appropriate civil authorities can respond. The military commander
will coordinate with civil authorities to ensure the response is appropriate for the public health
emergency.
(15) Any fatalities associated with quarantined or isolated individuals will be addressed
to prevent contamination and dissemination of the hazardous agent. The PHEO will recommend
measures for reasonable and necessary testing and safe disposition of human remains after
appropriate consultation with chain of command, local SLTT public health officials, and the
coroner’s office. The CDC, the Central Joint Mortuary Affairs Office, and the Office of the
Armed Forces Medical Examiner will provide guidance regarding the testing and safe disposition
of human remains in accordance with DoDI 1300.18.
3.3. NOTIFICATION PROCEDURES.
a. A declaration of a DoD public health emergency as defined by this issuance, will be
immediately reported by the military commander through the chain of command to the Secretary
of Defense.
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b. The PHEO will initiate the reporting of a public health emergency declaration, with the
military commander’s approval, through the chain of command to:
(1) The respective Military Department SGs and the Service Public Health Center and, if
the military commander is under the command of a GCC, to the Joint Staff Surgeon.
(2) SLTT public health agencies or HN health officials as applicable.
c. Reporting will follow the process described in Figures 5 and 6. Figure 6 is an expansion
of the right side of Figure 5 for CCMD and overseas notifications. Figure 7 provides additional
guidance on interpreting these diagrams.
(1) Every DoD Component identified in Figures 5 and 6 will ensure each of the
component’s specified reporting relationships is established and operational.
(2) The NMCC/GSAF is the designated DoD point of notification to the HHS SOC for
potential PHEICs. The HHS SOC serves as the U.S. Government’s National Focal Point (NFP)
for notifications under the WHO IHR.
(3) Circumstances suggesting a public health emergency from non-DoD sources will be
reported using the process described in Chairman of the Joint Chiefs of Staff Manual 3150.05D.
(4) There will be circumstances where it may be necessary to deviate from this outlined
process to provide the notification to additional agencies and components, with authorization
from appropriate authorities.
d. Notifications for public health emergency declarations by Coast Guard military
commanders will occur in accordance with Coast Guard and DHS procedures and as follows:
(1) The Coast Guard will interface with the process outlined in Figure 5 through
notifications made to the Armed Forces Health Surveillance Branch (AFHSB), which will relay
information as described in Figure 7, item 5.
(2) The Coast Guard will notify the PHEO for collocated DoD installations.
(3) When under the authority of the Navy, the Coast Guard will execute public health
emergency notification procedures as specified by Navy policy and directives.
(4) The Coast Guard will have additional notification procedures through internal
processes and under DHS requirements.
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DoDI 6200.03 March 28, 2019
Figure 5. Notification Routing Procedures (Overview)
Figure 6. Notification Routing Procedures (Command and Overseas Notification)
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Figure 7. Explanatory Text for Figures 5 and 6
1. PHEOs will initiate notification procedures for a public health emergency declaration with
approval by the military commander. For incidents that may be potential PHEICs, PHEOs will
complete a report in accordance with Paragraph 3.4. of this issuance to be submitted through this
same process. In some CCMDs, the Surgeon’s office may perform duties similar to that of the
PHEO.
2. The PHEO will provide the public health emergency declaration and relevant information,
including potential PHEIC reporting, to the military commander for further reporting and to the
appropriate Service SG and Service Public Health Center as appropriate.
3. Depending upon theater, operational, or regional policies, the military commander will
notify the appropriate authorities within their technical chain of command. This may include the
Service Major Command, the Service Chiefs, the CCMD, and the Service component, a joint
task force, a subunified commander, or other entity as established.
4. The PHEO will notify appropriate SLTT public health officials of the DoD public health
emergency declaration and accompanying response activities. In a civilian-declared public
health emergency, SLTT officials may directly notify the PHEO or other installation point of
contact depending on applicable agreements and communication plans.
5. The Military Department SGs and Service Public Health Centers will transmit
notifications to the AFHSB for further dissemination. While AFHSB primary notification is to
the ASD(HA) and to the NMCC/GSAF, other recipients of the notification will include
ASD(HD&GS); ASD(SO/LIC); the Military Department SGs; GCC; the Director, DHA; and
other DoD offices as required.
6. The NMCC/GSAF will notify the Secretary of Defense, CCMD, Military Services, and
affected major commands of the public health emergency declaration as appropriate. The
NMCC/GSAF will notify the HHS SOC/U.S. IHR NFP, upon ASD(HA) approval.
7. Command reporting follows CCMD tactics, techniques, and procedures and standard
operating procedures (SOPs) established for line notification to the NMCC. Once joint task
forces are operational, reporting will be in accordance with CCMD notification policy guidance.
8. PHEIC reporting policy under the WHO IHR is in accordance with determinations made
by the relevant CCMD, COM, and HN.
9. Based upon discussions between the HN, GCC, and COM, potential PHEICs or events
related to a declared PHEIC that involve U.S. Government affiliated personnel and dependents
will be reported to the WHO via the U.S. IHR NFP and potentially by the HN IHR NFP.
3.4. REPORTING OF POTENTIAL PHEICS.
a. Public health emergencies within the DoD will be assessed as potential PHEICs and
reported accordingly through the notification procedures in Paragraph 3.3.
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b. As part of the decision process for declaring a public health emergency, the PHEO will
also evaluate the threat as a potential PHEIC. The determination of a potential PHEIC under the
WHO IHR depends upon several factors.
(1) Due to the potential public health impact, these diseases must be reported
immediately in accordance with the WHO IHR: smallpox, poliomyelitis due to wild-type virus,
novel subtypes of human influenza, and severe acute respiratory syndrome. These diseases are
the only ones that the WHO specifically identifies for immediate notification. Reporting is
through the process outlined in Paragraph 3.3.
(2) Other disease and public health incidents, including those of unknown etiology, will
be evaluated as potential PHEICs based upon the significance of the event. Two affirmative
responses to any of the following four criteria indicate that PHEIC reporting is required:
(a) Is the public health impact of this event serious?
(b) Is the event unusual or unexpected?
(c) Is there a significant risk of international spread?
(d) Is there a significant risk of international trade or travel restrictions?
d. When reporting a potential PHEIC, the PHEO will provide detailed information on the
threat by addressing each of the four PHEIC criteria, including the etiology of the threat, public
health significance, affected population, and international impact.
e. Pursuant to the WHO IHR, the U.S. Government has 72 hours to formally notify the
WHO of all events that may constitute a PHEIC within the United States as well as when the
United States is in receipt of evidence of an international public health risk outside the United
States.
(1) The DoD will review and route the PHEO’s report of a potential PHEIC in
accordance with the procedures in Paragraph 3.3. of this issuance and notify the HHS SOC of the
potential PHEIC within 48 hours of submission of the PHEO’s report to the appropriate Military
Department SG and Service Public Health Center.
(2) The HHS SOC will inform WHO within 24 hours of notification of a potential
PHEIC within the United States. The HHS SOC will also inform WHO, as far as practical,
within 24 hours of receipt of evidence of a potential PHEIC outside the United States.
f. SLTT or HN public health officials may also report the potential PHEIC, however, this
duplication does not relieve DoD of its reporting requirements.
g. As a signatory of the WHO IHR, the United States stated an exception to PHEIC
reporting when notifications would undermine the ability of Military Services to effectively
pursue national security interests. This exception does not apply to internal DoD reporting of
potential PHEICs.
