After Action Report Improvement Plan Dreadful Droplets A Pneumonic Plague Outbreak Response Tabletop Exercise March 13, 2015 Florida Department of Health in Volusia County 1 Page
ADMINISTRATIVE HANDLING INSTRUCTIONS 1. The title of this document is The "Dreadful Droplets - A Pneumonic Plague Outbreak Response Exercise" After Action Report. 2. The information gathered in this AAR/IP is classified as For Official Use Only (FOUO) and should be handled as sensitive information not to be disclosed. This document should be safeguarded, handled, transmitted, and stored in accordance with appropriate security directives. 3. At a minimum, the attached materials will be disseminated only on a need-to-know basis and when unattended, will be stored in a locked container or area offering sufficient protection against theft, compromise, inadvertent access, and unauthorized disclosure. 4. Points of Contact: Health Department: Melanie Black Public Health Preparedness Planner, MSW Florida Department of Health in Volusia County 1845 Holsonback Drive Daytona Beach, Florida 32117 (Office) 386-274-0576 (E-Mail) melanie.black@flhealth.gov Exercise Director: Chris Floyd Disaster Resistant Communities Group LLC 6224 Wake Robin Lane Tallahassee Florida 32309 (Office) 850-241-3565 (E-Mail) chrisfloyd@drc-group.com 2 Page
CONTENTS ADMINISTRATIVE HANDLING INSTRUCTIONS... 2 CONTENTS... 3 EXECUTIVE SUMMARY... 4 SECTION 1: EXERCISE OVERVIEW... 5 Exercise Details... 5 Participant Information... 5 SECTION 2: EXERCISE DESIGN SUMMARY... 6 Exercise Purpose and Design... 6 Exercise Objectives, Capabilities and Activities... 6 Scenario Summary... 6 SECTION 3: ANALYSIS OF CAPABILITIES... 8 SECTION 4: CONCLUSION... 17 APPENDIX A: IMPROVEMENT PLAN... 18 APPENDIX B: PARTICIPANT FEEDBACK (Strengths Areas for Improvement)... 20 APPENDIX C: ACRONYMS... 25 3 Page
EXECUTIVE SUMMARY Dreadful Droplets - A Pneumonic Plague Outbreak Response Exercise was designed and facilitated as an opportunity for the management and staff of the health department to assess its ability to maintain operations while meeting the health needs of county residents during a potential Pneumonic threat. The purpose of this report is to analyze exercise results, identify strengths to be maintained and built upon, identify potential areas for further improvement, and support development of corrective actions. Incorporated in Section 3: Analysis of Capabilities of this After Action Report is a comprehensive listing of each Core Capability with its associated Major Strengths, Primary Areas for Improvement and Improvement 4 Page
Exercise Details SECTION 1: EXERCISE OVERVIEW Exercise Name: Type of Exercise: Dreadful Droplets - A Pneumonic Plague Outbreak Response Exercise Tabletop Exercise Start Date: March 13, 2015 Duration: Location: Sponsor: Three Hours Daytona Beach Florida Florida Department of Health in Volusia County Purpose: The exercise was designed and facilitated as an opportunity for the management and staff of the health department to assess its ability to maintain operations while meeting the health needs of county residents during a potential Pneumonic threat. Scenario Type: Potential Pneumonic Threat Participant Information Participant Location American Red Cross Embry-Riddle Aeronautical University Federal Bureau of Investigation Florida Department of Health Children s Medical Services Florida Department of Health in Volusia County Florida Division of Emergency Management Health Start Coalition of Flagler / Volusia Counties Inc Volusia County EMS / EVAC Volusia County Fire Service Number of Participants 37 5 Page
SECTION 2: EXERCISE DESIGN SUMMARY Exercise Purpose and Design The exercise was designed and facilitated as an opportunity for the management and staff of the health department to assess its ability to maintain operations while meeting the health needs of county residents during a potential Pneumonic threat. Exercise Objectives, Capabilities and Activities Capabilities-based planning allows for the exercise planning team to develop exercise objectives and observe exercise outcomes through a framework of specific action items that were derived from the Core Capabilities List. The capabilities listed below form the foundation for the organization of all objectives and observations in this exercise. Additionally, each capability is linked to several corresponding activities and tasks to provide additional detail. Based upon the identified exercise objectives below, the exercise planning team decided to demonstrate the following capabilities during this exercise: Continuity of Operations Implementation / Coordination / Demobilization Objective Objective # 1 Objective # 2 Objective # 3 Objective # 4 Core Capability Responder Safety and Health Emergency Operations Coordination Information Sharing Emergency Public Information and Warning Scenario Summary Monday Day 1 4:39PM The Florida Department of Health in Lake County (FDOH-Lake) has just contacted the Florida Department of Health in Volusia County (FDOH-Volusia) with information regarding two suspected cases of Pneumonic Plague found in a 49 year old female and a 19 year old male both of whom are currently in Lake County. Further talks with the FDOH-Lake revealed that the two suspect cases are mother and son and are both involved in an animal rescue agency in Trinidad Colorado. Both had prolonged contact with a cat that was sickly which subsequently died and was diagnosed with Pneumonic Plague post-mortem. 6 Page
