Sustaining the Soldier
No matter how much fuel and munitions COSCOM units push to the front each day or how awesome and lethal weapon systems become, it is our soldiers who tight battles. Soldiers need rations, water, clothing, individual equipment, protective gear and shelter. Construction, barrier, and fortification materials enhance soldier survivability and provide protection against enemy advances and enemy fires.
The health, morale, welfare, and combat capability of our soldiers are also affected by the provision of health and comfort items, field services, and health services. How well our soldiers are cared for influences their will to continue fighting.
Whenever possible, secondary field services, such as bath, laundry, and textile renovation, should be provided by the HN or through local contractors. Procurement support branch personnel plan and coordinate the use of HN or contracted supplies and services to reduce dependence on CONUS-based resupply operations and requirements for US field services support elements.
This chapter does not cover personnel functions. Strength management, reception and replacement operations, postal operations, and MWR support are provided by units assigned to the corps personnel group. For doctrine on personnel functions, refer to FM 12-6.
This chapter also does not cover finance support operations provided by finance support commands assigned to the corps finance group. For doctrine on finance support, refer to FM 14-7.
SOLDIER SUPPLY SUPPORT
The COSCOM support operations officer is responsible for the COSCOM's supply support of corps soldiers. He uses the COSCOM supply support structure to ensure that corps soldiers are provided rations, water, and clothing and individual equipment, as well as personal welfare and comfort items. He accomplishes this through his troop support branch and his supply management element, the CMMC.
CSS PLANS BRANCH
CSS plans branch personnel, assigned to the COSCOM support operations section, develop estimates and plans to support corps soldiers with rations, water, and health and comfort items. They also prepare plans to support soldiers with clothing, OCIE, protective MOPP gear, and shelter. They coordinate with and provide input to staff officers assigned to the COSCOM ACofS, G3's force design/plans branch, They recommend changes to the troop list based on requirements and DS/GS supply unit capabilities as well as requirements for additional water support in arid environments.
TROOP SUPPORT BRANCH
Troop support branch supply personnel, assigned to the support operations section, develop policies and programs for the external supply support provided by COSCOM units. They provide technical staff assistance to supply staff in subordinate CSGs. They coordinate supply support operations of the COSCOM with the coordinating general and special staffs of the COSCOM.
Troop support branch supply personnel develop and maintain estimates, analyses, and summaries of requirements for support plans. They recommend allocations, supply levels, and priorities for COSCOM units engaged in supply support functions. To do so, they continually coordinate external supply support plans, policies, and priorities for support with personnel assigned to the other branches under the support operations section as well as with the staff in the ACofS, G3 plans and operations branches. For example, they coordinate transportation requirements with transportation support branch personnel. They coordinate supply unit locations and movements with ACofS, G3 plans and operations staff.
During the alert phase, troop support branch supply personnel review force requirements and consumption data for the AO. They perform the tasks listed on Table 4-1 in preparation for deployment and staging. They use CSSCS reports to continually assess the capabilities and limitations of subordinate supply activities. CSSCS helps them determine the impact of projected activities on those support capabilities. As required, they recommend elements to accompany corps forces operating out of sector or supporting allies or a sister Service.
PROCUREMENT SUPPORT BRANCH
Procurement support branch personnel, assigned to the COSCOM support operations section, plan and coordinate the use of local resources to reduce dependence on CONUS-based resupply. They coordinate with CSG contracting personnel and with CA units on acquisition of HNS or contracted supplies. They validate that the items of supply are authorized to be obtained by contract.
Procurement support branch personnel obtain the following assistance from CA units:
- Area studies on possible areas of deployment.
- Data on locally available supplies.
- Contingency contracting kit materials (maps, telephone books).
- Recommendations from State Department Foreign Service personnel.
- Information on existing LOGCAP and HNS agreements for the AO.
- Access to the civilian and HN agencies.
Primary local supply requirements include fresh fruit, vegetables, and ice. Troop support branch personnel coordinate for mandatory veterinary inspections of these items.
LOGISTICS PREPARATION OF THE BATTLEFIELD
Advanced planning, based upon preplanned and updated intelligence data for contingency areas, is crucial for troop support. Identifying essential intelligence requirements improves planning. Troop support branch personnel make their priority intelligence requirements known to ACofS, G2 and G3 staff. They use the IPB products described in FM 34-130 as a source of planning data. IPB products aid them in anticipating requirements and developing plans on how to provide and protect troop support for a proposed operation.
CMMC SUBSISTENCE BRANCH
The subsistence branch of the CMMC's troop support materiel division manages subsistence items ranging from operational rations to refrigerated items. The branch implements the policies and plans of the COSCOM support operations officer/troop support branch chief. Branch personnel --
- Keep the troop support branch subsistence officer informed of trends and probable impacts.
- Analyze subsistence supply operations in the corps.
- Recommend changes in subsistence supply support to the COSCOM troop support branch chief.
- Forecast Class I requirements.
- Maintain visibility of subsistence the corps area.
- Direct the storage and distribution of subsistence.
- Review and analyze demands.
- Process Class I requisitions from the DMMCs and nondivision DS supply units.
- Coordinate with veterinary personnel for the inspection and certification of subsistence items.
- Direct the GS supply company to ship subsistence items.
- Monitor bakery production in coordination with the GS supply company's bakery team.
- Transmit replenishment requisitions for subsistence items to NICPs for resupply from CONUS.
- Manage hospital rations.
- Manage ration supplement sundries packs.
Strength reports serve as the basis for computing requirements for Class I and VI supplies. Initial stockage of subsistence items depends on authorized strengths, mission requirements, and deployment schedule. As the theater stabilizes, strength reports submitted by units serve as the basis for requisitioning subsistence.
The CMMC subsistence branch computes requirements for Class I and VI based on strength reports, demand history, and anticipated mission requirements.
The subsistence officer and subsistence NCO assigned to the COSCOM's troop support branch use SIDPERS reports reflecting actual troop strength to help determine support requirements. However, SIDPERS reports do not include allied, HNS, or EPW feeding requirements. Stockage plans should allow for surges in the number of soldiers to be supported. The CMMC subsistence branch adjusts stockage at Class I points to reflect actual subsisted strength.
Subsistence support requirements are also affected by the field feeding standard and ration cycle announced in the corps service support plan or order. Subsistence stockage at Class I points are affected if units in the corps rear area transition to A or B Rations earlier than indicated in the feeding plan. Stockage would also be affected by having corps units continue on A and B Rations to conserve operational ration stocks.
The feeding policy is three quality meals per day. To support this feeding policy, field commanders select from individual and group rations. FM 10-23 describes ration types.
Commanders structure their field feeding plan to fit the following tactical and logistical situations:
- MREs should be used during intense levels of combat or when unit activity precludes the use of prepared group rations. For example, soldiers in fighting positions; conducting attacks, raids, or ambushes; or dispersed at remote sites would use MREs. Army policy limits the use of MREs to no more than 10 consecutive days.
- T/B/A group meals are used in more stable or uncontested regions on the battlefield. Their use depends on the tactical situation and storage and handling capabilities. For example, --
- Semiperishable B Ration components enhance T Ration menus. Standard B Ration meals can be served when operations permit extensive preparation by cooks.
- Medical B Ration unique items, identified in SB 10-495-1, support patient feeding requirements. Special planning and requisitioning must occur for patient feeding with hospital B Ration items and the liquid B Ration. Hospitalized patients require three hot medical B Ration meals and a night meal daily. MREs are not authorized for patient feeding, except in emergency situations.
- Perishable A Ration items require food preparation personnel and equipment plus refrigeration support.
Plastic trash bags are provided with T Ration components to assist in disposal of empty tray pack containers and associated trash. They need to be procured through supply channels when the situation allows for preparation and feeding of A or B Ration meals.
COSCOM SUBSISTENCE ORGANIZATION
Subordinate COSCOM elements which provide Class I supplies include the --
- Quartermaster Supply Company DS (TOE 42447L000). This company can provide nearly 40 STONs of Class I stocks each day. As applicable, it provides augmenting or reinforcing support to FSB/MSB Class I points to enable them to provide support to corps forces in the brigade or division area.
- Quartermaster Supply Company GS (TOE 42418L00). This company can receive, store, and issue 117 STONs of Class I stocks per day.
- GS Supply Company Bakery Team (TOE 42518LA00). This team can bake 8,208 pounds of bread per day.
- GS Supply Company Perishable Subsistence Platoon (TOE 42518LB00). This platoon can receive and issue 128 STONs of perishable Class I per day in support of up to 55,000 troops. It can store approximately 235 STONs of perishable products in walk-in reefers to support local procurement of perishable subsistence.
