Attachment 1 - Performance Work Statement.pdf

Contractor Performance Work Statement (PWS) for

USAF Medical Home Station Medical Response (HSMR)

Sustainment Operations for AFMS Response (SOAR) 2-Day Public Health Emergency Exercise and Training

1. Course Description: HSMR SOAR Public Health Emergency Exercise and Training:

This two-day training and exercise event is designed to assess Air Force Medical Treatment Facilities (MTF) and train Medical Group personnel on HSMR program capabilities with a two-day focus on the ability to respond to a biological attack or a naturally occurring outbreak resulting in a public health emergency. All training and exercise events are designed to operationalize the use of the Air Force’s Response Training and Assessment Program (RTAP) material and to reinforce the use of RTAP tools with disaster team chiefs. Furthermore, all training and exercise events are based on public health emergency requirements and expected capabilities in Department of Defense (DoD) and USAF guidelines to include Defense Health Agency (DHA) Administrative Instruction 6055.02, Emergency Management Program, DoDI 6200.03, Public Health Emergency Management within the DoD, AFI 10-2501, Emergency Management Program, AFI 10-2519, Public Health Emergencies and Incidents of Public Health Concern, AFI 41-106, Air Force Medical Readiness Program, and AFTTP 3-42.32, Installation Medical All Hazards Response.

2. Public Health Emergency Concept of Operations (CONOPS): Training and exercise events will cover expected MTF and disaster team capabilities derived from AFTTP 3-42.32, the above listed policy documents, and RTAP tools to include tactical drills, team chief guides, and the RTAP Incident Response Matrix. That CONOPS that will be trained and exercised to include the following:

A. Ability to rapidly acquire, stage, and distribute medical countermeasures in a mass prophylaxis point of dispensing (POD) setting while meeting the needed scope and throughput capacity described in the Installation Mass Prophylaxis Plan and/or Disease Containment Plan.

B. Ability to utilize the assets of HSMR Allowance Standard (AS) 886E to provide medical countermeasures to protect initial victims, first responders, and prioritized personnel as well as to support POD operations.

C. Ability of the Pharmacy Team to expediently move the AS 886E cache and the ability of POD support teams to move HSMR material and needed operational supplies to a POD site location.

D. Ability of the Bioenvironmental Engineering (BE) Team, to respond to a biological agent to include unknown substances, conduct biological hazard evaluation and identification, and develop a health risk assessment.

E. Ability of the Laboratory Biological Detection Team (LBDT) to provide expertise in biological identification and risk analysis, collect and preserve evidence, conduct microbiology techniques, environmental testing, laboratory response network (LRN) shipments, and utilize AS 886I and analytical platforms within MTF facility requirements.

F. Ability of the Public Health (PH) Team to utilize AS 886P and perform outbreak detection, foodborne illness investigations, respond to communicable disease outbreaks, and conduct surveillance activities for biological events including foodborne and vectorborne disease outbreaks.

G. Ability of the Medical Control Center (MCC) to conduct command and control of all medical assets on behalf of the MTF commander during a biological response, to activate appropriate HSMR teams immediately when directed or upon notification of a suspected incident, to keep team chiefs informed about suspected contaminants, the number of patients being sent or transported to the medical unit from the incident site or POD site, and other required C2 actions.

H. Ability of Clinical, Disaster Mental Health, Immunizations, MCC, Manpower Security, Patient Administration, Pharmacy, Public Health, and Triage disaster teams to conduct mass prophylaxis planning and operational support consistent with expected actions in associated RTAP tactical drills on supporting POD operations.

3. Specific Tasks for Contractor:

A. Deliver a Training and Exercise Schedule: Contractor will provide a training and exercise schedule for the two-day public health emergency option to include times, subjects, and required personnel. Government Client (MTF) will provide the locations for the training and exercise events.

B. Conduct a Mass Prophylaxis POD Full Scale Exercise and Training Event based upon Training and Exercise Objectives in Attachment 2 using HSMR AS Equipment and Supplies.

C. Conduct a Biological Agent Tabletop Exercise that provides an exercise scenario and trains MTF leadership, teams, and members on biological agent response, mass prophylaxis planning activities, and POD operations.

D. Deliver a POD walk through advising session to work with the POD Manager and other MTF leaders on POD site selection, stations and clinics within POD operations, patient flowchart by response type, needed supplies (including HSMR AS) and support, potential bottleneck areas and POD operations troubleshooting, and expected patient throughput of the POD.

E. Provide a Bioenvironmental Engineering training session that guides the BE response team on health risk assessment (HRA) requirements and definitions, use of the HRA in a response environment, risk communication concepts and a risk communication practical drill.

