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Continuity of Operations for Community Health Centers 1

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Page 1: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Continuity of Operations for Community Health Centers

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Page 2: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Describe a training and exercise programDescribe the scope of a good TT&E programDescribe the HSEEP  Review various assistance materials

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Page 3: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

COOP includes. . . 

The activities of individual departments and agencies and their subcompartments to ensure that their essential functions are performed

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Page 4: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

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Essential Functions Delegation of Authority Orders of Succession Alternate Facilities Vital Records, Databases & Systems

Interoperable Communications

Contingency Staff and Responsibilities

Devolution Reconstitution

Testing, Training, and Exercises

Page 5: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Tests, training, and exercise program includes:

Measures to ensure that an agency’s COOP program is capable of supporting the continued execution of its essential functions throughout the duration of the COOP situation.

Page 6: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

TT&E Program Goals Train key personnel in functional areas of mission readiness

Provide opportunities to acquire skills and knowledge required to perform assigned COOP role

Build team unity Reflect lessons learned from TT&E events, current COOP information, and training needs

Page 7: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

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Testing and exercising COOP capabilities are essential to demonstrating and improving the ability of departments to execute their COOPs.  

Serve to validate or to identify improvements to the COOP’s policies, procedures, systems, and locations.  

Periodic testing and exercising also help to ensure that equipment and procedures are maintained in a constant state of readiness.

Page 8: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

An exercise can be used to:

• test the success of a training or development program

• evaluate a response plan 

• assess the readiness of an agency or community to respond to an emergency

Page 9: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Traditional Thinking 

The Cycle Approach

Page 10: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Reality Thinking

PlanTrain

Exercise

Evaluate

Each phase is conducted independently.

Page 11: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Planning, Training, Exercising and Evaluating are like gears driving the Preparedness Machine.

The challenge is getting the gears to mesh.

The HSEEP Preparedness Systems Approach continually integrates plan development and revisions with training programs, exercises and evaluations.

PlanTrain

Exercise

EvaluateHSEEP

All federally‐funded exercises must be HSEEP Compliant

Page 12: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Conducting an annual Training and Exercise Plan Workshop and developing and maintaining a Multi‐year Training and Exercise Plan. 

Planning and conducting exercises in accordance with the guidelines set forth in HSEEP Volumes I‐III.

Developing and submitting a properly formatted After‐Action Report/Improvement Plan (AAR/IP).  

Tracking and implementing corrective actions identified in the AAR/IP.”  

What does “HSEEP Compliance” mean?

See https://hseep.dhs.gov/  ‐‐HSEEP 101:  a program overview for first‐timers

“In order for an entity to be considered HSEEP compliant, it must satisfy four distinct performance requirements: 

Page 13: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Climbing the blocks depends on the maturity of your plan and participant training levels.

Planning an Exercise

Page 14: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Familiarize participants with current plans, policies, and procedures or with facilitating the development or revision of plans.  

• Seminars –Orient participants to new or updated plans, policies or procedures in an informal discussion.

•Workshops – Build plans or policies or test a new plan using a canned scenario.

•Tabletops (TTX) – Assess plans, policies and procedures in  scenarios involving key stakeholders. 

•Games – Compete operational teams’ responses using rules, data, procedures and scenarios that depict actual situations.

Planning the Exercise

Page 15: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Validate plans, policies and procedures, clarify roles and responsibilities and identify resource gaps in an operational environment.

• Drills – Test a specific operation/function of a single entity or team.

• Functional Exercises (FE) – Validate communications and command and control functions among multi‐agency coordination centers (a.k.a. Command Post Exercises).

• Full‐Scale Exercises (FSE) – Evaluate coordinated operations  among multiple agencies, jurisdictions and disciplines  with "boots on the ground" in real time, real place  scenarios.

Planning the Exercise

Page 16: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Seminars, workshops and drills can be low costand developed in‐house, without contract vendors.

Full‐scale exercises are typically the most expensive and require the most external support.  

Possible Funding Sources

• Department financial or CDC/ASPR‐HPP grant support, requested one year in advance, thru the DOH Two‐Tier Exercise approval process. 

• DHS funding for multi‐discipline community‐based exercises, by contacting  Emergency Management.

Planning the Exercise

Page 17: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Setting an exercise date drives all other tasks. 

• Allow at least 3 months of planning time for a discussion‐based exercise or drill. 

• Allow at least 6 months of planning time for a functional or full‐scale exercise.  

• Set the date in National Exercise Schedule System ‐‐NEXS.

• Set a date 12 months early if you will seek funding. 

• Notify your Exercise or Training Program Manager to enterthe date into the Multi‐Year Training and Exercise Plan.  

Planning the Exercise

Page 18: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

The most important factor for a successful exercise is organizing a skilled and experienced exercise planning team.  

The Planning Team:

• determines exercise objectives• tailors scenarios to meet objectives • determines logistical support

Planning the Exercise

Because of their involvement in planning, team members make ideal exercise facilitators, controllers, or evaluators. 

Page 19: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

• Vulnerable Population Representatives • Law Enforcement (LE)• Emergency Medical Services (EMS) • Fire and Rescue • Hospitals • County Emergency Managers • County Health Departments (CHDs) • Public Information Officers (PIOs) • Local School Districts • Volunteer and Faith‐Based Organizations• COOP Program Manager• Department of Agriculture and Consumer Services • Department of Business and Professional Regulation • Department of Environmental Protection • Fish and Wildlife• Regional Planning groups 

Planning the Exercise

This list is neither exhaustive nor mandatory

Page 20: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Scenario Development

The scenario provides the storyline that drives the exercise.