CLASS I DISTRIBUTION SYSTEM
During the initial stages of conflict, the CMMC computes the types and amounts of rations to be shipped and pushes rations forward to deployed units. The CMCC forecasts Class I movement requirements as input to the movement program.
The quantity shipped depends on anticipated troop strength, unit locations, type of operations, and field feeding capabilities. Based upon the theater command policy and authorized strength figures provided by the division and corps G1, the CMMC directs GS supply companies to "push" Class I supplies to Class I points. While the push system ensures that rations are available in the AO, rations may not be in the right supply point in sufficient quantity to support units. Units have limited control on the types of rations they receive.
Once the theater or AO stabilizes, the CMMC implements a "pull" or request system. As shown by Figure 4-1, field kitchens submit requests to their supporting Class I supply point. Class I supply points consolidate these requests and submit a requisition to the Class I section of the appropriate MMC. The DMMC and separate brigade and regiment MMCs transmit consolidated requisitions to the CMMC. In the corps rear area, Class I points consolidate requests from nondivision units and submit requisitions to the CMMC. While the pull system is more responsive to user requests, it requires longer ordering lead times than the push system.
The CMMC converts personnel strength data to meal quantities for each type of standard meal ration. This is based on the current field feeding ration mix or the tactical commander's instruction. The CMMC's subsistence branch cuts an MRO directing the issue from the general supply company Class I point to the nondivision DS supply company Class I point. The CMMC's subsistence branch transmits a requisition to the TAMMC for replenishment and for items not available in the corps.
Corps transportation assets deliver Class I supplies to nondivision DS supply company Class I points and to the MSB's S&S company's Class I point. Class I is normally provided by supply point distribution. Class I supply point personnel transmit issue data to their supporting MMC for posting to accountable records.
Packaging and coverings provide some protection and reduce contamination from liquid agents and radioactive fallout. Storing subsistence items in warehouses, buildings, and basements provides additional protection.
Rations must not be prepared or consumed when NBC contamination is present. Veterinary service teams inspect subsistence exposed to contamination. FMs 3-5 and 8-505 describe decontamination methods for subsistence. Units withdraw from the contaminated area before decontaminating rations and equipment and preparing meals.
Bread products form an essential component of T/B/A ration meals. Pouch bread serves as the initial source of bread on the battlefield. Shelf-stable pouch bread supplements all types of rations. As soon as the situation permits, fresh bread should be obtained from field bakeries, HNS, AAFES, or contracted commercial sources.
As soon as possible, food service elements should provide milk. Although a component of the T Ration meal, milk is provided separately -- either as dry milk, ultrahigh temperature milk, or fresh milk.
The GS supply company's perishable subsistence platoon (TOE 42518LB00) provides perishable subsistence A Ration support to the corps. In the LID, this platoon augments the HSC company in the DSA when meals other than MREs and T Rations are introduced.
The COSCOM needs to procure ice prior to introduction of A Ration feeding and to cool beverages in warm environments. Sources include HNS, Logistics Civil Augmentation Program, or locally designated commercial sources. Veterinary personnel ensure that ice is safe for consumption.
RATION SUPPLEMENT SUNDRIES PACKS
Ration supplement sundries packs contain Class VI personal hygiene and comfort items. They include candy, gum, stationery, soap, dental care products, and other items authorized by AR 700-23. A separate sundries pack exists for female soldiers.
Initially, soldiers carry personal hygiene and comfort items into the theater with them. As the supply system adjusts to demands, Class I points issue sundry packs with Class I items. Once the tactical situation stabilizes, soldiers may purchase personal demand items from mobile exchange sales teams. The COSCOM ACofS, G5 arranges for personal demand items through HN or contractor support. Command channels approve special requirements for sundries packs.
The subsistence officer assigned to the COSCOM's troop support branch needs to plan for subsistence and personal hygiene and comfort items to support humanitarian actions. His estimates and recommendations for support should include geriatrics support as well as refugee support.
PRISONER OF WAR SUPPORT
Support for PWs occurs at EAC. In the corps area, support for PWs consist principally of food and water. Depending upon time and distance to PW camps, the troop support branch subsistence officer may need to plan for initial subsistence for PWs. Corps G2 staff officers provide estimates. If available, captured subsistence may be used to feed PWs.
CSSCS CLASS I, VI, AND WATER REPORTS
Class I, VI, and water asset data are collected manually from all Class I points and water points. CSSCS software provides status data on Class I, VI and water assets located within the corps area. The system also provides asset data both in terms of quantities available and days of supply.
COSCOM troop support branch supply personnel use CSSCS Class I, VI, and water capability and asset displays to monitor current and projected asset availability for the force. They monitor ration and water distribution quantities and schedules. They recommend changes to subordinate CSG customer lists to agree with changing priorities and tactical situations.
COSCOM troop support branch supply personnel use CSSCS capability reports on Class I, VI, and water to assess the need for extra transportation support. They then coordinate this requirement with the COSCOM's transportation support branch staff.
Subordinate CSG support operations staff officers use CSSCS asset displays to analyze unique situations at a particular Class I or water supply point or support area. For example, CSG supply and field service staff officers use the display to anticipate a shortage of Class I items and coordinate with the HN to augment support.
The COSCOM provides potable water throughout the corps on a demand basis. Water supply to nondivision units in the corps area occurs on an area basis. Where circumstances permit, engineer utilities teams arrange for water to support units operating in freed facilities. Water sources must be approved by preventive medicine personnel.
COSCOM TROOP SUPPORT BRANCH
COSCOM troop support branch personnel plan water support for operations in arid environments. The water treatment NCO provides technical expertise on water quality control and treatment standards. Plans need to cover the following elements:
- Mission, size, and composition of the force to be supported.
- Amount and type of water required.
- Seasonal impacts.
- Storage and water distribution points.
- Distribution system or transportation mode.
- Water equipment required to support the operation.
- Organizations and personnel required to operate the water distribution system.
- Availability and capability of subordinate DS supply units or water units to provide the required support.
- Number and location of distribution points.
- Type of terrain and distance between units.
- Controls required in regions where water is a critical commodity.
CMMC PETROLEUM/WATER DIVSION
The CMMC's petroleum/water division provides centralized supply management, supply data, and information on COSCOM water supply support operations. This division's personnel perform the following functions:
- Keep the troop support branch chief informed of water supply status data.
- Monitor water allocations and corps priorities for water resources.
- Ensure that maneuver units maintain adequate stocks to meet requirements.
- Divert water stocks as necessary.
- Direct water shipments using plans for specific operations.
- Provide data and other assistance to support operations planning.
- Coordinate with preventive medicine teams on water quality matters.
- Direct the movement of water forward to meet unexpected requirements.
WATER SUPPORT REQUIREMENTS
The type of warfare, type of battlefield (nuclear environment and requirement for MOPP gear), and type of environment affect water requirements. Factors which also affect water support requirements include --
- Troop density and personal hygiene requirements.
- Command policy on type of ration provided.
- Command policy on frequency of showers and laundry support.
- Requirements for chemical decontamination.
- Engineer construction requirements.
- Mortuary affairs support.
FM 10-52 provides water consumption planning factors. These factors need to be adjusted based on data reported from water supply point production and distribution summary reports.
WATER SUPPORT ORGANIZATION
Figure 4-2 depicts the water support organization for arid regions.
DS supply companies (TOE 42447L000). These companies provide water support on an area basis. Their organic water supply section provides water purification and storage at water supply points using approved water sources. Section water purification specialists use organic equipment to pump, demineralize, purify, store, and test water. Whenever possible, the water supply point collocates with a Class I supply point. As required, the DS supply company attached to the CSB in the division area provides reinforcing support to FSBs/MSB to enable them to support corps forces in the brigade or division area.
Water supply companies (TOE 10468L000). These companies can establish and operate two tactical water distribution systems and up to eight DS issue points. FM 10-115 describes the mission of water supply companies. Water supply companies maintain adequate capabilities for water treatment on temperate, conventional battlefields. However, additional corps water purification capacity is required to provide for greatly increased requirements in hot, arid theaters and on integrated battlefields.
Corps water supply units produce a significant drain on transportation distribution capability. Water support teams can be attached to this company to provide additional bulk distribution capabilities.
Engineer organizations identify surface water sources, drill wells, and perform water point construction support. Construction and maintenance encompass rigid water storage tanks, pipelines, and water utilities at fixed installations. COSCOM troop support branch personnel coordinate with COSCOM engineer staff on requirements for developing water sites, site access, and other construction support requirements.
