FORT DETRICK, Md. -- For decades, sustainment practices for U.S. Army medical materiel have been somewhat of a patchwork system.
There were noted communication and training challenges, supply chain hurdles and questions surrounding who exactly was responsible for maintaining different medical devices and systems.
Those days are coming to an end with the establishment of U.S. Army Medical Logistics Command.
Prior to its creation in 2019, the Army did not have a Life Cycle Management Command, or LCMC, for medical materiel.
Now, AMLC is focused on changing the Army’s medical logistics culture to integrate with the sustainment enterprise, delivering readiness to the Army and joint forces.
Part of this change includes the creation of an Integrated Logistics Support Center, or ILSC, under AMLC.
The ILSC holds the critical role of synchronizing acquisition and sustainment activities throughout the medical materiel life cycle to ensure fielded systems are sustainable, supportable and affordable.
“The ILSC is really the key piece of being a life cycle management command,” ILSC Director Leigh Anne Alexander said. “The whole reason the Army stood up LCMCs about 20 years ago was to synchronize sustainment throughout the acquisition lifecycle, which is how the DOD makes decisions on what to develop, procure and field to the force.”
LCMCs provide the foundation for sustainable readiness across our Army formations. Originally launched through a memorandum of agreement between the Assistant Secretary of the Army (Acquisition, Logistics and Technology) and U.S. Army Materiel Command commanding general in 2004, LCMCs strategically and operationally align structure, processes and responsibilities to enable greater synergy, and improve the effectiveness and efficiency of all organizations involved in sustainment and the life cycle of programs and equipment.
As part of AMLC, the Army’s newest LCMC since 2019, the ILSC serves as an end-to-end integrator for medical materiel throughout its life cycle, starting at the very beginning of the product development stage all the way through divestiture of devices as they reach the end of their useful life.
In the past, the sustainment enterprise wasn’t closely connected to the initial phases of the acquisition and development process. Through the ILSC and its various divisions, subject-matter experts in sustainment and medical maintenance are now part of the Project Management Office’s Integrated Product Teams, or IPTs, which develop life cycle sustainment plans that extend far beyond just fielding a new device to the warfighter.
“We are responsible for that end-to-end improvement for readiness,” Alexander said. “We are working with our medical enterprise partners to connect the dots from a sustainability and sustainment viewpoint, especially in a way that nests within the larger Army processes.”
Overview of directorates
AMLC’s ILSC includes four directorates:
• Office of the Director, or OID (includes the Acquisition and Materiel Synchronization Division)
• Readiness and Sustainment Directorate, or R&S
• Logistics and Technical Support Directorate, or LTSD
• Logistics Assistance Directorate, or LAD
Each directorate handles a different, yet essential function to the ILSC’s overall operation, including acquisition and materiel synchronization in collaboration with program managers, or PMs, integrating Class VIII capabilities throughout the acquisition life cycle and leveraging industry “best practices” to optimize resources and supply chains to promote materiel readiness.
The ILSC works with the PMs at the U.S. Army Medical Materiel Development Activity to ensure eight key elements of sustainment are included in the overall transition to sustainment, or T2S, plan for each piece of medical equipment being developed and fielded to the force.
Those elements take into account things like supply chain management, technical advice, technical data and publications, depot maintenance, augmented field maintenance, transportation, sustaining engineering and end-of-life cycle disposal.
As the ILSC lead, OID oversees the overall program operation, including coordination with program executive offices, and capabilities and materiel developers on matters of acquisition sustainment planning, resourcing and execution.
OID also provides oversight for the synchronization of medical materiel acquisition and sustainment activities, as well as manages the materiel release and T2S processes to ensure sustainment resources are planned, programmed and executed throughout the equipment life cycle.
R&S ensures sustainment experts are part of the IPTs and that different maintenance support requirements, among other things, are incorporated in the materiel developer’s plans. For devices that go through the T2S process, R&S is responsible for executing the PM’s sustainment plans all the way through divestiture and disposal.
LTSD provides data analysis, supply chain and technical information support that provides total asset visibility to ILSC leadership, while LAD serves as the command and control team for the global network of staff and resources.
LTSD is able to harness data-driven information systems that allow AMC – the Army’s lead materiel integrator – to see medical akin to its other commodity areas.
LAD oversees the ILSC’s Logistics Assistance Program, or LAP, essentially a feedback loop that provides customers with a reach-back point and the ILSC with real-time data about the support the organization is providing the warfighter. LAP is embedded within the Army field support brigades to assist in resolving issues that the unit cannot resolve on their own, being the eyes and ears for Army MEDLOG at the brigade level and below.
“We have to be adaptable, and the only way you can be adaptable is to listen, take in the data and act on that,” LAD Director Jason Acevedo said.
Pam Wetzel, R&S director, said one of the pushes currently in her directorate is to emphasize the need for sustainment documentation, outlining needs like maintenance requirements, availability of repair parts and more, to be known by the materiel developer right from the start.
“The readiness of units can be negatively impacted without this clear guidance,” Wetzel said.
‘Mirror to PM’
Alexander described the ILSC as “the mirror to the PM shop” at USAMMDA during the acquisition phase, wherein logistics and sustainment subject-matter experts ensure those aspects are incorporated in the overall planning requirements, implementation procedures and cost projections for different medical devices.
“For us, what we need to do is make sure the requirements ensure sustainability,” she said. “That means we can update software on the battlefield; 68As and maintainers can actually repair the equipment in the field; and if they can’t, we have repair parts available, maintenance concepts within our (medical maintenance divisions).
“There’s a whole logistics plan for everything we do.”
Master Sgt. Wesley Ladlee, noncommissioned officer in charge for the ILSC, said the organization’s work so far has already produced tangible sustainment requirements for numerous items throughout the medical materiel catalog.
That work, both with new and existing devices and supplies, will only expand in the months and years to come as equipment goes through the T2S process.
“The changes are coming,” Ladlee said. “We are definitely still in our infancy, but we are meeting current challenges … while still learning and establishing ourselves. I think there’s a lot to be said about that.”
Funding and costs are also a crucial pieces of the puzzle, Alexander said, adding that the ILSC helps communicate costs needed to sustain medical equipment, like routine maintenance, calibration and repair, well into the later years of their useful life.
In general, when the Army fields a new weapons system, for example, it’s estimated that about 30% of the cost is up front, with about 70% coming on the back end to sustain the system, explained Art Braithwaite, LTSD director.
“The cost of procuring a system is just a small percentage of the overall cost of the life cycle from a cradle to grave perspective,” Braithwaite said, noting that a similar approach must be taken with regard to medical materiel assets. “… All those decisions that occur early on have an impact on how you’re going to sustain those systems once they are fielded.”
Alexander said it’s vital that the ILSC can articulate not only what is needed to manage equipment through its sustainment life cycle, but also operational and maintenance requirements.
“It’s about the capability we deliver, the solution that’s selected and also the funding associated with that,” she said. “We are integrated throughout that entire process.”
While the ILSC’s creation has been a major undertaking, it’s been long overdue in the grand scheme of the LCMC support system and a change that is welcomed to better align with other Army commodities.
“We’re now aligning ourselves with the rest of the Army for Class VIII as much as we possibly can,” Braithwaite said. “It’s not just how the Army does it. All the other services to it this way. Class VIII has always been unique in the way it was organizational structured.
“Now with an LCMC designation and an ILSC, it’s time for us to align with those processes.”