ARMY HEALTH SYSTEM

1 FM 4-02 ARMY HEALTH SYSTEMNOVEMBER 2020 DISTRIBUTION RESTRICTION: Approved for public release ; distribution is unlimited. This publication supersedes FM 4-02, dated 26 August 2013. HEADQUARTERS, DEPARTMENT OF THE ARMY This publication is available at the Army Publishing Directorate site ( ), and the Central Army Registry site ( ). *FM 4-02 DISTRIBUTION RESTRICTION: Approved for public release distribution unlimited. *This publication supersedes FM 4-02, dated 26 August 2013FM 4-02 i Field Manual No. 4-02 Headquarters Department of the Army Washington, , 17 November 2020 Army HEALTH SYSTEM Contents Page vii INTRODUCTION .. ix PART ONE ARMY HEALTH SYSTEM Chapter 1 ARMY HEALTH SYSTEM OVERVIEW .. 1-2 Section I Operational Environment .. 1-2 1-2 HEALTH Threat .. 1-3 Section II Warfighting Functions .. 1-4 SYSTEM of Systems .. 1-4 Force HEALTH Protection Mission .. 1-4 HEALTH Service Support Mission.

2 1-4 Section III Tactical Combat Casualty Care .. 1-6 Care Under Fire .. 1-6 Tactical Field Care .. 1-6 Tactical Evacuation .. 1-6 Casualty Evacuation .. 1-7 Medical Evacuation .. 1-7 Patient Evacuation .. 1-8 Section IV Army HEALTH SYSTEM Principles .. 1-8 Conformity .. 1-8 Proximity .. 1-9 Flexibility .. 1-9 Mobility .. 1-9 Continuity .. 1-9 Control .. 1- 10 Roles of Medical Care .. 1- 10 Eligibility of Care Determination .. 1-13 Knowledge of HEALTH Care Capabilities .. 1-13 Dissemination of Eligibility for Care Information .. 1- 13 Documentation .. 1-14 Sample Eligibility for Care Matrix .. 1-14 HEALTH Information Technology .. 1-15 Section V Global HEALTH Engagement .. 1- 19 Contents ii FM 4-02 17 November 2020 Chapter 2 ARMY HEALTH SYSTEM COMMAND AND CONTROL .. 2-1 Section I Overview of Army Echelons .. 2-1 Operational Environment .. 2-1 Army Command and Support Relationships .. 2-3 Theater Army.

3 2-4 Theater Army Surgeon's Section .. 2-5 Theater Sustainment Command .. 2-6 Section II Medical Command and Control Organizations .. 2-8 Medical Command (Deployment Support) .. 2-10 Medical Brigade (Support) .. 2-21 Medical Battalion (Multifunctional) .. 2-30 Section III Medical Commander, Command Surgeon, and Line .. Commander .. 2-36 Medical Commander .. 2-36 Command Surgeon .. 2-37 Commander .. 2-40 Section IV Army HEALTH SYSTEM Team of Teams .. 2-42 Chapter 3 ARMY HEALTH SYSTEM THE EFFECTS OF THE LAW OF LAND WARFARE AND MEDICAL ETHICS .. 3-1 Section I The Law of Land 3-1 Section II Geneva Conventions .. 3-1 Protection and Care .. 3-1 Enemy Wounded And Sick .. 3-3 Medical Repatriation .. 3-4 Protection and Identification of Medical Personnel .. 3-4 Protection and Identification of Medical Units, Establishments, Buildings, Materiel, and Medical Transports .. 3-6 Conditions not Depriving Medical Units and Establishments of Protection.