DoDI 6200.03 March 28, 2019
SECTION 3: DOD PUBLIC HEALTH EMERGENCY DECLARATIONS AND EMERGENCY HEALTH
POWERS 29
3.5. IMPLEMENTATION OUTSIDE THE UNITED STATES.
a. Many of the authorities cited in this issuance are inapplicable or cannot be implemented in
an environment outside the United States without the cooperation of HN authorities, except to
the extent as may be specified by governing international agreements.
b. HN ownership and control of installations outside the United States may prevent military
commanders from unilaterally implementing many of the provisions of this issuance.
Ultimately, U.S. authorities and control at locations outside the United States are subject to the
sovereignty of the HN, except as otherwise defined in applicable international agreements, such
as status-of-forces agreements, defense cooperation agreements, and base rights agreements.
c. A military commander’s authority over personnel outside the United States is limited.
This authority extends generally only to U.S. Service members, civilian employees of the U.S.
Government, U.S. DoD contractor employees (when specified by agreements), and the
dependents of these categories of personnel.
d. A military commander’s authority and emergency health powers may be limited in scope
as it pertains to HN personnel. Installations outside the United States will review their respective
HN agreement and incorporate, by supplement to this issuance, the authority local military
commanders possess as it pertains to HN personnel.
e. All installations located outside the United States will coordinate their responses to public
health emergencies with the appropriate GCC. Coordination with the COM and DoS should be
sought as appropriate.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 30
SECTION 4: PHEM ROLES AND PROCEDURES
4.1. COMMAND RESPONSIBILITIES.
a. Military Commander. The military commander:
(1) Ensures that all units and tenant organizations comply with requirements of this
issuance. No further delegation is authorized.
(2) Designates in writing a PHEO and an APHEO as defined in Paragraph 4.2.
Additional APHEOs may be designated as necessary.
(a) When appropriately qualified personnel, as defined by the Service military
medical department, do not exist at the installation level, military commanders may designate a
PHEO as appropriate at a higher level in the Service organizational structure with the guidance
of the Service HQ, as necessary. For DoD installations and military commands with widely
geographically dispersed responsibilities, military commanders may designate a PHEO at an
appropriate level within the organizational structure.
(b) In joint basing and tenant organization situations, the military commander will
designate the PHEO and the APHEO(s).
1. On those installations where a joint medical center is a tenant, the commander
of the joint medical center will make a qualified individual available to serve as PHEO for the
host installation.
2. In some locations, it may be appropriate to designate a PHEO from one of the
other tenant organizations, especially where a highly specialized skill set exists in another
organization. APHEOs may be selected from Military Services different to that of the PHEO.
3. Joint basing and tenant organization agreements should reflect the requirement
to provide a single coordinated response to any public health emergency.
4. When the designation of an appropriate PHEO is not forthcoming or causes
local difficulties, the Service HQ PHEO should be consulted for adjudication; however, the final
designation decision rests with the military commander.
(3) Ensures that the PHEO and APHEO(s) have adequate support and resources to
accomplish their mission. Direct communication between the military commander and the
PHEO will enhance preparedness for and response to public health emergencies.
(4) Ensures that FHP measures and PHEM are integrated into existing DoD installation
and military command continuity, emergency preparedness, and response plans and agreements
in accordance with DoDD 3020.26, DoDD 6200.04, DoDI 3020.52, and DoDI 6055.17.
(a) Ensures development of any necessary agreements with tenant medical,
veterinary, and public health organizations for PHEM preparedness.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 31
(b) Ensures appropriate public health, medical, and veterinary representation in the
Emergency Management Working Group (EMWG) in accordance with DoDI 6055.17.
(c) Ensures that a public health emergency response exercise (e.g., disease
containment plan (DCP) exercise or mass prophylaxis plan exercise) and a mass casualty
exercise are conducted annually, either in conjunction with host installation or tenant command
exercises or as stand-alone events.
(d) Ensures PHEO and MEM participation in installation and command exercises, as
appropriate. After action reports should be completed promptly following exercises to identify
corrective actions as well as to capture lessons learned in the appropriate Service-designated
format.
(e) Ensures that medical and public health response activities to emergencies are
managed in accordance with this issuance, DoDI 6055.17, and applicable Service instruction.
(5) Inside the United States, coordinates planning, preparedness, and response to public
health emergencies with SLTT governments, other DoD Components, other federal agencies’
regional offices, and forces operating under Title 32, U.S.C. (referred to in this issuance as “Title
32 forces”) in accordance with DoDI 3020.52 and DoDI 6055.17. These efforts are to maintain
effective communication channels with outside partners and to support the installation’s internal
preparedness and response activities.
(a) The military commander negotiates agreements with SLTT public health officials
to serve as RSS sites for SNS materiel if the installation has suitable storage capability and
sufficient capacity and if requested by SLTT public health officials. Support agreements are
completed in accordance with DoDI 4000.19. Agreements will clarify responsibilities and must
address situations when access to the installation is limited or restricted.
(b) The military commander negotiates agreements with SLTT public health officials
to serve as closed PODs for an installation’s population and is encouraged to do so as part of
their preparedness activities when possible.
1. Agreements will specify the populations served by the POD (e.g., Service
member, civilian, contractor, and beneficiary) and identify operational factors, including training
and exercise requirements.
2. Preparedness planning should include bridging strategies for MCM and other
medical materiel to cover the DoD population for up to 48 hours before resupply and assistance
from the SNS is received.
3. DoD installations are to use local and military MCM assets as practicable
before SNS assets, while ensuring priority access to MCM for mission essential personnel in
accordance with Section 4 of E.O. 13527.
4. Installations that do not have closed POD agreements should be prepared to
notify the installation’s general population how to access MCM assets through the local
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 32
community when necessary with the assistance of the PAO and in coordination with SLTT
public health officials.
(6) Outside the United States, exercises those emergency health powers granted in
accordance with applicable international agreement, or otherwise within his or her inherent
authority, in coordination with HN authorities.
(a) The PHEO will function as the military commander’s primary public health
advisor during an emergency regardless of HN actions.
(b) DoD installations located outside the United States must account for MCM
materiel transit time/access when determining onsite asset requirements and should rely on onsite
assets until other materiel becomes available.
(7) In response to a suspected or confirmed public health emergency and in consultation
with his or her PHEO and SJA/CJA, declares a DoD public health emergency within the scope of
the military commander’s authority and implements relevant emergency health powers to
achieve the greatest public health benefit while maintaining operational effectiveness. In
widespread events, the number of incidents and/or the geographical extent of the incident(s) may
warrant integration of response efforts at higher levels of command, e.g., Service or CCMD.
(8) Ensures that personnel accountability procedures are developed, assigned to
appropriate personnel, and executed as necessary, in accordance with DoDI 3001.02.
Accountability measures should account for the scope, severity, and unique circumstances of the
public health emergency.
