UNCLASSIFIED//


PASS TO ALL OFFICE CODES:
FM CNO WASHINGTON DC//N1//
TO NAVADMIN
INFO CNO WASHINGTON DC//Nl//

NAVADMIN 207/08
UNCLAS //N06000//
MSGID/GENADMIN/CNO WASHINGTON DC/Nl/JUL//

SUBJ/DEPLOYMENT HEALTH ASSESSMENT POLICY AND PROCESS//

REF/A/GENADMIN/CNO/291515ZMAY2003//
REF/B/GENADMIN/CNO/101249ZJUL2006//
REF/C/DOC/ASD(HA)/20060811//
REF/D/GENADMIN/CDRUSCENTCOM/061911ZJUL2007//
REF/E/GENADMIN/CNO/162133ZSEP2005//

NARR/REF A IS NAVADMIN 142/03, ENHANCED POST-DEPLOYMENT HEALTH
ASSESSMENTS.  REF B IS NAVADMIN 200/06, POST-DEPLOYMENT HEALTH
RE-ASSESSMENT (PDHRA) AND ELECTRONIC SUBMISSION OF DEPLOYMENT HEALTH
ASSESSMENTS (EDHA).  REF C IS DEPARTMENT OF DEFENSE INSTRUCTION (DODI)
6490.03, DEPLOYMENT HEALTH.  REF D IS MOD 8 TO USCENTCOM INDIVIDUAL
PROTECTION AND INDIVIDUAL/UNIT DEPLOYMENT POLICY.  REF E IS RESERVE
COMPONENT MEDICAL REQUIREMENTS FOR MOBILIZATION.//

RMKS/l.  THIS NAVADMIN SUPERSEDES AND CANCELS REFS A AND B, AND PROVIDES
GUIDANCE FOR THE DEPLOYMENT HEALTH ASSESSMENT (DHA) PROCESS.  DHA'S ARE
DIRECTED FOR SAILORS WHEN THEY EITHER DEPLOY WITH DUTIES INVOLVING MORE
THAN 30 DAYS ASHORE OCONUS; ARE MEMBERS OF A DEPLOYING UNIT OR DEPLOYED
INDIVIDUALLY ON THE GROUND TO USCENTCOM AOR; OR DEPLOY, REGARDLESS OF
DEPLOYMENT AREA OR DURATION, AND THE COMMANDER EXERCISING OPERATIONAL
CONTROL SPECIFICALLY DETERMINES THAT PERSONNEL UNDER HIS COMMAND WERE
EXPOSED TO A POTENTIALLY ADVERSE PHYSICAL OR MENTAL HEALTH THREAT (E.G.,
A DEPLOYED SHIP CONDUCTS OPERATIONS THAT EXPOSED SAILORS TO
CONTAMINANTS, DISEASE, OR TRAUMATIC EVENTS).  PER REF C, PERSONNEL WHO
ROTATIONALLY DEPLOY WITH SHIPS/SQUADRONS AFLOAT ARE SPECIFICALLY
EXCLUDED FROM THIS REQUIREMENT UNLESS THEY SERVED MORE THAN 30 DAYS WITH
BOOTS ON THE GROUND.

2.  THIS NAVADMIN ALSO DIRECTS A ONE-TIME SCREENING OF MEDICAL RECORDS
FOR DHA COMPLIANCE OF ALL PERSONNEL WHO HAVE COMPLETED AN IA ASSIGNMENT
IN THE USCENTCOM AOR SINCE OCTOBER 2001.  PROCEDURES FOR ONE-TIME
SCREENING ARE LISTED BELOW IN PARA 10.

