The Signal, Volume 17, Issue 1

Postmarked deadline for Sending 2007 Assimilation Application. Thursday, February 15. For more information, please contact LCDR Ali Danner at 770-488-1858. Also, LCDR Danner’s Assimilation Overview Session—and related checklist, officer's statement template, and handouts—can be viewed at the CDC Office of Commissioned Corps Personnel’s website. OCCO's information is posted on the CCMIS website.

ACOA Lunch and Learn: PHS Protocol and Service Standards. Thursday, March 15, 2007, Time: 1200-1400. Century Center, Building 1825, Conference room 1A/1B.

Atlanta COA Roadside Cleanup. Saturday, March 17, Time: 0930-1100. Church of Jesus Christ of Latter-Day Saints (1450 Ponce De Leon Ave NE). Contact: LCDR Robert L. Williams at 770.488-3341 or LCDR Joan Tapper at 404-635-5243.

Crunch and Run (Annual APFT). Saturday, March 17, Time: 0900. St. Pius High School Track. Contact: CDR Robert Knowles at 404-498-0426.

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Announcements

ACOA Newsletter and E-mail Announcements Will Be Sent Only to ACOA Members Beginning in July 2007!

Have you enjoyed receiving The Signal, ACOA’s bi-monthly newsletter, or our e-mail updates and announcements? Do you want to continue to receive them? Beginning in July 2007, ACOA will distribute the newsletter and e-mail announcements to ACOA members only. If you are not currently a member of ACOA, you must first join COA. If you have questions about becoming an ACOA member or about your current membership status, please contact our local membership coordinator, CDR Robert Knowles at 404-498-0426.

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ACOA Extends Thanks to Outgoing 2006 Executive Committee Members

ACOA would like to extend a special thank you to the outgoing members of the 2006 Executive Committee. These officers were instrumental in organizing and promoting a wide range of activities that benefited both the community and the officers of the greater Atlanta area.

CAPT Dan Cline, Treasurer
CAPT Deborah Levy, Member-at-Large
CAPT (Ret.) Gary Noonan, Retired Officer Representative
CDR Joseph (Joe) Little, Member-at-Large
CDR Nita Sood, Member-at-Large
CDR Linda West, Past President
CDR Craig Wilkins, Member-at-Large

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ACOA Welcomes the 2007 ACOA Executive Committee

ACOA welcomes the following officers who serve on the 2007 Executive Committee:

CDR Bruce Tierney, President
LCDR Danice Eaton, Vice President/President Elect
LCDR Lauren Zapata, Secretary
CDR Robert Knowles, Treasurer
CDR Jeff Bosshart, Past President
LCDR Ali Danner, Member-at –Large
LCDR Amanda Dunnick, Member-at –Large
LCDR Joan Tapper, Member-at –Large
LCDR Kristen Uhde, Member-at –Large
LCDR Robert L. Williams, Member-at –Large
LT Michael Schmoyer, Member-at –Large

Some members of the 2007 ACOA Executive Committee. Front row, L to R: LCDR Danice Eaton, CDR Bruce Tierney, LCDR Lauren Zapata. Back row, L to R: CDR Robert Knowles, LCDR Robert Williams, LCDR Ali Danner.

ACOA thanks the more than 120+ officers who volunteered for ACOA-sponsored events during 2006! To show our appreciation, we sent formal thank-you letters on ACOA letterhead to each officer who served as a volunteer for an ACOA-sponsored activity during 2006 (i.e., Crunch and Runs, Roadside Cleanups, Habitat for Humanity, Newsletter Articles, Promotion Ceremony, USO, etc.). If you volunteered for an activity, but did not receive a thank-you letter, please contact CDR Jeff Bosshart at 404-639-6275. Thanks again to each of you for volunteering to make 2006 such a successful year!

New PHS Flag Sales Coordinator

In an effort to support Esprit de Corps, as well as raise funds to support organization activities, ACOA developed and sells full-size USPHS flags and US/USPHS miniature flag desk sets. These flags are available for purchase by USPHS officers and civilians nationwide. In 2006, ACOA sold 86 USPHS flags and 61 flag desk sets. These flags were purchased for use at MOAA, as retirement, birthday and holiday gifts, and much more.

