Systemwide Emergency Management Status Report December 2016 Prepared by UCOP Risk Services (OPRS) I. Introduction This FY 2015-16 annual report is based on programmatic self-assessments completed by each of the ten campuses, and includes executive summaries for all locations including medical centers, UCOP, Lawrence Berkeley National Lab, and Agriculture & Natural Resources Division (ANR). Campus program self-assessments are benchmarked against the National Standard on Disaster/Emergency Management and Business Continuity/Continuity of Operations Programs (National Fire Protection Association [NFPA] Standard 1600-2016 edition). This collaboratively developed standard has been universally endorsed by the American National Standards Institute (ANSI), the 9/11 Commission, US Congress, and the federal Department of Homeland Security. The NFPA National Standard represents a total program approach to the challenge of integrating disaster and emergency management with business continuity planning. The University remains one of only a few major higher education systems nationwide that has voluntarily adopted this stringent standard. In conjunction with the National Standard, OPRS in collaboration with the UC Emergency Management Council (EMC), adapted The Joint Commission (formerly JCAHO) healthcare accreditation quantitative scoring framework methodology to evaluate program performance. The Joint Commission is a recognized international leader in standardized performance measurement, and the active participation and advice of our medical center colleagues led us to adopt this approach. In order to effectively adapt this performance measurement system, the Emergency Management Council developed a NFPA 1600 Standard benchmarking guide that defines specific measurable performance criteria for what constitutes varying degrees ( partial, substantial, or complete ) of conformance with each of the Standard s seventy-three (73) programmatic criteria. This comprehensive benchmarking guide was revised by the Emergency Management Council corresponding to the 2016 triennial update of the NFPA Standard and is included for reference in Appendix I. Adoption of this quantitative methodology has produced a systemwide performance measurement system that is more accurate, credible, objective, and consistent than use of purely subjective qualitative criteria. Quantitative analysis typically proves to be more informative and useful to both senior administration and campus program staff. OPRS strives to collaboratively support long-term demonstrable and measurable continual improvement in our emergency management programs. The 2016 triennial update of the NFPA Standard primarily focused on continuity planning and enhanced both the Business Impact Analysis (BIA) and the Continuity & Recovery program elements. The BIA is a key continuity planning element that evaluates the potential operational and financial impacts resulting from interruption or disruption of mission-critical campuswide essential functions, processes, infrastructure, systems, and personnel and identifies resources that may be needed to recover from any disruption in order to continue the University s mission of teaching, research, and patient care. The BIA will be used to develop campuswide continuity and recovery strategies and plans.
II. Systemwide Summary of Conformity with NFPA Emergency Management Standard Criteria Table 1 summarizes the self-assessments conducted by all ten Campuses. The numerical scores reflecting conformance with each programmatic criterion are defined by the following parameters: 0 = Non- 2 = Substantially 1 = Partially 3 = This section summarizes the degree of systemwide conformity with each of the NFPA National Standard s nineteen (19) basic program elements based on each campus self-assessments of the various multiple criteria comprising each corresponding program element. Trends and changes in systemwide conformity since last year are also summarized. Summary of Systemwide Conformity with NFPA Standard Program Elements 1. Program Management. All (10/10) of the campuses now conform or substantially conform with the six criteria, an increase of two (+20%) campuses since last year; four (4/10) campuses now report complete conformity with all six criteria, an increase of three (+30%) campuses since last year. 2. Program Coordinator/Manager.. Nearly all (9/10) of the campuses continue to conform or substantially conform with the single criterion; eight (8/10) campuses remain in complete conformity with the single criterion. 3. Compliance with Laws/Requirements.. All (10) of the campuses continue to conform or substantially conform with the two criteria; seven (7/10) campuses now completely conform with both criteria, an increase of two (+20%) campuses since last year. 4. Finance and Administration.. Most (7/10) of the campuses now conform or substantially conform with the four criteria, an increase of one (+10%) campus since last year; four (4/10) campuses are now in complete conformity with all four criteria, an increase of one (+10%) campus since last year. 5. Planning and Design Process.. All (10/10) of the campuses now conform or substantially conform with the five criteria, an increase of three (+30%) campuses since last year; three (3/10) campuses remain in complete conformity with all five criteria.
