CONTINUITY OF OPERATIONS (COOP) Exercise Series for FQHC’s & other Community – Based Health Care Providers 1

WELCOME and INTRODUCTIONS 2

EXERCISE TARGET CAPABILITIES The Capabilities listed below have been selected by the exercise design team. They provide the foundation for development of the exercise objectives and scenario, as the purpose of the exercise is to measure and validate performance of these capabilities and their associated critical tasks. Communication, Information Sharing; Dissemination Emergency Public Information & Warning Planning, Risk Management, Emergency Operations Center Management & On-Site Incident Management Support of staff member “Family Emergency Plans” Medical material management distribution & critical resource logistics distribution Community recovery 3

DESIGN OBJECTIVES The Exercise will focus on the successful implementation of existing policies, plans and procedures that support the activation of the facilities COOP Plan Demonstrate the ability to communicate internally (with staff) & externally (with patients, local emergency management and critical resource vendors.) Demonstrate the ability to support existing emergency response plans. Demonstrate the ability to develop and support an emergency specific Incident Action Plan (IAP). Demonstrate the ability to develop, support and maintain staff member’s “Family Disaster Plans.” Demonstrate the ability to inventory, manage, distribute and replenish critical resources. Demonstrate the ability to return to normal operations. 4

EXERCISE RULES There are no textbook solutions. Varying viewpoints, even disagreements, are expected. This is intended to be a safe, open, stress-free environment. Respond based on your knowledge of current plans and capabilities (i.e., you may use only existing assets) and insights derived from training Your organization’s positions or policies do not limit you. Make your best decision based on the circumstances presented. Decisions are not precedent setting and may not reflect your organization’s final position on a given issue. This is an opportunity to discuss and present multiple options and possible solutions. Assume cooperation and support from other responders and agencies. The situation updates, written material, and resources serve as the basis for discussion. 5

THE 2011 HURRICANE SEASONAL OUTLOOK FROM NOAA NOAA hurricane outlook indicates an above-normal Atlantic season The Atlantic basin is expected to see an above-normal hurricane season this year, according to the seasonal outlook issued by NOAA’s Climate Prediction Center – a division of the National Weather Service. Across the entire Atlantic Basin for the six-month season, which begins June 1, NOAA is predicting the following ranges this year: 12 to 18 named storms (winds of 39 mph or higher), of which: 6 to 10 could become hurricanes (winds of 74 mph or higher), including: 3 to 6 major hurricanes (Category 3, 4 or 5; winds of 111 mph or higher) Each of these ranges has a 70 percent likelihood, and indicate that activity will exceed the seasonal average of 11 named storms, six hurricanes and two major hurricanes. 6

Module 1 – Preparedness and Initial Response Pre-Landfall (+96 hours to +48/36 hours) Current Situation: It is a bright, sunny morning in South Florida. Miami-Dade residents are starting their daily routines. Vacationers from around the world are venturing out to enjoy the beaches and local tourist attractions. Meanwhile, meteorologist from the National Hurricane Center (NHC) and the Weather Forecast Office (WFO), Miami are monitoring Hurricane Suiter. SUMMARY OF INCIDENT: No current weather events are impacting the South Florida area. The National Weather Service has not issued Tropical Storm/Hurricane Watches or Warnings for South Florida. Residents and visitors are conducting business and leisure as usual. The Weather Forecast Office, Miami, has issued a Public Information Statement urging all residents and visitors in South Florida to monitor Hurricane Suiter. 7

Module 1 - Update - Preparedness and Initial Response Pre-Landfall ( +48 Hours to +36 hours) Current Situation: The weather remains pleasant in South Florida. Hurricane Suiter continues to strengthen and remains on a westward path towards the Miami/Dade area. Residents and visitors have been monitoring the progress of the storm via various media outlets. However, due to the uncertainty of the storm’s path, many residents and visitors are hoping for the best and haven’t considered potential protective actions. SUMMARY OF INCIDENT: The National Weather Service has issued Hurricane Watches and Warnings for the majority of South Florida. At this time, there are no disruptions to any municipal services. Local merchants are reporting a surge in the purchase disaster supplies. Monroe County has issued a Mandatory Evacuation Order for all non-residents and Voluntary Evacuation Orders for residents. Miami/Dade, Broward and Palm Beach Counties have issued Mandatory Evacuation Orders for all non-residents and a Voluntary Evacuation Order for all Coastal and low-lying area residents. Emergency Operations Centers (EOCs) in Miami/Dade, Broward, Palm Beach and Monroe counties are activated. Additionally, the State Emergency Operations Center (SEOC) is activated and stands ready to respond to any county mission request. 8