The mother and son both had tickets for the Daytona 500 and flew to Orlando on Saturday as they felt fine. Both developed mild Upper Respiratory Tract Infection (URI) symptoms during Sunday s race, however, they decided to drive back to their Lake County hotel as they were scheduled to fly out of Orlando early Monday afternoon. On Monday morning both were feeling significantly worse and decided to go to an Emergency Department (ED) at one of Lake County s hospitals. Sputum samples that were taken for culture showed gram negative cocco-bacilli and the astute hospital clinician recognized this could be Pneumonic Plague. Both were admitted to the hospital and started on antibiotics. The hospital then contacted the FDOH-Lake. The FDOH-Lake was short staffed and the Epidemiology Department did not get the message until mid-afternoon whereupon they contacted the hospital and were able to interview one of the patients (the other was intubated and on a ventilator). Upon learning they had been at the Daytona 500 they contacted the FDOH-Volusia. The FBI was also alerted as Pneumonic Plague is a reportable disease. 7 Page
SECTION 3: ANALYSIS OF CAPABILITIES Continuity of Operations Implementation / Coordination / Demobilization Performance Adequate Core Capability Objective # 1: Responder Safety and Health Associated Critical Tasks Function # 1.1: Identify responder safety and health risks. Needs Improvement Evaluator # 1 Exercise participants did not initially know whether the mandatory reportable disease was actually reported to FDOH by FOH-Lake. Just to ensure the disease was reported to FDOH as required by law, DOH-Volusia reluctantly reported the situation. Another reason FDOH-Volusia reported the situation to FDOH was that wanted guidance on what to do and how to handle the situation. Approach on what to do by FDOH-Volusia was overly cautious; thinking that there were no actual cases of the disease in Volusia County only suspect cases at this time. FDOH-Volusia senior staff should have been more pro-active; assemble and brief the Volusia County policy group or senior administrators from each county supporting agency. Assemble and brief the DOH-Volusia staff; provide situational awareness so staff at the very least can prepare the families, activate their family disaster plan. Send periodic updated through Everbridge / SERVFL notification system to FDOH-Volusia staff and supporting community agencies and partners. Knowledge is power; with current confirmed cases of the disease in an adjoining county FDOH-Volusia senior staff should have begun pre-planning, pre-positioning of resources, put specialty staff on stand-by. Liaison with all hospitals in the area, especially their infection control practitioners. 8 Page
Adequate Evaluator # 2 Participants discussed the need to identify and test responders who contacted infected patients early in the discussion. Communications and information sharing between FDOH- Volusia and their ESF-8 partners was reinforced and the need to utilize personal protective equipment was emphasized. There was no discussion of prophylaxing responders pending laboratory results who were in contact with infected individuals. Function # 1.2: Identify safety and personal protection needs. Needs Improvement Evaluator # 1 Lots of discussion between exercise participants but no hard, fast decisions on what to do first; staff tele-commuting was recommended for those staff that could. Social distancing was recommended but without guidance. Recommended to issue PPE to front line or client contact staff but there was no mention of any refresher training to staff; how to don and doff PPE, or any other guidance to ensure the PPE worn was effective. Brief, prepare and train staff in the response and recovery operations and actions needed when dealing or confronted with Pneumonic Plague. Training staff on PPE use, donning and doffing techniques. Keep staff informed; situational updates. Adequate Evaluator # 2 Participants discussed the need to identify and test responders who contacted infected patients early in the discussion. Communications and information sharing between FDOH- Volusia and their ESF-8 partners was reinforced and the need to utilize personal protective equipment was emphasized There was no discussion of prophylaxing responders pending laboratory results who were in contact with infected individuals. Performance Core Capability Adequate Objective # 2: Emergency Operations Coordination 9 Page