(9) Ensures an appropriate and measured local response to public health emergencies by
directing the PHEO, MTF commander or director, and MEM to establish, as required, a
temporary HPCON framework to provide stratified health protection measures for the overall
installation population that are specific to the scope and severity of the current situation.
(a) The HPCON level should be synchronized with the installation force protection
condition level, as detailed in Volume 2 of DoDI O-2000.16, and can include installation access,
appropriate FHP measures, and limitation of non-critical activities.
(b) The determination to change the HPCON level will be made by the military
commander in consultation with the PHEO and MTF commander or director.
(c) The HPCON framework is updated as necessary during the response to the public
health emergency as new FHP guidance becomes available and will be discontinued at the
termination of the public health emergency, unless renewed by the military commander for a
specified period of time.
(10) Ensures that risk and crisis communications are executed by the PAO in
coordination with the PHEO and all appropriate DoD installation and military command
stakeholders. Public messaging should be disseminated widely throughout the installation
community to ensure broad awareness of the HPCON level and recommended response actions.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 33
(11) Ensures appropriate syndromic surveillance is conducted to assess threats to public
health through the use of the Electronic Surveillance System for Early Notification of
Community-based Epidemics (ESSENCE) or other established surveillance systems in
accordance with DoDD 6490.02E.
(12) In carrying out activities under this issuance, cooperates with authorized law
enforcement and other agencies investigating or responding to an actual or potential terrorist act,
crime, or other relevant public health emergency. This includes reasonable steps to preserve
potential evidence of criminal activity.
(13) Ensures DMH services are available through a DMHR team in response to an all-
hazards incident by:
(a) Designating a licensed mental health provider (e.g., the Director of Psychological
Health) as the DMHR team lead, who is trained in disaster mental health services, and who has
overall responsibility for DMHR team training and service implementation, or identifying a pre-
existing capability and entering into appropriate support agreements, as noted in
Paragraph 4.1.a.(13)(c).
(b) Integrating DMH preparedness and response with other DoD installation and
military command emergency response plans.
(c) Entering into agreements, as needed, with other installations, DoD Components,
Reserve units, National Guard units, other federal departments or agencies, and civilian
providers for DoD installations to ensure access to a DMHR team when the personnel and
resources necessary to form a DMHR team are not present on a DoD installation.
(d) On installations where an MTF exists, the military commander may delegate the
appropriate responsibilities in Paragraphs 4.1.a.(13)(a) to 4.1.a.(13)(c) to the MTF commander or
director.
b. MTF Commander or Director. The MTF commander or director, as appropriate, (or, in
the Coast Guard, Commandant (CG-11) or designee):
(1) Establishes a comprehensive MTF EM program that complies with DoDI 6055.17
and integrates all aspects of public health and medical emergency planning (e.g., mass medical
care, medical logistics, DCP, and countermeasure acquisition and distribution). Ensures that
installation MTF plans reflect the availability of capabilities noted in Paragraph 2.9.f.
(2) Designates in writing a MEM as defined in Paragraph 4.3. AMEMs may be
designated as needed depending on capacity and facility needs.
(3) Ensures that the MEM has adequate support and resources to accomplish the mission.
(4) Authorizes licensed health care providers who are not credentialed or privileged,
including non-DoD civilian health care providers offering assistance, to provide care within their
facilities when necessary to respond to emergency requirements. Non-DoD civilian health care
providers will maintain their licensure through their respective States (see Paragraph 5.3.).
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 34
(5) Authorizes medical support agreements with local health care providers to provide
supplemental medical facilities, equipment, and other assistance as needed during emergencies.
(6) Directs MTF health care providers, medical examiners, pharmacists, laboratorians,
and associated health care personnel under his or her authority to promptly report to the
appropriate PHEO any circumstance suggesting a public health emergency to include diagnosed
illnesses or health conditions; prescription rates, types, or trends; and presumptive or confirmed
laboratory diagnostic results. These reports are in addition to reports required by otherwise
applicable surveillance systems, including non-DoD systems, and as required by
DoDD 6490.02E.
(7) Ensures each MTF identifies and designates all key response personnel (e.g., first
responders and first receivers) and coordinates to ensure they have access to the installation
during emergency conditions.
(8) Ensures all key response personnel are trained in the performance of the job
functions they are assigned to during emergency conditions.
(9) Ensures that MTF EM is integrated into existing emergency preparedness and
response plans (e.g., DCP and mass casualty plans) and agreements in accordance with
DoDI 3020.52 and DoDI 6055.17. These plans will be coordinated with both medical and non-
medical stakeholders, including the installation (or joint base) EM program, SLTT governments,
other federal agencies’ regional offices, Title 32 forces, and HN authorities, as applicable. These
plans will be exercised regularly, in accordance with applicable Service instructions, and revised
based on corrective action plans as necessary.
(10) Ensures appropriate syndromic surveillance is conducted to assess threats to public
health through the use of ESSENCE or other established surveillance systems.
4.2. PHEO AND APHEO.
a. Qualifications. PHEOs and APHEOs:
(1) Are either Service members or DoD civilian medical employees. The PHEO must be
a clinician (as defined by the Military Services in their respective implementing instructions).
The APHEO is not required to be a clinician.
(2) Have a Master of Public Health (or equivalent) degree or 4 years of experience in
public health, preventive medicine, or environmental health.
(3) Hold an active national security clearance at the SECRET level or above.
b. Requisite Training. To support effective preparedness, response, and recovery from
public health emergencies affecting DoD personnel, installations, and properties, PHEOs and
APHEOs must complete appropriate training.
(1) PHEM course requirements:
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 35
(a) Basic Training: Within 1 year of designation as a PHEO or APHEO, complete
the initial level of the PHEM course offered by the Defense Medical Readiness Training Institute
(DMRTI).
(b) Sustainment Training: Within 1 year of completing the 4th year of service as a
PHEO or APHEO and after every subsequent 4 years in the role, complete the advanced level of
the PHEM course provided by DMRTI.
(c) Re-activation: When returning to the role of PHEO or APHEO after 3 or more
years in other duty assignments and within 1 year of returning to the role, complete the
appropriate level of the PHEM course. Returning PHEOs and APHEOs will consult with their
commands or Service PHEO resources to determine which PHEM course to complete.
(2) PHEOs and APHEOs must be familiar with systems involved in coordination,
support, and integration with civilian authorities, including the National Incident Management
System, Incident Command System, and the National Planning Frameworks, in accordance with
DoDI 3020.52 and DoDI 6055.17.
(3) Public health and medical capabilities are critical components of CBRNE
preparedness and response on DoD installations. PHEOs and APHEOs will comply with the
knowledge requirements provided in DoDI 3020.52 on CBRNE capabilities within the DoD.
(4) Supplemental training may be required by the Military Services or CCMDs based on
specific issues related to the PHEO or APHEO role, installation, or geographic location.
c. Responsibilities. PHEOs and APHEOs provide military commanders with guidance and
recommendations on preparing for, declaring, responding to, mitigating, and recovering from
public health emergencies. PHEO responsibilities fall into 10 major categories and include:
(1) Collaborating closely with the EM program manager and the MEM in preparing for,
declaring, responding to, and recovering from a public health emergency.
(2) Maintaining situational awareness of public health and medical threats.
