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Chapter 8
8-70. Because mortuary affairs capabilities within DOD are extremely limited, mortuary affairs units
support civil authorities only when response or recovery requirements are beyond the capabilities of civil
authorities. When directed by the President or Secretary of Defense, DOD can provide advisory support,
search, recovery, receiving, decontamination, identification, processing, storage, and transportation
assistance of the remains. DOD mortuary affairs personnel integrate into federal, state, and local operations
to assist and augment the medical examiner or coroner according to state laws. It is DOD guidance that
only mortuary affairs personnel handle human remains, with the reverence, care, and dignity befitting them
and the circumstances.
8-71. In most states, the state medical examiner or coroner is legally responsible for operations associated
with the identification, processing, and disposition of human remains. Each state and territory has different
laws for processing human remains. DOD personnel may assist National Guard and civilian law
enforcement authorities in locating human remains and transporting them after processing. The search,
recovery, and movement of human remains may become a law enforcement issue when there is a
requirement to enter private property or when the location is clearly a crime scene. In the former, a law
enforcement official must enter the private premises first to conduct a search to determine if any deceased
persons are inside. In the latter, permission from law enforcement authorities must be received before
moving human remains.
8-72. The National Response Framework under ESF #8 gives Department of Health and Human Services
the lead in providing mortuary services. Mortuary services under ESF #8 are—
z
Identifying victims
(by means such as fingerprint, dental, DNA, pathological, and
anthropological).
z
Providing temporary morgue facilities.
z
Processing, preparation, and disposition of remains.
z
Returning personal effects.
z
If necessary, making remains and personal effects available to law enforcement.
8-73. There are three types of searches for victims and for human remains. Soldiers may conduct an
immediate or hasty search in the aftermath of a disaster, such as a flood or hurricane, to find and rescue
living personnel who are on rooftops, front porches, or trees, for example, waiting for rescue. A primary
search follows, by going house-to-house, knocking on doors, looking into windows, and listening for
sounds to determine if someone inside needs assistance. Federal military forces may accompany National
Guard or civilian law enforcement authorities and stand by to assist while they do the initial entry into the
house or private business. A deliberate or secondary search follows later by going house-to-house and
entering the premises to determine if any deceased persons are inside. Federal military forces again may
accompany and stand ready to assist National Guard or civilian law enforcement authorities.
Temporary Facilities
8-74. The United States Army Corps of Engineers, Army, and other Service engineers may prepare
temporary facilities or improve existing facilities to house military and supporting civilian personnel, and
for additional support basing. Mission assignments determine the support provided to civilian agencies,
while USARNORTH coordinates with the base support installation and subordinate Army commanders for
additional facilities to support military forces. USARNORTH and the joint force headquarters-state may
also coordinate for shared logistical facilities and housing; a memorandum of agreement may follow that
assigns shared costs and responsibilities. The USARNORTH and subordinate engineer staff coordinate
with Service engineer agencies
(such as Naval Facilities Engineering Command) to analyze cost,
availability, and schedules for construction of temporary facilities. Normally, housing for displaced citizens
comes through the joint field office under ESF #6, coordinated by FEMA and assisted by other federal
agencies, United States Army Corps of Engineers, and the American Red Cross. In situations involving a
mass evacuation or refugee crisis, DOD may receive mission assignments to provide shelter to civilians.
8-75. Service capabilities developed and procured for rapid global deployment may prove useful in
domestic emergencies. Such capabilities may include Air Force Red Horse and Prime Beef; Army rapid
8-16
FM 3-28
20 August 2010
Sustainment—Logistics and Personnel Services
deployment logistics and medical modules such as Force Provider; or pre-packaged Marine logistics sets
stored in the United States or on sea lift currently in U.S. waters.
OTHER LOGISTICS REQUIREMENTS FOR CIVIL SUPPORT OPERATIONS
8-76. Army units may require an extensive storage complex based on mission requirements and flow of
supplies. During an incident response, federal and state agencies and civilian partners distribute large
quantities food, water, ice, and clothing to affected citizens. Frequently, stockpiles of military supplies
supplement resources from civilian emergency stockpiles. When tasked, Soldiers assist in distribution.
Leaders need to understand that the law requires an accurate accounting for both the supplies and the
Soldiers’ effort.
Real Property
8-77. When requested and approved by their respective headquarters, National Guard and federal military
bases may support civilian agencies. Vacant warehouses, parking lots, open fields, potential staging areas,
universities, airports and airfields, hospitals, and other facilities may be used for support and service
activities, and temporary resettlement of dislocated persons. The Secretary of Defense, in coordination with
the owning service secretary, commits active military installations to support civilian agencies. The
adjutant general of the state exercises decision authority for use of National Guard bases and armories.
8-78. Permanent or temporary transfer of any accountable equipment from an Army unit to a sister
Service, other service component, or civilian agency requires Department of the Army approval. Loans
require proper authorization and documentation. The borrower signs a statement assuming liability for
equipment during the period of the loan, and for care, custody, security and safeguarding, proper use and
maintenance, and responsibility for all incremental costs accrued to the Army. Before issue, the Army
clearly defines condition standards for return and how and where to find the agency or organization that
borrowed the item. In an emergency situation, Soldiers may provide items of equipment to their military
counterparts or a civilian organization. They should document the transfer either in writing, or in an
operations log at their TOC. One expedient means of documentation is to record it digitally on cell phone
cameras. Transfer of weapons, combat or tactical vehicles, water vessels, or aircraft requires the approval
of the Secretary of the Army.
Maintenance
8-79. Army commanders and staff cooperate with the lead civil authority. Commanders consider support
for their own equipment and support for civilian equipment such as buses, trucks, ambulances, and power
generation equipment. Federal military forces require a mission assignment in order to provide
maintenance assistance to civilian equipment. National Guard assets provide support through immediate
response or upon approval by their joint task force. Commanders consider providing maintenance support
to nearby civilian responders (such as nongovernmental organizations); this can be one of the most
effective means of building unity of effort while improving support. As soon as possible, however,
contractors should replace military maintenance support to civilian agencies.
Transportation
8-80. USARNORTH planners assist USNORTHCOM and USTRANSCOM to plan, schedule, and control
federal military movements into, within, and out of an area of operations. They support joint movement
control and coordinate support with civilian agencies in the joint operating area. When tasked by a mission
assignment, Army movement control personnel may augment and assist civilian authorities manage traffic
into and out of a declared disaster area. The preferred means of manning traffic control points is through
National Guard forces, in order to avoid any conflict with the Posse Comitatus Act. Regular Army
personnel may support in a staff capacity or in a liaison capacity with law enforcement and National Guard
elements. The joint task force-state and federal military joint task force may establish a joint movement
center to ensure efficient movement within declared disaster areas. Federal military and state National
Guard commanders coordinate manning requirements. Transportation units may serve as part of a joint
force headquarters or as part of a pure Army force transportation headquarters (see figure 8-5).
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Chapter 8
8-81. Transportation units may serve as part of a joint headquarters or a pure Army transportation
headquarters. Units serve as part of forces (except for small table of organization and equipment staff
elements), not as part of the headquarters. They may provide services in unity of effort with civilian
transportation assets. Wheeled military units can distribute large quantities of essential cargoes over terrain
normally impassable to most civilian trucking. Inland cargo transfer companies prepare cargo for
transshipment at distribution centers. Seaport operations companies operate water ports, load and offload
ships, or assist civilian port operators. Watercraft companies move units, supplies, and equipment along
intra-coastal and inland waterways.
Figure 8-5. Example of joint movement center organization
Geospatial Support
8-82. In civil support operations, map coverage is critical to responding military and civil agencies. When
possible, all controlling headquarters operate from the same geographic reference(s). In many cases, locally
produced large-scale
(1:10,000 or 1:5,000) maps are optimal. Many of the local residents and first
responders are familiar with such local products. Local planning agencies, realtor associations, travel
agencies, or utility company records may be able to provide such detailed map coverage. Army geospatial
engineer units, federal mapping agencies or local topographic or printing companies may be able to
reproduce or modify these products as required. If map coverage does not exist over the area of operations,
agencies can request image-based products, which can be produced in a relatively short period.
8-83. The United States Army Geospatial Center at Fort Belvoir provides direct geospatial support and
products to deployed forces conducting civil support operations. This includes products such as maps,
hydrological studies, and “flyover capabilities.” These products can support the unit’s incident awareness
and assessment before, during, and after deployment.
PERSONNEL SERVICES IN CIVIL SUPPORT OPERATIONS
8-84. During a civil support operation, personnel support to military forces should not be overlooked.
Personnel support activities encompass the elements of postal operations management; morale, welfare and
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20 August 2010
Sustainment—Logistics and Personnel Services
recreation (MWR); and band operations. For DSCA operations, personnel support operations not only
support the military, but can also assist civil authorities in restoring capabilities that may be degraded.
8-85. The ability of the Army to support the United States Postal Service is important. Army support may
be requested to augment postal operations until normal postal services are restored in the affected area.
8-86. The MWR network, in coordination with servicing base support installations, provides DOD
personnel with an opportunity to relax and unwind while deployed normally through opportunities for
sports and recreation. While human resources organizations are not the executors of MWR centers,
acknowledging this aspect of personnel support during DSCA operations is essential to provide military
and civilians alike with an outlet that improves morale.
8-87. Administrative control over personnel remains with the parent Service and providing headquarters
unless otherwise specified by the supported combatant commander. National Guardsmen remain under the
administrative control of their respective state. The Army Reserve Command continues to exercise
administrative control over mobilized Army Reserve Soldiers. Active Component Soldiers receive
administrative support through their home station. The supporting commander may attach a human
resources team with the deploying unit to assist with administrative actions and coordinate with home
station for additional support as required. Adequate personnel support to the deployed force must be a
planning consideration for commanders and human resources providers.
HUMAN RESOURCES CONSIDERATIONS FOR CIVIL SUPPORT OPERATIONS
8-88. Human resources support requirements for DSCA operations depend on the operational
environment. Some human resources support can be coordinated at home station, at the base support
installation, when deployed with the organization, or from multiple deployed locations. Human resources
planners must consider the numbers and type of organizations involved, task-organization of the force,
level of support needed, and the operational environment
(including the technological capabilities
available).
Personnel Accountability
8-89. Civil support operations may require additional planning and preparation by the personnel staff
officer. The biggest single challenge is maintaining accurate strength accountability. This is a challenge for
both National Guard and federal military forces. Commanders take several steps to maintain personnel
accountability. These include—
z
Establish and maintain a central control point through which all Soldiers report and depart from
the operational area. This is not easy to control, since there are numerous ways to arrive and
depart.
z
Ensure accountability procedures and reporting requirements are accurate and integrated with
not only with the higher headquarters, but also the rear detachment.
z
Manage units provided by other states under Emergency Management Assistance Compact
Agreements carefully, since these units normally have a 30-day employment window. (This
applies to National Guard joint task force commanders.)
z
If possible, maintain unit integrity at as high a level as feasible, and specify a support
relationships between dissimilar units. This allows the parent unit commanders to mange
missions and accountability more effectively.
z
Remain aware of Soldiers in within the command that may be affected personally by a disaster
response mission. These Soldiers may have family in the affected area.
z
Consider bringing in one or more human resources platoons or teams to support civil authorities
in accomplishing their mission, using civilian agency systems. These elements may include
postal platoons to assist the United States Postal Service or casualty liaison teams to assist in
casualty operations.
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8-19
Chapter 8
Mail Services and Connectivity
8-90. The entire chain of command should ensure that basic services continue, with particular attention to
mail and internet connectivity. The latter becomes increasingly important each year as more Soldiers
depend upon online services for banking and communications. The commander should contract for
connectivity
(such as wireless networks) sufficient for Soldiers to use their own devices, or leased
terminals to remain connected when off duty.
Time Off
8-91. During extended operations, commanders should develop rotational plans to allow Soldiers and
civilians to spend a short time back at home station to deal with personal and professional issues. In most
civil support operations, there will be numerous courier vehicles and flights, and a well-managed personnel
control system can ensure that Soldiers get to where they need to go and back again efficiently.