EXERCISE INJECT DUE TO PRE-SCHEDULED VACATIONS AND STAFF ON SICK LEAVE, THE FACILITY IS NOT CURRENTLY OPERATING AT 100% STAFFING 10

Module 2 -Response Plan Maintenance and Recovery Transition (+24 hours to Post-landfall -72 hours) Current Situation: Hurricane Suiter continues on its current path. The weather in South Florida has deteriorated over the past few hours and tropical storm force winds are impacting coastal areas. Residents visitors, and evacuees are dealing with high wind, torrential rain and urban flooding as they attempt obtain last minute supplies, seek shelter and/or in need of medical attention. SUMMARY OF INCIDENT: Hurricane, coastal flood, inland/urban flood and tornado Warnings/Watches have been issued for all of South Florida. All schools, day care facilities and non-essential municipal public services are closed. Very few retail (food, gasoline, etc.) outlets are open and disaster supplies are difficult to obtain. Large portions of South Florida are experiencing power outages, sewage spills and boil water notices. Following standard hurricane procedures, the nuclear power plant at Turkey Point has shut down all reactors. There are wide spread landline telephone and internet outages in the South Florida area. Additionally, cellular telephone and Wi-Fi internet services are disrupted and unreliable. Due to urban flooding, many areas have limited or no ingress/egress. General and “Special Needs” shelters in Miami/Dade and Broward counties are at or near capacity. Hurricane Suiter has not made landfall & conditions will continue to deteriorate over the next several hours. 11

EXERCISE INJECT Before Watches and Warnings were issued, the CEO and most of the other top administrative staff departed for Washington, DC to attend a HRSA conference. As the potential threat increased, they maintained constant contact and directed response activities via phone and e-mail. However, due to current internet, landline and cellular phone disruptions, your on-site decision makers are unable to maintain contact. 15

EXERCISE INJECT Health Choice Network has just sent a runner over to advise that their building is damaged. All data services originating from that site are down for at least a month.  They have it backed up in North Dakota but computer services are down and they have no idea when it will be functional.  How will you process financials/patient data? (have a paper backup plan or local electronic version) 16

Module 2- Update -Response Plan Maintenance and Recovery Transition (+24 hours to Post-landfall -72 hours) Current Situation: The eye of Category 4 Hurricane Suiter moved ashore at Miami Beach 12 hours ago with maximum sustained winds of 140 mph. Suiter spread sustained major hurricane force winds of 111-130 mph with gusts to Category 4 strength across metropolitan Miami-Dade and Broward Counties. Storm surge heights of 6 feet above ground level inundated the barrier islands of Miami-Dade and Broward Counties, with sections of downtown Miami also experiencing inundation from storm surge near the Miami River. Both local and national media outlets are reporting widespread damage to residential, business and municipal structures. Local, regional and state emergency responders are conducting search and rescue operations in all impacted areas. As is typical with post hurricane weather conditions, it is a sunny, breezy, hot and humid day in South Florida. SUMMARY OF INCIDENT: Hurricane Suiter has made landfall and has caused major damage across South Florida. Local emergency services are concentrated on search and rescue missions and are not able to provide assistance to residents and visitors that require treatment for minor injuries. Electrical, water, sewage, landline and cellular telephone services are inoperable or have minimal capability across the region. Downed power lines pose a threat to residents and visitors across the region. Roadways throughout the region are impacted by standing water and debris. Public transportation is not operational at this time. Local residents have started to clear debris from properties. 17

FINAL EXERCISE INJECTS Miami-Dade County EOC ESF 8 is requesting providers to help staff Baptist Hospital for a week due to a surge in slightly injured patients The facility’s generator has quit working due clogging filters.  Various suppliers have contacted you stating that they are out of stock on essential supplies. Most items are back ordered. Re-supply may take as long as two weeks. In an effort to clear hospital emergency rooms, Miami-Dade County EOC ESF 8 is requesting that you provide medical services to their “Green Tagged” patients. 18

THANK YOU FOR YOUR PARTICIPATION! PLEASE TAKE A FEW MOMENTS TO FILL OUT THE EXERCISE EVALUATION FORM 19