Associated Critical Tasks Function # 2.1: Activate public health emergency operations. Needs Improvement Evaluator # 1 Recommended to contact FDOH-Volusia senior leadership team. Activate FDOH-Volusia COOP. Lack of decision-making; no one wanted to recommend any kind of activation until they were sure that the threat was imminent. Empower department managers to determine level of threat or incident and be able to initiate preparedness and initial response actions, and to develop incident objectives (IAP). Maintain continuous contact with the hospitals and walk-in clinics. Adequate Evaluator # 2 The importance of engaging partners early and the need to have regular situational briefings was discussed between all of the participants. Involving County Emergency Management as a conduit for information and coordination in cooperation with the FDOH- Volusia was discussed. FDOH-Volusia management and epidemiology staff coordination with FDOH emphasized. None Function # 2.2: Develop incident response strategy. Adequate Evaluator # 1 Activate the DOH-Volusia COOP but only because of excessive absenteeism (Day 3), not because of the disease threat. FDOH-Volusia staff did not determine what their essential functions were until prompted; it was suggested that each department or program manager would determine their essential functions. This should have already been accomplished well in advance; it should be standard operating procedure for each department to have its own COOP. 10 Page
Staff determined essential functions in priority order; Epidemiology, HIV Clinic, WIC, Vital Statistics and Environmental Health inspections. Many of these department functions can be accomplished remotely or electronically. Each department or program should have its own department COOP; micro version of the FDOH-Volusia COOP. FDOH-Volusia COOP should take priority over other community or outreach activities less supporting agency situational awareness and responder health and safety. Senior leadership involvement (most likely in real world scenario), but lack of decision-making and decision finality hampered the response strategy process and outcomes. Adequate Evaluator # 2 The need for regular senior leadership meetings / situational briefings emphasized with implementation of an Incident Command System command structure in coordination with ESF-8 partners and local Emergency Management. None Function # 2.3: Manage and sustain the public health response. Needs Improvement Evaluator # 1 FDOH-Volusia eventually determined that ESF-8 Health and Medical would be the lead county agency in response to the threat, although no one wanted to call it Pneumonic Plague for fear of triggering panic. Reluctantly contacted Volusia County Office of Emergency Management and requested Level 2 activation but did not list or consult with Volusia County of what supporting ESFs or agencies would be activated. Have the Volusia County Board of County Commissioners draft, if not issue at this time, a local state of emergency declaration. Begin cross-training staff to fill essential function roles and responsibilities. Request assistance, or at least begin the process of requesting assistance, from the FDOH and state; EPI Strike Teams, EH Strike Teams. Provide guidance to hospitals and walk-in clinics on what to do if plague suspected. 11 Page
Adequate Evaluator # 2 The need for regular senior leadership meetings / situational briefings emphasized with implementation of an Incident Command System command structure in coordination with ESF-8 partners and local and state Emergency Management. None Function # 2.4: Demobilize and evaluate public health emergency operations. Adequate Evaluator # 1 Return to normalcy as the incident or the situation improves locally. Incident did not finalize therefore unsure of how it would end so recovery operations were not discussed. Refer to demobilization guidance from FDOH, FDEM and local emergency management. Adequate Evaluator # 2 None None Performance Adequate Core Capability Objective # 3: Information Sharing Associated Critical Tasks Function # 3.1: Identify stakeholders to be incorporated into the information flow. Adequate Evaluator # 1 Initial response concerning possibility of Pneumonic Plague in Volusia County was to hush it up and keep it quiet because the FDOH-Volusia staff was not convinced it was plague; thought it might be severe cases of H3N2 influenza. A major concern was that if the news got out of plague in the county is what we could do to minimize the damage how we would pursue "damage control". No observable notifications were given to supporting community 12 Page
agencies except those involved at the exercise table. FDOH-Volusia senior staff should have been more pro-active; assemble and brief the Volusia County policy group or senior administrators from each county supporting agency. Assemble and brief the FDOH-Volusia staff; provide situational awareness so staff at the very least can prepare the families, activate their family disaster plan. Send periodic updated through Everbridge / SERVFL notification system to FDOH-Volusia staff and supporting community agencies and partners. Knowledge is power; with current confirmed cases of the disease in an adjoining county FDOH-Volusia senior staff should have begun pre-planning, pre-positioning of resources, put specialty staff on stand-by. Strong Evaluator # 2 Great understanding of the entire spectrum of ESF-8 partners, and outside entities that will need to be kept in the situational awareness and decision making loop. None Function # 3.2: Exchange information to determine a common operating picture. Needs Improvement Evaluator # 1 Recommended FDOH initiate Director / Administrator conference calls daily similar to the Ebola Virus Disease response. Develop Public Service Announcements (PSAs) concerning influenza. Utilize all Social Media sites to deliver PSAs. Post PSAs on FDOH-Volusia website. FDOH-Volusia senior staff should have been more pro-active; assemble and brief the Volusia County policy group or senior administrators from each county supporting agency. Assemble and brief the FOH-Volusia staff; provide situational awareness so staff at the very least can prepare the families, activate their family disaster plan. Send periodic updated through Everbridge / SERVFL notification system to FDOH-Volusia staff and supporting community agencies and partners. 13 Page
