FOR OFFICIAL USE ONLY

Homeland Security Exercise and Evaluation Program (HSEEP)

After Action Report/Improvement Plan
Formidable Footprints W/S #1
Version 1.0 02/04/09

FORMIDABLE FOOTPRINTS

FLORIDA/GEORGIA
WORKSHOP #1

JANUARY 28, 2009

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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

After Action Report/Improvement Plan

February 4, 2009

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FOR OFFICIAL USE ONLY
 FOR OFFICIAL USE ONLY
Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

HANDLING INSTRUCTIONS
1. The title of this document is Formidable Footprints Workshop #1 After
Action Report/Improvement Plan (AAP/IR).

2. The information gathered in this AAR/IP is classified as “For Official Use

Only.” It should be handled as sensitive information not to be disclosed to
the public [119.071 (3)(a) F.S.]. This document should be safeguarded,
handled, transmitted, and stored in accordance with appropriate security
directives. Reproduction of this document, in whole or in part, without prior
approval from Florida Department of Health is prohibited.

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. Point of Contact:

Jack Pittman, Exercise Manager

Florida Department of Health
Office of Public Health Preparedness
4052 Bald Cypress Way Bin A-23
Tallahassee, Florida 32399-1720
850.245.4444 ext. 3725
jack_pittman@doh.state.fl.us

Kelly Nelson, Asst. Exercise Manager

Florida Department of Health
Office of Public Health Preparedness
4052 Bald Cypress Way Bin A-23
Tallahassee, Florida 32399-1720
850.245.4089
kelly_nelson@doh.state.fl.us

FF W/S #1 3 Florida Department of Health

FOR OFFICAL USE ONLY
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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

CONTENTS
Administrative Handling Instructions........................3
Contents..................................................................4
Executive Summary..................................................5
Section 1: Formidable Footprints Overview...............6
Section 2: Workshop Discussion................................7
Section 3: Analysis of Workshop Discussion..............7
Major Strengths ..................................................7
Areas for Improvement ........................................7
Analysis ..............................................................8
Recommendations ...............................................8
Section 4: Conclusion...............................................8

FF W/S #1 4 Florida Department of Health

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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

EXECUTIVE SUMMARY
Florida, Alabama, and Georgia have responded to a wide variety of emergency
and disaster events -- hurricanes, wild fires, tornados, floods, toxic chemical
spills, and biological terrorism scares.

Typically, events that require emergency response are managed at the local
level with local resources. Some major events such as hurricanes, wild fires,
tornados, and floods cross county lines and overwhelm local resources and
require state response often with assistance of federal partners.

Some events occur in rapid succession or for a long period of time. During the
2004 hurricane season, for example, 50 Florida counties reported damage by
powerful storms hitting the state in rapid succession. During the peak period,
the State Emergency Response Team (SERT) reported up to 800 assistance
requests per day. Coordination of response across so many counties, proved
difficult for a fatigued SERT as well as operational staffs in affected county
emergency operations centers.

A pandemic event could result in an unprecedented, catastrophic disaster

affecting all communities, counties, and states over a period six months or
more. Furthermore, we can assume that most or all of the other states will be
affected by the pandemic thus severely limiting outside and federal
assistance.

This workshop series focuses on the sudden introduction of a new influenza

virus in a multi-county area that, in at least two workshops, crosses state
borders. The basic workshop scenario premise is that a medical and health
care corridor or footprint will form along the major interstate highways.
Citizens will cross state line to find better or different care than what is
available in their area.

Each workshop scenario begins with rapid initial case containment and then
strong community containment measures to prevent or at least reduce
potential pandemic spread. Hospitals, the medical and public health
communities will need consistent and measured risk communication. The
challenge is to quickly get control of the situation, requesting resources,
managing outcomes over both the short and long term event.

The workshop will seek to evaluate existing county, district, regional and
state-level planning where they exist while creating a nexus for future multi-
county and state pandemic planning.

