2019 STATEWIDE MEDICAL AND HEALTH EXERCISE

1. 2019 STATEWIDE MEDICAL AND HEALTH EXERCISE TABLETOP EXERCISE

2. EVERYONE IS PART OF THE RESPONSE • Ambulance Providers • Ambulatory Surgery Centers • Clinics • Department of Mental Health • Department of Public Health • Dialysis Centers • Emergency Management • EMS Agency • Fire • Home Health and Hospice Agencies • Hospitals • Long Term Care Facilities

3. WATER, WATER, EVERYWHERE

4. FLOODING • L.A. County has had an unusually wet season, with record rainfall. Persistent rain has caused the storm drain system to exceed normal water elevation throughout the county. • Officials are concerned that this could result in flash-flooding.

5. NOVEMBER 18, 2019 • The forecast calls for additional heavy rain over the next 72 hours • The National Weather Service issues a flash flood warning for the following counties: Los Angeles, Ventura, Santa Barbara, Orange, Riverside and San Bernardino • There is concern for mud slides in the burn areas of LA, Ventura, and Santa Barbara Counties

6. NOVEMBER 19, 2019 • Flooding has affected the roads leading in and out of the Long Beach and San Pedro ports. • Medical supplies are not being off loaded. • Supply chains are being affected throughout the County. • Public Health has issued a Public Service announcement: “Turn Around, Don’t Drown”

7. NOVEMBER 20, 2019 • Delivery drivers are unable to access your facility and you are not receiving critical shipments. • Facilities on generator power may need extra fuel but delivery may not be possible. • Staff with school aged children are reporting that they will be unable to come into work due to schools being closed and child care is unavailable.

8. NOVEMBER 21, 2019 • Floodwaters have reached some healthcare facilities and caused significant damage.

9. FLOODING CONTINUES • Large areas are without power, and some are without potable water • Residents are being rescued from flooded homes and vehicles all across LA County • Many roadways remain flooded and impassable .

10. DISCUSSION • How do you share information with staff? • What forms of redundant communication do you have? • How do you notify the DHS-DOC of your status and resource needs?

11. DISCUSSION • How do you determine critical patient/resident services versus those that could be suspended or transferred to a different facility? • How do you activate the facility’s Emergency Operations Plan (EOP), and notify all staff? • Would you consider the need for sheltering-in-place, facility lockdown, or evacuation? • Would you activate the Continuity of Operations Plans (COOP) where applicable?

12. DISCUSSION • How would you evaluate the facility and the workplace environment for any potential hazards or additional resource needs? • Who would conduct a safety briefing on PPE, psychological first aid, and other resources?

13. When would you implement the facility’s evacuation and/or relocation plans? How would you transport staff, patients/residents, and visitors? How would you provide updates to the DHS-DOC? Who would assess and report situation status, including flood damage to the facility, shelter-in-place or evacuation plans? What ICS forms would your facility use for System Status Reports? DISCUSSION

14. How would you track patients/residents? Would your facility use ICS 254 Disaster Victim Patient Tracking? How would you coordinate with your administration to address disaster behavioral health for staff, patients, and family? DISCUSSION

15. How do you track staff when they accompany evacuated patients/residents to other facilities? How do you notify family of relocated patients/residents? Does your facility have a plan for flooding? What are your plans to house staff onsite in the event they are unable to go home? Do you have continuity plans in place with key vendors to provide services/deliveries when access to the facility is limited? DISCUSSION QUESTIONS

16. QUESTIONS • Debrief questions • Identify three strengths • Identify three areas for improvement • What processes should be addressed in future efforts?