F. Provide a BE and LBDT joint training session on reviewing biological sampling strategies, coordination between BE and LBDT teams, team equipment, and sampling strategies.

G. Provide a PH training session that instructs on the use of HSMR AS 886P and key considerations for conducting food sample submissions in order to test implicated foods for suspected foodborne agents during a foodborne illness investigation. In addition, train on the use of 886P equipment in developing an installation vectorborne disease surveillance plan and conducting vector surveillance activities during an outbreak investigation.

H. Conduct a foodborne illness exercise and training event that trains required personnel (including public health, emergency departments, primary care management teams, pro-staff, and lab personnel) and meets training and exercise credit as per AFI 48-116, Food Protection Program. The session will cover required topics of training including patient diagnostic testing, patient 3-day food history interviews, data collection, epidemiological analysis of data collected, and food sample collection if available for testing and food operation risk mitigation.

I. Deliver an MCC operations training session that teaches both MCC operations and command and control during a biological agent response. Training topics for the MCC include radio etiquette, C2 common operating picture (COP), resource management during an all-hazards response, MCC activation procedures, and an MCC and MTF activation drill during a biological response to active teams and stand-up POD operations.

J. Conduct a post exercise hotwash session to engage team chiefs, medical WIT, medical readiness, and MTF leadership on lessons learned, observations and challenges during the full-scale exercise, areas needing corrective action plans, POD operation recommendations, and strengths identified.

K. Provide an in-brief and out-brief session for MTF executive staff and leadership on objectives of the two-day public health emergency training and exercise event and findings and recommendations from the training and exercise sessions.

L. Provide Full Scale Exercise Materials: Contractor will provide full scale exercise materials to include scenario briefing material, patient/actor simulation cards, exercise Master Event Scenario Listing (MESL), actor briefing, and safety briefing. MTF will provide HSMR AS equipment and simulated medical countermeasure material.

M. Ensure Functionality of Unit’s POD Equipment and Accessories: Contractor will validate set up of POD location, equipment, and supplies and advise team chiefs on equipment set up and POD operations.

N. Administer and Control POD Full Scale Exercise: Contractor will provide staff to administer all aspects of the full-scale exercise to include providing exercise controllers to manage MESL injects, the pace of exercise flow, and facilitate accomplishment of exercise objectives. MTF will provide medical WIT staff to assist exercise observation and document MDG after action activities.

O. Contractor will instruct POD Manager on how to identify challenges in POD operations to include bottlenecks in patient flow, inefficiencies with patient flow design and flow chart, and challenges in logistics, resources, and communications. Contractor will instruct team chiefs and team members on POD objectives and best practices in POD operations.

P. Contractor will deliver a base visit After-Action Report (AAR) based on the needs of the Government Client after training at each location. Contractor will detail how well medical group personnel were prepared for training and exercise requirements and provide recommendations for improvements in HSMR team training, program management, biological response capabilities, and MTF POD operations.

4. Security Clearance: Not required.

5. Period of Performance:

A. The period of performance will be based on contract award date.

B. Work will be performed at the following four AFGSC installations:

Barksdale AFB (2d Medical Group)

F.E. Warren AFB (90th Medical Group)

Kirtland AFB (377th Medical Group)

Whiteman AFB (509th Medical Group)

6. Government/Contractor Furnished Facilities, Equipment and Information:

A. The contractor shall furnish:

1) The necessary personnel to schedule all training events and manage curriculum.

2) Provide available training dates.

3) Conduct 120-day, 60-day, and 7-day base visit planning meetings to review the objectives of the two-day public health emergency training and exercise event and describe and review the planning and logistics support endeavors needed by the MTF for a successful base visit (e.g. scheduling of training locations, blocking schedules of MTF personnel, acquiring actors for the POD exercise, etc.). The Contractor can adjust the timeframe of the planning meetings based on the needs of the MTF.

4) One highly qualified Lead Instructor / Lead Exercise Controller and no less than two additional staff with expertise in biological agent response, POD full scale exercise operations, and subject matter expertise for all training and exercise sessions.

5) All training and exercise support materials (e.g., briefings, MESL, patient/actor simulation cards, etc.), contractor staff travel, and other services required to perform the tasks.

B. The Government will provide:

1) Name, phone, and e-mail of the MTF’s base visit POC for the Contractor to work with at the start of the planning cycle. Note: Close coordination between the Contractor and the MTF base visit POC is essential to keep scheduling on track.

2) Location of POD exercise site and other training agenda items.

3) On-base access for contractor staff.

4) Reimbursement for any of Contractor’s travel commitments if a Base “scheduled for training” cancels or re-schedules. The Contractor will book flights for personnel at 45 days prior to the base visit.

