Exercise PlanJust Another Day at the Mall…Full-Scale Exercise

Just Another Day at the Mall…

Full-Scale Exercise

Exercise Plan

October 18, 2017

Preface

Just Another Day at the Mall…Full-Scale Exercise Plan (ExPlan) gives elected and appointed officials, Observers, Players, other exercise participants, and media personnel the information necessary to observe or participate in the exercise. All exercise participants may view the Exercise Plan.

The Exercise Plan (ExPlan) was produced with the input, advice, and assistance from the Exercise Planning Team (EPT), which followed the guidance set forth in the Federal Emergency Management Agency (FEMA) Homeland Security Exercise and Evaluation Program (HSEEP). The information in this document is current as of the date of publication and is subject to change as dictated by the Exercise Planning Team (EPT).

The Just Another Day at the Mall…Full-ScaleExercise(FSE) is an unclassified exercise. The control of information isbased more on public sensitivity regarding the nature of the exercise than on the actual exercise content. Some exercise materials are intended for the exclusive use of exercise planners andplayers may view other materials as deemed necessary in the performance of their duties.

All exercise planners should use appropriate guidelines to ensure the proper control of information within their areas of expertise and to protect this material in accordance with current jurisdictional directives. Public release of exercise materials to third parties is at the discretion of the Exercise Director and the Exercise Planning Team (EPT).

Handling Instructions

  1. The title of this document is the Just Another Day at the Mall…Full-Scale Exercise Plan.
  2. The information gathered in this document 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. Reproduction of this document, in whole or in part, without prior approval from the Exercise Director and the Exercise Planning Team (EPT) is prohibited.
  3. At a minimum, the attached materials will be distributed only on a need-to-know basis and when unattended, will be stored in an area offering sufficient protection against theft, compromise, inadvertent access, and unauthorized disclosure.
  4. For more information, please consult the following point of contact:

Exercise Director:

