2017 Health Security Index

The 2017 National Health Security Preparedness Index has been released by the Robert Wood Johnson Foundation.  The Index provides measures of data nationally and for each state in the US across six public health domains, which include:

  1. Health security surveillance
  2. Community planning and engagement
  3. Information and incident management
  4. Healthcare delivery
  5. Countermeasure management
  6. Environmental and occupational health

The documents found on the website indicate a continued trend of improvement across the nation, but progress is slow, with some states lagging behind significantly according to the study, particularly in the deep south and mountain west regions.

The report identifies the following factors as having the greatest influence on the increase and intensity of US and global health threats:

  • Newly emerging and resurgent infectious diseases like Zika, MERS, and Ebola.
  • Growing antibiotic resistance among infectious agents.
  • Incomplete vaccination coverage.
  • Globalization in travel and trade patterns.
  • Political instability, violence and terrorism risks.
  • Aging infrastructure for transportation, housing, food, water, and energy systems.
  • Extreme weather events including storms, fires, floods, droughts, and temperature extremes.
  • Cyber-security vulnerabilities.

I think it’s important to note that while some of the factors listed above are distinctly within the public health realm, others are more universal in nature.  So not only are the findings of this study relevant to everyone, because public health is relevant to everyone, but many of the factors that influence the threats fall within areas of responsibility of broader emergency management and homeland security.

Public health matters are near the top of my list of greatest concern.  This report clearly shows that while we have made great strides in public health preparedness, we have a long way to go.  There is also no end game.  We don’t get to say we won after playing four quarters, three periods, or nine innings.  These are efforts in which we must persist, and not only with today’s tools and capabilities, but we must constantly look toward new tools.  However, as we do this, new threats will emerge.  It may seem intimidating, but it’s essential.

What are you doing to further public health preparedness capabilities?

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC

When in Doubt, Speak from Experience

Last week I had the pleasure of being invited to speak at a conference on incident management. This two-conference covered a variety of topics ranging from preparedness, response, and recovery; and while there was a lot of discussion on mass shootings, the conference covered all hazards.  There were a number of great presenters providing interesting insight and information.  Of course one of the most interesting and effective ways of learning, in public safety and other industries, is through lessons learned of actual incidents and events.  We had some detailed reviews of various incidents, including the Dallas shooting, the Aurora theater shooting, and the San Bernardino shooting.  These had extraordinary detail and discussion, driven by presenters who worked those incidents.

There was one presenter, however, who enjoyed telling stories of incidents which he had no involvement in.  Generally, most people who do such a thing have the common sense of keeping it to brief illustrative points based on specific factual information.  If someone is taking a scholarly approach, we would see more detail, but based upon their research and interviews.  This particular presenter, we’ll call him Bart (name changed), took neither approach.  He was a retired Sherriff’s deputy from a county in California.  He clearly had enough credentials to get himself invited to things, but if this was his general pattern of presenting, I’m guessing he rarely gets invited back.

Aside from his presentations not at all addressing the topic, he liked to tell stories, speaking at length about incidents and locations he has never been involved in.  He even admitted to not having any involvement, and instead citing ‘something he read’ as his source.  This would be sketchy on the surface, but it was even more frustrating when he told stories of NYC 9/11 and recent events in the National Capital Region with myself and a colleague seated at the front table… myself having worked a variety of aspects of 9/11 and my colleague who presently works in the National Capital Region.

Bart presented twice, once the first day, and again on the second day.  While we casted a couple of corrections his way on the first day, we were mostly shocked that he would venture into such territory, providing information that was at best 80% fact.  During his presentation the second morning, we were much less forgiving.  His continued anecdotes about these areas and incidents were relentless, and his lack of facts in the telling of these stories was simply unprofessional.  We called him out on it several times and it was clear from body language and general lack of interest that the room fully understood what was going on.

My general rule of thumb is to speak from experience.  Don’t tell someone else’s story.  That’s not to say you can’t speak about an incident or event you weren’t involved in, just make sure you stick to the facts and be respectful that you have ventured into someone else’s territory.  If you were involved in an incident, you may be inclined to be a bit more casual about your manner because you lived it, but if you weren’t at the incident, keep it formal, cite your fact, associate it with your point, and move on.  Don’t be Bart.

