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.

1. CCG©2013
Medical Disaster Preparedness & Response
“It’s Time for Change, It’s Time for Real Progress”

2. 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

3. 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

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 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

6. 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

7. 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

8. 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

9. CCG©2013
The Crisis Decision-Making Process

10. 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

11. 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

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-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

14. 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

15. 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

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 : Decision Makers
Strategic: Leader
Operational: Staff
Tactical: First Responder
4 Target Audiences

19. CCG©2013

20. 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

21. 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

22. CCG©2013
Advanced Tabletop Exercises
Medical Manual 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 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

24. CCG©2013
Conducting Networked Real Time Situational Exercises Enter the 21st Century
EXAMPLE

25. 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

26. 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

27. 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

28. CCG©2013

29. 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

30. CCG©2013
EMERGENCY MEDICAL RESPONSE SYSTEM 2020

31. CCG©2013
TACTICAL
OPERATIONAL
STRATEGIC
EMRS 2020
Emergency Medical Response System
A Concept In Development
EMRS 2020
Is a System,
Not an Application

32. 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

33. 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

34. 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

35. CCG©2013
Common Operating Picture (COP)
APPS
-Application
-Training
-Checklists
Drop Down Menus

36. CCG©2013
OFDA Supported
US Department of State
INFO ONLY

37. 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

38. 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

39. 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

40. CCG©2013
Construction / Management of Medical Response Camps
Camp life demands a social structure
Medical Camps
Registration Camps
Displaced Civilian Camps
Logistical Camps

41. CCG©2013
Contact Information
Domenic Tesoriero
tesorierod@yahoo.com
glopbalccg@yahoo.com
(954) 683-3435

42. CCG©2013

43. CCG©2013
ADDITIONAL SLIDES

44. 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

45. CCG©2013
Point of Injury
Collection Point
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 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

49. 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

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 / 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

52. 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

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