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

2. 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

3. 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

4. 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

5. 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

6. 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.

7. 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)

8. 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

9. OUREx EMS Objectives Objectives Capabilities Information Sharing AND
Validate the County EMS Coordinator and County EMS Points of Contact phone and 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

10. 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 .

11. 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

12. 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.

13. 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

14. 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

15. 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

16. 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

17. 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

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

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

20. 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)

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

22. 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

23. 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

24. 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