On March 7, 2024, the Maryland Region V Healthcare Coalition participated in a Chemical Emergency Surge Tabletop Exercise (TTX) hosted by the Maryland Hospital Association (MHA) that examined the preparedness efforts taken and response actions initiated to a mass casualty incident related to widespread sarin exposure. The exercise was designed to review existing emergency care assets, evaluate roles, and identify operational gaps during a large-scale chemical incident. The Maryland-National Capital Region Emergency Response System (MDERS) observed the exercise to gain better insights into healthcare response.

The Chemical Emergency Surge TTX covered three modules that engaged essential response components within the scenario, including initial recognition, community collaboration, and ongoing healthcare coordination. Each module contained information portraying a sarin attack at a large community gathering and the aftermath of chemical exposure casualties. The scenario emphasized the need to assess patients, decontaminate, treat injuries, and coordinate with public health and emergency managers. Throughout the exercise, participants from fire/EMS, public health, emergency management, acute-care facilities, and the Maryland Healthcare Coalition provided suggestions on specific response procedures utilized to reduce chemical exposure.

In the first module, units responded to a potential chemical agent release in a densely populated area with office buildings, retail space, and schools. Within minutes, multiple patients experiencing various symptoms arrived at nearby hospitals. During the response phase, participants discussed a variety of initial actions that involved the activation of the Emergency Operations Center (EOC), preparing Hazardous Materials (HAZMAT) operations, contacting poison control personnel, and deploying decontamination equipment to establish the immediate removal of contaminants. Considering the large acute exposure, participants reviewed real-time information sharing capabilities between hospitals and response partners particularly due to requesting specialized EMS transportation resources and disseminating critical incident information. In preparation for treating an influx of patients, these response activities set the foundation for ongoing healthcare coordination.

In the next phase, participants were informed of the evolving nature of the emergency with hospitals, clinics, physician offices, and other healthcare facilities becoming inundated with victims suffering from a range of adverse effects due to the sarin exposure. Participants referred and adhered to hospital protocols related to chemical emergency response to determine alternate areas for triage, on-site decontamination, and community evacuation. With the potential for misinformation and public concern, participants activated the EOC Joint Information Center (JIC) to coordinate public information with Healthcare Coalition members to provide consistent communication to mitigate mass panic.

While the actions of participating response agencies diminished the harm from chemical attack in the primary and immediate vicinity, participants explored other alternative methods to maintain and uphold regional healthcare coordination. Participants assessed mutual aid agreements to transport patients for ongoing care to facilities with appropriate resources, collect/dispose of contaminated materials, request staffing support, and execute situational awareness communication strategies among healthcare partners.

As the exercise concluded, participants enhanced their knowledge about the emergency notification processes and existing mutual aid agreements that were crucial in responding to and coordinating medical care. The discussion-based exercise examined the response capabilities across hospitals and healthcare facilities, revealing the necessity for more robust collaboration, resource allocation, and communication practices. MDERS supports active participation in exercises, viewing them as an indispensable training tool that fosters personnel development and optimizes operational efficiency.

For the last several years, the Maryland-National Capital Region Emergency Response System (MDERS) collaborated with the Prince George’s County Police Department (PGPD) to enhance PGPD’s leadership training opportunities. Both organizations identified the various courses offered by the Federal Bureau of Investigation-Law Enforcement Executive Development Association (FBI-LEEDA) as a useful opportunity to further educate PGPD supervisors, commanders, and executives.

The mission of FBI-LEEDA is to advance the science and art of law enforcement leadership by promoting the exchange of information to improve law enforcement management practices (FBI-LEEDA, n.d.). PGPD officers participated in a trilogy of courses, which were the Supervisor Leadership Institute, Command Leadership Institute, and Executive Level Institute. Students engaged with senior law enforcement leadership that facilitated instruction during the challenging four-and-a-half-day courses.

All three courses build upon the lessons learned from each respective class to form better law enforcement officers. The leadership concepts covered during classroom discussions include:

• Police Leadership: This activity introduced students to the characteristics of leadership through supervisory, personal, and professional traits. Students were then led through a self-evaluation of their own leadership qualities and expectations.

• Supervisory Credibility & Authenticity: Students were challenged to define credibility and how it relates to leadership. Students developed an understanding of the myriad of influences on credibility and leadership from different target groups. A focus was placed on actions, mannerisms, and behaviors essential to establish and maintain credibility.
• Leading Generations: Supervisors have the potential to lead at least four generations of employees. The characteristics associated with Baby Boomers, Gen X, Millennials, and Gen Z were reviewed to familiarize students with the nuances of leading each generation.

• Police Leadership in the 21^st Century: Introduced students to police strategic leadership concepts appropriate for the 21^st Students addressed current U.S. policing strategies and future trends.
• Bias and Diversity: Students explored the executive’s role in creating a sensitive workplace. Students and instructors discussed how negative bias-based issues can diminish the perception of police service delivery.
• Future Trends: Students learned about the future of policing by examining demographic shifts, advances in technology, and social shifts emerging in the U.S. requiring law enforcement departments to adapt.

