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USCENTCOM 091923Z APR 20 MOD FIFTEEN TO USCENTCOM INDIVIDUALPROTECTION AND INDIVIDUAL-UNIT DEPLOYMENT POLICYUNCLASSIFIED//SUBJ/MOD FIFTEEN TO USCENTCOM INDIVIDUAL PROTECTION AND INDIVIDUAL/UNITDEPLOYMENT AMPN/ORIGINAL USCINCCENT INDIVIDUAL PROTECTION AND INDIVIDUAL UNITDEPLOYMENT POLICY MPN/MOD FOURTEEN TO USCENTCOM INDIVIDUAL PROTECTION AND UNIT DEPLOYMENTPOLICY MESSAGE. MOD FOURTEEN IS NO LONGER VALID AND IS SUPERSEDED BY I 6490.03/DEPLOYMENT HEALTH//REF/D/DOC/USD(P&R)/09JUN2014//AMPN/DODI 6025.19/INDIVIDUAL MEDICAL READINESS//REF/E/DOC/COMDT CG/05JUN2018//AMPN/CH-2 TO COMDTINST M6000.1F/COAST GUARD MEDICAL MANUAL//REF/F/DOC/HQ USAF/05NOV2013//AMPN/AFI 48-123 AFGM2018-02/MEDICAL EXAMINATIONS AND STANDARDS //REF/G/DOC/HQDA/27JUN2019//AMPN/AR 40-501/STANDARDS OF MEDICAL FITNESS//REF/H/DOC/BUMED/20 FEB 2019//AMPN/NAVMED P-117/MANUAL OF THE MEDICAL DEPARTMENT (MANMED)//REF/I/DOC/USD(P&R)/05FEB2010//AMPN/DODI 6490.07/DEPLOYMENT-LIMITING MEDICAL CONDITIONS FOR SERVICE MEMBERSAND DOD CIVILIAN EMPLOYEES//REF/J/DOC/USD(A&S)/20DEC2011, CHANGE 2 31AUG2018//AMPN/DODI 3020.41/OPERATIONAL CONTRACT SUPPORT//REF/K/DOC/USD(P&R)/25JAN2017, CHANGE 3 12FEB2020//AMPN/ DTM 17-004/DOD CIVILIAN EXPEDITIONARY WORKFORCE//REF/L/DOC/ASD(FMP)/27MAR2019//AMPN/DODI 1100.21/VOLUNTARY SERVICES IN THE DEPARTMENT OF DEFENSE//1

REF/M/DOC/ASD(P&R)/16JUN2016, CHANGE 1 21DEC2017//AMPN/DODI 6200.05/FORCE HEALTH PROTECTION QUALITY ASSURANCE (FHPQA) N/AR 40-562, BUMEDINST 6230.15B, AFI 48-110 IP, CG COMDTINST M6230.4G/IMMUNIZATIONS AND CHEMOPROPHYLAXIS FOR THE PREVENTION OF INFECTIOUS TY SECRETARY OF DEFENSE MEMO/CLARIFYING GUIDANCE FOR SMALLPOX ANDANTHRAX VACCINE IMMUNIZATION TY SECRETARY OF DEFENSE MEMO/ANTHRAX VACCINE IMMUNIZATION NT SECRETARY OF DEFENSE MEMO/CLINICAL POLICY FOR THEADMINISTRATION OF THE ANTHRAX VACCINE ABSORBED//REF/R/DOC/AFPMB OUSD (A&S)/06NOV2015//AMPN/TECHNICAL GUIDE NO. 36/PERSONAL PROTECTIVE MEASURES AGAINST INSECTS ANDOTHER ARTHROPODS OF MILITARY ODI 6485.01/HUMAN IMMUNODEFICIENCY VIRUS (HIV) IN MILITARY SERVICE NT SECRETARY OF DEFENSE MEMO/POLICY FOR PRE AND POST DEPLOYMENTSERUM I 6465.01/ERYTHROCYTE GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY(G6PD) AND SICKLE CELL TRAIT SCREENING ANT SECRETARY OF DEFENSE MEMO/GUIDELINE FOR TUBERCULOSISSCREENING AND NT SECRETARY OF DEFENSE MEMO/IMPLEMENTATION OF REVISEDDEPARTMENT OF DEFENSE FORMS 2795, 2796 AND 2900//REF/X/DOC/USD(P&R)/11SEP2015, CHANGE 1 31MAR2017//AMPN/DODI 6490.13/COMPREHENSIVE POLICY ON TRAUMATIC BRAIN INJURY-RELATEDNEUROCOGNITIVE ASSESSMENTS BY THE MILITARY SERVICES//REF/Y/DOC/USD(P&R)/ 19JUN2019//AMPN/DODI 6490.03/DEPLOYMENT HEALTH//2

