Outbreak Unchecked Response Exercise (OUREx) December 5th, 2016 Western Region Planning Partner Update

OUREx Plans, Policies and Procedures Relevant plans, policies and procedures to be tested or examined during the exercise Hospital Medical Surge Plans Nursing Home Decompression Plans LHD POD Plans LHD NPI Plans Statewide EMS Mobilization Plan CEMP – Communication and Resource Procurement appendices

OUREx Exercise Play Timeline Dates of Exercises The exercise will span 7 work days: 2/27/17 Long Island 2/28/17 Lower Hudson Valley 3/1/17 Capital District 3/2/17 North Country 3/6/17 Central New York (South and East) 3/7/17 Central New York (North and West) 3/8/17 Western New York

OUREx Important Dates December 8, 2017 Hospital Planning Webinar Subject Time Location December 8, 2017 Hospital Planning Webinar 12:30PM – 2:00PM Webinar January 4, 2017 LHD NPI Planning Webinar 12:00PM – 1:00PM February 13, 2017 C/E Briefing LHD – PODs 10:00AM – 11:30AM LHD - NPIs 1:00PM – 2:30PM February 15, 2017 Hospitals 10:30AM – 12:00PM 1:00PM – 2:00PM March 8, 2017 Western Region Exercise Day HOC Open: 9:00AM – 1:00PM At Facility or POD site

Health-Related Exercise Locations Western Region Local Health Departments Local Health Department site for NPIs POD sites for LHDs conducting PODs Western Region Hospitals NYSDOH Health Operation Center (HOC) Buffalo, NY Central SIMCELL in Menands, NY

OUREx Inclement Weather Plan If a HEPC Exercise is affected by an event that would interrupt exercise participation, a discussion will be held with OHEP Central Office, Regional Office and HEPC representatives to determine potential courses of action (rescheduling/cancelling) for exercise conduct.

OUREx Capabilities to be Tested Medical Surge Emergency Operations Coordination Healthcare System Preparedness and Recovery (COOP functions) Information Sharing Medical Countermeasure Distribution and Dispensing Non-Pharmaceutical Interventions (NPIs)

OUREx Objectives Posted to HCS Hospitals Hospital Objectives – released 06/24/16 Hospital ExPlan released Local Health Departments POD Objectives – released 10/20/16 NPI Objectives – released 10/20/16

OUREx EMS Objectives Objectives Capabilities Information Sharing AND Validate the County EMS Coordinator and County EMS Points of Contact phone and email distribution lists, and update as needed. Test the communication plan component of the Statewide EMS Mobilization Plan with at least seven counties (one in each DOH regional/subregion) in assessing their local EMS agency capabilities and resources that could be deployed to another region in response to an infectious disease outbreak. Report EMS agency capabilities and resources back to BEMSATS. Provide situational updates to the Regional Healthcare Coalition upon request. Information Sharing AND Medical Surge   Posted to HCS

OUREx EM Objectives Objectives Capabilities Process and order resources through the NY Responds system in coordination with NYSDHSES and local County Emergency Management Offices . Establish effective communication through systems such as Mutualink and NY Responds in coordination with NYSDHSES. Ensure that local County Emergency Management Offices vet requests with their respective NYS DHSES Regional Staff before submitting the requests. E Provide situational updates to the Regional Healthcare Coalition upon request. MS Coordinator and County EMS Point of Operational Coordination AND Operational Communication Logistics and Supply Chain Management   .

OUREx Hospital Objectives Capabilities Demonstrate the ability of the hospital to notify staff and operate its Hospital Command Center (HCC). Include activation of Hospital Incident Command System (HICS). Demonstrate the ability of the hospital to implement information-sharing processes on a regular basis with other mutual aid partners, the Regional DOH Office, and with appropriate government agencies, utilizing redundant interoperable communications to: maintain situational awareness Demonstrate the ability of the hospital to communicate consistent elements of information (EEIs) to the Regional DOH Office, other mutual aid partners and the local public health/medical lead (PERFORMANCE MEASURE).   Emergency Operations Coordination AND Information Sharing

OUREx Hospital Objectives Capability Demonstrate the ability of the hospital to inventory patient census, acuity, and staffed bed availability in real time, and again after rapid patient discharge in order to decompress the facility (offload patients) GOAL: 2 hours Demonstrate the hospital’s coordination of hospital surge operations (on-load patients) with EMS operations. Evaluate the ability of the hospital to move and track patients to their final disposition (ED to a staffed available bed; hospital to healthcare facility: If an evacuation scenario - must use eFINDS). Demonstrate inclusion of individuals (highly suggested = minimum of 3) from one or more of the following at-risk populations : - Frail Elderly - Behaviorally involved - Pediatrics - Pregnant women - Physically disabled - Non-English speaking - Hearing impaired/deaf - Access/functional needs populations - Blind   Medical Surge    Activities involving the at-risk populations can be developed at the discretion of the Exercise Design Team, depending on the scenario and scope of the exercise.

