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Pol. No.
Section
9.0
Type
Training and
Exercises
Policy
Training and Exercise Policy
Approval
Preparedness
Effective Date
Revised Date
Attachment
9.0.1 Purpose
The purpose of this policy is to outline the health center’s commitment to the training of
the health center staff and to the exercising of all the plans contained herein.
9.0.2 Policy
It is the policy of the health center to establish an employee training and competency
program for the training of health center staff on all emergency management policies and
procedures contained herein. The training program will be based on established procedure
as well as data collected from the frequent exercising of the plans contained in this manual.
The exercise program of this health center will be based on the Homeland Security
Exercise and Evaluation Program (HSEEP). It is recommended that all health center
leadership and emergency preparedness coordinators take HSEEP training to better
establish a multi-year training and exercise program that will adequately test our
capabilities, plans, and procedures.
9.0.3 Multi-Year Training and Exercise Plan
This health center will enter into a multi-year training and exercise program. This program
will begin by testing specific capabilities rather than testing plans based on threats. The
training and exercise cycle emphasizes training staff on the capabilities of the health center,
testing these capabilities, evaluating the test, improving the shortfalls, and re-training the
staff on any changes that occur as a result of the test. Upon completion of the cycle, the
health center will repeat the test to continually improve its ability to respond to a disaster.
The HSEEP cycle is a continuous cycle of training, exercising, and development that will
strengthen the health center’s plans and improve the quality and performance of health
center capabilities and services.
This health center is committed to maintaining the highest quality care and services it can
offer to its community. In order to accomplish this, it will exercise its plans, exercise its
plans with its community partners, integrate its capabilities with those of its partners, and
exercise together to establish relationships, improve resource and intelligence sharing, and
ultimately improve its response to the community.
9.0.4 Annual Exercise Policy
It is the policy of this health center to perform an exercise at least once per year.
According to the Joint Commission (JC), all ambulatory health centers should perform at
least one exercise annually. However, the JC guidelines stipulate that if health centers are
designated emergency receiving facilities or are designated by any city, state, or federal
agency as a disaster receiving facility, they must design and perform at least one exercise
with patient influx. Although this regulation is open to interpretation based on the
capabilities and functions of health centers in general, and although this health center is
NEITHER a designated emergency 911 receiving facility, NOR a disaster receiving
facility, it will perform patient influx exercises. Since this health center does receive
patients with emergent conditions from time to time, it is in the best interest of this facility
to exercise these cases and its capabilities with regards to treating these patients.
This health center will therefore perform multiple exercises annually culminating into an
influx exercise. It will coordinate and integrate with its community partners to perform
exercises that will benefit the health center’s response to the community and strengthen
community response plans. It will integrate all lessons learned into its own plan as well as
share them with community partners to improve the community’s overall response to
emergencies and disasters.
9.0.5 Exercise Program Development
The Homeland Security Presidential Directive 8, enacted in 2003 established national
policies to strengthen preparedness and capabilities. In 2002, the National Strategy for
Homeland Security established the National Exercise Program (NEP). Together these
programs helped strengthen preparedness and worked together to achieve the national
preparedness goal to sustain capabilities. While the program was initially targeted toward
terrorist attacks, it now also works in all areas of response and recovery.
It is the policy of the health center to establish an exercise program to test all capabilities,
response, and recovery activities. Furthermore, it is the policy of this health center to learn
from these exercises to improve its plans, capabilities, and ultimately better serve its
patients and community.
To begin, establish a basic program by outlining the list of capabilities that pertain to the
health center. A capability is a function of the health center and what a health center can
do or accomplish during an emergency. The following is a list of the Target Capabilities
that have been developed by the HSEEP Program compared to health center functions:
HSEEP
Target
Capability
Area
Common
Target
Capabilities
HSEEP Target
Capabilities
Health Center
Capability
Health Center Example of the
Capability
The ability of the health center to
create a plan to mitigate a hazard.
Risk Management
Planning for
Preparedness,
Mitigation, Response,
and Recovery
The ability of the health
center to communicate
with other responders.
Using community
resources during an
emergency.