6. Hazard Vulnerability Assessment.. All (10/10) of the campuses now conform or substantially conform with the six criteria (one new criterion was added this year in the 2016 Standard update), an increase of three (+30%) campuses since last year; four (4/10) campuses remain in complete conformity with all six criteria. 7. Business Impact Analysis.. Four (4/10) campuses conform or substantially conform with the four new criteria (all four criteria were significantly revised in the 2016 Standard update); one (1/10) campus reports complete conformity with all four of the newly revised criteria. 8. Resource Needs Assessment.. Most (7/10) of the campuses continue to conform or substantially conform with the five criteria; three (3/10) campuses are now in completely conformity with all five criteria, an increase of two (+20%) campuses since last year. 9. Incident Prevention and Hazard Mitigation.. Nearly all (9/10) of the campuses now conform or substantially conform with the four criteria, an increase of three (+30%) campuses since last year; four (4/10) campuses now completely conform with all four criteria, an increase of one (+10%) campus since last year. 10. Crisis Communications and Public Information.. All (10) of the campuses continue to conform or substantially conform with the two criteria; seven (7/10) campuses remain in complete conformity with both criteria. 11. Warning, Notifications and Communications.. All (10) of the campuses continue to conform or substantially conform with the three criteria; eight (8/10) campuses are now in complete conformity with all three criteria, an increase of one (+10%) campus since last year. 12. Standard Operating Procedures (SOPs).. Most (8/10) of the campuses now conform or substantially conform with the four criteria, an increase of two (+20%) campuses since last year; two (2/10) campuses are now in complete conformity with all four criteria, an increase of one (+10%) campus since last year. 13. Incident Management.. All (10/10) of the campuses now conform or substantially conform with the eight criteria, an increase of two (+20%) campuses since last year; one (1/10) campus remains in complete conformity with all eight criteria.
14. Emergency Operations/Response Plan.. Nearly all (9/10) of the campuses now conform or substantially conform with the three criteria, an increase of one (+10%) campus since last year; six (6/10) campuses now completely conform with all three criteria, an increase of three (+30%) campuses since last year. 15. Business Continuity and Recovery.. Four (4/10) of the campuses conform or substantially conform with the four criteria (two of the criteria are new in the 2016 Standard update); none (0/10) of the campuses are in complete conformity with all four criteria as two new criteria were added to the Standard this year. 16. Employee Assistance and Support.. Most (8/10) of the campuses continue to conform or substantially conform with the two criteria, an increase of one (+10%) campus since last year; two (2/10) campuses now completely conform with both criteria, a decrease of one (-10%) campus since last year. 17. Training and Education.. Most (7/10) of the campuses now conform or substantially conform with the four criteria, an increase of one (+10%) campus since last year; four (4/10) campuses now completely conform with all four criteria, an increase of one (+10%) campus since last year. 18. Exercises and Tests.. Nearly all (9/10) of the campuses continue to conform or substantially conform with the two criteria; six (6/10) campuses are now in complete conformity with both criteria, a decrease of one (-10%) since last year. 19. Program Maintenance and Improvement.. All (10/10) of the campuses now conform or substantially conform with the four criteria, an increase of three (+30%) campuses since last year; seven (7/10) campuses now completely conform with all four criteria, an increase of three (+30%) campuses since last year. Systemwide Conformity with NFPA Standard - Trends Analysis All ten (10) campus locations reportedly now conform or substantially conform with the following eight (of nineteen total) NFPA Standard programmatic elements: program management; compliance with University requirements and state/federal laws; planning and design process; hazard vulnerability assessment; crisis communications and public information; warning, notifications, and communications; incident management; and program maintenance and improvement. This is a significant improvement since last year, when all ten campuses conformed with only three of the NFPA Standard program elements (26% systemwide increase in Standard conformity). Similarly, nearly all
(9/10) campuses also now conform with the following four NFPA programmatic elements: program coordinator/manager; incident prevention and hazard mitigation; emergency operations/response plan; and exercises and tests. This also represents a significant improvement since last year, when nearly all campuses conformed with only two of the NFPA Standard elements. Finally, most (7-8/10) of the campuses also report conforming with the following five NFPA programmatic elements: finance and administration; resource needs assessment; standard operating procedures; employee assistance and support; and training and education. So this year most of the campuses reportedly conform or substantially conform with seventeen of the nineteen (89%) NFPA Standard program elements, a substantial improvement since last year, when systemwide conformity was reported at 68% (thirteen of the nineteen NFPA program elements). In fact, the only two outstanding program elements that the University is not yet in substantial conformity with are the two newly revised continuity planning program elements that will be addressed by the continuity planners workgroup supported by the powerful new UC Ready continuity planning software tool. The greatest systemwide improvement in terms of achieving substantial conformity with the NFPA Standard were reported in the following four program elements: planning and design process; hazard vulnerability assessment; incident prevention and mitigation; and program maintenance and improvement (all of which had 30% systemwide improvement in conformity). In addition, 20% systemwide improvement in conformity was reported in the following three program elements: program management; standard operating procedures; and incident management. In terms of achieving complete conformity with all programmatic criteria, substantial individual campus progress was reported in the program maintenance and improvement; program management; emergency operations/response plan; compliance with laws/regulations; and resource needs assessment program elements. The greatest degree of systemwide improvement in achieving conformity with individual programmatic criteria was reported over the last year in the following four NFPA Standard program elements: program maintenance and improvement; program management; incident prevention and mitigation; and hazard vulnerability assessment. In contrast, slight systemwide regression was observed in conformance with the individual criteria associated with the following program elements: exercises and tests; standard operating procedures; and business continuity and recovery (due to newly revised criteria for this program element). More detailed information on all of the NFPA Standard program elements and their corresponding criteria can be found in the benchmarking guide contained in Appendix I.
