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Health Center Logo 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.