5) Information and access to uniquely available equipment and government-owned applications/information required to accomplish task objectives.

6. Travel:

A. Travel to various U.S. Air Force installations in CONUS and OCONUS to provide the training is anticipated, but not limited to:

Trip/Base Name: Barksdale AFB (2d Medical Group), F.E. Warren AFB (90th Medical Group), Kirtland AFB (377th Medical Group), Whiteman AFB (509th Medical Group) Type of Training: HSMR SOAR Public Health Emergency Two-Day Training & Exercise # Instructors: 3 Days of Prep & Training: For each instructor, approximately 8 hours travel to base location, 8 hours travel return from base location, 16 hours two-day training and exercise event, 40 hours of prep that includes conducting planning meetings with MTF, updating slide sets and training material to be specific to each base, updating base specific exercise materials, rehearsing training and exercise material for each session, coordination meetings with teams, booking travel, on site walk throughs, and developing the after action report.

B. Travel costs must comply with DoD Per Diem Rates listed at:

https://www.travel.dod.mil/

7. Reporting Requirements:

Contractor will provide a Base Visit After-Action Report (Attachment 3) based on the preference of the Government Client each time an installation receives a Public Health Emergency Two- Day Training and Exercise event to the established POC within 15 working days of event completion.

Attachments:

1. HSMR SOAR Public Health Emergency Training and Exercise Schedule

2. HSMR SOAR Public Health Emergency Training and Exercise Objectives

3. Format for Public Health Emergency Base Visit After Action Report https://www.travel.dod.mil/

Attachment 1 to Contractor Performance Work Statement (PWS) for

Home Station Medical Response (HSMR) Sustainment Operations for AFMS Response (SOAR)

PUBLIC HEALTH EMERGENCY TRAINING AND EXERCISE SCHEDULE

1. HSMR SOAR PROGRAM SCHEDULING:

1.1. The Public Health Emergency training and exercise schedule provided in paragraph 3 is the standard schedule for this two-day HSMR SOAR event and will be the schedule delivered to the MTF unless any changes to the standard schedule are requested by the MAJCOM or the MTF. It may be possible to substitute other HSMR SOAR training sessions on a one-for-one basis depending on the needs of the MAJCOM or MTF and the availability of contractor subject matter experts for the base visit. It is recommended that any changes to the standard schedule are approved by the MAJCOM SGX representative. The pricing quote listed on the invoice for this event is based on the standard schedule for the two-day Public Health Emergency training and exercise event.

1.2. This two-day HSMR SOAR event may be combined with an additional HSMR SOAR two-day training and exercise event (e.g. Continuity of Operations, Aircraft Mishap, Active Shooter, or C-CBRN Response) to establish a four-day training and exercise base visit. In the event of any session overlapping material between the two options, substitute training and exercise sessions will be offered from the other HSMR SOAR events to maximize value to the MTF. In this case a separate invoice will be provided for the second two-day HSMR SOAR option.

1.3. The HSMR SOAR program is tailorable to the needs of the MTF (or MAJCOM). While the two-day HSMR SOAR event standard schedule is the recommended approach, contact the contractor for an updated invoice if a different solution is desired. Additional training and exercise selections added to the two-day HSMR SOAR events results in program savings due to the consolidation of contractor travel expenses (approximately 25-30% of the two-day invoice total). Examples of additional solution approaches include:

1.3.1. Two HSMR SOAR events packaged together for a four-day base visit.

1.3.2. An additional training or exercise day (third day) added to the two-day HSMR SOAR option.

1.3.3. Two additional training days (third and fourth days) added to the two-day HSMR SOAR option.

1.3.4. Two HSMR SOAR events and an additional training day added for a five-day training and exercise option.

1.3.5. One-day training only or a one-day exercise only event.

1.4. Unless included with other training and exercise events, the A6A Associates Training and Exercise Team will travel to arrive on the day before the event and travel to depart on the day after the event. Days of the week for the two-day training and exercise event will be coordinated with the MTF POC. The A6A Team will coordinate their own travel and billeting accommodations, the base will not need to provide transportation or billeting.

2. Pre-Coordination Required Before Full-Scale Exercise:

2.1. MTF/CC ensures schedules are blocked for all assigned teams (and clinics as necessary) for the full-scale exercise from 0730 – 1130. Ensures availability of team chiefs, key personnel, and equipment set up personnel as needed to include logistics activities necessary from the preceding day (Day One).

