CONTOMS (Counter Narcotics and Terrorism Operational Medical Support Program)

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).

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 CRS-2 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: EMTTactical; 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 CRS-3 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 CRS-4 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 CRS-5 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?