Needless to say, I had several conversations with the conference organizer, who had no prior experience with Bart and was rather appalled at his presentations.

When in doubt, speak from experience.  Don’t be Bart.

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC

Incident Management & Proper Demobilization Planning

A fair amount of courses, especially those oriented toward the Incident Command System (ICS), mention demobilization, but that mention is usually fairly gratuitous.  Even the core ICS courses generally only offer a couple of paragraphs or a handful of bullet points.  The ICS 300, since it does focus more on incident planning, does contain some good additional material, but it’s still quite brief.  Demobilization is a best practice of incident management, along with staging areas, that are rarely done properly.  It’s not a surprise, though… there isn’t a lot of emphasis on them in ICS and related training, and generally what is out there is pretty poor quality.  This has been further emphasized through nine separate functional exercises I’ve conducted over the past couple of months where it was easily identified that most participants weren’t really familiar with what demobilization meant to them and their organizations. This is no slight on them… it comes down to training.

There is certainly room for improvement when it comes to the ICS National Training Curriculum.  In case you aren’t familiar, I’ve written pretty extensively on it in the past.  And yes, I still believe that ICS Training Sucks (click here to check out a few articles I’ve written on the topic).  In regard to demobilization, much of what is out there (including the ICS curriculum and otherwise), in addition to the couple of paragraphs or handful of bullet points, also puts a lot of emphasis on the Demobilization Check-Out (ICS form 221).  By all means, STOP THAT.  Throwing another form in front of people without proper context simply serves to confuse them further.  I’m not saying we need to train everyone to be a Demobilization Unit Leader (there is a specific course for that… and it’s less than great), but shoving another form in front of someone for seven seconds doesn’t do a damn bit of good… and in fact it probably does some measure of harm – especially for building the case made by some that ICS is nothing but a bunch of bureaucracy.  We need to actually show purpose.

Largely, those bits of prose contained in courses do a decent job in explaining why we need to demobilize.  Simply put, we don’t want people and other resources standing around for hours before they are told they can go home.  Along with this is usually the book answer of when we begin to plan for demobilization – that’s as soon as we order the resource.  In reality, I’ll give that a ‘kind of’ instead of a resounding agreement.  Most of the time, no, we’re not considering that, especially at the onset of an incident.  But we do need to start considering it early on, especially when we no longer need a lot of resources at the end of the first phase of an incident.  Further down the road, we also tend to have a lot of expensive resources and teams that need to be disengaged and dismantled from our incident organization and the operating area rather carefully before they can be sent home.  These deliberate actions are another good reason for proper demobilization planning.

Demobilization planning?  Yes, planning.  NOT the ICS 221.  That form is nothing more than an accountability sheet.  It is NOT a plan.  First off, demobilization planning is a team effort.  There needs to be involvement and input across much of the command and general staff of your incident management structure (be it a formal incident management team or otherwise).  It’s a planning effort, so it should be centered within your Planning Section.  For a larger incident, certainly designate a Demobilization Unit to do coordinate this.

How do we even make this happen?  First, the concept needs to be sold to command.  They will initially say no.  Expect it.  Many Incident Commanders not well practiced in formal demobilization think that even discussion of the term must be reserved for late in the game.  It might take a couple of attempts and a need to make your case.  Demob doesn’t signal an end to the entire operation, and in fact additional resources may be flowing into the incident as others are being demobilized.  Once command is sold on it, then it needs to be discussed with the entire command and general staff.  Everyone has input.  Most of the resources belong to ops, so they should be able to identify when certain resources will complete their operations and will no longer be needed.  The logistics organization may have a fair amount of resources in place largely to support operations, therefore, as certain operations are demobilized, logistics may also be able to demobilize some of their resources.  They may also want certain things returned and accounted for, such as radios.  And if any hazardous material was present, the Medical Unit within logistics may be arranging long-term medical monitoring, which needs to become part of demobilization.  The Liaison Officer may be getting pressured by outside agencies or organizations to release resources and/or may have to explain to certain assisting agencies why their resources are no longer needed.  Finance/Administration is aware of how much certain resources are costing the responsible party, both in direct costs as well as maintenance costs.  There may be others with input as well.

