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HSEEP SELF-HELP GUIDE

Blueprint for the Use of Volunteers in Hospitals and Rural Medical Centers This product was produced under the direction of the Mesa County Advanced Practice Center (APC) at the Mesa County Health Department and was supported by Award Number 1H75TP000309-01 from the Centers for Disease Control and Prevention (CDC) and the National Association of County and City Health Officials (NACCHO). Its contents are solely the responsibility of the Mesa County APC and do not necessarily represent the views of the CDC or NACCHO. The Homeland Security Exercise and Evaluation Program (HSEEP) is a capabilities and performance-based exercise program which provides a standardized policy, methodology, and terminology for exercise design, development, conduct, evaluation, and improvement planning. This HSEEP SELF-HELP GUIDE was produced with the understanding that adherence to the policy and guidance presented in the HSEEP Volumes ensures that exercise programs conform to established best practices and helps provide unity and consistency of effort for exercises at all levels of

government.

Information was obtained from various and assorted DHS, HSEEP, and NRF websites and support documents. Please take all information herein with the spirit in which it was intended- to make the HSEEP process easier to begin. Greg Rajnowski Emergency Planner/ESF8 Liaison Mesa County Health Department Grand Junction, Colorado Greg.Rajnowski@mesacounty.us

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Table of Contents

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Blueprint for Use of Volunteers in Hospitals and Rural Medical Centers Funded through a grant from NACCHO for Public Health Advanced Practice Centers

Introduction You need helplets face it. As if NIMS/ICS didnt throw enough at you for new jargon, acronyms, and daunting guidance documents, now you have a whole new way to be crushed by the sheer weight of paper you produce to document what you do; the Homeland Security Exercise and Evaluation Program, or HSEEP, for short. Luckily, this guidance is online, most of the information goes into the computer rather than being spit out of it and what you should have in the end will resemble nothing less than a professional document. The strengths of using the online toolkit are: (And no, these are not cut and paste from the official HSEEP website.) It stores exercise data for you and can be accessed anywhere, anytime. Repeat exercises with the same agencies/partners can be dropped into a new exercise once the initial information has been put into the system. In other words, the same exercise, with different people requires little to change. Basic information is dumped into the numerous documents you can create using the toolkit. The largest parts of the documentation process (the After Action Report and Improvement Plan Matrix) are built with the same data you enter while planning the exercise. Endless writing and rewriting tasks are reduced. Exercises created using the toolkit stick to the initial objectives, goals, tasks, and Target Capabilities and do not stray during the planning process. This keeps the goals that created the need for the exercise from being lost in the planning process. Its official.lets face it. Every document you produce using the toolkit says I have the HOMELAND SECURITY SEAL of APPROVAL. Why? Because it is HSEEP COMPLIANT!

1. What is HSEEP Compliance?

HSEEP Compliance is defined as adherence to specific HSEEP-mandated practices for exercise program management, design, development, conduct, evaluation, and improvement planning. Recently, many of the documents have replaced the compliance language with adheres to HSEEP Guidelines. This is to reinforce the fact that the HSEEP Toolkit is for tools/resources rather than required documentation. In order for an exercise to be considered HSEEP compliant it must satisfy four distinct performance requirements:

a.

Training and Exercise Plan Workshop (TEPW) All HSEEP compliant entities conduct a TEPW each calendar year in which they develop a Multi-year Training and Exercise Plan, which includes:

The entity's training and exercise priorities (based on an overarching strategy and previous improvement plans). The capabilities from the Target Capabilities List (TCL) which the entity will train for and exercise against.

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A multi-year training and exercise schedule which: o Reflects the training activities that will take place prior to an exercise, allowing exercises to serve as a true validation of previous training. o Reflects all exercises in which the entity participates. o Employs a "building-block approach" in which training and exercise activities gradually escalate in complexity. A new or updated Multi-year Training and Exercise Plan must be finalized and implemented within 60 days of the TEPW.

All scheduled exercises must be entered into the National Exercise Schedule (NEXS) System. The Multi-Year Training and Exercise Plan must be updated on an annual basis (or as necessary) to reflect schedule changes.

b.

