Santa Barbara County Disaster Healthcare Partners Disaster Training 2019

October 1st 2019 Santa Barbara

Santa Barbara County Public Health Department & Emergency Medical Services Agency

Jan Koegler, MPH Program Manager

Stacey Rosenberger, MPH Emergency Planner

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“The last place I want to meet you for the first time is during a disaster.”

Who’s your partner?

Introductions

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Training Objectives • Learn about potential vulnerabilities of our facilities

and agencies to flooding and an extended power outage.

• Review how partners and county and city emergency agencies work together in a disaster

• Learn how to participate in the 2019 medical &health community based exercise

• Identify ways to improve your response during flooding and a power outage

• Draft your exercise plan objectives, scenario and schedule of events 4

Agenda Exercise Scenario, Activities, and Schedule

Full Scale Exercise Requirements

Impacts of Flooding & Power Outages

County and Public Health Department Disaster Roles

How to Report Your Status and Resource Needs

Exercise Participation & Documentation 5

Exercise Training Schedule

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Exercise Days: November 19th-21st

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November 19th • 9am -12pm • Home Health & Hospice

Agencies, and Serenity House

November 20th • 9am -12pm • Skilled Nursing Facility

Evacuation

November 21st • 9am -12pm • All other facilities- Hospitals,

Clinics, Surgery Centers, Dialysis , Assisted Living, ICF

Scenario • Early morning on November 19 a winter storm causes flooding with road

blockages in Santa Maria, Lompoc, and areas of southern Santa Barbara. • Freeway underpasses are flooded in some areas. • Rain continues through November 21st leaving roads and homes flooded

for 3 days. • Santa Ynez River is close to overflowing its banks in Lompoc, and street

flooding is reported around the Lompoc Skilled and Rehabilitation Facility and a large assisted living facility.

• Ambulance access to Lompoc Hospital is delayed due to street flooding. • Santa Maria River is overtopping banks. Due to flooding, CHP has closed

surface streets and Highway 101 bridge between North Broadway and Highway 166.

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Scenario Cont. Road Closures: • Highway 101 at the county line

between San Luis Obispo and Santa Maria

• Hwy 1 between Lompoc and 101 closed due to rock falls

• Hwy 154 closed below Painted Cave closed in both directions due to rock falls, flooded roads and extremely limited visibility

Power Outages: • Power outages reported due

to trees down on power lines

• Large sections of cities are experiencing outages

• SCE and PGE representatives are telling the public that power cannot be restored for at least 24 hours

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Exercise Webpage

10 http://www.countyofsb.org/phd/statewideexercise/2019.sbc

2019 Disaster Exercise Participation Survey • Please complete the survey by October 31st • Let’s the PHD know what each facility/agency is planning on doing • Survey link:

https://www.surveymonkey.com/r/2019DisasterExercise

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CMS Emergency Preparedness Rule

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Emergency Plan • Based on a risk

assessment • Use an all-hazard

approach to risk assessment

• Update plan annually

Policies & Procedures • Develop based on risk

assessment & emergency plan

• Must address: subsistence of staff/patients, evacuation, shelter in place and tracking of patients

• Review/update annually

Communications Plan

• Complies with federal & state laws

• Coordinate patients are within facility, across providers, and with state, local public health and emergency management

• Annual update

Training & Exercise Program

• Initial & annual training on policies & procedures

• Conduct drills and exercises

• Tabletop annually • Annual Full scale

community based exercise

1. Conduct one FULL SCALE EXERCISE annually • Must participate in a community based exercise if offered • The PHD annual medical and health exercise in November is a

community based exercise • SNF/ICF’s have option to do PHD/ EMS Agency annual

evacuation exercise as full scale

2. Conduct one additional exercise • Can be a tabletop exercise

CMS Annual Exercise Requirements

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Disaster Exercise Process

Read/Train Procedure: “read thru”

Discuss Procedure: Tabletop

“talk thru”

Do Procedure: Full Scale

“walk thru”

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Need more information on exercise development?