ACOA would like to thank LCDR Amanda Dunnick who has served as the Flag Coordinator for the past two years. ACOA would like to introduce and welcome LT Carlos Bell as the new PHS Flags Sales Coordinator. LT Bell is an Epidemiologist/GIS Analyst for the Public Health Geospatial Research, Analysis & Services Program (GRASP) at ATSDR. LT Bell was commissioned on August 1, 2005 as a Health Services Officer.

ACOA members receive a discount and can purchase the USPHS flag for $50 and the US/USPHS flag desk set for $16. For more information, please contact LT Bell at 404-498-0393.

Please note: These items are for personal use. The USPHS flag is not intended to replace official USPHS flags, as noted in Subchapter CC29.9 of the Commissioned Corps Personnel Manual.

The Atlanta Commissioned Officers Association is seeking an ACOA member officer to serve as the ACOA co-webmaster. ACOA’s Internet site has been active since 2003. The website allows ACOA to keep Atlanta-based officers informed of new announcements, upcoming events and activities, etc. The website also provides information that is useful to officers nationwide, such as advertising items available for purchase from the ACOA store (e.g. USPHS flags and desk sets). ACOA traditionally has had two webmasters who share responsibility for maintaining the website.

The co-webmaster is responsible for making regular updates to the website’s content (e.g. adding a new announcement or deleting an old announcement). Skills in MS Frontpage or other web design software are necessary. Skills in HTML coding are helpful.

The website co-webmaster will be recognized by ACOA each year with a thank you letter from the ACOA President that can be included in your eOPF. If you are interested in this important volunteer PHS support activity, please contact LCDR Danice Eaton at 770-488-6143 for more details.

Don’t forget that ACOA has a uniform sale and swap! This is an important part of our fundraising efforts, so your contributions can make a difference.

Contact us if you have uniforms and/or uniform components (rank insignias, etc.) that you wish to donate or purchase at very reduced rates. We also swap gently used shoulder boards. A full listing of the current uniform shop inventory is available at ACOA's website.

Officers at CDC can donate uniform components by sending them via interoffice to the mailstops listed below. Atlanta-based officers outside of CDC can contact the representatives below for donation instructions.

The USO’s mission is to enhance the quality of life of the United States Armed Forces personnel and their families worldwide, and to create a cooperative relationship between United Military communities and those involved or supporting civilian communities.

Their flagship operation is the USO Jean Amos Center at Atlanta’s Hartsfield-Jackson International Airport. This USO Center, because of its strategic location in the world’s busiest airport, assists thousands and thousands of individuals annually.

The ACOA is seeking volunteers that would like to take part in supporting the Jean R. Amos USO Center at Hartsfield-Jackson International Airport. We staff the USO every 3rd Saturday of each month from 10:00am to 2:00 pm.

Commissioned Corps officer volunteers are needed during the following days/times:

Saturday, February 17th - 10:00 a.m. to 2:00 p.m. (1 additional volunteer needed)
Saturday, March 17th - 10:00 a.m. to 2:00 p.m.
Saturday, April 21st - 10:00 a.m. to 2:00 p.m.
Saturday, May 19th - 10:00 a.m. to 2:00 p.m.
Saturday, June 16th - 10:00 a.m. to 2:00 p.m.

LCDR Maleeka Glover is now coordinating ACOA officer activities at the USO. If you would like to volunteer, please contact LCDR Maleeka Glover to let her know which day you are available.

Consider volunteering. Be a part of sharing our camaraderie and community service to those who serve in the uniformed service. This is a wonderful and rewarding opportunity for everyone!

ACOA Lunch and Learn: PHS Protocol and Service Standards

Please join ACOA for a Lunch and Learn on Thursday, March 15 to hear about PHS Protocol and Service Standards, presented by the authors of the PHS Officer's Guide, CAPT James E. Knoben (Ret.) and CDR Alice D. Knoben. Lunch and beverages will be provided.

This is a great opportunity for you to learn more about PHS protocols and service standards from the experts! An opportunity to ask specific questions of the authors will follow their presentation of approximately 90 minute.

