The Maryland-National Capital Region Emergency Response System (MDERS), through its affiliation with Yale New Haven Health, recently implemented online First Receiver Operations Training (FROT) courses to assist local healthcare facilities maintain Occupational Safety and Health Administration (OSHA) requirements. MDERS is supporting first receiver awareness, safety, and annual review training at various hospitals in the National Capital Region, including Suburban, Holy Cross Health, University of Maryland Capital Region Health, Medstar Montgomery, Luminis Health Doctors Community Medical Center, and Adventist Health.

First receiver awareness level training is a 30-to-60-minute introductory course engaging participants in principles and procedures of decontamination, protection from specific chemical agents, respiratory protection, and personal safety issues. This training is required for healthcare personnel who work in the contaminant-free hospital post-decontamination area. Participants include emergency department clinicians, clerks, triage staff, and security staff members responsible for notifying hospital authorities of arrivals. An estimated 1,050 hospital-based first receivers will participate in the online training course to obtain contemporary awareness of mass decontamination operations.

The best practices for the protection of healthcare facility-based first receivers operations level training is an intermediate 8-hour online and instructor-led course providing healthcare personnel who have direct patient contact with lessons on decontamination topics. At the culmination of the course, participants acquired a comprehensive understanding of exposure to hazardous substances, hazard awareness, personal protective equipment (PPE), and special decontamination considerations. The practical session consisted of a demonstration of ambulatory and non-ambulatory decontamination during a mass casualty incident. A total of 1,125 healthcare workers will receive the training course to enhance the care of patients before and after thorough decontamination.

Ensuring the consistent training of hospital-based first receivers is reinforced by an annual 5-hour refresher for all hospital staff and healthcare personnel who completed the awareness and operations level courses. The online and instructor-led review will be provided to 1,125 participants who can be directly or incidentally exposed to a contaminated victim.

With the support of MDERS, hospital stakeholders have online access to the following courses:

• EM120: Best Practices for the Protection of Healthcare Facility-Based First Receivers, Awareness Level
• EM220: Best Practices for the Protection of Healthcare Facility-Based First Receivers, Operations Level
• EM220R: Best Practices for the Protection of Health Care Facility-Based First Receivers, Operations Level Refresher

Facilitating an online learning platform to a large and diverse staff audience in an accessible manner enhances emergency preparedness operations necessary to effectively respond to mass decontamination at various levels. While building on this effort, MDERS aims to expand the continuing education and training of healthcare personnel to uphold the quality of patient care.

The Montgomery County Police Department (MCPD) upholds a mission to equip, prepare, and bolster the response  capabilities of their Sniper Response Team to provide enhanced public safety and security at national special security events, as well as respond to active-threat incidents in Montgomery County and the National Capital Region. The Sniper Response Team is additionally tasked with reinforcing the response activities of law enforcement officers, including conducting surveillance to share intelligence with responding agencies on the ground. To accomplish this mission, the MCPD Sniper Response Team requires specialized tools, tactics, and capabilities.

For several years, the Maryland-National Capital Region Emergency Response System (MDERS) has collaborated with MCPD to ensure their cadre of sniper-trained officers are experts in the field and ready to deploy at a moment’s notice. In May 2022, MDERS funded the High Angle Sniper Training for nine members of the MCPD Sniper Response Team in Oregon with Anchor Risk, LLC. MCPD worked with the instructors to ensure the class was tailored to the specific needs of the department.. The multi-day course provided students with hands-on instruction to gain an understanding of non-standard shooting techniques, engagement methods, mission planning, and ballistic characteristics.

At the conclusion of the sniper training, participants provided the following feedback:

• “This training allowed me to learn how to work on shooting from high angles, which without the trip to the Pacific Northwest, I would have never been able to do.”
• “I learned observation and intelligence-gathering skills from high-elevation positions to convey to command.”
• “I gained a better understanding of environmental factors that affect the trajectory of a long-distance shot as well as when shooting at angles. Real-world experience provides us with much ­­­greater confidence if an actual situation occurs.”

The continued partnership between MDERS and MCPD ensures that the Sniper Response Team is capable to expand upon basic sniper techniques and are better prepared to protect the residents and visitors of Montgomery County.

