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Medical Disaster Preparedness & Response

“It’s Time for Change, It’s Time for Real Progress”

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ORGANIZATION

CCG is a medical disaster preparedness group providing the medical community a Disaster Tool Box to improve senior leadership crisis decision-making and staff coordination during response phase

CCG offers medical disaster preparedness consulting to Political Elected Officials, Medical / Logistical / Transportation EOC’s, Medical Directors / Managers / Administrators and Staff their members, Hospital and Clinic’s, ICP Commanders and other medical related IGOs and NGOs

CCG is staffed by experienced retired medical & disaster professionals who were highly skilled individuals in their former careers; DHS, FEMA, DOD, DHHS, UN and the private sector

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VISION

Dramatically increase effective medical disaster response, disaster coordination, capability and achieve Real Time Situational Awareness for medical organizations responding to all types of medical disasters

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Purpose

Build a coordinated, joint effort, in developing effective medical preparedness and response programs for the medical community to better respond to catastrophic disasters to save lives

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Tools for our Political Decision-Makers & EM Community

Preparedness PlatformTraining Exercise Platforms, Validation of Response Plans, Historical Review of Disaster Responses, Familiarization Tool and more…

Response PlatformEmergency Medical Response System 2020

Recovery PlatformMedical Camps

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Who are the Decision-Makers?Elected Politicians

The Mayor is responsible for decision-making and for coordinating city/town assets at the Disaster site

• State and Federal organizations are in Support:

• Mayor requests State Support (Governor). State is coordinating body for State resources

• Governor requests Federal Support (President). DHS is a coordinating body for outside resources in support of State / Disaster site

• In a disaster we have reverse leadership support

PRESIDENT

MAYORGOVENOR

The Balance of Leadership

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The response to the bridge collapse on 27 August 2007 found its roots in a FEMA course held in the aftermath of 9/11. In March 2002, FEMA brought together city and county officials to perform preparedness exercises in a four-day integrated emergency management course.

"We fumbled our way through the first exercise, we got better on the second one, and by the third, we were pretty good.”

The most important thing was that everyone both political and senior emergency managers participated in the training and exercises, from the City Mayor down.

Minneapolis Emergency Preparedness Director Rocco Forte

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Senior level Medical Preparedness Consulting

For Political Elected OfficialsMedical Directors / ManagersICP CommandersMedical EOC’s and Staff Members (Operation & Planning Officers)

Departmental, Interagency and Cross AgencyHospital and Clinic’s Responding to a Medical Crisis…Medical NGOs

• Crisis Decision Making Process• Validation of Response Plans • Real Time Information for Situational Awareness• Courses of Action Development• Decision Point Development• Effective Coordination of Medical Resources• Medical Resupply / Logistics• Patient Tracking• Common Operating Picture

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The Crisis Decision-Making Process

The Crisis Decision-Making Process (CDMP)

The current FEMA Decision-Making process (or Problem Solving) lacks many shortcomings. There process is an approach most found within the academia world, which is not in any sort a crisis problem solving process. The CDMP is a tried and proven process used my military commanders and their staff for centuries.

The CDMP we will be discussing is a true and tested process, modified from the Military Decision-Making process which has been successful within our own military for over 200 years.

ISSUES: DHS/ FEMA Operations / Plans Officers lack proper training and tools within each of their skill levels. Example map reading, which could have prevented the stadium issue during the Katrina disaster. Today, FEMA teaches the modified format of the 5-paragraphic operations order (Mr. Paul Regan, FEMA RI Plans Officer, RET CG Captain).

Pre Katrina / Post Katrina The change within, the struggle still continues today.

NOTES: Some mentioned terms may not be as labeled within FEMA or by some EM Commissioners / Directors.

“It’s Time for Change, It’s Time for Real Progress”

Welcome to the21st Century

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Critical Disaster Time Table

4 Types of Injured• Walking Injured• Non-Walking Injured• Unconscious Injured• Dead

H-Hour: Disaster Strikes

H to +1 Hour: Critical time, walking injured seek health care. Non-walking injured begin shouting for help. Unconscious injured need to be searched for.

H +1-2 Hours: Critical Time for non-walking injured that are trapped and unconscious injured needed to be found.

H +2-3 Hours: Walking injured accounted for (90%), Still seeking non-walking and unconscious injured.