Exercise Planning and Conduct The type of exercise selected by the entity should be consistent with the entity's Multi-year Training and Exercise Plan. Exercise objectives should be based on target capabilities and their associated critical tasks, which are contained within the Exercise Evaluation Guide (EEG). For example, if an entity, based on its risk/vulnerability analysis, determines that it is prone to hurricanes, it may want to validate its evacuation capabilities. In order to validate this capability it would first refer to the "Citizen Protection: Evacuation and/or In-Place Protection" EEG. Tasks associated with this capability include: "make the decision to evacuate or shelter in place;" "identify and mobilize appropriate personnel;" and "activate approved traffic control plan." An entity may wish to create its own Simple, Measurable, Achievable, Realistic, and Taskoriented (S.M.A.R.T.) objectives based on its specific plans/procedures associated with these capabilities and tasks, such as: 1) Examine the ability of local response agencies to conduct mass evacuation procedures in accordance with Standard Operating Procedures (SOPs); and 2) Evaluate the ability of local response agencies to issue public notification of an evacuation order within the timeframe prescribed in local SOPs. The scenarios used in exercises must be tailored toward validating the capabilities, and should be based on the entity's risk/vulnerability assessment. Exercise planners should develop the following documents, in accordance with HSEEP Volume IV, to support exercise planning, conduct, evaluation, and improvement planning:

For discussion-based exercises, this requires: o Situation Manual (SITMAN) or equivalent For operations-based exercises, this requires: o Exercise Plan (EXPLAN) o Player Handout

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o o

Master Scenario Events List (MSEL) Controller/Evaluator Handbook (C/E Handbook)

Templates and samples of these documents can be found in HSEEP Volume IV: Sample Templates and Formats, available on the HSEEP website (http://hseep.dhs.gov). Exercises should adhere to the planning timelines laid forth in HSEEP Volume I. Exercises must reflect the principles of the National Incident Management System (NIMS).

c.

After-Action Reporting After Action Reports (AARs) created for exercises must conform to the templates provided in HSEEP Volume III: Exercise Evaluation and Improvement Planning. Following each exercise, a draft AAR must be developed based on information gathered through use of Exercise Evaluation Guides (EEGs). Following every exercise, an After-Action Conference (AAC) must be conducted, in which: Key personnel and the exercise planning team are presented with findings and recommendations from the draft AAR. Corrective actions addressing a draft AARs recommendations are developed and assigned to responsible parties with due dates for completion. A final AAR with recommendations and corrective actions derived from discussion at the AAC must be completed within 60 days after the completion of each exercise.

d.

Improvement Planning An improvement plan (IP) will include broad recommendations from the IP organized by target capability as defined in the TCL.

Corrective actions must be linked to a capability element as defined in the TCL. Corrective actions must be measurable. Corrective actions must designate a projected start date and completion date. Corrective actions must be assigned to an organization and a point of contact (POC) within that organization. Corrective actions must be continually monitored and reviewed as part of an organizational Corrective Action Program. An individual should be responsible for managing the Corrective Action Program to ensure corrective actions resulting from exercises, policy discussions, and real-world events are resolved and support the scheduling and development of subsequent training and exercises.

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2. How do I get started?

The first step in any self-help program is to acknowledge that you have a problem and you need to seek help. Accessing resources for that help is a step in the right direction. A few suggestions online are: HSEEP Introduction: https://hseep.dhs.gov/pages/1001_About.aspx Download the following toolkit to learn the basic terminology: http://www.nursing.columbia.edu/pdf/PublicHealthBooklet_060803.pdf A good checklist: http://www.nyc.gov/html/doh/downloads/pdf/bhpp/bhpp-trainhospital-toolkit-app04.pdf Master the Disasterrelearning why we do tabletops vs. functional exercises: http://nccphp.sph.unc.edu/APC/dekalb/index.htm National Preparedness Guidelines: This includes the Target Capabilities List which will give you the goals and objectives for the tasks to be carried out during the exercise. http://www.dhs.gov/xprepresp/publications/gc_1189788256647.shtm

3. What type of HSEEP exercise should I do?

There are seven types of exercises are defined within HSEEP, subdivided into discussion-based and operations-based exercises. Begin with a discussion-based exercise; end with the one that you know will cause you a minor heart attack!

a.

Discussion-based exercises familiarize participants with current plans, policies, agreements and procedures, or may be used to develop new plans, policies, agreements, and procedures. Types of discussion-based exercises include:

Seminar. A seminar is an informal discussion designed to orient participants to new or updated plans, policies, or procedures (e.g., a seminar to review a new evacuation SOP. Workshop. A workshop resembles a seminar, but is employed to build specific products, such as a draft plan or policy (e.g., a TEPW is used to develop a Multi-year Training and Exercise Plan). Tabletop Exercise (TTX). A tabletop exercise involves key, personnel discussing simulated scenarios in an informal setting. TTXs can be used to assess plans, policies, and procedures. Games. A game is a simulation of operations that often involves two or more teams, usually in a competitive environment, using rules, data, and procedures designed to depict an actual or assumed real-life situation.

b.