PREVENTIVE MEDICINE SUPPORT
Preventive medicine organizations approve water sources and provide routine surveillance to ensure that water quality meets appropriate standards. Water purification equipment operators analyze both untreated and treated water to ensure that purification equipment is operating properly. They also verify that water is being adequately treated.
Requirements for nonpotable water increase with requirements to decontaminate personnel and equipment. Water quality surveillance equipment detects chemical and radiological contaminants. Water purification equipment removes or destroys chemical, radiological, and biological contaminants. FM 10-52describes contamination detection and treatment procedures. FM 3-5 describes water decontamination methods. However, water decontamination should be undertaken only by trained water purification personnel.
Water transport and distribution equipment prevents incidental contamination of potable water. Commanders ensure that units protect water from accidental or deliberate contamination and that sufficient potable water is available to prevent dehydration. A forced drinking policy can help prevent dehydration and heat casualties which result from wearing MOPP 4 gear.
CLOTHING AND OTHER CLASS II SUPPORT
Soldiers require clothing and MOPP gear as well as individual equipment and tentage. OCIE items are also required for RTD personnel, medical patients, contractors, reporters, essential civilians, NEO family members, local nationals, and EPWs.
The supply and service officer assigned to the COSCOM troop support branch develops policies and procedures for Class II support.
CMMC DEFENSE PERSONNEL SUPPLY BRANCH
The defense personnel supply branch, assigned to the CMMC's troop support materiel division, manages requirements for Class II (except maintenance related) supplies. This includes, but is not limited, to clothing, individual equipment, tents, and tarpaulins and associated textile fabrics. The branch implements the policies and plans of the COSCOM support operations officer/troop support branch chief. Branch personnel perform the following tasks:
- Review and analyze demands for Class II items.
- Prepare and maintain a list of command controlled and regulated Class II items.
- Implement policies outlined in AR 710-2 for operation of the stock record account.
- Ensure correct use of issue priority designators.
- Ensure that the quantity requested does not exceed authorized allowances.
- Forward validated requisitions to the CMMC input/output branch for preparation of shipping directives.
- Transmit requisitions to the appropriate NICP or the TAMMC.
- Direct the storage and distribution of Class II supplies.
CMMC GENERAL SERVICES SUPPLY BRANCH
The general services supply branch of the CMMC's troop support materiel division manages GSA materiel. Hand tools, office furniture, kitchen utensils and tableware, office supplies and machines, and personal toiletry products are examples of the supplies and equipment managed by this branch. The branch implements the policies and plans of the COSCOM support operations officer/troop support branch chief. Branch personnel --
- Review and analyze demands.
- Establish and review ROs based on past demand experience and anticipated requirements.
- Implement policies outlined in AR 710-2 for operation of the stock record account.
- Monitor ASL zero balance lines with dues out.
- Identify items requiring intensive management.
- Take action to satisfy dues out.
- Establish procedures for processing off-line requisitions.
- Direct the storage and distribution of GSA materiel.
INITIAL CLASS II ALLOWANCES
The mobilization column of CTA 50-900 lists clothing allowances for contingency plans and mobilization. The task force commander or contingency force commander designates which items soldiers wear or carry and which are transported. This impacts on load plans.
CTA 50-970 lists initial stockage levels and initial expendable and durable items. Replenishment is based on demands and anticipated requirements.
CLASS II SUPPORT ORGANIZATION
COSCOM units which provide Class II supplies include the --
- DS supply company (TOE 42447L000). This company can provide 33.95 STONs of Class II items per day in support of 18,500 nondivision soldiers.
- GS supply company (TOE 42418L000). This company can provide 101 STONs of general supplies.
CLASS II REQUISITION AND DISTRIBUTION FLOW
DMMC and nondivision DS supply units transmit requisitions for personnel support items to the CMMC. As applicable, the CMMC's defense personnel supply branch and general services supply branch validate the requisitions. The CMMC transmits MROs to the general supply company for issue.
The general supply company issues the supplies to the DS supply company Class II point and sends activity summaries to the CMMC. CMMC Class II managers, the COSCOM transportation support branch, and the supporting transportation activity coordinate delivery.
When required Class II supplies are not available at the general supply company, the CMMC transmits requisitions to the NICP. When Class II items are controlled, the CMMC transmits requisitions to the TAMMC.
NBC protective clothing and equipment may be in critical demand. DS supply companies can expedite their issue through the use of preconfigured push packages.
FM 3-5 describes decontamination methods for removing NBC agents from clothing and textile items.
CSSCS CLASS II REPORTS
CSSCS software displays the status of Class II assets on the CSSCS tracked items list. Data from DS/GS Class II supply points enters CSSCS through its interface with SARSS-1.
COSCOM troop support branch supply personnel use CSSCS Class II asset status displays to assess the current and projected availability of Class II assets for the force. They use CSSCS reports to assess the capability of DS and GS supply units to support changes in tactical operations. CSSCS data enables them to plan for shifts in Class II requirements in offensive versus defensive operations.
Subordinate CSG support operations staff officers use CSSCS asset data to assess unique situations at subordinate Class II points. CSSCS Class II asset data enables them to assess storage and distribution requirements and evaluate those requirements against DS/GS supply unit capabilities.
UNCLASSIFIED MAP SUPPLY, REQUESTS, AND DISTRIBUTION
The COSCOM troop support branch supply and service officer sets map stockage policy and determines reserve stockage requirements. Requirements planning should follow AR 115-11, as supplemented by MACOMs or theater commanders.
BMMCs and DMMCs consolidate requests and transmit unclassified map requirements to the CMMC. Nondivision units order unclassified maps through their supporting DS supply company. Since DS supply companies maintain only limited quantities of currently used unclassified maps, map requirements are transmitted to the CMMC.
The CMMC computes map requirements for the corps. It maintains stock status and asset visibility data on map products. Where no TAMMC exists, the CMMC coordinates issue of maps to units entering the theater without their basic load of maps. It preapproves requests for issue or replenishment stocks.
The COSCOM's general supply company's map storage site receives, stores, and maintains map and map products as well as corps reserve map stocks. This map storage site or DMA depot maintains "go to war" surge stocks. Upon receipt of MROs, map storage site personnel pull and prepare unclassified maps for shipment.
Corps transportation assets deliver maps to the DS supply company Class II, IV VII point. Maps are distributed by supply point distribution. Using units pickup maps at their supporting Class II, IV, VII point. Depending upon priority, maps can be pushed forward directly to the customer.
If maps are not available in the general supply company's map storage site, the CMMC requisitions maps through the TAMMC from the theater map depot or from DMA map storage sites in theater or CONUS. DMA ships map stock to the theater map depot operated by a TAACOM map supply detachment.
SPECIAL MAP PRODUCTS
Special map products satisfy specific command requests and do not normally enter the supply system. S2/G2 section staff officers validate requirements for special maps products, to include --
- Map overlays.
- Photo maps.
- Terrain related products.
- Small quantity quick response overprinting.
- Printing for support of a planned operation.
Requests for these products are sent through engineer channels to an engineer topographic unit. They are either hand carried to the requestor or picked up by the requestor.
CLASSIFIED MAP PRODUCTS
Classified map products are requisitioned through command channels on an exception basis. Intelligence officers prepare the classified map requirements appendix to OPLANs. OPSEC appendixes specify classified map product requisitioning procedures, destruction, and authorized disposal.
Maps ordered in advance of operations or ordered for operational planning are handled as classified documents. Map stockage needs to cover requirements for initial operational force deployment/employment and supported operations for a defined period of time during war, mobilization, or other crisis situations. The COSCOM support operations officer projects requirements to cover geographic areas where corps operations are likely.
Intelligence staff officers determine or verify classified map requirements in coordination with S3 operations staff prior to submission by S4s. S2/G2 section staff officers validate requests submitted to the CMMC for classified map products maintained at the GS level map storage site.
In accordance with AR 380-5 and OPSEC appendixes, classified map products are distributed to the requestor, not to the DS supply company. DSUs do not receive, store, or distribute classified map products.
BARRIER, FORTIFICATION, AND CONSTRUCTION MATERIALS SUPPORT
Barrier and fortification materials enhance soldier survivability, counter enemy advances, and provide protection against enemy fires.
PROTECTIVE POSITIONS, SHELTERS, AND FORTIFICATIONS
All units require some Class IV barrier and fortification materials to prepare individual and crew fighting and protective positions as well as field fortifications and perimeter defense.
Engineers require Class IV barrier and construction materials to prepare protective positions or protective shelters beyond the capabilities of supported maneuver elements. Engineers construct protective positions for --
- Artillery and air defense unit emplacements.
