After Action Report / Improvement Plan Hurricane Access Tabletop Exercise
ADMINISTRATIVE HANDLING INSTRUCTIONS
1. The title of this document is The "Hurricane Access - A Special Needs Shelter Tabletop Exercise" After Action Report.
2. The information gathered in this AAR/IP is classified as For Official Use Only (FOUO) and should be handled as sensitive information not to be disclosed. This document should be safeguarded, handled, transmitted, and stored in accordance with appropriate security directives.
3. At a minimum, the attached materials will be disseminated only on a need-to-know basis and when unattended, will be stored in a locked container or area offering sufficient protection against theft, compromise, inadvertent access, and unauthorized disclosure.
4. Points of Contact:
Public Health:
Scott Fryberger
Florida Department of Health in Orange County
(Office) 407-858-1400 # 2307
(E-Mail)
Exercise Director:
Chris Floyd
Disaster Resistant Communities Group LLC
(Office) 850-241-3565
(E-Mail)
CONTENTS
ADMINISTRATIVE HANDLING INSTRUCTIONS 2
CONTENTS 3
EXECUTIVE SUMMARY 4
SECTION 1: EXERCISE OVERVIEW 5
Exercise Details 5
Participant Information 5
SECTION 2: EXERCISE DESIGN SUMMARY 6
Exercise Purpose and Design 6
Exercise Objectives, Capabilities and Activities 6
Scenario Summary 6
SECTION 3: ANALYSIS OF CAPABILITIES 7
SECTION 4: CONCLUSION 11
APPENDIX A: IMPROVEMENT PLAN 12
APPENDIX B: PARTICIPANT FEEDBACK (Strengths – Areas for Improvement) 14
APPENDIX C: ACRONYMS 16
EXECUTIVE SUMMARY
Hurricane Access - A Special Needs Shelter Tabletop Exercise was designed and facilitated to provide an opportunity for agencies and organizations responsible for sheltering individuals with special medical needs an opportunity to assess their current knowledge and enhance their existing capabilities to open, manage and demobilize a Special Needs Shelter.
The purpose of this report is to analyze exercise results, identify strengths to be maintained and built upon, identify potential areas for further improvement, and support development of corrective actions.
Incorporated in Section 3: Analysis of Capabilities of this After Action Report is a comprehensive listing of each Core Capability with its associated Major Strengths, Primary Areas for Improvement and Improvement Recommendations
SECTION 1: EXERCISE OVERVIEW
Exercise Details
Exercise Name: / Hurricane Access - A Special Needs Shelter Tabletop ExerciseType of Exercise: / Tabletop
Exercise Start Date: / March 8, 2016
Duration: / Three Hours
Location: / Orlando Florida
Sponsor: / Florida Department of Health in Orange County
Purpose: The purpose of this exercise was to provide an opportunity for agencies and organizations responsible for sheltering individuals with special medical needs an opportunity to assess their current knowledge and enhance their existing capabilities to open, manage and demobilize a Special Needs Shelter.
Scenario Type: Hurricane
Participant Information
Participant / LocationFlorida Department of Health - Children's Medical Services
Florida Department of Health - Region 5
Florida Department of Health in Orange County
Orange County
Orange County Environmental Protection Division
Orange County Health Services
Orange County Office of Emergency Management
Number of Participants / 14
SECTION 2: EXERCISE DESIGN SUMMARY
Exercise Purpose and Design
The purpose of this exercise was to provide an opportunity for agencies and organizations responsible for sheltering individuals with special medical needs an opportunity to assess their current knowledge and enhance their existing capabilities to open, manage and demobilize a Special Needs Shelter.
Exercise Objectives, Capabilities and Activities
Capabilities-based planning allows for the exercise planning team to develop exercise objectives and observe exercise outcomes through a framework of specific action items that were derived from the Core Capabilities List. The capabilities listed below form the foundation for the organization of all objectives and observations in this exercise. Additionally, each capability is linked to several corresponding activities and tasks to provide additional detail.
Based upon the identified exercise objectives below, the exercise planning team decided to demonstrate the following capabilities during this exercise:
Special Needs Shelter OperationsCapability / Core Capability
# 1
/ Emergency Operations Coordination (PHP Core Capability # 3)# 2
/ Information Sharing (PHP Core Capability # 6)#3
/ Mass Care (PHP Core Capability # 7)Scenario Summary
It is late August and local residents have been complacent in their hurricane preparedness activities because this year’s hurricane season has only produced several tropical storms and a few minor hurricanes, none of which have made landfall. Families are preparing their children for the start of a new school year while local business owners and government agencies are thinking that the hurricane season could be very inconsequential. However weather forecasters are predicting a major change in the atmosphere that could see a sharp increase in the severity of hurricanes within the next few weeks.