Table 1: Campus Self-Assessments - NFPA Standard Conformity, December 2016 METRICS KEY: 0 = Non-conforming 1 = Partially 2 = Substantial 3 =
Table 1: Campus Self-Assessments - NFPA Standard Conformity, December 2016 METRICS KEY: 0 = Non-conforming 1 = Partially 2 = Substantial 3 =
III. ERMIS Emergency Management Key Performance Indicator (KPI) As part of its strategic approach to managing risk, the University has created the Enterprise Risk Management Information System (ERMIS), a centralized data warehouse that serves as the data repository for risk and controls related information. ERMIS provides a high level perspective that helps systemwide stakeholders quantify and track pre-defined Key Performance Indicators (KPIs). An Emergency Management KPI has been developed as part of the Safety Index dashboard reporting tool. This KPI averages all of the NFPA Standard scoring metrics that campuses enter into the online NFPA survey portal to produce a single consolidated NFPA score for each campus. In addition to each campus KPI, there is also a University systemwide enterprise average NFPA Standard KPI based on the average scores reported at all campus locations. As the graph below shows, the systemwide (or enterprise) KPI for conformity with all the NFPA Standard programmatic requirements increased over the last year, rising from an average NFPA score of (2.18) to (2.26), an increase of 4%. Note that a score greater than (2.0) indicates substantial conformity with the NFPA Standard program elements, so overall the entire University system remains in substantial conformity with the NFPA Standard. The degree of the systemwide net average increase was lessened due to one campus significant internal and external re-evaluation of their Emergency Management program that resulted in significant downgrades to many of that campus NFPA self-assessment scores, thereby lowering the overall systemwide enterprise average.
IV. Individual Program Executive Summaries The following Emergency Management program executive summaries describe the overall status of Campus and Medical Center programs as well as the Lawrence Berkeley National Lab, Office of the President (UCOP) and Agriculture & Natural Resources (ANR) Division programs. Each University location was requested to include information on significant programmatic progress, accomplishments, and developments over the last year; identification of program elements needing improvement; and major programmatic development goals or corrective actions planned for the coming year. Berkeley In 2016, the UC Berkeley Office of Emergency Management (OEM) received national recognition for its How to Become an Urban Survivor marketing campaign. The campaign s goal was to break free from traditional emergency messaging and inspire students to get prepared. OEM redesigned their website to focus on the audience s interests and needs. Utilizing pop culture, humor, and engaging graphics, OEM connected with Berkeley students and renewed their enthusiasm and curiosity in emergency preparedness. The website was awarded First Place in the website category by the National Association of Government Communicators and the campaign was given an Award of Excellence from the Campus Safety, Health and Environmental Management Association (CSHEMA). In order to maintain momentum, OEM partnered with residence hall staff to host a disaster movie night, keeping interest in the urban survivalist campaign high. In the coming year, the campus will continue to build on its outreach efforts with the goal of establishing best practices on how to engage students in emergency preparedness. Several drills and exercises were conducted this year, including an EOC activation test, a campuswide radio communications test, and a functional exercise for UC Berkeley s Crisis Management Team (CMT). The functional exercise was designed to practice and evaluate the policy level response to a 6.8-magnitude earthquake on the Hayward Fault. The CMT serves as the policy level decision-making body during emergencies and is co-chaired by the Vice Chancellor-Administration & Finance and the Executive Vice Chancellor & Provost. The exercise provided an opportunity for the CMT to discuss and make decisions on key emergency policy level questions, develop and approve a communications strategy, and identify the pertinent information, people, and resources needed for recovery policy decisions. Harvard Professor Dutch Leonard, an expert in crisis leadership, was the lead facilitator for the exercise. OEM, in collaboration with the campus Emergency Support Functions, completed the first campus Earthquake Plan. The Earthquake Plan is a component of the UC Berkeley Emergency Operations Plan and was written to address the special planning needs and unique response details required to mitigate the damaging effects of an earthquake on the campus and campus community.