(3) Advising the military commander regarding the declaration of a public health
emergency and the implementation of emergency health powers in accordance with relevant
public health laws, regulations, and policies, in coordination with the SJA/CJA.
(4) Ensuring appropriate epidemiological investigations are conducted.
(5) Recommending appropriate diagnosis, treatment, and prophylaxis of affected
individuals or groups and populations in consultation with appropriate clinical staff.
(6) Providing subject matter expertise to military commanders in the integration of
public health and medical preparedness with other DoD installation or military command
emergency response planning and exercises, including participating in annual exercises.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 36
(7) Supporting preparedness for public health emergencies and medical surge capacity in
collaboration with the MEM as appropriate, including providing subject matter expertise as
needed on agreements with civilian public health and medical authorities.
(8) Assisting in public affairs risk communications, including dissemination of health
protection measures detailed in the HPCON framework in coordination with the PAO.
(9) Advising the military commander on public health aspects of workplace and return to
work issues during the emergency response and recovery phases.
(10) Coordinating with other DoD Components, civilian SLTT, other federal agency
regional offices, Title 32 forces, and HN agencies and organizations in all responsibilities listed
in Paragraphs 4.2.c.(1) through 4.2.c.(9) as necessary.
d. PHEO Procedures. PHEOs and APHEOs:
(1) Ensure collaboration and serve as a clearinghouse for health-related information
during a public health emergency. The PHEO will work closely with other medical and non-
medical personnel; SLTT governments; other federal agencies’ regional offices; Title 32 forces;
and HN authorities (as applicable) to identify, confirm, and control a public health emergency
that may affect the DoD installation or military command.
(2) In the United States, coordinate through the chain of command, the local CDC
quarantine officer, and SLTT public health officials in relation to actions taken in accordance
with CDC quarantine authorities provided in Parts 70 and 71 of Title 42, CFR and SLTT
quarantine authorities. Outside the United States, in addition to the chain of command,
coordination will be with GCC, DoS, and appropriate HN public health officials.
(3) Provide accurate and relevant information to enable timely notification to affected
individuals of a public health emergency, its termination, and actions taken to control or mitigate
the emergency. Provision of information will be performed in coordination with the installation
or military command’s PAO and if applicable, a joint information center.
(4) Develop the HPCON framework, as directed by the commander, as a temporary risk
communication tool for the specific health threat, in consultation with the MTF commander or
director and MEM, based upon the scope and severity of the situation and provide guidance on
appropriate actions individuals should take to protect themselves.
(a) Health measures in the HPCON framework will be clearly defined and specified
in categories based on the impact of the health threat, specific precautions, and level of effort,
beginning with simple precautions and escalating the level of effort in subsequent categories,
based upon protective measures available to installation personnel (see Figure 8).
(b) Health precautions should utilize relevant FHP measures already identified when
possible and appropriate, which can include personal protective equipment, individual behavioral
actions, closure of installation facilities, MCM, and other protective measures to reduce the risk
of the health threat.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 37
(c) The PHEO updates the HPCON measures as necessary as the situation evolves
using available guidance from DoD and appropriate civilian medical and public health sources.
(d) PHEOs are encouraged to collaborate on risk communications HPCON content
with their counterparts at other affected DoD installations and SLTT public health officials to
ensure consistency of messaging and unity of effort.
(5) Use all available resources to assist in determining if a public health emergency
declaration is indicated and if a potential PHEIC should be reported.
(6) Maintain close contact and coordination with military veterinary authorities
concerning relevant actions taken under this issuance.
Figure 8. Conceptual HPCON Framework
Situation HPCON Example Health Protection Measures
Normal
baseline
0
Routine: Normal operations. Maintain standard
precautions such as routine hand washing, cough on
sleeve, good diet, exercise, vaccinations, education,
routine health alerts, and regular preparedness activities
Report of
unusual health
risk or disease
A
Limited: Health Alert. Communicate risk and
symptoms of health threat to installation; review plans
and verify training, stocks, and posture; prepare to
diagnose, isolate, and report new cases
Outbreak or
heightened
exposure risk
B
Moderate: Strict hygiene (no handshaking, wipe
common-use items); if exposed, self-isolate (wear mask
or remain home); avoid contaminated water/food or risk
area; vector control if applicable
High morbidity
epidemic or
contamination
C
Substantial: Social distancing (limit or cancel in-person
meetings, gatherings, temporary duty assignments);
shelter in-place indoors; utilize respirators; mass
distribution of MCM
High mortality
epidemic or
contamination
D
Severe: Restriction of movement (e.g., quarantine); mass
evacuation; mass decontamination; subsist on secure
food/water sources
(7) Maintain close contact and coordination with SLTT governments, other federal
agencies’ regional offices, Title 32 forces, and HN authorities concerning all actions taken under
this issuance. Outside the United States, a PHEO will coordinate with appropriate HN officials
and, if applicable, other allied forces public health officials. Consistent with the protection of
DoD installations, facilities, assets, and personnel, a PHEO will facilitate the assumption of
public health emergency responsibilities by civilian agencies with jurisdiction in relation to
persons other than Service members and property not owned by the DoD.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 38
(8) In the United States, provide SME support to the military commander, the EM
program manager, MEM, and others in executing agreements with SLTT SNS coordinators
regarding the receipt, distribution, and dispensing of SNS assets.
(9) In consultation with relevant officials and resources, support the military commander
and the EM program manager on mass fatality management, particularly recommending
measures for reasonable and necessary testing and safe disposition of human remains in CBRNE
incidents (see Paragraph 3.2.c.(15)).
4.3. MEM AND AMEM.
a. Qualifications. MEMs and AMEMs:
(1) Are either Service members or DoD civilian employees.
(2) Hold an active national security clearance at the SECRET level or above.
(3) Meet appropriate standards for credentialing and certification as identified by the
respective Military Department.
b. Requisite Training. To support effective preparedness, response, and recovery from
public health emergencies affecting DoD personnel, installations, and properties, MEMs and
AMEMs must complete appropriate training.
(1) PHEM course requirements:
(a) Basic Training: Within 1 year of designation as a MEM or AMEM, complete the
initial level of the PHEM course offered by DMRTI.
(b) Sustainment Training: Within 1 year of completing the 4th year of service as a
MEM or AMEM and after every subsequent 4 years in the role, complete the advanced level of
the PHEM course provide by DMRTI.
(c) Re-activation: When returning to the role as a MEM or AMEM after 3 or more
years in other duty assignments and within 1 year of returning to the role, complete the
appropriate level of the PHEM course. Returning MEMs and AMEMs will consult with their
commands or Service MEM resources to determine which PHEM course to complete.
(2) MEMs and AMEMs must be familiar with systems involved in coordination, support,
and integration with civilian authorities including the National Incident Management System,
Incident Command System, and the National Planning Frameworks, in accordance with
DoDI 3020.52 and DoDI 6055.17.
(3) Public health and medical capabilities are critical components of CBRNE
preparedness and response on DoD installations. MEMs and AMEMs will comply with the
knowledge requirements provided in DoDI 3020.52 on CBRNE capabilities within the DoD.