By early September area residents, business owners and government officials begin to follow the projected path of another tropical storm.
SECTION 3: ANALYSIS OF CAPABILITIES
Special Needs Shelter Operations
Performance / Core CapabilityAdequate /
Capability # 1: Emergency Operations Coordination (PHP Core Capability # 3)
Associated Critical TasksFunction # 1.1: Conduct preliminary assessment to determine need for public activation.
Adequate / Evaluator # 1
Observations / · The group discussed which agencies will be meeting to discuss shelter opening and then number of shelters to open based on the scale of the hurricane’s projected impact.
· Not all agencies involved with Special Needs Sheltering were represented in this exercise.
Recommendations / · All agencies and organizations with a responsibility for managing or supporting Special Needs Shelters need to meet annually to review plans and procedures prior to hurricane season.
· All agencies and organizations with a responsibility to manage or support Special Needs Shelters need to have at least one representative participating in future exercises.
Function # 1.2: Activate public health emergency operations.
Adequate / Evaluator # 1
Observations / · Exercise participants had a basic understanding and knowledge of ICS and NIMS. However there were participants that did not understand how the Special Needs Shelter would be managed.
· All DOH employees have pre-assigned Special Needs Shelter roles and responsibilities.
· All DOH employees have access, via the internet, to Job Action Sheets for their pre-assigned roles and responsibilities.
· All locations for the Special Needs Shelters have been pre-identified.
Recommendations / · Provide a refresher workshop, possibly via the internet, outlining how a Special Needs Shelter should be operated.
· Conduct joint multi-agency training for all personnel to be assigned to staff a Special Needs Shelter.
· It is recommended that the secondary and tertiary leadership staff positions be present at future exercises.
Performance / Core Capability
Adequate /
Capability # 2: Information Sharing (PHP Core Capability # 6)
Associated Critical TasksFunction # 2.1: Identify and develop rules and data elements for sharing.
Adequate / Evaluator # 1
Observations / · Stakeholders who should be included in information sharing were identified.
· DOH has an information line that is available to their employees that is updated regularly during an incident as well as the Everbridge Alert System that is tested at least quarterly.
Recommendations / · Conduct regular meetings, three or four times a year, with all of the agencies involved with Special Needs Sheltering.
· These meeting should include at a minimum Emergency Medical Services, the Department of Health, the School District (including the cafeteria managers), Transportation, Law Enforcement, Dialysis Centers, Hospitals, the oxygen supply company and any other medical suppliers.
Performance / Core Capability
Adequate /
Capability #3: Mass Care (PHP Core Capability # 7)
Associated Critical TasksFunction # 3.1: Determine Public Health role in mass care operations.
Adequate / Evaluator # 1
Observations / · Participants discussed DOH’s role in providing Nurses, ARNPs Doctors and HST's to monitor and assist Special Needs clients.
· DOH also maintains a large cache of equipment and supplies for the medical side of the shelter.
· Training is provided to all DOH Nursing staff members on an annual basis.
Recommendations / · All staff members (not only medical) who are required to work in a Special Needs Shelter should be trained in general Shelter Operations and in their specific shelter roles and responsibilities.
· This training should be reinforced on an annual basis and through exercises like this one.
Function # 3.2: Determine Mass Care needs of impacted population.
Adequate / Evaluator # 1
Observations / · Orange County Human Services provides mental health specialist to the shelters who monitor the clients (and staff) for any mental or behavioral health issues that may arise.
· DOH provides nursing staff who monitor medical needs.
Recommendations / · Additional staffing needs may arise if an incident extends over a prolonged amount of time.
· Some of the client's may run out of the medications they brought with them.
· Pre-planning to address this with pharmacies could help with this issue.
· Client's medical conditions may deteriorate with extended sheltering, which would require additional nursing staff to address needs.
· Behavior health needs will increase as well considering length of time and amount of damage sustained by the community.
· Pre-planning for alternative - transitional placement through meetings with long-term care facilities may help with this.
Function # 3.3: Coordinate public health, medical and mental health Mass Care Services.
Adequate / Evaluator # 1
Observations / · Additional medications and medical supplies may be obtained through ESF # 8 Health and Medical at the Orange County Emergency Operations Center.