• http://www.countyofsb.org/phd/statewideexercise/2019-trainings.sbc

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2019 Flooding & Power Outage Exercise

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Threats Flooding

• Winter storms/ prolonged heavy rains

• Dam break • Tsunami

Electrical Outage • Fire burning under

transmission lines • Fire – shut off for safety

of responders • Earthquake • Public Safety Power Shut

Down “PSPS” 17

How do you know if your facility or agency is at risk of flooding? • Past flooding experiences • Check flood maps:

• http://myhazards.caloes.ca.gov/ - Select Flooding tab and put in address • https://msc.fema.gov/portal/search#searchresultsanchor

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Carpinteria

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Santa Barbara

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Santa Barbara

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Goleta

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Buelton & Solvang

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Santa Ynez

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Flooding can cause….. • Staffing issues • Blocked roads due to

standing water or trees/debris in the road

• Damage to your building and/or campus

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Ways to Exercise Flooding • Plan for housing staff on

site • Evacuation • Alternate site to conduct

operations • Continuity of Business

• Identify staff that could be impacted by road closures

• If access to your building is blocked, identify areas for ambulances and staff to park

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Extended Power Outage

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PGE Grid

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SCE Grid

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Key Health Challenges in Power Outage • Home medical equipment- including oxygen

concentrators • Dialysis • Air conditioning

• Health conditions exacerbated by heat • Food spoilage • Pharmaceuticals & Vaccines • Blood bank • Gasoline for home health and other workers 30

Public Safety Power Shutoff (PSPS)

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Impacted Areas • PG & E in North

County • SCE in South County

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Notification from power companies

When possible electrical companies will provide up to 48 hours of advance notice

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1. Update contact information with local power company

• PG&E: www.pge.com/mywildfirealerts • SCE: www.sce.com/safety/wildfire/psps

2. Register for county alerts- www.readysbc.org 3. Sign-up as a medical baseline customer 4. Plan for where they will go, and who will assist

them, in an extended outage

Encourage clients/patients to….

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SCE Medical Baseline Program

https://www.sce.com/residential/assistance/medical-baseline

QUALIFYING MEDICAL DEVICES • Aerosol Tent • Air Mattress/Hospital Bed • Apnea Monitor • Breather Machine (IPPB) • Compressor / Concentrator • Dialysis Machine • Electronic Nerve Stimulator • Electrostatic Nebulizer • Hemodialysis Machine • Infusion Pump • Inhalation Pulmonary Pressure • Iron Lung • Left Ventricular Assist Device (LVAD) • Motorized Wheelchair/Scooter • Oxygen Generator • Pressure Pad • Pressure Pump • Pulse Oximeter/Monitor • Respirator (all types) • Suction Machine • The Vest/Airway Clearance System • Total Artificial Heart (TAH-t) • Ultrasonic Nebulizer

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How can we assist electricity dependent individuals? • Identify those individuals and facilities most at risk • Make sure individuals have a plan

• Extra oxygen tank • Someone to check on them and transport if necessary • Plan for a destination with power

• During large outages shelters for electrical dependent individuals • Note: If power outage is widespread few shelter sites have generators

• Be aware that dispatch may be overwhelmed with calls • Activate EOC call centers, contact clients and facilities to determine

status 37

http://www.countyofsb.org/phd/epp/poweroutages/

Outreach Campaign to Prepare Individuals Dependent on Electricity • Request that agencies distribute this resource and encourage or assist individuals to fill it out

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• https://prepareforpowerdown.com/

• http://prepareforpowerdown.com/wp-content/uploads/2019/06/Emergency-Power-Planning-Factsheet_revised-5.2018.pdf

• www.readysbc.org

• https://www.pge.com/en_US/safety/emergency-preparedness/natural-disaster/wildfires/public-safety-power-shutoff-faq.page

• https://www.sce.com/safety/wildfire/psps

• https://www.cpuc.ca.gov/deenergization/

Additional Resources

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Does my facility have priority for restoration? • Electricity providers are aware of buildings that are

essential service providers • This may expedite restoration, but it may not • Depends on the area damaged and where you are located • The health department will advocate for early restoration

of essential service providers • In a PSPS all facilities are at risk!