FF W/S #1 5 Florida Department of Health

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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

On January 28, 2009, 21 health and medical professionals from north central
Florida met with 21 health and medical professionals from south central Georgia
in a workshop to discuss cross-border issues and coordination in a pandemic
influenza scenario.
Four modules were presents in an escalating pandemic scenario. The written
facts presented in each module were punctuated by "Breaking News" videos
which added realism and emphasis to the need for consistent risk
communications across both sides of the state border. Hospitals provided
excellent discussion of logistics issues affecting their operations as the
pandemic worsened -- just-in-time inventories and the realization that
hospitals on both sides of the border used the same vendors and suppliers.
Topics related to off-site triage-sites, alternative standards of care, and roles
for faith-based and neighborhood organizations and volunteers, also provided
spirited discussion

This workshop series design contains elements from the US Department of

Homeland Security Target Capabilities List (TCL) under the Response Mission
Area, TCL Common Capability Planning:
• Emergency Triage and Prehospital Treatment
• Medical Surge,
• Medical Supplies Management and Distribution
• Emergency Public Information and Warning regarding hospital altered
standards of care
• Mass Prophylaxis for hospital staff
• Emergency Public Safety and Security Response

These comply with the Homeland Security Exercise and Evaluation Program
(HSEEP) terminology and guidelines for the conduct of a workshop.

FF W/S #1 6 Florida Department of Health

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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

Section 2: Workshop Discussion

The following comments were derived from a summary of group breakout discussions following 
each module presented in the workshop scenario. The items of discussion were key messages for 
public education, recommendations for security, medical surge and mass care, medical 
equipment/supply vendor issues, cross county collaboration, isolation/quarantine/containment, 
conclusions, and recommendation and considerations for future planning. 

Salient Discussion Points:

1.Voluntary vs. mandated quarantine and support for quarantined
individuals
2.Area/regional cross-state command center
3.Stress personal protection strategies/ social distancing, school closings
4.Open joint info center
5.Practice good health practices/stay home if sick
6.Devise good case definitions
10.Stress social distancing
11.Setup AMTS to relieve hospitals
12.Mutual Aid – PH no- others maybe
13.Question: What is Hospital System Communication? System? Some
unsure.
14.Same PR message from CDC to State to County
15.PIO has to have credibility and be well known to community
16.Need to establish a cross state Hot-Line Number
17.Need unified communication
18.Need more drills
19.Risk Communication messages with addition of social distancing/self
isolation
20.Activate Joint Information Center to send one message and coordinate
with state
21.Reduced staff is an issue that will need to be addressed
22.Communication – (coordinated) is the most important public health
response
23.Schools could be used as alternative treatment sites to relieve load on
hospitals

Conclusions:

FF W/S #1 7 Florida Department of Health

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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

1. Much planning has been done but more is needed

2. FL/GA would work together very well
3. Flood P.I. to Public to help calm fears
4. Mutual Aid- iffy for some disciplines
5. Every county is at different levels of the event
6. We need more preparation and communication.
7. Tough-tough discussions

Recommendations for Future Planning:

1.Establish cross-state command center
2.Create a checklist of actions and coordination
3.Key players need to be identified prior to an actual event
4.Keep conducting cross state events to encourage continued
communication
5.Strengthen communication between hospitals, Public Health, and the
community
6.Have Pandemic Phase’s available for participant to understand
roles/responsibilities
7.Local health departments need to determine priority groups
8.More planning needs to be done between public health and school
systems

Section 3: Analysis of Workshop Discussion

Major Strengths

• Interacting with different agencies from different states.

• Learning how agencies in Florida/Georgia are preparing
• The scenario’s were well written and well presented on dvd
• Very thought provoking discussion

Primary Areas for Improvement

• Need to establish coordinated educational materials up front for public
• Need to establish clear chain of command WHO/CDC/State/County
• Review area that need extensive planning and coordination (school closing,
volunteer, risk communications, technical communication)

Analysis and Recommendations

The workshop was a very good start toward building the lines of

FF W/S #1 8 Florida Department of Health

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Homeland Security Exercise and Evaluation Program (HSEEP)
After Action Report/Improvement Plan Formidable Footprints W/S #1

communication between partners in bordering states/counties. The workshop

concluded with a strong recommendation to continue the conversation across
the FL-GA border and to expand across a variety of health and medical topics.

Section 4: Conclusions

A blog has been established to invite attendees to keep lines of communications open
across county and/or state borders. This blog will also be used as a learning tool between
public health preparedness partners.

FF W/S #1 9 Florida Department of Health

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