Professional Emergency Manager Exam Application

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Professional Emergency Manager Exam Application For questions regarding the PEM program or exam please call 317-727-6682 or email agrisel@dhs.in.gov. Mail applications to: Ashlee Grisel, PEM Coordinator, Indiana Department of Homeland Security, 302 W. Washington Street E-208, Indianapolis, IN 46204. Complete application packets are due by Thursday August 22, 2013. Any packets received after the due date or any incomplete packets will be entered into the application process for the next exam offering. All packets should be presented in a professional format (binder, folder, etc) with tabbed dividers for ease in reading. PEM participants will receive a study guide with a complete application packet. If you have any special needs requiring consideration during the exam, please list them here: 1. Name: 2. PSID # (mandatory) - 3. Address: 4. City/State/Zip: 5. County: 6. Phone #: ( ) 7. Email: 8a. Agency represented 8b. Position 9. Exam date: Monday, September 9, 2013 (location will be sent out with approval email.) Once your application packet has been approved, you will be emailed a study guide for the exam. Please note the examination questions will be taken from the most recent version of the course. If you need materials from the most recent version, email Ashlee Grisel at agrisel@dhs.in.gov. When you arrive at the test site you will be provided with a #2 pencil, answer sheet, test packet, and blank paper for making notes. Blackberries, cell phones, or other communication devices, as well as computers, books, or notes will not be permitted during the test. Test must be passed with an 80%, you may retake the test once.

10a. IDHS maintains transcripts of IDHS courses for each student. If the course was taken from another state-level emergency management/homeland security agency, list where the course was taken and provide a copy of your certificate. Continue with this application only if you have successfully completed ALL of the following courses from IDHS or another state-level emergency management/homeland security agency (Michigan EMA, Ohio EMA, etc.). Check box if class was taken through IDHS. Introduction to Emergency Management Comprehensive Emergency Management Planning Homeland Security Exercise & Evaluation Program (HSEEP) Legal Issues in Emergency Management Debris Management Damage Assessment Course taken outside IDHS *You will also need to submit All the PDS & PDS Plus Certificates: PDS: 1. IS 139: Exercise Design (*Effective March 1, 2012, IS-120a: An Introduction to Exercises will replace IS 139 on the PDS series*) 2. IS 230: Fundamentals of Emergency Management 3. IS 235: Emergency Planning 4. IS 240: Leadership and Influence 5. IS 241: Decision Making and Problem Solving 6. IS 242: Effective Communication 7. IS 244: Developing and Managing Volunteers PDS Plus: 8. IS 634: Introduction to FEMA s Public Assistance Program 9. IS 703: NIMS Resource Management 10. IS 775: EOC Management & Operations 10b. A copy of your resume as well as a letter from your direct supervisor AND a letter from your county emergency management director AND direct supervisor recommending you for PEM Certification will also need included within your submission package.

10c. Part of the PEM Basic includes recent participation in an operations-based exercise as an organizer or member of the exercise design team (operations-based includes drills, functional or full scale; exercise should have been conducted within the last 3 years). Give a 1-2 paragraph description of the exercise and your role. You must include date (including year), location, scenario, agencies involved, and your role during the exercise. Sample description: On February 10 th, 2010 I participated in the Hoosier County Emergency Management Agency s Level 4 biological hazard functional exercise at the Oak Grove Community Center. I served as a member of the exercise planning team for the 6-hour exercise. The exercise involved the Hoosier County EMA, the Hoosier County Public Health Coordinator, Mapleton City Fire Chief Jane Kirkowicz, Police Deputy Chief Mark McGrath, Mayor Rebecca Bloomwood, Hoosier County public information officer Gary Dale, Mapleton School District Superintendent Bryan Boyd, Cherry Tree Town Marshall Tom Bartlett, Cherry Tree Fire Dept. 76 hazmat team, representatives from the Indiana State Department of Health, and Indiana Department of Homeland Security. The functional exercise ran from 9am- 4pm and was intended to test Hoosier County ESF responses to a biological incident (Ebola virus).

Professional Emergency Manager Level Professional Contributions Each student interested in taking the PEM exam must complete a series of emergency management courses, participate in an emergency management discussion-based exercise, and complete 6 of 19 professional contributions before being approved for the exam. You must include proof of the professional contributions as part of the application packet or the application will be denied. The following cover sheets are to be attached to each professional contribution.

Contribution #1 1. Author or co-author an article and publish it in a scientific or emergency services professional publication. Proof: Provide the article or a reader s digest version with authors credits.

Contribution #2 1. Facilitate an After Action Review (AAR) meeting and author a written AAR report of an exercise or actual event. Proof: Written report must include identification of shortfalls and strong points, corrective action plans, and lessons learned. Letter must accompany this stating that person submitting this contribution facilitated AND authored the report.

Contribution #3 1. Conduct a research project on an emergency management or homeland security-related problem that is applicable to Indiana. Research project should include a review of reports, documents, maps, or other articles related to the problem or a similar problem; in-depth analysis to define the problem including origin, cause, or contributing factors to the problem; and a conclusion stating the logical solution or a recommendation for future research. Proof: Include a list of sources used in compiling your project; paper defining the problem including origin, cause, or contributing factors to the problem; and a conclusion that includes a recommendation for further research. Paper must be at least 1500 words.

Contribution #4 1. Conduct a hazard analysis of your jurisdiction. List the probable hazards or threats. Develop a Risk Assessment to define the likelihood of occurrence. Develop a Vulnerability Analysis to determine how vulnerable your community is to the hazards or threats. Study your jurisdiction's Comprehensive Emergency Management Plan and other plans for addressing those hazards. Address any weaknesses and propose solutions through development of a prevention or protection strategy. Proof: Include a copy of your Vulnerability Assessment. Assessment should include any weaknesses and potential solutions to the vulnerabilities outlined in the assessment and a detailed prevention strategy.