As this discussion occurs, Planning/Demobilization should be keeping good notes as these comments, concerns, and priorities may become part of the demobilization plan.  The plan itself consists of five standard sections:

  1. General information – what does this plan pertain to and generally, what’s it about (it’s an overview).
  2. Responsibilities – This identifies, within the ICS structure, who is responsible for what in regard to demobilization
  3. Release Priorities – These are the agreed upon priorities identified by command and general staff.
  4. Release Procedures – This should have the most detail, starting with identification, authorization, and notification of the resource of their impending demobilization status. How far ahead of the demobilization are they advised?  Who do they have to talk to along the way?  What equipment should be returned?  Do they need to submit any reports or paperwork?  Who do they actually sign out with?  How and when do they return home?  Based on the nature of the incident, consider a mandatory overnight before they can travel, medical monitoring, and a debrief.  And always require resources to confirm that they have arrived safely back to their home station.  This, by the way, is where you reference the ICS 221 form, which will maintain accountability of the demobilization process.  Certainly customize this form to match your procedures.
  5. Reference Information – This can include travel information, contact information for key personnel (such as the Demobilization Unit Leader), maps, schedules, reminders, and other info.

Like the majority of implementations of ICS, demobilization planning is generally accomplished in the head of the IC and perhaps other staff.  That’s likely fine for more routine type 5 incidents, and even some type 4 incidents.  There may be some type 4 incidents that have enough complexity and disparity of resources, that a written plan is a good idea.  Certainly anything more complex should have a written plan.  Just as we should be writing incident action plans for planned events, demobilization plans should also be used.  If anything, it makes for good practice.  For the same argument, it’s also great for exercises (not only for the players, but also for exercise management).

Looking for a demobilization plan template?  Here’s one.  I’m not familiar with the authors, but it’s a fairly standard template for such a plan.  I’m generally wary of templates, but this is pretty basic.  If you might find yourself in the position of organizing incident demobilization for your agency or jurisdiction, save it and start modifying it now.  There are likely a set of standard priorities and procedures which you can identify now that you can include in the plan.  Be sure to have an ICS 221 that you can modify for implementation as well.  Just be sure to not ‘finalize’ either one of these… just like an IAP, they are documents developed specifically for an incident, event, or exercise.

So there you have it, a bit of demobilization planning advice from someone who is trained and experienced in actually doing it.  I hope this was helpful.  Of course I’m happy to provide some direct advice as well as happy to hear from others who are experienced themselves in demobilization.  What best practices have you identified?

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC

 

Operational Readiness – What is It?

A recent project I’ve been working on references ‘operational readiness’ as a key element of the training course.  We all know what operational readiness is, right?  We use the term all the time.  Surely, we must be able to find it defined in some key doctrine of FEMA.  Surprisingly not (and please, don’t call me Shirly).

Ah the internet… you’ll never find a more wretched hive of scum and villainy.  Searches for the definition of operational readiness reveal two different concepts.  The first is a corporate perspective on operational readiness, which focuses on an organization’s ability to do what it is supposed to do on a daily basis.  This definition also seems to be adopted by hospitals.  While tangential, the focus on daily operations isn’t really what we are looking at relative to emergency management.  The second is of military derivation.  Drawn akin to combat readiness, the definition speaks to the capability of a unit, system, or equipment to perform the function for which it was designed.  Yes, this gets a lot closer; such as operational readiness of an EOC to perform as intended when it is activated.  I find it interesting, however, that such a simple, yet powerful concept isn’t defined within our own area of practice.

Edit: A few days after publishing this article I did find a definition of operational readiness in the context of emergency management.  The source is Title 6 (Domestic Security) of the US Code § 741 (National Preparedness System).  Title 6 is essentially the codification of the Homeland Security Act of 2002.  The definition provided therein is largely akin to the definition provided previous of  military derivation, but at least we have something linked directly to emergency management.  See https://www.law.cornell.edu/uscode/text/6.  