Once students have successfully completed one segment of the series, they can proceed to one of the other courses associated with the trilogy. After completing all three courses, students are recognized as Trilogy Award recipients.

The FBI-LEEDA training series was selected as a unique leadership course opportunity to bolster professional development within PGPD. FBI-LEEDA has furnished PGPD officers with an enriching training series that encompasses all tiers of management, from first-line supervisors to executive-level management. PGPD continues to pursue advantageous opportunities to enhance command officer competency, law enforcement leadership, and professional development. Including FBI-LEEDA supports PGPD’s goal of establishing a well-rounded and sophisticated professional development framework that empowers law enforcement supervisors.

The training course garners positive feedback from PGPD officers, who exhibit receptiveness towards the imparted knowledge. Participants recognize the tangible benefits of acquiring leadership concepts and strategies, which offer practical solutions. Major Charles Magee of PGPD underscores the strategic importance of FBI-LEEDA leadership methods in enhancing the effectiveness of management-level officers.

Prince George’s County Police Department, Major Charles Magee

“From a training perspective, we have recognized the value of the FBI-LEEDA program in developing competent leadership, at every level. The overwhelmingly positive feedback received is a catalyst for our agency’s decision to host the FBI Trilogy series in Prince George’s County this year.”

MDERS remains dedicated to collaborating with our stakeholders to identify and address any training gaps that require support. As a testament to these ongoing efforts, as of Spring 2024, MDERS has supported 81 officers from PGPD in attending the FBI-LEEDA Trilogy Series. This initiative solidifies MDERS’ unwavering commitment to fostering continuous improvement and excellence in law enforcement practices.

 

 

References

Who we are – FBI-LEEDA. FBI-LEEDA. (n.d.). Retrieved from https://fbileeda.org/page/Who_we_are

In November of 2023, four Prince George’s County Police Department (PGPD) Special Operations Division (SOD) personnel attended the Direct-Action Resource Center (DARC) Advanced Sniper Integration course (ASIC) in Little Rock, Arkansas. MDERS has continuously supported DARC training for PGPD stakeholders over the last several years, including the Advanced Operational Breaching Techniques (AOBT) course and levels one and two of the Kinetic Breachers course. The DARC Advanced Sniper Integration training allowed law enforcement stakeholders to practice and enhance their skills individually and as a cohesive unit.

DARC, founded by a former United States Army Green Beret, is situated within a secluded outdoor training site in Arkansas. It offers a diverse array of shooting locations for snipers, notably featuring a 1000-yard range atop a 40-60 ft. platform. During the training, PGPD SOD personnel honed their skills in several advanced areas, including environmental condition adjustments, long-distance night shooting, angle shooting, primary/alternate shooting positions, overwatch and operations techniques, as well as vehicle hide-sight set-up. These skills, along with many others, are poised to enhance PGPD SOD’s operational readiness in addressing a wide spectrum of incidents, including those involving active assailants and barricaded individuals.

The PGPD SOD officers attending the DARC course engaged in a comprehensive training program aimed at seamlessly integrating a proficient sniper/observer team into the support framework for intricate and expansive tactical operations. A sniper/observer team is primarily comprised of four to six officers, all trained to fulfill both sniper and observer roles interchangeably. This six-day course allows snipers to refine their skills across diverse environments, including day and night operations, live-fire support of tactical ground operations, and flat-range operations. The second half of the course coincides with an Advanced Operational Breaching Techniques course, allowing participants to collaborate with another training class during live fire building clearance exercises, as well as interior and exterior explosive breaching scenarios.

Along with the four PGPD SOD personnel, two MDERS representatives, Hannah Thomas, and Elizabeth Adams, had the opportunity to attend and observe the training. Their presence coincided with the latter part of the training, during which the two courses, Advanced Sniper Integration Techniques and Advanced Operational Breaching Techniques, merged and conducted joint exercises. Hannah Thomas, a Senior Emergency Response Specialist with MDERS, recognized how crucial this training was and stated:

Senior Emergency Response Specialist Hannah Thomas

“Participants in this course experienced an unparalleled level of instruction. Witnessing the course content delivered to PGPD officers at  an exceptionally high standard was truly remarkable.”

Emergency Response Specialist Elizabeth Adams

“The training staff and PGPD SOD personnel welcomed MDERS representatives warmly and provided valuable insight into the essential and necessary training they were receiving and how attending DARC ultimately benefits their tactical operations.”

PGPD SOD will continue to receive ongoing support from MDERS to participate in future DARC training sessions, ensuring sustained skill development in alignment with the MDERS strategic plan. DARC remains one of MDERS’s most trusted and superior training providers. With their support, MDERS stakeholders have access to a contingent of subject matter experts to help them refine and enhance their skills in tactics and strategies for sniper operations.