Policy for Alcohol Use
8-92. One of the key policies that the supported commander must establish concerns the use of alcohol.
Commanders and leaders need to understand and enforce the personal conduct rules on consumption of
alcohol.
Awards
8-93. Personnel officers should review the awards and decorations that the command may award for
service, achievement, and heroism during civil support operations. Careful personnel accountability will
help ensure that Soldiers receive service ribbons authorized for civil support missions. Personnel officers
provide information to subordinate commanders on the criteria for awards and decorations and assist in
their expeditious submission and approval.
Casualty Reporting
8-94. Even during DSCA operations, there may be a requirement for casualty reporting and operations.
For military and civilian members who are killed or injured while performing a DSCA mission, the nearest
military installation coordinates with the home station casualty area center for family notification and
transportation. DOD civilians are treated similar to military members while deployed in support of DSCA
operations
8-95. Casualty reporting procedures during a DSCA operation are just as important as if in a combat
environment. It must also be understood that domestic media access can potentially be greater than in
overseas operations, and any delays in reporting can undermine the family notification process.
FINANCIAL MANAGEMENT CONSIDERATIONS FOR CIVIL SUPPORT OPERATIONS
8-96. When developing command resource requirements, the appropriate staff section must determine if
there are any existing agreements, regulations, or policy guidance that the financial manager must support.
Based on this staff review, the financial managers ensure adherence to proper billing and reimbursement
procedures. Resource requirements include, but are not limited to, contracting, transportation, support to
other agencies and force sustainment. The financial manager determines the method to fund these
requirements and what appropriations, authorities, and fiscal laws apply during the mission.
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Sustainment—Logistics and Personnel Services
8-97. Accounting systems track costs
(by event, program, unit, military department, and Army
management structure code for each transaction) based on the accounting classification associated with
transactions. Financial managers use the accounting classification for two main purposes. First, it helps
track expenditures at a detailed level. Second, it helps prepare and present fiscal information to the
command and staff, including the status of funds, mission or event cost, status of unfunded requirements,
and obligations rates.
8-98. Reimbursable costs may occur because of providing support to other organizations, units, and
Services, or agencies. Financial managers normally seek reimbursable authority by contacting the
USARNORTH reimbursement cell or the USNORTHCOM financial management augmentation team. The
reimbursement cell and financial management augmentation team manage reimbursable budget authority
for DSCA events and document expenses associated with these events.
8-99. Deployed units depend on support provided to the logistical system and to contingency contracting
efforts. A large percentage of financial management wartime efforts support the procurement process and
oversight is critical in preventing improper or illegal payments. Financial managers coordinate with
contracting officers and the staff judge advocate regarding local business practices. Procurement support
includes two areas: contracting support and commercial vendor services support.
8-100. Civil support operations may require additional financial management support. Financial
management consists of two core functions, resource management and finance operations. Resource
management support is found in the support brigade budget section. Finance operations support is arranged
based on analysis of the mission variables (METT-TC). Additional resource management and finance
operations support should be included in planning requirements for the support brigade. Financial
managers will coordinate with contracting officers and the staff judge advocate regarding local business
practices. Financial management detachment operations may include support to procurement, pay,
disbursing, and accounting.
8-101. Financial management detachment operations may include procurement and disbursing support.
Deployed units depend on support provided to the logistical system and to contingency contracting efforts.
A large percentage of financial management wartime efforts support the procurement process and oversight
is critical in preventing improper or illegal payments. Financial managers coordinate with contracting
officers and the staff judge advocate regarding local business practices. Procurement support includes two
areas: contracting support and commercial vendor services support.
8-102. Not every civil support mission requires a large operation. Often the support provided may consist
of a small element such as a dive team (such as the Navy element that responded to the Minneapolis bridge
collapse) or a pair of helicopters. Temporary duty status remains an effective means of deploying and
sustaining Soldiers performing limited missions. Depending on the situation, the supported agency may
contract the necessary support, the defense coordinating officer may provide for their support, or the
Soldiers may make arrangements following normal travel procedures.
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Chapter 8
RELIGIOUS SUPPORT CONSIDERATIONS FOR CIVIL SUPPORT OPERATIONS
8-103. The unit ministry team deploys during civil support operations for the primary purpose of
providing religious support to authorized DOD personnel. In this context, authorized DOD personnel is
defined as military members, their families and other authorized DOD civilians (both assigned and
contracted) as determined by the joint forces command. Laws implementing the Establishment Clause of
the Constitution of the United States generally prohibit chaplains from providing religious services to the
civilian population. However, following certain rare and catastrophic large-scale disasters, local and state
capabilities of all types, including spiritual care, may be overwhelmed. In these situations unit ministry
teams may serve as liaison to nongovernmental organizations (including faith-based organizations) when
directed by the joint forces command. In addition, the primary supported agency, in coordination with local
and state authorities, may determine that additional caregivers are needed and may request federal military
chaplains to provide care, counseling, or informational services to persons not affiliated with DOD.
Commitment requires meeting four criteria:
z
Such support is incidental, there is generally no significant cost, and support does not
significantly detract from the primary role of the unit ministry team as defined above.
z
Such support is during a Presidential emergency or disaster declaration.
z
There is an acute need for immediate ministry recognized by appropriate civilian authorities and
directed by a federal military commander.
z
There is a government-imposed burden of some sort, such as quarantine on a federal facility, or
there is no reasonable civilian alternative to meet the needs of persons not affiliated with DOD
who are affected by the emergency.
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20 August 2010
Chapter 9
Sustainment—Health Service Support
This chapter provides information on health service support during civil support
operations. It discusses coordination of military and civilian medical capabilities,
health service support considerations, and medical logistics. This discussion builds
on the doctrine presented in chapters 2, 3, and 8.
MEDICAL CAPABIILITY COORDINATION FOR CIVIL SUPPORT
OPERATIONS
9-1. Army health service support includes all medical services performed, provided, or arranged by the
Army Medical Department to meet health service support and force health protection requirements for the
Army and, as directed, for civilian agencies during civil support operations. Commanders review
considerations for transition to civilian medical organizations throughout operations. Department of
Defense (DOD) provides medical support for declared emergencies and major disasters under the guidance
of the National Response Framework’s emergency support function annex (ESF) #8, led by Department of
Health and Human Services (see chapter 2). The coordinated effort includes Department of Health and
Human Services, Federal Emergency Management Agency, DOD, Department of Veterans Affairs, state
and local governments, and the private sector. Generally, the primary coordination of local, state, and
federal medical assets occurs in a joint field office (discussed in chapter 2). Interagency coordination helps
determine the Army health service support capabilities required in response to an incident. A defense
coordinating officer, working in a joint field office, coordinates civil authorities’ requests for federal
military medical capabilities, including Army. Primary authorities within a joint field office can include
state and federal ESF #8 representatives, state National Guard surgeon(s), a joint regional medical plans
and operations officer, and the supported combatant command surgeons.
9-2. ESF #8 of the National Response Framework discusses multiagency public health and medical
support to state, tribal, and local governments. The National Response Framework continues to evolve; the
most up-to-date information is available online at http://www.fema.gov. The functional support areas
covered by ESF #8 are—
z
Assessment of public health and medical needs.
z
Health surveillance.
z
Medical care personnel.
z
Health, medical, and veterinary equipment and supplies.
z
Patient evacuation.
z
Patient care.
z
Safety and security of drugs, biologics, and medical devices.
z
Blood and blood products.
z
Food safety and security.
z
Agriculture safety and security.
z
All-hazard public health and medical consultation, technical assistance, and support.
z
Behavioral health care.
z
Public health and medical information.
z
Vector control.
z
Potable water and wastewater and solid waste disposal.
20 August 2010
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9-1
Chapter 9
z
Mass fatality management, victim identification, and decontaminating remains.
z
Veterinary medical support.
9-3. Medical response efforts begin at the local level and increase based on requests from local and state
authorities. A broad response may include federal military assets. Per ESF
#8, DOD performs the
following support functions:
z
Alerts DOD National Disaster Medical System federal coordinating centers (Army, Navy, and
Air Force) and provides specific reporting and regulating instructions to support incident relief
efforts.
z
Alerts DOD National Disaster Medical System federal coordinating centers to activate National
Disaster Medical System patient reception plans in a phased, regional approach, and when
appropriate, in a national approach.
z
At the request of the Department of Health and Human Services, provides support for the
evacuation of patients and medical needs populations to locations where hospital care or
outpatient services are available.
z
Using available DOD transportation resources, in coordination with the National Disaster
Medical System Medical Interagency Coordination Group, evacuates and manages victims and
patients from the regional evacuation point in the vicinity of the incident site to National
Disaster Medical System patient reception areas.
z
Provides available logistical support to public health and medical response operations.
z
Provides available medical personnel for casualty clearing and staging and other missions as
needed, including aeromedical evacuation and medical treatment. Mobilizes and deploys
available Reserve and National Guard medical units, when authorized and necessary to provide
support.
z
Coordinates patient reception, tracking, and management to nearby National Disaster Medical
System hospitals, Veterans Administration hospitals, and DOD military treatment facilities that
are available and can provide appropriate care.
z
Provides available military medical personnel to assist ESF #8 in the protection of public health
(such as food, water, wastewater, solid waste disposal, vectors, hygiene, and other
environmental conditions).
z
Provides available military veterinary personnel to assist ESF #8 personnel in the evacuation,
triage, medical treatment and temporary sheltering of pets, companion animals and livestock.
z
Provides available DOD medical supplies for distribution to mass care centers and medical care
locations being operated for incident victims with reimbursement to DOD.
z
Provides available emergency medical support to assist state, tribal, or local officials within the
disaster area and the surrounding vicinity. Such services may include triage, medical treatment,
behavioral health support, and the use of surviving DOD medical facilities within or near the
incident area.
z
Provides assistance, as available, in managing human remains, including victim identification
and mortuary affairs and temporary internment of the dead.
z
Provides evaluation and risk management support through use of defense coordinating officers,
emergency preparedness liaison officers, and joint regional medical planners.
z
Provides available blood products in coordination with the Department of Health and Human
Services.
z
Provides medical surveillance and laboratory diagnostic and confirmatory testing in
coordination with the Department of Health and Human Services.
(This list omits the United States Army Corps of Engineers.)
9-4. Most states have a statutory provision that addresses the recognition of medical licenses issued by
another state or the waiver of the states’ licensure requirements for military health care providers who enter
the state to provide medical treatment to civilians during an emergency or disaster. Military health care
providers will be covered by the Federal Tort Claims Act and the Medical Malpractice Immunity Act (see
9-2
FM 3-28
20 August 2010
Sustainment—Health Service Support
chapter 7 for a discussion of legal considerations). The Emergency Management Assistance Compact
agreements include license requirements for medical professionals from other states.
9-5. Initial federal-level incident response actions begin with assessment of public health and medical
needs and health surveillance requirements. Department of Health and Human Services deploys teams and
assets based on requests and the situation.
NATIONAL DISASTER MEDICAL SYSTEM
9-6. The Department of Health and Human Services’ Office of Preparedness and Response activates the
National Disaster Medical System when requested by local and state authorities. This system integrates
federal medical support into a unified medical response to augment state and local capabilities. The system
activates in preparation for or in response to a declared major disaster or emergency, for a specific period.
Requests for federal military support are processed as requests for assistance. Normally, requests for
assistance are developed into approved mission assignments.
9-7. The National Disaster Medical System has three major components:
z
Deployable medical response to a disaster area in the form of individuals and teams, supplies,
and equipment.
z
Patient movement from a disaster site to unaffected areas of the nation.
z
Definitive medical care at participating hospitals in unaffected areas.
In contrast to the Army health system, the National Response Framework and the National
Disaster Medical System classify mortuary services under public health and medical care (see
paragraphs 8-67 to 8-72).
Deployable Medical Response
9-8. The deployable medical response capability for domestic incidents includes civilian response teams
and equipment organized for rapid deployment. Team members are non-federal volunteers who may be
federalized as part-time employees when activated. They are principally a community resource available to
support local, regional, or state requirements. DOD medical teams may support these teams in emergency
situations.