Operations-based exercises validate plans, policies, agreements and procedures, clarify roles and responsibilities, and identify resource gaps in an operational environment. Types of operations-based exercises include:

Drill. A drill is a coordinated, supervised activity usually employed to test a single, specific operation or function within a single entity (e.g., a fire department conducts a decontamination drill). Functional Exercise (FE). A functional exercise examines and/or validates the coordination, command, and control between various multi-agency coordination centers (e.g., emergency operation center, joint field office, etc.). A functional exercise does not involve any "boots on the ground" (i.e.,

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first responders or emergency officials responding to an incident in real time). Full-Scale Exercises (FSE). A full-scale exercise is a multi-agency, multijurisdictional, multi-discipline exercise involving functional (e.g., joint field office, emergency operation centers, etc.) and "boots on the ground" response (e.g., firefighters decontaminating mock victims).

4. HSEEP- Well begun is half done! Mary Poppins said it, so it must be true; Well begun is half done. Beginning with the right tools and gathering the right information is the best way to get off on the right foot and eliminate backtracking for resources and information. What do you need first? The following are key:

A contact list spreadsheet: With the name, agency, phone number, and email of everyone that will be participating in the planning, execution, and evaluation of an exercise. Why? At some point you will need this information when using the toolkit, but you will also need to give credit and document participation for those that took part. Dont skimp on information here; whether they attend one planning meeting, or they attend every exercise youve ever organized, better to credit them in the spreadsheet than not. Exercise objectives: First, go to the toolkit and find the EEGs for the target capabilities in the topic area of the exercise. Not only will the EEGs help the planning group stay focused on goals, objectives, and tasks that are measurable, but they will address actual capabilities that make sense when viewed from a funding standpoint. You will be able to pin the federal funding for the exercise to the federal capability. You will find these downloadable files at: https://hseep.dhs.gov/pages/1002_EEGLi.aspx Exercise Evaluation Guides (EEGs): Print the EEGs and bring them to the initial planning meeting. For more information about using the EEGs, go to: https://hseep.dhs.gov/pages/1002_Exerc0.aspx

Helpful information: Last years exercise documentation, if you are taking the next step (i.e., turning a tabletop into a full scale.) Maps of the hypothetical Incident Area, the exercise county, city, building, etc. The time, date, location, and room number for the exercise setting. Discipline specific guidance: CDC, Emergency Management, World Health Organization, FBI/CIA. The Emergency Operations Plan (EOP) of the agency conducting the exercise, or the plan being tested (ie., Medical Surge plan).

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Set up a system for sharing files and documents during exercise planning: o A Resource Binder is a useful way to begin keeping documentation that you reference in designing the exercise. This binder can then be duplicated for the attendees (especially if this is an Orientation Seminar Tabletop Exercise). o File Transfer Program (FTP) address. Your local IT can set up an FTP that is a separate folder which people outside your system can and remove files. This is especially useful if you are planning with someone away from your agency that has a primitive computer server for email. o Create a reference list for players: store references, Web-links, plans, or technical material (statutes, federal guidance) that can be shared and referenced at a later date by players.

5. Begin an exercise using the toolkit. a. Register for the toolkit by visiting: https://hseep.dhs.gov/DHS_SSO/? b. c.
ReturnUrl=%2fhseep_em%2fToolkitHome.aspx Call K2Support at 1-877-612-HELP (4357) to obtain your username and password. Login. Click the DDS (Design and Development System) button. d. You are in! At the top is a row of options. Click on the Create Exercise link and begin. e. The first screen will be Exercise Name and Series screen. Having gathered all the information above (the spreadsheet, etc) you should be able to begin the exercise walkthrough. Creating an exercise is not a one-shot process. You can return later to change, modify, and edit anything you enter. This is YOUR resource.

6. Other resources for public health related exercises. CDC PowerPoint resources for a plague scenario:

http://www.bt.cdc.gov/agent/plague/trainingmodule/powerpoint.asp EPA Tabletop Exercise Materials for a Water System Scenario: http://www.epa.gov/safewater/watersecurity/tools/trainingcd/Pages/scenario1s.html Hospital Tabletop Toolkit: http://www.nyc.gov/html/doh/html/bhpp/bhpp-train-hospital.shtml Most self-help manuals are only meant for some of us. The rest of us need to seek professional help. For that, there are HSEEP classes are available that reference the actual volumes of training that are behind the toolkit itself. Visit the following links for more information: Regional Exercise Support Program Weblinks https://hseep.dhs.gov/pages/1001_Regio.aspx Training and Exercise Planning Workshops https://hseep.dhs.gov/support/TEPW_Users_Handbook_(V30).pdf HSEEP Mobile Training Course

7. Seek a Professional.

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https://hseep.dhs.gov/support/HSEEP_Mobile_Course(10.17.06_FINAL).doc

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Blueprint for Use of Volunteers in Hospitals and Rural Medical Centers Funded through a grant from NACCHO for Public Health Advanced Practice Centers