2.2. The HSMR SOAR base visit POC, MRO, and POD Manager should work together to ensure availability of the primary POD site location for the entire two-day HSMR SOAR Public Health Emergency training and exercise event. Pre-coordinate with the management of the POD site facility (e.g., gymnasium, community center, hanger, etc.) to ensure availability of site location for the entire two days to take into consideration time needed for walk through, set up, exercising, hotwash, and tear down).

2.3. All tasked MTF HSMR Team Chiefs ensure that they or a representative on their behalf are available for the activation drill and briefing (afternoon Day One), POD set up (afternoon Day One or early morning Day 2), and the POD full-scale exercise (0730 – 1130hrs).

2.4. Pharmacy Team Chief and/or POD Manager ensure they are available from 0800-1000 for review of Allowance Standard 886E and POD site walk through.

2.5. All POD support equipment and necessary HSMR team and POD support supplies should be in place at the primary POD site location by the exercise STARTEX. This includes modes of public health risk communication briefings, clinical team and patient assessment supplies, immunization support items and sharps containers, medication dispensing materials, medical record materials, drug information and fact sheets, patient handouts, patient transport vehicles (if used), etc.

2.6. The Medical Readiness Officer and base visit POC will need to obtain a minimum of 50 actors for the exercise who are available at the POD site location from 0730 – 1130. It is recommended to coordinate with Wing IG for assistance from other units in obtaining actors.

Other options include non-tasked medical personnel and/or family members of any medical personnel. Children aged 12 and over may serve as an actor as long as they have parental supervision at all times. Other sources of actors could include civil air patrol, air national guard, air force reserve, collocated joint units, or community organizations that have supported similar efforts in the past.

2.7. All IMAHR Team Chiefs will ensure the availability of all needed medical and administrative supplies to operate their team’s station within the POD facility.

2.8. The Medical Logistics Team Chief will ensure availability of personnel to assist with logistics and movement of equipment and supplies from the MTF to the POD site location for set up and tear down of the exercise event.

3. PUBLIC HEALTH EMERGENCY TRAINING AND EXERCISE SCHEDULE

3.1. Morning Day One Schedule

3.2. Afternoon Day One Schedule

3.3. Day Two Schedule

Attachment 2 to Contractor Performance Work Statement (PWS) for

PUBLIC HEALTH EMERGENCY TRAINING AND EXERCISE OBJECTIVES

1. Overall SOAR 2-Day Public Health Emergency Training and Exercise Objectives:

1.1. Prepare AF MTFs to respond to biological agents, public health emergencies, and incidents of public health concern where the event has an imminent threat of a significant number of illnesses, deaths, or severe degradation of mission capabilities or normal operations.

1.2. Meet the annual requirement for a public health emergency full scale exercise using a crawl, walk, run approach of didactic training, drills, and team integration events leading to an MTF full scale exercise (with Wing unit support when requested by the installation).

1.3. Understand the capabilities and employ the operational use of HSMR 886 Allowance Standards to respond to and mitigate a public health emergency or biological agent event.

1.4. Understand biological event detection and identification capabilities to include biological surveillance of syndromes and reportable events, outbreak investigations, foodborne illness investigations, vectorborne surveillance, hazardous material identification and quantification, pathogen identification, and available sampling capabilities for biological agents.

1.5. Understand the occurrence of a biological event that overwhelms local response capabilities and requires medical countermeasure support options to include assets from the Strategic National Stockpile (SNS) or DoD stockpile materials.

1.6. Participate in a mass prophylaxis point of dispensing (POD) exercise that demonstrates the MTF’s capability to provide medical countermeasures in an immediate response timeframe consistent with the capabilities stated in the installation’s mass prophylaxis plan (MPP) and disease containment plan (DCP).

1.7. Understand the decision-making process for declaring a public health emergency and medical advisory roles to the installation commander on emergency health powers to mitigate a biological event.

1.8. Assess the effectiveness of the installation’s MPP and DCP and provide recommendations to improve medical and public health emergency response guidance.

1.9. Understand factors where public health emergencies may result in surge requirements that overwhelm the response capacity, capability, and resources of MTFs and health care providers that may result in an inability to meet normal standards of care.

1.10. Understand casualty treatment capabilities during a public health emergency or biological event, supporting MOUs and local response capabilities, and how the MCRP describes the capabilities for the MTF to provide casualty care after a biological event.

1.11. Understand the Air Force Incident Management System (AFIMS) and how the MTF performs and supports command and control (C2) operations during a public health emergency of biological agent event.

2. Objectives for Training Session 1 – Public Health Team (PHT) and Integrated Training

2.1. Understand the response procedures for the PHT before, during, and after a CBRN related biological event.

2.2. Understand the capabilities of the HSMR AS 886P and how to maintain, in ready status, the equipment and supplies required for initial response to a biological event, including specialized detection and surveillance equipment for investigating food-borne illness outbreaks, performing vector-borne disease surveillance, and identifying suspected biological agents.