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Will Phone and Internet Work in Power Outage? • As long as the fiber optic cables and other infrastructure is good,

then internet should function. • However WIFI modems and routers will not have power • Determine if your facility or agency phones work in a power outage

• VOIP phones will not work without power

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What are the threats to cell service from Power Outages? • Individuals cannot call 911 from cell phone if battery dies • Cell and internet availability is based on the battery

backup or generator capability of each cell tower and internet data center feeding our area • Most towers have battery backup that should last a few hours • Others (longer range primary towers) have generators and can

run indefinitely as long as they can be refueled

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Tips to Keep your Phone Running During a Power Outage During a power outage: • Turn off phone’s location services, Wi-Fi, NFC, Bluetooth and any background apps to

preserve battery power • Dim the screen to the lowest point that you can comfortably read it • Avoid using the phone unless necessary • If your phone supports “low power mode,” enable that feature as soon as the power goes

out: • iPhone — go to Settings, scroll down to Battery and select Lower Power Mode. That will reduce

power consumption by disabling Siri, background apps, mail fetching and other power hungry activities

• Samsung Galaxy phones –Go to Settings and then Device and then Battery and select “ultra power saving mode”

• Other phones — Use a search engine to search for “power saving mode” + the name of your phone to see if it is available

• If you have access to a car, charge phone in car’s power plug • If the power comes back on, plug your phone back in. Power may not stay on.

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Power Restoration and Surges Avoid damage to electronics due to voltage surges during power restoration When power goes out: • Unplug appliances with electronic components • Computers, refrigerators, microwaves, TV’s • Plug back in, waiting a few minutes, after power is

restored • Good surge protector (Hi joules, low VPR) is an

alternative 44

How will staff get gasoline?

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• Limited gas stations with generators in Santa Barbara County

• Encourage staff to keep tanks at least half full if possible

County Emergency Operations Center In widespread and prolonged events: • Prioritize gasoline distribution for essential

services • Bring in gasoline trucks for essential workers

and essential generators

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Ways to Exercise Power Outage Procedures and Training

• Do you have a power outage procedure?

• Patient paper record procedure • Vaccine storage procedure • Are your staff trained in the

power outage procedure? • Do you have exam room

lanterns/batteries? • Generator/Fuel? • What is powered by generator?

Exercise Activities • Follow your procedure • Put building on generator • Print out records on battery

power • Activate downtime procedures • Access/use paper charts • Use vaccine and medication

maintenance procedure • Access patient schedules • Provide meals without power

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Communication during Disasters • What communications systems might work?

• Landlines/Fax line • Satellite Phones • Radios and walkie talkies • Texting/cell phones

• What might not work? • Cell phones (initially overloaded-no battery) • Email/Internet: tied to electricity /routers and cables • Facility phones if VOIP or the system requires power

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If Communication are Systems Out: • Do you have a disaster communication

plan/procedure? • Are your staff trained? • How will your facility/agency report that you need assistance? • How will the City/County/PHD determine your status?

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Disaster Communication Plan Template

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Disaster Communication Methods

• PHD 800 MHz radios: Hospitals, PHD Health Care Centers, Sansum, Direct Relief

• Facilities send a runner to report status to a City EOC to be relayed to County EOC, for urgent needs or closures

• Facilities could report immediate needs to a fire station or hospital

• Satellite phone at hospital and DOC/EOC • ARES will deploy to hospital (Amateur Radio Emergency Services)

• Other? What is your plan to communicate with staff? 51

• CAHAN is the official public health altering and notification program for California

• PHD uses CAHAN to alert partners in a disaster or emergency • All facilities should have at least 2 staff enrolled in CAHAN • Contact Stacey Rosenberger- phdpreparedness@sbcphd.org if

you need to sign-up for CAHAN

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Communication Insert for Your Plan

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Ways to Test Communication Do you have a plan for…

• With and without communication failure

• Communication to: • Staff • Clients • PHD/Emergency Agencies

• Equipment: generator, extra phone chargers, phone power pack

• Radio: solar or crank

Exercise your plan • Communicate to staff/clients

without internet or phones • Post information on large

sheets of paper for staff • Locate and use landline for

fax, test radio solar/crank • Use runners within your

building to bring messages • Use walkie talkies or radios to

request items, give assignments, status

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Need Full Scale Exercise Ideas?

