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Designing ,Developing, Implementation, Delivery and Evaluation of Emergency

Preparedness and Response Training and Education

Frank G. Rando,PA,RCP,CRT,CVT,EMT-PAHMP-NESHTA Aug. 29,2011,4:15-5:15 P.M.

Participants will be able to identify and discuss critical reasons for design,developmentimplementation ,delivery and evaluationof EP&R -TEE.

Participants will be able to identify and discuss key components of EP&R TEEkey components of EP&R- TEE

Participants will be able to recognize challenges in major aspects of EP&R-TEE

Participants will be able to identify and discuss TEE concepts,methodology and techniques for EP&R

Participants will be able to identify EH &S roles in EP&R-TEE

EP& R training ,education &exercises share commonalities in learning behaviors ,styles and training and educational methodology,aswith other fields.

Knowledge Comprehension Application Problem-solving

Cognitive Psychomotor Affective

Training outcomes often fail due to the instructor’s -trainer’s negative attitude , adverse style personality traits or lack of professionalism.

Negative attitudes and adverse personalities will fuel student resentment and create a hostile training environment .

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Well Organized

Ask Good Questions

Good Presentation Skills

Uses Humor in Presentations

Gestures

Encourages ParticipationSkills

Uses Multiple Instructional Media

Uses Multiple Instructional Strategies

Student Oriented

Good Listener

Encourages Participation

Adds Motion to Presentation

Varies Voice

Real Professional

Provides Feedback

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Have unique personalities and learning styles

Recognize “good” verses “bad” training Can learn fast Want to know “why” Want to make decisions Do not want to be treated like children Want organization to training session

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Want to make decisions Have specific objectives Have a past history of learning Learn best when new learning is related to

old learning

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EP & R -Multidisciplinary,interdisciplinary 10 major response disciplines-DHS Core KSAs eg.,Incident Command System -ICS

S i li d KSA Di i li ifi Specialized KSAs- Discipline-specific National uniformity and standardization a

challenge for certain aspects,eg myriad of training programs offering duplicate training

Current and evolving hazards and threat environment eg. Natural and man-made events

Lessons learned eg. 9/11/01,Katrina/Rita National strategies,directives,mandates,goals

H l d S it P id ti l Di ti eg. Homeland Security Presidential Directives (HSPDs),state,local ,institutional&agency needs

Regulatory compliance,OSHA,EPA,JC, Best practices and standards Hazard identification,HVAs,risk and threat

assessments

Complacency and unsafe practices

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Homer Simpson,CSP,CHMM,CETExplosive & flammable hazards

Responder & Life Safety are #1!! Incident stabilization Preservation of property and environment Feelings of satisfaction and accomplishment Physical& mental challenges ”Type A” Physical& mental challenges, Type A Desire to help one’s community and nation Job security and ancillary factors Prior military service in related field

eg.,medic/corpsman,military police,etc.

Responder Safety and Health Issues,eg heat stress,S.O.

Regulatory Compliance Training,eg HAZWOPER Operational Training,eg Sampling,& monitoring Operational Training,eg Sampling,& monitoring Knowledgebase,eg. Toxicology,HAZMAT chemistry Equipment/supply validation,purchasing

recommendations

Mitigation/Prevention

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Recovery

Response

DISASTER

Preparedness

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DetectionIncident CommandScene Security & SafetyAssess HazardsSupportTriage/TreatmentEvacuationRecovery

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Environmental health & safety hazards

Joshua LederbergNobel laureate at age 33

Natural disasters can create environmental disasters

Major hospital impacted

Multi-hazard operational setting

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Fukushima Daiichi nuclear-radiological event

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Multi-threat environment

Natural Disaster Environmental Environmental

DisasterDisaster

Scope ofScope ofHazardous Materials ProblemHazardous Materials Problem

Abundance and Prevalence

Better livingBetter livingthrough chemistry?through chemistry?

Toxic Warfare/Chemo-terrorism or Meth Lab?

Chemical Chemical ProductionProduction

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Transportation incidents/accidents Fixed facility spills and releases Hazardous waste sites-controlled/uncontrolled Toxic fires Environmental crimes Environmental crimes Sabotage and chemical terrorism Tactical and strategic chemical warfare

Emerging Infectious DiseasesEmerging Infectious Diseases

“Bioterrorism is the intentional or threatened use of viruses, bacteria, fungi, toxins from living organisms or other chemicals to g gproduce death or disease in humans, animals or plants.”

The Anthrax Letters-October 2001 Food supply and distribution-biosecurity and safety issues

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Water distribution systems possible Reservoirs-highly unlikely to succeed Water purification,dilution and natural forces

minimize or eliminate threat Unpolluted sources a challenge for many poor Unpolluted sources a challenge for many poor

and developing nations

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Hazard Vulnerability Analysis (HVA)

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Identify hazards, risks and vulnerabilities Perform hazard vulnerability analysis Categorize hazards, risks & vulnerabilities Write an “all hazards” Emergency Operations Plang y p

To address hazards and threats (H&T)

Train, drill and exercise on the EOP Document training, drills & exercises

Prepare After-action Report (AAR), and Improvement Plans (IP)

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Advance identification of potential problems in facility and community

Threat specific vs. “all-hazards” approach E l Examples: Chemical manufacturing, Treatment storage and disposal facilities (TSDFs), Geo-hazards, Severe weather, and Mass gatherings

.

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Vulnerability- the “state of being open to attack, hurt or injury,” (Merriam Webster’s Collegiate Dictionary,2002)

HVA d t d t i HVAs are used to determine: Who and what may be affected, harmed or

destroyed, and The capacity of the community to deal with the

effects of a disaster, incident or event Separate HVAs should be conducted for

each identified hazard

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The Hazard Vulnerability Analysis (HVA) process is a key element for developing an EOP and drives incident-specific planning

It helps identify, prioritize, and define threats that may impact business operationsthat may impact business operations

With this knowledge, specific steps may be taken to: Reduce the impact caused by threat occurrence,

and Subsequently, better ensure ongoing business

functions

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Risk- the probability of an outcome (Risk = Hazard X Vulnerability)

Risk Assessment - uses the results of the hazard identification and HVA to:hazard identification and HVA to: Determine the probability of an outcome from a

given hazard that affects an institution, or community

With known vulnerabilities and coping mechanisms

Probability may be expressed in: Numerical (30%), or Relative terms (low, moderate or high risk)

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HVAs and risk assessments need to be credible and realistic Probability is the likelihood of an event occurrence

It can be calculated through a retrospective assessment of event frequency, or

Predicted through a prospective estimation of risk factors

Impact is the severity or damage caused by a threat and should include: Effects on human lives, Business operations/infrastructure, and Environmental conditions

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Risk is the calculated score of the interactions between probability and impact that is applied to each threat type

Risks can be reduced by implementing th t iti ti ti iti fthreat mitigation activities for: Probability (e.g., reduced likelihood of electrical

failure through routine generator testing), or Severity (e.g., fewer earthquake injuries by

securing heavy wall cabinets)

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National Preparedness Goal-HSPD-8 Addresses integrated,all-Nation capabilities-

based approach to national preparedness Stregthening security and resiliency of the Stregthening security and resiliency of the

homeland through systematic preparation for all-hazards

HSPD-5-Management of domestic incidents by utilizing a single,comprehensive National Incident Management System (NIMS)

National Response Framework (NRF) Builds upon NIMS Comprehensive,all-hazards approach to prepare

for and respond to all domestic incidentsfor and respond to all domestic incidents Defines principles,roles and structures that

organize how we respond ,offers best practices and coordination of stakeholders in responding to domestic incidents and events.

IncidentIncidentCommandCommand

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Finance/Finance/AdministrationAdministration

SectionSection

LogisticsLogisticsSectionSection

OperationsOperationsSectionSection

PlanningPlanningSectionSection

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Incident “resources” refers to personnel, supplies, and equipment

During an incident, it is critical to know: What resources are needed and available Where deployed resources are locatedp y

Effective resource management ensures that response personnel are safe and incident objectives are achieved

Have resources been identified and requested? Radios, computers and other response equipment

Interoperability of communications

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The Incident Commander identifies and establishes needed facilities depending on incident needs

The most common type of facility you may The most common type of facility you may encounter is the Incident Command Post (ICP)

IC oversees all incident operations Has incident locations & facilities been

identified and requested?

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Resource management includes processes for: Identifying resource requirements Ordering and acquiring resources Mobilizing and dispatching resources Tracking and reporting on resource status Recovering and demobilizing resources

It also includes processes for reimbursing for resources and maintaining a resource inventory

On-scene through Logistics Section Off-scene through Emergency Operations

Center (EOC)57

What are the incident priorities? What are the initial incident objectives? What are the main functions for:

(Operations, Logistics, Planning and Fi /Ad i )?Finance/Admin)?

Should the functions be divided? If so, how?

How large is the incident? What resources will be required? What notification will be required?

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Target Capabilities List (TCL) Common Target Capabilities: Planning,Risk Management,Community

Preparedness & Participation,Intelligence & p p gInformation Sharing & Dissemination

Prevent Mission Area: eg. CBRNE Detection, Information Gathering & Recognition of Indicators & Warnings,Counterterrorism

Protect Mission Area:eg. Epidemiological Surveillance & Investigation,LabTesting,Critical Infrastructure Protection,Food/Ag Safety & Defense

Response Mission Area: eg. Responder Safety & Health, Environmental Health,WMD/ HAZMAT Response & Decontamination, Medical Surgep g

Recover Mission Area: eg. Structural Damage Assessment,Restoration of Lifelines,Economic and Community Recovery

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Universal Task List (UTL) –Document and tool designed to help implement capabilities-based planning process

It is a “living document”g National Planning Scenarios: 15 Scenarios developed to represent possible

natural and man-made threats and impacts Designed to guide and enhance national

homeland security preparedness efforts

Homeland Security Exercise Evaluation Program (HSEEP)

Purpose is to assist Federal exercise grant recipients with the design,development & p g pdelivery of high-quality,high-value disaster preparedness exercises based on best practices,lessons learned,and practitioner experiences.

Critical Infrastructure and Key Resources (CIKR) Annex

Designed to address assessment,prioritization, protection and restoration of critical infrastructure pand key resources during actual or potential domestic incidents or events

CIKR :Ag/Food,Banking/Finance,Chemical and Commercial facilities,Manufacturing, Transporation, Drinking Water & Water Treatment, Public Health & Healthcare, Govt., IT,Defense Industrial Base,ETC.

OSHA: HAZWOPER RESPIRATORY PROTECTION EPA NFPA NRC JC(AHO) ANSI UL State & local laws and ordinances

Employee’s role or work functions during H&T

Purchase Chemical Protective Clothing & Equipment (CPC&E) for identified H&T

Design a written program for: Design a written program for: Chemical protective clothing & equipment (CPC&E) Respiratory protection (RP) OSHA, 29 CFR 1910.120

Identify PPE requirements from hazards & threats

Design, develop and delivery training on CPC&E

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Evaluate written programs on: Chemical protective clothing & equipment (CPC&E) 29 CFR 1910.120

Respiratory protection (RP) 29 CFR 1910.13429 CFR 1910.134

Designate a “competent person” as Program Administrator to oversee program and conduct required evaluations

Practice, drill and exercise wearing CPC&E Document training, drills & exercises

Prepare AAR and IP

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Qualified person: A person with specific training, knowledge and experience in the area for which the person has the responsibility and the authority to control, 29 CFR 1910.120 (a)(3)

Competent person: A person approved or assigned by the employer to perform a specific type of duty or duties at a specific location or locations at the jobsite

Program Administrator: One who is qualified by appropriate training or experience that is commensurate with the complexity of the program to administer or oversee the respiratory protection program and conduct the required evaluations of program effectiveness, 29 CFR 1910.134 (c)

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Four levels of protection: A, B, C, and D Selection is based upon required protection

needed Disposal chemical protective clothing isp p g

First choice and better alternative

Types of chemical protective gloves are: Neoprene, Nitrile, PVC, and Rubber

OSHA regulations require employee training before use

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Levels A,B,C,D Critical areas that should be comprehensively and succinctly addressed should include: Management and planning Departmental/organizational roles and

responsibilities before, during, and after emergencies

Health and medical operations Communication (internal and external) Logistics Finance and administration

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Equipment Patient tracking Fatality management Decontamination Plant, facility, and utility operations Safety and security, and Coordination with external agencies

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Education – Transfer of knowledge, enlightenment, concepts expand consciousness, academic foundation, theoretical content, analytical thinking, “purist” (knowledge for knowledge sake)knowledge sake)

Training – Change behaviors, skill acquisition & development, job specific content, “nuts & bolts,” more practical (task-oriented, mission oriented, stakeholders expect “usable” info)