CONTOMS (Counter Narcotics and Terrorism Operational Medical Support Program)

CONTOMS (Counter Narcotics and Terrorism Operational Medical Support Program)

Order Code RS21081
Updated December 21, 2001
CRS Report for Congress
Received through the CRS Web
CONTOMS (Counter Narcotics and Terrorism
Operational Medical Support Program)
David J. Gerleman
Research Associate
Foreign Affairs, Defense and Trade Division
Steven A. Hildreth
Specialist in National Defense
Foreign Affairs, Defense, and Trade Division
Summary
Since the September 11th terrorist attack, greater attention has focused on federal,
state, and local readiness to respond to situations involving terrorism or weapons of mass
destruction (WMD). One such federal program that provided federal support to local law
enforcement and first responders is CONTOMS (Counter Narcotics and Terrorism
Operational Medical Support). Earlier this year, CONTOMS was scheduled for
elimination from the Department of Defense (DOD) budget; DOD argued that it should
not fund this activity without a direct appropriation from Congress. Various medical and
law enforcement organizations tried to reverse the proposed elimination. Shortly after
the terrorist attack, television’s America’s Most Wanted (AMW) featured CONTOMS
in a program segment, arguing its value, and increasing public awareness over the
program’s pending elimination. This report may be updated to reflect significant
developments.
Background & Mission
The CONTOMS program began in 1989 and was designed to meet the need for
specialized medical training to support law enforcement operations. It was the first such
federal program to address the complex response issues of a terrorist or ultra-violence
incident that might confront state and local emergency responders. The CONTOMS
mission is to serve as a bridge between the uniformed services–with focus on current
military medical knowledge and technology bases–and the civilian emergency services
community for sharing critical experience and expertise in responding to contingencies
within the United States. The program addresses the medical aspects of law enforcement
responses to WMD crisis management, counterterrorism, counternarcotics, protective
operations, hostage rescue, explosive ordnance disposal, maritime operations, civil
disorder, and major national security events.
Congressional Research Service ˜ The Library of Congress

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The CONTOMS program has provided training for over 5,000 civilian emergency
personnel from 750 agencies through law enforcement organizations in all 50 states.
CONTOMS is a mobile program involving both field and practical exercises conducted at
police academies and other training sites nationwide. Over 40 local, state, and federal law
enforcement agencies mandate CONTOMS certified training as a condition of employment
for their SWAT (Special Weapons and Tactics) medics.
CONTOMS policies are governed by a Board of Directors representing military
medicine, law enforcement, and prehospital care communities. The CONTOMS Law
Enforcement Special Operations Injury Epidemiology Database–the only database of its
kind–seeks to ensure ongoing program effectiveness and relevance. Supporters maintain
that, in addition to providing support to the law enforcement and emergency response
communities, that this collaborative relationship helps the Uniformed Services University
of the Health Sciences (USUHS) faculty and staff, selected Department of Defense (DOD)
graduate medical education programs, and military health care providers throughout the
world maintain currency and expertise for their mandated response to homeland
contingencies.
Training Services
CONTOMS provides a national standard curriculum, certification and a quality
assessment process to meet the needs of emergency medical providers who operate as part
of tactical law enforcement teams. Additionally, the program tracks data to guide
educational efforts so that they meet the needs of the law enforcement and special
operations communities. Courses generally are filled to capacity, with two applicants for
every class opening. The CONTOMS Medical Director’s Course, for instance, presented
at the 2001 Annual Meeting of the National Association of EMS Physicians, was widely
attended. In addition, the program’s faculty are available for consultation with federal,
state, and local agencies to help meet requirements, solve problems, or conduct needs
assessments. CONTOMS offers the following medical/evidence-based courses: EMT-
Tactical; The Advanced School; Commanders Course; Medical Director’s Course; and,
the Instructor Development School. The program is endorsed by, and/or receives
continuing education credit from: the National Tactical Officers Association (NTOA); the
National Association of Emergency Medical Technicians (NAEMT); and the Continuing
Education Coordinating Board for Emergency Medical Service (CECBEMS).
Role of the Henry M. Jackson Foundation
For ten years the CONTOMS program has received some financial and contract
management support and administrative assistance from the Henry M. Jackson Foundation
for the Advancement of Military Medicine headquartered in Rockville, Maryland. Select
foundation employees also serve with CONTOMS as education and training specialists.
The foundation, which is a private, not-for-profit service organization named after former
U.S. Senator Jackson of Washington, was chartered in 1983 and employs over 1,200
medical, scientific, management, and administrative staff. The foundation’s stated purpose
is to “serve as a focus for the interchange between military and civilian medical personnel,
and to encourage the participation of the medical, dental, nursing, veterinary, and
biomedical sciences in the work of the foundation for the mutual benefit of military and
civilian medicine.” The foundation, which has thirty research sites funded by both federal

