Ground Truth : Senior Enlisted Soldiers Offer Perspective on Reshaping Medical Logistics

By Sgt. Maj. Monnet Bushner, Sgt. Maj. Francis Famularcano, Retired Command Sgt. Maj. Tony Flanagan, Sgt. Maj. Joel Lara-Baeza, and Master Sgt. Wesley LadleeDecember 14, 2022

Staff Sgt. Cody Harrison, a biomedical equipment specialist stationed at the U.S. Army Medical Materiel Agency’s Medical Maintenance Operations Division at Hill Air Force Base, Utah, works on a portable transfusion pump on Nov. 30, 2021.
Staff Sgt. Cody Harrison, a biomedical equipment specialist stationed at the U.S. Army Medical Materiel Agency’s Medical Maintenance Operations Division at Hill Air Force Base, Utah, works on a portable transfusion pump on Nov. 30, 2021. (Photo Credit: Photo by Katie Ellis-Warfield) VIEW ORIGINAL

Logistics is a strategic and methodical operation that takes effective planning, preparation, and future forecasting at all echelons to maintain and sustain readiness. While most aspects take place at the strategic level, it is the tactical environment where lives are saved or lost. As with all commodities, the backbone of medical logistics is people — a dedicated workforce of Soldiers and civilians. Among this group, the noncommissioned officers serve as the “ground logisticians” that enable combat medics, doctors, and nurses who render first aid and battlefield care, as well as the maintainers who ensure medical devices work and tactical units are integrated into the end-to-end medical supply chain. Senior enlisted leaders represent the commander, communicating the commander’s goals and direction to the enlisted workforce while simultaneously representing the enlisted personnel’s views and concerns to the commander. With that voice, they bring a unique perspective to medical logistics because they have experienced both the best and worst of delivering and sustaining health care in the operational environment. This article focuses on how U.S. Army Medical Logistics Command (AMLC) is working to tackle four Class VIII challenges, including education and training, information systems, acquisition and sustainment, and customer support.

Education and Training

The Army needs to do a better job of codifying Class VIII processes and training Soldiers. Part of this effort is updating doctrine, but it also requires evolving training. Today’s Soldiers may pick up a copy of their standard operating procedures, but they probably would prefer a video. So, AMLC is developing how-to videos that break down different aspects of the medical logistics process. Additionally, various educational and cross-training opportunities will be promoted to the workforce. For deploying units, training is offered directly to operators before they go into a theater to assess capabilities and address gaps. Sometimes, additional hands-on training is necessary. Teams can be deployed to forward operating locations to assist operational units and connect them with the right medical materiel centers to ensure they meet their resupply needs.

Information Systems

Currently, the Army medical logistics information technology systems are not optimized or integrated with the other supply classes. Medical units use multiple systems for tracking different types of equipment and supply, and they do not always communicate directly. This issue is actively being addressed as part of a wider effort to consolidate these systems under one umbrella within the Global Combat Support System — Army, enabling access for all users and allowing the AMLC and other key leaders to monitor and track readiness metrics. A consolidated data system will improve synchronization, while enabling the end users and higher command stakeholders to better understand what’s happening at the operational level. Along with educating the customer base and sharing how AMLC can support the wider Army mission, a primary goal is to streamline processes that consider and synchronize medical materiel with other classes of Army supply.

Acquisition and Sustainment

One of the biggest misconceptions about medical logistics is that there are giant medical supply warehouses and a supply chain that delivers Class VIII medical supplies and equipment to the warfighter is readily available. Medical logistics is complex because the Army relies on the same commercial vendor base that outside private-sector and nongovernmental entities use. This creates competition for equipment and supplies, including durables, expendables, potency, and dated items, in addition to other challenges related to the commercial supply chain. New technologies and best practices also create a constant cycle of modernization, requiring units to adapt and evolve how they support the fight. The rapid cycle of change creates a moving target in the world of medical logistics, which is often a misunderstood commodity from a customer standpoint. Not only are there delays, interruptions, or complications, but a less-than-ideal acquisition process has created wider impacts, ranging from sustainment challenges for older devices and supply items to the lack of oversight on important data and metrics used to justify certain military occupational specialties (MOS) throughout the force, like 68A or Biomedical Equipment Specialist. 68As, for example, are vital to ensuring medical devices are well maintained, ready, and able to support the warfighter at a moment’s notice, from a simple patient monitor to a highly specialized CT scanner. These are in-demand jobs that require extensive skill and expertise. Without adequate sustainment planning on the front end of the acquisition phase, it can lead to problems later in the lifecycle of a device, such as needed operating system updates or ongoing repair needs that can lead to added downtime. 68As must be involved from the start of the capability development. Under the AMLC structure and in development with the materiel developer, U.S. Army Medical Research and Development Command, we are working to identify and mitigate sustainment issues. In just the last few years, several issues have been addressed and resolved — some that would have created challenges for units once fielded to the force. AMLC continues to work on new equipment being fielded while simultaneously addressing known issues with older legacy devices still in use.