H +3 Hours Plus: Non-walking injured trapped and unconscious injured life span begin to diminish quickly.

Critical Issues• Air EVAC availability• Bleeding

H +3 Hour Plus

H +2-3 Hour Plus

H +1-2 Hours

H to +1 Hour

H-Hour

H to H+3 is the most critical hour for response in saving

the majority of lives

H

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Special Staff

Multiple sections, Plans, one member of Operations and other single members selected by the Crisis team required for a successful response, i..e.., Public Affairs, Logistics, Transportation, etc… - Plans is the lead for this team.

Planners are always planning 12/24 hrs out, Ops execute and monitors those plans.

Coordinating Staff

Members designated by of the Crisis Team to coordinate dedicated resources. This is usually members of the Operations section assisted by others members bringing in resources. - Operations is the lead for this team.

Crisis Team (Principle Staff)

Commissioners, special advisors and any other individual the Mayor, or Crisis team feels is necessary. - The EM Commissioner is usually the lead for this team, the Mayor may decide to designate another dependent on the ground situation.

The Political Decision Maker … The Mayor

The Crisis Decision-Making Process

The Crisis Decision-Making Process (CDMP) is a very effective, speedy, disciplined and clear process. The complete process should not take more than 20 minutes.

The Mayor has three staff’s; Crisis Team (Principle Staff), Special Staff (Ops/Plans) & Coordinating Staff (Resource). The Special Staff (Ops/Plans) prepares & validates a minimum of two Course of Actions (2 different ways to respond), then brief’s the Mayor & Principle Staff members for approval.

The Mayor and Principle staff may make changes as needed or even discard these recommendations. Once the Mayor makes his / her final decision, the Order/Task is given to the Coordinating Staff to be verbally executed.

If pressed for time, the Mayor with the Principle Staff can initiate direct orders/tasks to the Special Staff for execution, or the Coordinating Staff have advice them just to plan for one COA.

NOTE: Good decisions = Situation Awareness = Being informed every 30 minutes

Achieving Situational Awareness

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CT Initial briefing every30 mins., as major events

develop‘Real Time Situational

Awareness’

Alert(OPNS / PLANS) Gather

New Information& Brief (15-30 Minutes)

(OPNS) Automatically InitiateResponse Plan

# 1234

(PLANS) Course of Action(s) Development, Comparison

and ValidationDisaster

Crisis Team (CT) Pre-Approved Response Plans

(OPNS/PLANS) Issue Verbal Fragmentary Response Order (VFRO)

(OPNS/PLANS) CONTINUE PLANNINGSend VFRO Orders As Needed

(PLANS) COA Briefing / Change / Approval

CT changes or approves for release

CT briefed makes changes or approves for release

ISSUE VFRO ORDERS CONTINUE PLANNING ISSUE VFRO ORDERS CONTINUE PLANNING

CT briefed makes changes or approves for release

Response Plan 1234Force Package A

Verbal Orders Issued Only Crisis Team Approval

T h e C r i s i s D e c i s i o n - M a k i n g P r o c e s s

Mayor andCrisis Team

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Decision Making Techniques

Residual risks

LOG Base

Secure routes

Best COA

Tent city

Suitable locations for forward medical facilities

Medical Exchange Points

COA21

Course of ActionsFactors

NOTE: The factors in this example are neither all-inclusive nor always applicable.

Sample Decision Matrix

Residual risks

LOG Base

Secure routes

Best COA

Tent city

Suitable locations for forward medical facilities

Medical Exchange Points

COA21

Course of ActionsFactors

NOTE: The factors in this example are neither all-inclusive nor always applicable.

Sample Decision Matrix

The Crisis Decision Making Processis about team work and having the right tools

War Game MethodRemarksAction

Issue Warning Order 1Receipt of Mission1

Sand BoardIssue Warning Order 2Mission Analysis2

NOTE: After issuing the order / tasking there is no need for further orders to be issued unless there are major changes. Use the Warning order format only.

Sand/Map Board- Issue Orders / Tasking

- Prepare OPORD/OPLANCOA Approval4

Constructive SimulationsDecision MatrixCOA Development and Analysis3

Crisis Course of ActionWar Game MethodRemarksAction

Issue Warning Order 1Receipt of Mission1

Sand BoardIssue Warning Order 2Mission Analysis2

NOTE: After issuing the order / tasking there is no need for further orders to be issued unless there are major changes. Use the Warning order format only.