REF/Z/DOC/USD(P&R)/16MAR2018//AMPN/DODI 1322.24/MEDICAL READINESS TRAINING (MRT)//REF/AA/USD(I)/20MAR2009, CHANGE 2 25APR2018//AMPN/DODI 6420.01/NATIONAL CENTER MEDICAL INTELLIGENCE NT SECRETARY OF DEFENSE MEMO/GUIDANCE ON MEDICATIONS FORPROPHYLAXIS OF ANT SECRETARY OF DEFENSE MEMO/NOTIFICATION FOR HEALTHCAREPROVIDERS OF MEFLOQUINE BOX ANT SECRETARY OF DEFENSE MEMO/UPDATED POLICY FOR PREVENTION OFARTHROPOD-BORNE DISEASES AMONG DEPARTMENT OF DEFENSE PERSONNEL DEPLOYEDTO ENDEMIC PROCEDURES FOR DEPLOYMENT HEALTH CR 40-2/DEPLOYMENT FORCE HEALTH PROTECTION//REF/GG/DOC/AFHSB/01JAN2020//AMPN/ARMED FORCES REPORTABLE MEDICAL EVENTS GUIDELINES & CASE DEFINITIONS//REF/HH/ DOC/CENTCOM/23JUN2016//AMPN/CCR 40-5/MEDICAL INFORMATION SYSTEMS//REF/II/DOC/USD(P&R)/18SEP2012, CHANGE 2 26NOV2019//AMPN/DODI 6490.11/DOD POLICY GUIDANCE FOR MANAGEMENT OF MILD TRAUMATIC BRAININJURY/ AND CONCUSSION IN THE DEPLOYED SETTING//REF/JJ/DOC/OTSG/16MAR2018//AMPN/MEDCOM POLICY MEMO 18-008/STINGING INSECT ALLERGY RETENTION AND N/ASSISTANT SECRETARY OF DEFENSE MEMO/CLINICAL PRACTICE GUIDELINES FORDEPLOYMENT LIMITING MENTAL DISORDERS AND PSYCHOTROPIC ODI 1300.28/IN-SERVICE TRANSITION FOR TRANSGENDER SERVICE MEMBERS//REF/MM/DOC/HHS/OCT2015//STIMULANT AND RELATED MEDICATIONS: U.S. FOOD AND DRUG ADMINISTRATION-APPROVEDINDICATIONS AND DOSAGES FOR USE IN ADULTS//3

REF/NN/DOC/HQ USAF/17JAN2019//AMPN/AFI 31-126/DOD MILITARY WORKING DOG (MWD) PROGRAM//REF/OO/WEBSITE/CDC/31MAR2020//CORONAVIRUS DISEASE 2019 (COVID-19) – PEOPLE WHO ARE AT HIGHER RISK FOR SEVEREILLNESS. RAPRECAUTIONS/PEOPLE-AT-HIGHTER-RISK.HTMLRMKS/1. (U) THIS IS MODIFICATION FIFTEEN TO USCENTCOM INDIVIDUAL PROTECTION ANDINDIVIDUAL/UNIT DEPLOYMENT POLICY. IN SUMMARY, MODIFICATIONS HAVE BEEN MADE TOPARAGRAPH 15 FROM MOD FOURTEEN, REF B.1.A. PARAGRAPH 15 REQUIRED CHANGES IN RESPONSE TO ONGOING COVID-19 PANDEMIC;THEREFORE, IT IS BEING REPUBLISHED IN ITS ENTIRETY. MOD 15 SUPERSEDES ALLPREVIOUS VERSIONS. THE MODIFICATIONS TO THE FITNESS STANDARDS FOR MEDICALDEPLOYABILITY (PARAGRAPH 15 AND TAB A) ARE BASED ON GUIDANCE FROM THE CENTERFOR DISEASE CONTROL (REF OO). CHANGES ARE BASED ON NON-DISCRIMINATORY DATAREGARDING THE CURRENTLY KNOWN MORBIDITY AND MORTALITY RATES FOR COVID-19, TIEDTO THE FORCE PROTECTION CONCERN THAT THOSE INDIVIDUALS POSE AN UNACCEPTABLERISK TO THE FORCE AND RISK OF OVERWHELMING THE LIMITED MEDICAL RESOURCES IN ATHEATER OF COMBAT. DURING THE COVID-19 PANDEMIC, COMMANDERS HAVE THEDISCRETION TO MAKE THE REQUIREMENTS MORE RESTRICTIVE IF THEY FEEL THEIR