Norm Sturm

Cochise County Emergency Manager

520-432-9220

Preface and Handling Instructions1FOR OFFICIAL USE ONLY

Exercise PlanJust Another Day at the Mall…Full-Scale Exercise

Contents

Exercise Cover Page...... i

Preface

Handling Instructions

Exercise Overview

General Information

Exercise Objectives and Core Capabilities

Background Information

Participant Roles and Responsibilities

Exercise Assumptions and Artificialities

Exercise Logistics

Safety

Fire Safety

Emergency Medical Services

Weapons Policy

Site Access and Security

Post-exercise and Evaluation Activities

Hot Washes

Facility/Agency Hot Wash

Participant Feedback Forms

Facility/Agency Controller and Evaluator Hot Wash

General Exercise Controller and Evaluator Hot Wash

Evaluation

Exercise Evaluation Guides

After-Action Report

After-Action Conference

Improvement Planning

Participant Information and Guidance

Exercise Rules

Players Instructions

Before the Exercise

During the Exercise

After the Exercise

Simulation Guidelines

Appendix A: Exercise Schedule

Appendix B: Communications Plan

Player Communications

Controller Communications

Communications Check

Player Briefing

Public Affairs

Appendix C: Acronyms

Contents1FOR OFFICIAL USE ONLY

Exercise PlanJust Another Day at the Mall…Full-Scale Exercise

Exercise Overview

Exercise Name / Just Another Day at the Mall…Full-Scale Exercise
Exercise Dates / October 18, 2017
Scope / The Just Another Day at the Mall…Full-Scale Exercise is a full-scaleexercise (FSE) designed to include all Cochise County Fire, Hazardous Material teams, and Hospitals and public health partners. This exercise is being conducted to validate the ability of plans, equipment and personnel to respond to a Hazardous Materials Event and subsequent medical surge situation and to test public health and healthcare coordination for Cochise County.
Mission Area(s) / Response
Core Capabilities / Public Health Preparedness Program - Emergency Support Function 8: Public Health and Medical Services (ESF-8)
Capability 6: Information Sharing
Function 3: Exchange information to determine a common operating picture
Capability 10: Medical Surge
Function 3: Support jurisdictional medical surge operations
Reference: Public Health Preparedness Capabilities: National Standards for State and Local Planning, March 2011, Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response
Hospital Preparedness Program:
Capability 1: Foundation for Healthcare and Medical Readiness
Objective 4: Train and Prepare the Health Care and Medical Workforce
Activity 1: Promote Role-Appropriate National Incident Management System Implementation
Capability 2: Health Care and Medical Response Coordination
Objective 2: Utilize Information Sharing Procedures and Platforms
Activity 3. Utilize Communications systems and platforms
Objective 3: Coordinate Response Strategy, Resources, and Communications
Activity 1. Identify and Coordinate Resource Needs during an Emergency
Capability 4: Medical Surge
Objective 2: Respond to a Medical Surge
Activity 1. Implement Emergency Department and Inpatient Medical Surge Response
Activity 2. Implement Out-of-Hospital Medical Surge Response
Activity 4. Provide Pediatric Care during a Medical Surge Response
Activity 8. Respond to Behavioral Health Needs during a Medical Surge Response
Reference: 2017-2022 Health Care Preparedness and Response Capabilities,Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, November 2016.
Objectives / Public Health Emergency Preparedness - Emergency Support Function 8: Public Health and Medical Services (ESF-8)
  1. Cochise County Emergency Support Function 8: Public Health and Medical Services(ESF-8) will notify partners of the emergency incident and provide situational updates via the Arizona Health Alert Network (AzHAN).
  2. Demonstrate the ability to exchange information to determine a common operating picture.
  3. Demonstrate the ability to support jurisdictional medical surge operations.
  4. Utilize the Arizona Health Alert Network (AzHAN) system to notify the Southern Arizona Health Care Coalition (SoAZHCC) and Arizona Pediatric Disaster Coalition (APDC) of situational status.
Hospital Preparedness Program
  1. Hospitals will practice decompression at 20% of inpatient census. Of the 20% of patients, 50% will be transferred to Long Term Care, 25% will be transferred to home health, and 25% will be discharged home.
  2. Hospitals will transfer admitted inpatient pediatric patients to Honor Health hospitals.
  3. Hospitals will track transferred patients using EMTrack.
  4. Healthcare facilities will utilize the Healthcare Incident Command System or other National Incident Management System aligned incident command system.
  5. Local healthcare agencies and facilities will demonstrate their ability to share information with regional medical and healthcare facilities.

Threats/
Hazards / Hazardous Materials release at a crowded movie theater followed by medical surge.
Scenario / On the morning of October 18, 2017, there are an estimated 50 people in attendance at a screening of the classic Shirley Temple movie “Curly Top” at the Cinemark Theater, Theater #6, at the Mall at Sierra Vista. As the final movie trailer ends and feature begins, a “patron” sitting in the last row of the theater jumps to his feet and screams: “LOOSERS Unite!” “Death to all who do not join us!” and proceeds to run down the aisle throwing handfuls of powder onto stunned moviegoers. After leaving the approximately 50 patrons covered in a cloud of white powder, the LOOSER runs out of the theater using the emergency exit.
Sponsor / Cochise County Emergency Services, Southern Arizona Health Care Coalition, Sierra Vista Fire Department, Frye Fire Department, Douglas Fire Department and The Mall at Sierra Vista, Cochise County RACES
Participating Organizations / Cochise County Emergency Services, Southern Arizona Healthcare Coalition, Pima County, Greenlee County, Graham County, Sierra Vista Fire Department, Frye Fire Department, Douglas Fire Department, Fort Huachuca Fire Department, Cochise County Sheriff’s Office, Sierra Vista Police Department, The Mall at Sierra Vista, Canyon Vista Medical Center, Benson Hospital, Copper Queen Community Hospital, Northern Cochise Community Hospital, and Mt. Graham Regional Medical, United Community Health Center, Cenpatico Integrated Care, Bayada Home Health Care, Casa Del Luz Hospice, Copper Queen Home Health, Dependable Home Health Inc. Nogales, Kindred at Home, Legacy Home Health, Soulistic Hospice-Tucson, Carondelet Holy Cross Hospital, Douglas Free Standing ED, Green Valley Hospital, Copper Queen Long Term Care. A complete listing of participants can be found in the Just Another Day at the Mall… Full-Scale Exercise Participant List. Cochise County Emergency Services and the Southern Arizona Healthcare Coalition will be simulated through the Simulation Cell (SimCell).
Point of Contact / Cochise County
Norm Sturm
Cochise County Emergency Manager
520-432-9220

Exercise Overview1FOR OFFICIAL USE ONLY

Exercise PlanJust Another Day at the Mall…Full-Scale Exercise

General Information

Exercise Objectives and Core Capabilities

The following exercise objectivesdescribed below are the expected outcomes for the exercise. The objectives are linked to core capabilities, which are distinct critical elements necessary to achieve the specific mission area(s). The objectives and aligned core capabilities were selected by the Exercise Planning Team and provide the basis for exercise evaluation. Table 1 shows the relationship between exercise objectives and core capabilities.