Patient Movement
9-9. To move patients out of a disaster area, local authorities initially set up casualty collection points.
Initially transportation support may include commercial aviation companies, private organizations, and
individual citizens. If local medical services are inadequate, local authorities request state assistance. A
state may operate regional evacuation points. When local authorities request state assistance, support may
include the National Guard ground and aviation assets. If state and local authorities are unable to establish
casualty collection points or regional evacuation points, they may request federal authorities to rapidly
deploy teams, such as U.S. Public Health Service Commissioned Corps teams, to assist. If resources still
are inadequate, local and state authorities can request additional federal medical evacuation assistance.
9-10. When necessary, the Department of Health and Human Services requests federal military support
through ESF #8 for evacuating seriously ill or injured patients. Federal military support may include
providing transportation assets, operating and staffing National Disaster Medical System federal
coordinating centers, and processing and tracking patient movements from regional evacuation points to
reception facilities. DOD takes the lead for federally managed evacuation efforts.
9-11. The United States Transportation Command
(USTRANSCOM) Global Patient Movement
Requirements Center may deploy a joint patient movement team. A joint patient movement team regulates
and tracks all patients, including civilians, transported on DOD assets to reception facilities. The team
regulates and tracks patients using the USTRANSCOM regulating and command and control evacuation
system.
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9-3
Chapter 9
9-12. USTRANSCOM coordinates DOD transportation assets. Most seriously ill patients are evacuated by
air. USTRANSCOM establishes aeromedical evacuation centers. Depending on the nature and scope of the
disaster, transportation may be by air, surface, or sea:
z
Air Mobility Command.
z
Military Surface Deployment and Distribution Command.
z
Military Sealift Command.
9-13. Civilian medical teams meet patients at the reception facilities. These teams determine which patients
will go to which National Disaster Medical System hospitals. Procedures are based on local agreements
and advance coordination among National Disaster Medical System federal coordinating centers and
hospitals. Transportation directly to the hospitals is by local ground and air transport.
Definitive Medical Care
9-14. The National Disaster Medical System provides a nationwide network of nonfederal acute care
hospitals. These hospitals provide definitive care for disaster victims when the need exceeds the
capabilities of the affected local, state, or federal medical systems.
9-15. Sixty-two federal coordinating centers coordinate with a network of approximately 1,800 nonfederal
National Disaster Medical System member hospitals and eighty-two patient reception areas to provide an
80,000-bed capability for definitive acute medical care.
9-16. Within this system, the federal coordinating center roles include—
z
Soliciting participation in the National Disaster Medical System by nonfederal area hospitals.
z
Assisting in coordination of area disaster plans with hospital representatives.
z
Arranging annual National Disaster Medical System exercises, and developing procedures for
participants to report on bed availability.
z
Triaging.
z
Transporting and tracking of incoming patients to area hospitals.
UNITED STATES ARMY MEDICAL COMMAND SPECIALIZED INCIDENT RESPONSE
CAPABILITIES
9-17. United States Army Medical Command (USAMEDCOM) has the capability to task-organize its table
of distribution and allowances assets and deploy them in support of Army Medical Department missions.
These capabilities are not intended to supplant table of organization and equipment units but can be used to
support domestic disasters, chemical, biological, radiological, nuclear, or high-yield explosives incidents,
and other designated support. The table of distribution and allowances assets of the USAMEDCOM and its
subordinate commands is used to provide the capabilities needed. USAMEDCOM capabilities include—
z
Health facilities planning.
z
Investigational new drug capability.
z
Radiological advisory medical capability.
z
Theater lead agent for medical materiel (TLAMM) support.
z
Medical command, control, communications, and telemedicine capability.
z
Behavioral health and religious support capability.
z
Public health support.
z
Burn capability.
9-18. Health facilities planning provides a rapid deployable capability to address, assess, and assist in the
comprehensive evaluation of health facility support systems and medical facility issues.
9-19. Investigational new drug capability provides guidance in the administration of investigational new
drugs and vaccines as biological threat countermeasures in mass casualty incidents (such as anthrax,
botulinum, and smallpox).
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Sustainment—Health Service Support
9-20. Radiological advisory medical capability provides direct comprehensive radiological health and
medical guidance and specialized services to the combatant commander, on-scene commander and local
medical officials responding to a radiological nuclear event.
9-21. TLAMM support provides rapidly deployable medical logisticians to base support installations in
support of the United States Northern Command (USNORTHCOM) joint task force-medical, DOD
installations, and various civil support requirements. The TLAMM capability coordinates linkage of
medical supply chain support from the base support installation to class VIII supply sources.
9-22. Medical command, control, communications, and telemedicine capability provides an intuitive,
compact, and deployable medical command, control, communication and telemedicine information
technology package as augmentation for incident response.
9-23. Behavioral health and religious support capability provides behavioral health care and religious
support to local, state, federal, and other government authorities in response to man-made and
environmental disasters. These capabilities augment behavioral health and religious support to local
medical authorities. They support trauma ministry, mass casualty ministry, and spiritual assessment.
9-24. Public health support is a multifunctional capability that combines preventive medicine, veterinary
services, and smallpox epidemiological response. This capability is still being refined but will be able to
provide initial disease and occupational and environmental health threat assessments, conduct or assist in
the field investigations of disease or injury outbreaks or clusters, and assess environmental destruction or
risk related to animal health and food safety.
9-25. Burn capability provides expert worldwide aeromedical evacuation for any critical illness or injury,
with particular expertise in the stabilization and management of trauma and burn patients.
HEALTH SERVICE SUPPORT CONSIDERATIONS FOR CIVIL
SUPPORT OPERATIONS
9-26. This section briefly discusses special considerations for health service support during civil support
operations. This discussion is not exhaustive. The overarching consideration is that disaster response
operations are multiagency operations in support of civil authorities. Army health system units support and
cooperate with various nonmilitary organizations, consistent with ESF #8 and under appropriate local,
state, and federal laws. Army health system units support and cooperate with various nonmilitary
organizations, consistent with ESF #8 and under appropriate local, state, and federal laws. Continuous
coordination helps avoid duplication of effort. In each situation, the nature and scope of the response
depends on the requirements of the incident. Refer to Field Manual (FM) 8-42 for additional information.
9-27. Public health authorities conduct surveillance and rapid needs assessment immediately after an
incident. Army health system personnel review all relevant intelligence products from the Armed Forces
Medical Intelligence Center, Centers for Disease Control and Prevention, U.S. Army Center for Health
Promotion and Preventive Medicine, and other public health entities before deployment and employment.
Army health system personnel should deploy as part of the military advance party detachments. Medical
units acquire information as rapidly as possible for developing medical courses of action.
9-28. Commanders ensure that medical personnel conduct pre and post-deployment assessments for all
Soldiers according to DOD and Service policies. On-scene, following the emergency treatment or
evacuation of civilian patients, Army health system units emphasize preventive medicine and force health
protection.
COMMAND RELATIONSHIPS
9-29. Based on the size of the disaster and capability of local and state assets, federal medical personnel
may be under the command of a defense coordinating officer, a task force commander, or a joint task force
commander. The normal command relationship will be operational control. Army medical forces that
deploy under immediate response authority remain under the command parent unit or installation until the
defense coordinating officer or joint task force assumes operational control of forces. Under a joint task
20 August 2010
FM 3-28
9-5
Chapter 9
force, medical forces may be aligned functionally, geographically or by Service (such as a joint force land
component command or a joint force air component command) depending on the joint task force
commander’s concept of support and intent. Likely tasks remain the same as those listed in this chapter.
Task force-medical, for example, is a component of the federal military chemical, biological, radiological,
nuclear, and high-yield explosives consequence management response forces. Task force-medical and its
subordinate units are organized to accomplish assigned medical tasks for disasters.
Medical Surveillance
9-30. Medical surveillance and sharing of health-related intelligence help guide decisions for incident
response operations. Medical personnel gather data and monitor health threat indicators throughout
operations. Integrated medical surveillance tasks include—
z
Describing and monitoring medical, public health, and psycho-social effects.
z
Identifying changes in agents and host factors.
z
Detecting changes in health practices.
z
Detecting illness or injuries, including sudden changes in disease occurrence.
z
Detecting, investigating, and analyzing collected data to identify necessary interventions.
z
Monitoring long-term disease trends.
z
Providing evidence for establishment of response protocols.
z
Providing information about probable adverse health effects for decisionmaking.
z
Investigating rumors.
z
Determining needs and match resources in affected communities.
9-31. Medical personnel identify potential health hazards and develop and implement countermeasures.
They provide education and training to personnel on potential health threat exposures. They perform
environmental and personal monitoring and sampling to document exposure. They monitor the health of
the force, gauge the pre-deployment health status of units, and identify preexisting (baseline) health
characteristics of assigned Service members. They ensure sampling data, reports, and assessments are
evaluated, reported, and archived. They ensure that occupational and environmental hazard exposure
incident data and reports are submitted to the Defense Occupational and Environmental Health Readiness
System (DOEHRS) portal. Refer to DODI 6490.03 for more information.
9-32. Additionally, veterinary personnel develop a vigorous veterinary surveillance program that includes
food, water and ice inspections, suspected animal-to-human disease outbreak investigations, animals
treated, and any other veterinary-related events. They archive veterinarian-related sampling data for
analysis.
MEDICAL RISK ASSESSMENT
9-33. A Medical health risk assessment is developed as part of the preventive medicine estimate. Army
units coordinate risk assessments with civil authorities. The intent is to identify any health threat and its
potential impact on the mission. The assessment includes analysis of weather, altitude, terrain, endemic
diseases, local food and water sources, zoonotic diseases (disease transmitted from animals to humans),
parasites, hazardous plants and animals, and potential exposure to hazardous and toxic materials. Refer to
FM 4-02.17 for Army doctrine on preventative medical services. See also Army Regulation (AR) 11-35.
9-6
FM 3-28
20 August 2010
Sustainment—Health Service Support
9-34. The completed medical risk assessment is used to—
z
Determine immunization and chemoprophylaxis requirements.
z
Determine personal protective equipment requirements.
z
Conduct health threat briefings on the health hazards.
z
Provide individual training to all deploying personnel on health and specific protective
measures.
z
Educate medical support personnel on recognition, prevention, and treatment of potential
diseases, injuries, exposures.
The primary disaster related health threats include—
z
Contaminated food.
z
Contaminated water.
z
Environmental conditions (heat and cold).
z
Environmental contamination (air, water, soil).
z
Inadequate living or sleeping conditions (crowding and ventilation, for example).
z
Disease vectors.
z
Accidents.
z
Stress.
ASSISTING CIVIL AUTHORITIES WITH INSPECTIONS OF WATER, FOOD, AND WASTE
9-35. Army health system units assist civil authorities with water, food and waste disposal inspections as
requested. This includes monitoring approved sources of food, water, and ice products as well as
production, distribution and storage systems. Waste disposal site inspections include solid, medical and
hazardous waste streams and will comply with state and federal standards. Public health hazards caused by
inadequate or contaminated services may pose a greater threat than the initial incident. Medical units, when
requested, support civil authorities with sanitation inspections of potable water sites, systems, and
containers. Inspections or surveys are conducted using civilian forms in accordance with local, state and
federal guidelines.
9-36. Under most conditions, threats posed by contaminated water and food are interrelated. Medical
personnel may support civil authorities with food service sanitation inspections, food service sanitation
training, and illness outbreak investigations. Inspections are performed according to local, state, and
federal standards.
9-37. Medical personnel may help civil authorities to conduct sanitation inspections of waste handling
operations to determine health threats. Medical personnel may also assist with training on countermeasures
and use of personal protective equipment, sanitation inspections, or environmental surveillance of affected
areas.
BEHAVIORAL HEALTH
9-38. Disasters produce strong and unpleasant emotional and physical responses in victims and rescuers.
Common symptoms are—
z
Confusion.
z
Fear.
z
Anxiety.
z
Hopelessness.
z
Helplessness.
z
Sleeplessness.
z
Anger.
z
Grief.
z
Guilt.