- Antitank guided missile systems and armored vehicles.
- Critical command and control facilities.
- Critical logistics facilities.
Engineers also require barrier materials to build dummy defensive or attack positions and emplace dummy minefield and weapon positions. More complex deception requires the use of prefabricated deception devices used in constructing dummy tank farms, supply points, or marshaling areas.
CONSTRUCTION AND BRIDGING MATERIALS
Existing road networks are rarely adequate for the heavy traffic associated with movement and support of corps forces. Rather than construct new roads, corps engineers upgrade or maintain existing roads. New construction is often limited to short access roads to assembly areas and bypasses around obstacles. To support this, the COSCOM prepositions Class IV construction materials as far forward as the tactical situation allows.
Engineers also require Class IV construction materials for expedient construction of airstrips, landing zones, and forward arming and refueling points in support of forward aviation. Corps engineers focus on repairing extensive damage to critical airfields.
For deliberate crossings, engineers require Class IV construction and bridging materials to assemble rafts or bridges. While division engineers normally accompany assault forces across the river, corps engineers construct or repair approach and egress sites and build bridges for use by follow-on support forces.
Corps G3 plans and operations staff officers keep COSCOM troop support branch staff informed of breaching, bridging, barrier, or base development construction requirements which significantly change Class IV requirements estimates. The branch chief passes these requirements on to the CMMC commodity managers for Class IV material.
CLASS IV SUPPORT ORGANIZATION
The COSCOM's Class IV support organization consists of:
- DS Supply Companies (TOE 42447L000). These companies can receive, store, and issue 29.65 STONs of Class IV items per day to nondivision units in their area of responsibility.
- A General Supply Company (TOE 42418L000). This company can receive, store, and issue 212 STONs of bridging equipment and fortification and construction supplies daily.
CLASS IV REQUEST AND DISTRIBUTION FLOW
The request flow depends on whether Class IV supplies are controlled or noncontrolled. Whenever possible, corps trucks deliver barrier materials to the emplacement site.
Controlled Class IV Supplies
Heavy tonnage Class IV supplies critical to base development or tactical operations may be command controlled. Units submit requests for controlled Class IV supplies through command channels. As early as possible, corps engineer units in the division sector need to make their requirements known to the COSCOM/CSG LO at the DISCOM or the CSB LO at the FSBs. The LO directs their proper disposition and assists as necessary.
Following command release approval, the COSCOM support operations officer/troop support branch chief directs the CMMC to release the supplies. The CMMC forwards an MRO to the GS supply company directing the issue. The CMMC also coordinates with the CMCC for throughput to engineer sites or for movement to forward supply points in the corps or division area. The GS supply company coordinates with the area MCT to obtain transportation support.
If controlled Class IV supplies are not on hand, the CMMC sends the requisition to the TAMMC. When supplies are on hand in a TAACOM subordinate GS supply company, the TAMMC directs their issue upon command approval. When supplies are not on hand, the TAMMC transmits the requisition to the appropriate CONUS NICP.
Noncontrolled Class IV Supplies
Units submit requests for noncontrolled Class IV supplies to their supporting DS supply company's Class II, packaged III, IV, and VII supply point. If the supplies are on hand, the supply point issues the supplies and notifies the CMMC of the issue through its SARSS-1 interface with the CMMC's SARSS 2A/2B.
If noncontrolled Class IV supplies are not on hand, the DS supply company transmits a requisition to the CMMC. If the supplies are available in the corps rear area, the CMMC cuts an MRO directing its issue. The CMMC coordinates with the CMCC for movement of supplies to forward supply points. If the supplies are not available, the CMMC transmits the requisition to the appropriate CONUS NICP.
To minimize requirements placed on supply LOCs, the bulk of barrier material should be purchased locally. The COSCOM's procurement support branch personnel coordinate purchase requirements with CA elements. CA personnel assist subordinate CSG contracting personnel with the local procurement of Class IV construction supplies.
Warnings of impending nuclear strikes increase requirements to shield fortifications. However, the COSCOM's CSGs send construction and barrier materials forward only in support of specific plans or requirements.
CSSCS CLASS IV REPORTS
CSSCS software tracks Class IV assets which appear on the CSSCS tracked items list. It distinguishes between assets located in Class IV supply points and assets in individual units.
The interface between SARSS-1 and CSSCS enables supply points to report on Class IV assets in the supply points. Battalion and separate companies within the corps area manually enter data on a Class IV data collection form.
COSCOM troop support branch personnel assess the current and projected availability of Class IV assets for the force. They use Class IV asset display data to assess storage and distribution requirements. They use CSSCS to display the unique Class IV status of an individual unit or supply point. CSSCS reports help them plan for shifts in Class IV usage in support of offensive versus defensive operations.
SARSS STOCK STATUS REPORTS
Figure 4-3 depicts the interface between SARSS-1 at the supply units and SARSS-2A/2B at the CMMC. Subordinate DS and GS supply units transmit SARSS-1 stock status reports on Class IV stocks to the CMMC. As a backup to this electronic data network, couriers carry floppy disks of SARSS-1 unfilled supply requisitions to the CMMC. CMMC commodity managers use SARSS-2A/2B to aid them in controlling critical stocks, performing lateral issues, and computing requirements.
SOLDIER FIELD SERVICES SUPPORT
Soldier field services are divided into primary and secondary services. On an austere battlefield, the COSCOM may provide only mortuary affairs support. When the situation stabilizes, it provides the secondary services (CEB, laundry, and renovation). If possible, these secondary field services are provided by the HN or through local procurement. Otherwise, US or allied military services may be used. The necessity of these services to soldier welfare and morale is such that they should be provided even if HN sources are not available.
CSS PLANS BRANCH
CSS plans branch personnel, assigned to the COSCOM's support operations section, develop plans for providing field services support to all corps soldiers. The supply and service officer recommends allocations and priorities for COSCOM units engaged in field services functions. Appropriate plans branch personnel develop personnel and equipment requirements data and recommend changes to the troop basis and modification of field services unit MTOEs to the ACofS, G3's force design/plans branch.
TROOP SUPPORT BRANCH
Troop support branch field services personnel, assigned to the COSCOM's support operations section, recommend priorities of field services support. They coordinate field services support planning and policies with staff in the other support branches under the support operations section.
Troop Support Branch Chief
The troop support branch chief exercises staff supervision over field services support. He coordinates the development of policies, plans, and programs for field services support provided by COSCOM units, to include mortuary affairs, CEB, laundry, and renovation. The laundry and bath officer determines the frequency of use and requirements for local civilian labor to offset requirements for CEB and laundry services. The supply and field services officer coordinates with procurement support branch personnel on contracting HNS to offset shortfalls in field services support. He relays terrain/location requirements of field services units and mortuary affairs collection points to corps rear CP operations cell staff.
Troop Support Branch Field Services Staff
During the alert phase, troop support branch field services personnel perform the deployment tasks listed on Table 4-2. They update policies and plans for field services support, to include location, area coverage, and scope. They provide technical advice on field services matters to the COSCOM support operations officer and to the COSCOM commander and staff. They update the services portion of estimates and corps service support plans. COSCOM field services staff officers assist field services staff in subordinate CSGs. Troop support branch field services staff officers use CSSCS displays to access overall field services capabilities and to analyze support problems.
PROCUREMENT SUPPORT BRANCH
Procurement support branch personnel, assigned to the COSCOM's support operations section, coordinate with troop support branch personnel for ways to offset corps field service requirements by contracting for services. The supply and services officer provides policy guidance on procurement of services, to include cost forecasting, contract formulation, cost analysis, source selection, and quality assurance.
ACofS, G5 SECTION
ACofS, G5 section personnel establish policies and procedures in coordination with the corps G4 and G1 for HN or contract of local services, to include --
- Dining facility and KP support.
- Bath services.
- Local labor support.
- Sanitation support.
- Mortuary services (within specific parameters).
CA units provide information on services available in the AO. SJA personnel provide legal advice relative to the acquisition and ethics of field services contracts.
Field services units provide support on an area basis to division as well as nondivision soldiers. Figure 4-4 depicts how a COSCOM might employ its field services elements on the battlefield.
In this example, the COSCOM attached a DS field services company to the forward CSG's CSB in the DSA. That company provides CEB, field laundry, and lightweight textile renovation. It attached the remaining DS field services companies to CSBs on the basis of one company per 18,500 soldiers supported. To support reconstitution, it attached CEB and laundry teams and a mortuary affairs collection platoon to a regeneration task force.