2.3. Understand integration and coordination with local and state response agencies, as appropriate in PHT planning in order to ensure the response to a public health emergency or biological event is a coordinated community effort.

2.4. Understand response to foodborne illness outbreaks and how to determine the possible source of the infection and report findings.

2.5. Understand how to interview patients to determine possible sources of infection and inspect facilities to determine possible environmental sources of infection.

2.6. Understand how to collect food samples, package and ship specimens to the appropriate testing laboratory, and coordinate as necessary with the lab team (886I) for available food-borne assays.

2.7. Understand how to report investigation results with recommended preventive measures to the PHEO, squadron commander, MDG commander, wing commander, MAJCOM/SG, MAJCOM/PHO, USAFSAM, and local and state health departments as required.

2.8. Understand how to conduct vector and vector disease surveillance, how to establish and manage the installation vector surveillance plan, how to identify vectorborne diseases of military significance, and how to establish a local area vector profile.

2.9. Understand how to use AS 886P supplies to collect, prepare, and submit vector samples IAW with Air Force and USAFSAM entomology guidelines.

2.10. Understand chain of custody procedures for foodborne or vectorborne samples suspected of containing a biological threat agent.

2.11. Understand vector identification principles, how to coordinate with support agencies for complete vector identification at the genus and species level, and how to perform local vector identification during a vectorborne outbreak.

2.12. Understand control and mitigation measures for vector populations within the local area vector profile.

3. Objectives for Training Session 2 – POD Advisory Walk Through

3.1. Understand the logistics, support, site selection, and operational procedures and requirements of a mass prophylaxis point of dispensing site in response to a public health emergency or biological event.

3.2. Understand the capabilities of the HSMR AS 886E and how to maintain, in ready status, the equipment and supplies required for initial response to a biological event and POD support operations.

3.3. Understand integration and coordination with local and state response agencies, as appropriate in POD operations to ensure the response to a public health emergency or biological event is a coordinated community effort.

3.4. Understand the scope of the installation MPP, the target objectives for POD throughput capacity and capabilities, and the expected patient throughput of the POD during the full-scale exercise.

3.5. Understand how to organize, equip, and operate a POD site for mass prophylaxis distribution to include the supplies needed for POD support for all HSMR and MCRP supporting teams.

3.6. Understand POD communications and command and control procedures within the MTF and within the AFIMS structure.

3.7. Understand the POD patient flow chart, required stations to operate the POD, and how to measure effectiveness in the POD’s operational efficiency through the analysis of patient flow bottlenecks and operational challenges. The A6A contractor will discuss patient flow options and potential mitigation steps with the POD Manager during both the POD site facility walk through and the full-scale exercise.

4. Objectives for Training Session 3 – Bioenvironmental Engineering Team and Integrated Training

4.1. Understand the response procedures for the BE Team before, during, and after a CBRN related biological event.

4.2. Understand the capabilities of the HSMR AS 886H and how to maintain, in ready status, the equipment and supplies required for initial response to a biological event.

4.3. Understand integration and coordination with local and state response agencies, as appropriate in BE Team planning in order to ensure the response to a public health emergency or biological event is a coordinated community effort.

4.4. Understand health risk assessment support to the incident command objective of saving lives, protecting property, and continuing and recovering the mission.

4.5. Understand the use of data quality objectives, including qualitative and quantitative criteria for clarifying objectives, and defining the appropriate types of data needed in order to assist in determining a sampling strategy.

4.6. Understand BE team inputs to the initial site assessment to include obtaining information from integration partners’ initial site assessments to establish a common operating picture, request information from integration partners on witness/victim signs, symptoms, or injuries, and collect information that will be useful for hazard identification.

4.7. Understand how to provide Site Safety and Health Plan (SSHP) inputs to the Incident Safety Officer and how to determine hazard quantification actions for the incident commander.

4.8. Understand how to evaluate identified health hazards, determine hazard quantification data required to support health risk estimation and risk assessment.

4.9. Understand how to provide PPE requirements for responders and incident site operations, how to provide initial input regarding site entry on PPE requirements and protective measures, and how to perform up or down selection of PPE.

4.10. Understand how to provide the IC with initial assessment of health hazards to advise on hazard control zone management to include cordon contraction or expansion.

4.11. Understand how to identify populations at risk (e.g., responders, base housing residents, workers in “Building 445,” or people at a local mall) and how to identify environmental media by which health hazards are transported (e.g., air or water) and potential routes of exposure (e.g., inhalation, dermal, ingestion) for the populations at risk.