In 2019, the Maryland-National Capital Region Emergency Response System (MDERS) identified structural collapse response as a strategic priority for Montgomery County Fire and Rescue Service (MCFRS) and Prince George’s County Fire/EMS Department (PGFD). MCFRS and PGFD determined that to ensure an appropriately robust structural collapse response capability that each department needs to be able to deploy 13 trained personnel with the necessary equipment to the scene of a structural collapse incident within 40 minutes and provide cross-county mutual aid within 90 minutes.

To support this priority, MDERS sponsored personnel from MCFRS and PGFD to participate in a structural collapse specialist course in September 2022. This course trains personnel on the critical duties and activities as outlined in their position task books and is a requirement for any individual participating in structural collapse response. This training program, hosted at the Montgomery County Public Safety Training Academy, began with eight hours of computer-based training (CBT), followed by 80 hours of hands-on training. The specialized techniques learned and practiced that are necessary to perform rescues at structural collapse incidents included:

• Breaching: Students learned techniques to break through and access obstructed areas. Participants drilled holes in a triangle formation, then chiseled away the surrounding areas, allowing the triangle to be lifted out, revealing an opening for entrance or extraction.
• Breaking: Students learned the skills and techniques to safely break apart larger pieces of debris to facilitate manual removal without further compromising the structural integrity of a collapse site.
• Lifting: Students learned building methodology and principles of physics to lift large pieces of cement and other debris without the help of a large crane. These techniques ensure that responders are able to remove large amounts of debris before crane operations can be implemented. Students additionally learned how to coordinate crane operations via hand signals to lift and remove debris.
• Shoring: Students learned basic stabilization techniques to create supports that prop up surrounding debris to allow safe ingress and egress from collapsed buildings.
• Burning: Students learned the various characteristics of available torches and the best situations to utilize a particular type to cut through rebar, steel beams, or other metal objects. Students also learned the techniques to effectively cut the metal without comprising the structural integrity in an area of a building.
• Building Construction: Students learned about basic construction and engineering principles to familiarize themselves with a structure and also to construct apparatus needed for an effective rescue.

With the completion of this course, MCFRS and PGFD further increase their cadre of certified structural collapse specialists, ensuring each department’s ability to deploy a fully staffed response team of 13 individuals on scene of a collapse event within 40 minutes. Additionally, by jointly training across both departments, MCFRS and PGFD can deploy fully interoperable mutual aid within 90 minutes of a large collapse event.

To further bolster structural collapse response capabilities within the Maryland-National Capital Region, MDERS is coordinating with MCFRS and PGFD to host two technical search specialist courses and an additional structural collapse specialist course in 2023. These courses, alongside a robust equipment cache, ensure both departments are able to effectively deploy and respond to structural collapse incidents.

As the deployment of small unmanned aerial systems (sUAS) programs continues to expand across the United States, public safety agencies face challenges in maintaining sUAS platforms. To support stakeholders within the Maryland-National Capital Region, MDERS sponsored pilots from Prince George’s and Montgomery County public safety agencies, as well as MDERS, to participate in the Understanding Unmanned Aerial Systems Maintenance course hosted by Tactical Drone Concepts, Inc. in September 2022. This course combined maintenance theory, best practices, and hands-on application to guide students through potential maintenance issues they may encounter.

The Understanding UAS Maintenance course engaged students in classroom discussion and hands-on instruction to develop the knowledge, skills, and abilities to implement in-house maintenance programs for UAS vehicles. Students attending the course gained a functional understanding of the component parts and software programming used to operate unmanned aircrafts, as well as soldering techniques to repair wire and electronic components on tactical and training aircraft. Upon completion of the course, Maryland-National Capital Region stakeholders enhanced their understanding of diagnosing and troubleshooting maintenance issues associated with sUAS. Students can further apply this knowledge as public safety agencies in both Prince George’s and Montgomery Counties continue to develop their internal maintenance policies and procedures.

