MS 261: Medical Office and Medical Officers

Date: 05/24/94
Responsible Office: VS/MS
Supercedes: MS 261 2/31/85, 11/22/82


1.0	Purpose
2.0	Medical Office
3.0	PCMO
	3.1	Designation of PCMO
		3.1.1	Responsibilities of the PCMO
	3.2	Supervision of PCMO
	3.3	Medical Limitations of the PCMO
		3.3.1	Medical Care Provided to Trainees and Volunteers Without Their Consent
		3.3.2	Non-Volunteer Care
4.0	Effective Date

Attachments

IN PROGRESS OF OBTAINING

Attachment A The Medical Office

Attachment B PCMO Responsibilities

Attachment C Responsibilities of an Area Peace Corps Medical Officer

1.0 Purpose

This Manual Section Prescribes the establishment of a Medical Office and the designation of a Peace Corps Medical Officer (PCMO) at all Peace Corps posts, and summarizes the responsibilities and working relationships of the PCMO.

2.0 Medical Office

Each overseas Peace Corps post will have a Medical Office consistent in size and scope with the needs of the Peace Corps program, unless the Office of Medical Services, after consultation with the Country Director, concurs in a different arrangement (see Attachment A for Medical Office specifications). Volunteers should receive care at the Medical Office from the PCMO whenever possible.

3.0 PCMO

Each Peace Corps Post will have a PCMO, who may be a physician, nurse practitioner, registered nurse or a physician's assistant. The health professional skill level needed at post will be designated by the Office of Medical Services. A Volunteer may not serve as a PCMO. In very unusual circumstances, a non-medical person may be appointed temporarily as a Medical Coordinator, but will have no direct responsibility for the health care of Volunteers. A Medical Coordinator will maintain the medical office, keep accurate records, maintain medical confidentiality, and arrange for professional practitioners to provide preventive and curative health services. The Coordinator may dispense medical kits and non- prescription items.

3.1 Designation of PCMO

The appropriate Regional Director, in consultation with the Country Director will select the PCMO at each Post after the Office of Medical Services determines that the individual has the professional qualifications necessary to meet the health needs of Volunteers at that Post. In making this judgment, the Office of Medical Services will consider the following:

The medical delivery system available to Volunteers in the country and
Past experience in that country with regard to endemic diseases, serious illnesses, medical evacuations, and environmental hazards.

3.1.1 Responsibilities of the PCMO

Manual Section 262 describes the medical services available in-country to Trainees, Volunteers, and dependents. The primary responsibility of the PCMO is the provision of these services (specific medical care and medical administrative services provided by Peace Corps are described in Attachment B). Some Peace Corps countries are served by an Area Peace Corps Medical Officer (APCMO) or a Regional Medical Advisor (RMA). An APCMO or an RMA is a physician who, in addition to serving as a physician advisor in a base country, supports PCMOs in one or more neighboring countries (the specific responsibilities of an APCMO or RMA are described in Attachment C).

In addition to these duties the PCMO serves as a regular member of the country team and medical advisor to the Country Director. In this capacity, the PCMO will:

Participate in staff meetings and Volunteer conferences;
Visit Volunteers on site;
Share with the Country Director and other staff members information and ideas gained through travel and visits with Volunteers;
Inform the Country Director on a regular basis of medical information which affects programs in-country;
Provide advice regarding matters relating to Volunteer health in-country, including site selection and assignment (see Manual Section 267, "Medical Confidentiality," for a full description of the information that may be provided to a Country Director); and,
Keep the Country Director informed during medical emergencies so that the Country Director may assist in providing administrative and logistical support (see Manual Section 267, "Medical Confidentiality," for specific policies and procedures for handling emergencies).

3.2 Supervision of PCMO

A PCMO works under the direction of the Country Director in all administrative matters. Likewise, an APCMO works under the administrative direction of the Country Director in the base country, but also is responsible for serving Country Directors in the neighboring Posts which he/she supports (see Attachment C for APCMO responsibilities). An RMA works under the administrative direction of the Office of Medical Services. In all professional medical matters, the PCMO receives guidance, direction, and support from the Office of Medical Services, the APCMO or the RMA. Medical activities of the PCMO must conform to the Peace Corps Manual and the Technical Guidelines for Overseas Medical Staff.

3.3 Medical Limitations of the PCMO

3.3.1 Medical Care Provided to Trainees and Volunteers Without Their Consent

Ordinarily medical care may not be provided to Volunteers or Trainees without their consent. However, when the PCMO determines that failure to provide such care could result in physical harm to the Volunteer or Trainee or others, he or she may dispense treatment without the Volunteer's or Trainee's permission providing such material care is in accordance with local law. In making such a decision the PCMO should consult, when appropriate, with the best available host country medical professionals and with the Office of Medical Services.

If questions arise concerning proper procedures in this matter, the PCMO should seek advice from the Office of Medical Services and the Office of General Counsel.

3.3.2 Non-Volunteer Care

The PCMO is not responsible, except in emergency situations, for the medical care of non-Peace Corps Volunteers, including former Volunteers, Peace Corps staff and dependents, Peace Corps contractors, or other U.S. Federal employees and their dependents. In countries where adequate medical resources are not available, the PCMO may provide care to the above personnel under local agreement. Reciprocal arrangements with Department of State Medical personnel for back-up support, such as laboratory facilities or coverage during absences, are authorized. However, contractors may only provide care to those persons specified in the contract, except in emergencies.

4.0 Effective Date

This Manual Section shall take effect on the date of issue.

Attachment A	The Medical Office
Attachment B	PCMO Responsibilities
Attachment C	Responsibilities of an Area Peace Corps Medical Officer