20 August 2010
FM 3-28
9-7
Chapter 9
z
Shock
z
Aggressiveness.
z
Mistrustfulness.
z
Loss of confidence.
z
Physical pain.
z
Over-dedication to mission.
9-39. Behavioral health personnel play a vital role in any DOD force performing civil support operations.
Behavioral health personnel apply psychological first aid when required and advise leaders on preventive
measures. Examples of preventive measures for behavioral health during disaster response operations
are—
z
Providing basic needs for food, shelter, and health care.
z
Listening to peoples’ stories.
z
Keeping families together.
z
Providing frequent, clear, updated information to victims.
z
Helping maintain connection with friends and family.
z
Providing responders with regular communication with family members back home.
z
Maintaining awareness of the stress levels of others.
z
Providing responders with a rest area for sleep, hygiene, and food that is separate from the
public and media.
z
Insisting on proper sleep, nutrition, and exercise among responders.
z
Not forcing people to share stories.
z
Not giving simple, generalized reassurances (such as “everything will be ok”).
z
Not telling people how they may feel, or “why” things happened to them.
z
Not making promises one cannot keep.
z
Not criticizing current relief efforts in front of those needing help.
9-40. Handling of human remains is particularly stressful. Examples of behavioral health preventive
measures used during handling of human remains are—
z
Providing basic needs for food, shelter, and health care.
z
Listening to peoples’ stories.
z
Keeping families together.
z
Providing frequent, clear, updated information to victims.
z
Helping maintain connection with friends and family.
z
Providing responders with regular communication with family members back home.
z
Maintaining awareness of the stress levels of others.
z
Providing responders with a rest area for sleep, hygiene, and food that is separate from the
public and media.
z
Insisting on proper sleep, nutrition, and exercise among responders.
z
Not forcing people to share stories.
z
Avoiding simple, generalized reassurances (such as “everything will be ok”).
z
Not telling people how they may feel, or “why” things happened to them.
z
Not making promises one cannot keep.
z
Not criticizing current relief efforts in front of those needing help.
9-8
FM 3-28
20 August 2010
Sustainment—Health Service Support
9-41. Additional stress management personnel may be required to meet health requirements. Combat and
operational stress control and behavioral health teams educate Soldiers about recognition and treatment of
stress prior to operations. During deployment, they conduct investigations of suspected stress outbreaks.
They use results of the investigations to identify corrective measures. Stress management personnel inform
commanders of the impact stress may have on operations and of any irregularities in stress statistics or
trends. They conduct briefings to newcomers arriving in the area of operations about stress threats and
countermeasures. They brief personnel exiting the area of operations on possible stress-related conditions
that may manifest and procedures for follow-up.
VETERINARY SUPPORT
9-42. Pets and livestock require veterinary care during incident response operations. Veterinary issues
should be anticipated and planned for. Preventive measures help reduce the spread of disease and minimize
injuries. Veterinary concerns affecting public health include—
z
Spoilage of human food and water supply (through contamination by animals).
z
Animal bites.
z
Outbreaks of diseases transmitted between animals and humans.
z
Impact on public behavioral health due to the emotions owners feel for their animals. (This is
more evident in seniors and children.)
z
Overall health of pets, companion animals, and livestock.
Military Working Dogs
9-43. Veterinarians care for working animals during operations (military and interagency). They ensure
follow-up care upon redeployment. Based on risk assessments and potential exposures to medical threats
additional immunization and chemoprophylaxis may be required for working animals prior to or during
deployment. Veterinarians also ensure follow-up care and health surveillance upon redeployment.
Additional immunization and chemoprophylaxis may be required for military working dogs prior to
deployment.
Animal Remains
9-44. To avoid potential spread of disease, animal remains should be disposed of properly and as
expeditiously as possible. Army units may be tasked to assist civil authorities with carcass disposal
operations. Carcass disposal methods and locations are determined by local and state authorities.
Considerations related to animal carcass disposal are similar to those listed in paragraph. 9-42. Waivers
may be required.
MEDICAL LOGISTICS FOR CIVIL SUPPORT OPERATIONS
9-45. During civil support operations, USAMEDCOM continues medical logistics support to Army
installations through its medical treatment facilities and clinics and serves as the TLAMM for
USNORTHCOM. As the TLAMM, USAMEDCOM coordinates directly with USNORTHCOM, Defense
Logistics Agency (as the DOD executive agent for medical materiel), and the single integrated medical
logistics manager to ensure the appropriate level of medical logistics support. Medical logistics support is
normally a Service responsibility. However, in joint operations, the USNORTHCOM commander
designates one of the Service components to serve as the single integrated medical logistics manager
responsible for providing centralized medical logistics support to USNORTHCOM joint task forces and
other government agencies.
20 August 2010
FM 3-28
9-9
Chapter 9
9-46. USAMEDCOM uses existing Army medical logistics automated systems, infrastructure (including
installation medical supply activities at Army medical treatment facilities in the continental United States),
Defense Logistics Agency contracts, and support relationships with regional DOD logistics organizations
and supply support activities to execute the TLAMM mission. As the TLAMM, USAMEDCOM’s medical
logistics capability is ready to deploy for civil support operations. Support includes providing class VIII
supply chain and medical logistics support to deployed medical joint task forces. When directed,
USAMEDCOM medical logistics enablers can assist a joint task force in coordinating for the receipt and
distribution of resources from the Centers for Disease Control and Prevention’s Strategic National
Stockpile. The Strategic National Stockpile is a national repository of antibiotics, chemical antidotes,
antitoxins, life-support medications, IV administration, airway maintenance supplies, and medical and
surgical items. The Strategic National Stockpile is designed to re-supply state and local public health
agencies in a biological or chemical incident.
9-47. Federal military class VIII requisitions flow from the supported units, through the TLAMM master
ordering facilities, to the prime vendor contracted to provide the requested item. The designated prime
vendor delivers the requested item to the supporting medical logistics company. Joint task force-medical
units are expected to deploy with their full unit basic load of class VIII supplies. Service components are
responsible to resupply its forces for the first ten days of the operation or until the TLAMM and joint task
force-medical logistics unit are operational. Once the medical logistics units are operational, supported
units will establish accounts with the deployed medical logistics company for class VIII resupply support.
Requisitions are forwarded using existing automated systems. The primary DOD requisitioning system is
the Defense Medical Logistics Standard Support System’s Customer Assistance Module. The TLAMM
conducts post-operational financial reconciliation with other Service components and USNORTHCOM for
reimbursement.
BLOOD AVAILABILITY
9-48. Department of Health and Human Services monitors blood availability nationally. It maintains
contact with the American Red Cross, American Association of Blood Banks Inter-organizational Task
Force on Domestic Disasters and Acts of Terrorism, and the Armed Services Blood Program Office. The
Department of Health and Human Services determines—
z
The need for blood, blood products, and supplies used in their manufacture, testing, and storage.
z
The ability of existing supply chain resources to meet needs.
z
Emergency measures needed to augment or replenish existing supplies.
9-49. Department of Health and Human Services sends a request for assistance through military channels
when blood product requirements exceed capacity. The USNORTHCOM Joint Blood Program Office, in
coordination with the Armed Services Blood Program Office, manages blood products within DOD.
9-50. The Armed Services Blood Program has blood distribution and storage assets in the continental
United States. The Armed Services Whole Blood Processing Laboratories are the major blood product
distribution hubs. Deployable blood distribution assets include Blood Support Detachment and Blood
Transshipment Systems. In addition, medical treatment facilities on DOD installations can be used for
limited expanded blood product storage.
9-51. When Department of Health and Human Services requests blood distribution assets, the
USNORTHCOM joint blood program office coordinates with United States Army North (USARNORTH),
joint task force-medical and Joint Forces Command to accommodate blood distribution and storage.
9-10
FM 3-28
20 August 2010
Sustainment—Health Service Support
SPECIAL NEEDS POPULATIONS
9-52. The National Response Framework defines a special needs population as a group with special
functional needs before, during, and after an incident. Special functional needs include maintaining
independence, communication, transportation, supervision, and medical care. For example, individuals in
need of additional assistance may have disabilities, live in institutionalized settings, be very young or very
old, or have limited English proficiency. Army medical and nonmedical personnel may support response
efforts for special needs populations.
MANAGEMENT OF MASS CASUALTY EVENTS
9-53. The military may be tasked to support civilian medical capabilities as needed in the handling of mass
casualties. DOD coordinates closely with Department of Health and Human Services and other public
health providers in the joint operations area. Army medical planning staffs cooperate closely with
responding organizations under the guidelines of the National Incident Management System and the
National Response Framework. The military augments civilian medical capabilities as needed in the
handling of mass casualties resulting from chemical, biological, radiological, nuclear, and high-yield
explosives attacks) or other toxic material contamination. For pertinent Army doctrine, refer to
FMs 4-02.283, 4-02.285, 4-02.7, and 8-284. Also see the Field Management of Chemical Casualties
Handbook, Third Edition, for additional information.
9-54. In a mass casualty situation, triage establishes who receives treatment first by placing casualties into
four categories. Terminology and priorities for these categories differ in military and civilian environments,
but the basic concepts are similar. See FM 3-28.1, table VII-2 and table VII-3 for more information about
triage in civil support operations. The Army’s senior medical commander coordinates treatment priorities
with the lead civil medical authority.
20 August 2010
FM 3-28
9-11
Appendix A
Planning Checklists
This appendix contains a variety of checklists designed to help unit commanders and
staffs with their military decisionmaking process during a civil support operation.
The appendix provides general checklists for situational assessment (overall, joint
task force, organizational, and local agency) and individual staff section checklists.
These checklists are not prescriptive.
INITIAL SITUATIONAL AWARENESS AND ASSESSMENT
A-1. Table A-1, pages A-1 to A-2, lists items to consider for initial situational awareness and assessment.
This list is not all inclusive; items need not be considered in the sequence shown.
Table A-1. Initial planning checklist for situational awareness and assessment
Number
Brief description of items to consider for initial situational awareness and assessment
1.
Damage assessment estimates from incident commanders and situational assessment teams
2.
Homes, especially those with light construction, such as mobile homes
3.
Status of roads, rail lines, airports, airfields, communications nodes and seaports.
4.
Other factors associated with the local community and the nature of the disaster (Refer to appendix B for
more information on safety considerations.)
5.
Status of first responders and their assets (such as vehicles, communications, and fuel)
6.
Debris removal and clearing lines of communication
7.
Environmental hazards, natural or manmade
8.
Fires, toxic chemical spills (toxic and nontoxic), ruptured pipelines, downed power lines
9.
Weather or geographic hazards
10.
New and emerging threats (such as civil disorder, or another natural disaster)
11.
Further evacuations needed or taking place
12.
Sustainment
13.
Medical capacity
14.
Communication status
15.
Aviation facilities
16.
Search and rescue efforts underway
17.
Water purification, ice, and means of delivery
18.
Availability of basic personal hygiene and cleaning materials
19.
Sanitation capabilities
20.
Security
21.
Available shelter
22.
Availability of food and means of distribution
23.
Electrical power and electrical grid
24.
Availability of gasoline and diesel fuel
25.
Availability of JP-8
26.
Command and control
27.
Incident command structure in place
20 August 2010
FM-3-28
A-1
Appendix A
Table A-1. Initial planning checklist for situational awareness and assessment, continued
Number
Brief description of items to consider for initial situational awareness and assessment
28.
Liaison and planning staff for headquarters
29.
Counselors for citizens affected by the disaster
30.
Communications
31.
Chains of command and positions of authority
32.
Types of communication and information management systems in use by first responders and other
responding organizations
33.
Communication assets required for Soldiers to communicate with the joint task force HQ and other
responding groups
34.
Identifying alternatives when communication systems are not operating or not compatible
35.
Identification of responding organizations not yet integrated with the overall effort; facilitating cooperation
with these groups (including volunteer groups)
36.
Maps, global positioning system (GPS), and other topographic resources to navigate to specific locations
when roads and landmarks are destroyed. Map products used by local organizations and first responders.