If we examine the definitions of each word, there is a bit of redundancy.  One of the definitions of the word operational (an adjective), provided by Merriam-Webster, states ‘ready for or in condition to undertake a desired function’.  A definition provided by the same source for readiness (a noun) states ‘ready for immediate use’.  (weren’t we always taught to not use the word we were defining in the definition?).  Anyhow, this doesn’t seem particularly helpful to us.

Let’s consider what our expectations are of operational readiness in the context of emergency management and homeland security.  Fundamentally (and reinforced by what we covered in the previous paragraph), both words, operational and readiness, imply an ability to perform within defined parameters at any time.  Readiness is often seen as a synonym of preparedness, although I would suggest that in this context, readiness is achieved through preparedness.  If we don’t have each of our POETE elements in order, our state of readiness is likely to be severely diminished.

The context of the term operational readiness generally focuses on a goal we want to achieve and maintain.  We want units, systems, and equipment (reasonably drawn from the militarily-derived definition) to perform in an emergency response to accomplish intended results.  I like to emphasize a difference from the military definition in that last part.  While we have expectations of resources to perform as they were designed to, in emergency management we do on occasion call upon resources (units, systems, and equipment) to perform, not necessarily as they were designed or originally intended, but in creative ways, either pre-planned or ad-hoc.  I think that our definition of operational readiness must leave room for innovation – which is application (and thus readiness) at a higher taxonomy level.

All that aside, I’m not intending to create a definition for the term here, but largely wanted to raise awareness of the lack of a definition within our own area of practice and provide some consideration for what we expect the term to mean through our regular usage.  There is certainly discussion that can be had on measuring operational readiness, which is a separate topic that I’ve largely explored (although not using that particular phrasing) through posts on preparedness and POETE assessments (see the previous link provided).

What thoughts do you have on operational readiness as a term and a concept? Have you come across a definition in emergency management or homeland security doctrine that I might have missed?

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC

ARFF Supports I-85 Fire

Great image from Fox 5 Atlanta, showing ARFF engines from Hartsfield-Jackson Atlanta International Airport assisting with the I-85 fire in Atlanta.  From what I’ve read, these resources are credited with containing the fire by use of fire suppression foam.  Airports can provide a variety of resources to the communities they are in. Joint preparedness activities can strengthen these relationships.

A New Standard for Emergency Management Programs

Over two years ago I wrote on the two primary standards for emergency management programs in the United States – the Emergency Management Accreditation Program (EMAP) and the National Fire Protection Association (NFPA) 1600: Standard on Disaster/Emergency Management and Business Continuity Programs.  These two standards are voluntary in their adoption and provide common sense guidelines on proven effectiveness and best practices for emergency management programs.  EMAP goes the additional step in offering accreditation for jurisdictions and/or programs based upon compliance with their standards.

Recently, New York’s Governor Cuomo announced what is apparently the nation’s first state-coordinated local emergency management accreditation program.  New York’s program is based upon 21 standards, created and maintained by a committee co-chaired by the NYS Emergency Management Association and the NYS Office of Emergency Management.  The accreditation process identified by NYS’ program guidance is fairly similar to EMAP’s, with application, preparation, a site visit, and committee review.

On the plus side, New York’s system is a further encouragement of the use and application of standards and has enough similarity to EMAP which puts the two accreditations on a close enough path that a jurisdiction can pursue both with little deviation.  The processes of preparation, an on-site review, and final accreditation council review are very similar. Further, agencies accredited through the New York State program are granted the ability to display the accreditation program logo, similar to EMAP, as a matter of pride and recognition.  New York’s system also requires a periodic reaccreditation, which encourages jurisdictions to maintain their accreditation standards.

