An Active Shooter/Complex Attack TTX Template
This tabletop exercise template focuses on testing the response plan for an active shooter or complex attack incident, involving various emergency response partners. Participants will discuss and evaluate their coordination and communication abilities in such scenarios.
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Presentation Transcript
An Active Shooter/Complex Attack TTX Template For local Health Departments and their emergency response partners December 2015
Welcome and Introductions Introductions Name Position and agency
Purpose Today we will be conducting a tabletop exercise to test the health district s plan for an active shooter/complex attack incident. Discussions will allow for an assessment of the participants knowledge of the district plan and evaluate one s skills and abilities to effectively coordinate and communicate activities in such an incident.
Participants Health District Hospital Regional Healthcare Coordination Center Law Enforcement Fire/EMS Local Emergency Management Local Community Services Board (behavioral health) Representative from OCME district
Exercise Objectives Discuss the plans of Health Department and hospital/emergency partners to coordinate an emergency response involving an active shooter/complex attack Examine the ability of Health Department and its hospital/emergency response partners to share critical information in an incident that involves an active shooter/complex attack
Exercise Capabilities CORE CAPABILITIES Planning, Community Resilience Situational Assessment, Intelligence, and Information Sharing Communications Operational Coordination PHEP CAPABILITIES Community Preparedness Information Sharing HPP CAPABILITIES Healthcare System Preparedness Information Sharing Communications Emergency Operations Coordination Communications Emergency Operations Coordination
Exercise Guidelines Low stress, no fault environment There are no trick questions and no hidden agenda Respond to the scenario using your knowledge of current plans and capabilities. Treat the scenario as if it is real; don t fight it
Agenda Welcome/Introduction .15 minutes Module 1 Initial Incident .30 minutes Module 2 Response to Incident ..30 minutes Break .15 minutes Module 3 Secondary Incident/ Response .. .45 minutes Module 4 Conclusion ... ...30 minutes Debrief ....30 minutes
Logistics Breaks Restrooms Please silence phones and pages Emergency exits
Roles Players - Players are personnel who have an active role in discussing or performing their regular roles and responsibilities during the exercise. Players discuss or initiate actions in response to the simulated emergency. Observers - Observers do not directly participate in the exercise. However, they may support the development of player responses to the situation during the discussion by asking relevant questions or providing subject matter expertise. Facilitators - Facilitators provide situation updates and moderate discussions. They also provide additional information or resolve questions as required. Key Exercise Planning Team members also may assist with facilitation as subject matter experts (SMEs) during the exercise.
Roles contd Evaluators - Evaluators are assigned to observe and document certain objectives during the exercise. Their primary role is to document player discussions, including how and if those discussions conform to plans, polices, and procedures. Scribes Scribes take notes of what is discussed during the exercise; these notes provide the recordkeeping of what transpired at the tabletop.
Initial Incident Scenario -December 14, 2015 1:30 p.m. The local health department is holding the following walk-in services today: Pregnancy testing Sexually Transmitted Infections services Communicable Disease services (Testing/counseling TB and HIV patients) A walk in Influenza Vaccination Clinic WIC services are also on-going.
Initial Incident Scenario contd At this time there are 30 patients and 24 employees in the clinical and waiting areas as well as the eligibility offices. Also, on the first floor, there are 3 in Records 6 total in other offices On the second floor, where the administrative and environmental health offices are, there are a total of 25 employees working in their offices.
Initial Incident Scenario contd Suddenly, a masked person bursts into the waiting and clinical areas, randomly shooting at people. Everyone begins to scatter. The popping noise of the gun fire alerts the other employees in the building.
Module 1 Questions LOCAL HEALTH DEPARTMENT What action should be taken by The employees and patients in the clinical/waiting areas? Employees and patients in the eligibility offices? The other employees upstairs? the Health Director? Not knowing what has happened, what is the LHD plan/policy for notifying which of the following and how will the notification be provided o Police o EMS o Local Emergency Management o The Offices of Emergency Preparedness (OEP) and Community Health Services o Local Community Services Board/Behavioral Health What tactical communications are available at the health department? What are considered back up communications should phones and laptops be unavailable or inoperable?