This is also an excellent networking opportunity to meet other officers in the Atlanta area and talk about how you can be involved in this year's ACOA career enhancing activities!
Hope to see you there!

When: Thursday, March 15, 2007, 12:00 PM – 2:00 PM
Where: Century Center, Building 1825, Rooms 1A and 1B

USPHS Officer’s Guide Available

ACOA has received copies of the Knoben & Knoben USPHS Officer’s Guide: Protocol & Service Standards from National COA. The guide was published by the Commissioned Officers Foundation in 2006 and a FREE copy was made for each active duty PHS officer. If you are interested in receiving a copy, please contact one of the following officers:

CDR Jeff Bosshart, Corporate Square, Building 8, at 404-639-6275
CDR Robert Knowles, Century Center, Building 1825, at 404-498-0426
CDR Joseph Little, Chamblee Campus, Building 101, at 770-488-3339
CDR Bruce Tierney, Clifton Road Campus, Building 16, at 404-639-4223
LCDR Amanda Dunnick, Koger Center, Stanford Building, at 770-488-1989
LCDR Danice Eaton, Koger Center, Columbia Building, at 770-488-6143

ACOA will keep you informed as other distribution points are established. We are currently arranging for a representative from the downtown area for those officers assigned to BOP, EPA, FDA, CMS, HRSA, OS, etc. If you are stationed out-of-state please ask your local COA chapter for a copy or contact COA directly at 301-731-9080 or 1-866-366-9593. Only one copy per officer, please.

Notary Available to ACOA Officers Free of Charge!

CDR Todd Going is a notary and would like to extend his service to ACOA officers free of charge. CDR Going can be reached at 404-498-0470. His office is located at Century Center, Building 1825, Room 3035.

ACOA Roadside Cleanup Schedule for 2007

Mark your calendars! The 2007 ACOA Roadside Cleanups have been scheduled as follows:

Saturday, March 17, 2007, 0900 to 1100
Saturday, May 12, 2007, 0900 to 1100
Saturday, August 18, 2007, 0900 to 1100
Saturday, October 13, 2007, 0900 to 1100

Volunteers should meet at the Church of Jesus Christ of Latter-Day Saints (1450 Ponce De Leon Ave NE). ACOA will supply garbage bags and orange safety vests. Please do not forget your gloves to protect against glass and other sharp objects. If possible, please wear a COA, PHS, CDC, ATSDR or other DHHS t-shirt. Wearing of the PHS ball cap, without rank device, is also encouraged. Family members are also invited – the more the merrier!

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CRUNCH and RUN: OFRD Physical Fitness Testing

Have you been putting off taking the physical fitness test required for OFRD readiness? Procrastinate no more! We anticipate it will take less than an hour for an officer to complete the three components of the fitness test, which include: 1.5 mile run/walk, push-ups, and crunches or the side-bridge exercise.

Officers should bring their own water bottles and towels/mats. Your scores will go home with you, so feel free to use this as a practice or the actual fit test.

Here is the partial 2007 schedule for the Crunch and Runs at St. Pius High School Track, located at Shallowford Road and I-85:

Saturday, March 17, Time: 0900. Contact: CDR Robert Knowles at 404-498-0426.

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Renew Your Base Vehicle Decal Online

If you received your base vehicle decal from a Navy installation (i.e., NAS Atlanta), then you may be able to renew it online. Check out the participating installations. Click on the “Who Can Renew Online” link to locate the installation. Also, when you enter your renewal information, you will notice that there is no "US PHS" option in the Applicant Status section. Other officers have recommended selecting the “US Navy” option.

Service Opportunities with ACOA Committees for 2007

Are you looking for a great way to get more involved with Commissioned Corps activities? A number of positions are open to Atlanta Commissioned Officers Association (ACOA) members to serve on the various committees that coordinate ACOA activities. All Atlanta-area active duty and retired PHS officers in good standing with COA and ACOA are eligible to serve on ACOA Committees. Representation from all Atlanta-area HHS agencies as well as non-HHS agencies with PHS details is strongly encouraged. Members of committees will be recognized by ACOA each year with a thank-you letter from the ACOA President that can be included in your eOPF. It is also a great opportunity to meet and work with fellow officers from across the Atlanta area.

