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Ccg 5 april 2014

CCG is a medical disaster preparedness group that provides tools and consulting to improve crisis decision-making and coordination during disaster response. They offer preparedness platforms including training exercises, response plans, and recovery platforms. Their vision is to dramatically increase effective medical disaster response and achieve real-time situational awareness for medical organizations. CCG staff are experienced retired medical and disaster professionals who provide senior-level preparedness consulting to various decision-makers and organizations. They develop exercise programs using different platforms to train leaders, staff, and first responders to be prepared for disasters.

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CCG©2013 Medical Disaster Preparedness & Response “It’s Time for Change, It’s Time for Real Progress”
CCG©2013 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
CCG©2013 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
CCG©2013 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
CCG©2013 Tools for our Political Decision-Makers & EM Community Preparedness Platform Training Exercise Platforms, Validation of Response Plans, Historical Review of Disaster Responses, Familiarization Tool and more… Response Platform Emergency Medical Response System 2020 Recovery Platform Medical Camps
CCG©2013 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 The Balance of Leadership
CCG©2013 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
CCG©2013 Senior level Medical Preparedness Consulting For Political Elected Officials Medical Directors / Managers ICP Commanders Medical EOC‟s and Staff Members (Operation & Planning Officers) Departmental, Interagency and Cross Agency Hospital 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
CCG©2013 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 the 21st Century
CCG©2013 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
CCG©2013 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
CCG©2013 CT Initial briefing every 30 mins., as major events develop „Real Time Situational Awareness‟ Alert (OPNS / PLANS) Gather New Information & Brief (15-30 Minutes) (OPNS) Automatically Initiate Response Plan # 1234 (PLANS) Course of Action(s) Development, Comparison and Validation Disaster Crisis Team (CT) Pre- Approved Response Plans (OPNS/PLANS) Issue Verbal Fragmentary Response Order (VFRO) (OPNS/PLANS) CONTINUE PLANNING Send 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 1234 Force 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 and Crisis Team
CCG©2013 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 Process is 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/OPLAN COA Approval4 Constructive SimulationsDecision MatrixCOA Development and Analysis3 Crisis Course of Action 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/OPLAN COA 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
CCG©2013 THE TRAINING & EXERCISE PLATFORM
CCG©2013 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.
CCG©2013 Political : Decision Makers Strategic: Leader Operational: Staff Tactical: First Responder 4 Target Audiences
CCG©2013
CCG©2013 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 Officials Medical Directors / Managers Medical 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
CCG©2013 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 Series DHS / HSEEP Compliance
CCG©2013 Advanced Tabletop Exercises Medical Manual Exercise Preparedness Series DHS / HSEEP Compliance Political Elected Medical Directors Medical Managers Hospitals & Clinics Medical Responder Leadership
CCG©2013 Constructive Simulated Supported Example Functional Exercise Constructive Simulation Supported Exercises Medical Simulation Exercise Preparedness Series DHS / HSEEP Compliance Live Exercise Platform Live Exercise Platform Simulated Exercise Platform SEAMLESSEXERCISEPLATFORM RRCC STATE CITY Crisis Team CITY EOC LIVE Platform Constructive Simulation Model M o d e l R e p l i c a t e s
CCG©2013 Conducting Networked Real Time Situational Exercises Enter the 21st Century EXAMPLE
CCG©2013 Leadership & Staff First Responders C2-C4I Exercise Platforms Individual Drills Team / Crew Drills Departmental Drills / Training Seminars Workshops (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 NEOC FBI Police Fire Medical More… 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 • Ambulance s EDRE
CCG©2013 DI-T&E Roadmap Simple single echelon collective T&E roadmap Political & Policy Makers Resource Coordinators -NEMO -Regional EOC -Municipality First Responders -Regional -Municipality FE CPX TTX-O STAFFEX FE CPX Individual Drills Crew Drills Team Drills FTX / FSE
CCG©2013 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 Industry Leaders Military Commanders Educators Pre-Exercise: Develop / Validate / COA Staff Member Programs Decision Makers Combined Exercise Series Operations Officer Planning 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 / Manager Programs Crisis Decision- Making Process Lessons Learned Risk Assessments REAL WORLD READINESS FSE Live Field Exercises EDRE “No Notice” Exercise Deployment Readiness Evaluation CAP