RISK TOMISSION IS TOO HIGH. THE COVID-19 MODIFICATIONS CONTAINED HEREIN WILL BE LIMITED TOTHE DURATION OF THE PANDEMIC AFTER WHICH TIME MOD 16 WILL BE RELEASED1.B. PARAGRAPH 15 OF REF A HAS BEEN REWRITTEN AS FOLLOWS:15.A. DEFINITIONS.15.A.1. DEPLOYMENT. FOR MEDICAL PURPOSES, THE DEFINITION OF DEPLOYMENT IS TRAVELTO OR THROUGH THE USCENTCOM AREA OF RESPONSIBILITY (AOR), WITH EXPECTED ORACTUAL TIME IN COUNTRY (PHYSICALLY PRESENT, EXCLUDING IN-TRANSIT OR TRAVEL TIME)FOR A PERIOD OF GREATER THAN 30 DAYS, EXCLUDING SHIPBOARD OPERATIONS, ASDEFINED IN REF C.15.A.2. TEMPORARY DUTY (TDY). TDY MISSIONS ARE THOSE MISSIONS WITH TIME INCOUNTRY OF 30 DAYS OR LESS.15.A.3. PERMANENT CHANGE OF STATION (PCS). PCS PERSONNEL, INCLUDING EMBASSYPERSONNEL, WILL COORDINATE WITH THEIR RESPECTIVE SERVICE COMPONENT MEDICALPERSONNEL FOR MEDICAL GUIDANCE AND REQUIREMENTS FOR PCS TO SPECIFICCOUNTRIES IN THE USCENTCOM AOR. AUTHORIZED DEPENDENTS MUST PROCESS THROUGHTHE OVERSEAS SCREENING PROCESS AND EXCEPTIONAL FAMILY MEMBER PROGRAM (EFMP),IF REQUIRED. ALL PERSONNEL MUST BE CURRENT WITH ADVISORY COMMITTEE ONIMMUNIZATION PRACTICES (ACIP) IMMUNIZATION GUIDELINES AND DOD TRAVEL GUIDELINES.HOST NATION IMMUNIZATION AND MEDICAL SCREENING REQUIREMENTS APPLY. PORTIONSOF MOD 15 WILL APPLY AS DELINEATED IN TAB B.15.A.4. SHIPBOARD PERSONNEL. ALL SHIPBOARD PERSONNEL WHO DEPLOY INTO THE AORMUST HAVE CURRENT SEA DUTY SCREENING AND REMAIN FULLY MEDICALLY READYFOLLOWING ANNUAL PERIODIC HEALTH ASSESSMENT (PHA). DEPLOYMENT HEALTHASSESSMENT PER 15.H APPLIES IF DEPLOYED TO OCONUS FOR GREATER THAN 30 DAYS WITHNON-FIXED U.S. MEDICAL TREATMENT FACILITIES (MTF).15.B. APPLICABILITY. THIS MOD APPLIES TO U. S. MILITARY PERSONNEL, TO INCLUDEACTIVATED RESERVE AND NATIONAL GUARD PERSONNEL, DOD CIVILIANS, DODCONTRACTORS, DOD SUB-CONTRACTORS, VOLUNTEERS, AND THIRD COUNTRY NATIONALS4

(TCN) TRAVELING OR DEPLOYING TO THE CENTCOM AOR AND WORKING UNDER THEAUSPICES OF THE DOD. LOCAL NATIONALS (LN) WILL MEET THE MINIMAL MEDICALSTANDARDS ADDRESSED IN SECTION 15.C.1.F. MILITARY WORKING DOGS (MWD) ANDCONTRACT WORKING DOGS (CWD) WILL MEET MINIMAL STANDARDS ADDRESSED IN SECTION15.C.1.G.15.C. MEDICAL DEPLOYABILITY. THE FINAL AUTHORITY FOR ENTRY INTO THE CENTCOM AORRESTS WITH THE CENTCOM SURGEON AND MAY BE DELEGATED TO CENTCOM SERVICECOMPONENT SURGEONS. THE DEPLOYER’S MEDICAL EVALUATING ENTITY OR DEPLOYINGPLATFORM OR COMMANDER ARE NOT AUTHORIZED TO WAIVE MEDICAL DEPLOYMENTSTANDARDS. DEPLOYED HEALTH SERVICE SUPPORT INFRASTRUCTURE IS DESIGNED ANDPRIORITIZED TO PROVIDE ACUTE AND EMERGENCY SUPPORT TO THE EXPEDITIONARYMISSION. ALL PERSONNEL (UNIFORMED SERVICE MEMBERS, GOVERNMENT CIVILIANEMPLOYEES, VOLUNTEERS, DOD CONTRACTOR EMPLOYEES), CONTRACT WORKING DOGS(CWD) AND MWD TRAVELING TO THE CENTCOM AOR MUST MEET MEDICAL, DENTAL, ANDBEHAVIORAL HEALTH FITNESS STANDARDS, AND BE REASONABLY EXPECTED TO REMAIN SOFOR THE DURATION OF THEIR DEPLOYMENT. INDIVIDUALS DEEMED UNABLE TO COMPLY WITHCENTCOM DEPLOYMENT REQUIREMENTS ARE DISQUALIFIED FOR DEPLOYMENT IAW SERVICEPOLICY AND MOD 15. PERSONNEL FOUND TO BE MEDICALLY NON-DEPLOYABLE WHILEOUTSIDE OF THE CENTCOM AOR FOR ANY LENGTH OF TIME WILL NOT ENTER OR RE-ENTERTHE THEATER UNTIL THE NON-DEPLOYABLE CONDITION IS COMPLETELY RESOLVED OR ANAPPROVED WAIVER FROM A CENTCOM WAIVER AUTHORITY IS OBTAINED. SEE REF D, E, F, G,H. DOD CIVILIAN EMPLOYEES ARE COVERED BY THE REHABILITATION ACT OF 1973. AS SUCH,AN APPARENTLY DISQUALIFYING MEDICAL CONDITION NEVERTHELESS REQUIRES THAT ANINDIVIDUALIZED ASSESSMENT BE MADE TO DETERMINE WHETHER THE EMPLOYEE CANPERFORM THE ESSENTIAL FUNCTIONS OF THEIR POSITION IN THE DEPLOYED ENVIRONMENT,WITH OR WITHOUT REASONABLE ACCOMMODATION, WITHOUT CAUSING UNDUE HARDSHIP. INEVALUATING UNDUE HARDSHIP, THE NATURE OF THE ACCOMMODATION AND THE LOCATIONOF THE DEPLOYMENT MUST BE CONSIDERED. FURTHER, THE EMPLOYEE’S MEDICALCONDITION MUST NOT POSE A SUBSTANTIAL RISK OF SIGNIFICANT HARM TO THE EMPLOYEEOR OTHERS WHEN TAKING INTO ACCOUNT THE CONDITIONS OF THE RELEVANT DEPLOYEDENVIRONMENT. SEE REF I.15.C.1. MEDICAL FITNESS, INITIAL AND ANNUAL SCREENING.15.C.1.A. MEDICAL READINESS PROCESSING. THE MEDICAL SECTION OF THE DEPLOYMENTSCREENING SITE MAY PUBLISH GUIDANCE, IAW MOD15 AND SERVICE STANDARDS, TO ASSISTIN DETERMINING MEDICAL DEPLOYMENT FITNESS. DEPLOYING PERSONNEL MUST HAVE ANEVALUATION BY A MEDICAL PROVIDER TO DETERMINE IF THEY CAN SAFELY DEPLOY ANDOBTAIN AN APPROVED WAIVER FOR ANY DISQUALIFYING MEDICAL CONDITION(S) FROM THECOMPONENT SURGEON OR CENTCOM SURGEON PRIOR TO DEPLOYING.15.C.1.B. FITNESS INCLUDES, BUT IS NOT LIMITED TO, THE ABILITY TO ACCOMPLISH ALLREQUIRED TASKS AND DUTIES, BY SERVICE REQUIREMENTS OR DUTY POSITION,CONSIDERING THE ENVIRONMENTAL AND OPERATIONAL CONDITIONS OF THE DEPLOYEDLOCATION. AT A MINIMUM, PERSONNEL MUST BE ABLE TO WEAR BALLISTIC, RESPIRATORY,SAFETY, CHEMICAL, AND BIOLOGICAL PERSONAL PROTECTIVE EQUIPMENT; USE REQUIREDPROPHYLACTIC MEDICATIONS; AND INGRESS/EGRESS IN EMERGENCY SITUATIONS WITHMINIMAL RISK TO THEMSELVES OR OTHERS. GIVEN THE DIRECT THREAT PRESENTED BYCOVID-19 AND THE SIGNIFICANT RISK OF HARM, FITNESS NOW INCLUDES PEOPLE BEINGUNDER THE AGE OF 6515.C.1.C. EXAMINATION INTERVALS. AN EXAMINATION WITH ALL MEDICAL ISSUES ANDREQUIREMENTS ADDRESSED WILL REMAIN VALID FOR A MAXIMUM OF 15 MONTHS FROM THE5