4.12. Understand how to compare sampling results to guidelines and standards established to determine possible outcomes and how to analyze health risk assessment tool outputs or other information gained on hazards.

4.13. Understand how to communicate the HRA to the IC, EOC, Crisis Action Team (CAT), Installation Control Center, other C2 nodes and response partners, as appropriate, using approved command, control, and communication procedures.

4.14. Understand how to communicate the HRA to Public Affairs for public information releases or for other risk communication purposes when approved by information release authority.

4.15. Perform a HRA drill by completing a HRA Worksheet designed to assist the health risk assessor to rapidly organize the necessary information to accomplish the emergency response HRA and to formulate a concise, plain language risk communication to provide to the IC, leadership or public affairs.

4.16. Understand how to accomplish a biological strategy overview to include available equipment, detector capabilities, sampling strategies, and HRA guidance for a potential biological event.

5. Objectives for Training Session 5 – Bioenvironmental Engineering Team and Laboratory Detection Team Integrated Training and White Powder Drill

5.1. Understand the roles and the integration efforts between the LBDT and BE teams in order to facilitate seamless coordination and efficient communication during sample collection, transportation, and identification. Both teams should understand the other’s processes and tools to successfully achieve a rapid hand off between the teams while accurately communicating response details.

5.2. Understand how to identify possible health hazards associated with a biological incident and how to identify sample requirements.

5.3. Understand how to practice sound contamination avoidance techniques to limit the spread of contamination.

5.4. Understand communication protocols with the MCC to determine incident hazards, report team member accountability, and identify immediate support required.

5.5. Understand how to test samples on the appropriate biological agent diagnostic system or polymerase chain reaction instrument using appropriate PPE IAW pre-established instrument and analytical protocols and following BSL-2 precautions.

5.6. Understand how to report preliminary results to the senior laboratory officer, attending physician, medical unit commander, PHEO, BEE, and other appropriate agencies, such as PH, the MCC, and local and regional public health authorities IAW local procedures.

5.7. Understand how to send clinical specimens or environmental samples that are suspected as a biological threat agent regardless of diagnostic system or polymerase Chain Reaction instrument result to a reference laboratory for confirmation analysis.

5.8. Understand proper protocols for receiving and testing a biological sample with no contamination on the packaging. Understand how to properly prepare, secure, and deliver samples during presumptive positive lab analysis.

5.9. Understand how to deliver samples from the BE Team to the LBDT with established chain of custody (in the event of a clinical specimen) and understand how to follow chain of custody procedures for environmental samples. Understand how to maintain chain of custody on all samples throughout processing, analysis, and transportation.

5.10. Understand how to use appropriate PPE and follow pertinent safety precautions to receive specimens/samples containing suspected biological threat agents.

5.11. Understand how to communicate sampling data and methods to the MCC and how to consult with AFOSI and Security Forces to determine if law enforcement escort is required for sample transport, (i.e., the contamination is suspected to be intentional and knowing which agencies will be involved in sample processing).

6. Objectives for Training Session 6 – Foodborne Illness Training and Exercise

6.1. Understand epidemiological methods for outbreak recognition of a foodborne event to include identifying potential cases, patient symptomology, patient diagnostic testing, and epidemiological associations.

6.2. Understand how to conduct patient food history interviews and identify potential sources of the foodborne outbreak.

6.3. Understand how to determine implicated foods and sources and establish control measures to prevent the spread of further illness.

6.4. Understand the integration roles and response procedures between the PHT, LBDT, clinical teams, emergency services, PHEO, MEM, and other professional staff or teams.

6.5. Understand the capabilities of the HSMR AS 886P and how to maintain, in ready status, the equipment and supplies required for investigating food-borne illness outbreaks. Know how to collect food samples, package and ship specimens to the appropriate testing laboratory, and coordinate as necessary with the LBDT for available food-borne assays (HSMR AS 886I).

6.6. Understand how to report investigation results with recommended preventive measures to the PHEO, squadron commander, MDG commander, wing commander, MAJCOM/SG, MAJCOM/PHO, USAFSAM, and local and state health departments as required.

7. Objectives for Training Session 7 – Biological Agent Response Tabletop Exercise

7.1. Understand how to review and assess key components and planning factors of the Installation’s Disease Containment Plan (DCP) and Mass Prophylaxis Plan (MPP) in public health emergency response planning.

7.2. Understand how to identify potential planning gaps in the DCP and MPP that should be addressed and incorporated into the unit’s self-assessment process.

7.3. Understand outbreak detection and recognition protocols for a public health emergency or biological agent event.

7.4. Understand incident response protocols for a potential biological agent event to include MCC and HSMR team activation, medical support to incident scene response, public health emergency medical advisory roles, and medical support to installation leadership and C2 actions.