4 3-9 The 1977 Protocols to the Geneva Conventions .. 3-10 Compliance with the Geneva Conventions .. 3-10 Medical Care for Detained Personnel .. 3-11 Section III Medical Ethics .. 3-11 Ethical Considerations for the Medical Treatment of Detainees .. 3-11 Chapter 4 ARMY HEALTH SYSTEM OPERATIONS .. 4-1 Section I Planning For Army HEALTH SYSTEM Support .. 4-1 Unified Land Operations .. 4-1 Operational 4-1 Mission Variables .. 4-5 Task-Organization .. 4-7 Section II Support To Decisive Action .. 4-7 Offensive Tasks .. 4-8 Defensive Tasks .. 4-8 Stability Tasks .. 4-9 Defense Support of Civil Authorities .. 4-10 Section III Setting the Theater, Theater Opening, Early Entry, and Expeditionary Medical Operations .. 4-11 Theater Opening and Early Entry Operations .. 4-12 Expeditionary Medical Operations .. 4-12 Section IV Support To Detainee Operations .. 4-14 Medical Personnel Organic to Maneuver Units.

5 4-15 Contents 17 November 2020 FM 4-02 iii Medical Personnel Organic to Military Police Units .. 4-16 Army HEALTH SYSTEM Units in Support of Detainee Operations .. 4- 16 PART TWO FORCE HEALTH PROTECTION Chapter 5 OPERATIONAL PUBLIC HEALTH .. 5-1 Mission .. 5-2 Protection Warfighting Function .. 5-2 Organizations and Personnel .. 5-2 Primary Tasks .. 5-3 Chapter 6 VETERINARY SERVICES .. 6-1 Section I Veterinary Responsibilities .. 6-1 Section II Food Protection Mission .. 6-3 Section III Animal Care Mission .. 6-3 Veterinary Role 1 Medical Care .. 6-4 Veterinary Role 2 Medical Care .. 6-6 Veterinary Role 3 Medical Care .. 6-6 Veterinary Role 4 Medical Care .. 6-7 Section IV Veterinary Public HEALTH .. 6-7 Chapter 7 COMBAT AND OPERATIONAL STRESS CONTROL .. 7-1 Section I Combat and Operational Stress Control Responsibilities .. 7-1 Section II Program and Resources .. 7-1 Brigade Combat Teams.

6 7-1 Medical Company (Area Support) .. 7-2 Medical Detachment, Combat and Operational Stress Control .. 7-2 Primary Tasks .. 7-2 Section III Behavioral HEALTH and Neuropsychiatric Treatment Aspects .. 7-3 Treatment Provision .. 7-3 Primary Tasks .. 7-3 Chapter 8 DENTAL SERVICES .. 8-1 Section I Dental Services Preventive Dentistry .. 8-1 Preventive Measures .. 8-1 Primary Tasks .. 8-1 Section II Dental Services Treatment Aspects .. 8-1 Levels of Dental Support .. 8-2 Categories of Dental Care .. 8-2 Primary Tasks .. 8-3 Chapter 9 LABORATORY SERVICES .. 9-1 Section I Area Medical Laboratory Support .. 9-1 Field Environmental Laboratory .. 9-1 Primary Tasks .. 9-2 Section II Clinical Laboratory Services .. 9-3 Chemical, Biological, Radiological, And Nuclear Clinical Laboratory Support .. 9-3 Primary Tasks .. 9-3 PART THREE HEALTH SERVICE SUPPORT Chapter 10 DIRECT PATIENT CARE .. 10-1 Section I Medical Treatment (Organic and Area Support).

7 10-1 Medical Company .. 10-2 Contents iv FM 4-02 17 November 2020 Primary Tasks .. 10-2 Section II Theater Hospitalization .. 10-2 Primary Tasks .. 10-3 Combat Support Hospitals .. 10-3 Hospital Center .. 10-5 Hospital Center Components and Employment .. 10-6 Augmentation Teams .. 10-7 Chapter 11 MEDICAL EVACUATION .. 11-1 Section I Integrated Medical Evacuation SYSTEM .. 11-1 Theater Evacuation Policy .. 11-1 Organizations .. 11-3 Primary Tasks .. 11-4 Section II Medical Regulating .. 11-4 Section III Strategic Medical Evacuation and Patient Movement .. 11-5 Chapter 12 MEDICAL LOGISTICS .. 12-1 Section I Medical Logistics Management in an Operational Environment 12-1 Section II Medical Logistics SYSTEM .. 12-1 Medical Logistics Management Center .. 12-1 Medical Logistics Company .. 12-2 Medical Detachment (Blood Support) .. 12-2 Medical Detachment Optometry .. 12-2 Primary Tasks .. 12-2 Section III Strategic Medical Logistics Support.