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 39
(4) Supplemental training may be required by the Military Services or CCMDs based on
specific considerations related to the MTF, installation, or geographic location.
c. Responsibilities. MEMs and AMEMs coordinate planning and preparedness, and support
MTF commanders or directors in the execution of an all-hazards MTF EM program. MEMs
have the primary responsibility for the overall implementation and management of the MTF EM
program, to include related elements such as continuity of operations, when specified by Service-
level guidance. MEM responsibilities include:
(1) Ensure MTF EM plan development and management activities are comprehensive
and compliant with applicable DoD and Service-level requirements, including DoDI 6055.17,
such that plans are functionally aligned and integrated as a nested component within the host
installation, as applicable.
(2) Ensure that threat information, vulnerability assessments, and all mitigating actions
are considered in executing MTF EM activities as defined in DoDI 6055.17.
(3) Support MTF EM program accreditation by ensuring compliance with EM standards
set by the Joint Commission.
(4) Act as the MTF point of contact with the installation’s EM program manager, and
serve as an active participant in the installation EMWG. Serve on the Recovery Work Group
when activated. Coordinate with appropriate installation agencies to determine the support
requirements in installation plans for mass prophylaxis, disease containment, mass casualty, and
public health emergency response. This support may include, as appropriate, public health
aspects of mass care, special needs populations, patient evacuation, and shelter-in-place. MEMs
at standalone MTFs will coordinate with their host installation’s EM program on planning
activities and how to participate in the host installation’s EMWG and Recovery Work Group.
(5) Provide subject matter expertise in the integration of public health and medical
capabilities into installation EM planning to reduce the impact on the health and well-being of
the installation’s population during an incident.
(6) Assist with installation exercise design and development to ensure medical
capabilities and capacities are incorporated, exercised, and evaluated as appropriate, including
participation in annual exercises.
(7) Support MTF commanders or directors in the coordination and integration of EM-
related training and exercises. Determine exercise goals and objectives to fully test medical
response capabilities as noted in response plans.
(8) Serve as the MTF lead for military/civilian coordination as it relates to EM. Act as
the point of contact in the development of appropriate medical support agreements with civilian
public health and medical authorities.
(9) Integrate the acquisition, delivery, and distribution procedures of all available public
health and medical materiel caches, including relevant DoD and SNS assets, into MTF and
installation response plans as appropriate.
DoDI 6200.03 March 28, 2019
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(10) Serve as the primary advocate to ensure that appropriate resource needs are
identified to execute mission requirements.
d. MEM Procedures. MEMs and AMEMs:
(1) Serve as the central points of contact for MTF emergency planning and for
coordinating public health and medical support to installation, local, or regional emergency
response requirements.
(2) Coordinate closely with functional SMEs through the MTF and installation
emergency preparedness committees or working groups, the PHEO, and the EMWG to ensure
plans are adequate, supportable, coordinated, and synchronized.
(3) In the United States, assist the military commander in the execution of agreements
with SLTT SNS coordinators regarding the receipt, distribution, and dispensing of SNS assets
with the assistance of the EM program manager and PHEO.
4.4. VETERINARY PERSONNEL. In accordance with DoDD 6400.04E, veterinary
personnel:
a. Provide veterinary services, as defined in DoDD 6400.04E, and subject matter expertise
for DoD installations or military commands for animal health matters related to PHEM.
b. Coordinate and integrate veterinary public health and veterinary medical planning (e.g.,
veterinary medical care, medical logistics, and countermeasure acquisition and distribution) with
PHEM preparedness and response planning activities where appropriate.
c. Report to the appropriate PHEO any circumstance suggesting a public health emergency.
This responsibility is in addition to reports required by otherwise applicable surveillance
systems, including non-DoD systems.
d. Provide operational guidance and support as necessary during a suspected or confirmed
public health emergency, which may include:
(1) Animal health and welfare to include identification of affected or susceptible animals
as well as detection or control of animal disease using strategic vaccination and treatment.
(2) Animal health surveillance.
(3) Food safety and defense.
(4) Training.
(5) Laboratory diagnosis.
(6) Biosecurity, cleaning, and disinfection.
DoDI 6200.03 March 28, 2019
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(7) Criteria for animal quarantine or isolation (to include consideration of pets if the
owner is under restriction of movement orders).
(8) Animal euthanasia.
(9) Coordination with wildlife management and vector control personnel.
(10) Risk communication message content.
4.5. DMHR TEAMS.
a. DMHR teams are multidisciplinary. They include, at a minimum, individuals in each of
the following areas:
(1) Mental health (e.g., a psychiatrist, psychologist, social worker, psychiatric nurse
practitioner, a mental health technician, or licensed provider who is trained in acute mental
health intervention).
(2) Spiritual support (e.g., a chaplain and a religious affairs enlisted member).
(3) Family support (e.g., a community readiness consultant).
b. DMHR teams are led by licensed mental health providers.
c. DMHR teams have the following responsibilities:
(1) Coordinate with family assistance centers on the installation and other agencies to
arrange DMH services for family and community members impacted by an all-hazards incident.
(2) Establish SOPs, in accordance with recognized national practice guidelines, such as
the National Institute of Mental Health Publication No. 02-5138, that include at a minimum:
(a) The composition and role of the team.
(b) A listing of the available, locally-trained resources with contact information,
including employee assistance programs.
(c) A description of local conditions and any identified high-risk groups.
(d) A response plan for team activation.
(e) Plans for conducting DMH needs assessments and surveillance.
(f) Required initial/periodic training.
(3) Establish a plan for maintaining individual DMHR team member psychological
health in accordance with recognized national practice guidelines, such as the Department of
DoDI 6200.03 March 28, 2019
SECTION 4: PHEM ROLES AND PROCEDURES 42
Health and Human Services Publication No. ADM 90-0537. Ensure integration of the plan
within the DMHR SOPs.
(4) Provide DMH services to include prevention, outreach, screening, triage,
psychological first aid, education, and specialty referral(s) to individuals and groups who have
had or may have had exposure to an all-hazards incident. These services are not medical
services, and therefore do not involve medical or mental health record documentation.
(5) Train annually as part of the overall installation EM exercises in accordance with
DoDI 6055.17.
(6) Train at least quarterly as a DMHR team, using evidence-based practices, to develop
and maintain the competencies necessary to provide DMH services. Training will cover, at a
minimum, prevention, outreach, screening, triage, psychological first aid, education, and referral
services for individuals and groups who have had or may have had exposure to an all-hazards
incident. Training will also cover command consultation and ethical issues during disasters.
(7) Identify and train primary and alternate DMHR team members for each role to ensure
continuous access to DMH services. Regional and rapid response teams should involve any
installation-level and other DoD or command-authorized local mental health, spiritual support,
and family support resources to augment DMH services and to provide knowledge of local
community characteristics and needs.
(8) Coordinate efforts with the EM program manager, PHEO, and MEM as appropriate,
and integrate efforts of the DMHR team into the overall installation’s emergency preparedness,
response, and recovery activities.