Recommendations / · Develop a good plan for logistics within the shelter including equipment and supply tracking will be helpful to determine needs before they become critical.
· This will include having a person in charge of supplies and ordering.
· Establish a relationship with local vendors (pharmacy, medical equipment providers, etc.) to ensure that supplies can be requested and delivered to the shelter as needed.
Function # 3.4: Monitor Mass Care population health.
Adequate / Evaluator # 1
Observations / · Nursing and mental health staff will continuously monitor the health of the individuals, and will refer to a higher level of care if necessary.
· School janitorial staff will maintain cleanliness of the facility and restrooms. (It is the responsibility of all staff to keep their areas clean.)
Recommendations / · Even with good care, client's medical conditions tend to deteriorate during extended periods of sheltering.
· The environment is extremely stressful and hard on the frail clients that will be there i.e. sleeping on cots, noise, lack of bathing, long trips to the restroom and cafeteria, worry about their homes and their pets, all this compounds the stress they are under.
· It is extremely important for all staff that work at the shelter be trained to understand how to be cognizant of this and to be empathetic.
· Pre planning for discharge to a more appropriate atmosphere will go a long way to help.
SECTION 4: CONCLUSION
Exercises such as this one allow personnel to validate training and practice strategic and tactical prevention, protection, response and recovery capabilities in a risk-reduced environment. Exercises are the primary tool for assessing preparedness and identifying areas for improvement, while demonstrating community resolve to prepare for major incidents.
Exercises aim to help entities within the community gain objective assessments of their capabilities so that gaps, deficiencies, and vulnerabilities are addressed prior to a real incident.
Exercises are the most effective (and safer) means to:
· Assess and validate policies, plans, procedures, training, equipment, assumptions, and interagency agreements;
· Clarify roles and responsibilities;
· Improve interagency coordination and communications;
· Identify gaps in resources;
· Measure performance; and
· Identify opportunities for improvement.
This exercise succeeded in addressing all of the above as it provided examples of good to excellent participant knowledge, teamwork, communication and use of plans and procedures while pointing out areas in need of improvement and clarification.
Listed below is a summary of the level of performance the Core Capabilities and Tasks evaluated during the exercise. This summary outlines the areas in which exercise participants are strong as well as identifying areas that the departments should invest future planning, training and exercise funds on.
Special Needs Shelter OperationsCapability / Core Capability / Performance
# 1 / Emergency Operations Coordination (PHP Core Capability # 3) / Adequate
# 2 / Information Sharing (PHP Core Capability # 6) / Adequate
# 3 / Mass Care (PHP Core Capability # 7) / Adequate
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After Action Report / Improvement Plan Hurricane Access Tabletop Exercise
APPENDIX A: IMPROVEMENT PLAN
This Improvement Plan has been developed specifically for the Florida Department of Health in Orange County based on the results of Hurricane Access - A Special Needs Shelter Tabletop Exercise conducted on March 8, 2016. These recommendations draw on both the After Action Report and the After Action Conference.
Core Capability / Issue / Area for Improvement / Corrective Action / Capability Element / Primary Responsible Organization / Organization POC / Start Date / Completion DateEmergency Operations Coordination / There was a lack of participation in the exercise by all of the agencies and organizations assigned lead or support roles regarding the operation of Special Needs Shelters. / All agencies and organizations with a responsibility for managing or supporting Special Needs Shelters need to meet annually to review plans and procedures prior to hurricane season. / Planning / Emergency Management / 6/1/16 / On-Going
All agencies and organizations with a responsibility to manage or support Special Needs Shelters need to have at least one representative participating in future exercises. / Exercising / Emergency Management
DOH / 6/1/16 / On-Going
Mass Care / While most participants had a basic understanding of ICS and NIMS many did not know how the Special Needs Shelter itself will be managed. / Develop a set of simple Special Needs Shelter training videos based on each of the Job Action Sheets. / Training / DOH / 6/1/16 / 8/1/16
Utilize the videos found in the Shelter Operations Section of the Just In Time Disaster Training Library as a self-study training tool.
http://ow.ly/TbpvT / Training / DOH / 6/1/16 / On-Going
There is a lack of knowledge on behalf of the staff that will be assigned to work within Special Needs Shelters on how the shelters will be managed. / Design, conduct and evaluate a Special Needs Shelter Tabletop Exercise specify for the staff that would be assigned to work in the shelter. This exercise would focus on the operation of a Special Needs Shelter. / Exercising / Emergency Management
DOH / 6/1/16 / 11/1/16
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