Preface -- Contents -- Figures -- Tables -- Summary -- Acronyms -- CHAPTER ONE- Introduction -- Background -- Research Objectives and the Influence of September 11 -- Research Methods -- Terminology -- Terrorism -- CBRNE Versus Weapons of Mass Destruction -- How This Report Is Organized -- CHAPTER TWO- The Military Health System and Military Support to Civil Authorities -- The Two Primary Missions of the Military Health System -- The Military Health System Missions Share Resources -- Military Medical Assets -- Mission Medical Assets -- Infrastructure Medical Assets -- DoD Organization, Guidance, and Planning -- Organization for Military Operations -- Guidance -- Plannin -- Limitations to Consider When Planning for Military Assistance -- Military Assets May Be Engaged in Other Missions -- Military Assets Are Maintained at Various Readiness Levels Based on Wartime Requirements -- CHAPTER THREE- The Evolution of Structures, Systems, and Processes for Domestic Preparedness -- Recommendations from National Commissions -- New Players and New Roles in Homeland Security -- The Office of Homeland Security and the National Strategy -- The Department of Homeland Security -- Homeland Security Presidential Directive-5 -- The National Response Plan -- The Role of DoD in Civil Response: An Overview -- The National Disaster Medical System -- Other DoD Directives Related to Civil Support -- The Director of Military Support -- The Assistant Secretary of Defense for Homeland Defense -- U.S. Northern Command -- CHAPTER FOUR- Legal and Other Barriers to Military Support to Civil Authorities -- Constitutional and Historical Bases for Use of the Military Domestically -- Statutory and Regulatory Authorities Enabling the Use of Military Assets toSupport Civil Authorities -- Constitutional Authority -- Congressional Authority: Posse Comitatus Act and Its Progeny.

Congressional Authority: Civil Disturbance (or Insurrection) Statutes -- Congressional Authority: Counterdrug and Related Statutes -- Congressional Authority: Disaster Relief and the Stafford Act -- Congressional Authority: Counterterrorism and Weapons of Mass Destruction -- Congressional Authority: Quarantines, Evacuations, and Curfews -- Congressional Authority: New Authority for Use of the Reserve Components -- Constraints on the Exercise of Explicit Authority -- Executive Authority: The President's Residual Authority -- Executive Authority: Martial Law -- Executive Authority: Executive Order -- Executive Authority: DoD Policy on Military Assistance in Civilian Emergencies -- Legal Liabilities Implicated by the Use of Military Medical Assets to SupportCivil Authorities -- Liability Under the Federal Tort Claims Act of 1946 -- Liability Under Section 1983 and Bivens for Violations of Constitutional Rights -- Liability Related to the Management of Property, People, and Information -- Distinguishing Between Homeland Defense and Civil Support -- Nonlegal Constraints on the Use of the Military -- Diffuse Nature of Authority -- Reluctance to Seek Federal Assistance -- Apprehension About Military Assistance -- Cultural Barriers -- Capabilities -- Requirements Identification -- Conclusions -- Recommendation -- CHAPTER FIVE- Military Medical Support to Civil Authorities: Historical Case Studies -- DoD's Role in Medical Response -- Research Methods for Case Studies -- Hurricane Andrew Background -- Government and Military Response to Hurricane Andrew -- Hurricane Marilyn Background -- Government and Military Response to Hurricane Marilyn -- Tropical Storm Allison Background -- Government and Military Response to Tropical Storm Allison -- What Lessons Can Be Learned from These Case Studies? -- A Conceptual Framework for Response.

Decentralized Versus Centralized Response -- Civilian Versus Military Response -- CHAPTER SIX- Exercise-Based Studies of Potential Military Medical Support to Civil Authorities -- Objective -- Exercise Methods -- Exercises Were Based on an Established Methodology -- The Analytic Framework for the Exercise -- The Design and Testing Process Included Consideration of a Menu of Potential Issues -- Terrorist Attack Scenarios -- The Georgia Exercise: Smallpox Attack -- Background -- Georgia Emergency Response Services -- The Threat and the Scenario -- The Exercise -- Exercise Results: Issues and Observations -- The California Exercise: Radiological Dispersion Device Attack -- Background -- California Emergency Response Services -- The Threat and the Scenario -- The Exercise -- Exercise Results: Issues and Observations -- Conclusions -- CHAPTER SEVEN- Conclusions and Recommendations -- Conclusions -- Recommendations -- APPENDIX A- Interview Protocol -- APPENDIX B- Organizations Interviewed and Exercise Participants -- APPENDIX C- DoD Directives Related to Civil Support -- APPENDIX D- Materials Used in Georgia Exercise -- APPENDIX E- Smallpox Outbreak Model Used in the Georgia Exercise -- APPENDIX F- Excerpt of Quadrennial Defense Review -- Bibliography.