Identifying a map system useable by most organizations
37.
Electronic and hard copy products used to portray the common operational picture across boundaries or
jurisdictions and all organizations
38.
Location for the Army headquarters and where to place supporting staff and liaisons
39.
Existing staff and liaisons needing augmentation
40.
Public affairs assets required to acquire and relay accurate, useable information to the public
41.
Synchronization of public affairs operations with the lead civil authority and local news media
42.
Resource requirements
43.
Document actions to assure prompt acquisition of resources and timely reimbursements (Refer to chapter
6 for information required for reimbursement.)
44.
Resources available now and later in the operation
45.
Contracting management and support
46.
How to synchronize civil and military resource prioritization
47.
Communication assets required to obtain resources during the operation
48.
Transportation assets available to move resources and transport personnel
49.
Accounting systems to activate for military reimbursement
50.
Procedures to track expenditures within funding systems
51.
Legal
52.
Initial plans and orders review by staff judge advocate
53.
Review standing rules of the use of force
54.
Permissible actions according to military status of Soldiers (federal Title 10 Active Duty, National Guard
Title 32, and state active duty)
55.
Pertinent local, state, and federal laws
56.
Coordination and planning with other responding groups
57.
Obtain a copy of the most up-to-date disaster plan from the lead civil authority with the applicable
emergency
58.
Obtain a copy of the applicable joint force land component command contingency plan
59.
Extract how the plan covers the tasks and responsibilities of all organizations based on METT-TC
60.
Determine where Army support is required
61.
Review the makeup and focus of the other organizations
62.
Designate staff responsibility to collect lessons learned
A-2
FM 3-28
20 August 2010
Planning Checklists
JOINT TASK FORCE CHECKLIST
A-2. Table A-2 provides a list of initial tasks for a joint task force. This list is not all inclusive; items need
not be considered in the sequence shown.
Table A-2. Initial planning checklist for a joint task force
Number
Brief description of initial tasks for consideration for a joint task force
1.
Coordinate with military (Air National Guard, Army National Guard, Coast Guard, Air Force, Navy, Marine
Corps), local, state, federal agencies and organizations and nongovernmental organizations and
volunteers. The bottom line is command control systems coordinate with virtually any agency, organization
or individual that can help support the mission to reduce loss of life, limb and property. Determine the most
feasible solutions for effective communication.
2.
Ensure that initial communications capabilities are self-sufficient and interoperable with both first
responders and local authorities. This usually means commercial internet and telephone capability.
3.
Bring all communications equipment, to include computers, cables, routers, switches, and power supply.
Procure and plan for the use of additional communication devices: telephone (satellite, cellular or land
line), radio (military maritime, and civilian, in all bandwidths), Non-Secure Internet Protocol Router
Network, SECRET Internet Protocol Router Network, video equipment, video teleconferencing, and
satellite-based commercial Internet systems. The goal is to communicate effectively and reduce
restrictions to effective communication.
4.
Ensure all equipment has operators, essential repair parts, operating and repair manuals, tools, initial fuel
and power generation required.
5.
Send qualified signal leaders to ensure operators and equipment are used effectively.
6.
Prepare to provide a limited amount of critical communications equipment (cell phones, radios, base sets,
etc.) to first responders.
7.
Plan and coordinate for additional, extended logistical and maintenance support for equipment and
personnel as well as unexpected requirements including generator support; maintenance of equipment;
fuel requirements of vehicles, systems, and generators; and support for others' equipment (such as
charging cell phones from your power source, charging satellite phones, identify internal and external
electronic repair capabilities).
8.
Ensure that communications structures are expandable and flexible to meet future needs. Remember that
military units and civilian agencies may require extended communications support.
9.
Conduct a synchronization meeting between all primary entities that have impact as soon as possible.
ORGANIZATIONAL AND UNIT CHECKLIST
A-3. Table A-3 lists initial tasks for Army units. This list is not all inclusive; items need not be considered
in the sequence shown.
Table A-3. Initial planning checklist for Army units
Number
Brief description of initial tasks for consideration for Army units
1.
Bring all communications equipment, to include computers, cables, routers, switches, and power. Ensure
all equipment has operators, essential repair parts, operating and repair manuals, tools, initial fuel and
power generation required.
2.
Send qualified signal leaders to integrate signal systems and to ensure operators and equipment are used
effectively.
3.
Plan and coordinate for additional, extended logistical and maintenance support for equipment and
personnel.
4.
Ensure that communications structures are expandable and flexible to meet future needs.
5.
Establish reach-back capability.
20 August 2010
FM 3-28
A-3
Appendix A
LOCAL AGENCIES
A-4. A complete or precise list of potential responding groups is not practical. Initial disaster response
efforts tend to be chaotic, and responders in various regions or types of disasters are different. At the
beginning, no one knows exactly who is responding. Therefore, these lists provide a starting point for
Army staffs to seek and obtain precise information during a given mission so they can establish
communication. Most local government contact information is available in local phone books under
"government." Some information is available by internet searches or even word of mouth.
CIVILIAN LEADERSHIP
A-5. Local civil authorities normally can be found at these locations:
z
Local town hall (local government employees and elected officials).
z
County seat (county government employees and elected officials).
z
Emergency operations centers.
PRIMARY EMERGENCY RESOURCES
A-6. Primary emergency resources may come from—
z
Law enforcement (local sheriff or chief of police).
z
Fire department.
z
Ambulance district.
z
Department of public works or engineering, including geospatial information and services
offices.
z
Search and rescue teams.
z
Hazardous materials response teams.
z
Local transportation assets (private or public).
z
Bomb disposal (locations of bombs, bomb disposal assets).
z
Local medical centers and hospitals.
z
County, city, or town transportation departments.
z
Department of public works or engineering.
z
Finance officers (such as a city or county treasurer).
z
Public safety center.
OTHER RESOURCES
A-7. Additional resources may come from—
z
Local library (source for maps, specific local information).
z
Recreation and tourism center (source for maps and specific, local information).
z
Chief medical examiner.
z
Local and regional religious and service club organizations
z
Morgue.
z
Forensic specialists.
z
Department of education (temporary infrastructure, storm and fallout shelters).
z
Labor center (hiring of local workers).
z
LP gas and petroleum boards (location of damaged gas and oil lines, oil spills).
z
Historical preservation society.
z
Local Chamber of Commerce
A-4
FM 3-28
20 August 2010
Planning Checklists
VOLUNTEER RESPONDERS
A-8. Examples of volunteer responders may include—
z
Volunteer security.
z
Volunteer fire fighters.
z
Volunteer and commercial security and law enforcement.
z
Volunteer and commercial skilled labor with equipment.
z
Volunteer and commercial transportation with knowledge of locations.
z
Volunteer and commercial medical services and search and rescue crews.
z
Volunteer and commercial organizations providing food, water, and shelter.
z
Corporate and independent agriculture.
z
Private education facilities and staff.
z
Local veterinarians, animal shelters, and wildlife volunteers.
z
Commercial gas and petroleum companies.
z
American Red Cross.
z
Salvation Army.
z
Volunteer responders.
z
Young Lawyers Association.
z
Catholic Charities.
STAFF CHECKLISTS
A-9. Tables A-4 through A-8 provide checklists to assist with initial planning for S-1, S-2, S-3, S-4, and
S-6 staffs. Staffs use the military decisionmaking process and ensure the use simple, concise statements in
language all parties (including civilians) understand. The Army uses the National Incident Management
System and National Response Framework for planning and coordination with other organizations as much
as possible.
A-10. Table A-4 lists initial planning items for the S-1. This list is not all inclusive; items need not be
considered in the sequence given.
Table A-4. Initial planning checklist for the S-1
Number
Brief description of items for initial consideration by the S-1
1.
Soldier readiness processing
2.
Personnel accountability, including government and contractor personnel and volunteers
3.
Coordination for postal service with the local postal office
4.
Requests for military pay support
5.
Coordination for chaplain activities
6.
Automation equipment including power generation, back-up battery packs with surge protection, photo
copiers, printing capability with backup printer, field filing systems, supplies, tool kit, mobile shelving,
tables, chairs, waterproof shelter, heating, cooling.
20 August 2010
FM 3-28
A-5
Appendix A
A-11. Table A-5 lists initial planning items for S-2. This list is not all inclusive; items need not be
considered in the sequence given.
Table A-5. Initial planning checklist for the S-2
Number
Brief description of items for initial consideration by the S-2
1.
Intelligence preparation of the battlefield (modified intelligence preparation of the battlefield). NOTE: This
is an analysis of the environment and civil considerations under incident awareness and assessment.
2.
Maps (paper and electronic) both civilian and military, electronic topographic capability. Knowledge to
incorporate systems to build map products useable to help locate personnel and critical facilities or
infrastructure in areas where road signs, roads, and landmarks are destroyed. Do military and Army
civilian areas of responsibility correlate?
3.
Population demographics of residential areas. Residents of economically distressed areas are more likely
to remain in the area and require support.
4.
Ethnic distribution of population in disaster areas; identify types of linguists required.
5.
Areas without electricity.
6.
Areas without water, status of water purification systems, and availability of commercial purification
equipment and products, improvised water purification systems.
7.
Location and capabilities of medical facilities.
8.
Status of sanitation systems.
9.
Relief and drainage systems. Effects on mobility for unit vehicles in rescue and relief efforts. Estimated
time to drain flooded areas; include bridging requirements if applicable.
10.
Obstacles. Identify areas where debris impedes mobility.
11.
Surface materials. Type and distribution of soils and subsoils in area and soil trafficability.
12.
Manmade features. Identify roads, railroads, bridges, tunnels, mines, towns, industrial areas, and piers.
Identify unsafe structures requiring demolition.
13.
Availability of unmanned aircraft systems.
14.
Topographic systems with global positioning system and software.
15.
Operations and physical security.
16.
Arms room.
17.
Automation equipment including power generation, back-up battery packs with surge protection, photo
copiers, printing capability with backup printer, field filing systems, supplies, tool kit, mobile shelving,
tables, chairs, waterproof shelter, heating, cooling.
18.
Local criminal activity and gangs for Force Protection purposes. Note this may contain Sensitive
information—check with the staff judge advocate.
19.
Coordination with local law enforcement to proscribe registered sex offenders from family sections of
emergency shelters. Note this will contain Sensitive Information - check with the staff judge advocate.
20.
Special needs populations such as retirement homes and group homes. Note this may contain sensitive
information—check with the staff judge advocate.
A-12. Table A-6, on page A-7, lists initial planning items for the S-3. This list is not all inclusive; items
need not be considered in the sequence given.
A-6
FM 3-28
20 August 2010
Planning Checklists
Table A-6. Initial planning checklist for the S-3
Number
Brief description of items for initial consideration by the S-3
1.
Simple, concise definition of command and support relationships (Army and coordinating organizations).
2.
Priority: location of victims requiring rescue, evacuation, and medical treatment; status of local emergency
medical capabilities; hazards or potential threats; and facilities (such as schools or warehouses) for
temporary housing.
3.
Status of lines of communication, major roads, railroads, waterways, ports, and airports, and airfields in
the area. State the nature and extent of damage and projected repairs.
4.
Characteristics of physical damage in specific areas: housing, commercial, industrial, public utilities, and
so on. Start damage assessment in high-density and low-income areas: mobile homes, high-rise
apartment buildings, and business offices.
5.
Numbers and locations of dislocated persons. Economically distressed areas tend to have more victims.
These areas may be near industrial areas containing hazardous materials. Identify hazards such as fires,
chemical spills, or ruptured pipelines.
6.
Local sources of media reproduction, especially high-speed, large-format printing.
7.
Availability of civilian engineer equipment and personnel.
8.
Advance party. Include signal officer, engineer, provost marshal, JAG, contracting officer, information
operations officer, and internal logistical planner.
9.
Daily schedule.
10.
Briefings and reports.
11.
Points of contact for subject matter experts.
12.
Packing lists.
13.
Transportation (tactical) and convoy operations.
14.
Mission-related training and mission rehearsal exercises.