• http://www.countyofsb.org/phd/statewideexercise/2019-trainings.sbc

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Break • Flood maps • Get up and look at flood maps • Is your facility in flood area? • Are roads to your facility in flood area?

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County Disaster Response & Public Health Role During A Disaster

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EOC and PHD DOC Activations Agency Date Incident Name Location

PHEP/EMSA November 2018

Woolsey Fire Ventura

PHD DOC May-June 2019

Measles Santa Barbara/Ventura

EOC/PHD February 2019 Storms 1-3 Santa Barbara EOC/PHD September

2019 Conception Boat Incident – Mass Casualty

Santa Barbara

PHEP/EMSA September 2019

PSPS Santa Barbara

PHEP/EMSA September 2019

McMurray Fire Santa Ynez

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Organizational Levels of Disaster Response & Assistance

59 Field

Operational Area

Local Government

OES Region

State County Emergency Operations Center

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COUNTY EMERGENCY OPERATIONS CENTER

Public Works DepartmentOperations

Center

Public Health DepartmentOperation

Center

City of Santa Maria

City of Guadalupe

City of Buellton City of Solvang

City of Goleta City of Carpinteria

City of Santa Barbara

City of Lompoc

Sheriff’s Department Operation

Center

County Fire Department Operation

Center

Role of County and Cities in Supporting Essential Services

If you need resources to maintain services in a disaster who will you ask for help?

• Vendors • Partners • Public Health Department • Cities

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County EOC

City EOC Public Health Department /EMS

Healthcare or Long Term Care Facility or

Agency

Licensing CDPH & CCLD

Water/Utility Service Generator Shelter PortaPotties 911 Calls

Medical Evacuations Transportation

Generator Medical Shelter

Medical Services/Supplies

Public Health Department & EMS Agency Healthcare arm of emergency management • Responsibilities:

• Report the status of healthcare, residential care, mental health, environmental health to CDPH

• Order medical/public health mutual aid • Assure and facilitate ongoing delivery of care

• Activate field EMS and outpatient operations • Coordinate care among Disaster Healthcare Coalition Partners

• Evacuate and shelter medically fragile • Assist with medical and general population sheltering

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Required Function as identified in CA Health and

Safety Code §1797.153 Lead Entity Associated Disaster Plans, Policies, & Procedures

1. Assessment of immediate medical needs. PHD/EMS

2. Coordination of disaster medical and health resources.

PHD

3. Coordination of patient distribution and medical evaluation.

PHD/EMS

4. Coordination with inpatient and emergency care providers.

PHD/EMS

5. Coordination of out-of-hospital medical care providers.

PHD/EMS

6. Coordination and integration with fire agency personnel, resources, and emergency fire pre-hospital medical services.

PHD/EMS

7. Coordination of providers of non-fire based pre-hospital emergency medical services.

PHD/EMS

8. Coordination of the establishment of temporary field treatment sites.

PHD

9. Health surveillance and epidemiological analyses of community health status.

PHD

10. Assurance of food safety. PHD

11. Management of exposure to hazardous agents. EHS 49 CFR 1910.12

12. Provision or coordination of mental health services.

ADMHS

13. Provision of medical and health public information protective action recommendations.

PHD

14. Provision or coordination of vector control services.

EHS

15. Assurance of drinking water safety. EHS

16. Assurance of the safe management of liquid, solid, and hazardous wastes.

EHS

17. Investigation and control of communicable disease.

PHD

MHOAC 17

functions

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PUBLIC HEALTH DEPARTMENT

MHOAC in Action

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SNF FACILITY LOSES

GENERATOR PSPS

Heat Wave Evacuation

Needed

CALL TO EMS DUTY

OFFICER “MHOAC”

Launches Reddinet to

Request Beds and

Transport

Requests ambulances and W/C vans from

Region 1

Opens PHD Department Operations Center to

Coordinate Send situation status report to Region,

CDPH, and State EMSA

67 Healthcare, long term care,

animal services, environmental health, EMS,

status

MHOAC

Status Report and Requests from

Medical and Health during disaster

Reporting Status and Requesting Resources Medical and Health Operational Area

Coordinator “MHOAC”

Public Health Department Operations Center (DOC)

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Operations Section is a hub for

communication with partners for status and

resource requests

Disaster Status Report Santa Barbara to CDPH

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Feed 1 Situation Report Q/ 12-24h

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How to Contact the PHD/EMS Agency

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How will PHD contact you?

