Continuity of Operations for Community Health Centers

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Cori Merritt
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1 Continuity of Operations for Community Health Centers 1

2 Describe a training and exercise program Describe the scope of a good TT&E program Describe the HSEEP Review various assistance materials 2

3 COOP includes... The activities of individual departments and agencies and their subcompartments to ensure that their essential functions are performed 3

4 Essential Functions Delegation of Authority Orders of Succession Alternate Facilities Vital Records, Databases & Systems Interoperable Communications Contingency Staff and Responsibilities Devolution Reconstitution Testing, Training, and Exercises 4

5 Tests, training, and exercise program includes: Measures to ensure that an agency s COOP program is capable of supporting the continued execution of its essential functions throughout the duration of the COOP situation.

6 TT&E Program Goals Train key personnel in functional areas of mission readiness Provide opportunities to acquire skills and knowledge required to perform assigned COOP role Build team unity Reflect lessons learned from TT&E events, current COOP information, and training needs

7 Testing and exercising COOP capabilities are essential to demonstrating and improving the ability of departments to execute their COOPs. Serve to validate or to identify improvements to the COOP s policies, procedures, systems, and locations. Periodic testing and exercising also help to ensure that equipment and procedures are maintained in a constant state of readiness. 7

8 An exercise can be used to: test the success of a training or development program evaluate a response plan assess the readiness of an agency or community to respond to an emergency

9 Traditional Thinking The Cycle Approach

10 Reality Thinking Plan Train Exercise Evaluate Each phase is conducted independently.

Planning, Training, Exercising and Evaluating are like gears driving the Preparedness Machine. Train Plan The challenge is getting the gears to mesh.

11 Planning, Training, Exercising and Evaluating are like gears driving the Preparedness Machine. Train Plan The challenge is getting the gears to mesh. Exercise Evaluate HSEEP The HSEEP Preparedness Systems Approach continually integrates plan development and revisions with training programs, exercises and evaluations. All federally funded exercises must be HSEEP Compliant

12 What does HSEEP Compliance mean? In order for an entity to be considered HSEEP compliant, it must satisfy four distinct performance requirements: Conducting an annual Training and Exercise Plan Workshop and developing and maintaining a Multi year Training and Exercise Plan. Planning and conducting exercises in accordance with the guidelines set forth in HSEEP Volumes I III. Developing and submitting a properly formatted After Action Report/Improvement Plan (AAR/IP). Tracking and implementing corrective actions identified in the AAR/IP. See HSEEP 101: a program overview for first timers

13 Planning an Exercise Climbing the blocks depends on the maturity of your plan and participant training levels.

14 Planning the Exercise Familiarize participants with current plans, policies, and procedures or with facilitating the development or revision of plans. Seminars Orient participants to new or updated plans, policies or procedures in an informal discussion. Workshops Build plans or policies or test a new plan using a canned scenario. Tabletops (TTX) Assess plans, policies and procedures in scenarios involving key stakeholders. Games Compete operational teams responses using rules, data, procedures and scenarios that depict actual situations.

15 Planning the Exercise Validate plans, policies and procedures, clarify roles and responsibilities and identify resource gaps in an operational environment. Drills Test a specific operation/function of a single entity or team. Functional Exercises (FE) Validate communications and command and control functions among multi agency coordination centers (a.k.a. Command Post Exercises). Full Scale Exercises (FSE) Evaluate coordinated operations among multiple agencies, jurisdictions and disciplines with "boots on the ground" in real time, real place scenarios.

16 Planning the Exercise Seminars, workshops and drills can be low cost and developed in house, without contract vendors. Full scale exercises are typically the most expensive and require the most external support. Possible Funding Sources Department financial or CDC/ASPR HPP grant support, requested one year in advance, thru the DOH Two Tier Exercise approval process. DHS funding for multi discipline community based exercises, by contacting Emergency Management.

17 Planning the Exercise Setting an exercise date drives all other tasks. Allow at least 3 months of planning time for a discussion based exercise or drill. Allow at least 6 months of planning time for a functional or full scale exercise. Set the date in National Exercise Schedule System NEXS. Set a date 12 months early if you will seek funding. Notify your Exercise or Training Program Manager to enter the date into the Multi Year Training and Exercise Plan.

18 Planning the Exercise The most important factor for a successful exercise is organizing a skilled and experienced exercise planning team. The Planning Team: determines exercise objectives tailors scenarios to meet objectives determines logistical support Because of their involvement in planning, team members make ideal exercise facilitators, controllers, or evaluators.

Planning the Exercise Vulnerable Population Representatives Law Enforcement (LE) Emergency Medical Services (EMS) Fire and Rescue Hospitals County Emergency Managers County Health Departments (CHDs)

19 Planning the Exercise Vulnerable Population Representatives Law Enforcement (LE) Emergency Medical Services (EMS) Fire and Rescue Hospitals County Emergency Managers County Health Departments (CHDs) Public Information Officers (PIOs) Local School Districts Volunteer and Faith Based Organizations COOP Program Manager Department of Agriculture and Consumer Services Department of Business and Professional Regulation Department of Environmental Protection Fish and Wildlife Regional Planning groups This list is neither exhaustive nor mandatory

20 Scenario Development The scenario provides the storyline that drives the exercise. Determine the type of threat/hazard (e.g., bio, pandemic, chemical, natural disaster). Determine degree of difficulty. (No pain, no gain.) Make it look real! (moulage, miniatures and maps) Consider Be careful timing. about holding totally unannounced exercises. Determine the venue (space and safety).

21 Planning the Exercise Exercise Staffing Facilitators: in discussion based exercises, are responsible for ensuring that discussions remain focused. Controllers: experienced exercise staff, who manage play and operate incident site and SimCell. They: Understand exercise context. Provide key data to players. Prompt player actions through planned or on the spot injects. Compress time to ensure exercise continuity/completion. Are accountable to senior or chief controller. Chief Controller: approves on the spot injects and announces StartEx and EndEx.

22 Planning the Exercise Exercise Staffing Evaluators: chosen for expertise in areas they evaluate, play a passive role. The Operations Section selects evaluators, including the Chief Evaluator/team leader who oversees the AAR/IP. Evaluators use EEGs/notes to record observations. Training should cover what to look for/record and how to use EEGs. Evaluators must: Be at their designated posts when players arrive. Have a good view of player actions. Listen to discussions. Focus on observing activities/tasks/times/events. Avoid prompting players or answering questions.

23 Planning the Exercise Exercise Staffing Actors: volunteers who simulate specific roles (i.e., disaster casualty victims) to add realism. The Logistics Section recruits and briefs actors. Controllers must monitor actors to ensure they do not ad lib and create unplanned/spurious injects.

24 Planning the Exercise Exercise Staffing Simulators: controllers who perform the roles of non participating individuals or organizations to drive realistic exercise play. Simulators may be in a SimCell and communicate with players via radio, phone or . Players: those for whom the exercise is conducted. They have active roles in responding to an incident by discussing (in a discussion based exercise) or performing (in an operations based exercise) their roles and responsibilities. Observers: may include VIPs and media. They must not participate in exercise play, evaluation or control functions, but they may be asked for comments or observations.

Planning the Exercise Exercise Staffing Safety Officer: the most important member of the exercise team; identified by a distinctive vest or armband; looks out for the safety of all exercise

25 Planning the Exercise Exercise Staffing Safety Officer: the most important member of the exercise team; identified by a distinctive vest or armband; looks out for the safety of all exercise participants and must have no other duties. Responsibilities include: Reviewing exercise documentation for safety issues. Briefing participants on safety concerns. Being vigilant for safety issues during the exercise. Issuing STOP EXERCISE orders when needed. Documenting safety incidents for the AAR/IP.

26 Conducting the Exercise Recon exercise venue(s) 24 hours before the event. Arrive before start time to handle remaining logistic/administrative issues, arrange registration and ensure exercise staff are briefed/in place. If discussion based, review room layout/access. If operations based, review assembly area(s), response route(s), response operations area(s), parking areas, registration area, observer/media accommodations and SimCell facility. On the day of the exercise, Murphy rules!

27 Conducting the Exercise Avoid unplanned confrontations with Law Enforcement Officers! Have a strict weapons policy and make sure everyone knows it

28 Conducting the Exercise Evaluation is the cornerstone of exercises. It documents strengths and areas for improvement. It requires pre developed Exercise Evaluation Guidelines and includes formal exercise evaluation, integrated analysis and drafting the AAR/IP. Photography, sound recordings and videography are important documentation tools to supplement written evaluations and comments. A picture is worth 1,000 words but permission may be needed particularly if minors are involved.

A Hot Wash Is conducted in each functional area by the area s controller or evaluator. Enables evaluators to capture events while they are fresh in players minds.

29 A Hot Wash Is conducted in each functional area by the area s controller or evaluator. Enables evaluators to capture events while they are fresh in players minds. Allows players to provide immediate feedback, verbally and through distribution of Participant Feedback Forms. May be held separately with actors. Hot washes are held immediately following ENDEX. The AAR/IP includes information gathered during a hot wash.

30 Developing an AAR/IP Exercise objectives. Key decisions. Player training. Resource shortcomings. Plans, policies and procedures adequacy. Players familiarity with these documents. Agencies/Jurisdictions coordination and cooperation. Lessons learned. Strengths. Areas for improvement.

31 Improving the Process Each task not completed as expected is an opportunity for evaluators to search for a root cause the source of, or underlying reason behind, an identified issue. To arrive at a root cause, evaluators trace the origin of each event to earlier events and their respective causes. If an individual did not perform well, the root cause(s) may be due to insufficient training, experience, communications, a procedure or the plan. The root cause should never be identified as a person. Find the Root Cause

Once recommendations, corrective actions, responsibilities and due dates are identified in the IP, the exercising organization tracks each corrective action to completion.

32 Once recommendations, corrective actions, responsibilities and due dates are identified in the IP, the exercising organization tracks each corrective action to completion. The HSEEP Corrective Action Program (CAP) System is an excellent tool for tracking IP recommendations. It assigns IP activities with responsible organizations, action officers and completion dates. It allows action officers to update completion of their tasks. It has an alert system reminder for overdue tasks.

33 Keeping up the Maintenance Plan Leadership is the lubrication that keeps the gears turning. Train Exercise Evaluate

34 Federal Continuity Guidance Circular Continuity Assistance Tool Continuity Evaluation Tool HSEEP Multi Year Plan 34

Planning & Conducting an Exercise - An Interactive Workshop

Planning & Conducting an Exercise - An Interactive Workshop Joseph (Joe) M. Golden, Jr., EMT-P, CET, CHMM, CEM, CBCP, MEP September 13, 2018 September 13, 2018 2 Workshop Objective Given the Homeland Security