Customer Support

With the establishment of AMLC in 2019, the customer support landscape has vastly improved. As the Army’s “home for medical logistics,” AMLC serves as the Class VIII Life Cycle Management Command (LCMC), delivering readiness to the force while executing the medical materiel management functions for combatant commands in order to set and sustain operational medical capabilities in all phases, including large-scale combat operations and multidomain operations. AMLC’s primary goals are to close communication gaps, improve processes throughout the entire life cycle of medical materiel from factory to foxhole, and serve as the single point of contact for all things related to support and sustainment for global medical logistics. As the executors of this mission, AMLC’s renewed vision is a welcome change in operational tempo, specifically in ongoing improvements that impact many noted challenges seen at the tactical level in the past. Perhaps the most important capability that AMLC’s creation brings the medical logistics community is a consolidated voice and, in many cases, a seat at the table in wider Army processes, like the acquisition process. As the LCMC for medical materiel, AMLC is now part of the process from the start when new capabilities are developed and fielded to the joint force, helping to consider different aspects of the sustainment puzzle. This includes repair parts, manuals, and other sustainment needs to help operators in a deployed setting. AMLC is now the single entry point for all things medical logistics supporting the operational force. Gone are the days when one had to know someone connected to a nearby hospital or fixed-base medical operation to get the needed supplies. AMLC now coordinates that capability. Restructuring in recent years has changed the way the Army operates in the realm of medical logistics by moving and reorganizing different capabilities to new commands. AMLC preserves customer service continuity by breaking down communication barriers, creating processes that work for all, ensuring accountability of current assets, and enabling predictability of future demands.

Final Thoughts

The senior enlisted leaders within Army medicine are encouraged by the changes happening within Class VIII. U.S. Army Materiel Command empowers AMLC to go after issues and find solutions. Enlisted Soldiers are a huge part of that effort because they know the ground truth. The message to all readers today is to keep striving for improvements within the Class VIII commodity that align with readiness and taking care of people.


Sgt. Maj. Monnet Bushner currently serves as the U.S. Army Military District of Washington Inspector General Sergeant Major at Fort McNair, D.C., and is the former senior enlisted leader for U.S. Army Medical Logistics Command. Bushner holds a master’s degree in Organizational Management from Ashford University, an institution now affiliated with the University of Arizona.

Sgt. Maj. Francis Famularcano is the former senior enlisted adviser at the U.S. Army Medical Materiel Center — Europe. Famularcano holds a bachelor’s degree in Liberal Arts with an emphasis in Management from Excelsior College in Albany, New York.

Retired Command Sgt. Maj. Tony Flanagan served as support operations sergeant major for U.S. Army Medical Logistics Command. Before that, he served as command sergeant major for the 14th Combat Hospital, Fort Benning, Georgia. He is a graduate of the U.S. Army Sergeants Major Academy.

Sgt. Maj. Joel Lara-Baeza currently serves as the command sergeant major at William Beaumont Hospital at Fort Bliss, Texas. He is the former senior enlisted leader at the U.S. Army Medical Materiel Center-Korea. Lara-Baeza holds a bachelor’s degree in Organizational Leadership from Trident University International, based in Cypress, California.

Master Sgt. Wesley Ladlee currently serves as the noncommissioned officer in charge of the Integrated Logistics Support Center, under U.S. Army Medical Logistics Command. He also serves as the senior enlisted leader for the Army’s Biomedical Equipment Specialist (68A) MOS. Ladlee’s military education includes the Medical Equipment Management Course, Instructor Training Course, and Master Resiliency Trainer Course, among others.


This article was published in the Fall 22 issue of Army Sustainment.


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