If you are interested in serving on any of the committees noted below, please contact or send a brief self nomination to the committee chair(s). As part of your self nomination please provide the following information: rank, PHS category, agency affiliation, the position of interest and a brief description (150 words maximum) of your interest in serving with an ACOA committee or specific role for 2007. Your narrative should also include prior leadership experience, previous COA or ACOA experience, or any other knowledge and/or skills you think would benefit ACOA and Atlanta-area officers. The ACOA Executive Committee is seeking to fill the specific roles noted below as soon as possible. Committee positions will be filled by the respective committee chairs at their discretion on a first come basis until the committee is filled.

Current Committee Chairs and Contact Information

If you have questions about a specific committee, please contact the officer(s) listed below:

Communications Committee: Seeking 4-8 volunteers
Co-Chair: LCDR Lauren Zapata: 770-488-6358
Co-Chair: LCDR Kristin Uhde: 404-639-7602
Description: The purpose of the Communications Committee is to communicate pertinent information to Atlanta branch members via the newsletter, The Signal, the ACOA website and the ACOA Distribution list. General members are welcome and encouraged to contact the committee co-chairs to volunteer for this committee. In addition to seeking general committee members, the co-chairs also are seeking one individual to serve as the ACOA co-webmaster and HTML programmer (see job description above). Please contact LCDR Danice Eaton if interested in the webmaster role at 770-488-6143.

Community Service Committee: Seeking 4-8 volunteers
Co-Chair: LCDR Robert Williams: 770-488-3341
Co-Chair: LCDR Joan Tapper: 404-635-5243
Description: The purpose of the Community Service Committee is to provide service to the community, increase recognition of the Commissioned Corps, and promote Atlanta Branch membership with local community service efforts. Staffing the USO at the Hartsfield-Jackson International Airport, Roadside Clean-Up and Habitat for Humanity projects are just some of the committee’s activities.

Professional Development: Seeking 4-8 volunteers
Co-Chair: LCDR Ali Danner: 770-488-1858
Co-Chair: CDR Nicole Smith: 404-639-0279
Description: The purpose of the Professional Development Committee is to provide information and opportunities to officers regarding career enhancement and leadership development. “Lunch and Learns” are held roughly every other month. In the past, “Lunch and Learns” have addressed topics such basic readiness, assimilation, awards, uniforms, retirement and Space-A travel. Monthly “Crunch and Run” events are organized by this committee. They occur on one Saturday each month at St. Pius High School.

Program Committee: Seeking 2-3 volunteers
Chair: LCDR Danice Eaton: 770-488-6143
Description: The purpose of the Program Committee is to provide input to the ACOA Executive Committee on suggested topics and speakers for meetings and assist with meeting logistics (reserving a room, arranging travel/hotel/transportation for speakers if necessary, assisting with room set-up and refreshments, etc.).

Special Projects: Seeking 4-8 volunteers
Co-Chair: LCDR Amanda Dunnick: 770-488-1989
Co-Chair: LT Michael Schmoyer: 770-488-6514
Description: The purpose of the Special Projects Committee is to coordinate special projects to benefit local officer esprit de corps. Activities include the annual promotion ceremony and the fall social. New activities being considered by this committee include a less formal, spring-time social for officers and their families, a formal “Dining Out” for officers and spouses/guests, and an Atlanta version of the annual “Anchor and Caduceus Dinner” held in Washington, D.C. each January in recognition of the birthday of the Commissioned Corps (January 4th).

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Happy Birthday to the Commissioned Corps!
Submitted by CDR Bruce Tierney

Most of us are probably aware of the origins of the Public Health Service going back to the passage of an act in 1798 providing for the care and relief of sick and injured merchant seamen that was signed into law by President John Adams on July 16th of that year. After all, the 1798 date is readily visible to us all on a regular basis on our name tags, uniform patches, as well as the PHS Seal and Flag. Many of you were members of the Corps during its Bicentennial Year in 1998, but there is another date of significance that we should take note of each year as well.