Sand/Map Board- Issue Orders / Tasking

- Prepare OPORD/OPLANCOA Approval4

Constructive SimulationsDecision MatrixCOA Development and Analysis3

Crisis Course of Action

Note 4: Ensure OPNS and Plans work together

Note 5: Ensure resources are in good working condition

Note 6: Ensure support elements work with OPNS & Plans

Note 3: Everything is oral, paperwork to follow including approval

Note 2: Plan to move resources to a strategic location

Note 1: Always look and plan for 6-12 hours ahead

Issue Operation / Planning Order14

Review facts and assumptions13

Issue Warning Order12

Issue leader’s guidance11

Get approval of new restated mission10

Conduct a mission analysis briefing9

Write the restated mission8

Determine critical information requirements

7

Conduct risk assessment6

Identify critical facts and assumptions5

Determine constraints4

Review available assets3

Review current on-site disaster status2

Analysis Higher HQ Mission / Tasking1

CommentsActionStep

Mission Analysis Steps

Note 4: Ensure OPNS and Plans work together

Note 5: Ensure resources are in good working condition

Note 6: Ensure support elements work with OPNS & Plans

Note 3: Everything is oral, paperwork to follow including approval

Note 2: Plan to move resources to a strategic location

Note 1: Always look and plan for 6-12 hours ahead

Issue Operation / Planning Order14

Review facts and assumptions13

Issue Warning Order12

Issue leader’s guidance11

Get approval of new restated mission10

Conduct a mission analysis briefing9

Write the restated mission8

Determine critical information requirements

7

Conduct risk assessment6

Identify critical facts and assumptions5

Determine constraints4

Review available assets3

Review current on-site disaster status2

Analysis Higher HQ Mission / Tasking1

CommentsActionStep

Mission Analysis Steps

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THE TRAINING & EXERCISE PLATFORM

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THE BIG PICTURE: In preparation for launching an exercise program and designing individual exercises, it is important to have a clear vision of the entire exercise process

An exercise is a focused practice activity that places the participants in a simulated situation requiring them to function in the capacity that would be expected of them in a real event. Its purpose is to promote preparedness by testing policies and plans and training personnel. In this unit, you will explore some of the benefits that organizations derive from exercising.

WHY EXERCISE? Exercises are conducted to evaluate an organization’s capability to execute one or more portions of its response plan or contingency plan. Many successful responses to emergencies over the years have demonstrated that exercising pays huge dividends when an emergency occurs.

There are two main benefits of an exercise program:

•Individual training: Exercising enables people to practice their roles and gain experience in those roles.

•System improvement: Exercising improves the organization’s system for managing emergencies.

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Political : Decision Makers

Strategic: Leader

Operational: Staff

Tactical: First Responder

4 Target Audiences

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Medical Exercise Preparedness Series

Senior Medical leadership and Staff Members:

- Medical Seminars & Workshops- Crisis Medical Decision Making- Developing Decision Points- COA / Decision Points Development- Review / Validate Response Plans- Review Historic Responses- Develop Primary & Alternate Strategic Guidance

Medical Exercise Series:DHS / HSEEP Compliance

-TTX (Discussion, Operation & Interactive)-Functional Exercises-Real Time Functional Exercises-Full Scale Exercises-Constructive Simulation Supported Exercises

For Political Elected OfficialsMedical Directors / ManagersMedical EOC’s and Staff Members(Operation & Planning Officers)Hospital and Clinic’s Responding to a Medical Crisis…ICP Commanders, IGOs and NGOs

- Crisis Decision Making- Course of Action Development- Developing Decision Points- Manual & Advanced Exercise Support- Simulation Supported Exercises- Specialize in EOC, Medical, Logistical and Transportation Exercises

President LBJ Conducting a Sand Table Exercise

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CCG provides three of the four exercise platforms available on the market

• Manual (Supports Basic TTX, Advanced TTX and Functional Exercises)• Constructive (Supports Functional and Full Scale Exercises)• Live (Full Scale Exercises)

XWhat’s the difference?

