1. Continuing Care Assessment and Planning Workshop
December 10, 2015 and January 27, 2016

2. Agenda Emergency Management Structure Types of Emergency Plans
Planning Process
Hazard Assessment
Develop and Utilize
Emergency Operations Planning
Document Development
Implementing the Plan

3. Introductions Name Agency Experience using or writing emergency plans
Interesting fact

4. Outcomes Current Needs Existing Questions Known Concerns
Desired Resources

5. Current Process
Plans
Assessment Process
Plan Development
Validation

6. Emergency Management Cycle

8. Emergency Management Overview

11. Where do ICS responders operate?
Staging Area
Base
Event Scene
Incident Command Post

12. Additional Support Event Scene EOC Staging Area Base
Incident Command Post

13. County EOC SEOC FEMA Neighboring County West Neighboring County East
Neighboring State West
Neighboring State East
SEOC
FEMA

14. ESF-8 Health and Medical
Hospital 1 H2 H3
General
Hospital
Hospital
System A
Hospital
System B
Community
Clinic
Public Health
ESF-1 Transportation
Specialty
Hospital
ESF-8 Health and Medical
EMS
ESF-3 Public Works
County EOC
Coroner
ESF-13 Law Enforcement
ESF-4 Firefighting
ESF-6 Mass Care

15. Plans

16. Types of Plans Emergency Response Plan (ERP)
Emergency Operations Plan (EOP)
Continuity of Operations Plan (COOP)
a.k.a. Business Continuity Plan (BCP)

17. Interoperability
Emergency Management and Emergency Response personnel interact and work well together.

18. Planning Process Hazard Assessment Plan Development
Education and Review
Revision
Education
Exercise

19. Hazard Assessment

20. Overview of HVA Definitions and terminology Common utilization HVA
THIRA
Gap Analysis
Common utilization
Healthcare requirements
Hazard mitigation plans
Development of emergency plans
Budget justification

21. Utilization of HVA Assess Plan Equip Train and exercise Request assets
Support response

22. HVA Components

23. Components
Event or Risk
Probability
Impact
Duration
Preparedness

24. Event/Risk Identify and prioritize hazards Review agency hazards
Historical and current data from multiple sources
Define scope and magnitude of risk
Differentiate risks that create different impacts
Examine factors that influence probability of events with no history

25. Impact Personnel and clients Facilities and resources
Building and supplies
Mission critical elements
Communications, expertise, utilities
Internal and external
Facility and community impact
Human, business, property, infrastructure

26. Duration Agreed upon scope of impact Warning
Event time vs response time

27. Preparedness Internal External Plans Training Equipment
Capability vs Capacity

28. Assessment Tool Probability, risk, and mitigation assigned a value
Chance of occurrence and magnitude of impact
Mitigation activity scores are reversed
Scores derived from assessment of:
Personal knowledge
Experience and historical data
Subject matter experts
Group consensus

29. Placeholder for HVA tool
SEVERITY = (MAGNITUDE - MITIGATION)
EVENT
PROBABILITY
HUMAN IMPACT
PROPERTY IMPACT
BUSINESS IMPACT
PREPARED-NESS
INTERNAL RESPONSE
EXTERNAL RESPONSE
RISK
Likelihood this will occur
Possibility of death or injury
Physical losses and damages
Interruption of services
Preplanning
Time, effectiveness, resources
Community/ Mutual Aid staff and supplies
Relative threat*
SCORE
0 = N/A = Low = Moderate = High
0 = N/A = Low = Moderate = High
0 = N/A = Low = Moderate = High
0 = N/A = Low = Moderate = High
0 = N/A = High = Moderate = Low or none
0 = N/A = High = Moderate = Low or none
0 = N/A = High = Moderate = Low or none %
Tornado 0%
Severe Snow Storm
Structure Fire
Wild Fire
Violence in the facility
Violence in the community
Hurricane
Pandemic Influenza
Snow Storm/Blizzard
AVERAGE
0.00
*Threat increases with percentage
Table adapted from Kaiser Permanente.
RISK = PROBABILITY * SEVERITY
Placeholder for HVA tool

30. Likelihood this will occur Possibility of death or injury
INCIDENT
PROBABILITY
INCIDENT EFFECT
PREPAREDNESS
RISK
HUMAN
PROPERTY
FACILITY
WARNING
DURATION
PLANNING
TRAINING
IMPACT
TIME
EQUIPMENT
Likelihood this will occur
Possibility of death or injury
Amount of property severely damaged
Complete interruption / shutdown of facility or services
Incident anticipation time
Time incident may continue
Emergency Management / Operations Plan
Staff trained and equipped
Relative Threat
4 = Highly Likely (probable within this year)
4 = Multiple deaths
4 = >50%
4 = >30 days
4 = <6 hours
4 = >1 week
4 = No EMP or EOP
4 = staff not trained on EOP
= Very High
3 = Likely (probable within 3 years)
3 = Injuries result in permanent disability
3 = 25-50%
3 = >2 weeks
3 = 6-12 hours
3 = <1 week
3 = EMP/EOP partially complete
3 = some staff trained, no equipment
= High
2 = Possible (probable within 5 years)
2 = Injuries do not result in permanent disability
2 = 10-25%
2 = >1 week
2 = hours
2 = <1 day
2 = EMP/EOP complete
2 = most staff trained, some equipment
= Moderate
1 - Unlikely (probable within 10 years)
1 = Injuries treatable with first aid
1 = <10%
1 = 24 hours or less
1 = 24+ hours
1 = <6 hours
1 = EMP/EOP exercised and/or evaluated
1 = Anticipated staff trained and properly equipped
= Low
Bomb Threat
0.00
Workplace Violence
Tornado
Severe Thunderstorm
Winter Storm (Ice, Snow, Low temperatures)
Flood
Fire
Power Outage
Info Systems Failure
HVAC Failure
Water Service Failure
Phone Service Failure
Medical Gas Failure
Medical Vacuum Failure
Disease Outbreak
Mass Casualty Incident
Hazmat Exposure
Supply Shortage
VIP Situation
Infant Abduction
Average Score
#DIV/0!