Table 1.

Exercise Objective / Core Capability
Public Health Emergency PreparednessObjective 1:
Cochise County Emergency Support Function 8: Public Health and Medical Services(ESF-8) will notify partners of the emergency incident and provide situational updates via the Arizona Health Alert Network(AzHAN) system. / Public Health Preparedness Capability 6: Information Sharing
Function 3: Exchange information to determine a common operating picture
Public Health Preparedness Capability 10: Medical Surge
Function 3: Support jurisdictional medical surge operations
Public Health Emergency Preparedness Objective 2:
Demonstrate the ability to exchange information to determine a common operating picture. / Public Health Preparedness Capability 6: Information Sharing
Function 3: Exchange information to determine a common operating picture
Public Health Emergency Preparedness Objective 3:
Demonstrate the ability to support jurisdictional medical surge operations. / Public Health Preparedness Capability 10: Medical Surge
Function 3: Support jurisdictional medical surge operations
Public Health Emergency Preparedness Objective 4:
Utilize the Arizona Health Alert Network (AzHAN) system to notify the Southern Arizona Health Care Coalition (SoAZHCC) and Arizona Pediatric Disaster Coalition (APDC) of situational status. / Public Health Preparedness Capability 6: Information Sharing
Function 3: Exchange information to determine a common operating picture
Hospital Preparedness Program Objective 1:
Hospitals will practice decompression at 20% of inpatient census. Of the 20% of patients, 50% will be transferred to Long Term Care, 25% will be transferred to home health, and 25% will be discharged home. / Hospital Preparedness Program Capability 4: Medical Surge
Objective 2: Respond to a Medical Surge
Activity 1. Implement Emergency Department and Inpatient Medical Surge Response
Activity 2. Implement Out-of-Hospital Medical Surge Response
Hospital Preparedness Program Capability 2: Health Care and Medical Response Coordination
Objective 3: Coordinate Response Strategy, Resources, and Communications
Activity 1. Identify and Coordinate Resource Needs during an Emergency
Hospital Preparedness Program Objective 2:
Hospitals will transfer admitted inpatient pediatric patients to Honor Health hospitals. / Hospital Preparedness Program Capability 4: Medical Surge
Objective 2: Respond to a Medical Surge
Activity 4. Provide Pediatric Care during a Medical Surge Response
Hospital Preparedness Program Objective 3:
Hospitals will track transferred patients using EMTrack. / Hospital Preparedness Program Capability 2: Health Care and Medical Response Coordination
Objective 2: Utilize Information Sharing Procedures and Platforms
Activity 3. Utilize Communications Systems and Platforms
Hospital Preparedness Program Objective 4:
Healthcare facilities will utilize the Healthcare Incident Command System (HICS) or other National Incident Management System (NIMS) aligned incident command system. / Hospital Preparedness Program Capability 1: Foundation for Healthcare and Medical Readiness
Objective 4: Train and Prepare the Health Care and Medical Workforce
Activity 1: Promote Role-Appropriate National Incident Management System Implementation
Hospital Preparedness Program Objective 5:
Local healthcare agencies and facilities will demonstrate their ability to share information with regional medical and healthcare facilities. / Hospital Preparedness Program Capability 2: Health Care and Medical Response Coordination
Objective 2: Utilize Information Sharing Procedures and Platforms
Activity 3. Utilize Communications systems and Platforms

Background Information

Cochise County Emergency Services is conducting a full-scale exercise, the Just Another Day at the Mall…Full-Scale Exercise. County partners from emergency services, Coalition partners from healthcare sectors, including Behavioral Health, Long Term Care/Skilled Nursing, Ambulatory Care, Hospitals, County Public Health, Hospice/Home Health and community resource sectors will be participating in the exercise.