3.  THE DHA PROCESS IS DESIGNED TO IDENTIFY STRESS INJURIES AND OTHER
HEALTH CONCERNS THAT REQUIRE FURTHER ASSESSMENT OR TREATMENT.  DHA IS
MANDATED BY DOD TO SCREEN SAILORS PRIOR TO DEPLOYMENT, TO IDENTIFY
HEALTH CONCERNS AFTER DEPLOYMENT, AND TO FACILITATE APPROPRIATE CARE.
DHA CONSISTS OF:
    A.  PRE-DEPLOYMENT HEALTH ASSESSMENT (PRE-DHA, DD FORM 2795),
CONDUCTED WITHIN 60 DAYS PRIOR TO DEPLOYMENT.
    B.  POST-DEPLOYMENT HEALTH ASSESSMENT (POST-DHA, DD FORM 2796),
CONDUCTED WITHIN 30 DAYS BEFORE OR AFTER RETURN TO HOME STATION.
    C.  POST-DEPLOYMENT HEALTH RE-ASSESSMENT (PDHRA, DD 2900), CONDUCTED
BETWEEN 90 AND 180 DAYS AFTER RETURN TO HOME STATION. 
PDHRA CAN BE DONE IN CONJUNCTION WITH THE PERIODIC HEALTH ASSESSMENT IF
TIME FRAMES COINCIDE.

4.  THE DHA CAPTURES THE NECESSARY DATA TO MONITOR THE HEALTH OF OUR
SAILORS IN ORDER TO PROACTIVELY IDENTIFY AND MANAGE HEALTH ISSUES.     
    A.  COMMANDERS, COMMANDING OFFICERS, AND OFFICERS-IN-CHARGE MUST BE
PERSONALLY INVOLVED IN MONITORING THE DHA PROCESS TO ENSURE THAT EVERY
SAILOR'S CONCERNS AND ISSUES RECEIVE THE APPROPRIATE ATTENTION AND
CONSIDERATION. 
    B.  COMMAND LEADERSHIP AND MEDICAL PERSONNEL WILL USE THE MEDICAL
READINESS REPORTING SYSTEM (MRRS) TO TRACK THE DHA PROCESS.

5.  BASIC STEPS FOR DHA PROCESS:
    A.  SAILORS ACCESS AND COMPLETE DHA FORMS ELECTRONICALLY AT
HTTPS://WWW-NMCPHC.MED.NAVY.MIL/EDHA.  COMMAND MAY OBTAIN A PASS PHRASE
FOR ITS SAILORS BY CONTACTING THE EDHA HELPDESK AT (757) 953-0717/DSN
377 OR EMAIL: EDHA(AT)NMCPHC.MAR.MED.NAVY.MIL
    B.  DHA'S MUST BE REVIEWED VIA A FACE-TO-FACE INTERVIEW WITH A
HEALTH CARE PROVIDER:
      (1) FOR DD FORM 2795: THIS CAN BE A NURSE, CORPSMAN, OR
MEDICAL TECHNICIAN.  A POSITIVE RESPONSE TO QUESTIONS 2,3,4,7, OR 8
REQUIRES REFERRAL TO A PHYSICIAN, PHYSICIAN ASSISTANT (PA), NURSE
PRACTITIONER (NP) OR INDEPENDENT DUTY CORPSMAN (IDC). 
      (2) FOR DD FORMS 2796 AND 2900: THE INTERVIEWER MUST BE A
PHYSICIAN, PA, NP OR IDC. 
    C.  THE PROVIDER REVIEW PAGE FOR ALL DHA'S MUST BE COMPLETED
ELECTRONICALLY BY A PHYSICIAN, PA, NP, OR IDC AND SUBMITTED INTO THE
NAVY AND MARINE CORPS PUBLIC HEALTH CENTER (NMCPHC) AND ARMED FORCES
MEDICAL SURVEILLANCE CENTER (AFMSC) DATABASES. 
    D.  A SIGNED PAPER COPY OF THE COMPLETED DHA FORM SHALL BE PLACED IN
THE MEDICAL RECORD FOR VALIDATION AND CONTINUITY OF CARE.
    E.  ENSURE APPROPRIATE REFERRAL AND FOLLOW-UP FOR ANY IDENTIFIED
CONCERNS.
    F.  AS OF 1 JULY 2008, ALL ACTIVE COMPONENT PERSONNEL TRANSITIONING
THROUGH WARRIOR TRANSITION CENTER (WTC), CAMP ARIFJAHN, KUWAIT ARE
COMPLETING THE ONLINE POST DHA AND MEETING WITH A REGISTERED MEDICAL
PROVIDER TO CONDUCT THE FACE-TO-FACE REQUIREMENTS OF THE ASSESSMENT.
REQUIRED BLOOD SERUM DRAWS (REFERENCE SAMPLES) AND FOLLOW-ON REFERRALS
FOR MEDICAL EVALUATION AND TREATMENT MUST BE COMPLETED AFTER SAILORS
RETURN TO CONUS AT MILITARY TREATMENT FACILITIES (MTF) SUPPORTING PARENT
COMMANDS (IN THE CASE OF IA MANPOWER MANAGEMENT (IAMM) SAILORS) AND NEW
GAINING COMMANDS (IN THE CASE OF GSA SAILORS).
    G.  RESERVE COMPONENT SAILORS ARE RETURNING TO THE NAVY MOBILIZATION
PROCESSING SITES (LOCATED AT NORFOLK, SAN DIEGO, GULFPORT, AND PORT
HUENEME) TO COMPLETE POST DHA REQUIREMENTS DURING DEMOBILIZATION
OUT-PROCESSING.