DoDI 6200.03 March 28, 2019
SECTION 5: MTF SURGE CAPABILITIES AND PROCEDURES FOR HEALTH CARE IN DOD PUBLIC
HEALTH EMERGENCIES 43
SECTION 5: SURGE CAPABILITIES AND PROCEDURES FOR HEALTH
CARE IN DOD PUBLIC HEALTH EMERGENCIES
5.1. GENERAL.
a. Public health emergencies of national significance, such as pandemic influenza, are likely
to result in surge requirements that overwhelm the response capacity, capability, and resources of
both medical facilities and health care providers. Under these conditions, situational standards of
care will be adopted, and difficult decisions regarding the allocation of limited resources will be
required. Within DoD, all levels of command and health care providers will incorporate these
principles in developing their public health emergency response plans and in determining the
allocation of limited medical resources.
b. The MHS will adopt the framework in this section for the delivery of medical care at
MTFs during public health emergencies and will incorporate it into all aspects of planning for
these emergencies.
c. The provisions of this section are intended to establish a standard of care appropriate to
the circumstances of the public health emergency and differ from the standard of care ordinarily
applicable in MTFs, absent a declaration of public health emergency.
5.2. PRIORITIZING DELIVERY OF MEDICAL CARE AND AUTHORIZING
SITUATIONAL STANDARDS OF CARE DURING PUBLIC HEALTH EMERGENCIES
INVOLVING MASS CASUALTIES.
a. The MHS direct care system has two primary objectives: to support the national security
mission and to provide care for MHS-eligible beneficiaries with MTF primary care managers.
MTF commanders or directors will fulfill both of these primary objectives, however during
resource scarcity, critical mission requirements may necessitate a higher priority of national
security missions over beneficiary care.
(1) Supporting the Mission. Under emergency conditions, the allocation of resources
may not be based solely on medical necessity or risk, but also may be based on operational or
other national security requirements, as directed by the President or Secretary of Defense. Some
Service members, for example, may receive a higher level of care due to operational
requirements, independent of their immediate medical risk.
(2) Providing Beneficiary Care. While other objectives of the direct care system may
have lesser priority in terms of supporting the mission, this prioritization does not obviate the
responsibility to continue to care for beneficiaries enrolled with MTF primary care managers.
These beneficiaries have an understandable expectation of continued access to their primary
care. Such expectation, however, does not create an entitlement for care at a specific MTF.
b. MTF commanders or directors are directed to make public health emergency plans to
meet surge requirements related to the two primary missions.
DoDI 6200.03 March 28, 2019
SECTION 5: MTF SURGE CAPABILITIES AND PROCEDURES FOR HEALTH CARE IN DOD PUBLIC
HEALTH EMERGENCIES 44
(1) Determination of critical personnel, rather than blanket policies affecting all Service
members in an area of responsibility, will help meet the two seemingly conflicting objectives
affecting mission requirements and beneficiary care. This approach will require a critical
analysis at local levels of what represents a critical role.
(2) MTF commanders or directors will make arrangements to ensure that the minimum
level of care provided to all enrolled beneficiaries is, at the very least, comparable to local
community standards in the context of the public health emergency.
(3) Such arrangements may include special work schedules; increased use of Reserve
Component members, intermittent employees, re-employed annuitants, contractor personnel, and
volunteers; and coordination with the TRICARE Managed Care Support Contractor.
(4) Planning to ensure the smooth transition of care for MTF-enrolled patients by non-
DoD providers, to the extent that is necessary, must be accomplished well in advance of
emergency conditions.
(5) To fully manage expectations and educate the beneficiary population on the
emergency response plan relating to access to care, risk communication messages and products
must clearly state where to receive care in the event of a public health emergency.
c. As in any mass casualty event, when the number of casualties exceeds the available
capabilities to rapidly treat and evacuate, the adoption of situational community standards of care
will be required.
(1) In U.S. settings, the situational standard of care, at the very least, should be
comparable to local civilian community standards. In many settings, the standard of care may
exceed that of the local civilian community.
(2) In HN settings, the situational standard of care will not necessarily mirror that of the
HN but will be based on available assets and requirements consistent with preexisting DoD
medical triage practice.
d. During a declared public health emergency, to the extent necessary to deal with mass
casualties and without unnecessarily compromising the quality of care, the MTF commander or
director may authorize situational standards of care, including but not limited to:
(1) The scope of practice of health care practitioners and supporting technical staff (e.g.,
medical technicians, hospital corpsmen) may be expanded beyond the scope for which the
practitioner is ordinarily privileged or authorized to perform, consistent with the judgment of the
MTF commander or director and the training, experience, and capability of the practitioners
involved.
(2) SOPs or standard clinical guidelines for specialty referrals, confirmatory clinical
testing, use of equipment, provider-to-patient ratios, and similar matters may be suspended.
(3) Standard procedures for documentation regarding health care options, discussions,
and decisions may be altered.
DoDI 6200.03 March 28, 2019
SECTION 5: MTF SURGE CAPABILITIES AND PROCEDURES FOR HEALTH CARE IN DOD PUBLIC
HEALTH EMERGENCIES 45
(4) Establishment of alternate or supplemental care sites that do not meet normal
facilities standards.
(5) Expanded use of telemedicine.
e. When resources are insufficient to meet the health care needs of beneficiaries in a public
health emergency, the MHS will use the limited resources to achieve the greatest good for the
greatest number. In this context, “good” is defined as lives saved and suffering alleviated.
(1) In an environment of insufficient resources, MTF commanders or directors will not
require expenditure of resources if treatment likely would prove futile or if a disproportionate
amount of assets would be expended for one individual at the cost of many other lives that
otherwise could be saved.
(2) MTF commanders or directors are to ensure the most competent medical authority is
available, at the lowest level of command possible, to make medical judgments of this nature.
f. Decisions involving triage for care and the allocation of medical supplies must take into
account the values of personal rights and fairness to all. Critical mission requirements may
require allocation of resources based on operational factors rather than medical risk.
(1) MTF commanders or directors must communicate regularly and clearly on the
resource limitations that exist at their facilities to maximize the communities’ effective response
to a public health emergency.
(2) MTFs will provide care to their enrolled populations as noted in Paragraphs 5.2.a.
and 5.2.b. Other eligible beneficiaries are expected to seek care at the facilities where they
routinely receive primary care.
(3) Access to MTF care will comply with the beneficiary group priority list at
Part 199.17 of Title 32, CFR. However, availability of care is always subject to mission
requirements directed by the President or Secretary of Defense as authorized by federal law.
g. MTF commanders or directors and health care providers throughout the DoD need to
engage in ongoing planning and decision-making consistent with this general policy and
responsive to changing local conditions.
(1) MTF commanders or directors must effectively communicate decisions regarding
resource limitations to each other and the community before emergencies occur, as well as
during emergencies when conditions change.
(2) A decision made in one area may not be appropriate for another due to conditions
such as population demographics, susceptibility, capacity, and resources.
(3) Conditions affecting decisions include, but are not limited to, availability of health
care providers and resources such as pharmaceuticals, ventilators, and hospital beds, all in the
context of evolving disease characteristics on target and at-risk populations. A discussion of
DoDI 6200.03 March 28, 2019
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HEALTH EMERGENCIES 46
planning challenges, including ethical issues, is included in the Mass Medical Care Community
Planning Guide from the HHS Agency for Healthcare Research and Quality.