7.5. Understand sampling strategies, techniques, and protocols for biological agent events.

7.6. Understand mass prophylaxis planning strategies to include sources of medical countermeasure acquisition and how to determine the mass prophylaxis plan scope and population at risk.

7.7. Understand determining factors for POD site selection, set up of POD operations, POD staffing requirements, and POD logistical support requirements.

7.8. Understand health risk assessment data and risk communication needs for a biological event or public health emergency.

7.9. Understand POD operations by medical / HSMR support team and support requirements from other Wing agencies or units to include POD logistics, security, and communications support.

7.10. Understand POD activation and deactivation protocols, POD command and control functions, and how to integrate POD operations within the AFIMS C2 construct.

7.11. Understand integration and coordination with local and state response agencies in public health emergency response planning in order to ensure the response to a biological event is a coordinated community effort.

8. Objectives for Training Session 8 – MCC Operations

8.1. Understand the Air Force Incident Management System, POD command and control center, and other C2 constructs applicable to the MCC during a biological event or public health emergency.

8.2. Understand how to establish a common operation picture (COP) within the MCC operations center to include potential systems and tools to support the development of a COP and communications with the EOC and other relevant teams and agencies.

8.3. Understand the medical unit commander’s information requirements and how to establish and manage essential elements of information.

8.4. Understand plotting and mapping functions within the MCC, data needed for response operations, and systems or tools used by the unit and installation to accomplish.

8.5. Understand MCC activation protocols and immediate actions to include timeliness of activation requirements, MCC checklist identification and management, initial medical response team actions on scene, initial medical response team actions at the MTF, and immediate steps necessary to safeguard the medical facility, patients, and staff.

8.6. Understand elements of radio operations to include radio etiquette, radio discipline, clear and concise transmissions, use of the NATO phonetic alphabet, key words used in radio procedures, how to utilize a radio, how to begin and end transmissions, and how to conduct radio checks.

8.7. Understand resource management challenges during a biological event or public health emergency and sources of medical material support and mitigation measures.

8.8. Understand methods to track and resource data and requests across the MTF and how to communicate key resource management information to the disaster teams, MTF leadership and the EOC. Know how to document and display resource management requests in the MCC and

EOC.

8.9. Know sources of medical material support available to the MTF to include War Reserve Material (WRM), contingency medical material, MC-CBRN Assets, Patient Movement Item Program, DoD stockpiles and TLAMM, MOUs for local or host nation support, the Strategic National Stockpile, base operating supplies and peacetime operating stock, and other sources of material that may be locally available.

8.10. Understand vehicle resources at the MTF, avenues for additional vehicle and patient movement support, and how to manage vehicle resource tracking requests in the MCC.

8.11. Understand the role and how to establish the use of inventory trigger points to manage asset demand during an incident response.

8.12. Conduct an activation drill associated with a public health emergency / biological agent event and measure effectiveness of MCC and response team activation.

9. Objectives for Training Session 9 – Mass Prophylaxis and POD Full Scale Exercise

9.1. The overall objectives for the POD FSE are:

9.1.1. Establish a baseline (or additional data points) on the medical group’s throughput capacity of a mass prophylaxis POD operation.

9.1.2. Determine if the POD patient processing number objective listed in the MPP can be met (e.g. processing of 100 patients per hour through the POD).

9.1.3. Assess the patient flow chart effectiveness and POD operation efficiency through analysis of patient flow bottlenecks and operational challenges.

9.1.4. Establish if patient care and patient safety challenges can be identified and managed appropriately by the POD manager, team chiefs, and POD staff.

9.2. Understand how to request additional resources, logistics, and manpower support through AFIMS C2 systems during POD operations.

9.3. Understand how to immediately standup POD operations and deliver medical countermeasures to a large population in less than 24 hours.

9.4. Understand how to manage a specific biological agent threat scenario and conduct effective medical counter measure operations available for the response.

9.5. Understand how to set up and operate all the required clinical and support stations required to conduct POD operations during a biological agent event response.

9.6. Understand how to use the RTAP Tactical Drills by MCRP or HSMR team in support of POD operations:

9.6.1. The Clinical Team will staff and assemble the Clinical Station to operate and be able to receive patients by the POD opening time. Medical treatment is provided according to Air Force and CDC guidelines to include screenings, medical evaluations, and other diagnostics as dictated by the event causing a need for POD activation.

9.6.2. The Disaster Mental Health (DMH) Team will staff and assemble the DMH Station to operate and be able to receive patients by the POD opening time. DMH will evaluate, assess, and provide counseling for patients referred to the POD mental health station and support methods for efficient patient flow and POD operations.