That 1798 act created a fund to be used by the Federal Government to provide medical services to merchant seamen in American ports. The marine hospital fund was administered by the Treasury Department (where the Public Health Service would remain until 1939) and financed through a monthly deduction from the wages of the seamen. Medical care was provided through contracts with existing hospitals, and increasingly as time went on, through the construction of new hospitals for this purpose. The earliest marine hospitals were located along the East Coast, with Boston being the site of the first such facility, but later they were also established along the Gulf and Pacific Coasts, the Great Lakes and inland waterways. Indeed, the only remaining U.S. Marine Hospital is in Louisville, Kentucky, near the banks of the Ohio River, and was named to the National Trust for Historic Preservation’s “11 Most Endangered Historic Places” list in 2003.

But for the first 70 years, what would become the Marine Hospital Service and eventually the Public Health Service of today was little more than a loose network of locally controlled hospitals that often had inadequate funding. Political, rather than medical reasons, often influenced both the locations of hospitals and the selection of physicians, and the Treasury Department had little supervisory authority over the hospitals. But in 1869, an extensive study of the marine hospitals commissioned by the Secretary of the Treasury resulted in a critical report of the system and led to the passage of reform legislation in 1870.

The 1870, reorganization converted this loose network of locally-controlled hospitals into the Marine Hospital Service, with its headquarters in Washington, D.C. The position of Supervising Surgeon was created to administer the Service, and Dr. John Maynard Woodworth was appointed as the first Supervising Surgeon (later changed to Supervising Surgeon General in 1873 and finally just Surgeon General in 1902). Woodworth took office on March 29, 1871, and as a result of his experience as a former Army surgeon during the Civil War, rapidly worked to reform the system by adopting a military model for his medical staff. Woodworth placed physicians in uniform and instituted examinations for applicants instead of appointing physicians on the recommendation of the local Collector of Customs. Physicians were no longer appointed to serve in a particular facility, but appointed to the general Service which resulted in a cadre of mobile, career service physicians who could be assigned and moved as needed to the various marine hospitals.

Surgeon General Woodworth’s notable career included serving as one of the founders of the American Public Health Association and laying the foundations for the passage of the National Quarantine Act of 1878, which helped move the Marine Hospital Service into public health activities and paved the way for its later evolution into the Public Health Service. Although Woodworth began putting physicians in uniforms as early as 1871, he did not live to see this change formally recognized. Surgeon General Woodworth died in office on March 14, 1879, at the age of only 42. At the time of his death, he was in the midst of a political battle with the fledgling American Public Health Association that he had helped found and its allies in Congress over the possibility that a new National Board of Health would supersede the newly revamped Marine Hospital Service as the primary federal health agency.

On April 3, 1879, John B. Hamilton was appointed Supervising Surgeon General at the tender age of 31, succeeding fellow Army veteran Surgeon General Woodworth. Surgeon General Hamilton had also served as an Army medical officer before entering the Marine Hospital Service in 1876. He showed an early talent for public health practice during an 1877 assignment to the Boston Marine Hospital when he resolved a crisis resulting from changing land use in the area that had blocked hospital sewage from draining properly and causing unexpected outbreaks of infectious disease among patients. Hamilton resolved the crisis successfully by directing a renovation of the facility’s drainage and sewage systems.

The Marine Hospital Service outlasted the National Board of Health and emerged in the 1890s as the primary federal health agency which was due in no small part to Surgeon General Hamilton’s skills as a political negotiator as well as a bureaucrat. Under his tenure, the Marine Hospital Service gained authority for national quarantine on sea and land, a new laboratory devoted to bacteriology—the newest public health science of the day—and formal recognition of merit-based requirements for a Commissioned Corps of medical officers.

And this brings us to the birthday of the Commissioned Corps! The Congress formally authorized the Commissioned Corps on January 4, 1889 with an act to regulate appointments in the Marine Hospital Service of the United States. The act was signed by President Grover Cleveland and our Uniformed Service was officially born. But Surgeon General Hamilton was not able to win an equal footing for the Marine Hospital Service’s Commissioned Corps with the salaries and ranks accorded to military medical officers, and as a result he resigned his post as Surgeon General on June 1, 1891.