Knowledge is power; with current confirmed cases of the disease in an adjoining county FDOH-Volusia senior staff should have begun pre-planning, pre-positioning of resources, put specialty staff on stand-by. Adequate Evaluator # 2 Participants discussed need for regular situational awareness briefings between public health and ESF-8 partners and the sharing of information to provide all parties with a common operating picture. None Performance Needs Improvement Core Capability Objective # 4: Emergency Public Information and Warning Associated Critical Tasks Function # 4.1: Activate the emergency public information system. Needs Improvement Evaluator # 1 FDOH-Volusia eventually determined that the local or county Joint Information Center (JIC) should be activated. Set-up a FDOH-Volusia call center or brief and provide talking points to 911 call center operators on what to do and who to call if plague suspected. Televise FDOH-Volusia Medical Director; provide face to face assurances to the community. Adequate Evaluator # 2 The participants discussed the need to engage local JIC / agency PIOs as well as the DOH's Office of Communications in the preparation and dissemination of a common messaging to the public. None Task # 4.2: Establish avenues for public interaction and information exchange. 14 Page
Needs Improvement Evaluator # 1 Issue PSAs for influenza were discussed with an emphasis on social distancing. Also discussed messaging through the department s web site, 2-1-1 and employee hotline. Social Media monitored at the local level but not used for response messaging. None Needs Improvement Evaluator # 2 The participants discussed the use of various avenues for exchanging and disseminating information; e.g. websites, PSAs, social media, etc. Currently the DOH does not allow the widespread use of Social Media for the dissemination or collection of information. This hampers the effective exchange of information with a wide segment of the population. The DOH should evaluate authorizing personnel at the local level the ability to monitor and post information within Social Media to enhance the department's ability to get information out to the public. Function # 4.3: Issue public information, alert, warnings and notification. Needs Improvement Evaluator # 1 Issued PSAs for influenza. Error on the side of caution and issue PSAs on medical conditions, social distancing, who to call and what to do. Assure community that the chances of being infected are minute. Recommend all healthcare providers and hospitals test for influenza. Adequate Evaluator # 2 The participants discussed the use of various avenues for exchanging and disseminating information; e.g. websites, PSAs, social media, etc., as well as the use of various 15 Page
emergency alerting systems, such as Reverse911, as deemed suitable for the situation. Currently the DOH does not allow the widespread use of Social Media for the dissemination or collection of information. This hampers the effective exchange of information with a wide segment of the population. The DOH should evaluate authorizing personnel at the local level the ability to monitor and post information within Social Media to enhance the department's ability to get information out to the public. 16 Page
SECTION 4: CONCLUSION Exercises such as this one allow personnel to validate training and practice strategic and tactical prevention, protection, response and recovery capabilities in a risk-reduced environment. Exercises are the primary tool for assessing preparedness and identifying areas for improvement, while demonstrating community resolve to prepare for major incidents. Exercises aim to help entities within the community gain objective assessments of their capabilities so that gaps, deficiencies, and vulnerabilities are addressed prior to a real incident. Exercises are the most effective (and safer) means to: Assess and validate policies, plans, procedures, training, equipment, assumptions, and interagency agreements; Clarify roles and responsibilities; Improve interagency coordination and communications; Identify gaps in resources; Measure performance; and Identify opportunities for improvement. This exercise succeeded in addressing all of the above as it provided examples of good to excellent participant knowledge, teamwork, communication and use of plans and procedures while pointing out areas in need of improvement and clarification. Listed below is a summary of the level of performance the Core Capabilities and Tasks evaluated during the exercise. This summary outlines the areas in which exercise participants are strong as well as identifying areas that the departments should invest future planning, training and exercise funds on. Continuity of Operations Implementation / Coordination / Demobilization Objective Core Capability Performance Objective # 1 Responder Safety and Health Adequate Objective # 2 Emergency Operations Coordination Adequate Objective # 3 Information Sharing Adequate Objective # 4 Emergency Public Information and Warning Needs Improvement 17 Page
