COMBAT HEALTH SUPPORT IN STABILITY OPERATIONS AND SUPPORT OPERATIONS
CONTENTS CHAPTER ONE INTRODUCTION BACKGROUND RESEARCH OBJECTIVES AND THE INFLUENCE OF SEPTEMBER 11 RESEARCH METHODS TERMINOLOGY TERRORISM CBRNE VERSUS WEAPONS OF MASS DESTRUCTION HOW THIS REPORT IS ORGANIZED CHAPTER TWO THE MILITARY HEALTH SYSTEM AND MILITARY SUPPORT TO CIVIL AUTHORITIES THE TWO PRIMARY MISSIONS OF THE MILITARY HEALTH SYSTEM THE MILITARY HEALTH SYSTEM MISSIONS SHARE RESOURCES MILITARY MEDICAL ASSETS MISSION MEDICAL ASSETS INFRASTRUCTURE MEDICAL ASSETS DOD ORGANIZATION, GUIDANCE, AND PLANNING ORGANIZATION FOR MILITARY OPERATIONS GUIDANCE PLANNING LIMITATIONS TO CONSIDER WHEN PLANNING FOR MILITARY ASSISTANCE MILITARY ASSETS MAY BE ENGAGED IN OTHER MISSIONS MILITARY ASSETS ARE MAINTAINED AT VARIOUS LEVELS OF READINESS BASED ON WARTIME REQUIREMENTS CHAPTER THREE THE EVOLUTION OF STRUCTURES, SYSTEMS, AND PROCESSES FOR DOMESTIC PREPAREDNESS RECOMMENDATIONS FROM NATIONAL COMMISSIONS NEW PLAYERS AND NEW ROLES IN HOMELAND SECURITY THE OFFICE OF HOMELAND SECURITY AND THE NATIONAL STRATEGY THE DEPARTMENT OF HOMELAND SECURITY HOMELAND SECURITY PRESIDENTIAL DIRECTIVE-5 THE NATIONAL RESPONSE PLAN THE ROLE OF DOD IN RESPONSE: AN OVERVIEW THE NATIONAL DISASTER MEDICAL SYSTEM OTHER DOD DIRECTIVES RELATED TO CIVIL SUPPORT THE DIRECTOR OF MILITARY SUPPORT THE ASSISTANT SECRETARY OF DEFENSE FOR HOMELAND DEFENSE U S NORTHERN COMMAND CHAPTER FOUR LEGAL AND OTHER BARRIERS TO MILITARY SUPPORT TO CIVIL AUTHORITIES CONSTITUTIONAL AND HISTORICAL BASES FOR USE OF THE MILITARY DOMESTICALLY STATUTORY AND REGULATORY AUTHORITIES ENABLING THE USE OF MILITARY ASSETS TO SUPPORT CIVIL AUTHORITIES CONSTITUTIONAL AUTHORITY CONGRESSIONAL AUTHORITY: POSSE COMITATUS ACT AND ITS PROGENY CONGRESSIONAL AUTHORITY: CIVIL DISTURBANCE (OR INSURRECTION) STATUTES CONGRESSIONAL AUTHORITY: COUNTERDRUG AND RELATED STATUTES CONGRESSIONAL AUTHORITY: DISASTER RELIEF AND THE STAFFORD ACT CONGRESSIONAL AUTHORITY: COUNTERTERRORISM AND WEAPONS OF MASS DESTRUCTION CONGRESSIONAL AUTHORITY: QUARANTINES, EVACUATIONS, AND CURFEWS CONGRESSIONAL AUTHORITY: NEW AUTHORITY FOR USE OF THE RESERVE COMPONENTS CONSTRAINTS ON THE EXERCISE OF EXPLICIT AUTHORITY EXECUTIVE AUTHORITY: THE PRESIDENT’S RESIDUAL AUTHORITY EXECUTIVE AUTHORITY: MARTIAL LAW EXECUTIVE AUTHORITY: EXECUTIVE ORDER EXECUTIVE AUTHORITY: DOD POLICY ON MILITARY ASSISTANCE IN CIVILIAN EMERGENCIES LEGAL LIABILITIES IMPLICATED BY THE USE OF MILITARY MEDICAL ASSETS TO SUPPORT CIVIL AUTHORITIES LIABILITY UNDER THE FEDERAL TORT CLAIMS ACT OF 1946 LIABILITY UNDER SECTION 1983 AND BIVENS FOR VIOLATIONS OF CONSTITUTIONAL RIGHTS LIABILITY RELATED TO THE MANAGEMENT OF PROPERTY, PEOPLE, AND INFORMATION DISTINGUISHING BETWEEN HOMELAND DEFENSE AND CIVIL SUPPORT NONLEGAL CONSTRAINTS ON THE USE OF THE MILITARY DIFFUSE NATURE OF AUTHORITY RELUCTANCE TO SEEK FEDERAL ASSISTANCE APPREHENSION ABOUT MILITARY ASSISTANCE CULTURAL BARRIERS CAPABILITIES REQUIREMENTS IDENTIFICATION CONCLUSIONS RECOMMENDATION CHAPTER FIVE MILITARY MEDICAL SUPPORT TO CIVIL AUTHORITIES: HISTORICAL CASE STUDIES DOD’S ROLE IN MEDICAL RESPONSE RESEARCH METHODS FOR CASE STUDIES HURRICANE ANDREW BACKGROUND GOVERNMENT AND MILITARY RESPONSE TO HURRICANE ANDREW HURRICANE MARILYN BACKGROUND GOVERNMENT AND MILITARY RESPONSE TO HURRICANE MARILYN TROPICAL STORM ALLISON BACKGROUND GOVERNMENT AND MILITARY RESPONSE TO TROPICAL STORM ALLISON WHAT LESSONS CAN BE LEARNED FROM THESE CASE STUDIES? A CONCEPTUAL FRAMEWORK FOR RESPONSE DECENTRALIZED VERSUS CENTRALIZED RESPONSE CIVILIAN VERSUS MILITARY RESPONSE CHAPTER SIX EXERCISE-BASED STUDIES OF POTENTIAL MILITARY MEDICAL SUPPORT TO CIVIL AUTHORITIES OBJECTIVE EXERCISE METHODS EXERCISES WERE BASED ON AN ESTABLISHED METHODOLOGY THE ANALYTIC FRAMEWORK FOR THE EXERCISE THE DESIGN AND TESTING PROCESS INCLUDED CONSIDERATION OF A MENU OF POTENTIAL ISSUES TERRORIST ATTACK SCENARIOS THE GEORGIA EXERCISE: SMALLPOX ATTACK GEORGIA EMERGENCY RESPONSE SERVICES THE THREAT AND THE SCENARIO THE EXERCISE EXERCISE RESULTS: ISSUES AND OBSERVATIONS THE CALIFORNIA EXERCISE: RADIOLOGICAL DISPERSION DEVICE ATTACK CALIFORNIA EMERGENCY RESPONSE SERVICES CHAPTER SEVEN CONCLUSIONS AND RECOMMENDATIONS RECOMMENDATIONS