The Assistant Secretary of Defense for Health Affairs (ASD(HA)) is chartered under United States Department of Defense Directive (DoDD) 5136.1 in 1994. This DoDD states that the ASD(HA) is the principal advisor to the U.S. Secretary of Defense on all "DoD health policies, programs and activities." In addition to exercising oversight of all DoD health resources, ASD(HA) serves as director of the Tricare Management Activity. The ASD(HA) reports to the Undersecretary of Defense (Personnel and Readiness), or USD(P&R). A political appointee responsible for the United States Department of Defense's Military Health System , the ASD(HA) is an Executive Service Level IV official. He or she is nominated by the President of the United States, and confirmed by the United States Senate.