APPENDIX A: IMPROVEMENT PLAN This Improvement Plan has been developed specifically for Florida Department of Health in Volusia County based on the results of Dreadful Droplets - A Pneumonic Plague Outbreak Response Exercise conducted on March 13, 2015. These recommendations draw on both the After Action Report and the After Action Conference. Capability Observation Recommendation Responsible Agency Completion Date FDOH-Volusia was not aware of the roles and responsibilities of Emery-Riddle University in regards to disease outbreak prevention / response. Meet with all colleges and universities in Volusia County to enhance current relationships between FDOH-Volusia and the colleges and universities in regards to disease outbreak prevention / response. FDOH-Volusia 10/1/2015 Responder Safety and Health There was an overall lack of understanding regarding Social Distancing and how it should be implemented. Offer basic information to FDOH-Volusia personnel and ESF 8 partners regarding Social Distancing. Providing access to the following Social Distancing video is an easy way to meet this goal. www.drc-group.com/project/jittsocialdistancing.html FDOH-Volusia On-Going Emergency Operations Coordination Tracking the status of employees that were un-able to report for work was identified. A number of ESF 8 partners that participated in the exercise had COOPs that need to be revised / updated. FDOH-Volusia currently has such a system in place. Information regarding the existing system and how it is used should be made available to all FDOH-Volusia personnel. FDOH-Volusia should encourage ESF 8 partners to review, revise and / or update their existing COOPs. FDOH-Volusia FDOH-Volusia On-Going On-Going 18 Page
Emergency Public Information and Warning Currently the FDOH does not county FDOH offices to post information to any Social Media networks. FDOH-Volusia will continue to follow guidance and procedures established by the FDOH regarding the use of various Social Media networks. FDOH-Volusia On-Going 19 Page
APPENDIX B: PARTICIPANT FEEDBACK (Strengths Areas for Improvement) Strengths Excellent communications between partners and FDOH-Volusia. All had a viable COOP. Learned more about services of partner agencies. Worked well as a team and everyone participated. Open discussion. Already have a plan, good understanding of the plan and its implementation. Greater understanding of community partners operations and challenges. Very good communication between FDOH-Volusia and partners. Our COOP seems to be on target. Our employees that can do work from home should have VPN access now so if there was a need, that would be already established. The collaboration of the different agencies and their COOPs. Topics of discussion. Set-up and the training material. We had excellent communication between FDOH-Volusia employees and the partners that joined us. Learned that many of our employees can do their jobs from home. Environmental Health can be given their assignments and not have to come in at all. Cooperation between agencies seems to be going well. We determined that FDOH-Volusia can have many of their staff telework. FDOH- Volusia has laptops with VPN's available, but more importantly, our community partner have laptops available to assist. They advised that these were available for situations such as this. This was a great "AHA" moment. Enlightened me on the important roles that our community partners play in emergency situations and how our roles merge. Excellent communication and participation within our group. 20 Page
It was good to understand how other agencies dealt with the issues presented by pandemic callouts. Because it is a hazard that affects all agencies similarly, it made for a good learning experience. Having one person scribe in to the system, and capture the thoughts of the group as a whole kept discussion flowing. It was a good mix of people so we were able to learn about some of the resources that available in the area / region / state. Discussions with ESF-8 Partners. Working out COOP issues that arises during the discussions. Looking at non-hurricane issues. The background information provided on the plague. The open discussion and communication between the different departments of the FDOH-Volusia along with the ESF 8 partners. The understanding that different agencies need to share plan information to ensure the needed coordination is there. Communication across agencies. A better understanding of different agencies COOPs. Teamwork. Participants approached exercise seriously. Participants worked well together and accepted everyone else's point of view. Friendly, no stress atmosphere. The communication and information sharing between all agencies participating. Knowing our community is well prepared and has a COOP. Acknowledging there would be shared resources locally which we were not aware existed. We had completed COOP. Great discussion. Everyone seemed to understand their roles during the exercise. Good cooperation and dialog with our community partners. 21 Page