Stakeholders from the Prince George’s County Police Department, the Montgomery County Police Department, the Montgomery County Fire and Rescue Service, and the Montgomery County Office of Emergency Management rated the overall course highly. Participants provided the following feedback:

• “I believe there are some best practices we can take from this class regarding maintenance. We learned greatly from our classmates about their programs and what works best for them.”
• “A new appreciation for aircraft maintenance has been instilled in me due to being able to take the class.”
• “The lessons learned will benefit the day-to-day maintenance of our UAS vehicles.”

As a subrecipient of the National Capital Region’s (NCR) Urban Area Security Initiative (UASI) award, the Maryland-National Capital Region Emergency Response System (MDERS) complies with federal regulations for grant-funded projects. One such regulation is the Federal Emergency Management Agency’s (FEMA) Environmental and Historical Preservation (EHP) review process. The EHP review process aims to minimize the impacts of any project on the environment and historically designated sites, including floodplains, wetlands, archeological sites, historic structures, protected coastal areas, critical wildlife habitats, clean air and water, and minority and low-income populations among others. In order to ensure the long-term preservation of these sites, any project that could cause permanent impacts must be approved by FEMA through the EHP process.

MDERS, in its support of emergency response partners across Prince George’s and Montgomery Counties, supports numerous projects that fall under the jurisdiction of the EHP review process. Notably, any building modification, including the permanent installation of equipment, must be approved by FEMA. In addition to building modifications, any training opportunity that occurs in a non-designated training facility, as defined by the local agencies, requires FEMA EHP approval to ensure no damage or permanent impacts will be made to the training site.  As the single point of collaboration on multi-disciplinary, multi-jurisdiction emergency response capability enhancement, MDERS manages the EHP review process on behalf of its stakeholders.

The required application includes a FEMA-provided questionnaire that defines the scope of the project in question. The FEMA screening form prompts users to provide a variety of information including grant project names, contact information, estimated cost, project description, and the intended construction to be conducted on the building. Additionally, the screening form must be accompanied by secondary photo documentation. The required photos must include a picture of the structure and if possible, a building sign. This preliminary information is sufficient in most cases but, FEMA requires additional photo documentation for building over 45 years old, as older buildings are more closely associated with potential environmental concerns and an enduring historical significance. The extra photos must clearly identify the area(s) that any alteration to the building will occur so that FEMA can closely assess the environmental and historical ramifications of the specific areas of construction.

Within the MDERS portfolio, the Public Access Trauma Care (PATC) program is most intertwined with the EHP process. As part of the PATC program, MDERS works closely with both Prince George’s and Montgomery Counties to install readily accessible bleeding control kits and medical supplies in public schools and government buildings. These items are stored in PATC cabinets, which are permanently affixed to interior walls similarly to fire extinguishers or automated-external defibrillators (AEDs). Before these cabinets are installed, MDERS must submit the required EHP documentation to ensure that any alteration to a building does not harm the environment and protects its historical significance.

MDERS began the EHP process for the PATC program by coordinating with stakeholders to determine how many buildings would be impacted and their respective ages. By delineating buildings by age, MDERS determined which buildings required additional photo documentation and which did not. MDERS then worked closely with subrecipients to identify the strategic location of PATC kits and cabinets, conduct the needed photography, and compile the information for submission to FEMA for approval.

To better meet the needs of its stakeholders, MDERS developed an EHP checklist for the PATC program. This checklist not only provided all the necessary information to FEMA, but also served as a resource to stakeholders to refer back to for the ultimate installation of the PATC cabinets.

While the EHP process can appear daunting, MDERS is committed to helping its stakeholders through the FEMA review process and ensure that projects are executed in accordance with the Maryland-National Capital Region’s needs and in compliance with federal regulations.

For more information on the EHP review process, please visit: https://www.fema.gov/grants/guidance-tools/environmental-historic.

On August 19th, the Maryland-National Capital Region Emergency Response System (MDERS) hosted a cybersecurity workshop for emergency response partners in and around the Maryland-National Capital Region. Designed to help emergency response organizations prepare for and respond to a cyber incident, the workshop explored the current cyber threat landscape and implications of a cyber incident on state and local governments.