Simulations

Simulators

Medical Exercise Preparedness SeriesDHS / HSEEP Compliance

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Advanced Tabletop ExercisesMedical Manual Exercise Preparedness Series

DHS / HSEEP Compliance

Political ElectedMedical DirectorsMedical ManagersHospitals & ClinicsMedical Responder Leadership

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ConstructiveSimulatedSupported

Example

Functional Exercise

Constructive Simulation Supported ExercisesMedical Simulation Exercise Preparedness Series

DHS / HSEEP Compliance

Live ExercisePlatform

Live ExercisePlatform

Simulated ExercisePlatform

SE

AM

LES

S E

XE

RC

ISE

PLA

TF

OR

M

RRCC

STATE

CITY Crisis Team

CITY EOC

LIVEPlatform

Constructive Simulation Model

M o d e l R e p l i c a t e s

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Conducting Networked Real Time Situational Exercises Enter the 21st CenturyEXAMPLE

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Leadership & Staff

First Responders

C2-C4I Exercise Platforms

Individual DrillsTeam / Crew DrillsDepartmental Drills / Training

SeminarsWorkshops (Example: Crisis Decision Making Process)Tabletops (TTXs)Function Exercises (FE)

Collective Training / Assessments

Full Scale Exercises (FSE)

Full Scale Exercises (FSE)

NOTES: - Leaders and Staff from Police, Fire, EMT also conduct C2-C4I training- C4I: Command, Control, Communications, Coordination and Information- EDRE: No Notice Exercise Deployment Readiness Evaluation (8-18 hours)- FSE (Leadership, Full Staff & 25% First Responders)

Leader / Staff Training and Exercises

NEOCFBIPoliceFireMedicalMore…

MOH EOC

ICP

Regional / City EOC

First Responder Training

Police

Fire

EMT

Medical Ambulances

etc…

First Responder Drill Platforms

CAP

Training & Exercise Program

Real World Readiness

Certification Exercises

Full Scale Exercise

H-HR H+2 H+4 H+10 H+18

Leadership x x x x x

Staff x x x x x

ICP x x x x x

FR leadership x x x x x

First Responders 10-25%

10-25% 0 0 0

Exercise Deployment Readiness Evaluation

H+8 H+12

EOC

ICP

First Responder

• Police

• Fire

• Medical

• Ambulances

EDRE

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DI-T&E Roadmap

Simple single echelon collective T&E roadmap

Political & Policy MakersResource Coordinators-NEMO-Regional EOC-Municipality

First Responders-Regional-Municipality

FECPX

TTX-OSTAFFEX

FECPX

IndividualDrills

CrewDrills

TeamDrills

FTX / FSE

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The CCG Roadmap To Real World Readiness

The Decision Makers Toolbox

CCG Provides Leaders and Staff Greater “In-depth” Training and Exercise Opportunities

Certification Exercises

Organization(s)CertifiedPolicy & Political

Decision Makers

IndustryLeaders

Military Commanders

Educators

Pre-Exercise: Develop / Validate / COA

Staff MemberPrograms

Decision Makers Combined Exercise Series

Operations OfficerPlanning Officer

Crisis Decision-Making Process

Scenario Writing

Exercise Planning

Risk Assessment

Plans Writing

Immediate & Post Analysis

Lessons Learned

and much more…

Scenario Development

Plans Writing & Validation

Exercise Planning

Map / Sand Board Exercises

Validation Exercises

Crisis Decision Making Process

Milestone Calendar

MESL Development

Training Objectives

Risk Assessment

Immediate & Post Analysis

and much more…

Operation Centers

Federal - State - City - Towns

Agencies - Departments

Advanced Tabletop Exercises

Standalone Support Exercises

Functional Exercises

Simulated Driven Exercises

Live Combined / Notional Exercises

Immediate Hot Washes

Post Analysis

and much more…

EM Director / ManagerPrograms

Crisis Decision-Making Process

Lessons Learned

Risk Assessments

REAL WORLD

READINESS

FSELive Field Exercises

EDRE“No Notice”

ExerciseDeploymentReadinessEvaluation

CAP

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An example in combining Collective and Individual Training, Exercise and Evaluation standards… Preparing Decision-makers, Staff members, Resource Coordinators and Individual, Crew and Team members