73 pg.14 of the Coalition Governance, Preparedness & Response Plan

• CAHAN is the official public health altering and notification program for California

• PHD uses CAHAN to alert partners in a disaster or emergency • All facilities should have at least 2 staff enrolled in CAHAN • Contact Stacey Rosenberger- phdpreparedness@sbcphd.org if

you need to sign-up for CAHAN

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Disaster Healthcare Partners Role During A Disaster

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Disaster Healthcare Partners Coalition Plan

• Governance Document • Preparedness • Response

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http://www.countyofsb.org/phd/epp/coalition.sbc

Role: Defined in the Disaster Healthcare Partners Agreement

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Sign the Agreement

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In a Disaster: How do we know the Status of Your Facility or Agency? You provide your facility/agency status: Open or Closed? Can accept patients? Can support field

operations? Damaged building? Needs to evacuate? 79

How to Communicate Status • Partners provide status to the PHD Via:

• Hospitals and SNF : “Reddinet” • Partners: Email or fax status report forms • Verbal status is OK initially • Call, fax, sat phone, runner, radio, or ARES if

communication damaged

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ReddiNet During the Exercise

• Used by Hospitals & SNFs to report bed availability & status 81

SNF/ICF & Assisted Living Status Report

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Clinic Status Report

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Cumulative Status Report Facility Status

Report 1

Facility Status

Report 2

Facility Status

Report 3

Cumulative Status Report

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Organization Command center reviews and populates cumulative Status Report providing a full picture of organization capacity and capability to the PHD DOC

PHD DOC

Organization Command Center

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Dialysis Center Status Report

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Ambulatory Surgery Center Status Report

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Home Health & Hospice Agency Status Report

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Provide list of all patients who your agency is unable to contact, refuses evacuation or is sheltering in place.

Hospital Status Report

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What does PHD do with all the forms you submit?

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Requesting Resources from the PHD • What forms will you

use if you want to make a resource request? • General • Personnel • Medical

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What to include on Resource Requests • Provide specific details,

size, type • Delivery site location

and contact information

• Signed • You may be responsible

for paying for the item(s) procured

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Status Report Activity Based on the scenario and what your facility plans to do for the exercise:

1. Complete a status form for your facility/agency type 2. Identify one potential resource need & what form

you will need to submit to the PHD DOC

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Scenario • Early morning on November 19 a winter storm causes flooding with road

blockages in Santa Maria, Lompoc, and areas of southern Santa Barbara. • Freeway underpasses are flooded in some areas. • Rain continues through November 21st leaving roads and homes flooded

for 3 days. • Santa Ynez River is close to overflowing its banks in Lompoc, and street

flooding is reported around the Lompoc Skilled and Rehabilitation Facility and a large assisted living facility.

• Ambulance access to Lompoc Hospital is delayed due to street flooding. • Santa Maria River is overtopping banks. Due to flooding, CHP has closed

surface streets and Highway 101 bridge between North Broadway and Highway 166. 94

Scenario Cont. Road Closures: • Highway 101 at the county

line between San Luis Obispo and Santa Maria

• Hwy 1 between Lompoc and 101 closed due to rock falls

• Hwy 154 closed below Painted Cave closed in both directions due to rock falls, flooded roads and extremely limited visibility

Power Outages: • Power outages reported

due to trees down on power lines

• Large sections of cities are experiencing outages

• SCE and PGE representatives are telling the public that power cannot be restored for at least 24 hours

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BREAK! • Review CAHAN list!