The MA collection company, attached to the rear CSG's S&S battalion, is allocated on the basis of one company per corps to provide initial care and services for remains before evacuation to CONUS or to a mortuary or temporary cemetery in theater.
Forward Collection Platoons
These platoons operate collection points within corps, division, and brigade areas. The COSCOM/CSGs allocated mortuary affairs assets to provide collection support where most needed. A total of 20 collection points set up to receive and evacuate remains and personal effects. They have limited capability to search for and recover remains. Collection section personnel can also operate in direct support of task forces, brigade-size or larger.
Main Collection Platoon
This platoon prepares and arranges for remains to be evacuated by air or surface transportation. During recent low-intensity conflicts, remains are normally evacuated directly from the battlefield to CONUS port of entry mortuaries. However, the tactical or logistical situation may require evacuation to a mortuary or temporary cemetery in theater.
The COSCOM provides CEB support as soon as the tactical situation permits. CEB support helps maintain soldier health, morale, comfort, and welfare. COSCOM field services units attempt to meet the Surgeon General's directive of a bath and exchange of clothing at least once a week for each soldier. COSCOM OPLANs indicate the priority of support. For example, priority of support normally goes to personnel decontamination stations, regeneration sites, and hospitals. If chemical units are unable to provide decontamination support, CEB teams provide decontamination assistance.
COSCOM CEB SUPPORT ORGANIZATION
If units or individuals must assume responsibility for laundry and bath, the supporting DS supply unit provides appropriate supplies to the unit.
Contaminated soldiers must be separated from noncontaminated soldiers at the bath points. The nearest field laundry decontaminates clothing and towels. CEB teams decontaminate shower equipment and monitor runoff bath water for contamination.
LAUNDRY AND RENOVATION SUPPORT
FM 10-280 describes field laundry operations. As secondary field services, field laundry and renovation support are provided only when the tactical situation permits. Whenever possible, the HN or a designated contractor provides these services. Procuring laundry supplies lessens requirements on the US supply system.
COSCOM SUPPORTING UNITS
DS field services companies (TOE 42419L000) provide laundry and renovation services support. The laundry and bath officer assigned to the troop support branch coordinates backup support requirements with the TAACOM ACofS, Services' section staff.
Battledress overgarments and lightweight chemical/biological protective garments are not designed for decontamination or reimpregnation. Burning heavily contaminated clothing items may create downwind vapor hazards. Units must obtain permission from higher headquarters before burying contaminated clothing and disposing of contaminated water in soakage pits prepared by engineers.
Garbage, rubbish, and liquid and solid waste material constitute a hazard to soldier health or welfare. Field sanitation procedures promote soldier health and help control insect and rodents. Unit field sanitation teams provide technical advise on sanitation standards.
FM 21-10 describes field hygiene and sanitation procedures. Units dispose of liquid waste in a soakage pit or trench with a grease trap. They dispose of solid waste by burying in garbage pits or trenches. Burying helps to eliminate rat, fly, and mosquito hazards.
S4s establish central trash sites within each base or base cluster area. They make arrangements to backhaul garbage and set up a refuse collection schedule and a system of collection to agree with the method of refuse disposal within their area.
SOPs specify policy on garbage disposal in the AO. Each food service site provides facilities for collection and storage of refuse and garbage. Refuse can be disposed of by burying in a pit, trench, or sanitary fill; burning in an incineration trench; contracting with disposal services; or dumping at sea.
Sanitary fill sites provide a method of burying waste, to include dry trash, incombustible rubbish, and garbage. COSCOM ACofS, G4 staff offiers request that engineer elements prepare sanitary fill sites or regulated dumps to dispose of incombustible trash within each CSG's AO.
Engineer elements construct dumps of limited height and area near embankments or highway fills. The dumps should be compacted daily by truck traffic and ultimately leveled by a bulldozer. Units evacuate refuse to the sanitary fill or dump site.
DISPOSAL BY INCINERATION
Units in a site for more than one week burn solid waste in an open incinerator. CSG field services staff officers coordinate burning schedules within their AO with the area RAOC and affected base cluster S2/3s.
Engineer utilities teams construct small incinerators near hospital units. These teams also construct a central incinerator in each forward CSG area and multiple central incinerators throughout the rear CSG AO. The corps assigns utilities teams based upon the population served. Normal allocation is based on 2,500 to 4,000 soldiers supported.
The area RAOC approves central incinerator sites. Solid waste which cannot be burned because of the smoke signature created by incinerators should be buried or hauled to a refuse disposal site.
CONTRACTED DISPOSAL SERVICES
CSG and COSCOM procurement personnel coordinate refuse disposal contracts through area civil affairs teams. CSGs contract to use existing HN landfills or to have landfills created. They also contract to have local labor operate the landfills in their AO. Civilians can use edible garbage as animal food. CSG field services staff officers coordinate with S4s in subordinate units to ensure that units correctly dispose of hazardous waste and waste products generated by HSS facilities and maintenance operations.
DUMPING AT SEA
Dumping refuse at sea is not recommended if other disposal methods can be used. However, in island contingency situations, when sanitary fills or construction of incinerators is not feasible, units may dump refuse at sea. Garbage cans can be loaded onto barge, scow, or other offshore transport and hauled at least 5 miles offshore for dumping. Transportation officers coordinate with the vessel master to assure that prevailing winds and currents do not return garbage to defile inhabited friendly shores.
MORTUARY AFFAIRS SUPPORT
MA support is tailored to the tactical and logistics situation. Depending upon transportation assets, MA capability, and the MA subprogram in effect, remains are recovered and evacuated to CONUS port of entry mortuaries or to a mortuary or temporary cemetery in theater.
COSCOM TROOP SUPPORT BRANCH
The memorial activities officer and MA NCO coor dinate with CSS plans branch staff in development of plans for recovery of remains and MA support. They develop a remains evacuation flow diagram as an annex to the COSCOM OPLAN. That diagram should identify the responsible staff element at each point at which remains change custody. They provide input to the corps service support plan. Their input includes staff recommendations on --
- Evacuation policy.
- Processing of personal effects.
- Burial of allied soldiers, enemy soldiers, refugees, DA civilians, and PWs.
- MA equipment with which units deploy.
- Procedures for isolated burials, mass burials, and contaminated remains.
The COSCOM support operations officer obtains permission from the theater Joint Mortuary Affairs Office for mass burials. Emergency burials can be authorized by the senior commander of the affected unit when it is impossible to evacuate remains to a MA collection point. STANAG 2070 prescribes emergency burial procedures to be used by NATO forces.
MORTUARY AFFAIRS SUBPROGRAMS
The MA subprogram selected to support military operations depends on the size and location of the theater, projected death rates, and the capability to process remains. The theater commander determines which of the MA subprograms will be put in effect. Figure 4-5 depicts theater support under each subprogram.
During a low intensity non-NBC conflict, COSCOM units could provide mortuary supplies in support of a current death subprogram. When scenarios project high fatality rates that preclude immediate evacuation, the COSCOM could establish temporary cemeteries under the graves registration subprogram. Under the concurrent return subprogram, the two cemetery platoons at EAC combine to operate one in-theater mortuary. ARs 600-8-1 and 638-30 and FM 10-63 describe the following subprograms:
- Current Death Subprogram. During peacetime and in LIC situations, this subprogram provides mortuary supplies and services for the disposition of remains and personal effects of those for whom the Army is responsible.
- Concurrent Return Subprogram. Following search and recovery, units evacuate remains to a mortuary where a positive identification is established, Mortuary personnel then embalm the remains for return per final disposition instructions by the next of kin. TDA augmentation of the MA company at EAC is required to provide civil service embalmers and identification specialists.
- Graves Registration Subprogram. Following search and recovery, units evacuate remains to a temporary cemetery in the corps rear area or COMMZ. Personnel effects are removed prior to temporary burial. They are sent to the personal effects depot at EAC for further disposition instructions. After tentative identification, remains are temporarily interred until the tactical and logistical situation allows for their return. When hostilities end, MA personnel exhume remains from temporary burial sites for return to CONUS or other designated location and permanent disposition under the return of remains program. Next of kin may request that the remains be interred in a permanent American cemetery overseas or shipped to a cemetery of their choice.
MORTUARY AFFAIRS SUPPORT ORGANIZATION
Each service must provide or arrange support for its deceased personnel and their personal effects. However, the Army provides general support to other Services when their requirements exceed their capabilities to provide MA support.