A team of local cybersecurity practitioners led participants through a series of plenary instruction and breakout discussions. These subject-matter experts, including Markus Rasucheker J.D., Director of Cybersecurity for the University of Maryland Center for Health and Homeland Security (CHHS), Ben Yelin J.D., CHHS Director of Public Policy & External Affairs, and Netta Squires J.D., Emergency Management Specialist II Montgomery County Office of Emergency Management and Homeland Security (OEMHS), applied their knowledge of the Maryland-National Capital Region and its agencies directly into the workshop curriculum.

Participants learned about the key motivators for launching a cyber-attack on local governments. They examined several recent cyber-attacks on county and State government organizations and the cascading effects they have on those directly and indirectly impacted. The facilitators guided stakeholders through the following seven-step planning process to prepare their emergency response organizations for a cyber incident:

• Establish a project leadership team
• Resource identification
• Beginning the planning process
• Drafting a plan
• Thinking through high-level policy considerations
• Thinking through legal/policy considerations
• Thinking through operational considerations

Stakeholders concluded the workshop by completing a scenario-based capstone exercise drawing on lessons learned and reinforcing cyber preparedness and response concepts. All participants walked away from the workshop with a cybersecurity preparedness planning guide and the knowledge and tools needed to enhance their organization’s cybersecurity preparedness planning efforts.

Workshop participants provided positive feedback and highlighted the need for additional cyber preparedness and response training opportunities for emergency response partners in the Maryland-National Capital Region.

The Public Access Trauma Care (PATC) program, led by the Maryland-National Capital Region Emergency Response System (MDERS), empowers the residents and visitors of Montgomery and Prince George’s County to respond to life threatening bleeding and trauma. MDERS collaborates closely with both counties to identify, procure, deploy, and train upon the medical supplies necessary to treat major bleeding injuries, pneumothorax, and shock. As part of this program, government buildings and public schools are outfitted with publicly accessible PATC kits.

In the Montgomery County Public Schools (MCPS) system, each high school maintains 20, 5-pack PATC kits located in readily identifiable cabinets distributed throughout each building. These kits contain a QuikLitter patient movement device, a Combat-Application Tourniquet (CAT), compression dressing, compressed gauze, medical gloves, trauma shears, two chest seals, a survival blanket, a sharpie, duct tape, and an instruction card. Through these supplies, a student or staff member can deliver immediate medical aid to an injured person prior to the arrival of first responders. As recently as January 2022, one of these PATC kits was utilized to treat an injured student at Magruder High School suffering from a gunshot wound.

Currently, MCPS staff train on the identification of injury patterns and administration of proper medical care through the PATC program. As MCPS looks to expand the capability further, program leaders identified the need to better train students the knowledge, skills, and abilities to use the PATC kits in a real-world situation. To meet this need, MDERS procured 84 PATC training kits on behalf of MCPS to supplement health curriculum and training opportunities in Montgomery County high schools.

MDERS partnered with MCPS to configure the training kits to best meet the needs of Montgomery County high schools. To ensure students are prepared to deploy a PATC kit in a real-world situation, each training kit contains a variety of equipment mirroring the supplies an individual may find in the PATC kits installed throughout MCPS. Each high school received three training kits comprised of the following supplies:

• 15 Combat Application Tourniquets (CAT)
• 15 Elastic Bandages
• 15 Conforming Stretch Gauze Bandages
• 15 Hyfin Twin Pack Chest Seal Trainers
• 10 Wound Cube Simulators
• 3 Emergency Trauma Dressings
• 1 Cloth/Silk Tape
• 1 QuickLitter Transport Device
• 2 Emergency Mylar Blankets
• 2 Medical Shears
• 2 Hyfin Twin Pack Chest Seals
• 2 Compressed Gauze Packages
• 2 Pairs of Nitrile Gloves
• 2 Sharpie Markers
• 2 Mini Duct Tape Rolls
• 1 PATC Kit

MCPS plans to utilize the training kits during a three-day lesson about identifying medical emergencies and rendering basic medical aid. During this curriculum, students will learn to recognize specific injury patterns and understand associated harm and risks. Instructors will then demonstrate how to safely and effectively render aid using proper medical techniques. During the final component of the curriculum, students will use the provided training materials to practice the application of chest seals, direct pressure, and tourniquets, as well as how to pack a wound and prevent shock. The knowledge, skills, and abilities provided through this program will better prepare students to administer life-saving medical care in real-world emergency.