• Make sure your facility/agency has at least two staff in CAHAN

• Update staff CAHAN information- highlight staff that need to be deleted

• Fill out CAHAN sign-up form if you need to be added to they system

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Exercise Participation & Documentation

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Preparing for the Exercise • Review your emergency operations plan

• Decide what procedures or policies you want to test • Develop your Exercise Plan

• Determine objectives and activities that go with those objectives

• Develop your scenario • Plan full scale activities to test your procedure using the

Schedule of Events & Evaluation Guide

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Exercise Day: November 19th-21st • Activate your emergency operations plan and command structure • Exercise facility/agency power outage procedures and any other

procedures or policies you have identified • Communicate with PHD: CAHAN, Submit a Status Report and/or

Resource Request. • Evaluate participation using schedule of events and evaluation

guide • Debrief with your staff • Write after action report

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Exercise Schedule Date/Time Activity

Tuesday, November 19th - 9:00am-12pm

Home Health Agencies • CAHAN goes out to Home Health, Hospice Agencies

and Serenity House • Gives scenario, starts exercise day • Conference Call

Wednesday, November 20th – 9:00am-12pm

Skilled Nursing Facilities & CCRCs • CAHAN • Evacuating SNF report • Conference Call

Thursday, November 21st - 8:00 am

CAHAN sent out to all healthcare partners Gives scenario, starts exercise day Facilities activate plans and start your exercise

9:00am-11:00am Submit Status Reports & Resource Requests to PHD

11:00 am Conference call between healthcare partners & PHD

12:00 pm End of Exercise 100

Partner Instructions

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• Found on the exercise webpage

• Instructions provided for each each exercise day

What documents & forms do you need? On PHD Exercise Webpage

• Exercise Plan & After Action Report

• Schedule of Events & Evaluation

• Status Report • Resource Request

Your own

• Sign- in sheet • HICS/NHICS/ICS Forms

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Exercise Plan & After Action Report

Exercise Plan

After Action Report

Exercise Plan &

AAR

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Exercise Plan & After Action Report

104 http://www.countyofsb.org/phd/statewideexercise/2019-forms.sbc

Objectives & Tasks

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Developing Objectives – Describe what you trying to test SMART Objectives • Specific • Measurable • Achievable by staff • Realistic • Timebound

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Not So SMART • Test the ability to

communicate with staff during an emergency

SMART • Staff will

demonstrate activation of the disaster communication procedure within 20 minutes of drill alert. 107

Sample Objectives & Tasks Objective Task/Activity to Meet Objective

Set-up, staff, and activate HICS for the Hospital Command Center within 20 minutes of code disaster call.

Overhead page activated to call staff to HCC. 6 major HICS roles assigned. Staff access vests and job checklists. Logistics section set up command center.

Activate and demonstrate use of the power outage communication procedure (within 30 minutes of activation).

Staff locate procedure. Staff and client communication provided according to procedure. Unplug fax line, plug in analog phone, use phone to report status to PHD DOC.

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Objectives, Tasks, and Evaluation Sheet

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Objective Task/Activity to Meet Objective Met Partially

Met Not Met

1. Staff will demonstrate activation of the disaster communication procedure within 20 minutes of drill alert.

Staff locate disaster communication procedure

Staff activate overhead paging system to announce activation of disaster communication within 20 minutes

Staff locate and activate walkie talkies and use them to communicate.

Staff locate analogue phone line and plug in landline phone.

Staff perform activities on procedure checklist

2. Facility will be able to use generator power to maintain health of residents within 20 minutes of power outage.

Generator comes on when power goes out. Staff locate red plugs for essential client/resident needs and assure items are appropriately plugged in.

Objectives and Activity Samples List

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Threat Objective Facility Type Activity

Power Outage

Demonstrate ability to activate disaster plan including staff communication, set-up, and staff agency/facility command center within 30 minutes of exercise/event notification. All

Perform call in process for staff to the command center. Staff take all actions to set-up command center . Access of disaster plan and procedures in hard copy. Staff put on vests and locate job checklists.

Power Outage

Activate and demonstrate use of the power outage communication procedure (within 30 minutes of activation). All

Staff locate power outage communcation procedure.Provide staff and client communication according to procedure.Unplug fax line, plug in analog phone, use phone to report status to PHD DOC.