Mitigating Hazards
Information Gathering
and Recognition of
Indicators and
Warnings
The use of the Health
Alert Network or the
Health Commerce
System.
The Sentinel Program detects
clusters of emerging disease in a
community.
Planning
Communications
Citizen Preparedness
and Participation
Testing the ability of the health
center to communicate effectively
with partners.
Testing the use of CERT to assist
the health center operate during an
emergency.
The ability of the mitigation
committee to identify and address
hazards to improve response. An
example is to maintain the
generator.
Preventative
Mission Area
Target
Capabilities
Intelligence Analysis
and Production
The ability of the health
center to gather
information and
maintain a situational
awareness.
The ability of the health
center to gather
information and share
best practices to deal
with an issue.
The ability of a health
center to identify an
incident and respond to
that incident.
The ability to process, plan and
act around information about a
disaster that affects the health
center.
The ability of a health
center to conduct an
investigation on a new
pathogen.
The ability of a health
center to conduct
investigations into a
new pathogen by
offering testing to the
community.
The investigation into tracing back
to an index case and sharing that
with public health.
Citizen Protection:
Evacuation and Shelter
in Place
The ability of a health
center to assist public
officials in protecting
patients by assisting in
an evacuation or
assisting in sheltering
patients in place.
The health center helping public
officials and hospitals by assisting
in an area evacuation during a
coastal storm.
Critical Resource
Logistics and
Distribution
The ability of a health
center to quickly
receive a supply and
distribute that among
The ability of a health center to
give out emergency supplies to the
public quickly or to distribute it
among its partners.
Intelligence and
Information Sharing
and Dissemination
Chemical, Biological,
Radiological, Nuclear,
and High-Yield
Explosives Detection.
The dissemination of information
about a particular public health
issue.
The ability of a health center to
identify potentially contaminated
patients and exercise an isolation
protocol.
Protection
Mission Area
Target
Capabilities
Epidemiological
Surveillance and
Investigation.
Public Health
Laboratory Testing
H1N1 testing at health centers.
Response
Mission Area
Target
Capabilities
Emergency Public
Information and
Warning
Environmental Health
Emergency Operations
Center Management
Fatality Management
Isolation and
Quarantine
Mass Prophylaxis
Medical Supplies
Management and
Distribution
Medical Surge
the community.
The ability of a health
center to communicate
with its community
The ability of the health
center to conduct
environmental health
services during a
disaster.
The ability of a health
center to establish and
manage an EOC.
The ability of the health
center to manage mass
fatalities.
The ability of the health
center to perform
isolation and quarantine
services.
The ability of a health
center to issue
prophylaxis to the
public.
The ability of the health
center to receive
supplies and distribute
them to the community
The ability of the health
center to receive large
numbers of patients and
increase its ability to
treat them.
Issuing public statements and
communicating with patients
about an emerging pathogen.
Assisting 9/11 responders with
breathing problems.
Operating an EOC to manage an
emergency.
The ability of the health center to
operate a temporary morgue and
communicate with the medical
examiner to manage fatalities.
The ability of the health center to
isolate patients and maintain them
apart from a healthy population.
The ability of a health center to
establish a POD and vaccinate the
community.
The health center receives KCl to
give to its patients.
The ability of the health center to
activate its staff and increase the
ability to absorb and treat large
numbers of patients.
9.0.6 Exercise Program Management
It will be the responsibility of the Emergency Management Committee, headed by the
Emergency Preparedness Coordinator, to manage the training and exercise program and
plan. It will also be the responsibility of the Emergency Management Committee to
evaluate all exercises, develop all emergency management training curricula, and to
provide training to all health center employees.
According to HSEEP, the following steps should be followed with regards to developing an
exercise program:
1. Define and assess the capabilities of the health center. Make sure that the health center
provides for capabilities that can handle a wide range of threats.
2. Begin planning based on the health center’s capabilities.
3. Produce an emergency management plan that addresses all areas of the health center’s
functions.
4. Train employees on the plan.
5. Test those plans by developing exercises.
6. Evaluate performance.
7. Incorporate lessons learned into the program.
8. Retrain staff on the changes to the plan.
9. Re-evaluate those plans.