VA, USTRANSCOM join forces during Ultimate Caduceus 2025

Timeliness, coordination and communication all came together as VA emergency managers and medical centers around the nation participated in the annual Ultimate Caduceus (UC25) exercise July 21 to Aug. 2 hosted by U.S. Transportation Command (USTRANSCOM). This multistate exercise tests how the Department of Defense (DOD) and its interagency and industry partners coordinate military patient movement from overseas to hospitals within the United States.

For VA, the exercise began with emergency managers assigned to the VHA’s Office of Emergency Management and deploying to USTRANSCOM’s Patient Movement Coordination Cell (PMCC) in St. Louis, Missouri, to initiate response efforts at VA medical centers for the reception of simulated wounded service members from an overseas crisis. From the PMCC, VA Federal Coordinating Centers (FCC) in Boise, Detroit, Little Rock, Portland, Reno and Tampa were notionally activated to test readiness levels for immediate patient tracking and reception capabilities. However, one of VA’s FCCs went the extra mile to exercise their capabilities in real time.

The Albuquerque FCC

On the morning of July 30, the New Mexico VA Health Care System (NMHCS) and about a dozen partner agencies consisting of more than 100 personnel, such as medics from the 377th Medical Group out of Kirtland Air Force Base, New Mexico; Region 4 Healthcare Coalition; Albuquerque Fire Rescue and Albuquerque Ambulance System came together at the Albuquerque International Sunport to transform a snow barn into a patient reception area. As a U.S. Air Force HC-130J cargo aircraft carrying simulated injured troops arrived from overseas, Federal and local partners went to work with one common goal—save lives.

“The NMHCS was eager to get involved and train alongside our DOD and local partners throughout Albuquerque who play a vital role in this mission,” said Benton Weintraub, executive director. “The time, attention and resources we put into UC25 makes us that much more prepared and ready to respond when needed at the VA’s Albuquerque FCC.”

Dozens of simulated patients hooked up to medical equipment were off-loaded from the aircraft on stretchers and quickly taken into the reception area to track and assess for follow-on definitive care. Some patients were immediately placed in ambulances and taken to local hospitals. The constant theme throughout was military and civilian uniforms side-by-side to carry out their critical mission.

Enduring partnerships

VA and DOD’s partnerships in exercising FCCs are routine, occurring more than a dozen times each year. FCCs are a primary function of the National Disaster Medical System (NDMS) and can be applied to large-scale combat operations and other incidents, such as natural disasters. Although Veterans are always the highest priority, VA plays a vital role in supporting public health and medical services to the public during emergencies and disasters.

For UC25, VA used the Joint Patient Assessment and Tracking System, a method for tracking all federal patient movement during a disaster, including those who are being moved or evacuated, are admitted to federally supported shelters, or are receiving definitive care at local NDMS facilities.

“The idea is primarily patient tracking—getting them in and then out to hospitals. This being a Large Scale Combat Operation (LSCO) exercise with active-duty military, it changes the process for our usual tracking, so we went through various scenarios to test our interoperability for tracking military patients,” said Dennis Pollard, VHA area emergency manager.

Emergency Managers like Pollard have worked alongside Federal, state and local partners for decades, building and sustaining relationships in communities all over the country.

UC25 involved more than 1,000 military and civilian personnel, including teams from 21 civilian hospitals and representatives from VA, Department of Health and Human Services, and the Defense Health Agency. This year’s activities included both virtual and in-person training in Albuquerque, New Mexico, Joint Base Pearl Harbor-Hickam and Honolulu, Hawaii; Sacramento, California; Travis Air Force Base, California; and Scott Air Force Base, Illinois.

“Ultimate Caduceus underscores our commitment to delivering world-class care and rapid evacuation for our military,” said Col. Christopher Backus, USTRANSCOM command surgeon. “With our government and civilian partners, we stand ready to bring our warfighters home, no matter where they are.”