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Faced with budgetary constraints, the U.S. Army must decide how to best invest for readiness. It cannot afford to modernize all units with current medical equipment and sustain all units with consumable medical items at all times. To help the Army consider how best to invest in medical materiel equipping, the U.S. Army Medical Materiel Agency (USAMMA) asked RAND Arroyo Center to survey medical materiel owned by the Army, procurement and fielding costs for it, alternative supply options, and the effect that alternative options would have on capabilities and risk. This report summarizes this requested analysis. Specifically, this report describes the current Army medical materiel strategy, equipping costs, readiness levels, and recommendations for optimizing the Army medical materiel strategy. The purpose of the project was to update the current Army Medical Department equipping strategy to optimize medical readiness by most effectively equipping the operational medical force in support of global contingency missions in a limited resource environment. Ensuring that more units have medical equipment to deploy more rapidly would require more funds from the Army or a shift in the way that available funds are applied.

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Amphibious warfare --- Decontamination (from gases, chemicals, etc.) --- Biological decontamination --- Radioactive decontamination --- War --- Public Health Practice --- Technology, Industry, and Agriculture --- Technology, Industry, Agriculture --- Social Problems --- Public Health --- Sociology --- Environment and Public Health --- Health Care --- Social Sciences --- Anthropology, Education, Sociology and Social Phenomena --- Biological Warfare --- Chemical Warfare --- Military Science --- Decontamination --- Nuclear Warfare --- Military & Naval Science --- Law, Politics & Government --- Military Science - General --- Planning --- Atomic Warfare --- Warfare, Atomic --- Warfare, Nuclear --- Naval Science --- Military Sciences --- Naval Sciences --- Science, Military --- Science, Naval --- Sciences, Military --- Sciences, Naval --- Warfare, Chemical --- Chemical Warfares --- Warfares, Chemical --- Biologic Warfare --- Warfare, Bacterial --- Warfare, Biological --- Bacterial Warfare --- Warfare, Biologic --- Science, Social --- Sciences, Social --- Social Science --- Community-Based Distribution --- Contraceptive Distribution --- Delivery of Healthcare --- Dental Care Delivery --- Distribution, Non-Clinical --- Distribution, Nonclinical --- Distributional Activities --- Healthcare --- Healthcare Delivery --- Healthcare Systems --- Non-Clinical Distribution --- Nonclinical Distribution --- Delivery of Dental Care --- Health Care Delivery --- Health Care Systems --- Activities, Distributional --- Activity, Distributional --- Care, Health --- Community Based Distribution --- Community-Based Distributions --- Contraceptive Distributions --- Deliveries, Healthcare --- Delivery, Dental Care --- Delivery, Health Care --- Delivery, Healthcare --- Distribution, Community-Based --- Distribution, Contraceptive --- Distribution, Non Clinical --- Distributional Activity --- Distributions, Community-Based --- Distributions, Contraceptive --- Distributions, Non-Clinical --- Distributions, Nonclinical --- Health Care System --- Healthcare Deliveries --- Healthcare System --- Non Clinical Distribution --- Non-Clinical Distributions --- Nonclinical Distributions --- System, Health Care --- System, Healthcare --- Systems, Health Care --- Systems, Healthcare --- General Social Development and Population --- Environment, Preventive Medicine & Public Health --- Environment, Preventive Medicine and Public Health --- Health, Public --- Problem, Social --- Problems, Social --- Social Problem --- Health Practice, Public --- Health Practices, Public --- Practice, Public Health --- Practices, Public Health --- Public Health Practices --- Wars --- Decontamination (from radioactive substances) --- Radiological decontamination --- Biological agents decontamination --- Biological materials decontamination --- Decontamination from biological agents --- Decontamination of biological agents --- Infectious agents decontamination --- Microbiological agents decontamination --- Joint operations (Military science) --- Troops, Landing of --- Radiation --- Violence --- Bioterrorism --- Community Health --- Health, Community --- Preventive Medicine --- Education, Public Health Professional --- Contamination (Technology) --- Nuclear engineering --- Radioactivity --- Disinfection and disinfectants --- Microbial contamination --- Chemical warfare --- Civil defense --- Gases, Asphyxiating and poisonous --- Unified operations (Military science) --- Safety measures --- War use --- Armed Conflict --- Conflict, Armed --- Conflicts, Armed --- Labor Exploitation --- Social Exploitation --- Exploitation, Labor --- Exploitation, Social --- Exploitations, Labor --- methods. --- prevention & control. --- United States. --- Planning. --- Operational readiness. --- U.S. Navy

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This report assesses the relationship between defense spending in Hawaii and the levels of output, employment, and earnings in Hawaii's economy. The presence of defense activity in Hawaii is significant, but how much does it add to Hawaii's economy? We collected data on defense expenditures on personnel and procurement and estimated the relationship between these expenditures and the levels of output, employment, and earnings in Hawaii's economy. The analysis uses an input-output model for Hawaii that describes the relationship among industries and final demand. DoD expenditures in Hawaii during FY 2007-2009 averaged $6.5 billion per year in 2009 dollars - $4.1 billion for personnel and $2.4 billion for procurement. These expenditures were associated with $12.2 billion worth of Hawaii's output, 18 percent of Hawaii's 2009 GDP, and 101,000 jobs. We considered the sensitivity of the estimates to a number of factors, including undercounting or overcounting defense procurement, Hawaii state taxes paid by defense personnel, the savings rate of defense personnel, Impact Aid to Hawaii schools, spending by afloat and deployed personnel, and procurement by commissaries and exchanges. Most factors made little difference, but the savings rate of personnel and where the earnings of afloat and deployed personnel are spent could decrease the results by approximately 10 percent.

United States. --- Appropriations and expenditures --- Economic aspects. --- United States --- Hawaii --- Defenses --- Economic conditions.

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Soon after Hurricanes Irma and Maria hit the U.S. Virgin Islands (USVI) in September 2017, recovery activities began. But more than three years after the hurricanes, the territory still has substantial recovery needs. The USVI government estimates that, to fully recover from the damage, it will need to execute

Disaster relief --- Hurricane Irma, 2017. --- Hurricane Maria, 2017. --- Hurricanes --- Economic aspects --- United States Virgin Islands.