Continuity of Operations Planning Project Tabletop Exercise May 6 th, 2009

Self Introductions Let us know who you are, why you are here, what you hope to gain from participation, and where you would rather be.

Agency Introductions What does you Agency do? What other Agencies do you work with?  Board of Pharmacy (Debra)  Health Policy Authority (Doug)  DOC (Deborah)  KDHE (Doug)  Commission on Disability Concerns (Martha)  Office of the Securities Commissioner ( Lynn)  Pooled Money Investment Board (Elizabeth)  Kansas Insurance Department ( Karen)  Attorney General (Jerry)  State Fire Marshall (Dan)

Exercise Basics

TTX Ground Rules  This TTX will be conducted in a stress free, informal environment.  Use your expert knowledge to poke holes in the process and suggest solutions  Participate openly in all discussions  Respect the thoughts, ideas and opinions of your fellow participants (disagreements are okay, they may point out a weak area of a plan and help foster mutual solutions)  Keep your thoughts and comments to the point in consideration of time constraints

Goals of the TTX  Knowledge of Roles and Responsibilities  Ability to Openly Interface with Other Agencies  Understand General Flow of Possible Incident  Improvement of All Plans

Exercise Introduction  The exercise will include disaster scenario information that will be presented to the exercise participants.  The TTX will be managed and facilitated by Bold Planning Solutions.  There will be three primary exercise modules (or disaster events) that will build on each other as the exercise progresses.  The exercise will be based on realistic disaster event scenarios which could affect the operations of all Agencies.  The exercise will focus on Continuity of Operations, not emergency operations.

Module Details  Module Scenario Presentation – During this time, Bold Planning Solutions will provide details and information about the disaster scenario to the exercise team.  Module Questions and Individual Worksheets – After presenting the disaster scenario, Bold Planning Solutions will outline a number of topics and questions that should be considered by each individual participant.  Group Breakout Meetings – Each pre-assigned group will meet separately to discuss the scenario and the suggested topics and questions. Important issues not suggested by Bold Planning Solutions should also be considered at this time. Each group will prepare a Incident Action Plan with priority action items and priority questions/issues.

Module Details Continued  Group Presentations – Each group will designate a speaker who will present their Incident Action Plan to the overall exercise team.  “Hot-Wash” Discussion – After the group presentations, an open discussion will be facilitated for all participants. This discussion will focus on coordination issues and overall policy items.

Incident Action Plans For each Module your table has an Incident Action Plan Please take a few minutes toward the end of your Module discussion to fill it out Determine you priority action items (the things that need to get done first) Rank your priority action items Determine the significant questions and issues from your discussions Rank your questions and issues from most vexing to least vexing We will collect these at the end of the TTX and use them to create an After Action Report to help everyone improve their plans

Exercise Timeline Each module will last approximately one hour with the following estimated schedule: Scenario Presentation – 5 minutes Questions and Issues – 5 minutes Group Meetings – 20 minutes Group Presentations – 20 minutes Hot-Wash Discussion – 10 minutes

Influenza Basics

The Language of Flu Hemagglutinin: A protein that allow sthe virus to bind to cells Neuraminidase: A protein that helps newly created viruses break out of a cell Drift: A gradual change of the hemagglutinin or neuraminidase proteins on the surface of a particular strain of influenza virus that occurs in response to host antibodies in humans who have been exposed to it. Epidemic: A disease occurring suddenly in a community, region or country in numbers clearly in excess of normal. Pandemic: Significant person to person spread of a novel antigen causing wide spread disease in humans who are immunologically naive to this new subtype. Herald Wave: A novel flu strain emerging at the end of a flu season, returning next flu season Subtype: A classification of virus among influenza type A viruses. Currently, there are 15 subtypes of type A influenza.

Seasonal Influenza Three types of influenza viruses: A, B and C. Influenza A and B viruses cause seasonal epidemics Influenza type C infections cause a mild respiratory illness Influenza A viruses are divided into subtypes based hemagglutinin and the neuraminidase There are 16 different hemagglutinin subtypes and 9 different neuraminidase subtypes,

Example Influenza A Subtypes DateSubtypeNotes 1918H1N1pandemic of "Spanish" flu"Spanish" flu 1957H2N2pandemic of "Asian" flu 1962H2N2epidemic 1964H2N2epidemic 1968H3N2pandemic of "Hong Kong" flu 1976H1N1swine flu in recruits

Seasonal Influenza, Human Toll In the U.S., each year an estimated 25–50 million cases of seasonal flu leading to 150,000 hospitalizations and 30,000–40,000 deaths yearly. Extrapolated to the rest of the world: 1 billion cases of flu, 3–5 million cases of severe illness and 300,000–500,000 deaths annually.

Seasonal Influenza, Monetary Toll Recent flu cost estimates of the flu in the U.S.: Between $71-$167 billion annually Millions of working days lost Medicare reimbursements costing from $750 million to $1 billion Millions of dollars of pharmaceutical products consumed

Historical Pandemics Bubonic plagueBubonic plague in 1300s which killed twenty million people in six years, a quarter of the total population Asiatic flu in 1890 was noted for its very high mortality Spanish fluSpanish flu in 1918 which in six months killed an estimated 25 million people Asian fluAsian flu in 1957 that caused approximately 70,000 deaths in the United States Hong Kong fluHong Kong flu in 1968 that is attributed to approximately 34,000 deaths in the United States

Setting the Stage

Sunday, April 19 th, 2009 at 9:30PM A Spreading Flu

Module 1

Monday, April 20 th, 2009 at 1:30AM The “Swine Flu” Comes to Topeka

Questions and Issues  How is your COOP activated and utilized?  Who activated the COOP? What if they are out Sick?  How is your Agency prepared to react to this sudden event?  How is your Agency gathering information about the current situation in the region? From whom?  How does your management staff communicate with key staff about the current status?  How does your Agency (or the State) communicate information to employees?  What decisions are made about continuing operations for Monday morning? Who makes these decisions?  Does the month, day, or date of the event effect how your Agency reacts?

Module 2

Monday, April 20 th, 2009 at 8:30AM The Flu Hits Hard

Questions and Issues  What are the priorities with respect to staff safety?  What Agency mission essential functions must be performed given this disruption?  How are staff members who have potentially been exposed to the flu treated? Are they told to stay home or made to wear a mask?  How are those who elect to stay home out of fear treated?  How are staffing levels being maintained?  Who are the primary staff and team members with responsibility for managing the departments and their essential functions? What if they are out sick?  What equipment and resources are available for your personnel to use at home?  Do your personnel have access to all necessary database, computer, and software systems from home?  How do you talk to the public?  How do you talk to the Media?

Module 3

Monday April 27 th, 2009 at 11:00AM The Next Week

Questions and Issues  What Agency mission essential functions must be performed?  How are staffing levels being maintained within your Agency for critical Mission Essential Functions?  How are staffing resources being allocated to State Agencies?  How do you keep your supply level up?  Does the fact that other Agencies are having the same staffing problems and are unable to provide all of their normal services effect your operations?  How do you communicate with your customers (the public)? What do you tell them?  What are your sick leave and general leave policies, and how does an event like this impact these policies?  What is your Agency doing to assist staff with family recovery issues?

Successful Completion

Monday, July 29 th, 2009 at 11:00AM Back in Business

Participant Evaluation Your feedback is important! Please fill out the Participant Evaluation Form in your exercise package and turn-in before leaving.

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