MDG's diagnosis of inefficiencies integral to SOT improvement Published Jan. 12, 2023 By John Ingle 82nd Training Wing Public Affairs SHEPPARD AIR FORCE BASE, Texas – As the “student out of training” load here reaches a healthy level, two primary drivers that often place Airmen in Training in that status are inching toward a clean bill of health. Airmen in Training must complete specific requirements, or Personnel Processing Codes, before they are able to leave Sheppard AFB after graduation. That includes medical clearances and, if needed, a review by the Exceptional Family Member Program for Airmen with a dependent with special needs. These medical reviews were found to be part of several breakdowns in the student assignments and orders process that were delaying the departure of new graduates by weeks or, in some cases, months. The end result of the cumulative effect was more than 500 Airmen in Training in SOT status for one reason or another. Staff Sgt. Aaron Perez, former EFMP noncommissioned officer in charge at the 82nd Medical Group, said the Sheppard office would have about 10 AiT in SOT status at any given time in the process, which can be quite lengthy to ensure the proper level of care is available where the military member is being assigned. Before changes began to take shape in October 2021, special needs coordinators here would communicate directly with gaining unit coordinators to find out if the installation or local community could support the family, he said. If the gaining unit or local community had the ability to provide the proper level of care, the Airman would be approved for that assignment. If it were the opposite, Perez said the Airman would be placed in the “reassignment” category, and Air Force Personnel Center would look for another installation for the Airman, as well as a location or local community that could provide the level of care needed for the dependent. Perez said that while coordinators here felt their process was efficient, there was a lack of understanding among other organizations on base as to how long the process takes. Getting into the process late into their time here would almost guarantee a delay for an Airman if there were dependent placement issues. He said EFMP was part of the AiT initial briefing when the Airmen arrived from basic military training, but this information being passed down wasn’t sticking. That’s what created a backlog in EFMP because AiT weren’t completing the process due to a lack of visibility by coordinators on who needed EFMP assistance. “Without Airmen saying, ‘Hey, I have dependents,’ whether they had specialty care needs or not, we couldn’t identify them and we didn’t get a roster,” he said. “So, that’s what led to the huge SOT number on the EFMP staff load.” Perez said they looked internally to find out why they weren’t catching AiT earlier in the process until sometimes after they graduated. He said educating military training leaders on the EFMP process and the importance in starting it soon after AiT arrive here was an integral step in turning the tide. A change at the 82nd Force Support Squadron’s student processing center also paid big dividends when the office began providing a list of AiT potentially needing to go through the EFMP process. Perez said this allowed the EFMP office the ability to identify those Airmen with dependents that would need an EFMP review early upon arrival here, rather than learning of the need just before an AiT graduates. Another medical hang-up preventing new graduates from leaving, specifically those in shorter courses, was the amount of time needed for dental, medical or mental health conditions. Lt. Col. (Dr.) Kun-Jang Chang, Aerospace and Operational Medicine Flight commander in the 82nd Operational Medical Readiness Squadron, said the issue from a dental perspective was the lack of specialty providers such as an oral surgeon at the clinic. The absence of that specialty often meant AiT would have to go to a local provider for the care they needed, which often times meant lengthy delays. Couple that with time-consuming treatments and one-to-two-month-long courses, and some Airmen weren’t going to be able to be cleared for overseas assignments. Chang said he asked Oscar Salas, an OMRS nurse and retired Air Force medic, to get class rosters sooner so the dental flight could get ahead of the curve. He explained sending an Airman needing extensive dental care to an overseas location delays their ability to get to their unit and get spun up on their job because they have to gain dental clearance first. The solution, he said, was to review dental X-rays obtained during basic training, as well as documented dental needs. The staff then determined if treatment would require more than two dental appointments. If the Airman required extensive care, they would be disqualified from going overseas, eventually requiring AFPC to look for another location for the Airman. Salas said another kink in the process was when the Wing Airman in Training tracker went away in July 2021, which resulted in the clinic losing track of 500-600 AiT. He said they created an internal tracker and requested information from FSS, ultimately taking about a month to have eyes on who needed care. But, he said, they had already taken a significant hit. He said he was part of the early meetings to identify and how to plug gaps in the process to make sure new graduates were moving on within 24 hours of receiving their certificate. For medical clearances, he said getting the list early allowed them to begin their processes. Salas explained overseas bases have different medical clearance requirements. For example, an Airman going to Korea will have more to accomplish that one going to Germany. The changes made within the medical group have yielded positive changes, Salas said. “If I get the list on Monday, typically by Friday I will be able to clear people two months out from graduation. I’d say 95 percent of them,” he said. “That other 5 percent, most of that ended up being dental. Now since they changed their processes, there’s hardly any Airmen that are pending dental clearance. Most of the ones that are pending clearance now are due to lingering medical or mental health issues.” Chang said the biggest change in the process occurred at FSS with the development of Project Journey and their streamlined process. He said the improved information flow from the organization has allowed the medical group and others to process AiT quicker, which enables them to get orders quicker, outprocess Sheppard and move on to the operational Air Force. The 82nd MDG’s ability to diagnose inefficiencies in their clearance process has played an integral role in reducing the number of SOTs at Sheppard. With consistent coordination and cooperation among the key players in the process, that number will only continue to improve.