6.  THE FOLLOWING RESPONSIBILITIES ARE ASSIGNED:
    A.  DCNO (MPTE) (OPNAV N135) IS RESPONSIBLE FOR NAVY POLICY
DEVELOPMENT AND COMPLIANCE OVERSIGHT REPORTS.
    B.  USFF IS THE SUPPORTED COMMANDER AND IS RESPONSIBLE FOR EXECUTION
AND COMPLIANCE ENFORCEMENT. 
    C.  ALL MAJOR CLAIMANTS AND ECHELON II COMMANDS (SUPPORTING
COMMANDS) WILL ENSURE COMPLIANCE WITHIN THEIR AREA OF RESPONSIBILITY AND
WILL PROVIDE USFF WITH COMPLIANCE REPORTS AND EMPHASIZE DHA PROCESS
DURING APPROPRIATE COMMAND ASSESSMENTS/EVALUATIONS.
    D.  NAVY MEDICINE WILL PROVIDE MEDICAL SUPPORT SERVICES FOR COMMANDS
TO COMPLETE DEPLOYMENT HEALTH ASSESSMENTS.

7.  COMMAND RESPONSIBILITIES:
    A.  ROTATIONAL FORCE COMMANDS ARE RESPONSIBLE FOR ENSURING THAT AC
AND RC SAILORS MEETING ANY OF THE CRITERIA CONTAINED IN PARA 1 COMPLY
WITH THE DHA PROCESS AS LISTED IN PARA 3.  FOLLOW-UP ANY CONCERNS
IDENTIFIED BY THE DHA PROCESS IN COORDINATION WITH MEDICAL PROVIDERS,
AND VALIDATE DHA COMPLETION AND APPROPRIATE FOLLOW-UP AS PART OF CHECK
IN/CHECK OUT PROCESSING.
    B.  INDIVIDUAL AUGMENTEE ACTIVE COMPONENT (IA-AC) PARENT COMMAND'S
RESPONSIBILITIES:
        (1) ENSURE SAILORS COMPLETE DD FORM 2795 WITHIN 60 DAYS OF
REPORTING TO NAVY MOBILIZATION PROCESSING SITES (NMPS) OR COMBAT SKILLS
TRAINING (NAVY IA COMBAT SKILLS TRAINING (NIACT) OR ARMY COMBAT SKILLS
TRAINING).  FOR GSA PERSONNEL, THE DD FORM 2795 MUST BE COMPLETED PRIOR
TO TRANSFERRING FROM DETACHING COMMAND.
        (2) FOR POST-DEPLOYMENT MONITOR TO ENSURE DD FORM 2796 AND DD
FORM 2900 HAVE BEEN COMPLETED IN COMPLIANCE WITH PARA 3. 
FOLLOW-UP ANY CONCERNS IDENTIFIED IN THE DHA PROCESS IN COORDINATION
WITH MEDICAL PROVIDERS AND VALIDATE DHA COMPLETION AND APPROPRIATE
FOLLOW-UP AS PART OF CHECK IN/CHECK OUT PROCESSING.
   C.  NAVY MOBILIZATION PROCESSING SITES (NMPS) ARE RESPONSIBLE FOR
ENSURING:
        (1) IA-RC SAILORS COMPLETE PRE-DHA AND FOLLOW-UP FOR ANY
IDENTIFIED CONCERNS.
        (2) COMPLETION OF POST-DHA FOR IA SAILORS (AC AND RC).  RC
SAILORS INDICATING ISSUES ON THE DD 2796 WILL BE PROCESSED PER REF D.
    D.  NAVY OPERATIONAL SUPPORT CENTERS (NOSC) RESPONSIBILITIES:
        (1) ENSURE IA-RC SAILORS COMPLETE BASIC MEDICAL READINESS
REQUIREMENTS AS DELINEATED IN REF E.  ANY CONCERNS REGARDING SAILORS'
DEPLOYABLE STATUS SHOULD BE ADDRESSED WITH AN APPROPRIATE MEDICAL
DEPARTMENT REPRESENTATIVE.
        (2) COLLABORATE WITH UNIT COMMANDERS TO ENSURE SAILORS COMPLETE
THE PDHRA (DD 2900) BETWEEN 90 AND 180 DAYS AFTER RETURN FROM
DEPLOYMENT.  RC PDHRA SCREENING IS PROVIDED THROUGH DOD HEALTH AFFAIRS
CONTRACT SERVICES, EITHER AT A NOSC-COORDINATED ONSITE SCREENING EVENT,
OR BY CALLING THE DOD-SPONSORED PDHRA CALL CENTER (1-888-PDHRA-99).
MEMBERS INDICATING ISSUES ON THE DD 2900 MAY BE APPROVED FOR A "ONE-TIME
LINE OF DUTY" AUTHORIZING A MEDICAL EVALUATION APPOINTMENT TO DETERMINE
IF A MEDICAL CONDITION REQUIRING TREATMENT EXISTS.
        (3) VALIDATE ALL DHA COMPLETIONS AS PART OF UNIT TRANSFER
PROCEDURES.
    E.  DEPLOYMENT HEALTH CENTERS (DHC).  NAVY MEDICINE HAS ESTABLISHED
DHC'S AT NHC HAWAII, NH OKINAWA, NMC SAN DIEGO, NH CAMP PENDLETON, NH
TWENTY-NINE PALMS, NBHC PORT HUENEME, NH LEMOORE, NH OAK HARBOR, NNMC
BETHESDA, NHC QUANTICO, NHCNE NEWPORT, NMC PORTSMOUTH, NH CAMP LEJEUNE,
NH BEAUFORT AT MCRD PARRIS ISLAND, NH JACKSONVILLE, NH PENSACOLA, AND
BHC GULFPORT.
        (1) DHC'S SUPPORT THE PDHRA (DD 2900) PROCESS, INCLUDING THE
EVALUATION AND TREATMENT OF DEPLOYMENT RELATED PRIMARY CARE AND
PSYCHOLOGICAL HEALTH CONCERNS.
        (2) DHC ASSETS MAY ALSO SUPPORT PRE- AND POST-DHA PROCESSES.
        (3) POINT OF CONTACT FOR DHC PROGRAM IS CDR FAITH BURRELL, BUMED
M3C3, AT (202) 762-3049/DSN 762 OR EMAIL: PDHRA(AT)MED.NAVY.MIL.