9.6.3. The Immunizations Team will staff and assemble the Immunizations Station to operate and be able to receive patients by the POD opening time. The Immunizations Team will prepare and conduct mass immunization administration and support methods for efficient patient flow and POD operations.

9.6.4. The Manpower and Unit Security (MUS) Team will staff and assemble and ready to operate by the POD opening time. The MUS Team will provide 24-hour security to the POD site facility to include control of personnel and vehicle traffic. The MUS Team Chief will coordinate POD Security with Base Security Forces on response and recommendations.

9.6.5. The Medical Command and Control Center (MCC) will activate the POD Command and Control Center (PCC) to communicate and coordinate POD operations within the time standard identified in the MCRP, other local guidance, or as established by local leadership. The PCC will assist the POD Manager by communicating and coordinating POD operations information with team chiefs and the MCC ensuring the POD Manager maintains situational awareness of all POD activities.

9.6.6. The Patient Administration Team (PAT) will staff and assemble both the Patient Administration (or POD check in) Station and the POD Exit Station to operate and be able to receive patients by the POD opening time. PAT will provide administrative set-up support, controlling patient flow, administering/collecting patient forms and conducting patient records/data management. PAT will ensure collection of forms, accurate patient contact information and proper medication at the out-processing station.

9.6.7. The Pharmacy Team will staff and assemble the Pharmacy Station to operate and be able to receive patients by the POD opening time. The Pharmacy Team will implement any applicable or necessary memorandums of understanding (MOUs) for medical countermeasure support. The Pharmacy Team will evaluate, assess, and provide prophylaxis to all patients processing through the POD with efficient capacity for patient flow and to address the base population at risk.

9.6.8. The POD Manager will activate all required personnel and MOUs to stand up POD operations and establish POD Command and Control IAW Incident Command System (ICS) within 45 minutes of POD activation notification. The POD Manager will stand up the POD facility, secure required medical material and supplies, prepare staff to operate all necessary POD stations, and commence POD operations by receiving patients and distributing prophylaxis within two hours of POD activation notification.

9.6.9. The Public Health Team will staff and assemble the Public Health (or POD Briefing) Station to operate and be able to receive patients by the POD opening time. The

Public Health Team will prepare and conduct a public health and risk communication briefing for patients processing through the POD and support methods for efficient patient flow and POD operations.

9.6.10. The Triage Team will staff and assemble the Triage Station to operate and be able to receive patients by the POD opening time. The Triage Team will evaluate, assess, and triage all patients who transit the POD with efficient capacity to maintain flow and address the base population at risk.

9.7. At the conclusion of the exercise, all Team Chiefs, Medical Readiness Officer, MEM, POD Manager, and WIT will participate in a hotwash facilitated by the A6A contractor. The hotwash will identify lessons learned, positive value approaches to the POD operations that may be highlighted as best practices, and recommendations for plan updates and future training and exercises.

9.8. At the conclusion of the hotwash, all teams will return equipment to a “response ready” mode by removing items used only for training and replacing or repairing any items expended or damaged during training. Equipment will be stored in a “response ready” fashioned and organized so that the first item needed is at the front of the storage area.

9.9. Exercise event critiques will be provided to all participating members to offer the opportunity to provide feedback both on the MTF’s operations and the event administered by the A6A contractor.

Attachment 3 to Contractor Performance Work Statement (PWS) for

PUBLIC HEALTH EMERGENCY TRAINING AND EXERCISE

AFTER ACTION REPORT FORMAT

MEMORANDUM FOR MDG/CC

FROM: A6A CONTRACTOR

Subject: HSMR SOAR 2-Day Public Health Emergency Training and Exercise Event After Action Report, at (Location), (Date of Training)

1. A6A Contractor will supply a post base visit and full-scale exercise summary report with input from participating Wing Inspection Team (WIT), team chiefs, medical readiness officer, observers, and MAJCOM SGX representatives.

A. Base Visit Training and Exercise Objectives

B. Exercise and Training Requirements Fullfilled

2. Exercise Overview Including:

A. Date(s) and location(s) and number and types of casualties

B. Type of incident/exercise, scenario and a list of participating teams, organizations, and key individuals, as applicable.

C. Exercise results and achievement of objectives.

3. HSMR AS Preparedness, Staging, Storage, and Equipment Recommendations

4. Base Visit Observations and Recommendations

5. Recommended Areas for Improvement

6. Best Practices Observed

7. Recommendations for Installation/MTF Plan Updates (MCRP, MPP, DCP)

8. A6A Contractor and MAJCOM SGX Points of Contact.

//SIGNED//

Contractor