31. SEVERITY = (MAGNITUDE - MITIGATION) REGIONAL PREPARED-NESS
SEVERITY = (MAGNITUDE - MITIGATION)
EVENT
PROBABILITY
HUMAN IMPACT
PROPERTY IMPACT
BUSINESS IMPACT
CRITICAL FACILITIES
AGENCY PREPARED-NESS
REGIONAL PREPARED-NESS
RISK
Likelihood this will occur
Possibility of death or injury
Physical losses and damages
Interruption of Business Activity
Disruption of critical services or businesses
Resources and Effectiveness
Community aid and support
Relative threat*
0-3" Snow 0%
3-12" Snow
>12" Snow
Ice Storm
Flash Flooding
Extended Rain Flooding
Tornado EF0-EF2
Tornado EF3-EF5

32. Utilization Improvement planning Mitigation strategies
Training and Exercise Plan (TEP)
Event analysis

33. Corrective Action Description
Improvement Plan
Capability/
Critical Area
Recommendation
Corrective Action Description
Primary Responsible
Completion Date
Retest Date
Resource Mobilization
There is a need to ensure that all new hires are trained in emergency preparedness plans
All new hires complete all training within 30 days of hire
HR Manager
9/15
12/15
Plan for shelter-in-place needs to be reviewed.
Identify hazards that would not permit shelter-in-place
Safety Officer;
Emergency Management Director
Teachers need to be made aware that their lounge may not be available for several hours.
Place signage in Teacher’s Lounge to indicate the potential for its use as a SAFE ZONE for the facility
Safety Officer
Telephone lines in Teacher’s Lounge are limited to two lines.
Staff to bring personal cell phones with them to SAFETY ZONE and agree to allow them to be used for facility business purposes

34. Practical hva development

35. Tactics Worksheet Divide and conquer Small portions
Root cause or justification
Gather information
Scenario based discussion
Questionnaire

36. Tactics Committee Legitimize through use After events Competition
New faces
Recognition
Legitimize through use
After events

37. Emergency Planning

38. Big Picture Objective Leadership support Champion Concept Time
Resources to implement
Champion
Lead and coordinate

39. Big Picture Wheels are wheels – sort of Small portions
Regular meetings
Test periodically

40. Plan Contents Introduction and Authorities
Basic information about the facility
Key contacts and emergency management structure
Plan introduction
Legal and business authority for the plan
Lines of authority

41. Plan Contents Hazard Analysis/Identification
Specific hazard descriptions
Site information such as staffing, beds, and patient type
Geographic hazards (flood plain, railroad, fixed facility hazmat)

42. Plan Contents Concept of Operations Incident Management (ICS and CC)
Notification and activation
Recording information
Communications Plan
Security and safety
Medical records management
Specific action (i.e. shelter-in-place, surge, evacuation, fatality management)
Patient management

43. Plan Contents
Recovery
Insurance
Repopulating facility
Licensing

44. Plan Contents Appendix Annexes Contacts Maps
Support agreements (supply, alternate site)
Utilities
Annexes
Hazard Specific

45. Validation
Educate
Test
Revise

46. Resources

47. Scenario based discussion
Apply the concepts
Scenario based discussion

48. Scenario

49. Scenario Analysis
It is Tuesday morning, the facility has a full schedule all week, all resident rooms are full, and some staff are out for vacation.
A storm producing severe lightning, strong winds, and what appears to have been a microburst impacted the community and your facility.

50. Scenario Analysis Power to the facility is out.
There is building damage including a leak in the roof and some electrical systems not working due to what appears to have been a lightning strike to the building.
The children of two employees have called to report that their houses were damaged.

51. Scenario Analysis
The local news is reporting intermittent power outages across the area. Some traffic signals are not functioning, many roads have debris in them, and there is localized flooding blocking roads.
Three family members of residents have called to inquire about their family member.

52. Application Utilization of Planning Mitigation Preparedness Response
Recovery

53. Discussion
Concerns
Actions
Communications
What
When
How
Where

54. Improvement Planning Training Exercise
Specific plans internal and external integration into plans
Training
Types of training
Participants
Exercise
Type of exercise
Objectives

55. Next Team and Champion Assessment Plan Development or Refinement
Validation

56. All Clear Emergency Management Group, LLC
Contact
All Clear Emergency Management Group, LLC
Will Moorhead