Power Outage

Staff demonstrate ability to activate the facility/agency computer/power downtime procedures (within XX minutes of outage.). All

Begin computer downtime procedures within 5 minutes of power outage. Staff take necessary actions to print out patient schedules, records, charts. Staff locate and demonstrate ability to use paper charts.

Activity: Developing Objectives & Tasks • 10 minutes:

• Develop your facility/agency specific objectives and tasks to test that objective

• Share ideas with group

111

Scenario • Early morning on November 19 a winter storm causes flooding with road

blockages in Santa Maria, Lompoc, and areas of southern Santa Barbara. • Freeway underpasses are flooded in some areas. • Rain continues through November 21st leaving roads and homes flooded

for 3 days. • Santa Ynez River is close to overflowing its banks in Lompoc, and street

flooding is reported around the Lompoc Skilled and Rehabilitation Facility and a large assisted living facility.

• Ambulance access to Lompoc Hospital is delayed due to street flooding. • Santa Maria River is overtopping banks. Due to flooding, CHP has closed

surface streets and Highway 101 bridge between North Broadway and Highway 166.

112

Scenario Cont. Road Closures: • Highway 101 at the county line

between San Luis Obispo and Santa Maria

• Hwy 1 between Lompoc and 101 closed due to rock falls

• Hwy 154 closed below Painted Cave closed in both directions due to rock falls, flooded roads and extremely limited visibility

Power Outages: • Power outages reported due

to trees down on power lines

• Large sections of cities are experiencing outages

• SCE and PGE representatives are telling the public that power cannot be restored for at least 24 hours

113

Developing Facility/Agency Specific Scenario Include:

• Impacts to Facility/Agency • Building damage, communication loss, utility loss, damage around

the facility, access to the building etc.

• Impacts to Staff • # of staff unable to come into work due to road closure or family, any

staff injuries, staff stuck at facility due to road closures etc.

• Impacts to Patients/Residents • # of injured patients/ residents

114

Activity: Scenario Mad Libs • Add screen shot of

scenario madlibs 10 minutes:

• Complete Facility/Agency specific Scenario

• Share with group

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Schedule of Events & Evaluation

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• PHD will provide Exercise Schedule of Events & Evaluation Guide for each exercise day • PHD activities that partners need to response to are in bold • Items in blue shaded rows are examples and can be changed/update by partners

Activity: Filling in Schedule of Events • 10 minutes:

• Write in the objectives and tasks you developed earlier • Write in any messages or events that activate exercise play:

• Overhead page alerting staff to the exercise • Incident Commander being given note with information about a downed tree

blocking facility • Facilities reports over walkie talkie that there is standing water in one section

of the building

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What forms need to be to submitted to PHD?

November 19th-21st All Healthcare Partners: Status Report

Emailed, Faxed or ReddiNet (SNF/Hospitals)

Resource Request (Optional) Home Health: List of patients in impacted

area Evacuating Skilled Nursing Facility List of residents- where they

went and how they were transported

After the Exercise After Action Report &

Improvement Plan Photos (optional) Submit to

phdpreparedness@sbcphd.org by January 31st

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2019 Exercise Participation Record

Participation Letter

Submitted Status Report

Respond to ReddiNet

Respond to CAHAN Alerts

Submitted After Action Report

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Participation Letter

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Document, Document, Document!

• Exercise Plan & After Action Report

• Photos of exercise • Sign-in sheets • Letter of Participation from

Public Health Department

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1. Collect all documents used during the exercise

2. Conduct after an action meeting

3. Write an After Action Report and Improvement Plan

4. Submit AAR/IP to PHD

Exercise Training Schedule

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Wrap Up & Next Steps • Complete & turn in training evaluation form • Plan for your exercise with your planning team:

• Decide what procedures or policies you want to test • Determine objectives and activities that go with those objectives • Complete Exercise Plan for your facility

• Call in to pre-exercise conference calls as needed • Attend Final Exercise Planning Meeting if needed

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We appreciate your time and efforts to build response capacity for emergencies and disasters in your community!

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