15.
Weapons qualification.
16.
After action reviews.
17.
Composite risk management. See FM 5-19 and Appendix B.
18.
Liaison officers.
19.
Airspace command and control. See appendix F.
20.
Checks with S-6 on dedicated satellite and cell phones and satellite, cable, or Internet capability.
21.
Automation equipment including power generation, back-up battery packs with surge protection,
photocopiers, printing capability, field filing systems, supplies, tool kit, mobile shelving, tables, chairs,
waterproof shelter, heating, cooling.
22.
End state and exit strategy. Set end state conditions as soon as possible and recognizing when the unit’s
work is complete. Coordinate these conditions with other organizations. (The Army responds to disasters
when conditions temporarily overwhelm state and local governments.) Include the following checks:
•
Be attentive to measures of performance and the conditions the Army achieves to declare
mission success and the end state.
•
Make clear to state and local governments that the Army presence is limited and temporary.
•
Agree with state and local governments on the acceptable end state, usually recognized as
when state and local governments can re-establish normal operations.
•
Use commercial vendors and contractors.
•
Unit training before civil support mission
NOTE: Army forces avoid allowing state or local governments to become dependent on Army assistance (which could
impede long-term recovery). Army forces return tasks to civilian organizations as soon as feasible. If local
businesses and contractors can perform tasks assigned to Army forces, the continued employment of the
Army may become unnecessary or illegal. It may deprive local citizens of employment opportunities. The
primary role of the Army is to train, prepare for, and execute combat operations. Even a short absence from
this focus on combat operations may degrade a unit’s preparedness.
20 August 2010
FM 3-28
A-7
Appendix A
A-13. Table A-7 provides planning items for the S-4. This list is not all inclusive; items need not be
considered in the sequence given.
Table A-7. Initial planning checklist for the S-4
Number
Brief description of items for consideration by the S-4
1.
Sources of all classes of supply needed for critical restoration activities.
2.
Life support: mobile weatherproof shelters with all required equipment, billeting, mess, rations, water, bath
and laundry.
3.
Funding. Units capture costs for reimbursement. Reimbursable authority may be provided.
4.
Transportation (administration). See chapter 2 of Coordinating Military Deployments on Roads and
Highways: A Guide for State and Local Agencies, May 2005, published by the U.S. Department of
Transportation, Federal Highway Department, Petroleum, Oils, and Lubricants.
5.
Fuel access and fuel requirements.
6.
Minimum of a 90-day supply of repair parts based upon weather and increased use of certain types of
equipment in unique environments.
7.
Locations or sources to purchase parts, fuel, oils, lubricants.
8.
Maintenance and recovery.
9.
Reception, staging, onward movement, and integration.
10.
Ammunition storage.
11.
Automation accessories required for austere environment.
12.
Maintain an accurate record of the mission. Items to include:
13.
Record of missions performed.
14.
Rosters of personnel involved.
15.
Travel and per diem (military and civil service).
16.
Civilian employee overtime
17.
Temporary personnel wages, travel, and per diem.
18.
Lodging cost.
19.
Transportation cost (car and bus rentals, chartered aircraft, and fuel).
20.
Contracting cost.
21.
Equipment provided or operated (estimated hourly cost for operation).
22.
Material provided from regular stock. (all classes of supply).
23.
Laundry expenses.
24.
Official or morale phone calls.
25.
Retain receipts and other supporting documents. Supporting documents include:
26.
Unit orders.
27.
Temporary duty (TDY) orders.
28.
TDY payment vouchers. (Refer to unit procedures for Defense Travel System Management)
29.
Vehicle dispatch logs.
30.
Fuel card receipts.
31.
Hand receipts.
32.
Request and receipt of supplies.
33.
Government credit card receipts.
34.
Copy of contracts.
35.
Memorandums and other documentation of exceptions to policy and regulations.
36.
Mortuary services
A-8
FM 3-28
20 August 2010
Planning Checklists
A-14. Table A-8 shows initial planning items for S-6 (or G-6). This list is not all inclusive; items need not
be considered in the sequence given.
Table A-8. Initial planning checklist for the S-6
Number
Brief description of items for consideration by the S-6
1.
Incorporate local and state responders into exercises prior to an incident to identify likely communications
challenges.
2.
Establish liaison with military (Air National Guard, Army National Guard, Coast Guard, Air Force, Navy,
Marine Corps), local, state, federal agencies and organizations and nongovernmental organizations and
volunteers. The bottom line is command control systems coordinate with virtually any agency, organization
or individual that can help support the mission to reduce loss of life, limb and property. Determine the most
feasible solutions for effective communication.
3.
Initial communications capabilities are self-sufficient and interoperable with both first responders and local
authorities.
4.
If operating as a joint task force headquarters, the Joint Communication Control Center (JCCC) should
incorporate and co-locate technical representatives from subordinate units (task force S-6s, assigned
signal battalion etc) with JCCC to facilitate planning and collaboration.
5.
Plan for all means of communications and purchasing of additional communication devices: telephone
(satellite, cellular or land line), radio (military maritime, and civilian, in all bandwidths), Non-Secure Internet
Protocol Router Network, SECRET Internet Protocol Router Network, video equipment, video
teleconferencing, and satellite-based commercial Internet systems. The goal is to communicate effectively
and reduce restrictions to effective communication.
6.
Do not send equipment without operators, essential repair parts, operating and repair manuals, tools,
initial fuel and power generation required.
7.
Send qualified signal leaders to ensure operators and equipment are used effectively.
8.
Prepare to provide communications equipment (cell phones, radios, base sets, etc.) to first responders
based on mission assignments.
9.
Plan and coordinate for additional, extended logistical and maintenance support for equipment and
personnel as well as unexpected requirements including generator support; maintenance of equipment;
fuel requirements of vehicles, systems, and generators; and support for others' equipment (such as
charging cell phones from your power source, charging satellite phones, identify internal and external
electronic repair capabilities).
10.
Know the power requirements for your equipment. Always bring your own power generation equipment,
parts and fuel for essential communication equipment.
11.
Communications (voice, data, video) with various emergency operations centers including military (Air
National Guard, Army National Guard, Coast Guard, Air Force, Navy, Marines), local, state, or federal.
12.
Communications structures are expandable and flexible to meet future needs. What can be established
initially and expanded to handle a greater demand? Small deployable packages ahead of larger
deployable command posts for immediate feedback of requirements.
13.
Establish reach-back capability.
14.
Conduct a synchronization meeting between all primary entities that have impact as soon as possible.
15.
Realize that geography and weather affects signal performance. A communications system that worked
well at one location might not work in another.
20 August 2010
FM 3-28
A-9
This page intentionally left blank.
Appendix B
Safety
This appendix highlights safety concerns during civil support operations. It focuses
on composite risk management and accident reporting. National Guard and federal
military forces adhere to similar safety requirements.
SAFETY AND INTERAGENCY INCIDENT RESPONSE
B-1. Several official Web sites contain excellent safety information to assist incident responders at all
levels identify hazards and protect the civilian population. Examples are—
z
Occupational Safety and Health Administration (OSHA) (http://www.osha.gov/).
z
Centers for Disease Control and Prevention (http://www.cdc.gov/).
z
Federal Emergency Management Agency (http://www.fema.gov/).
z
Ready Army (http://www.acsim.army.mil/readyarmy/).
These Web sites contain information for specific types of disasters to ensure responders at all levels have
the safety tools to provide support and to aid the rapid return to normalcy after incidents.
B-2. During interagency incident response operations, an incident action plan identifies the incident
action safety officer. Appropriate DOD personnel must contact the incident action safety officer and
participate in any safety boards or meetings.
COMPOSITE RISK MANAGEMENT IN CIVIL SUPPORT
OPERATIONS
B-3. Disaster response involves numerous hazards. Composite risk management is the Army’s primary
process for identifying hazards and managing risks. Composite risk management is integrated into all
phases of mission or operational planning, preparation, execution, and assessment. Composite risk
management is a process used to mitigate risks associated with all hazards that have the potential to injure
or kill personnel, damage or destroy equipment, or otherwise impair mission effectiveness.
B-4. Hazard identification, mitigation, and management of risk are key factors in safely conducting civil
support operations. The Army uses composite risk management program as the primary decisionmaking
tool for the commander and staff, while the other Services use operational risk management. Both
programs are used to identify hazards associated with operations and to mitigate risks. Commanders
implement both throughout the operations process.
B-5. Field Manual (FM) 5-19 provides in-depth guidance in composite risk management, with examples
for required staff estimates (see also FM 5-0). The Army Combat Readiness/Safety Center created the
Ground Risk Assessment Tool (for both classified and unclassified networks) as a tool for commanders
and staff to integrate the composite risk management process. Fewer accidents occur when Soldiers are
aware of hazards and hazard prevention measures. The intent of this information is to increase awareness
and reduce risk.
B-6. In a civil support operation, safety and accident prevention are critical to mission accomplishment.
Training and operating to standard are key elements in ensuring safe and effective mission
accomplishment. Responses to any of the incidents addressed in this publication do not imply a need for
participants to cast aside safety and standards in order to accomplish the assigned tasks. Commanders,
leaders at all levels, Soldiers, and Army civilians are responsible for safety and safe completion of all tasks
while conducting civil support operations.
20 August 2010
FM-3-28
B-1
Appendix B
B-7. The Department of Defense Instruction (DODI) 6055 series is the basis for Department of Defense
(DOD) safety and occupational health programs. The Army safety program is addressed in Army
Regulation
(AR) 385-10, Department of the Army Pamphlet
(DA PAM) 385-10, and supporting
publications. The Air Force uses the Air Force Instruction (or AFI) 91 series; the Navy uses the Chief of
Naval Operations Instruction (or OPNAVINST) 5100 series; and the Marine Corps uses the Marine Corps
Orders (or MCO) 5100 series in applying the DODIs.
B-8. Hazards associated with civil support operations vary greatly based on the incident. For each
situation, the Army uses appropriate equipment and procedures to prevent injury and equipment loss. This
translates to effective and efficient mission accomplishment. Safety equipment can include hard hats,
combat helmets, gloves, personal protective equipment, biohazard protection, respirators, water hazard
protection, personal flotation devices, goggles, face shields, and knee and elbow pads. Subordinate units
should coordinate with their joint task force safety officer regarding the type of personal protective
equipment, and ensure that the S-4 or G-4 submit the requisitions.
B-9. In general, disaster response operations require Soldiers to—
z
Be aware of the surroundings and know how to enter damaged structures as required.
z
Be alert for exposed electrical, gas, other utility lines, fallen or flying debris and raw sewage.
z
Wear appropriate protective gear.
z
Avoid moving or tampering with propane tanks unless necessary.
z
Watch for nails, glass, and other sharp objects.
z
Follow appropriate procedures when they discover human remains.
z
Do not attempt to recover human remains (unless serving as a trained member of a recovery
crew.)
z
Avoid domestic and wild animals when possible. Leave handling of such animals to trained
personnel.
Note: Soldiers should not attempt to enter collapsed structures except under the supervision of
trained rescue personnel. Untrained personnel risk endangering themselves as well as any
survivors.
HAZARDS
B-10. To identify hazards, the Army obtains information about the characteristics of the specific
geographical region and the overall effects of the disaster. For example, flooding of buildings has
significant secondary effects in hot, humid environments. Toxic mold and fungus thrive in these
conditions. Standing, water-damaged structures can become uninhabitable for humans but may shelter
dangerous stray or wild animals, insects, and reptiles.
B-11. Specific types of disasters require specific types of safety equipment. For example, safety equipment
for disasters triggered by high winds and water includes life preservers and other marine-specific safety
gear, waterproof boots, and special handling equipment for stray pets. Engineering safety equipment for
assessment of damaged infrastructure includes equipment for safe repair of damaged electrical facilities,
towers, buildings, and bridges. Disasters triggered by chemical, nuclear, and biological terrorist events or
accidents require both Army and civilian protective clothing and masks. The Army uses civilian masks and
clothing because the Army protective mask does not filter certain chemicals and the mission oriented
protective posture suit may not protect against some chemical hazards. Purchase or issue of civilian
OSHA-approved filtration masks and clothing is required for specific contamination agents.