CCG©2013
CCG©2013 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
CCG©2013 EMERGENCY MEDICAL RESPONSE SYSTEM 2020
CCG©2013 TACTICAL OPERATIONAL STRATEGIC EMRS 2020 Emergency Medical Response System A Concept In Development EMRS 2020 Is a System, Not an Application
CCG©2013 Emergency Medical Response System 2020 Response Real Time Situational Awareness Tactical, Operational and Strategic Integrated Multi-Purpose Medical Combined Software Common Operating Picture (COP) Clinical Echelons of Care Communications Logistics Locations Patient 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
CCG©2013 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 Movement Communications -Text -Chat -Live streaming Logistics -Medical Medical Patient ID Bracelets Scan capable (to & from) w/ use of patient wrist bands
CCG©2013 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
CCG©2013 Common Operating Picture (COP) APPS -Application -Training -Checklists Drop Down Menus
CCG©2013 OFDA Supported US Department of State INFO ONLY
CCG©2013 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
CCG©2013 CITY STATE FEDERAL NGO’s IGO’s Faith Based Org’s Who’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 lead WHO is informative, not directive Assignment of health sectors Sign-in sheets Echelons of care / Roles of care Communications Coordination Transportation and more ???? UN Health Cluster HQ USA Germany UK France Spain IGOs NGOs Example International Response
CCG©2013 Disaster Area Town 2Town 1 Central Data Depository State State EOC FEMA EMRS2020 Common 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
CCG©2013 Construction / Management of Medical Response Camps Camp life demands a social structure Medical Camps Registration Camps Displaced Civilian Camps Logistical Camps
CCG©2013 Contact Information Domenic Tesoriero tesorierod@yahoo.com glopbalccg@yahoo.com (954) 683-3435
CCG©2013
CCG©2013 ADDITIONAL SLIDES
Alert Gather New Information (15-30 Minutes) Automatically Initiate OPLAN # 1234 Course of Action Development and Validation Issue Verbal Fragmentary Response Order (VFRO) CONTINUE PLANNING Send 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
CCG©2013 Point of Injury Collection Point MorgueHospitalTrauma
CCG©2013 Live Exercise Platform Live Exercise Platform Simulated Exercise Platform Virtual Simulators Live / Real World C2 Manual Constructive Simulation The Integrated Training & Exercise Platform Training In-depth
CCG©2013 Combining Leader / Staff and First Responder Training and Exercise Roadmap 6 Month Example Start Day E -180 E -150 E -120 E -90 E -30 Exercise Day STARTEX ENDEX E +5/30 Exercise Level Staff Exercise I Participants Exercise Activity Staff Exercise II Participants Exercise Activities C2 Exercise I Participants Exercise Activities Emergency Readiness Deployment Exercise Live Field Exercise Immediate on site organization AAR‟s E +5 Formal 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 limited 25-100% E +30 Formal Written Detailed AAR City Town Exercise Length MSN: Validate RPLAN 2 Hours MSN: Validate Support RPLAN 4 Hours MSN: Conduct C2 Training 16 Hours 4 Shifts 8 Hours 2 Shifts 2-3 Days 4 Shifts 2-4 Hours 2-4 Hours Training Review E -165 Primary Leader Workshop E -160 Primary Staff Workshop E -130 Support Leaders Workshop E -125 Support Staff Workshop E -100 Leaders Workshop E -95 Staff Workshop Immediate AAR at ENDEX Exercise Support Model Advanced Tabletop Constructive Simulations Constructive Simulations Live / Constructive Live / Constructive AAR AAR REMARKS Organizations 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 simulated and/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 Drills Virtual 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 Resources People Equipment Vehicles Terrain Weather Day / Night Water Boats Weapons Buildings Rubble Disasters Natural Man-made Terrorists Integrating Multiple Training, Exercise and Evaluation Platforms CSM‟s are a totally Seamless inter-active platform Decision 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
CCG©2013 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
CCG©2013 References DHS / FEMA EXERCISE TYPES -T&EPW User’s handbook REF: 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
CCG©2013 Mayor & Crisis Staff Exercise Team - Evaluators / AAR - White Cell / HICON - Red Cell -Simulation Cell -Tech Team -Computer Op Exercise Planning Team A rep from each participating origination EM Director Exercise Director IGO / NGOs Mayor & Services Representatives 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 Initiate Response 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 PLANNING Send 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 and Crisis Team

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Ccg 5 april 2014

  • 1.
    CCG©2013 Medical Disaster Preparedness& Response “It’s Time for Change, It’s Time for Real Progress”
  • 2.
    CCG©2013 ORGANIZATION CCG is amedical 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
  • 3.
    CCG©2013 VISION Dramatically increase effectivemedical disaster response, disaster coordination, capability and achieve Real Time Situational Awareness for medical organizations responding to all types of medical disasters
  • 4.