The Exercise Roadmap 6 Month Cycle Calendar

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EMERGENCY MEDICAL RESPONSE SYSTEM 2020

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TACTICAL

OP

ER

AT

ION

AL

STRATEGIC

EMRS 2020Emergency Medical Response System

A Concept In Development

EMRS 2020Is a System,

Not an Application

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Emergency Medical Response System 2020Response

Real Time Situational Awareness Tactical, Operational and Strategic

Integrated Multi-Purpose Medical Combined Software

Common Operating Picture (COP)ClinicalEchelons of CareCommunicationsLogisticsLocationsPatient Tracking

EMRS2020 allows Medical leadership to take remote-charge from when the incident happens

EMRS2020 provides a Common Operating Picture (COP) for everyone to view and respond

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EMRS 2020 is an integrated software program built on a free standard platform that can be downloaded to any existing Smart Phone, Pad, Laptop or Desktop

Common Operating Picture-Facilities

-Organizations-Medical Collection Points

Clinical-Emergency Medical Records

-Patient MovementCommunications

-Text-Chat

-Live streamingLogistics-Medical

Medical Patient ID BraceletsScan capable (to & from) w/

use of patient wrist bands

EMR

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Suite for Automated Global Electronic bio-Surveillance is a collection of modular, flexible, freely-available software tools for electronic disease surveillance in resource-limited settings

Global Electronic Bio-Surveillance

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Common Operating Picture (COP)

APPS-Application-Training-Checklists

Drop Down Menus

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OFDA SupportedUS Department of State

INFO ONLY

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UN Health Cluster Timeline Response to Haiti EQ

Medical Response Failed•No Clear medical Response Plan•No Medical Leadership•No Medical Guidance•No Medical Coordination•No Med Org assigned areas•No Med Echelons of Support•No Med Collection Points•No Medical Registration•No Follow-on Medical Support•…and on and on

Lack of follow-on medical support, as much as 10,000 injured may have died.

Lack of medical leadership, survivors migrated to flood areas before rainy season.

Lack of medical leadership, outbreak of Cholera

INFO ONLY

UN is not a lead, it is a supportive organization

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CITYSTATEFEDERALNGO’sIGO’sFaith Based Org’sWho’s in-charge?Who’s making decisions?Who’s on the Ground?

USA

NGO

UK

SP

IGO

GER

FRA

UN

OUTSTANDING MEDICAL ISSUES

•Medical Rep not available to lead•Assignment of health sectors•Echelons of care / Roles of care•Communications•Coordination•Transportation•and more ????Where do I send

the injured needing follow

on?

Where can I get a cell phone that

works here?

Where do I send my patients?

I need to power up my mobile

equipment, but where?

Where are the medical

collection points

Where am I needed most?

How are we being

resupplied?

Where do we setup our hospital?

OUTSTANDING CLUSTER ISSUES

MOH Rep not available to leadWHO is informative, not directiveAssignment of health sectorsSign-in sheetsEchelons of care / Roles of careCommunicationsCoordinationTransportationand more ????

UN Health Cluster HQUSAGermanyUKFranceSpainIGOsNGOs

Example International Response

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Disaster Area

Town 2Town 1

Central DataDepository

State

State EOC FEMA

EMRS2020Common Operating Picture

EMRS2020 allows Medical leadership to take remote-charge from when the incident happens

Real Time Situational Awareness Tactical, Operational and Strategic

EMRS2020 provides a Common Operating Picture for everyone to

view and respond to

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Construction / Management of Medical Response CampsCamp life demands a social structure

Medical CampsRegistration CampsDisplaced Civilian CampsLogistical Camps

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Contact Information

Domenic Tesoriero

tesorierod@yahoo.comglopbalccg@yahoo.com

(954) 683-3435

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A D D I T I O N A L S L I D E S

AlertGather New Information

(15-30 Minutes)

Automatically Initiate OPLAN #

1234

Course of Action Development and

Validation

Issue Verbal Fragmentary Response

Order (VFRO)

CONTINUE PLANNINGSend VFRO Orders As

Needed

COA Briefing / Change / Approval

The Critical Decision Making Process

ISSUE VFRO ORDERS CONTINUE PLANNING ISSUE VFRO ORDERS CONTINUE PLANNING

• The Critical Decision Making Process (CDMP) is a very effective, speedy, disciplined and clear process. The complete process should not take more than 20 minutes. The CDMP is not an academia problem solving process, it is a tried and proven military process that has been used for centuries.

