Outbreak Unchecked Response Exercise OUREx October 20 2016
Outbreak Unchecked Response Exercise (OUREx) October 20, 2016 Exercise Briefing for Preparedness Field Reps
2 OUREx Briefing Objectives • Review exercise design elements and planning updates • Address any outstanding issues and questions • Discuss next steps
3 OUREx Design Team • • • New York State Department of Health – OHEP – BCDC – Wadsworth Center – Environmental Health – PAG – BEMSATS – WNY, CNY, MARO, and CD Regional Offices – OPCHSM Saratoga Hospital New York State Office of Mental Health • • • Division of Homeland Security and Emergency Services – State Office of Emergency Management Office of Temporary and Disability Assistance New York State Office of Children and Family Services – Commission for the Blind Community Health Centers Association of New York State Healthcare Association of New York State
4 OUREx Workgroups • • LHD Subgroup – BCDC – Environmental Health – Regional Offices – PHP Reps – PAG – Labs – OHEP Healthcare Subgroup – OPCHSM – Saratoga Hospital – HANYS – Regional Offices – HPP Reps – PAG – OHEP – Nursing Home Associations • EMS/EM Subgroup – OEM – BEMSATS – OPCHSM • At-risk populations Subgroup – OMH – CHCANYS – OTDA – Commission for the Blind – OHEP
5 OUREx Capabilities to be Tested • Medical Surge • Emergency Operations Coordination • Healthcare System Preparedness and Recovery (COOP functions) • Information Sharing • Medical Countermeasure Distribution and Dispensing • Non-Pharmaceutical Interventions (NPIs)
6 OUREx Plans, Policies, and Procedures • Relevant plans, policies, and procedures to be tested or examined during the exercise – – – Hospital Medical Surge Plans Nursing Home Decompression Plans LHD POD Plans LHD NPI Plans Statewide EMS Mobilization Plan CEMP – Communication and Resource Procurement appendices
7 OUREx Design • Coalition-level, Full-scale exercise – – – HPP grant requirement Must include LHDs, hospitals, EMS, and Emergency Managers Must include at-risk populations Deliverable for both LHDs and hospitals, so all will play Engaging as many EMS and EMs as possible via State BEMSATS and State OEM, and the objectives they have developed
8 OUREx Design • Exercise design elements – As of 10/1/16 • 23 LHDs conducting PODs – 9 non CRI counties (Clinton, Delaware, Greene, Hamilton, Warren, Broome, Tioga, Livingston, Ontario) – 14 CRI counties • 34 LHDs conducting NPI component of the exercise – Will Regional Offices activate their incident command ? • Who will be involved in communicating with facilities and LHDs? • Will Regional Reps serve as Coalition conduits? In Regional Rep role? Under discussion at ROs
9 OUREx Design • SIMCELLs – Central SIMCELL in Menands – Regional SIMCELLs in each sub-region/region on day of play CNY MA R O Y WN Capital District
10 OUREx Logistics • Exercise locations – On-site • • Local hospitals and LHDs – NPIs; POD sites for LHDs conducting PODs; Regional SIMCELL sites to be determined by region; Central SIMCELL in Menands • A/V requirements – Computers, phones • Badging and identification of Controller/Evaluators
11 OUREx Exercise Timeline • Dates of Exercises – The exercise will span 7 work days: • 2/27/17 Long Island • 2/28/17 Lower Hudson Valley • 3/1/17 Capital District • 3/2/17 North Country • 3/6/17 Central New York (South and East) • 3/7/17 Central New York (North and West) • 3/8/17 Western New York
12 OUREx Exercise Timeline Long Island 2/27/17 Lower Hudson Capital District N. Country Central NY Valley S and E 2/28/17 February, 2017 3/1/17 3/2/17 3/6/17 Central NY Western W and N NY 3/7/17 March, 2017 3/8/17
13 OUREx Design – Bi-directional Information Sharing Regional HOC/ HEPC HUB
14 OUREx Inclement Weather Plan If a HEPC Exercise is affected by an event that would interrupt exercise participation, a discussion will be held with OHEP Central Office, Regional Office, and HEPC representatives to determine potential courses of action (rescheduling/cancelling) for exercise conduct.