B-12. The pace of work in a disaster response and other incidents is demanding. Leaders monitor their
Soldiers to avoid physical exhaustion. Rotating personnel between more demanding tasks and less
demanding tasks mitigates the accumulation of fatigue. Leaders need to establish and enforce viable sleep
plans.
B-2
FM 3-28
20 August 2010
Safety
PERSONAL HYGIENE
B-13. Personal hygiene requires every leader’s personal attention. Many natural and manmade
contaminants pose risks during civil support operations. Precautions include providing potable water,
sanitary laundry and bath facilities, and latrines. Soldiers should wash their hands often, and make sure that
waste is disposed of properly.
FOOD SAFETY
B-14. Trained personnel should inspect food and water sources frequently for safety. Contamination may
come from sources such as extreme heat, chemicals, biohazards, pest infestations, smoke, and flooding.
PREVENTABLE INJURIES
B-15. Many injuries to the eyes, ears, head, hands, back, and feet are preventable with appropriate safety
gear. When appropriate, Soldiers wear protective lenses, goggles, or face shields. Leaders enforce the use
of hearing protection when personnel are operating heavy equipment, generators, or chain saws. Helmets
or hard hats must be worn in construction areas in accordance with civilian requirements. Combat helmets
(such as Kevlar helmets) do not provide the same protection as civilian hardhats. Soldiers must remove
rings or other jewelry that conduct electricity or may become hooked or snagged or interact adversely with
chemicals or heat. Soldiers must wear gloves as required. Soldiers must use proper lifting techniques and
lifting equipment to avoid back injuries. Soldiers must wear the correct footwear for the job and follow
preventative measures for trench foot and fungal infections.
RESPIRATORY HAZARDS
B-16. Respiratory hazards are common in any disaster area. These include smoke, ash, molds, various
airborne contaminants, toxic chemicals, and radiation. Soldiers can be exposed to asbestos, carbon
monoxide, nuisance dust, or other caustic vapors. Qualified individuals should conduct tests to identify
hazards. When needed, Soldiers must use the appropriate Army or civilian gas, mist, fume, or dust
protective masks to remove airborne toxins. Commanders and leaders must understand that current
mission-oriented protective posture or JSLIST gear does not provide adequate protection against most
toxic industrial chemicals and toxic industrial materials.
BLOOD-BORNE PATHOGENS AND DISEASES SUCH AS TETANUS
B-17. Everyone involved in disaster response operations must be aware of the risk from blood-borne
pathogens. At a minimum, Soldiers must have up-to-date hepatitis and tetanus immunizations. Soldiers
must observe basic preventive medicine precautions. Soldiers must use the following equipment, whenever
required:
z
Latex or rubber gloves.
z
Over-garments for clothing protection.
z
Face masks for respiratory protection.
z
Goggles for eye protection from splashes or spills.
z
Bleach and chlorine for cleanup and decontamination of biohazards.
z
Biohazard bags.
STRESS
B-18. Everyone involved in rescue and recovery operations experiences increased stress and anxiety.
Medical combat and operational stress teams, Army Chaplains, leaders, and Soldiers are trained to manage
stress. For information on control of combat stressors and for details about specific leader and individual
actions to control stress, see FM 4-02.51, and FM 6-22.5. Primary stress management support channels for
civilians include local churches and the American Red Cross. The Red Cross can send stress management
teams to help citizens affected by the disaster.
20 August 2010
FM 3-28
B-3
Appendix B
ANIMALS
B-19. Disaster conditions increase the risk of bites and scratches from domestic or wild animals, including
venomous snakes and rats. Soldiers can become infested with lice and fleas. The danger from diseases such
as rabies increases. Household pets can become more aggressive or dangerous than usual. Soldiers take
precautions to avoid animal and snakebites. They do not taunt, play with, or handle animals unless trained
and authorized.
BITING OR STINGING INSECTS AND SPIDERS
B-20. Soldiers need to be aware of and protect themselves from mosquitoes, ticks, chiggers, ants,
venomous spiders, fleas, lice, wasps, and bees. Refer to Army Center for Health Promotion and Preventive
Medicine at http://phc.amedd.army.mil/home/ for information on health and personal safety.
HAZARDOUS PLANTS
B-21. Numerous hazardous plants require special handling and safety procedures. Some species of brush,
such as oleander, are poisonous. Oleander is used as an ornamental plant around parks and residential
areas. Burning it releases toxic chemicals. Poison ivy and poison oak are harmful when touched or burned.
Refer to the Army Center for Health Promotion and Preventive Medicine website at
ELECTRICAL HAZARDS
B-22. All electrical transformers pose severe risks. Electrical lines can present a lethal shock hazard. To
avoid injuries, Soldiers—
z
Do not attempt to move transformers during cleanup.
z
Mark transformers and report locations to the chain of command.
z
Do not touch, work or operate equipment near downed power lines. Electricity might be restored
to downed power lines without notice.
B-23. As commercial power is re-supplied, all emergency generators should be taken offline. Only
qualified utility or engineer personnel conduct the changeover. If a downed power line is difficult to see
but is in a traffic area, Soldiers clearly mark the area so no one touches the downed wire.
B-24. Soldiers use caution when antennas are near power lines. They should avoid erecting antennas near
power lines. They identify antennas that may fall on power lines or on people and take appropriate action
to prevent accidents or injury.
POWER GENERATOR SAFETY
B-25. Generator usage during Civil Support operations can create special concerns. Soldiers entering
homes and buildings need to be aware of the carbon monoxide threat posed by generators used indoors
with inadequate ventilation. Military personnel using generators should ensure—
z
Generators are only operated by trained personnel.
z
Safe refueling.
z
Proper grounding and bonding of generators.
z
Carbon Monoxide hazards.
z
Generator fire hazards and fire protection.
z
Generator electrical load limits and capacity.
z
Electrocution hazards, prevention and first aid.
B-4
FM 3-28
20 August 2010
Safety
HANDLING CONTAMINATED ITEMS
B-26. Soldiers take precautions when handling and collecting contaminated items. A collection site for
contaminated items is established. In addition, sites are designated for showering and clothing changes
before Soldiers move to non-contaminated areas. For more information, see the following websites:
z
United
States
Army
Maneuver
Support
Center
of
Excellence:
z
Occupational Safety and Health Administration: www.osha.gov.
z
Chemical, Biological, Radiological, and Nuclear Defense Information Analysis Center:
z
Center for Disease Control and Prevention: http://www.cdc.gov.
FIRE
B-27. Fires trigger extreme heat, toxic gases, fumes, and toxic dust hazards. Most Army units do not have
all the equipment required to fight large fires. Special breathing and burn prevention equipment is required.
For further information, refer to the United States Army Maneuver Support Center of Excellence Web site
(above) and Fire Rescue I at http://www.firerescue1.com.
USE OF CHAIN SAWS
B-28. Chain saws are inherently dangerous. Chain saw safety guidance is available through every chain
saw manufacturer and the Occupational Safety and Health Administration website, www.osha.gov. They
require maintenance and prudent use to reduce risk of injury and death. Leaders ensure chainsaw
operators—
z
Receive training before operation. This includes procedures for chain saw use and maintenance,
and how to ensure cut trees fall safely.
z
Use personal protective equipment including eye protection, hearing protection, leg guards, and
gloves (adjusted according to weather conditions).
z
Check for nails, wire, and other metal objects before cutting.
USE OF VEHICLES AND TRANSPORTATION
B-29. Soldiers must drive defensively and remain alert to potential hazards. Leaders and operators of
vehicles—
z
Pair experienced drivers with inexperienced drivers for supervision and hands-on training.
z
Use experienced drivers in difficult terrain.
z
Remind drivers to slow down in limited visibility, on rough terrain, and during inclement
weather.
z
Secure vehicle antennas to prevent contact with power lines and other objects.
z
Take into account the maximum fording depth for each vehicle type, and ensure proper fording
equipment and accessories are installed before entering water areas.
z
Use ground guides during periods of limited visibility.
z
Ensure operators are licensed on their vehicle. Operators designated to transport hazardous
materials and ammunition must be licensed to load, transport and off-load these materials.
B-30. All operators of vehicles perform—
z
Preventive maintenance checks and services, especially under adverse or unusual conditions.
z
Special requirements covered in the “Operating under Unusual Conditions” section of their
respective operator’s manual.
20 August 2010
FM 3-28
B-5
Appendix B
B-31. Leaders conduct convoy briefings before movement. Additionally, leaders ensure all vehicle
operators know how to—
z
Conduct a physical reconnaissance of the route to avoid hazards. Mark unavoidable hazards on a
strip map and include them in the convoy briefing.
z
Reconnoiter the route for bridges or underpasses that might be too low for large vehicles.
z
Assess roads, bridges, and overpasses that may not be posted with weight or height restrictions.
z
Reconnoiter routes for hazards below the water line before operations begin.
z
Check water height before driving on submerged surfaces. (A good rule of thumb is not to drive
into running water deeper than the vehicle axle.)
ACCIDENT REPORTING
B-32. AR 385-10 and DA PAM 385-40 address accident reporting requirements. All accidents will be
reported within 24 hours to the task force safety office. Accidents meeting the following criteria may
require more in-depth investigations and/or Army Combat Readiness/Safety Center investigator support—
z
Injury to any military personnel that results in a lost workday.
z
Estimated damage of $2,000 or more to any military property or equipment.
z
Nonfatal injury or illness to any civilian resulting from military operations that requires either
hospitalization of 24 hours or more or the loss of work.
z
Estimated damage to civilian property of $2,000 or more resulting from military operations.
B-33. At a minimum the following information is provided for each accident reported:
z
Point of contact for the accident information and their duty.
z
Point of contact telephone number.
z
Unit involved in the accident.
z
Location of the accident.
z
Date and time of the accident.
z
Name and rank of personnel involved.
z
Extent of injuries.
z
Type of property or equipment damage.
z
Estimated cost of damage.
z
Estimated environmental cost.
z
Description of circumstances and events.
B-6
FM 3-28
20 August 2010
Appendix C
National Guard Weapons of Mass Destruction-Civil
Support Teams
Weapons of mass destruction—civil support teams of the state National Guard can
respond to a chemical, biological, radiological, nuclear, or high-yield explosives
incident. They provide immediate response capabilities to assist local and state
agencies. They can also respond to other types of disasters. A weapons of mass
destruction—civil support team often provides support for smaller-scale incidents
where specific technical capabilities are required.
ORGANIZATION OF THE WEAPONS OF MASS DESTRUCTION-
CIVIL SUPPORT TEAM
C-1. A weapons of mass destruction—civil support team (WMD-CST) includes twenty-two full-time
Title 32 team members from Army and Air National Guard, Active Guard, and Reserve personnel. It
comprises six sections: command, operations, communications, medical and analytical, administration, and
logistical, and survey. WMD-CST members receive specialized training and state-of-the-art equipment
(both commercial and military) so they can rapidly and accurately identify and model the extent of
chemical, biological, or radiological contamination in a given area. They can provide a technical reach-
back capability to other experts. The specialization within the team contains a greater number of senior
personnel than normally found in a similar-sized military unit.
MISSION OF THE WEAPONS OF MASS DESTRUCTION-CIVIL
SUPPORT TEAM
C-2. The mission of the WMD-CST is to support civil authorities at domestic chemical, biological,
radiological, nuclear, or high-yield explosives incident (CBRNE incident) sites by identifying chemical,
biological, radiological, nuclear, and high-yield explosives (CBRNE) agents and substances, assessing
current and projected consequences, advising on response measures, and assisting with appropriate
requests for additional support. This includes incidents involving the intentional or unintentional release of
CBRNE materials, including toxic industrial chemicals and materials, and other disasters that result or
could result in the catastrophic loss of life or property in the United States.
EMPLOYMENT OF THE WEAPONS OF MASS DESTRUCTION-CIVIL SUPPORT TEAM
C-3. In the event of an emergency resulting from actual or suspected use of a weapon of mass destruction,
the National Guard Bureau facilitates WMD-CST employment through the response management plan.