• The Political or Crisis Decision Maker has three staff’s; Crisis Team (Principle Staff), Special Staff (Ops/Plans) & (Resource) Coordinating Staff. The Special Staff (Ops/Plans) prepares & validates two Course of Actions (2 different ways to respond), then brief’s the Decision Maker & Principle Staff members for approval.

• The Decision Maker and Principle staff may make changes as needed. The Order is then given to the Coordinating Staff to be verbally executed.

• If pressed for time, the Decision Maker with the Principle Staff can initiate orders to the Coordinating Staff for execution, or advice them just to plan for one COA.

NOTE: Good decisions = Situation Awareness = Being informed every 15-30 minutes

Special Staff

Two sections, Plans and Ops: Planners always plan 12/24 hrs out, Ops execute and monitors those plans

Coordinating Staff

Designated by members of the Crisis Team to coordinate all resources

Crisis Team

Commissioners, Advisors or any other individual the Decision Maker feels is necessary

Achieving Situational Awareness

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Point of Injury

Collection Point

MorgueHospitalTrauma

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VirtualSimulators

Live / Real World C2 Manual

ConstructiveSimulation

The Integrated Training & Exercise PlatformTraining In-depth

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Combining Leader / Staff and First Responder Training and Exercise Roadmap6 Month Example

Start DayE -180

E -150 E -120 E -90 E -30 Exercise DaySTARTEX ENDEX E +5/30

ExerciseLevel

Staff Exercise IParticipants

Exercise ActivityStaff Exercise II

ParticipantsExerciseActivities

C2 Exercise I Participants

Exercise Activities

Emergency Readiness

Deployment Exercise

Live Field Exercise

Immediateon site

organization AAR’s

E +5Formal Verbal AAR

State -Decision Maker-Crisis Staff-Special Staff-ICP CDR-Organizational Leaders & Staff’s-ORG Training Objective Standing List

-Scenario Development-Scenario Validation & Approval-Leaders Brief-ORG Training Objectives (See Remarks)

-Decision Maker-Crisis Staff-Special Staff-ICP CDR-Organizational Leaders & Staff’s

Brief, Validate and Final Approval of:-RPLAN-Support RPLAN

-Decision Maker-Crisis Staff-Special Staff-ICP CDR-Organizational Leaders & Staff’s

NO NOTICE EXERCISE

Can be limited25-100%

E +30Formal Written Detailed

AAR

City

Town

Exercise Length

MSN: Validate RPLAN

2 HoursMSN: Validate Support

RPLAN4 Hours

MSN: Conduct C2 Training

16 Hours4 Shifts

8 Hours2 Shifts

2-3 Days4 Shifts

2-4 Hours 2-4 Hours

Training Review

E -165 Primary Leader WorkshopE -160 Primary Staff Workshop

E -130 Support Leaders WorkshopE -125 Support Staff Workshop

E -100 Leaders WorkshopE -95 Staff Workshop

Immediate AAR at ENDEX

Exercise Support Model

Advanced Tabletop Constructive Simulations Constructive Simulations Live / Constructive Live / Constructive AAR AAR

REMARKSOrganizations submit exercise training

objectives 1 month prior for MESL development and issue at STAFFEX I

Finalized RPLAN and SUPPORT RPLANs are distributed to organizational leaders

NLT E -110

Exercises are conducted from organizations response sites

Can be simulatedand/or live

E -5 Conduct leaders walk through

Organizations conduct self evaluations

Lessons Learned

First Responders

Leaders Conduct individual drills

Leaders Conduct crew and team drills

Leaders See Remarks Can be included in EDRE

E -5 Conduct leaders walk through

AAR

Individual DrillsVirtual Simulators

Review - Test - Evaluate

-Crew drills-Team Drills

Review - Test - Evaluate

REMARKS

Train to standard Evaluate to standard Train to standard Evaluate to standard Decision Maker conduct a mini live exercise combining Staff and First Responders

EDRE when live is evaluated by external ORG. of same type

Conclusion

Commissioners and Organizational leaders are not evaluated. They are abreast of all activities. A Deputy Commissioner is always the Exercise Director. This position can be rotated.