An MA collection company is normally attached to the S&S battalion of the rear CSG. The collection company has the capability to process a total of 400 remains per day. Its five forward collection platoons can operate four collection points each. This provides for a total of 20 collection points throughout the corps, division, and brigade areas. Collection platoons can also operate in direct support of contingency operations and task forces. Those collection points employed in the DSA can be attached to the DISCOM. Those employed in the BSA could be OPCON to FSBs.
Collection point personnel receive remains and personal effects and make initial identification. Each of the collection points can receive and perform initial identification for approximately 20 remains per day, for an aggregate total of approximately 400 remains per day. Combat and CS units are responsible for performing initial search and recovery operations. However, the collection platoon can form search and recovery teams to help locate and recover remains and personal effects not recovered during combat and post combat operations or following an air crash or artillery strikes.
When the corps commander grants the authority to use emergency war burial or mass burial procedures, collection platoons can also conduct emergency war burial or mass burial operations. HNS and PW personnel can dig and fill mass burial graves. However, HN laborers must not handle or process remains or the personal effects of US personnel.
The collection company's main collection platoon locates in the corps rear area. It receives remains from the five forward collection platoons. The main collection platoon arranges for remains to be further evacuated to the rear by air and surface transportation to cemetery/mortuary platoons in the theater Army area. It also arranges for personal effects to be transported to the theater's personal effects depot.
Units do not evacuate contaminated remains to MA collection points unless the remains have been completely decontaminated. A mortuary affairs collection point-decontamination can be established. If not decontaminated, the remains are interred at a site as close to the site of death as possible. The memorial activities officer coordinates engineer support for emergency burial. STANAG 2070 and QSTAG 655 prescribe emergency war burial procedures. FM 10-63and STANAG 2002 prescribe how to mark contaminated grave sites.
Once hostilities cease or time and resources permit, remains may be recovered and decontaminated following procedures in FM 3-5. Remains must be decontaminated before they leave the burial site. An NBC staff NCO advises on the proper procedures to use.
A mass fatality field information management system accounts for and tracks remains from the first collection point to the port of entry mortuary in CONUS. Systems interface between MA evacuation channels and medical facilities ensures accuracy and completeness of data transferred.
COSCOM HEALTH SERVICE SUPPORT
HSS conserves the fighting strength of the corps force. Echelon III HSS organizations in the corps area provide the divisions and troops in the corps area with hospitalization and other HSS for continued care and treatment of their sick, injured, and wounded. HSS is tailored to the mission requirements, composition of the corps force, and geographical AO. FM 8-10 describes both the current HSS force structure and Medical Force 2000 initiative. It provides a guide for obtaining as well as providing HSS. FM 8-10-2 prescribes HSS specifically for the corps.
COSCOM MEDICAL BRIGADE/GROUP
Depending upon the size of the corps, the senior medical organization in the corps may be a medical brigade or a medical group. COSCOM medical brigade or medical group staff officers establish HSS policies for the command. They coordinate plans, policies, and procedures for HSS operations in support of corps forces, to include:
- Intratheater medical evacuation.
- Hospitalization and treatment
- Medical laboratory services.
- Blood management.
- Health service logistics.
- Medical equipment maintenance.
- Preventive medicine.
- Dental services.
- Combat stress control.
- Veterinary services.
FM 8-55 provides doctrinal guidance for planning HSS. To preclude planning HSS operations which cannot be executed with limited medical and logistics resources, medical brigade/group staff officers coordinate HSS portions of OPLANs/OPORDs with medical plans personnel in the COSCOM support operations section's CSS plans branch. They also coordinate with the DISCOM to determine additional HSS requirements for the division sector. These may include --
- Far forward surgical care provided by the MASH.
- Corps air and ground ambulance support.
- Reconstitution of forward elements.
- Combat stress control teams.
- Other requirements determined through the mission analysis process.
COSCOM medical brigade/group staff officers keep the COSCOM commander and staff informed of the status of HSS within medical brigade/group units. They may recommend the following ways to offset shortfalls in HSS capabilities:
- Temporarily reduce the corps evacuation policy.
- Cross-level evacuation assets.
- Increase the use of nonmedical ground and air assets to support medical evacuation.
- Divert assets from less critical missions.
- Seek assistance from supported units.
- Seek assistance from TA.
- Use ally or HN assets.
CSS PLANS BRANCH
The medical plans officer and medical NCO assigned to the CSS plans branch coordinate with medical brigade/group staff officers in adjusting the medical support portions of COSCOM OPLANs in consonance with probable AOs and assigned missions. They coordinate with medical brigade's medical materiel management center staff on providing and coordinating medical supply and medical maintenance. They refine COSCOM OPLANs in coordination with medical brigade/group's staff based on the factors of METT-T and data on the population to be supported, to include allies, EPW, and civilian personnel. They also provide input to the COSCOM ACofS, G3's force design/plans branch and ACofS, G5 staff on when medical elements phase into support operations.
Table 4-3 lists deployment planning tasks performed by medical plans personnel assigned to the CSS plans branch and the medical supply/maintenance officer assigned to the troop support branch. The medical brigade/group may have to supplement the medical personnel assigned to these branches.
TROOP SUPPORT BRANCH
The medical supply/maintenance officer and chief medical NCO assigned to the troop support branch focus on medical logistics support areas. They assess medical logistics requirements to support contingencies and tactical missions. They synchronize medical logistics support requirements with transportation and procurement support branch staff. They perform the following tasks:
- Keep the COSCOM support operations officer informed of medical logistics requirements.
- Monitor critical medical supply status.
- Plan ways to offset shortfalls in existing war reserves.
- Analyze requirements to adjust the content of follow-on preconfigured medical supply packages in light of the operational environment and possibility for local acquisition.
- Develop medical logistics plans for buildup to an approved theater stockage level.
The medical supply/maintenance officer and medical plans officer estimate the impact on distribution systems based on the requisition, procurement, storage, distribution, and maintenance of medical equipment and supplies. They also coordinate with transportation support branch and maintenance support branch personnel to prioritize medical supply and medical maintenance.
Troop support branch medical staff officers coordinate --
- Preconfigured medical resupply packages with the supporting MEDLOG battalion for initial resupply of deploying medical units.
- Sensitive and special transportation requirements for refrigeration and security of blood and medical supplies and equipment with the CMCC.
- Covered storage requirements for medical supplies with CSG support operations supply staff.
- Requests for nonmedical casualty evacuation support with transportation support branch personnel and ACofS, G5 staff.
- Repair status of medical evacuation assets with maintenance branch staff.
- Veterinary inspection of rations with medical brigade/group staff.
- Throughput, on an exception basis, and backhaul of medical supplies with the CMCC.
- Humanitarian support requirements with ACofS, G5 staff.
- Local acquisition of items such as blankets, hospital linens, and compressed gases from the HN or contractors with procurement support branch staff and CA elements.
- Disposition of captured medical supplies and equipment with ACofS, G2 and medical brigade/group staff.
- Evacuation of medical materiel and equipment with CMCC to avoid imminent capture by enemy forces.
- Destruction or disposal of medical materiel with engineer units.
HEALTH SERVICE SUPPORT ORGANIZATION
The modular structure of the medical brigade/group HSS organization shown on Figure 1-10 allows medical resource managers to rapidly tailor, augment, reinforce, or reconstitute HSS elements. The corps HSS organization is designed to acquire, receive, and sort casualties; provide emergency medical treatment; and evacuate for further treatment.
The actual structure of any corps HSS system depends upon the mission, strength, and tactical disposition or composition of the corps. Depending upon the size of the corps, the HSS organization consists of a medical brigade or medical group. For a small corps, one consisting of only two divisions, a medical group headquarters can provide C2 of corps HSS. The senior medical commander, whether medical brigade or group, serves as the COSCOM surgeon.
When several medical groups employ within a corps, they normally deploy geographically. The groups located in the forward portion of the combat zone focus primarily on evacuation and hospitalization of patients from the division areas. They provide area HSS for personnel located in their AO.
Medical groups located in the corps rear area provide backup support to the forward medical groups. They also provide area HSS to soldiers in the corps rear area.
Figure 4-6 depicts the sample employment of a medical group and its subordinate elements on the battlefield. For simplicity, only those elements supporting one division on line are shown.
The area support medical battalion (TOE 08455L000) provides routine Level I and emergency Level II medical treatment on an area support basis to those units within the corps that do not have organic medical resources. It also provides medical evacuation support on an area basis from site of injury or unit location to the treatment facility.
In a contingency operation, due to the rapid expansion of the HSS work load, the joint or unified command coordinates the use of all HSS resources. Following the dominant user principle, the commander of the joint or unified command selects the Service or Services responsible for specific HSS. Extensive use of cross-servicing takes advantage of the geographic location of facilities.