8.  DHA DOCUMENTATION AND DATA MANAGEMENT:
    A.  ALL DHA'S SHALL BE SUBMITTED ELECTRONICALLY.  PAPER COPIES OF
DHA'S ARE NO LONGER AUTHORIZED FOR SUBMISSION. 
        (1) INSTRUCTIONS FOR COMPLETION AND ACCESS TO ELECTRONIC DHA'S
ARE PROVIDED AT THE NMCPHC WEBSITE HTTPS://WWW-NMCPHC.MED.NAVY.MIL/EDHA.
        (2) POINT OF CONTACT FOR ASSISTANCE WITH THE ELECTRONIC DHA WEB
APPLICATION (EDHA) IS MR. AZAD AL-KOSHNAW, AT (757) 953-0938/DSN
377 OR EMAIL AT EDHA(AT)NMCPHC.MED.NAVY.MIL.  THE NMCPHC HELP DESK MAY
BE CONTACTED AT (757) 953-0717/DSN 377 OR EMAIL:
EDHA(AT)NMCPHC.MAR.MED.NAVY.MIL
    B.  COMMANDERS CAN VALIDATE COMPLETION OF DHA'S BY INDIVIDUAL OR
LARGER AGGREGATIONS USING APPROPRIATE UIC'S TO PRODUCE A MRRS COMPLIANCE
REPORT.
        (1) IF WHILE ON DEPLOYMENT A COMMANDER DICTATES DHA COMPLIANCE
FOR PERSONNEL WELFARE DUE TO AN IDENTIFIED HEALTH THREAT TO A SPECIFIC
AREA, COMPLIANCE WILL BE MANUALLY SELECTED BY MEDICAL PERSONNEL IN MRRS
FOR THOSE INDIVIDUALS OR UNITS WHO REQUIRE PDHA'S AND PDHRA'S.
        (2) FOR ACCESS OR ASSISTANCE WITH MRRS, POINT OF CONTACT IS PSC
DAVENPORT, OPNAV N16, AT (703) 695-3418/DSN 225, OR EMAIL:
MRRSPO(AT)NAVY.MIL.

9.  PROGRAM COMPLIANCE AND MONITORING:
    A.  ECHELON I.  OPNAV N135 WILL PROVIDE CNO WITH QUARTERLY
COMPLIANCE REPORTS.  COMPLIANCE REPORTS WILL BE BASED ON DHA COMPLETION
DATA IN MRRS.
    B.  SUPPORTED COMMAND.  USFF IS THE SUPPORTED COMMANDER AND WILL
PROVIDE SPECIFIC REPORTING GUIDANCE SEPCOR.
    C.  SUPPORTING COMMANDS.  ALL MAJOR CLAIMANTS AND ECHELON II
COMMANDS WILL MONITOR DHA COMPLIANCE AND ANY REFERRAL FOLLOW-UP THROUGH
MRRS.

10.  TO ACCOMPLISH THE ONE-TIME MEDICAL RECORD REVIEW OF SAILORS WHO
HAVE COMPLETED AN IA ASSIGNMENT TO USCENTCOM AOR SINCE OCTOBER 2001,
COMMANDERS ARE DIRECTED TO DO THE FOLLOWING:
    A.  CANVASS SAILORS WITHIN YOUR COMMAND TO DETERMINE IF THEY HAVE
COMPLETED AN IA ASSIGNMENT AS OUTLINED IN PARA 2.
    B.  ACCESS MRRS TO VERIFY THE COMPLETION OF THE DD FORM 2900 FOR
EACH SAILOR'S MOST RECENT DEPLOYMENT.
C.  IF COMPLETION OF DD 2900 IS NOT REFLECTED IN MRRS BUT A PAPER COPY
IS PRESENT IN SAILOR'S MEDICAL RECORD, TRANSFER THE INFORMATION TO AN
ELECTRONIC DD FORM 2900 AND SUBMIT.
D.  IF THE SERVICE MEMBER HAS NOT COMPLETED A DD FORM 2900, FOLLOW THE
STEPS IN PARA 5. 
    E.  THIS REVIEW SHALL BE COMPLETED BY 31 OCTOBER 2008 TO ENSURE THE
MRRS DATA ACCURATELY REFLECTS DHA COMPLIANCE.  ECHELON II COMMANDERS
REPORT COMPLETION OF THIS REVIEW TO USFF (N1).

11.  POINT OF CONTACT:  MR. STEVEN R. ZAHL, OPNAV N135 AT (901)
874-4355/DSN 882 OR E-MAIL AT STEVEN.ZAHL(AT)NAVY.MIL.

12.  RELEASED BY VADM M. E. FERGUSON III, N1.//