Considerable effort was also put into further developing the Building Coordinator program. Key protocols and documents that support emergency field operations were developed. These protocols support the collection of information from the field following a large-scale evacuation of campus buildings. OEM trained Building Coordinators on the updated procedures and documents and tested them during the Great ShakeOut earthquake drill. This year, the EOC staff received advanced training in their roles and responsibilities. OEM delivered another round of EOC section-specific training to staff. Each training consisted of hands-on interactive activities and each EOC section participated in a table-top exercise as part of the training sessions. EOC staff also received training on Information Management as well as Psychological First Aid. Additional training developed and delivered this year includes: EOC Coordinator Training, Limited Emergency Response Coordinator Training, Emergency Management Area Training, and Building Coordinator 101 Training. In 2016, OEM also completed procurement of a campus stockpile of food and water. The stockpile is designed to accommodate 10,000 people over three days and is an important step forward in UC Berkeley s ability to respond to a major emergency. Finally, the campus launched the new UC Ready continuity tool to high impact campus units. The software tool, along with a new approach to continuity, will further strengthen the ability to protect and continue the campus mission through any disruption. Lawrence Berkeley National Laboratory The Lawrence Berkeley National Laboratory (LBNL) emergency management program experienced a productive year in 2015-16, with efforts aimed at solidifying its status as a comprehensive program with a commendable level of readiness. Two EM team members received qualification as CERT Train-the-Trainers and Program Managers through FEMA. One EM team member received the Director s Award for Operational Excellence due to efforts assisting Department of Energy (DOE) headquarters with the revision of Order (O) 151.1D, as well as for the development of the LBNL Technical Planning Basis. The LBNL Emergency Response Organization (ERO) is comprised of the Incident Command Team (ICT), Emergency Management Team (EMT), and Emergency Oversight Team (EOT) and several Incident Command System (ICS)-based support groups including Command, Logistics, Planning, Operations, and Finance, and Mission Support Sections. ERO training efforts for 2015-16 continued to focus on Basic ERO Training which was revised and provided for the second consecutive year. EMT personnel were also provided position-specific training. Several drills and exercises were conducted in 2015-16. The LBNL site-wide Annual Exercise was an earthquake scenario held on August 24, 2016 and included field play, first responders, as well as the deployment of disaster assistance teams. First responder hazards awareness training on topics including site familiarity, radiological and materials hazards, and laser safety was developed and provided to firefighters and security personnel. Additionally, drills and
seminars were provided for Building Emergency Teams, EMT members, EOT members, and CERT members. Two more disaster assistance teams were created. Building Emergency Teams were expanded, reaching lead team member readiness for 98% of LBNL buildings. All new hires starting after March 2016 are now required to complete a training focused on hazards and protective actions applicable to LBNL. Other successes in 2015-16 include identifying and establishing a space for a dedicated EOC, thereby increasing readiness levels for response. Another success was procuring and staging five zone disaster containers for basic life necessity supplies and a cache of medical and comfort items in the event personnel are unable to leave the site or first responders are unable to respond to LBNL during a regional catastrophe. At LBNL, the Continuity Program is integrated with the Emergency Management Program. Members of the EMT are key responders for the Continuity Program. Several assessments of the program were performed in 2015-16, including IT Disaster Recovery. Additionally, LBNL s Continuity Plan was updated in 2015-16, with the identification of ESAs, essential records, and critical infrastructure. A complete revision of the plan is expected in 2016-17, and will include development of an Infectious Disease and Pandemic Plan. Davis UC Davis Emergency Management and Mission Continuity program had many accomplishments in 2015-16 including the hiring of a new director and mission continuity planner and continues to strive to develop a robust and comprehensive emergency management and mission continuity program. The office provided ongoing technical support to Sacramento campus partners to ensure all emergency management plans are linked and coordinated to support a comprehensive program that leverages all UCD resources to support disaster/emergency response and recovery across the UCD enterprise. In 2015-16, program accomplishments included beginning an annual update/rewrite of the UCD Emergency Operations Plan with assignment of departments as functional leads rather than individual staff. An increased emphasis was placed on administrative unit business impact analysis as a critical component of institutional resilience to support campuswide recovery planning. Increased use of the Virtual EOC/SharePoint website enabled information sharing across the UCD enterprise. Functional exercises were conducted including an Event and Crisis Management Team tabletop that was an administration level exercise to review family care, communication and coordination issues following an active shooter incident. All campus executive leadership participated in multiple emergency management trainings including event management protocols and crisis communication coordination. UCD participated in National Preparedness Month encouraging students to visit the campus Emergency Management website to help increase awareness of our WarnMe mass notification