Module 2 Response to Initial Incident
Response to Initial Incident The employees who are in offices downstairs protect themselves by hiding under their desks or barricading their doors. . Nine employees who were upstairs are able to escape unseen by going down the back stairs of the building. One of these employees, using his mobile phone, calls 911 to report the incident
Response to Initial Incident contd December 14, 2:30 p.m. Local law enforcement and EMS respond to the scene. After a thorough search of the building and its environs, they find 30 injured and 5 dead, but no sign of the shooter.
Module 2 Questions LOCAL HEALTH DEPARTMENT Does the Health Department have a plan for handling an active shooter/complex attacks? How has law enforcement assisted in the plan development and/or reviewed the plan? At what point would you activate the HDOC or District Emergency Coordination Center for this incident? Who is notified of this action? What is the district plan/policy in providing situational awareness in a situation as this? Explain the district plan/policy in obtaining behavioral health assistance for this type of incident.
Module 2 Questions contd LAW ENFORCEMENT What recommendations would you give survivors at the health department? What are contact notifications you make per your plans? For instance, do you notify local emergency management? LOCAL EMERGENCY MEDICAL SERVICES How large should the incident be to request additional resources? LOCAL EMERGENCY MANAGEMENT Who should be responsible for notifying your office? Would the EOC be activated for an incident like this? If not, what would be the trigger to activate opening the EOC?
Module 2 Questions contd OCME Would the district office of the OCME notified? If so, who notifies the office and how? COMMUNITY SERVICES BOARD/BEHAVIORAL HEALTH Describe your plans/policies to assist in incidents like this
Module 3 Secondary Incident/Response
Secondary Incident/Response December 14, 2015 At 2 pm, as hospital employees are returning from their lunch, a bundle of 3 pipe bombs detonates in the parking lot adjacent to the loading dock of <fill in name of hospital>. The blast has resulted in 45 casualties with explosive-related injuries (blunt force trauma, hemorrhaging, burns) and 16 fatalities.
Module 3 Questions HOSPITAL What is the plan/policy of your facility for providing situational awareness of an incident like this and to whom? Given part of the hospital physical plant and a number of employees are out of commission, what is the plan/policy for requesting additional personnel/resources/diversion? EMERGENCY MANAGEMENT Would the EOC be activated at this point if it had not been already? At what level would it be activated? What are the plans/policies that govern consideration to be given in establishing a Family Assistance Center?
Module 3 Questions contd OCME Explain the plan/policy for handling incidents that include more than ten fatalities? What is the policy regarding situational awareness when mass fatalities are involved? EMERGENCY MEDICAL SERVICES What is the trigger that indicates you need additional resources to respond to this incident concurrently with the Health Department incident? What is your plan/policy for requesting additional resources to assist in these 2 incidents?
Module 3 Questions contd LAW ENFORCEMENT What would be the role of law enforcement in this situation? How is this role balanced against what is going on at the Health Department? HEALTH DEPARTMENT What are plans/policies for providing situational awareness of this and the on-going shooter incident? Would your HDOC or ECC remain open or be activated? REGIONAL HEALTHCARE COORDINATOR What would your role be at this point?
Module 4 - Conclusion At the Health Department, witnesses provide a description of the assailant. Several witnesses and survivors provide a description of a vehicle they thought was suspicious as well as a license plate number that was seen in the hospital parking lot earlier. The officer sees a vehicle matching the description of the one seen in the hospital parking lot. She also notices that the driver is driving erratically. Calling for back up, she begins to slowly follow the car, but the driver begins speeding away. Soon, the vehicle reaches an intersection which is blocked by other police cars. Unable to escape, gun fire is exchanged and the driver is killed. A quick search of the car results in finding a list containing businesses and facilities to attack; one of the places was the Health Department because they wouldn t let him know if his daughter was on birth control and another was the hospital, because they conducted medical procedures on his daughter that he felt were inappropriate.
Module 4 Questions What actions will be taken at this point by Law Enforcement Hospital Local Health District Regional Healthcare Coordinator Emergency Medical Services District Office of the Chief Medical Examiner Local Emergency Management Community Services Board/Behavioral Health
Debrief Share as much as possible Don t assign blame; offer solutions Be respectful of others what they share Please let 1 person speak at a time Provide what went well and areas in need of improvement; include proposed solutions Following the hotwash, we will hone down to the top 3 for each area What have you learned during this tabletop exercise?
HOTWASH Areas in need of improvement 1. What went well 1. 2. 2. 3. 3.
Thank you for your participation