• Determine the type of threat/hazard (e.g., bio, pandemic, chemical, natural disaster).

• Determine degree of difficulty. (No pain, no gain.)

• Make it look real! (moulage, miniatures and maps)• Consider timing.

• Determine the venue (space and safety).

Be careful about holding totally unannounced exercises.

Page 21: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Exercise Staffing

Facilitators: in discussion‐based exercises, are responsible for ensuring that discussions remain focused.

Controllers: experienced exercise staff, who manage play and operate incident site and SimCell.  They:

• Understand exercise context.• Provide key data to players.• Prompt player actions through planned or on‐the‐spot injects.• Compress time to ensure exercise continuity/completion.• Are accountable to senior or chief controller. 

Chief Controller: approves on‐the‐spot injects and announces“StartEx” and “EndEx.”

Planning the Exercise

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Exercise Staffing

Evaluators: chosen for expertise in areas they evaluate, play a passive role.  The Operations Section selects evaluators, including the Chief Evaluator/team leader who oversees the AAR/IP.  

Evaluators use EEGs/notes to record observations. Training should cover what to look for/record and how to use EEGs.    

Evaluators must:

• Be at their designated posts when players arrive.•Have a good view of player actions.• Listen to discussions.• Focus on observing activities/tasks/times/events.•Avoid prompting players or answering questions.

Planning the Exercise

Page 23: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Exercise StaffingActors: volunteers who simulate specific roles (i.e., disaster casualty victims) to add realism. 

The Logistics Section recruits and briefs actors.

Controllers must monitor actors to ensure they do not ad lib and create unplanned/spurious injects.

Planning the Exercise

Page 24: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Exercise Staffing

Simulators: controllers who perform the roles of non‐participating individuals or organizations to drive realistic exercise play.  Simulators may be in a SimCell and communicate with players via radio, phone or email.

Players: those for whom the exercise is conducted. They have active roles in responding to an incident by discussing (in a discussion‐based exercise) or performing (in an operations‐based exercise) their roles and responsibilities.

Observers: may include VIPs and media.  They must not participate in exercise play, evaluation or control functions, but they may be asked for comments or observations. 

Planning the Exercise

Page 25: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Exercise Staffing

Safety Officer: the most important member of the exercise team;identified by a distinctive vest or armband; looks out for the safety of all exercise participants and must have no other duties.

Responsibilities include:

• Reviewing exercise documentation for safety issues.

• Briefing participants on safety concerns.

• Being vigilant for safety issues during the exercise.

• Issuing STOP EXERCISE orders when needed.

• Documenting safety incidents for the AAR/IP.

Planning the Exercise

Page 26: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Conducting the Exercise

• Recon exercise venue(s) 24 hours before the event.

•Arrive before start time to handle remaininglogistic/administrative issues, arrange registration andensure exercise staff are briefed/in place.

• If discussion‐based, review room layout/access.

• If operations‐based, review assembly area(s), response route(s), response operations area(s), parking areas, registration area, observer/media accommodations and SimCell facility.

On the day of the exercise, Murphy rules!

Page 27: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Avoid unplanned confrontations with Law Enforcement Officers!Have a strict weapons policy and make sure everyone knows it

Conducting the Exercise

Page 28: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Evaluation is the cornerstone of exercises. It documents strengths and areas for improvement.  It requires pre‐developed Exercise Evaluation Guidelines and includes formal exercise evaluation, integrated analysis and drafting the AAR/IP.

Photography, sound recordings and videography are important documentation tools to supplement written evaluations and comments.

A picture is worth 1,000 words…

but permission may be needed particularly if minors are involved.  

Conducting the Exercise

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A Hot Wash…

• Is conducted in each functional area by the area’s controller or evaluator.

• Enables evaluators to capture events whilethey are fresh in players’ minds.

•Allows players to provide immediate feedback, verbally and through distributionof Participant Feedback Forms.

•May be held separately with actors.

Hot washes are held immediately following ENDEX.

The AAR/IP includes information gathered during a hot wash.

Page 30: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

•Exercise objectives. • Key decisions. • Player training. • Resource shortcomings. • Plans, policies and procedures adequacy.• Players’ familiarity with these documents.•Agencies/Jurisdictions coordination and cooperation.• Lessons learned.• Strengths. •Areas for improvement. 

Developing an AAR/IP

Page 31: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Improving the Process

Each task not completed as expected is an opportunity for evaluators to search for a root cause – the source of, or underlying reason behind, an identified issue.

To arrive at a root cause, evaluators trace the origin of each event to earlier events and their respective causes.

Find the Root Cause

If an individual did not perform well, the root cause(s) may be due to insufficient training, experience, communications, a procedure or the plan.

The root cause should never be 

identified as a person.

Page 32: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Once recommendations, corrective actions, responsibilities and due dates are identified in the IP, the exercising organization tracks each corrective action to completion. 

The HSEEP Corrective Action Program (CAP) System is an excellent tool for tracking IP recommendations. 

• It assigns IP activities with responsible organizations,   action officers and completion dates.

• It allows action officers to update completion of their tasks.

• It has an alert system reminder for overdue tasks.

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Keeping up the Maintenance

Plan

Train

ExerciseEvaluate

Leadership is the lubrication that keeps the gears turning.  

Page 34: Continuity of Operations for Community Health Centers€¦ · Continuity of Operations for Community Health Centers 1 ... • Volunteer and Faith‐Based Organizations • COOP Program

Federal Continuity Guidance Circular

Continuity Assistance ToolContinuity Evaluation ToolHSEEPMulti‐Year Plan

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