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and private sources, seeks to achieve these goals by assisting military personnel in the
conduct of quality medical research and education programs. All members of the USUHS
faculty members are guest scientists at the foundation and provide cross-disciplinary
collaboration.
Funding
Federal Government funding for the CONTOMS program has fluctuated in recent
years. Since 1990, the Pentagon’s Office of Drug Enforcement Policy and Support, which
reported through the Assistant Secretary of Defense for Special Operations/Low Intensity
Conflict–ASD (SO/LIC)–has funded CONTOMS at between $800,000- $1.5 million
during the years 1990-1994, and at about $950,000 per year for 1995-1999. In part, as a
step toward its gradual elimination, funding was cut to $333,000 for FY 2000 and FY
2001. The training fees CONTOMS students pay increased from $140 in 1990 to $595 in
2000. In response to DOD budget cutbacks, alternative supplemental funding was, in part,
obtained from other sources. Most of the grants and other monies secured, however, were
mandated specifically for state and local law enforcement training, precluding military
applicants. This restriction apparently added impetus to DOD arguments to shift the
responsibility for CONTOMS to the Department of Justice. SO/LIC determined that the
nexus between counterdrug and the CONTOMS Program was insufficient for continued
funding by DOD, and discontinued funding for FY 2002. The September 11th attacks,
however, have prompted Congress to reexamine the program’s long-term benefits and
restore its funding in the FY2002 budget.
Current Status
Since September 11, 2001, CONTOMS has provided support for on-going
emergencies for the U.S. Park Police and other government law enforcement divisions,
including deployment to the Pentagon and to the World Trade Center sites in response to
requests for assistance from the U.S. Marshals Service. In addition, CONTOMS personnel
supported a joint exercise for the FBI Hostage Team. Program supporters argue that no
other program had the credibility or expertise to support this particular exercise.
Because of budget cuts, CONTOMS program staff has been reduced from thirty-five
to nine essential personnel. Program supporters maintain this has seriously threatened
successful collaboration between DOD and the civilian emergency response sector. It is
further argued that uncertain funding has forced the civilian community to implement
stopgap, inadequate, and temporary measures as substitute alternative training. Supporters
have recommended that the CONTOMS program should have its budget cuts restored,
although there are differing views whether it should be funded through DOD or the
Department of Justice. Although DOD does not object inherently to continuing
CONTOMS under its jurisdiction if Congress specifically appropriates funding for the
program, DOD argues that unless this occurs the law enforcement community should be
made fiscally responsible for the program rather than DOD.
CONTOMS officials have recommended an appropriation for the current fiscal period
of $2.4 million; $400,000 would be used for a special purchase of needed
chemical/biological response equipment. Program administrators estimate that a baseline

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appropriation of $2 million per year would fund the program at a level that would allow
continued operations.
CONTOMS has been temporarily supported in part by reimbursable funding and
grants from Federal agencies, as well as research funding and support from the USUHS.
It is not clear to what degree the Henry M. Jackson Foundation may be willing or able to
fund this program with or without federal assistance in the future. Alternative, non-DOD
funding was exhausted as of mid-November 2001. Title VI of the Defense Appropriations
Act for FY2002 (H.R. 3338) provided $50 million for peer reviewed medical research.
While CONTOMS was not allocated specific funding, Congress did recommend that DOD
consider CONTOMS as a candidate research program (conference report H.Rept 107-350,
dated December 20, 2001).
Public Interest
Earlier in 2001, medical and law enforcement organizations started appealing to
Congress to support CONTOMS funding. These groups included the National
Association of Emergency Medical Technicians, the National Tactical Officers
Association, Concerns of Police Survivors, and the National Trooper’s Coalition. These
groups cited CONTOMS as a unique program upon which State and Local Emergency
Responders depend to ensure the safety of their members and communities when operating
in crisis environments. These groups also maintained that the program was vital to all
communities because it had taken the lead in addressing operational coordination issues
between law enforcement and emergency providers.
In addition, publicity was generated further through television’s America’s Most
Wanted, which produced a show on Sept. 22, 2001, that highlighted the benefits of
CONTOMS. The producers of AMW reportedly received numerous contacts from
viewers voicing positive support for CONTOMS. Many of these same individuals
contacted their Representatives and Senators via a banner on the AMW web site dedicated
to keeping the CONTOMS program alive.
In general, CONTOMS supporters argue that is should be recognized and embraced
by DOD as a critical military-civilian program that provides great benefits to both groups
while engendering an environment of effective cooperation between the two. Furthermore,
it is suggested that DOD is the only agency with the comprehensive cache of bio-hazard
and WMD knowledge also equipped with the medical infrastructure necessary to keep the
CONTOMS program on the cutting-edge. Supporters conclude that CONTOMS should
become an earmarked DOD budget appropriation [preferably within the USUHS budget]
with guaranteed funding and no longer made dependant upon special budgetary
supplements to remain operational year after year. Other than DOD’s concerns about
funding the program without a specific congressional appropriation, there do not appear
to have been other significant issues raised concerning the program’s operation.
Questions for Congress
A few questions are raised by the current status of the CONTOMS program. Should
the CONTOMS program be eliminated, maintained, or expanded in the wake of
September 11th attacks? At what level should the program be funded? Should financial

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support and administration of the CONTOMS program be the responsibility of the
Department of Defense, the Department of Justice, or shifted in some degree to state and
local law enforcement agencies?