Contribution #5 1. Be a FEMA Master Exercise Practitioner through EMI s MEP Program. Proof: With verification of current status (emails, certificates, etc.).

Contribution #6 1. Be a FEMA Master Trainer through the EMI s Master Trainer Program. Proof: With verification of current status (emails, certificates, etc.).

Contribution #7 1. Develop a course of at least 6 hours in length pertaining to emergency management or homeland security issues Proof: Course must be compliant with the US DHS Office of Grants and Training guidelines. Guidelines include development of a period of instruction, lesson plans, agenda, instructor guide and student manual, visuals, and a training support package consisting of handouts, exams, answer sheets, and any other materials related to the course. This proof can be put in your packet in CD form or you can submit hard copies.

Contribution #8 Teaching Complete a teaching or instructional commitment relating to disaster/emergency management that equals or exceeds three hours of actual platform instruction. The emphasis of this area is teaching the concept of Disaster/Emergency Management. Providing training technical skills (HAZMAT, Fire, Law Enforcement or EMS) to technical or professional people is not teaching professional disaster or emergency management. Example of teaching under this category include teaching a course on emergency management at a college or university, teaching professional development course of three hours or more related to Emergency Management, or similar instructional commitment where the emphasis is on professional emergency management topics. Teaching is intended to educate about the profession of emergency management, not teach technical skills. Teaching ICS or All Hazards Planning would be acceptable under this contribution. Teaching how to wear PPE or decontaminate people would be examples of training people in technical skills and is not acceptable. Proof: Provide a copy of the course syllabus and date(s) course was conducted.

Contribution #9 1. Provide proof of legislative contact related to an improvement of emergency management or homeland security policy or law. Proof: Proof may be legislative session minutes, written documentation from a supervisor attesting to your role, or a transcript.

Contribution #10 1. Assist in the design or development of standard operating procedures for an agency, department, business, or any public or private entity Proof: Provide a copy of the SOPs. Give a brief (2 paragraph) description of your role in preparing the procedures. Examples: Hospital s, school, disaster shelter, specialty public safety teams, et cetera. Also include letter from agency head stating you as the lead on this project.

Contribution #11 1. Assist in the design or development of a continuity of operations plan for an agency, department, business, or any public or private entity Proof: Provide a copy of the plan. Give a brief (2 paragraph) description of your role in preparing the plan. Examples: Hospital s, school, disaster shelter, specialty public safety teams, et cetera.

Contribution #12 1. Be involved in creating or revising a local ordinance or state statute, resolution, proclamation, or executive order related to emergency management, homeland security, public health, or public safety. Proof: Examples include NIMS resolution, No Burn ordinances, Debris Management ordinance, and Emergency Management ordinance.

Contribution #13 1. Serve in a leadership role for a local, district, or state-level emergency management committee, task force, organization, or advisory board. Proof: Provide a copy of the meeting minutes from at least 2 meetings with your presence and position listed. Examples include Chairperson, Secretary, Treasurer, Vice Chair, Task Force Commander, or Training Officer.

Contribution #14 1. Be a current member of the International Association of Emergency Managers, the National Emergency Management Association, the Indiana Emergency Management Alliance, AHIMTA, or any other national or internationally recognized emergency management association. Proof: With verification of current status. Example: current card, roster, or paid dues receipt.

Contribution #15 1. Be a member of a specialty team such as a tactical team, search and rescue, water rescue, HAZMAT team, et cetera. Proof: Provide a letter from team leader or supervisor stating your name, how long you ve been a member of the team, what kinds of events the team participates in, and your responsibilities on the team.

Contribution #16 1. Provide a seminar or workshop on any emergency management or homeland security subject in your jurisdiction. Proof: Provide a copy of both the agenda and presentation with date and facilitator contact information including email and/or phone number. Exercise must also be documented and approved in NEXS.

Contribution #17 1. Be an active participant or a volunteer of the Emergency Operations Center staff or fill a command or general staff position in the Incident Command System at an actual incident. Proof: Provide a letter from EOC Manager or EMA Director citing your involvement. Include a description of the event including type of event, date, and operational periods. If you are the EMA Director, provide a letter from the Chief Elected Official citing your involvement in the EOC or event.

Contribution #18 1. Be a member of the local Citizens Corps Council or be an IDHS certified Community Emergency Response Team (CERT) trainer. Proof: Provide a letter from the Citizen Corps Council Director citing your involvement. Letter should include details such as your name, how long you ve served with the council, your job duties on the council, and any special projects or achievements related to the council or Citizen Corps. orprovide a copy of your IDHS CERT TtT certificate.

PEM Basic Professional Contribution Cover Sheet Contribution #19 1. Receive an award or special recognition for excellence in emergency management or public safety. The award, honor or special recognition must be personalized (i.e. addressed, inscribed or whatever) and refer directly to the applicant. Awards for longevity (25 years of service) or routine performance awards are normally not adequate for inclusion under this category. Proof: Choose one of the following: Provide a picture of you with your award and a description of why you received the award; provide a newspaper clipping or VALID internet link recognizing your achievement; or provide a copy of the award if it is a letter or certificate. A thank you letter for participation in an event (exercise, meeting, or giving a briefing on emergency management) does not satisfy this requirement. This contribution should recognize an outstanding effort you gave to the emergency management profession, not a recognition of every day job duties.