    CCG©2013 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
  • 5.
    CCG©2013 Tools for ourPolitical Decision-Makers & EM Community Preparedness Platform Training Exercise Platforms, Validation of Response Plans, Historical Review of Disaster Responses, Familiarization Tool and more… Response Platform Emergency Medical Response System 2020 Recovery Platform Medical Camps
  • 6.
    CCG©2013 Who are theDecision-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 The Balance of Leadership
  • 7.
    CCG©2013 The response tothe 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
  • 8.
    CCG©2013 Senior level MedicalPreparedness Consulting For Political Elected Officials Medical Directors / Managers ICP Commanders Medical EOC‟s and Staff Members (Operation & Planning Officers) Departmental, Interagency and Cross Agency Hospital 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
  • 9.
  • 10.
    The Crisis Decision-MakingProcess (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 the 21st Century
  • 11.
    CCG©2013 Critical Disaster TimeTable 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
  • 12.
    CCG©2013 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
  • 13.
    The Crisis Decision-MakingProcess 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
  • 14.
    CCG©2013 CT Initial briefingevery 30 mins., as major events develop „Real Time Situational Awareness‟ Alert (OPNS / PLANS) Gather New Information & Brief (15-30 Minutes) (OPNS) Automatically Initiate Response Plan # 1234 (PLANS) Course of Action(s) Development, Comparison and Validation Disaster Crisis Team (CT) Pre- Approved Response Plans (OPNS/PLANS) Issue Verbal Fragmentary Response Order (VFRO) (OPNS/PLANS) CONTINUE PLANNING Send 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 1234 Force 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 and Crisis Team
  • 15.
    CCG©2013 Decision Making Techniques Residualrisks 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 Process is 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/OPLAN COA Approval4 Constructive SimulationsDecision MatrixCOA Development and Analysis3 Crisis Course of Action 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/OPLAN COA 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
  • 16.
    CCG©2013 THE TRAINING &EXERCISE PLATFORM
  • 17.
    CCG©2013 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.
  • 18.
    CCG©2013 Political : DecisionMakers Strategic: Leader Operational: Staff Tactical: First Responder 4 Target Audiences
  • 19.
  • 20.
    CCG©2013 Medical Exercise PreparednessSeries 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 Officials Medical Directors / Managers Medical 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
  • 21.
    CCG©2013 CCG provides threeof 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 Series DHS / HSEEP Compliance
  • 22.
    CCG©2013 Advanced Tabletop Exercises MedicalManual Exercise Preparedness Series DHS / HSEEP Compliance Political Elected Medical Directors Medical Managers Hospitals & Clinics Medical Responder Leadership
  • 23.
    CCG©2013 Constructive Simulated Supported Example Functional Exercise Constructive Simulation SupportedExercises Medical Simulation Exercise Preparedness Series DHS / HSEEP Compliance Live Exercise Platform Live Exercise Platform Simulated Exercise Platform SEAMLESSEXERCISEPLATFORM RRCC STATE CITY Crisis Team CITY EOC LIVE Platform Constructive Simulation Model M o d e l R e p l i c a t e s
  • 24.
    CCG©2013 Conducting Networked RealTime Situational Exercises Enter the 21st Century EXAMPLE
  • 25.
    CCG©2013 Leadership & Staff FirstResponders C2-C4I Exercise Platforms Individual Drills Team / Crew Drills Departmental Drills / Training Seminars Workshops (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 NEOC FBI Police Fire Medical More… 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 • Ambulance s EDRE
  • 26.
    CCG©2013 DI-T&E Roadmap Simple singleechelon collective T&E roadmap Political & Policy Makers Resource Coordinators -NEMO -Regional EOC -Municipality First Responders -Regional -Municipality FE CPX TTX-O STAFFEX FE CPX Individual Drills Crew Drills Team Drills FTX / FSE
  • 27.
    CCG©2013 The CCG RoadmapTo 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 Industry Leaders Military Commanders Educators Pre-Exercise: Develop / Validate / COA Staff Member Programs Decision Makers Combined Exercise Series Operations Officer Planning 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 / Manager Programs Crisis Decision- Making Process Lessons Learned Risk Assessments REAL WORLD READINESS FSE Live Field Exercises EDRE “No Notice” Exercise Deployment Readiness Evaluation CAP
  • 28.
  • 29.
    CCG©2013 An example incombining 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
  • 30.
  • 31.
    CCG©2013 TACTICAL OPERATIONAL STRATEGIC EMRS 2020 Emergency MedicalResponse System A Concept In Development EMRS 2020 Is a System, Not an Application
  • 32.