DATE OF THE PHYSICAL, OR 12 MONTHS FOLLOWING DEPLOYMENT, WHICHEVER IS FIRST. SEETAB A AND REF D, J, K, L FOR FURTHER GUIDANCE. GOVERNMENT CIVILIAN EMPLOYEES,VOLUNTEERS, AND DOD CONTRACTOR PERSONNEL DEPLOYED FOR MULTIPLE OR EXTENDEDTOURS OF MORE THAN 12 MONTHS MUST BE RE-EVALUATED FOR FITNESS TO STAYDEPLOYED. ANNUAL IN-THEATER RESCREENING MAY BE FOCUSED ON HEALTH CHANGES,VACCINATION CURRENCY, AND MONITORING OF EXISTING CONDITIONS RATHER THAN BEINGCOMPREHENSIVE, BUT SHOULD CONTINUE TO MEET ALL MEDICAL GUIDANCE AS PRESCRIBEDIN MOD 15. UNLESS SPECIFICALLY OBLIGATED BY CONTRACTUAL ARRANGEMENT,EXPEDITIONARY MILITARY MEDICAL ASSETS ARE NOT TO BE USED FOR RE-EVALUATION OFCONTRACTORS TO STAY DEPLOYED. IF INDIVIDUALS ARE UNABLE TO ADEQUATELYCOMPLETE THEIR MEDICAL SCREENING EVALUATION IN THE AOR, THEY SHOULD BEREDEPLOYED TO ACCOMPLISH THIS YEARLY REQUIREMENT. PERIODIC HEALTHSURVEILLANCE REQUIREMENTS AND PRESCRIPTION NEEDS ASSESSMENTS SHOULD REMAINCURRENT THROUGH THE DEPLOYMENT PERIOD.15.C.1.D. SPECIALIZED GOVERNMENT CIVILIAN EMPLOYEES WHO MUST MEET SPECIFICPHYSICAL STANDARDS (E.G., FIREFIGHTERS, SECURITY GUARDS, POLICE, AVIATORS, AVIATIONCREW MEMBERS, AIR TRAFFIC CONTROLLERS, DIVERS, MARINE CRAFT OPERATORS,COMMERCIAL DRIVERS, ETC.) MUST MEET THOSE STANDARDS WITHOUT EXCEPTION, INADDITION TO BEING FOUND FIT FOR THE SPECIFIC DEPLOYMENT BY A MEDICAL AND DENTALEVALUATION PRIOR TO DEPLOYMENT IAW MOD 15. CERTIFICATIONS MUST BE VALID ANDRENEWED AS REQUIRED THROUGHOUT THE ENTIRETY OF THE DEPLOYMENT. IT IS UP TO THEINDIVIDUAL TO PLAN FOR AND RECERTIFY THEIR RESPECTIVE REQUIREMENTS.15.C.1.E. DOD CONTRACTOR EMPLOYEES MUST MEET STANDARDS OF FITNESS FORDEPLOYMENT AND MUST BE DOCUMENTED TO BE FIT FOR THE PERFORMANCE OF THEIRDUTIES, WITHOUT LIMITATIONS, BY MEDICAL AND DENTAL EVALUATION PRIOR TODEPLOYMENT IAW MOD 15. CONTRACTORS MUST COMPLY WITH REF J AND SPECIFICALLYENCLOSURE 3 FOR MEDICAL REQUIREMENTS. EVALUATIONS SHOULD BE COMPLETED PRIORTO ARRIVAL AT THE DEPLOYMENT PLATFORM.15.C.1.E.1. PREDEPLOYMENT AND/OR TRAVEL MEDICINE SERVICES FOR CONTRACTOREMPLOYEES, INCLUDING COMPLIANCE WITH IMMUNIZATION, DNA, AND PANOGRAPHREQUIREMENTS, EVALUATION OF FITNESS, AND ANNUAL SCREENING ARE THERESPONSIBILITY OF THE CONTRACTING AGENCY PER THE CONTRACTUAL REQUIREMENTS.QUESTIONS SHOULD BE SUBMITTED TO THE SUPPORTED COMMAND'S CONTRACTING ANDMEDICAL AUTHORITY. SEE TAB A AND REF J FOR FURTHER GUIDANCE.15.C.1.E.2. ALL CONTRACTING AGENCIES ARE RESPONSIBLE FOR PROVIDING THEAPPROPRIATE LEVEL OF MEDICAL SCREENING FOR THEIR EMPLOYEES. SCREENI