Apparently, even 117 years ago political matters were no stranger to the administrative workings of the Commissioned Corps!

CDR Bruce Tierney
2007 ACOA President

Information and excerpts for this article taken from the following sources:
Fitzhugh Mullan, Plagues and Politics: The Story of the United States Public Health Service
http://www.surgeongeneral.gov/
http://www.usphs.gov/
http://www.marinehospital.org/

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The Field Medical Readiness Badge – What is It, and How Can I Get It?
Submitted by LT Aimee Treffiletti

What is the FMRB?

The Field Medical Readiness Badge (FMRB) recognizes officers who have met criteria beyond the required force readiness standards. It is awarded on the basis of proven knowledge and skill related to force readiness and performance while engaged in Corps deployments.

The FMRB is a pewter special skills badge in the design of a chaplain’s cross with the anchor and caduceus overlay. Once awarded the FMRB, an officer may continue to wear the badge indefinitely regardless of whether the badge was earned under the previous or current eligibility criteria.

How do I qualify for the FMRB?

In July 2006, ADM Agwunobi, the Assistant Secretary for Health, issued a Commissioned Corps Instruction detailing the revised eligibility criteria for the FMRB.

To qualify for the FMRB, officers must meet the force readiness standards in addition to the following eligibility criteria:

a. Service Requirement. Be serving on extended active duty in the Corps.

b. Physical Readiness Requirement. Must pass the Annual Physical Fitness Test (APFT) Level II as the minimum fitness standard. (NOTE: participating in the President’s Challenge does not qualify for the FMRB.)

c. Training Requirement. Complete the compulsory modules Web-based training for FMRB. These will include required modules from the ‘core’, ‘clinical’ (if applicable), and ‘optional’ curricula of the Web-based OFRD modules. The website http://ccrf.hhs.gov/ccrf/training.htm contains the details of the FMRB Web-based training requirements. The modules for the FMRB are located on the new USPHS Learning Management System. Instructions for logging into this website are available at http://ccrf.hhs.gov/ccrf/USPHS_LMS_webpage_info.pdf. Once logged in, click on the “Courses” tab to locate the FMRB specific modules.

d. Deployment Requirement. Participate in one or more Corps deployments consisting of a minimum of 7 days. Deployment days may be accumulated from multiple deployments performed within the last 3 years prior to the date of the officer’s application for the FMRB.

I completed the criteria – now what?

Once the officer has met all the criteria, there is nothing left for them to do. The Office of Force Readiness and Deployment (OFRD) will periodically review and determine those officers who meet the eligibility criteria. A list of officers who meet the requirements will then be forwarded to the Office of Commissioned Corps Operations (OCCO) for processing in accordance with standard award procedures.

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TRICARE Mail Order Pharmacy (TMOP)—A Win/Win Situation
Submitted by CAPT Dan Cline

TRICARE’s Mail Order Pharmacy (TMOP) option is a win/win situation for all involved in that it dramatically reduces the Department of Defense cost for prescription drugs (an estimated $200 million in 2007), while offering maintenance medications to beneficiaries for a significantly reduced cost compared to TRICARE’s retail pharmacy option.

For example, A TRICARE beneficiary who is currently prescribed two maintenance medications (one generic - $3 co-pay, and one brand name - $9 co-pay) will pay $144 per year using a TRICARE retail pharmacy. However, the same beneficiary using TMOP will pay $48 per year. Do the math – a saving of $96 per year! Plus, if you throw in the time and gas saved from not having to travel to the pharmacy 12 times per year, you save even more.

TRICARE Mail Order Pharmacy (TMOP)—A Win/Win Situation
Submitted by CAPT Dan Cline

TRICARE’s Mail Order Pharmacy (TMOP) option is a win/win situation for all involved in that it dramatically reduces the Department of Defense cost for prescription drugs (an estimated $200 million in 2007), while offering maintenance medications to beneficiaries for a significantly reduced cost compared to TRICARE’s retail pharmacy option.