Cochise County Emergency Services and the Southern Arizona Health Care Coalition will be simulated by the exercise Simulation Cell. Cochise County Health & Social Services serves as Emergency Support Function 8: Public Health and Medical Services (ESF-8), which is activated by Cochise County Emergency Services to support public health and medical services response.

Participant Roles and Responsibilities

The term participant encompasses many groups of people, not just those playing in the exercise. Groups of participants involved in the exercise, and their respective roles and responsibilities, are as follows:

  • Players. Players are persons who have an active role in performing their regular roles and responsibilities during the exercise. Players initiate actions, tasks or missions in response to the simulated emergency.
  • Controllers. Controllers manage exercise play, set up and operate the exercise site, implement the evaluation process, and work with the assigned safety officer or act as the safety officer to ensure the safety of the Players, Actors, and others participating in the exercise. They issue exercise material to Players as required, monitor the exercise timeline, and supervise the safety of all exercise participants.
  • Evaluators. Evaluators evaluate and provide feedback on a designated functional area of the exercise. Evaluators observe and document performance against established capability targets and critical tasks, in accordance with the Exercise Evaluation Guides (EEGs). This position may also be filled by the Controller, i.e. one person may need to act as Controller and Evaluator.
  • Actors. Actors simulate specific roles during exercise play, typically victims or other bystanders.
  • Observers. Observers visit or view selected segments of the exercise. Observers do not play in the exercise, nor do they perform any control or evaluation functions. Observers view the exercise from a designated observation area and must remain within the observation area during the exercise. Very Important Persons (VIPs) are also Observers, but may be grouped separately.
  • Media Personnel. Some media personnel may be present as Observers, pending approval by the sponsor organization and the Exercise Planning Team.
  • Support Staff. The exercise support staff includes individuals are the planners of the exercise who also perform administrative and logistical support tasks during the exercise (e.g., registration, catering).

Exercise Assumptions and Artificialities

In any exercise, assumptions and artificialities may be necessary to complete play in the time allotted and/or account for logistical limitations. Exercise participants should accept that assumptions and artificialities are inherent in any exercise, and should not allow these considerations to negatively impact their participation.

Assumptions

Assumptions constitute the implied factual foundation for the exercise and, as such, are assumed present before the exercise starts. The following assumptions apply to the exercise:

  • The exercise is conducted in a no-fault learning environment wherein capabilities, plans, systems, and processes will be evaluated.
  • The exercise scenario should be considered plausible but will have artificialities that are necessary due to time constraints, and events occur as they are presented during exercise play. The scenario is taken from real world incidents.
  • Players will follow appropriate plans, procedures, regulations, and training they have received.
  • Participating agencies may need to balance exercise play with real-world emergencies. Real-world emergencies take priority.

Artificialities

During this exercise, the following artificialities apply:

  • Not all resources may be involved in this exercise that normally would respond to these types of incidents.
  • Emergency Support Function 8: Public Health and Medical Services (ESF-8) will operate out of the SimCell for this exercise.
  • Another exercise, the U of A Game Changer will be simulated as occurring at the same time as the hazardous materials incident in this exercise scenario. Exercise participants should consider that both simulated incidents were caused by terrorists and that the entire region is impacted at the same time.

General Information1FOR OFFICIAL USE ONLY

Exercise PlanJust Another Day at the Mall…Full-Scale Exercise

Exercise Logistics

Safety

Exercise participant safety takes priority over exercise events. The following general requirements apply to the exercise:

  • A Safety Controller at each participating facility/agency site is responsible for participant safety; any safety concerns must be immediately reported to the Safety Controller. The Safety Controllers and Exercise Director will determine if a real-world emergency warrants a pause in exercise play and when exercise play can be resumed.
  • For an emergency that requires assistance, use the phrase “real-world emergency.” The following procedures should be used in case of a “real-world emergency” during the exercise:
  • Anyone who observes a participant who is seriously ill or injured will immediately notify emergency services and the closest facility/agency Controller, and, within reason and training, render aid.
  • Any facility/agencyController made aware of a real emergency will internally initiate“real-world emergency”facility procedures and notify the Exercise Director with the location and description of the emergency.
  • The Exercise Director will notify all participating facilities or agencies if there is a community-wide“real-world emergency” and the exercise needs to be stopped.A “real-world” community-wide emergency may require that all facilities or agencies participate in the response.

Fire Safety

Standard fire and safety regulations relevant to the jurisdiction or venue will be followed during the exercise.