system. The office passed out five hundred water bottles, key chains, and first aid kits to increase awareness for the Crisis Manager and Guardian Personal Safety Applications. The Emergency Management website was expanded to include student, faculty and staff preparedness info both at home and in the workplace. Davis Health System The UC Davis Health System (UCDHS) Emergency Management Program is overseen by its Emergency Preparedness Committee and continues to excel through continuous improvement and achievements throughout the year. UCDHS EM successfully complied with and completed all Emergency Management Joint Commission requirements. UCDHS continued to participate in the Federal Hospital Preparedness Program and received grant funding administered through Sacramento County. During 2015-16, UCDHS activated its Emergency Operations Plan once in response to an actual patient surge event. An After Action Report was completed shortly after that event. UCDHS conducted two full-scale exercises, one functional exercise, five tabletop exercises, and four code triage drills in the last year. Exercise scenarios included active shooter incidents, a transportation accident involving hazardous materials, and a flood event. The full-scale exercises conducted in 2015-16 were designed and evaluated in compliance with Homeland Security Exercise and Evaluation Program requirements. UCDHS identifies and tracks completion of improvement actions identified in all disaster exercises and responses to actual emergencies. UCDHS achieved all four of its goals for 2015-16, including finalizing and exercising a new mass casualty response plan, conducting active shooter exercises, beginning implementation of the new UC Ready business continuity planning software, and evaluating web-based tools for HICS documentation. Goals for next year include updating three all-hazard plans, conducting a patient surge tabletop exercise, continue implementing the UC Ready continuity planning software, and developing a plan to use SharePoint for HICS documentation. Irvine In 2015-16, UC Irvine Emergency Services continued to enhance its emergency management and business continuity programs. Accomplishments during the year included enhanced outreach, training and exercises, completion of the Secure-In-Place Annex, roll out of the ZotReady emergency preparedness campaign, continued implementation of the new UC Ready continuity planning tool, and continued implementation of key initiatives outlined in the 2014-2018 Strategic Plan. Section-specific training for EOC staff and WebEOC training for EOC and DOC staff was held in February 2016. In May 2016, a full-scale exercise was held with the campus Emergency
Operations Center (EOC), the Environmental Health and Safety, Facilities Management, Office of Information Technology, and Student Housing Department Operations Centers (DOCs). The Seismic Shenanigans scenario focused on a 7.1 magnitude earthquake on the Newport- Inglewood Fault causing major damage to the campus and local infrastructure. The EOC was activated in two shifts, allowing the EOC to practice handoff and shift change for the first time. Additional training and exercise opportunities were held throughout the year including cost recovery training for the Documentation Unit in EOC Finance Section; a Meningitis-B outbreak tabletop with the Student Health Center, Housing, and Student Affairs staff; and building walkthroughs with the Rapid Building Assessment Team (RBAT). Emergency Services continued the development of the Care and Shelter Team (CAST) by offering American Red Cross Psychological First Aid Training and Shelter Fundamentals. Additionally, a tabletop exercise was held with the Shelter Managers to discuss various issues that could arise in a care and shelter situation. UCI once again participated in the Great ShakeOut earthquake drill in October 2015. A campuswide email message was sent out a week prior to the event in order to inform the campus community about earthquake preparedness and to encourage participation on the day of the ShakeOut drill. On October 15, 2015 at 10:15 AM, a campuswide zotalert was issued asking people to drop, cover, and hold on to practice earthquake safety. A follow-up allclear/thank you for participating message was sent out a few minutes later. In July and August of 2015, the Emergency Services Unit was given the opportunity to speak with all 5,000 incoming freshman about emergency preparedness on campus during the Student Parent Orientation Program (SPOP). The team has been invited back to participate during the 2016 SPOP sessions. In an effort to further increase awareness of emergency preparedness planning, UCI continues to utilize several social media sites including an emergency management blog, Facebook, Twitter, Google+ and Nixle to share both campus and personal preparedness information. In 2014, the Emergency Services Manager partnered with a student group to develop the ZotFinder emergency mobile application for Apple ios users. In late 2015, the Android version was released as well. Over 2,500 users have downloaded the ZotFinder application. Campus Search and Rescue (CSAR), UCI's version of a campus emergency response team, finished its twentieth training series and continues to see strong support from the campus community. More than 380 people on campus have completed the training since its inception. Momentum continues to grow and with the increase in awareness of natural and humancaused disasters, people are looking for ways to improve their level of preparedness. Building upon the refresher classes that were offered in 2014 and 2015, four more refresher classes were offered in Spring 2016. The goal is to continue to offer refresher classes throughout the year to allow past CSAR graduates the opportunity to refresh their skills and receive newly added training content. In March 2016, the Emergency Services Unit hired Brianna Bailey as a Training Coordinator added to the team. Her main role is to assist with further development of
the Zone Crew Building Evacuation Team and the Campus Search and Rescue (CSAR) training program. UCI has been working diligently to complete the campuswide Business Impact Analysis (BIA) in the 18-month timeframe that was originally established with an anticipated completion date of November 2016. The BIA began in June 2015 and is the first phase of a multi-year effort in developing a Campus Continuity Plan/Framework. To date, the project has required 77 interviews with 48 departments across campus. The Campus Continuity Subcommittee, responsible for overseeing the BIA process, has reviewed over 290 documented essential functions altogether and has strategically chosen 31 of these to be identified in the campus framework as Department Essential Functions (DEFs). The Subcommittee has convened for three quarterly meetings with a fourth scheduled for August 2016. Additionally, UCI has partnered with UC Santa Barbara in helping lead the UC systemwide continuity workgroup towards a new strategic approach changing from a department-centric planning to more comprehensive organizational enterprise-wide continuity planning. UCI continues to implement the initiatives outlined in the 2014-2018 program