MDERS continues to provide training materials and PATC supplies to the residents and visitors of Montgomery and Prince George’s Counties. For more information on the PATC program, please email mders@maryland.gov.

The Maryland-National Capital Region Emergency Response System (MDERS) serves as a key partner in the design and conduct of public safety exercises in Prince George’s and Montgomery Counties. MDERS’s Training and Exercise Program works closely with fire/rescue/emergency medical services, law enforcement, emergency management, public health, and healthcare systems to ensure a robust exercise capability within the region and within individual agencies. As part of this support, MDERS offers instruction on the Homeland Security Exercise and Evaluation Program (HSEEP) to local agencies so they may better implement their individual exercise programs.

Originally published in 2002 by the Federal Emergency Management Agency (FEMA), HSEEP establishes guidelines for the development and implementation of effective exercise programs. HSEEP outlines key guidelines in five components of the exercise cycle: program management, design and development, conduct, evaluation, and improvement planning. These guidelines ensure a consistent methodology across jurisdictions and agencies, while remaining adaptable to individual organizations’ needs. In 2020, FEMA released an update to HSEEP, reflecting feedback solicited from the exercise community. Key changes to the 2020 HSEEP updates include: increased inclusivity of the whole community, additional tools and training resources for exercise design, application of “SMART” methodology to improvement planning, and the implementation of an Integrated Preparedness Plan (IPP) to replace the Multi-Year Training and Exercise Plan (MyTEP).*

In response to the 2020 revisions, the District of Columbia Homeland Security and Emergency Management Agency (HSEMA) delivered an updated HSEEP course offering to the National Capital Region (NCR), which encompassed the new changes. MDERS Training and Exercise staff assisted HSEMA with the instruction of the updated HSEEP course, and as a result, began developing new curriculum for MDERS stakeholder agencies.

Since assisting HSEMA with the instruction of their updated curriculum, the MDERS Training and Exercise Program worked to customize its HSEEP course to better meet the needs of the MDERS stakeholder community. When partnering with a specific agency, MDERS tailors the course materials and group activities to enhance participant engagement according to the makeup of the class. Each offering of the HSEEP course includes a capstone functional exercise project to ensure that students can apply critical thinking and conflict resolution skills to solve real-world situations. During the capstone, MDERS instructors provide students with a scenario and exercise templates. Students then collaborate to design, develop, and conduct the exercise within the allotted time. The capstone project reinforces principles and best practices, while allowing students to make inferences and form recommendations based on the knowledge learned throughout the course.

MDERS will deliver the first offering of the updated HSEEP course to the Prince George’s County Office of Homeland Security and Emergency Management (PH OHSEM) in the fall of 2022.

For more information on requesting an HSEEP course for your agency or organization, please reach out to the MDERS Training and Exercise Team by emailing MDERS.Training@Maryland.Gov.

*For a full list of changes implemented by FEMA in the HSEEP 202 Revision, please visit: https://www.fema.gov/emergency-managers/national-preparedness/exercises/hseep.

Since 2014, the Prince George’s County Police Department (PGPD) prioritized the development and implementation of a comprehensive training program for the department’s Special Operations Division (SOD) personnel. PGPD identified several tactical capabilities requiring specialized training, including sniping, breaching, close-quarters battle (CQB), and incident command. Through the Maryland-National Capital Region Emergency Response System (MDERS), PGPD partnered with the Direct-Action Resource Center, a leading training facility in Little Rock, AR. DARC specializes in tactical, technical and strategic planning, developmental training, evaluation, and implementation for the military, law enforcement, public agencies, and private enterprises.

DARC offers curriculum designed to build in complexity as students progress into more advanced tactics. DARC requires all students to complete two pre-requisite courses prior to enrolling in more advanced offerings. These pre-requisites are identified and summarized below.

• LECTC-1: Teaches tactical personnel the basics of enemy tactics, chemical, biological, radiological, nuclear, and explosive (CBRNE) operations.
• LECTC-2: Further expands upon the principles learned in LECTC-1 while incorporating the basics of live fire breaching tactics and hostage rescue best practices.