The response management plan prescribes national response categories assigned by the National Guard
Bureau for each WMD-CST, consisting of three mission categories: Priority (gold), Ready (silver), or
Standby (bronze). The assigned response category directs how rapidly a WMD-CST must be prepared to
deploy to an incident scene after official notification. Non-mission-capable teams receive a “black” status,
which alerts the National Guard Bureau to cover that state with other teams. Note that the legislation
creating the WMD-CST program permits WMD-CSTs to deploy across state boundaries in Title 32 status
without a formal written agreement, but based simply on a verbal agreement between the affected
governors. Up to 22 WMD-CST’s, for example, deployed to states affected by Hurricane Katrina over a
45-day period in 2005.
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C-1
Appendix C
C-4. Priority response (gold) requires the deployment of an advanced party of the WMD-CST no later
than 90 minutes after the official time of notification (N-hour) and deployment of the remaining WMD-
CST no later than N + 3 hours to support a response anywhere within the Nation. Ready response (silver)
requires units to focus on preparing for possible priority response missions outside their home state.
WMD-CSTs in this response category, once directed, must deploy to the event no later than N + 24 hours.
Standby response (bronze) requires units to focus on areas such as training requirements and leave. WMD-
CSTs in this category, once directed, must prepare for and deploy no later than N + 72 hours.
CAPABILITIES OF THE WEAPONS OF MASS DESTRUCTION-CIVIL SUPPORT TEAM
C-5. The Analytical Laboratory System is a self-contained, C-130 transportable, mobile, analytical
platform. The Analytical Laboratory System provides advanced technologies with enhanced sensitivity and
selectivity for identification and characterization of CBRNE agents. Within the compartments of the
Analytical Laboratory System, operators have the ability to prepare, extract, analyze, and store
environmental samples and to document the contaminated environmental conditions. They may also
prepare samples for possible law enforcement evidence in the event of a criminal or terrorist incident, and
send them to other national laboratory networks. The members of the Analytical Laboratory System team
provide the incident commander with the best available on-site analysis of hazards. This allows the state
and federal agencies to determine appropriate follow-on response to a CBRNE incident. When linked to
the Unified Command Suite, the Analytical Laboratory System provides on-site data and analysis to
national laboratories and subject matter experts.
C-6. The Unified Command Suite is a self-contained, stand-alone C-130 air-mobile, fielded
communications system that operates in urban and undeveloped areas using portable and fixed equipment.
The Unified Command Suite provides real-time voice, data, and video communications reach back
(unclassified and classified) among WMD-CST members, local and state emergency response agencies,
lead federal agents, and supporting military activities. This enhanced communications system allows
technicians with the WMD-CST to share on-scene data and analysis with any responding or supporting
agency.
C-7. The advanced echelon of the team deploys using a specially equipped sport utility vehicle with
capabilities similar to the Unified Command Suite, but with limited encryption. It is interoperable with the
Unified Command Suite and first responders. En route, advanced echelon capabilities allow mobile voice
and data international maritime satellite, satellite telephone communications, a media center with onboard
navigational information, and intra-team communications.
C-8. Because it was designed to comply with incident command system specifications, the WMD-CST’s
integrated command, operations, medical, and communications sections can form the support nucleus of a
much larger incident command staff. During large terrorist incidents and natural disasters these teams have
provided incident commanders critical communications, hazard predication modeling, medical assessments
and support staff. Joint and interagency CBRNE incident response task forces of over 200 people have
been structured around the WMD-CST’s sections.
LIMITATIONS OF THE WEAPONS OF MASS DESTRUCTION-CIVIL SUPPORT TEAM
C-9. Although WMD-CST can provide a wide array of support, the teams have limited endurance
without follow-on support. The WMD-CST can conduct 24-hour continuous operations for limited
periods. (Extended CST deployments have lasted 60 days during sustained response operations.) However,
commanders should consider providing the team additional personnel for continuous operations extending
beyond 18 hours. The WMD-CST is one-deep in most specialty functions. Factors such as ongoing
training
(including required schools), mission preparation requirements, leave, illness, and personal
emergencies reduce the number of personnel available for contingency missions. Required response times
require careful management by the adjutant general to ensure mission readiness. To meet increased force
requirements or sustained mission duration multiple WMD-CSTs are frequently employed to an incident.
C-10. WMD-CST equipment receives rapid resupply in the form of push packages from the consequence
management support center. Equipped with CBRNE detection and protection equipment found in many
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National Guard Weapons of Mass Destruction-Civil Support Teams
government and civilian agencies the WMD-CST can also purchase needed equipment during a response.
These packages typically move by commercial carrier to the response location.
C-11. The civil support team usually deploys using organic vehicles. Teams routinely practice airlift
movement to reinforce responses in more remote states and territories. Normally, the Air National Guard
moves the teams using C-130 transports. Interstate movement times can vary widely due to distance,
available airlift, and weather. Although WMD-CST equipment is rail mobile, that mode is the least timely.
C-12. WMD-CST is capable mainly of self-decontamination. Limited capabilities and supplies exist for
decontamination of other first responders.
C-13. The organic medical capability of WMD-CST, including formulary, is very limited. The team only
has enough medical capability to support team personnel.
C-14. The WMD-CST is a National Guard response asset. Strategic planning normally excludes them from
Army contingency force packages deployed outside the United States and its territories. However, United
States Northern Command or United States Pacific Command may request one or more WMD-CST as part
of a civil support mission.
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C-3
Appendix D
CBRNE Enhanced Response Force Package
The National Guard chemical, biological, radiological, nuclear, and high-yield
explosives enhanced response force package provide specialized consequence
management capabilities required by local, state, or federal authorities. It is the
“medium” Army response package, considerable larger than the weapons of mass
destruction-civil support teams but much smaller than the chemical, biological,
radiological, nuclear, and high-yield explosives consequence management response
force. Seventeen chemical, biological, radiological, nuclear, and high-yield
explosives enhanced response force packages, distributed among the National Guards
of Massachusetts, New York, Pennsylvania, West Virginia, Florida, Illinois, Texas,
Missouri, Colorado, California, Hawaii, Ohio, Minnesota, Georgia, Virginia,
Nebraska, and Washington, ensure that every Federal Emergency Management
Agency region has at least one available.
CAPABILITY OF THE CBRNE ENHANCED RESPONSE FORCE
PACKAGE
D-1. The National Guard chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE)
enhanced response force packages support mass casualty decontamination at or near chemical, biological,
radiological, nuclear, or high-yield explosives incident
(CBRNE incident) sites, casualty search and
extraction, emergency medical treatment, triage, and patient stabilization. A request for a CBRNE
enhanced response force package can originate from a variety of state sources. Requests are channeled
through the joint force headquarters-state and coordinated with the state emergency management agency or
equivalent. A CBRNE enhanced response force package can deploy within 6 hours of alert and perform
their mission upon arrival at the incident site. With augmentation and support, the CBRNE enhanced
response force package can continue operations for 72 hours or longer, at which time much larger federal
military forces will have arrived to continue the mission.
ORGANIZATION OF THE CBRNE ENHANCED RESPONSE FORCE
PACKAGE
D-2. National Guard Soldiers and Airmen form a CBRNE enhanced response force package. Unlike the
Weapons of Mass Destruction-Civil Support Team (WMD-CST) personnel, however, they are not full-
time active guard and reserve, but must be called up by their governor. They organize and train for no-
notice CBRNE consequence management. A CBRNE enhanced response force package deploys to an
incident site and provides command and control, casualty decontamination operations, casualty search and
extraction, and emergency medical triage and patient stabilization. When reinforced with a security
element, a CBRNE enhanced response force package also conducts cordon and entry control point
missions. A CBRNE enhanced response force package can be task-organized with almost any National
Guard or Regular Army headquarters. Operational parameters include—
z
A CBRNE enhanced response force package will normally operate under state command and
control as an element of the National Guard (Title 32).
z
A CBRNE enhanced response force package supports the state’s incident command system
when requested through the state emergency management system.
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Appendix D
z
A CBRNE enhanced response force package may be federalized (placed in Title 10 status), and
pass to the attachment or operational control of a federal military joint task force or other higher
headquarters. The modular combat support brigade is optimum force headquarters for a CBRNE
enhanced response force package.
z
A single CBRNE enhanced response force package can operate a maximum capacity for up to
12 hours, with subsequent rest periods. If the incident commander requires 24-hour operational
support, the force headquarters requests one or more additional CBRNE enhanced response
force package.
D-3. A CBRNE enhanced response force package comprises four response elements: medical treatment,
decontamination, search and extraction, and a command and control team. Typical attachments may
include a Fire Fighting Element, a Fatality Search and Recovery Team, Air and Ground Casualty
Transportation assets, and Air National Guard Expeditionary Medical Support Teams. The joint force
headquarters-state (JFHQ-state) is responsible for coordinating administrative and logistic requirements
that will be required for training certification, orders, travel, equipment maintenance, and storage. Figure
D-1 shows an example of a CBRNE enhanced response force package organization.
Figure D-1. Example of CBRNE enhanced response force package organization
D-4. The command and control element must be prepared to execute recall of a CBRNE enhanced
response force package and coordinate adequate transportation for CBRNE enhanced response force
package personnel and equipment to the incident site. At the incident site, the command and control
element coordinates with the incident or task force commander.
D-5. The medical element provides short duration, pre-hospital emergency medical treatment during a
CBRNE response mission and at rescue sites. Specifically, the team works with decontamination or
casualty extraction teams to provide emergency medical treatment and triage in a contaminated
environment and stabilization and treatment in the cold zone prior to evacuation.
D-6. The decontamination element conducts ambulatory and non-ambulatory patient decontamination
under supervision of medical personnel. The decontamination element will don appropriate personal
protective equipment (defined as a minimum of Level C) when conducting decontamination.
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CBRNE Enhanced Response Force Package
D-7. Unlike most search and rescue teams, search and extraction element has capability to identify and
recover casualties from a contaminated environment. As a type II collapse search and rescue team, a
CBRNE enhanced response force package can conduct medium intensity operations for 12 to 24 hours.
D-8. The parent National Guard joint force headquarters may attach a security element as shown. This
normally comes out of that state’s National Guard Response Force. The security element receives training
in contaminated environment operating procedures. Note that if a WMD-CST is on scene, a CBRNE
enhanced response force package may assume operational control of it. Although not shown, the Defense
Threat Reduction Agency can support a CBRNE enhanced response force package with technical
information on contaminants and other hazards through reach-back to subject matter experts. States should
be prepared to task-organize explosive ordnance disposal and CBRNE enhanced response force package
capabilities to respond to situations involving explosives. Detachments of the 52nd Ordnance Group
(EOD), located around the country, provide explosive ordnance disposal capability in response to requests
for federal assistance. Many civilian law enforcement agencies also possess explosive ordnance disposal
capability.
MISSION OF THE CBRNE ENHANCED RESPONSE FORCE
PACKAGE
D-9. The search and extraction element locates and removes the casualties from a contaminated area (the
“hot zone”) to an initial decontamination area known as a “warm zone.” Medical personnel with the search
element perform initial triage and prioritize casualties before decontamination. The decontamination
element moves the patient to decontamination, records the casualty, and decontaminates the patient. Once
decontaminated, the medical team provides medical treatment and stabilization in a contaminant-free area
(the “cold zone”) prior to evacuation to an area hospital. If required, the security detachment controls all
entry and exit from a CBRNE enhanced response force package area. Figure D-2 depicts a typical flow of
patients.
Figure D-2. Example of patient flow
DEPLOYMENT OF THE CBRNE ENHANCED RESPONSE FORCE PACKAGE
D-10. When alerted, CBRNE enhanced response force package members report to designated armories or
staging areas and will deploy by the fastest means available to the incident site. A CBRNE enhanced
response force package command and control element will establish liaison with the incident command
staff and the National Guard task force commander. A CBRNE enhanced response force package will
deploy with equipment to the incident site or staging area using organic transportation, or designated
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