8 12-2 Section IV Medical Logistics Support for Roles 1 and 2 Medical Treatment Facilities .. 12-5 Section V Medical Logistics Support for Role 3 Medical Treatment Facilities .. 12-5 Section VI Medical Logistics Support to joint HEALTH Services .. 12-5 Appendix A ARMY HEALTH SYSTEM SUPPORT TO THE ARMY STRATEGIC ROLES .. A-1 Appendix B COMMAND AND SUPPORT RELATIONSHIP .. B-1 Appendix C SURGEON AND SURGEON SECTION .. C-1 Appendix D MEDICAL INTELLIGENCE .. D-1 Appendix E INSTITUTIONAL FORCE SUPPORT TO THE OPERATIONAL ARMY .. E-1 Appendix F ARMY HEALTH SYSTEM SYMBOLS .. F-1 GLOSSARY .. Glossary-1 REFERENCES .. References-1 INDEX .. Index-1 Figures Figure 1-1. SYSTEM of systems .. 1-5 Figure 1-2. Army HEALTH SYSTEM support operational framework .. 1-5 Figure 1-3. Army HEALTH SYSTEM Principles .. 1-8 Figure 2-1. Army HEALTH SYSTEM support logic chart .. 2-2 Contents 17 November 2020 FM 4-02 v Figure 2-2.

9 Army HEALTH SYSTEM command and support relationships .. 2-4 Figure 2-3. Medical structure in theater .. 2-6 Figure 2-4. Notional deployed medical command (deployment support).. 2-11 Figure 2-5. Medical Command (deployment support) organizational structure .. 2- 13 Figure 2-6. Medical command (deployment support) staff structure .. 2-14 Figure 2-7. Notional deployed medical brigade (support) .. 2- 21 Figure 2-8. Medical brigade (support) organizational structure .. 2-22 Figure 2-9. Medical brigade (support) staff structure .. 2-24 Figure 2-10. Notional deployed medical battalion (multifunctional) .. 2-31 Figure 2-11. Medical battalion (multifunctional) organizational structure .. 2-32 Figure 2-12. Medical battalion (multifunctional) staff structure .. 2-33 Figure 2-13. Army HEALTH SYSTEM a team of 2-42 Figure 9-1. Four levels of identification .. 9-2 Figure A-1. Army HEALTH SYSTEM support during operations to shape.

10 A-2 Figure A-2. Army HEALTH SYSTEM support during operations to prevent ..A-3 Figure A-3. Army HEALTH SYSTEM support during large-scale ground combat operations ..A-5 Figure A-4. Army HEALTH SYSTEM support during operations to consolidate gains ..A-7 Figure C-1. Surgeon link to medical and warfighting functions .. C-3 Figure C-2. Ten medical functions aligned with warfighting functions .. C-3 Figure C-3. Surgeon and protection/sustainment cell coordination and synchronization matrix . C-4 Figure E-1. The Soldier Recovery Unit ..E-4 Tables Introductory Table-1. Rescinded Army terms .. x Introductory Table-2. Modified Army terms .. xi Table 1-1. HEALTH threat .. 1-3 Table 1-2. Sample eligibility for medical and dental care support matrix .. 1-15 Table 2-1. Primary tasks and purposes of the medical command and control function .. 2-9 Table 4-1. Medical aspects of the operational variables.