strategic plan. Key activities for 2015-16 included redesigning emergency procedures flip charts; offering numerous training and exercise opportunities to the various response teams on campus; and continued implementation of the campus Business Impact Analysis (BIA) process. Activities in the coming year will continue to focus on enhancements to the campus RBAT and CAST teams, development of the campus Medical Emergency Response Team (MERT), rollout of the Alertus Desktop Notification system on campus computers, updates to the campus Hazard Vulnerability Assessment (HVA) and development of a campus Hazard Mitigation Plan. Irvine Medical Center In 2015-16, UC Irvine Health conducted emergency response exercises to meet The Joint Commission requirements as well as additional tabletop exercises to address internal objectives related to utility outage and radiation events. By the end of 2016, UC Irvine Health will have participated in a Countywide mass casualty and Code Silver response drill involving a surge of walk-in patients, the Great ShakeOut drill, the Statewide Medical Health Exercise drilling our ability to respond to an influx of pediatric patients and establishing a family reunification site. In addition to these exercises, numerous projects have been initiated to better prepare the organization for future events including the inception of an Emerging Infectious Disease Response Team and Program as well as implementing the Health System s first mass notification system. Our May 2016 Countywide disaster drill highlighted opportunities for improvement related to mass notification. Action items related to this program gap have been addressed with the implementation of UC Irvine Health s Everbridge mass notification tool. From May through November, a small multi-disciplinary team worked to implement the tool prior to our November 17 Statewide Medical Health Exercise deadline. With the drill date approaching, our
small team successfully tested the tool on the day of the exercise sending out a message to all 9,000+ UC Irvine Health and School of Medicine staff. Previously in 2014-15, work was focused on the Organization s ability to respond to an Ebola event. Through 2015-16, UC Irvine Health, through the dedicated work of a new Infectious Disease Emergency Manager, implemented a comprehensive Emerging Infectious Disease Program as well as Response Team. This multi-disciplinary group trains regularly on the protocols established during the Ebola crisis. The goal of the program and team is perpetual readiness for any emerging infectious disease that may present in our emergency department or clinics. In the coming year, UC Irvine Health will continue to focus on developing our emergency management and continuity program in the following areas: revised Surge Plan (with wholeorganization emphasis); Business Continuity Plan development using the UC Ready program; incorporating our response protocols with County response plans; and staff development through emergency management course offerings. Los Angeles UCLA s Office of Emergency Management (OEM) made several improvements in the program this year, specifically in the areas of emergency notification, warden training and training for EOC staff. UCLA replaced its emergency notification vendor with a new vendor Everbridge. This change enabled the campus to add multiple notification channels (push notifications, two additional SMS notification channels and one additional e-mail channel) for each user. The change also allowed UCLA to include parents of the on-campus elementary school students in our notification system. Finally, some additional capabilities, such as polling and two-way communication during notifications were added which improved the usefulness of the system. There are plans to extend the system to include more digital message boards, Voice Over Internet Protocol (VOIP) telephone notifications and desktop pop-up notifications for university-owned computers. UCLA OEM developed a comprehensive training program for facility, floor and area wardens to both ensure compliance with applicable OSHA regulations and to ensure the safe evacuation and accountability of all members of the campus community during an emergency. To date, UCLA has completed the first iteration of training for all facility wardens. Approximately 90% of all campus buildings have at least one trained facility warden, and most have multiple wardens. Training for floor and area wardens has begun and should be completed by the end of the fiscal year. UCLA has revamped its EOC staffing to come into better compliance with ICS standards. To further enhance its capabilities, training is being conducted to bring EOC staff up to a Type II standard in each position in the EOC. The plan calls for having two persons Type II-certified per EOC position by the end of the fiscal year with an eventual goal of four trained individuals per position. To facilitate this plan, UCLA has certified one OEM member as an instructor in CERT,
SEMS, and ICS. Additionally, the campus has added a full-time training member to the staff on a one-year, contract basis. Training has begun along with recruitment to fill vacant positions. The first round of training is expected to be completed by the end of the fiscal year. UCLA responded to several incidents this year. The most noteworthy incident was a murder/suicide on campus that resulted in a large-scale active shooter response and subsequent lockdown. As a result of this incident, the campus convened a Safety Task Force to review safety and emergency response on campus. The Task Force released its findings in October 2016, resulting in a number of proposed changes for the Office of Emergency Management. Los Angeles Health System Last year, UCLA Health continued participation at both medical center campuses in the Federal Hospital Preparedness Program (HPP), receiving grant funding administered through Los Angeles County. UCLA Health continued to provide leadership around hospital emergency management as a voting member of the Los Angeles County Healthcare Coalition. UCLA Health was also represented on the LA County Health Care Recovery (HCR) workgroup to develop resources for business continuity planning and assisted in the delivery of two workshops for hospitals and other healthcare organizations throughout the county. As a Disaster Resource Center and designated Trauma Surge facility, Ronald Reagan UCLA Medical Center remained a regional resource for disaster planning, response and recovery efforts among the hospitals, clinics, and other partners on the west end of Los Angeles County. UCLA Health Emergency Management continued