PATIENT EVACUATION AND MEDICAL REGULATING
Patients are evacuated by means of transport which meets the treatment demands of their wounds, injury, or illness. The medical evacuation battalion (TOE 08446L000) coordinates both air and ground ambulance evacuation assets. Corps air or ground ambulance units evacuate patients from division, separate brigade, and nondivision treatment stations to corps hospitals. In conjunction with the theater evacuation policy, patients are evacuated no further than their medical condition requires. FM 8-10-6 provides doctrinal guidance on medical evacuation in a theater of operations.
Unless the soldier's protective equipment is contaminated, NBC protective masks and other protective equipment remain with each patient throughout their period of evacuation and hospitalization in the combat zone. When protective clothing is contaminated, the soldier's protective clothing is cut off at the aid station. The soldier is evacuated in a chemical warfare agent protective patient wrap.
Weapons and ammunition are not normally evacuated with patients. The parent unit retrieves weapons and ammunition from casualties prior to their evacuation through medical channels. S4 personnel make periodic checks at battalion aid stations and the brigade forward support medical company to secure such items.
Treatment and Evacuation of EPWs
EPWs receive medical treatment and evacuation based on their medical condition and the applicable provisions of the Geneva convention. EPWs requiring hospitalization are transferred from the corps holding facility to medical facilities. They are segregated from US and allied patients being treated or evacuated by the same medical elements. As directed by the theater commander, EPWs being medically treated or evacuated should be guarded by other than medical assets. Captured medical supplies can be used in the treatment of EPW patients. For additional information on the medical treatment and evacuation of EPWs, refer to FM 8-10.
Movement by air is the preferred means of evacuation for patients with serious wounds or injuries judged urgent. Corps air ambulance units (TOE 08447L000) provide aeromedical evacuation and emergency movement of medical personnel, equipment, and supplies and blood products in the combat zone. USAF, supplemented by cargo aircraft, provide tactical air evacuation from the corps area to COMMZ hospitals. Deceased personnel are not transported in air ambulances.
Ground Ambulance Evacuation
When the combat situation, weather, or patient condition makes aeromedical evacuation impractical, the ground ambulance company (TOE 08449L000) evacuates patients from the division rear area to corps medical facilities and airheads. The ground ambulance company also transports medical personnel and supplies. Ground ambulances do not transport deceased personnel.
The medical regulating system controls patient movement to medical facilities that can best provide the required medical care. It determines the where, when, and how of patient evacuation. The regulation process ensures that evacuation continues only as far rearward as the patient's medical condition dictates or the situation requires.
Medical regulating officers at the medical brigade and medical group headquarters provide technical control and supervision over the medical regulating system. They direct the flow of patients within the combat zone. They also coordinate with the joint medical regulating office for movement of patients from the rear combat zone to medical facilities in the COMMZ or CONUS.
The TAMMIS medical regulating subsystem provides rapid assessment and visibility of the evacuation work load. It allows staff officers to determine the appropriate facility and maintain visibility of hospital beds.
CORPS HOSPITAL UNITS
The hospital units within the corps include mobile army surgical hospitals (TOE 08763L000) and combat support hospitals (TOE 08705L000).
- Each MASH provides hospitalization and far forward surgical intervention for those non-transportable patients that require stabilization prior to further evacuation. Each MASH is capable of rapid deployment. It is the only hospital capable of operating within the division AO.
- Each CSH provides initial wound/injury surgery and medical treatment of critically injured patients requiring specialized care. It stabilizes them for further evacuation or treatment and RTD.
In addition, a medical holding company (TOE 08458L000) provides 1,200 cots for the convalescence and reconditioning of RTD patients. It is minimally staffed and equipped and provides basically for selfcare patients who expect to RTD.
Soldiers keep their NBC protective masks near them throughout their hospitalization. Their individual weapons and CTA 50-900 field equipment remain with their unit.
The destruction effects of nuclear and chemical weapons increase patient work load and place heavy demands on HSS. FM 8-9 describes medical operations in a NBC environment.
Objectives of HSS in an NBC environment include --
- Making optimal use of limited HSS resources in mass-casualty situations.
- Maintaining continued operation of HSS facilities.
- Protecting medical and paramedical personnel from contaminated patients.
- Avoiding the spread of contamination into medical facilities.
Whenever possible, patients are decontaminated prior to evacuation by aircraft or ground ambulances. Decontamination platoons or elements establish decontamination stations near MTFs. Contaminated patients are not admitted to medical facilities. Adequately protected medical personnel render treatment for contaminated patients who require immediate critical advance trauma life support in areas specifically designated for this purpose. FM 8-285 describes medical treatment for chemical casualties. FM 8-10-4 provides more information on patient decontamination.
Authorization of the M51 collective protective shelter system exists only for battalion aid stations and the division clearing station. No collective protection exists for corps hospital facilities. In the event of a NBC attack, corps hospitals evacuate patients to a clean hospital. Decontamination platoons or elements decontaminate the contaminated hospital facility and full operation begins as soon as possible.
REEQUIPPING MEDICAL RETURN TO DUTY SOLDIERS
Reequipping RTD soldiers involves the reissuing of MOPP gear, individual clothing and equipment, and, on an as needed basis, weapons and ammunition to soldiers upon their release from medical treatment facilities. This reissue involves the minimum amount of items required to protect soldiers from the environment and the threat during transit to the gaining unit. Figure 4-7 depicts the process for reequipping medical RTD soldiers.
Weapons, Ammunition, and Excess Equipment
The Geneva convention prevents MTFs from providing RTDs with weapons and ammunition. Ammunition, individual weapons, and excess equipment belonging to patients evacuated to the rear are disposed of as directed by command SOP.
Level I and II MTFs
Within all echelons of a theater, soldiers released from Level I battalion aid stations or Level II MTFs need minimal reequipping. They may only require access to their clothing bag. Uncontaminated protective mask, hood, and carrier remain with the soldier during treatment and evacuation at all levels. MTFs return personal property and effects to these RTD soldiers upon their release. Level I MTFs coordinate with the soldier's assigned unit regarding reequipping and transportation upon discharge. Level II MTFs coordinate this support with the brigade S4 or the unit's logistics representative.
Level III and IV MTFs
Level III and IV MTFs provide minimal basic uniform items and, if required, MOPP gear to RTD soldiers to protect them during transit to replacement companies. Corps hospitals request the minimal Class II supply items authorized for issue to RTD soldiers from the DS supply company providing area support in their AO. OCIE items that arrive with patients at these MTFs and cannot be reissued are returned to the supply system.
The supporting MCT arranges transport of medical RTD soldiers from the hospitals to the replacement company site for processing.
Replacement Company Reequipping Mission
After discharge from Level III and IV MTFs, RTD soldiers obtain the balance of their clothing and equipment as well as weapon and ammunition from the personnel group's DS replacement companies. FM 12-6 prescribes this reequipping mission.
Replacement companies reequip RTD soldiers using existing manpower, borrowed manpower from replacement operations, HNS, and contracting. Backup support is provided from the DS supply company providing area support in their AO.
Due to the different roles and tasks of various units, additional items may be required to make RTD soldiers mission capable after their arrival at the gaining unit. The issue of these additional items is the responsibility of the gaining unit.
HOSPITALIZATION OF US, ALLIED, EPW, AND CIVILIAN PERSONNEL
When the allied nation concurs, US Army personnel may be hospitalized in allied military hospitals. If their condition precludes evacuation to a military hospital, they may be hospitalized in civilian hospitals of allied nations.
Allied military personnel may be hospitalized in US Army hospitals until their condition permits their return to allied forces control.
EPWs are hospitalized and provided medical care in accordance with the provisions of the Geneva convention. Whenever possible, they are segregated from US and allied patients.
Local national civilian patients should not be hospitalized in US Army medical treatment facilities.
HEALTH SERVICE LOGISTICS
Health service logistics support includes --
- Supply of Class VIII.
- Production of oxygen and resuscitative fluids.
- Fabrication of optical items.
- Maintenance of biomedical items.
- Processing, storage, and distribution of blood.
Forward and rear medical logistics battalions (TOEs 08485L000 and 08695L000) provide medical supply and medical maintenance support. Blood bank platoons provide blood services support. A medical logistics support detachment may be augmented when troop strength or the number of hospitals supported exceeds the capabilities of the logistics battalions.
CLASS VIII MEDICAL SUPPLY
All units plan, program, order, receive, store, and consume Class VIII supplies in accordance with appropriate regulatory accounting procedures.