For more information about DARC, please visit https://www.darc-usa.com/courses

In recent years, medical facilities have experienced an uptick of threats and violent events.[1] Within this increased threat landscape, it is imperative that medical facilities and emergency response agencies jointly prepare for active assailant incidents. The Maryland-National Capital Region Emergency Response System (MDERS) facilitated a Tabletop (TTX)-In-A Box with partners from MedStar Montgomery Medical Center (MMMC), Montgomery County Fire and Rescue Services (MCFRS), Montgomery County Office of Homeland Security and Emergency Management (OEMHS), and Montgomery County Police Department (MCPD). The exercise was designed to examine the initial actions of each participating entity and their ability to establish a Unified Command (UC) during an active assailant incident. This exercise will help bolster the response capabilities for each discipline to respond to an active assailant incident in a medical setting.

To test each discipline’s response capabilities, participating agencies determined that a discussion based TTX would be the best approach. MDERS’s TTX-In-A-Box program is a systematic, scalable, and economical approach for developing and enhancing critical capabilities that foster interdisciplinary and interjurisdictional collaboration and coordination. The tool consists of a portable kit containing all materials required to run the hybrid exercise. For these exercises, work groups are formed and comprised of subject matter experts (SMEs) from relevant disciplines. In this exercise, the work group consisted of SMEs from MMMC, MCFRS, OEMHS, and MCPD. The work group provided invaluable input to craft a scenario to test the participants’ ability to adequately respond to an active assailant incident occurring in a hospital setting.

Eleven participants served as players during the exercise and were joined by over 45 observers. The exercise was guided by injects from a master scenario exercise list (MSEL) to simulate a realistic, continuous flow of information. Participants had to sift through pertinent and irrelevant information to determine the appropriate response in a dynamic situation. In the early stages of the exercise, each entity was responding within the framework of their discipline-specific policies and plans. As the scenario progressed, the entities formed a UC to make collaborative decisions and delegate tasks to the appropriate agency.

Overall, this exercise produced useful conversations about communication channels between participating agencies, triage care to victims, establishing a unified command, positioning of fire and police staging areas, dissemination of information to the public, reunification processes, reestablishment of healthcare within the facility, and patient movement to other healthcare facilities. These conversations will continue between partners to resolve identified gaps to enhance response operations.

MDERS remains committed to providing ongoing exercise support to our stakeholders in Montgomery and Prince George’s Counties. These exercises are tailored to bolster response capabilities and fortify the resilience of our communities. Through these ongoing efforts, our goal is to ensure readiness and efficiency in handling emergencies while safeguarding the well-being of our residents.

[1] Glatter, R., & Papadakos, P. (n.d.). The Epidemic of Violence in American Hospitals [Review of The Epidemic of Violence in American Hospitals]. Time.com; Time. Retrieved February 13, 2024, from https://time.com/6337450/the-epidemic-of-violence-in-american-hospitals/.

The Maryland-National Capital Region Emergency Response System (MDERS) hosted its seventh annual symposium in early May. This forum brings industry leaders and distinguished speakers together to discuss topics related to homeland security threats. This year’s symposium theme was Reimagining Homeland Security:  What Public Safety Leaders Need to Know to Navigate the Evolving Threat Landscape. The two-day virtual event allowed our regional partners to understand emerging and evolving threats that impact the National Capital Region.

The program started off with a panel discussion on public order and crowd control. Darrell Darnell moderated the conversation and was joined by Glendale Fire Chief Ryan Freeburg, Philadelphia Office of Emergency Management Homeland Security Program Manager Gary Spector, Yale University’s Associate Vice President for Public Safety and Community Engagement Ronnell Higgins, and Emergency Department Physician and the Institute of Emergency Management Director for the MedStar Washington Hospital Center Craig DeAtley. The panelists explored discipline-specific and multiagency coordination in planning for and responding to large-scale public order events. Symposium attendees posed various questions to the panelists to facilitate discourse about various public order topics. The breadth of this discussion supplied participants with lessons learned and best practices for response to large-scale planned and unplanned public order events.

Day two of the program featured a variety of homeland security topics that leaders should consider such as, critical infrastructure security and resiliency, cyber risk management, and the consequences of political violence on U.S. elections.  The morning kicked off with a presentation by Jonathon Monken of Converge Strategies and Daniel Genua from the Cybersecurity Infrastructure Security Agency (CISA) on physical threats to critical infrastructure. The speakers explored current threats to power infrastructure and provided recommendations on how to mitigate and respond to potential threats when they arise.

The critical infrastructure presentation was followed by a panel discussion on cyber threats and consequence management. The panelists, Daniel Genua from CISA and David Paniwozik from the Federal Bureau of Investigation (FBI) discussed basic steps organizations can take to reduce their vulnerability to a cyber intrusion and limit the cascading effects of a cyberattack.

Closing out the program was a presentation on political extremism and its potential impact on election security. Seamus Hughes from George Washington University and Katie Reisner from States United Democracy Center discussed current trends and threats posed by terrorist groups and how some radicalization efforts can heighten political violence.

The Symposium was well received by those who tuned into this year’s program. The featured topics were carefully curated to provide the MDERS stakeholder community with information and tools that will aid them in their ability to respond to emerging and evolving threats. MDERS would like to sincerely thank all speakers for their participation, Howard University for broadcasting the event, and the MDERS staff who were involved in the planning and execution of this year’s program. MDERS’s next symposium will be held in the spring of 2024.