15 OUREx Objectives • Hospitals – Objectives released June 24, 2016 – Posted to HCS • Local Health Departments – POD Objectives – released 10/20/19 – NPI Objectives – released 10/20/19 • Coalitions – TBD after Regional Offices determine roles and activation of ICS at regional level
16 Hospital Objectives
17 OUREx Hospital Objectives 1. Demonstrate the ability of the hospital to notify staff and operate its Hospital Command Center (HCC). Include activation of Hospital Incident Command System (HICS). 2. Demonstrate the ability of the hospital to implement information-sharing processes on a regular basis with other mutual aid partners, the Regional DOH Office, and with appropriate government agencies, utilizing redundant interoperable communications to: a) maintain situational awareness 3. Demonstrate the ability of the hospital to communicate consistent elements of information (EEIs) to the Regional DOH Office, other mutual aid partners and the local public health/medical lead (PERFORMANCE MEASURE). Capabilities Emergency Operations Coordination AND Information Sharing
18 OUREx Hospital Objectives 1. 2. 3. 4. Demonstrate the ability of the hospital to inventory patient census, acuity, and staffed bed availability in real time, and again after rapid patient discharge in order to decompress the facility (offload patients) GOAL: 2 hours Demonstrate the hospital’s coordination of hospital surge operations (onload patients) with EMS operations. Evaluate the ability of the hospital to move and track patients to their final disposition (ED to a staffed available bed; hospital to healthcare facility: If an evacuation scenario - must use e. FINDS). Demonstrate inclusion of individuals (highly suggested = minimum of 3) from one or more of the following at-risk populations : - Frail Elderly - Behaviorally involved - Pediatrics - Pregnant women - Physically disabled - Non-English speaking - Hearing impaired/deaf - Access/functional needs populations - Blind Capability Medical Surge Activities involving the at-risk populations can be developed at the discretion of the Exercise Design Team, depending on the scenario and scope of the exercise.
19 OUREx Hospital Objectives 1. Evaluate the hospital’s ability to reference and incorporate components of its appropriate plans (e. g. , COOP, 96 hour Sustainability Plan, the Isolation and Quarantine Plan, the Alternate Care Site Plan, etc. ) to prioritize and continue mission essential services after HCC activation. 2. Determine if event has caused a complete or partial disruption of health care service delivery, and delineate how this disruption occurred with prioritized mission essential functions (suggested minimum of 3). 3. Demonstrate appropriate activities that focus on rapid resumption of the prioritized mission essential functions (suggested minimum of 3). Capabilities Healthcare System Preparedness (Continuity of Operations) AND Healthcare System Recovery
20 Local Health Department Objectives Points of Dispensing
21 OUREx LHD Objectives - PODs 1. 2. 3. 4. 5. Objectives Identify medical countermeasure dispensing strategies. Activate dispensing strategies, dispensing sites, dispensing modalities, and other approaches as necessary to achieve the dispensing goals appropriate to the targeted population. Demonstrate the ability of the LHD to identify five (5) individuals considered to be at-risk who present during the POD: - Frail Elderly - Physically disabled - Pediatrics - Non-English speaking - Behaviorally involved - Hearing impaired/deaf - Pregnant women - Blind - Physically disabled Demonstrate one (1) mechanism (beyond POD flow design for ADA compliance) that supports and/or assists the at-risk individual. Provide situational updates to the Regional Healthcare Coalition upon request. Capabilities Medical Countermeasure Distribution and Dispensing AND Information Sharing
22 Local Health Department Objectives Non-Pharmaceutical Interventions
23 OUREx LHD Objectives - NPIs Objectives 1. 2. 3. 4. 5. Identify and delineate two (2) strategies to initiate social distancing. In consultation with the county attorney, draft a written notice for voluntary isolation, as well as talking points for an oral explanation of the written notice. Develop one public message related to NPI strategy that is targeted toward (specific – TBD) at-risk individuals. Activate three (3) supportive services or wrap-around services that the county could implement to support voluntary/involuntary quarantine, including behavioral health needs. Provide situational updates to the Regional Healthcare Coalition upon request. Capabilities Non-Pharmaceutical Interventions AND Information Sharing Integration of access and functional needs populations
24 Emergency Medical Services Objectives
25 OUREx EMS Objectives Capabilities 1. Validate the County EMS Coordinator and County EMS Points of Information Sharing Contact phone and email distribution lists, and update as needed. 2. Test the communication plan component of the Statewide EMS AND Mobilization Plan with at least seven counties (one in each DOH regional/subregion) in assessing their local EMS agency capabilities Medical Surge and resources that could be deployed to another region in response to an infectious disease outbreak. 3. Report EMS agency capabilities and resources back to BEMSATS. 4. Provide situational updates to the Regional Healthcare Coalition upon request.