Units maintain a supply of medical consumables on shelf for immediate local area supply. Commanders add supplemental project stocks. Authorized levels of Class VIII supplies are determined by referring to the appropriate 6545-8-CL supply catalog for the assigned set, kit, or outfit.
Source of Supply
Nondivision units operating in the corps rear area establish an account for Class VIII supplies with the nearest medical logistics battalion supporting element. They requisition and receive supplies from this medical supply activity. Medical units supporting units in reserve also draw medical supplies from the nearest medical logistics battalion.
Nondivision units operating in a division sector maintain a three-to five-day Class VIII supply level. They are normally resupplied by the medical logistics battalion. When nondivision units are attached to a division, they can be resupplied by the division medical supply office, provided such short term arrangements are made prior to deployment. The division medical supply office is resourced to support division units. It is not equipped to handle unprogrammed requirements.
Nondivision units submit request for Class VIII supplies through command channels to the MEDLOG battalion. Those nondivision units allowed to requisitioning Class VIII resupply from division medical supply offices or battalion/squadron medical supply offices submit their requirements through command channels to those offices. The MEDLOG battalion forwards requisitions for Class VIII supplies to the TMMMC. The TMMMC submits the requisitions to CONUS for direct shipment to the corps.
MEDLOG battalions distribute medical supplies using the supply point distribution method. However, ground ambulances returning to forward areas may assist in transporting medical supplies forward.
Prepackaged Resupply Set
PRSs contain two or three days of consumable medical supplies, to include the combat medic aid bag and the combat lifesaver bag, to support each of the modular medical assemblages authorized divisional units. The corps MEDLOG battalion builds PRSs from its ASL stocks. It maintains an inventory of PRSs to support divisional requirements.
The DISCOM's division medical supply office coordinates requirements for PRSs with the supporting MEDLOG battalion unit. The division surgeon and division medical supply officer request local adjustment to the PRSs based on special mission requirements, the tactical situation, or extreme environmental conditions.
To minimize distribution problems, direct exchange of items such as Litters, blankets, pillows, and splints are used throughout the patient evacuation chain, For example, when a medical evacuation helicopter picks up or delivers patients on litters covered with blankets, it exchanges a like number of litters and blankets with the medical unit involved.
Captured medical supplies must not be destroyed. Units evacuate captured medical supplies through medical channels to a MEDLOG battalion. Medical facilities use captured medical supplies to treat EPW. The disposition of captured medical supplies are governed by the provisions of the Geneva convention.
Nondivision units operating in the corps rear area receive unit level medical maintenance support from the same medical facilities providing medical supply support. Units requisition repair parts for medical equipment through medical supply channels. The medical equipment maintenance platoon of the supporting MEDLOG battalion provides DS medical maintenance.
The corps surgeon provides staff supervision for blood supply and distribution within the corps rear area. Blood collecting and processing normally occurs in CONUS or the COMMZ. However, blood bank platoons augment corps MEDLOG battalions to collect and process blood when sufficient donors exist.
Corps hospitals maintain blood collection and processing equipment to meet emergency requirements to include, if necessary, initial storage. The amount of blood authorized depends on day-to-day usage and anticipated operations. Units supporting forward elements engaged in combat receive priority of issue. MTFs avoid excessive stockpiling of blood.
OTHER HEALTH SERVICES
PREVENTIVE MEDICINE SERVICES
Preventive medicine services reduce the potential for illness and disease. All commanders establish and maintain a comprehensive preventive medicine program. All units organize field sanitation teams as prescribed by AR 40-5 and FM 21-10-1. These teams maintain a prescribed load of supplies.
Preventive medicine services cover --
- Mess sanitation.
- Personal hygiene.
- Prevention of cold and heat injuries.
- Water supply.
- Control of communicable diseases.
- Maintenance of immunizations.
- Occupational health.
- Waste disposal.
- Pest management.
The COSCOM surgeon supervises the execution of preventive medicine services. A wide variety of command information publications on preventive medicine areas may be obtained from the COSCOM PAO.
Preventive medicine sanitation and entomology detachments (TOEs 08498L000 and 08499L000) deploy early to define preventive medicine materiel requirements in the AO. A preventive medicine detachment provides delousing of large numbers of prisoners, civilians, or troops. The preventive medicine entomology detachment provides aerial dispersal of pesticides.
Preventive medicine personnel monitor water point operations and unit sanitation activities on an area basis. They investigate and recommend actions to improve --
- Sanitation of food service facilities.
- Troop housing.
- Water supplies.
- Waste disposal.
- Industrial hygiene.
Units send requests for preventive medicine services to the supporting medical group/brigade.
Dental services help prevent oral diseases, promote dental health, and provide treatment to eliminate or reduce the effects of dental disease and injury. Dental personnel assigned to dental units, hospitals, and medical companies provide dental support.
The dental battalion (TOE 08476L000) consists of dental service medical companies (TOE 0847L000), dental service detachments (TOE 08479L000), and dental prosthodontics teams (TOE 08588L000). Dental service companies provide dental treatment to troops within their geographic area of responsibility.
During the initial phases of combat, dental elements limit dental services to emergency treatment to relieve pain and the provision of expedient repair of dental prosthetics. Corps dental service support focuses on preventing unnecessary evacuation of soldiers requiring both routine and emergency treatment. Priority of treatment in forward areas is given to combat units, Army aviation units, and CS units. In rear areas, divisions or separate brigades being reconstituted receive priority of treatment. As the situation permits, dental elements perform normal dental services in the corps area on an area basis. During periods of increased hostilities, the COSCOM surgeon can direct that dental officers perform triage and advance trauma management.
COMBAT STRESS CONTROL SERVICES
A combat stress control company (TOE 08476L000) employs in the corps to provide support for a two-or three-division slice. That company consists of combat stress control preventive teams and combat stress control restoration teams (TOE 08468L000). These teams augment area support medical companies and the regeneration task force. They also staff reconditioning centers which provide one-to three-day restoration and seven-day reconditioning treatment of battle fatigue casualties. FMs 8-51, 22-9, and 26-2 provide additional information on stress management.
Veterinary service detachments and platoons (TOEs 08409L000, 08418L000, 08419L000, and 08417L000) contribute to the health of the command by --
- Performing sanitary inspections of potential food sources.
- Assuring food wholesomeness by performing food hygiene, safety, and related food quality assurance inspections.
- Inspecting, monitoring, and testing subsistence and food-producing animals contaminated by, or suspected of being contaminated by, NBC agents.
- Providing services related to the control of animal diseases that are communicable to humans.
- Performing veterinary care for all government owned animals.
- Assisting in the preventive medicine program.
- Participating in civic action programs when authorized.
When directed by the COSCOM surgeon, veterinarians can serve in a medical care and treatment role, augmenting medical treatment staffs during the initial period of hostilities.
Veterinarians inspect subsistence prior to its purchase, entry into the supply system, or issue. They also certify subsistence items or captured rations items as acceptable for consumption before they can be consumed or distributed. Only ice obtained from veterinary approved sources may be used for refrigeration of subsistence or for human consumption.
Veterinary personnel inspect, monitor, and test rations or food-producing animals contaminated or suspected of being contaminated by NBC agents prior to their issue or consumption. However, units decontaminate rations or food producing animals contaminated by NBC agents.
THEATER ARMY MEDICAL MANAGEMENT INFORMATION SYSTEM
TAMMIS supports the information management requirements of medical units during contingency operations and war. It assists medical commanders by providing timely information needed to transport, treat, and track patients at medical facilities.
- MEDREG - Medical Regulating. MEDREG manages patient evacuation by matching evacuation requirements against resources.
- MEDPAR - Medical Patient Account and Reporting. MEDPAR tracks patients, determines the availability of medical resources, and supports personnel strength accounting and casualty reporting systems.
- MEDLOG - Medical Logistics. MEDLOG automates the requisitioning of medical materiel (Class VIII) to support medical units.
- MEDBLD - Medical Blood (Management). MEDBLD projects blood usage, tracks blood inventories, and alerts decision makers to potential shortages of blood products.
Each TAMMIS subsystem has CSS command and control capabilities. They provide status summary reports of medical units, patient evacuation work load, and critical resources through predetermined reports or information selected by the user/CSS commander.
Medical brigade/group staff and the medical staff assigned to the CSS plans branch use the interface between CSSCS and TAMMIS to plan medical logistics support. When direct electronic communications are not available, users pass information by courier via floppy diskettes, tapes, or hard copy to the required headquarters.
The interface between TAMMIS and CSSCS provides status data on medical units and medical assets in the corps area. CSSCS medical reports provide both overview and detail medical status data for medical staffs in the COSCOM CSS plans branch and troop support branch.
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