its focus on Communications, Resources and Assets, Safety and Security, Management of Staff, Utilities, and Management of Patients through the work of dedicated subcommittee members under the oversight of the Emergency Management Executive Steering Committee. Some of our many accomplishments include a successful Joint Commission Triennial Survey of Ronald Reagan UCLA Medical Center in July 2016 with no negative findings in Emergency Management; development of shadow bed patient charts in the electronic health record to enhance surge capacity by allowing doubleoccupancy of single patient rooms; completion of initial configuration of the UC Ready continuity planning tool and implementation of a Business Impact Analysis (BIA) process; relaunch of the Emergency Department Disaster Committee to further develop the Mass Casualty Incident Response Plan; development and implementation of clinic Emergency Action Plan (EAP) engagement to better integrate remote ambulatory care locations into systemwide planning; and launch of a new initiative with Communications, Media and Marketing to refine, train and exercise disaster and crisis communications processes. UCLA Health continued efforts around planning, training and implementing program elements for emerging infectious disease response. The Infectious Disease Safety and Emergency Management Program has maintained capabilities as an Ebola Treatment Center (ETC) in LA County, while broadening the program s focus to address provider safety in response to a range of infectious diseases. UCLA Health has remained a leader in planning efforts in this area,
working closely with LA County Public Health and Emergency Medical Services Agency. Continued refinement of Emerging Infectious Disease plans based on lessons learned and changing public health guidance and policies remains an ongoing priority for UCLA Health. Actual events and incident responses over the last year included standby support for the 2016 Los Angeles Marathon; planning and operational support for electronic health record application go-live event; response to the tragic UCLA Campus shooting incident on June 1, 2016; and several activations for unplanned internal infrastructure incidents, such as utility and information systems outages and floods. Emergency or disaster exercises over the last year included multiple decontamination drills, and participation in the 2015 Los Angeles County Public Health Medical Counter Measures Functional Exercise which included the actual distribution of prophylactic antibiotics to hospitals in response to a simulated aerosolized anthrax attack. UCLA Health also conducted the annual 2016 Disaster and Trauma Symposium and coordinated exercise series, with the topic of mass shootings in the local community. UCLA Health also partnered with Los Angeles Police Department to offer a series of realistic, simulation-based Active Shooter Response trainings for staff and faculty. Goals for the coming year include continued participation in the Federal HPP grant program, continued focus on department-level planning and rollout of the UC Ready continuity planning tool, and continued focus on staff outreach, education and training. Merced UC Merced s Emergency Management Program continues to work toward creating a culture of preparedness focused on prevention, protection, mitigation, response, and recovery. UCM accomplishes this by providing training opportunities that teach personal, workplace, and classroom safety strategies. In May 2016, UCM conducted a county-wide, multi-agency Violent Incident Response and Rescue drill. Participants included local law enforcement, fire, and EMS emergency responders. In June 2016, UCM hosted FEMA Enhanced Threat and Risk Assessment Training. Participants were guided through all phases of the Department of Homeland Security (DHS) and FEMA risk management process, as applied to specific facilities within Merced County. Threats and hazards to pre-designated sites were prioritized, and vulnerabilities at different locations were identified through an on-site inspection by participant teams. The consequences of terrorist threats, man-made and natural hazards to the sites were estimated, and options for mitigation that included equipment, training, and exercises were defined. In August 2016, FEMA returned to UCM and presented Managing Critical Incidents for Higher Education. This class was similar to a FEMA Multi-Hazard Emergency Planning for Higher Education class that UCM hosted in January 2014. Participants were led through managing a critical incident by applying an all-hazards, multi-disciplinary, community approach based on
the National Incident Management System s (NIMS) Incident Command System (ICS) and Multi- Agency Coordination Systems. The course combined lecture and team activities and culminated with an instructor-led, role play exercise customized for UCM. On November 4, 2015 UCM experienced a tragedy involving a stabbing that occurred in a classroom. The incident quickly escalated to an officer-involved shooting when the officer was forced to end the threat as four people had already been stabbed. Within minutes allied agencies responded to assist the campus community. Throughout the days and weeks that followed resources from the University of California system could be seen throughout campus. Their presence supported efforts for UCM to rally together and help each other. We are #BobcatStrong. When Governor Brown signed the state s budget in June 2016, $1.1 million was specifically allocated to UCM for public safety equipment. This funding will be used to improve campus safety infrastructure and ensure responders have the equipment they need in an emergency. The equipment is for general campus safety (not specifically for the police department) and includes evacuation chairs, Automated External Defibrillators (AEDs) and other equipment that would aid emergency responders. In 2016-17, UCM will continue to use innovative approaches to educate, train and instill emergency preparedness in alliance with the campus plans for significant growth. Riverside In 2015-16 under the direction of the Vice Chancellor of Business and Administrative Services, the opportunity to reorganize and develop a more robust Enterprise Risk Management (ERM) division emerged which included the Emergency Management program and Business Continuity. After several years of the campus continuing to search for an Emergency Manager that met the needs, mission and vision of UCR, the reorganization helped facilitate the hiring of a candidate and re-focus the emergency and continuity programs in new directions. The newly developed ERM division is responsible for identifying, analyzing, mitigating, preparing for, responding to and recovering from a multitude of risks UCR faces each day. By removing Emergency Management and Continuity Planning from Environmental Health & Safety, the newly developed ERM unit includes the following key enterprise functions: Emergency Management Environmental Health & Safety UC Police Department Risk Management Training Center of Excellence The new ERM structure also clearly aligns with UCR s Business and Administrative Services operational objectives to use industry best practices, eliminate duplication of efforts, create