5.3. USE OF VOLUNTEERS TO SUPPLEMENT HEALTH CARE PERSONNEL.
a. Upon a declaration of public health emergency, the MTF commander or director may
supplement the available staff of health care personnel with the use of volunteers.
b. The policies and procedures of DoDI 1100.21 and DoDI 5200.02 will apply to the use of
volunteers under this section, except that:
(1) For purposes of credentialing and privileging, the MTF commander or director may
accept information and documentation provided through HHS’s Emergency System for Advance
Registration of Volunteer Health Professionals (also known as “ESAR-VHP”), or other such
documentation that the MTF commander or director determines reliable.
(2) There is no requirement for a criminal background check. However, volunteers
without a criminal background check require close clinical supervision when they are caring for
patients under the age of 18.
c. Volunteers under Paragraph 5.3. are considered employees of the DoD to the extent
provided in DoDI 1100.21.
d. For purposes of licensure requirements, a current, valid license in a State (or other federal
jurisdiction) is required.
(1) There is no requirement that the license be unrestricted, such as a license restricted to
Federal Government practice, so long as the restriction does not indicate a lack of qualifications
to provide the services covered by the volunteer agreement.
(2) There is no requirement for a license from the specific State (or other federal
jurisdiction) where the DoD installation or treatment facility (including a temporary facility
treating DoD personnel and health care beneficiaries and under DoD control) is located.
e. Temporary privileges for volunteers supplementing health care personnel in a DoD-
declared public health emergency may be initiated only when the MTF’s EM plan or installation
EM plan has been activated and the MTF is unable to handle the immediate patient needs.
(1) These privileges allow non-staff practitioners to come to the aid of the MTF during a
public health emergency.
(2) The MTF commander or director may grant temporary privileges, but there must be
policy and procedure in place that addresses current accreditation requirements and temporary
privileges.
(3) All temporary privileges will immediately terminate once the EM plan is no longer
activated; however, the MTF may choose to terminate temporary privileges prior to that time.
DoDI 6200.03 March 28, 2019
GLOSSARY 47
GLOSSARY
G.1. ACRONYMS.
AFHSB
Armed Forces Health Surveillance Branch
AMEM
alternate medical emergency manager
APHEO
alternate public health emergency officer
ASD(HA)
Assistant Secretary of Defense for Health Affairs
ASD(HD&GS)
Assistant Secretary of Defense for Homeland Defense and Global
Security
ASD(SO/LIC)
Assistant Secretary of Defense for Special Operations and Low-
Intensity Conflict
CBRNE
chemical, biological, radiological, nuclear, and high-yield
explosives
CCMD
Combatant Command
CDC
Centers for Disease Control and Prevention
CFR
Code of Federal Regulations
CJA
command judge advocate
COM
chief of mission
DCP
disease containment plan
DHA
Defense Health Agency
DHS
Department of Homeland Security
DMH
disaster mental health
DMHR
disaster mental health response
DMRTI
Defense Medical Readiness Training Institute
DoDD
DoD directive
DoDI
DoD instruction
DoS
Department of State
EM
emergency management
EMWG
Emergency Management Working Group
E.O.
Executive Order
ESAR-VHP
Emergency System for Advance Registration of Volunteer Health
Professionals
ESSENCE
Electronic Surveillance System for Early Notification of
Community-based Epidemics
FHP
force health protection
GCC
geographic Combatant Commander
GSAF
Global Situational Awareness Facility
HHS
Department of Health and Human Services
HN
host nation
DoDI 6200.03 March 28, 2019
GLOSSARY 48
HPCON
health protection condition
HQ
headquarters
IHR
International Health Regulations (2005)
LRN
Laboratory Response Network
MCM
medical countermeasures
MEM
medical emergency manager
MHS
Military Health System
MTF
medical treatment facility
NFP
National Focal Point
NMCC
National Military Command Center
PAO
public affairs office
PHEIC
public health emergency of international concern
PHEM
Public Health Emergency Management
PHEO
public health emergency officer
POD
point of dispensing
RSS
receipt, staging, and storage
SG
Surgeon General
SJA
staff judge advocate
SLTT
State, local, tribal, territorial
SME
subject matter expert
SNS
Strategic National Stockpile
SOC
Secretary’s Operations Center
SOP
standard operating procedure
U.S.C.
United States Code
USD(P&R)
Under Secretary of Defense for Personnel and Readiness
USD(P)
Under Secretary of Defense for Policy
WHO
World Health Organization
G.2. DEFINITIONS. Unless otherwise noted, these terms and their definitions are for the
purpose of this issuance.
all-hazards. Defined in Presidential Policy Directive 21.
COM. Defined in the DoD Dictionary of Military and Associated Terms.
DoDI 6200.03 March 28, 2019
GLOSSARY 49
Cities Readiness Initiative. A federally-funded, CDC-managed effort to prepare major cities
and metropolitan areas to respond to a large-scale bioterrorist event by dispensing antibiotics and
other medical supplies to the entire identified population within 48 hours of the decision to do so.
closed POD. A site intended for the dispensation of medications to a select or pre-defined
population, not the general public.
communicable disease. An illness due to a specific infectious agent or its toxic products that
arises through transmission of that agent or its products from an infected or affected individual,
animal, or a reservoir to a susceptible host, either directly or indirectly through an intermediate
animal host, vector, or the inanimate environment.
conditional release. Temporary supervision and monitoring of an individual or group, who may
have been exposed to a quarantinable communicable disease to determine the risk of disease
spread. Supervision is accomplished through in-person visits, telephone, or through electronic or
Internet-based monitoring.
DMH. Provision of prevention, outreach, screening, triage, psychological first aid, education,
and referral services to individuals and groups who have had or may have had exposure to an all-
hazards incident.
DMHR team. Designated team that provides command consultation, prevention, outreach,
screening, triage, psychological first aid, education, and referral services following an all-hazards
incident.
ESSENCE. DoD’s syndromic surveillance tool that monitors and provides alerts for rapid or
unusual increases in the occurrence of infectious diseases and biological outbreaks.
HPCON level. A framework to inform an installation’s population of specific health protection
actions recommended in response to an identified health threat, stratified by the scope and
severity of the health threat.
isolation. The separation of an individual or group infected or reasonably believed to be infected
with a communicable disease from those who are healthy in such a place and manner to prevent
the spread of the communicable disease.
LRN. Defined in DoDI 6440.03.
military commander. Defined in DoDI 5200.08.
MTF. Defined in the DoD Dictionary for Military and Associated Terms.
MTF commander or director. The commander or director of a facility established for the
purpose of furnishing medical or dental care to eligible individuals.
open POD. A public site designed for dispensation of medications to the general population.
DoDI 6200.03 March 28, 2019
GLOSSARY 50
POD. A location where pharmaceuticals and other medications are distributed to the end user;
these facilities may range from small clinics to large operations with multiple staging and
operations areas; these facilities may also support a range of methods of distributing drugs and
medications to the patients.
public health emergency. An occurrence or imminent threat of an illness or health condition
that poses:
A high probability of a significant number of deaths in the affected population considering
the severity and probability of the event;
A significant number of serious or long-term disabilities in the affected population
considering the severity and probability of the event;
Widespread exposure to an infectious or toxic agent, including those of zoonotic origin, that
poses a significant risk of substantial future harm to a large number of people in the affected
population;
Health care needs that exceed available resources; or
Severe degradation of mission capabilities or normal operations.