For example, A TRICARE beneficiary who is currently prescribed two maintenance medications (one generic - $3 co-pay, and one brand name - $9 co-pay) will pay $144 per year using a TRICARE retail pharmacy. However, the same beneficiary using TMOP will pay $48 per year. Do the math – a saving of $96 per year! Plus, if you throw in the time and gas saved from not having to travel to the pharmacy 12 times per year, you save even more.

Here’s how it works:

TMOP is administered by Express Scripts Inc. (ESI), and is available for prescriptions that beneficiaries take regularly. Beneficiaries may save up to three times the amount of money by using the TMOP for maintenance medications rather than retail network pharmacies. Beneficiaries may receive up to a 90-day supply for most medications. Prescription refills may be requested by mail, phone, or online. Beneficiaries who have prescription drug coverage from other health insurance (OHI) plan may not use TMOP, unless the medication is not covered under the other plan, or the beneficiary exceeds the dollar limit of coverage under the other plan.

To use TMOP, beneficiaries register with TMOP by completing the registration form available at the ESI Web site. They should follow the instructions on the ESI Web site to submit the form. Beneficiaries must then mail their health care provider's written prescription and the appropriate copayment to ESI. New prescriptions may also be faxed or phoned in by the provider. Within 10-14 days, the medications are sent directly to the beneficiary.

For more information about TMOP, beneficiaries may visit the ESI Web site or contact TMOP member services at 1-866-DOD-TMOP, (1-866-363-8667), within the Continental United States; or toll-free, 1-866-ASK-4PEC, (1-866- 275-4732), outside the Continental United States. Beneficiaries may also visit the TRICARE Pharmacy Web site.

FAQ: Can Express Scripts dispense medications that need to be refrigerated?
Yes. Express Scripts will ship medications requiring refrigeration in cold packs. Please note that refrigerated medications cannot be shipped to APO/FPO addresses.

Please contact CDC’s Health Benefits Advisor, CAPT Dan Cline, at 770-488-1883 for any questions/concerns regarding the content of this article.

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Intensity of your physical activity is the second most important thing to actually doing it!

First, if you are not currently fitting in some sort of physical activity or exercise consisting of at least 10 minutes at a time—START THIS NOW! This can include anything—from walking and dancing to stair climbing. But the important thing is to START—for your health. TRACK your progress (www.presidentschallenge.org) and NOTE any personal benefit or outcomes you experience through a daily log or journal.

Next, INTENSITY is important to understand since the reason we strive to do 30 minutes of activity (or accumulated bouts of 10 minutes) is for the health benefits. So, the level of INTENSITY=EFFORT you put forth is where these benefits are reaped. So how hard is it? The recommendation states: moderate intensity.

Moderate is defined in a variety of ways—all of which translate to a general level of effort where you notice an increase in your breathing and heart beat. The most important thing to remember is to not exercise to the point where you are completely out of breath or experiencing pain. The best pace is comfortable and fun—and you will look forward to doing it again and again and again!

Moderate is defined in a variety of ways—all of which translate to a general level of effort where you notice an increase in your breathing and heart beat. The most important thing to remember is to not exercise to the point where you are completely out of breath or experiencing pain. The best pace is comfortable and fun—and you will look forward to doing it again and again and again!

Decide which measure of intensity below is best for you, and use that as your guide in the selection, as well as the monitoring of your activity while you are active!

The Borg Perceived Exertion Scale
0	Nothing at all
.5	Very, very light (just noticeable)
1	Very light
2	Light (weak)
3	Moderate
4	Somewhat hard
5	Heavy (strong)
6
7	Very heavy
8
9
10	Very, very heavy (maximal)

Target Heart Rate Table
Age (years)	Target HR Zone 50–85 % (beats per minute)	Average Maximum Heart Rate 100 % (beats per minute)
20	100 - 170	200
25	98 - 166	195
30	95 - 162	190
35	93 - 157	185
40	90 - 153	180
45	88 - 149	175
50	85 - 145	170
55	83 - 140	165
60	80 - 136	160
65	78 - 132	155
70	75 - 128	150
From the American Heart Association

Something still doesn’t work? See the Top 10 Gym Mistakes that may apply to you.