C2 Exercise II TBD by Decision Maker based on organizations performance at C2 Exercise I. Keep scripted events to a minimum. Interject new events as deemed by Organizational Leader

Conduct random EDRE’s or reevaluate weaker Organizations

If an organization shows poor performance, reschedule a C2 DDMT supported EDRE immediately . Full State level live exercises not recommended. Leaders and staff plus 25% of First Responders

CCG©2013

Target Audience Type of Exercise

Political / Decision Makers: Seminars, *Familiarization, *FE and **FSE

Strategic / Leader: Seminars, Workshops, TTX, *FE and **FSE

Operational / Staff: Seminars, Workshops, TTX, *FE and *FSE

Tactical / First Responder: Drills, Workshops and FSE

* Constructive Simulation Supported Exercise

** FSE are too costly, Leadership walkthroughs are recommended to keep costs down

CCG Recommendations

CCG©2013

Real Time Interactive Simulation Models Replicate

ResourcesPeopleEquipmentVehicles

TerrainWeatherDay / NightWaterBoatsWeaponsBuildingsRubble

DisastersNaturalMan-madeTerrorists

Integrating Multiple Training, Exercise and Evaluation Platforms

CSM’s are a totally Seamless inter-active platformDecision Makers, Staff Members, Managers and Coordinators

People play their emergency roles from actual response locations Game inter-action with training audience is eliminated

Exercise prep time and resource costs minimized

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Live - Modeling & Simulation (M&S) involving real people operating real systems. Relatively high cost since it is very human resource/materiel intensive and not particularly repeatable.

Virtual - M&S involving real people (i.e. simulation player/puckster) operating simulated systems. Virtual simulations inject Human-in-the-Loop in a central role by exercising motor control skills (e.g., flying an airplane), decision making skills (e.g., committing fire control resources to action), or communication skills (e.g., as members of a C4I team). Relatively medium cost since it is less human resource/materiel intensive, some reuse can occur, and repeatability is moderate.

Constructive - M&S that involve simulated people operating simulated systems. Real people stimulate (make inputs) to such simulations, but are not involved in determining the outcomes. This small group of people are totally seamless to the training audience. Relatively low cost since it is the least human resource/materiel intensive, reuse is high, and repeatability is high.

Manual – TTX, Sand Board and Map Board Exercises

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ReferencesDHS / FEMA EXERCISE TYPES -T&EPW User’s handbookREF: https://hseep.dhs.gov/support/TEPW_Users_Handbook_%28V30%29.pdf

Discussion / Operations - Based Exercises

Discussion-Based Exercises

• Seminars• Workshops• Tabletop Exercise (TTX-D)

Operations-Based Exercises

• Drills• Tabletop Exercise (TTX-O)• Functional Exercise• Full Scale Exercise

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Mayor &Crisis Staff

Exercise Team- Evaluators / AAR- White Cell / HICON- Red Cell-Simulation Cell- Tech Team- Computer Op

Exercise Planning TeamA rep from each

participating origination

EMDirector

ExerciseDirector

IGO / NGOs

Mayor & ServicesRepresentatives

Schedule of Events-CDC-IPC-MPC / MSEL-FPC-Initial Walk Through-PRE STARTEX / Lay Down-STARTEX-PAUSEX / HOT WASH-ENDEX-AAR

The Exercise Planning Team

Alert(OPNS / PLANS) Gather

New Information(15-30 Minutes)

(OPNS) Automatically InitiateResponse Plan

# 1234

(PLANS) Course of Action(s) Development, Comparison

and Validation

ISSUE VFRO ORDERS

CONTINUE PLANNING

ISSUE VFRO ORDERS

CONTINUE PLANNING

(PLANS) Issue Verbal Fragmentary Response Order (VFRO)

(PLANS) CONTINUE PLANNINGSend VFRO Orders As Needed

(PLANS) COA Briefing / Change / Approval

Planning Teams Relationship with the Mayor and Crisis Team

Special Staff / Planning Team is comprised of members from each department supporting response efforts. The team is lead by the lead Planning Officer.

Planning team restrictions: Resources

The Planning team has a close and direct relationship with the Mayor and the Crisis team. Planning is a continues 24 hours process.

Mayor andCrisis Team