26 Emergency Management Objectives
27 OUREx EM Objectives 1. Process and order resources through the NY Responds system in coordination with NYSDHSES and local County Emergency Management Offices. 2. Establish effective communication through systems such as Mutualink and NY Responds in coordination with NYSDHSES. 3. Ensure that local County Emergency Management Offices vet requests with their respective NYS DHSES Regional Staff before submitting the requests. E 4. Provide situational updates to the Regional Healthcare Coalition upon request. 5. MS Coordinator and County EMS Point of Capabilities Operational Coordination AND Operational Communication AND Logistics and Supply Chain Management
28 OUREx - Master Scenario Event List (MSEL) • Chronological listing of the events that drive exercise play • Each MSEL entry will contain the following: – – – Designated scenario time Inject number Controller responsible for delivering the inject Intended player Message Expected player response
29 Exercise Time Inject # From To Message Expected Outcome/ Actions 0900 1 SIMCELL ALL PLAYERS STARTEX 0915 2 SIMCELL Hospitals The NYSDOH is • Hospitals requesting that receive IHANS all hospitals notification complete a • Hospitals HERDS survey of complete HERDS current bed survey within availability within one hour and one hour. submit to NYSDOH Exercise begins
30 OUREx MSEL Development Session • Participants will develop specific MSEL injects to support evaluation of their organizations’ objectives and critical tasks • Working session – October 26, 2016 – 9: 00 am – 4: 00 pm
31 OUREx Important Dates Date Subject Time Location June 17 , 2016 Initial Planning Meeting 10: 00 – 12: 30 p. m. 800 N. Pearl St. , Room 218 Webinar September 20, 2016 Mid-Planning Meeting 10: 30 – 1: 00 p. m. 800 N. Pearl St. , Room 218 Webinar Briefing for OHEP Director and Deputy Directors 1: 00 – 2: 00 p. m. 800 N. Pearl St. , Room 322 Briefing for Field Reps 1: 00 – 3: 00 p. m. 800 N. Pearl St. , Room 322 Webinar October 14, 2016 October 20, 2016 You are here October, 2016 Objectives Distributed to Partners October 26, 2016 MSEL Huddle 9: 00 – 4: 00 p. m. 800 N. Pearl St. , Suite 322 Conference Room January 17, 2017 Final Planning Meeting 10: 30 – 1: 00 p. m. 800 N. Pearl St. , Room 218 Webinar February 7, 2017 Last Touch Base Meeting 10: 30 – 1: 00 p. m. 800 N. Pearl St. , Room 218 Webinar
32 OUREx Important Dates Date Subject Time Location C/E Briefing LHD – PODs C/E Briefing LHD - NPIs 10: 00 – 11: 30 a. m. Webinar 1: 00 – 2: 30 p. m. Webinar C/E Briefing Hospitals 10: 30 – 12: 00 p. m. Webinar February 23 -24, 2017 Increasing #s of patients arriving at Emergency Departments 10: 00 a. m. IHANS notification to LI and LHV Partners February 27 -28, 2017 Increasing #s of patients arriving at Emergency Departments 10: 00 a. m. IHANS notification to Capital District Partners March 2 -3, 2017 Increasing #s of patients arriving at Emergency Departments 10: 00 a. m. IHANS notification to CNY partners March 6 -7, 2017 Increasing #s of patients arriving at Emergency Departments 10: 00 a. m. IHANS notification to LI and LHV partners February 13, 2017 February 15, 2017 1: 00 – 2: 00 p. m.
33 OUREx Important Dates Date Subject Time Location February 27, 2017 OUREx – LI Business hours Hospitals, LHD POD Sites, Local EMs, EMS February 28, 2017 OUREx – LHV Business hours Hospitals, LHD POD Sites, Local EMs, EMS March 1, 2017 OUREx – CD Business hours Hospitals, LHD POD Sites, Local EMs, EMS March 2, 2017 OUREx – N. Country Business hours Hospitals, LHD POD Sites, Local EMs, EMS March 6, 2017 OUREx – CNY (S/E) Business hours Hospitals, LHD POD Sites, Local EMs, EMS March 7, 2017 OUREx – CNY (W/N) Business hours Hospitals, LHD POD Sites, Local EMs, EMS March 8, 2017 OUREx (WNY) Business hours Hospitals, LHD POD Sites, Local EMs, EMS
34 OUREx Important Dates Date Subject Time Location ~ March 8 – March 22, 2017 Hotwashes – Regional level Regional Offices to determine March 10, 2017 Hotwash – OHEP and Design Team TBD 800 N. Pearl St. , Suite 322 Webinar April 17, 2017 After Action Conference - OHEP and Design Team TBD 800 N. Pearl St. , Suite 322 Webinar May 22, 2017 Draft OHEP AAR sent to senior management N. A. Finalize AAR and distribute N. A. June, 2017
35 OUREx Next Steps • Development of Exercise Materials - ongoing – – – Exercise Plans Controller and Evaluator Handbook Exercise Evaluation Guides Master Scenario Event List Participant Feedback Forms Other exercise materials, as needed • MSEL Huddle – October 26, 2016 • Finalize activities of ROs during the exercise
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