OUREx Hospital Objectives Capabilities Evaluate the hospital’s ability to reference and incorporate components of its appropriate plans (e.g., COOP, 96 hour Sustainability Plan, the Isolation and Quarantine Plan, the Alternate Care Site Plan, etc.) to prioritize and continue mission essential services after HCC activation. Determine if event has caused a complete or partial disruption of health care service delivery, and delineate how this disruption occurred with prioritized mission essential functions (suggested minimum of 3). Demonstrate appropriate activities that focus on rapid resumption of the prioritized mission essential functions (suggested minimum of 3). Healthcare System Preparedness (Continuity of Operations)   AND Healthcare System Recovery

OUREx LHD Objectives - PODs Capabilities Identify medical countermeasure dispensing strategies. Activate dispensing strategies, dispensing sites, dispensing modalities, and other approaches as necessary to achieve the dispensing goals appropriate to the targeted population. Demonstrate the ability of the LHD to identify five (5) individuals considered to be at-risk who present during the POD: - Frail Elderly - Physically disabled - Pediatrics - Non-English speaking - Behaviorally involved - Hearing impaired/deaf - Pregnant women - Blind - Physically disabled Demonstrate one (1) mechanism (beyond POD flow design for ADA compliance) that supports and/or assists the at-risk individual. Provide situational updates to the Regional Healthcare Coalition upon request. Medical Countermeasure Distribution and Dispensing AND Information Sharing   20% of the population for the site being used, per hour of POD e.g.: if the population calculated for that site = 200 per hour, then the number for POD attendees would be: 200 X .20 = 40 X 2 hours = 80

OUREx LHD Objectives - NPIs Capabilities Identify and delineate two (2) strategies to initiate social distancing. In consultation with the county attorney, draft a written notice for voluntary isolation, as well as talking points for an oral explanation of the written notice. Develop one public message related to NPI strategy that is targeted toward (specific – TBD) at-risk individuals. Activate three (3) supportive services or wrap-around services that the county could implement to support voluntary/involuntary quarantine, including behavioral health needs. Provide situational updates to the Regional Healthcare Coalition upon request. Non-Pharmaceutical Interventions AND Information Sharing Integration of access and functional needs populations  

Exercise Evaluators All exercise sites will require onsite Evaluator(s) All sites will require a Controller Injects will flow from the Master SIMCELL to the Controllers to guide exercise play

Controllers and Evaluators Identify Controllers and Evaluators by January Will need to provide C/E names to Pat Anders Identify if your C/Es need HSEEP Training January HSEEP Webinar offering for those needing training. 2/5/15

Simulation Cell (SIMCELL) SIMCELL will represent individuals who would respond in a real event but are not participating in current exercise

Master SIMCELL Controller Healthcare Controllers SIMCELL Logistics Master SIMCELL Controller Pat Anders Healthcare Controllers LHD Controllers EM Controller EMS Controllers Area of Play

Planning Recommendations Brief your facility Administration and EP Committee now Identify your on-site Controller / Evaluator (C/E) Ensure C/E is aware of C/E Briefing dates Identify your required players and send save the dates Reserve rooms / facilities (PODs)

Planning Recommendations Send test email to NYSDOH Western Region Health Operation Center (WR HOC) email address: wrocomm@health.ny.gov Should receive confirmation response within 5 days Verify sending / receiving prior to exercise date Save email in your contacts

Hospital Tips Medical Surge to the ED will be a focus; can use simulated patients/ actors (must be simulated patients for at-risk groups); or functional. If will use simulated patient actors, consider contacting agencies now. Figure at least 20% of average ED volume. Patient profiles are available. Same objectives as WRECKIT; most activity will be conducted in the HCC Deliverable Element of Completion is the AAR/IP 2/5/15

Now Start recruiting Actors, if needed At least for at-risk group representation Identify Controller(s)/ Evaluators Identify C/Es who need (voucherable) HSEEP training Brief on the exercise internally 2/5/15

More Information Expecting more information on: What types of data will be provided; there will be injects from Menands. Injects and expectations for interactive play between agencies, ie, LHDs Considering an exercise between LHDs and hospitals of the SNS request process 2/5/15