    CCG©2013 Emergency Medical ResponseSystem 2020 Response Real Time Situational Awareness Tactical, Operational and Strategic Integrated Multi-Purpose Medical Combined Software Common Operating Picture (COP) Clinical Echelons of Care Communications Logistics Locations Patient 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
  • 33.
    CCG©2013 EMRS 2020 isan 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 Movement Communications -Text -Chat -Live streaming Logistics -Medical Medical Patient ID Bracelets Scan capable (to & from) w/ use of patient wrist bands
  • 34.
    CCG©2013 Suite for AutomatedGlobal 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
  • 35.
    CCG©2013 Common Operating Picture(COP) APPS -Application -Training -Checklists Drop Down Menus
  • 36.
  • 37.
    CCG©2013 UN Health ClusterTimeline 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
  • 38.
    CCG©2013 CITY STATE FEDERAL NGO’s IGO’s Faith Based Org’s Who’sin-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 lead WHO is informative, not directive Assignment of health sectors Sign-in sheets Echelons of care / Roles of care Communications Coordination Transportation and more ???? UN Health Cluster HQ USA Germany UK France Spain IGOs NGOs Example International Response
  • 39.
    CCG©2013 Disaster Area Town 2Town1 Central Data Depository State State EOC FEMA EMRS2020 Common 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
  • 40.
    CCG©2013 Construction / Managementof Medical Response Camps Camp life demands a social structure Medical Camps Registration Camps Displaced Civilian Camps Logistical Camps
  • 41.
  • 42.
  • 43.
  • 44.
    Alert Gather New Information (15-30 Minutes) Automatically InitiateOPLAN # 1234 Course of Action Development and Validation Issue Verbal Fragmentary Response Order (VFRO) CONTINUE PLANNING Send 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
  • 45.
    CCG©2013 Point of Injury CollectionPoint MorgueHospitalTrauma
  • 46.
    CCG©2013 Live Exercise Platform Live Exercise Platform Simulated Exercise Platform Virtual Simulators Live/ Real World C2 Manual Constructive Simulation The Integrated Training & Exercise Platform Training In-depth
  • 47.
    CCG©2013 Combining Leader /Staff and First Responder Training and Exercise Roadmap 6 Month Example Start Day E -180 E -150 E -120 E -90 E -30 Exercise Day STARTEX ENDEX E +5/30 Exercise Level Staff Exercise I Participants Exercise Activity Staff Exercise II Participants Exercise Activities C2 Exercise I Participants Exercise Activities Emergency Readiness Deployment Exercise Live Field Exercise Immediate on site organization AAR‟s E +5 Formal 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 limited 25-100% E +30 Formal Written Detailed AAR City Town Exercise Length MSN: Validate RPLAN 2 Hours MSN: Validate Support RPLAN 4 Hours MSN: Conduct C2 Training 16 Hours 4 Shifts 8 Hours 2 Shifts 2-3 Days 4 Shifts 2-4 Hours 2-4 Hours Training Review E -165 Primary Leader Workshop E -160 Primary Staff Workshop E -130 Support Leaders Workshop E -125 Support Staff Workshop E -100 Leaders Workshop E -95 Staff Workshop Immediate AAR at ENDEX Exercise Support Model Advanced Tabletop Constructive Simulations Constructive Simulations Live / Constructive Live / Constructive AAR AAR REMARKS Organizations 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 simulated and/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 Drills Virtual 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
  • 48.
    CCG©2013 Target Audience Typeof 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
  • 49.
    CCG©2013 Real Time Interactive SimulationModels Replicate Resources People Equipment Vehicles Terrain Weather Day / Night Water Boats Weapons Buildings Rubble Disasters Natural Man-made Terrorists Integrating Multiple Training, Exercise and Evaluation Platforms CSM‟s are a totally Seamless inter-active platform Decision 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
  • 50.
    CCG©2013 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
  • 51.
    CCG©2013 References DHS / FEMAEXERCISE TYPES -T&EPW User’s handbook REF: 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
  • 52.
    CCG©2013 Mayor & Crisis Staff ExerciseTeam - Evaluators / AAR - White Cell / HICON - Red Cell -Simulation Cell -Tech Team -Computer Op Exercise Planning Team A rep from each participating origination EM Director Exercise Director IGO / NGOs Mayor & Services Representatives 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
  • 53.
    Alert (OPNS / PLANS)Gather New Information (15-30 Minutes) (OPNS) Automatically Initiate Response 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 PLANNING Send 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 and Crisis Team