opportunities for collaboration, implement enabling technologies, and prioritize institutional responsibility for safety and risk management. With the development of the ERM structure, the Emergency Management program had the opportunity to complete a candid re-evaluation of campus preparedness and compliance with NFPA 1600 in 2015-16. The results drove the development of a long-term Strategic Plan focused on improving campus preparedness, enhancing emergency response, developing vital plans, training essential personnel, and exercising critical functions directly aligning with our campus strategic plan, UCR 2020: the Path to Preeminence. In Spring 2016 all ERM units, with the exception of the Police Department, moved into a newly built EH&S facility where the daily interaction helped facilitate the development of new projects, identification of new risks, and mitigation of situations that could have a major financial, reputational, compliance and operational impact to the university. In addressing these issues and providing some predictive analysis, monthly meetings with the executive team, the Emergency Management Policy Group (EMPG) were established. The Crisis Management Plan was overhauled, the group was trained and was then brought together several times throughout the year in response to events and disruptions to the campus. Most significant was the EMPG s support in the development of the Sobering Center, a response to several large-scale student concerts on campus. By working closely with American Medical Response (AMR) and establishing a mobile emergency room atmosphere we were able to transfer medical liability to the AMR doctors, nursing staff and EMT support while maintaining the student privacy and follow-up support through Student Affairs and Conduct. Another significant example was the relocation of the Emergency Operations Center (EOC) out of the Police Department and into a newly built training room capable of supporting large-scale emergency operations that may impact the campus community. Within 72 hours of completion of the EOC it was established and configured to coordinate the multi-agency support for Presidential Candidate Hillary Clinton s visit and campaign rally on campus. With the recent hire of an Executive Director of Enterprise Risk Management the attention of the Emergency Management program over the next fiscal year will focus on training and exercising EOC staff, revising outdated emergency plans, advancing the continuity planning program by developing department essential functions based on the ten identified campus essential functions, furthering external relationships with community and higher-education partnerships, and working towards more of a collaborative UC systemwide focus and standard of Emergency Management and Continuity Planning.
San Diego The 2015-16 fiscal year resulted in a number of efforts to strengthen the Office of Emergency Management on the UC San Diego campus. A new Environment, Health and Safety (EH&S) director was hired who has a strong emergency management background, bringing a fresh perspective and a desire to build upon past successes. Improvements were made to existing systems and activities that had been successful in the past were continued. Improvements to our Triton Alert mass notification system were implemented, EOC staff training was conducted, training to the campus community staff was provided and preparedness efforts have resulted in a UCSD campus that is better prepared to prevent, respond and recover to all types of incidents. This past year has seen UCSD transition from an opt-in to an opt-out emergency notification system. Students, faculty and staff are required to either enter their SMS (text) number and/or an additional phone number or opt-out of receiving Triton Alert notifications. All community members with a ucsd.edu email address are automatically entered into the system and so there is no option to opt-out of receiving Triton Alert email notifications. This has resulted in an increase of users from approximately 24,000 the previous year to over 80,000 users at this time. This increase has created challenges and the notification system is currently being refined to deliver the messages via multiple media in an optimum timeframe. Throughout the year tabletop exercises and EOC section seminars were conducted to ensure familiarity among Executive Policy Group (EPG) and Emergency Operations Center (EOC) staff. UCSD EOC staff coordinated with regional partners to maximize this year s training. An active shooter tabletop exercise was conducted in May 2016 for the EPG and included a presentation from the UC Santa Barbara Emergency Manager including lessons learned from the Isla Vista tragedy. The September tabletop exercise was based on a wildfire scenario and included UCSD EOC staff, San Diego County OES staff, San Diego Fire and Rescue personnel and a presentation from Cal IT2 on wildfire behavior modeling that has been developed here on campus. These exercises had defined, pre-established program goals, and included tabletop exercises utilizing the elements of SEMS/NIMS, Incident Command System (ICS), and were concluded with post exercise debriefings. The Emergency Management Division takes great pride in speaking to new students and their parents at a number of student orientation events. These discussions include information on Triton Alert. Students and their family members are also offered the opportunity to register with Alert San Diego, the communication system managed by the San Diego County Office of Emergency Services which provides alert information about fires, floods, earthquakes, and other disasters that occur within San Diego County. Finally, information is provided about the SD Emergency app, which is another way for members of our campus community to receive information during times of an emergency that is affecting our region. The Emergency Management Division will continue to take a multi-media approach to providing emergency information to members of our community.