Everyone had their COOP in place and was aware how to keep operating during an emergency situation. Good learning experience about how all our community partners function and come together during any type of disaster. Scenario. Feedback. Good open discussion. Understanding of COOP. Communication between agencies. Documentation was well organized. The appropriate types of partners were represented at the table. Appropriate level of discussion and identification for areas of improvement with our response. Open and engaging discussion between community partners and the FDOH-Volusia staff. Opportunity to review COOP. Agency and partners have their COOP. Parties had a great understanding of their COOP. Recognition and participation of ESF-8 partner agencies throughout the community. Participants identified the need to establish and ICS structure early in the incident. The inclusion of information sharing with response and ESF-8 partners early in the incident. Areas for Improvement The fire department identified a need to work with EVAC in the implementation of their plan. Establish an absenteeism repository with HR for call outs during one of these events utilize the school nurses for other than shelter duty within the county. MOU with Universities and other educational institutions in our region: emergency management to coordinate leap into the Social Media arena and utilize it to our advantage. 22 Page
Mutual Aid Agreement that have not been established between EVAC and other agencies. More knowledge of each organization s COOP. Utilize outside assistance more often to monitor Social Media. More cross training between departments would help when a large amount of staff are out. Better communication with the department. FDOH-Volusia and some of the other partners need to improve the manner in which they do staff accountability in a situation where there is a disease outbreak so we can identify which staff are out with the outbreak disease and which are out with other issues. We need to look into HIPPA regulations prior to improving our procedure. It would be nice to have a partner / community resource list for all agencies. Continuous leadership communication - to determine essential services - help available to perform these services - and attain additional help as needed. Review of procedures to identify the type of illness when staff is called out during a pandemic. What is to be asked legally, when would we report to FDOH- Volusia, etc. Identification of scheduling patterns and maintaining levels of service in regards to percentage of call outs. Review of COOP for a pandemic with ground staff. To look at the COOP, which was activated during a health crisis. How that effects staffing and need for outside resources. Address the needs of direction from the FDOH-Volusia to the local health system, hospitals,school and doctors during the FDOH-Volusia time of shortages How the FDOH-Volusia would recover after the long team COOP. Include support agencies in the COOP review process. Branch out agreements with the school district nurses to provide assistance in more events than just sheltering. Tracking sick personnel. Incorporating Social Media to emergency plans. Cross training among departments. Surveillance for illness interdepartmentally. 23 Page
Someone at each location needs to take charge, someone has to be in command and make a decision. Need a greater cross section of subject matter experts from within and outside FDOH- Volusia. Look at community partner's MOA's in detail. Learn what other community partners had to offer the FDOH-Volusia. There protocols were different from the FDOH-Volusia s and they had resources that we could utilize. Communication between senior leadership and other staff members need improvement to help prevent a community panic. Social Media is not used or cannot be used by employees. Everyone knows that a large segment of today s society rely on Social Media to get their news. Need an MOU with the local universities. Interagency sharing of COOP so we might be able to determine if they could be finetuned. Improve our COOP to include this type of public health emergency. Ensure that our plan development includes our response partners. Personnel accountability on a daily basis versus waiting or implementing such during a disaster. FDOH needs to clarify policy for Social Media for county based health department offices. Ability to engaging in Social Media from a local standpoint. Social distancing Clarify. Department / agencies need to develop or define how they would quantify mass illness and handle mass illness within their department / agency. There is a gap in communicating / sharing information with the public due to the limitations of personnel being authorized to utilize the various avenues of Social Media. Few people were aware of the approved agency Crisis and Emergency Risk Communication Plan. 24 Page
APPENDIX C: ACRONYMS Acronym Meaning COMM CONOPS COOP EOC ESF IAP IC ICS IMT JIC LOFR MOA MOU NIMS OPS PIO SitRep SOG SOP UC Communications Concept of Operations Continuity of Operations Plan Emergency Operations Center Emergency Support Function Incident Action Plan Incident Command Incident Command System Incident Management Team Joint Information Center Liaison Officer Memorandum of Agreement Memorandum of Understanding National Incident Management System Operations Public Information Officer Situation Report Standard Operating Guideline Standard Operating Procedure Unified Command 25 Page