2009 Statewide Medical and Health Functional Exercise

Meeting Exercise Requirements through H1N1 After Action and Improvement Planning

Instructions for Operational Area Exercise Leads

Over the past month, State and local government, health care facilities, and other response partners have responded to the Novel Influenza A(H1N1) outbreak. These response functions have included activating pandemic influenza operations in many of the areas identified in the objectives for the June 18, 2009 functional exercise. Therefore, the requirements for the functional exercise have been modified to allow a choice of activities on June 18. Each Operational Area and each response partner may conduct either of the following activities:

  • Conduct the functional exercise as planned, according to the directions provided in the Exercise Guidebook issued on April 10, 2009. All requirements of the Exercise Guidebook must be met, including identifying which partners will participate in the functional exercise and completing an After Action Report (AAR), and Improvement Plan (IP). OR
  • Conduct a Planning Conference that focuses on development of operational planning actions for resurgence of the H1N1 or other novel virus. The primary focus of the Planning Conference will be on development of specific action plans with assignments and timelines for key items in the IP. The Planning Conference will be based on the AAR/IP developed by each response partner. Following the Planning Conference, each Operational Area will prepare a summary AAR/IP including specific action plans.

Operational Areas selecting this option must follow the requirements in this guidance.

State agencies will participate in a Planning Conference on this date.

Purpose:

This guidance is to provide direction for Operational Area Exercise Leads [previously identified for each Operational Area] to conduct a Planning Conference that focuses on operational planning for a resurgence of the H1N1 or other novel virus.

The objectives for this activity are to identify lessons learned, evaluate the local response to the Novel H1N1 Influenza A virus outbreak and prepare for the possible resurgence of a novel influenza virus to which the public has no immunity and for which there is no vaccine. The emphasis of this activity will be on operational planning.

Novel Influenza A(H1N1) Response Activities:

In response to the Novel Influenza A (H1N1) outbreak, CDPH, local health departments and emergency management agencies, healthcare facilities, and other response partnersconducted many response functions, including but not limited to the following:

  • Increased disease surveillance efforts
  • Conducted epidemiological case contact investigations
  • Tested a large number of laboratory specimensat public health laboratories
  • Issued guidance on infection control, distribution and use of antivirals, laboratory testing, school dismissal and community mitigation, and other subjects
  • Issued risk communications for healthcare providersand the public
  • Received and distributed State and federal stockpiles of antiviralsand other medical supplies and equipment
  • Provided alerting and notification of staff and response partners
  • Activated EmergencyOperationsCenters, DepartmentOperationsCenters, JointInformationCenters, and HospitalCommandCenters
  • Conducted Incident Action Planning

Participating in the Planning Conference:

Each Operational Area Partnership may elect to participate in the Planning Conference option if the local health department and key emergency response partners activated for the Novel Influenza A (H1N1) outbreak.

If this option is selected, it is essential that all requirements in this guidance be met as CDPH has been advised that continued funding of California’s federal Public Health Emergency Preparedness grants is dependent on meeting these requirements.

An Operational Area or individual response partners within an Operational Area may elect to conduct the 2009 Statewide Medical and Health Exercise on June 18 as originally planned. For example, a health care facility that did not respond to the H1N1 outbreak may need to conduct the functional exercise at the facility level in order to meet Joint Commission accreditation requirements. Within an Operational Area, there may be response partners that select both options. In this situation, it is the responsibility of the Operational Area Exercise Lead to ensure that all response partners are able to fully meet the requirements for whichever option they choose.

Planning Conference Requirements:

In order to meet CDC and HPP grant requirements, individual organizations and Operational Areas must meet the following requirements:

  • Completethe first three phases of the 2009 Statewide Medical and Health Training and Exercise program: satellite broadcast, gap analysis and tabletop exercise.
  • Each response partner must conduct an after action review(hotwash) and complete a draft AAR and IP based on their actual response to the Spring 2009 H1N1 novel virus outbreak.
  • The Operational Area must conduct a Planning Conference, complete a summary AAR and develop an operational IP with specific action steps, assignments, and timelines. These documents must be submitted to CDPH.

Prior to June 18th

Each response partner must complete the first three phases of the 2009 Statewide Medical and Health Training and Exercise: the satellite broadcast, gap analysis and tabletop exercise.

The following actions shall be taken in preparation for the June 18 Planning Conference:

  • Step 1: Prior to attending the Planning Conference, each response partner should identify the Target Capabilities and objectives that were tested during the H1N1 response. Target Capabilities and objectives are listed in the Exercise Guidebook; it is anticipated that Operational Areas selecting the Planning Conference Option will identify Target Capabilities and activities beyond the three selected for the functional exercise.
  • Step 2: Each response partner should send their list of Target Capabilities and objectives to the Operational Area Exercise Lead by June 5, 2009.
  • Step 3: Each response partner should complete an AAR/IP Summary Report for their organization, using the appropriate version of the form in Attachment C. The report should focus on identifying key issues which must be addressed and providing specific plans for addressing them. The issues raised should be identified for their strengths and gaps with best practices acknowledged and documented.
  • Step 4: Operational Area Exercise Leads should distribute the Intent to Participate form in the Exercise Guidebook to all organizations regardless of their level of response to the event. If Operational Area Exercise Leads received these forms from response partners during the exercise planning process, Operational Area Exercise Leads should confirm that each organization still plans to participate and identify which option they will follow.

June 18, 2009: Planning Conference

  • The Planning Conference should be conducted within the same timeframe as the original functional exercise: 08:00 AM to 2:00 PM. If the Operational Area Exercise Lead believes the Planning Conference cannot be held on June 18, 2009, they may submit a written justification via email to their CDPH Project Officer, requesting consideration of an alternate date. In order to meet grant and Joint Commission requirements, alternate dates must be close to June 18.
  • The Operational Area Exercise Lead should develop the agenda for the conference. The agenda shallinclude:
  • Review of the response actions taken by individual response partners as well as the Operational Area as a whole.
  • Planning for a resurgence of influenza, with the development of an operational IP with specific action steps, assignments and timelines.

A draft proposed agenda for this event is included in Attachment B.

After June 18:

Following the Planning Conference, each Operational AreaExercise Lead shall complete the attached Operational Area Conference Summary Report (Attachment A) and submit it to its CPDHProject Officer no later than July 5, 2009. This Summary Report was developed for Operational Areas to report the roll-up of information obtained during the Planning Conference.

Next Steps:

  • Analysis of the Summary Reports from all Operational Areas will be presented at the PHEP Conference to be held on July 29-29, 2009.
  • In August 2009,CDPH will reconvene the Training and Exercise Workgroup to develop a Multi-Year Training and Exercise Plan. This Multi-Year Plan will establish the priorities, goals,and timelines, coinciding with other State and Federal exercises.

For questions or clarification on the 2009 Statewide Medical Health Exercise, please contact the your CDPH Project Officer.

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