State and Regional Exercises: Lessons Learned

National Governor’s Association ConferenceNational Governor’s Association Conference

Boston Seaport HotelBoston Seaport Hotel

January 12, 2004January 12, 2004

Suzanne Condon, Associate CommissionerSuzanne Condon, Associate CommissionerCenter for Environmental Health and Center for Environmental Health and

Center for Emergency PreparednessCenter for Emergency Preparedness

Massachusetts Department of Public HealthMassachusetts Department of Public Health

““Preparation for the likely prepares us for the unlikely”Preparation for the likely prepares us for the unlikely”

Introduction

1.1. Introduction/ExercisesIntroduction/Exercises

2.2. Major Issues Involved in Exercises and Major Issues Involved in Exercises and PlanningPlanning

3.3. Collaborative Exercise Program in Collaborative Exercise Program in MassachusettsMassachusetts

4.4. Summary of Important LessonsSummary of Important Lessons

Recent Exercises

Operation Yankee, August 2003Operation Yankee, August 2003 Measured Response to Bioterrorism TTX, Measured Response to Bioterrorism TTX,

October 2003October 2003 Emergency Powers Working Group TTX, Emergency Powers Working Group TTX,

December 2003December 2003 Various SNS Exercises Various SNS Exercises

Key Areas of Lessons Learned

PlanningPlanning All-Hazards ApproachAll-Hazards Approach CommunicationsCommunications Training Training Policy/Decision-MakingPolicy/Decision-Making Risk CommunicationRisk Communication Multi-Disciplinary Collaboration Multi-Disciplinary Collaboration

Planning

Need to exercise completed written plansNeed to exercise completed written plans Take Baby Steps: There is a necessary Take Baby Steps: There is a necessary

hierarchy in types of exerciseshierarchy in types of exercises Need to have all our ducks in a rowNeed to have all our ducks in a row Cannot be afraid of the evaluationCannot be afraid of the evaluation

All-Hazards Approach

““Preparation for the likely prepares us for Preparation for the likely prepares us for the unlikelythe unlikely””

Events do not occur in silosEvents do not occur in silos Triggering events may vary; initial response Triggering events may vary; initial response

mechanisms do notmechanisms do not

Communications

Ensure capability across jurisdictionEnsure capability across jurisdiction InteroperabilityInteroperability Redundant modes neededRedundant modes needed Relationships important; should not be the Relationships important; should not be the

first time people interactfirst time people interact

Training

Need for standardized incident command system Need for standardized incident command system (NIMS)(NIMS)

Cross-disciplinaryCross-disciplinary Including forensic epidemiology, chain of Including forensic epidemiology, chain of

custody issuescustody issues Awareness of authorities and emergency Awareness of authorities and emergency

powerspowers Need to train executives and elected officials on Need to train executives and elected officials on

processprocess

Policy/Decision-Making

Need to keep elected officials apprised of Need to keep elected officials apprised of processprocess

SNS – when to requestSNS – when to request What constitutes a public health What constitutes a public health

emergencyemergency The bigger the event, the more volatile it The bigger the event, the more volatile it

may becomemay become

Risk Communication

How much information do you have?How much information do you have? How do you act on limited information?How do you act on limited information? What to release to the public, and whenWhat to release to the public, and when Issues regarding stockpile requests, mass Issues regarding stockpile requests, mass

prophylaxis, evacuation, shelteringprophylaxis, evacuation, sheltering At what point does the scale tip?At what point does the scale tip?

Multi-Disciplinary Collaboration

Emergencies are rarely restricted to one Emergencies are rarely restricted to one community or to one disciplinecommunity or to one discipline

Partners from public safety, public health Partners from public safety, public health and other organizations should be involvedand other organizations should be involved

Events do not recognize borders or Events do not recognize borders or organizational chartsorganizational charts

Need for mutual aid agreements, regional Need for mutual aid agreements, regional plansplans

MA Statewide Exercise Program

DPH and EOPS partnershipDPH and EOPS partnership CDC, HRSA and ODP grant fundingCDC, HRSA and ODP grant funding Statewide Exercise Advisory CommitteeStatewide Exercise Advisory Committee RFR to design, implement, and evaluate RFR to design, implement, and evaluate

multi-disciplinary tabletop, functional and multi-disciplinary tabletop, functional and full-scale exercisesfull-scale exercises

Summary

Planning is key to preparednessPlanning is key to preparedness Planning is crucial to effective exercisesPlanning is crucial to effective exercises Communication/collaboration is essentialCommunication/collaboration is essential Developing partnerships at all levels before Developing partnerships at all levels before

an event occurs has multiple benefitsan event occurs has multiple benefits