PHEIC. An extraordinary public health event as declared by the Director of the WHO that
constitutes a public health risk to other countries through the international spread of the health
hazard and potentially requires a coordinated international response.
quarantinable disease. Any of the communicable diseases defined in E.O. 13295, as amended.
quarantine. The separation of an individual or group that has been exposed to a communicable
disease, but is not yet ill, from others who have not been so exposed, in such manner and place to
prevent the possible spread of the communicable disease.
restriction of movement. Limiting movement of an individual or group to prevent or diminish
the transmission of a communicable disease, including limiting ingress and egress to, from, or on
a military installation; isolation; quarantine; and conditional release.
RSS site. Sites with adequate warehouse space, cargo management, and logistics assets that
accept SNS assets deployed to SLTT public health authorities for secure storage.
Service public health centers. Navy and Marine Corps Public Health Center, U.S. Air Force
School of Aerospace Medicine, U.S. Army Public Health Center.
SNS. A national repository of antibiotics, chemical antidotes, antitoxins, life-support
medications, intravenous administration fluids and sets, airway maintenance supplies, and
medical/surgical items. The SNS is designed to supplement and re-supply State and local public
health agencies in the event of a national emergency anywhere and at any time within the United
States or its territories.
DoDI 6200.03 March 28, 2019
GLOSSARY 51
telemedicine. Defined in the DoD Dictionary of Military and Associated Terms.
terrorism. Defined in the DoD Dictionary of Military and Associated Terms.
TRICARE. Defined in DoDD 5136.13.
United States. Defined in the DoD Dictionary of Military and Associated Terms.
zoonotic disease. Diseases transmissible under natural conditions between vertebrate animals
and humans.
DoDI 6200.03 March 28, 2019
REFERENCES 52
REFERENCES
Agency for Healthcare Research and Quality, “Mass Medical Care with Scarce Resources: A
Community Planning Guide,” February 2007
Chairman of the Joint Chiefs of Staff Manual 3150.05D, “Joint Reporting System Situation
Monitoring Manual,” January 31, 2011
Code of Federal Regulations, Title 32, Part 199.17
Code of Federal Regulations, Title 42
Department of Health and Human Services Publication No. ADM 90-0537, “Field Manual for
Mental Health and Human Service Workers in Major Disasters,” 2000
DoD 6025.18-R, “DoD Health Information Privacy Regulation,” January 24, 2003
DoD Directive 3020.26, “Department of Defense Continuity Programs,” February 14, 2018
DoD Directive 3025.18, “Defense Support of Civil Authorities (DSCA),” December 29, 2010, as
amended
DoD Directive 5111.1, “Under Secretary of Defense for Policy (USD(P)),” December 8, 1999
DoD Directive 5111.10, “Assistant Secretary of Defense for Special Operations and Low-
Intensity Conflict (ASD(SO/LIC)),” March 22, 1995, as amended
DoD Directive 5111.13, “Assistant Secretary of Defense for Homeland Defense and Global
Security (ASD(HD&GS)),” March 23, 2018
DoD Directive 5124.02, “Under Secretary of Defense for Personnel and Readiness
(USD(P&R)),” June 23, 2008
DoD Directive 5136.01, “Assistant Secretary of Defense for Health Affairs (ASD(HA)),”
September 30, 2013, as amended
DoD Directive 5136.13, “Defense Health Agency (DHA),” September 30, 2013
DoD Directive 5400.11, “DoD Privacy Program,” October 29, 2014
DoD Directive 6200.04, “Force Health Protection (FHP),” October 9, 2004, as amended
DoD Directive 6400.04E, “DoD Veterinary Public and Animal Health Services,” June 27, 2013,
as amended
DoD Directive 6490.02E, “Comprehensive Health Surveillance,” February 8, 2012, as amended
DoD Instruction 1100.21, “Voluntary Services in the Department of Defense,” March 11, 2002,
as amended
DoD Instruction 1300.18, “Department of Defense (DoD) Personnel Casualty Matters, Policies,
and Procedures,” January 8, 2008, as amended
DoD Instruction 3001.02, “Personnel Accountability in Conjunction with Natural or Manmade
Disasters,” May 3, 2010
DoD Instruction 3020.52, “DoD Installation Chemical, Biological, Radiological, Nuclear, and
High-Yield Explosive (CBRNE) Preparedness Standards,” May 18, 2012, as amended
DoD Instruction 4000.19, “Support Agreements,” April 25, 2013, as amended
DoD Instruction 5200.02, “DoD Personnel Security Program (PSP),” March 21, 2014, as
amended
DoDI 6200.03 March 28, 2019
REFERENCES 53
DoD Instruction 5200.08, “Security of DoD Installations and Resources and the DoD Physical
Security Review Board (PSRB),” December 10, 2005 as amended
DoD Instruction 6025.23, “Health Care Eligibility Under the Secretarial Designee (SECDES)
Program and Related Special Authorities,” September 16, 2011 as amended
DoD Instruction 6055.17, “DoD Emergency Management (EM) Program,” February 13, 2017, as
amended
DoD Instruction 6200.02, “Application of Food and Drug Administration (FDA) Rules to
Department of Defense Force Health Protection Programs,” February 27, 2008
DoD Instruction 6205.4, “Immunization of Other Than U.S. Forces (OTUSF) for Biological
Warfare Defense,” April 14, 2000
DoD Instruction 6440.03, “DoD Laboratory Network (DLN),” June 10, 2011
DoD Instruction O-2000.16, Volume 2, “DoD Antiterrorism (AT) Program Implementation:
DoD Force Protection Condition (FPCON) System,” November 17, 2016, as amended
DoD Manual 8910.01, Volume 1 “DoD Information Collections Manual: Procedures for DoD
Internal Information Collections,” June 30, 2014, as amended
Executive Order 13295, “Revised List of Quarantinable Communicable Diseases,” April 4, 2003
as amended
Executive Order 13375, “Amendment to Executive Order 13295 Relating to Certain Influenza
Viruses and Quarantinable Communicable Diseases,” April 1, 2005
Executive Order 13527, “Establishing Federal Capability for the Timely Provision of Medical
Countermeasures Following a Biological Attack,” December 30, 2009
Executive Order 13674, “Revised List of Quarantinable Communicable Diseases,” July 31, 2014
National Institute of Mental Health Publication No. 02-5138, “Mental Health and Mass
Violence: Evidence-Based Early Psychological Interventions for Victims/Survivors of Mass
Violence. A Workshop to Reach Consensus on Best Practices,” 2002
Office of the Chairman of the Joint Chiefs of Staff, “DoD Dictionary of Military and Associated
Terms,” current edition
Presidential Policy Directive 21, “Critical Infrastructure Security and Resilience,” February 12,
2013
United States Code, Title 5, Section 301
United States Code, Title 50, Section 797
United States Code, Title 18, Section 1382
United States Code, Title 10
United States Code, Title 32
United States Code, Title 42
World Health Organization, “International Health Regulations (2005),” Third Edition, 2016