After completing the LECTC-1 and LECTC-2 prerequisites, students may enroll in specialized response areas, such as advanced operational breaching, advanced sniper integration, and tactical night vision instruction. These courses provide operators with the knowledge and tools required to lead a breaching team, integrate a sniper and observer team in tactical operations, deploy during large venue counter-terrorism operations, and conduct operations using night-vision capabilities. The specific courses attended by PGPD since 2014 are identified and summarized below.

• Level One Breacher Course (L1BC): Educates operators on the basics of safe, practical, and effective explosive breaching techniques for tactical operations.
• Advanced Explosive Breaching and Program Supervisors Course: Focuses on explosive breaching and the development and sustainment of a breaching program for managing or supervisory positions within an organization.
• Advanced Sniper Integration Course (ASIC): Instructs sniper and observer teams on the skills and tactics necessary to provide support for tactical operations in complex environments or large venues under a variety of conditions, ranges, visibility, and target types.
• Tactical Night Vision Instructor Course: Instructs law enforcement training officers on the deployment, integration, limitations, and considerations of night vision technology to bring back to their local departments and create in-house training programs for other law enforcement personnel.
• Tactical Supervisor/Managers Course: Trains SWAT supervisors and managers to prepare SWAT teams for operations, document their activities, conduct short- and long-term planning, including training, sustainment, outfitting, and acquisition of specialized skills.

As a result of the long-standing partnership, PGPD and DARC collaborated to develop a custom-tailored curriculum that incorporates tactical emergency casualty care (TECC) in CQB situations, under both live and simulated fire. This course, entitled Close Quarters Battle/TECC, integrates emergency medicine, explosive and ballistic breaching, live-fire training, and force-on-force training across a variety of high threat scenarios including active shooters, high risk warrants, barricades, hostage rescue, and complex coordinated terrorist attacks. To date, 31 members of PGPD SOD participated in this specialty offering.

Through DARC, over 147 PGPD officers trained on tactical capabilities, mater advanced skillsets, and gain operational experience to respond to high-stress austere environments. PGPD continues to pursue opportunities to provide more advanced and specialized training for its personnel so that they may better serve the residents of Prince George’s County.

In January 2022, the Montgomery County Police Department (MCPD) responded to an active shooter incident involving a student at Magruder High School in Montgomery County, Maryland. Following that incident, and considering other recent active shooter events, MCPD leadership saw an opportunity to provide training to their executive staff to better prepare them for similar situations.

Between February and April 2022, MCPD planned and conducted four tabletop exercises for MCPD executive staff with support from the Maryland-National Capital Region Emergency Response System (MDERS). These exercises assessed MCPD executive staff’s ability to manage the first 30-60 minutes of a major incident, including phases one and two of their response process, while reinforcing participants knowledge and understanding of MCPD directives, policies, and procedures.

A planning team comprised of MDERS and MCPD personnel met bi-weekly for eight weeks to design and develop these exercises. The MCPD representatives selected to participate on the exercise planning team are considered subject matter experts. These individuals all played a role in the response to the Magruder High School incident. Their firsthand knowledge of the incident informed the scenario and Master Scenario Events List (MSEL). MCPD’s directives, policies, and procedures, including the Active Assailant Emergency Response Plan, also informed the development of the MSEL.

The exercise scenario occurred at a local high school in Montgomery County and was modeled after the shooting incident at Magruder High School. The scenario aimed to build MCPD executive staff’s confidence in handling a critical incident. Interactive exercise play, which combined the use of props and floor plans, alongside a discussion facilitated by MCPD and MDERS personnel engaged exercise participants as they responded to the scenario.

In total, 58 MCPD representatives participated in this exercise series, which marks the first MDERS-supported exercises for the department. While the formal after-action review process is ongoing and expected to conclude in August 2022, preliminary feedback from exercise participants was positive. With the completion of this initial exercise series, MCPD executive staff better understand the need for proficiency in key areas of incident command and response. The department continues to work towards providing additional opportunities for officers to build and refine their incident command skills, and gain the operational experience needed to perform in high-stress environments.