Where New York’s program differs from EMAP…

  • EMAP accreditation is available to any entity, whereas New York’s appears to be specifically designed for local/county emergency management offices, although it does acknowledge the need for a whole community approach to emergency management
  • EMAP standards identify what components must be in place, not the means and methods used to accomplish those components. This is a significant difference from New York State’s program, which rather heavy handedly dictates means and methods, including mandatory completion of New York State’s emergency management and certification training by key staff, completion of the State’s County Emergency Preparedness Assessment (CEPA) program, and active use of the NY Responds system.  While fundamentally, I agree with promoting these as standards across the state, requiring them for accreditation can lead to a stagnated or stalled program if better training or systems are made available and the standard is not able to be kept current.  Required means and methods also stall innovation, which is another reason by NFPA 1600 and EMAP shy away from this practice.  That said, the aforementioned means and methods are the standard of practice in New York State, so this is a good opportunity to reinforce use of those standards.

New York’s new standard provides a solid exploration into the new territory of state-coordinated accreditation.  I’m a big proponent of states’ rights, and firmly believe this to be a good practice, especially when such accreditations reflect the principles of nationally recognized standards such as EMAP and NFPA 1600.  I don’t view New York’s system as being competitive with EMAP, rather it is quite complimentary.  With additional interests in standards, I’m hopeful that all standards will remain contemporary and cutting edge, constantly encouraging excellence and striving for improvements.

As always, I’m interested in your thoughts on state-coordinated accreditation and emergency management standards in general.

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC

Thinking Beyond the Active Shooter

While there is obviously a great deal of attention placed on preparing for, preventing, and responding to active shooter events, is that where the focus really needs to be?  Yes, active shooter incidents are devastating, but they aren’t taking into consideration the full potential of we might be facing.  The DHS definition of ‘active shooter’ actually allows room for additional potential, but the term is still misleading and indicates the presence of only one perpetrator.  (DHS definition: “Active shooter is an individual actively engaging in killing or attempting to kill people in a confined and populated area.”)

First, let’s consider that more than one person could be perpetrating the incident.  Second, let’s consider that the perpetrator/perpetrators might be using something other than or in addition to firearms.  This could include edged weapons, blunt weapons, improvised explosives, or other threats.  Third, let’s consider an increased complexity, including synchronized attacks conducted by one or more independent teams occurring at multiple locations sequentially or in close succession.

To address these potentials, we’ve heard the terms ‘Active Assailant’, which certainly addresses individual(s) using any form of weapon(s) in their attack methodology.  This can also address the more highly complex incident type, which is commonly referred to as a ‘Complex Coordinated Attack’ or ‘Complex Coordinated Terrorist Attack’.  In essence, we are talking about the same conceptual incident, with varying complexity.  But what’s the difference?

The difference is that we should be preparing for a credible worst-case scenario.  While a single shooter is more likely to occur in most places, we’ve seen incidents of knife attacks such as those in recent months in London and Japan.  We’ve also seen motor vehicle attacks in Berlin and NiceThe Columbine High School attack involved firearms, knives, and improvised explosive devices, although the latter weren’t successfully detonated.  For their own reasons, none of these seem to match up with the impression most have with the term ‘Active Shooter’.  ‘Active Assailant’ might be better a better term generally for these kinds of incidents.   More specifically, by current standards, Columbine would likely meet the definition of ‘Complex Coordinated Attack’.  A complex coordinated attack doesn’t necessarily require a high value target or an international terrorist group to perpetrate.

When a jurisdiction plans for a flood, they generally don’t prepare for a couple of road washouts that might occur with a hard rain storm.  They should be preparing for the sudden destructive power of flash floods and the slower but equally devastating potential of areal flooding.   If the jurisdiction is prepared for the credible worst-case scenario, their preparations should be able to address flooding of a lower magnitude.  I’d argue the same for the range of active assailant incidents.  Active shooter incidents are one specific type of active assailant incident, but are not what our preparedness activities should be focused on, as these kinds of incidents can be much more complex and devastating.  Preparedness efforts should, instead, focus on the complex coordinated attack, which is arguably the most multifaceted and impactful type of this incident.  Preparing for the credible worst-case scenario will help ensure our preparedness across the entire spectrum of this kind of incident.

As always, feedback is appreciated.

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC