Continuity of Operations Plan

Healthcare Continuity of Operations

The Continuity of Operations Plan (COOP) for Wyoming Region 1 Healthcare Coalition, Inc. (R1HCC) embodies our commitment to ensuring that vital healthcare operations persist seamlessly, even in the face of disruptions and emergencies. This section delineates the underlying purpose, background, and scope that guide the establishment, functionality, and continuous improvement of the COOP. By detailing our guiding principles and operational framework, this section provides a foundational understanding of the Coalition's dedication to preserving the health and well-being of the communities we serve.

Purpose

The purpose of the Healthcare Continuity of Operations plan for the R1HCC is to ensure a coordinated, efficient, and effective response to, and recovery from, situations causing a surge in healthcare demands within the counties of Campbell, Crook, Johnson, Sheridan, and Weston in northeast Wyoming. R1HCC, while not directly providing patient care, plays a pivotal role in enabling the seamless operation of its core member agencies, which includes hospitals, EMS agencies, public health departments, and emergency management agencies.

Furthermore, we recognize and welcome additional members who contribute towards the preparedness, response, and recovery during such surge events. By drawing together a broad spectrum of healthcare and emergency professionals, we aim to create a robust network capable of maintaining the health and safety of the northeast Wyoming community amidst any challenges.

Understanding the unique needs and challenges of our region, this plan is designed to foster collaboration and mutual assistance among member agencies, ensuring that they are well-prepared and equipped to handle a range of scenarios. These might include natural disasters, pandemics, or other events leading to a significant surge in healthcare needs.

Through this plan, R1HCC underscores its commitment to strengthening the healthcare backbone of our region, ensuring that every individual has access to timely, uninterrupted, and high-quality medical attention, regardless of the circumstances.

Background

The roots of the R1HCC can be traced back to initiatives driven by the Wyoming Department of Health (WDH). For nearly a decade, the coalition functioned under the WDH, but in 2022, R1HCC transitioned to operate as an independent nonprofit entity. This evolution marked a significant step in its journey to enhance healthcare preparedness in the region.

Historically, the events of September 11, 2001, prompted the WDH to secure funding aimed at bolstering hospitals' disaster response capabilities. Over time, this initiative expanded in scope to envelop a wider segment of the medical community, bringing in emergency medical services, long-term care facilities, community clinics, hospice, and home care under its purview.

The global COVID-19 pandemic served as a testament to the pivotal role R1HCC plays within the region's healthcare ecosystem. The challenge posed by the pandemic reinforced the need for a structured, cohesive, and efficient response mechanism to handle medical surges and emergencies.

Today, R1HCC stands fortified by its diverse local stakeholders, functioning in tandem to bolster the region's emergency preparedness. As a coalition, R1HCC operates in alignment with guidelines from the Assistant Secretary for Preparedness and Response (ASPR), drawing from the Hospital Preparedness Program (HPP) to ensure that the region's healthcare framework is both agile and resilient.

Scope

The R1HCC COOP is formulated to ensure that the core functions and responsibilities of healthcare entities and associated stakeholders within the five-county region of northeast Wyoming continue seamlessly during and after disruptions or emergencies.

Geographical Reach

This COOP is all-encompassing, addressing the needs and intricacies of Campbell, Crook, Johnson, Sheridan, and Weston Counties, ensuring every corner of the region is prepared for continuity challenges.

Member Inclusion

Core Members: The fundamental pillars of the R1HCC are the hospitals, EMS agencies, public health departments, and emergency management agencies across our five counties.

Extended Members: Beyond the core group, R1HCC's mission is furthered by various other entities that collaborate in various capacities. Their expertise and resources, while different from core members, are crucial in the broader context of continuity and preparedness.

Emergency Types

This COOP emphasizes maintaining continuity during events leading to patient surges. Though we have annexes that target specific emergencies like chemical, infectious disease, trauma, pediatric, and burn incidents, our continuity protocols cater to all kinds of patient surge events.

Operational Role

At its essence, the R1HCC is poised to act as an information coordination center, consolidating communication and data flows among members. As we redefine and refine our mission, this role might undergo shifts to resonate more with regional necessities and board aspirations.

Availability

The ultimate goal is for R1HCC to be operational around the clock every day of the year. Given constraints such as reliance on volunteers and a 20-hour managerial week, there are challenges. Nevertheless, efforts are underway to potentially augment this availability.

Integration with Other Plans

The COOP is intricately woven to align with and complement both the R1HCC Preparedness Plan and the R1HCC Response Plan, along with their respective emergency-specific annexes. Additionally, guidelines from the Wyoming Department of Health's Crisis Standards of Care (CSC) are integrated, ensuring our operations and protocols are consistent with state-level directives.

Review & Revisions

The scope and tenets of this COOP are subject to an annual review. Adjustments reflect the evolving needs of the region, feedback from activations, and stakeholder inputs. Special reviews might also be triggered by significant regional changes or incidents.

Stakeholder Engagement and Communications

Effective stakeholder engagement and clear, consistent communication are vital to the successful implementation and operation of the R1HCC's COOP. This section underscores the importance of forging and maintaining strong relationships with all members and partners, ensuring that every entity involved is aligned with our shared objectives. By detailing our strategies and methodologies for consistent communication, this section highlights the Coalition's proactive approach to keeping all stakeholders informed, aligned, and prepared for potential contingencies.

Internal Communications

Effective communication remains a cornerstone of R1HCC's operations, enabling our organization to stay agile, informed, and coordinated, especially during emergencies. The internal communications strategy ensures timely information dissemination and fosters cohesion and mutual understanding among our members.

Key Personnel and Entities

Ultimate decision-making authority within R1HCC resides with the Board of Directors and its officers. These individuals hold the responsibility for crucial communications, especially during emergencies and significant organizational shifts.

Communication Channels

• Software Suite: The primary channel for emergency communications is the Juvare software suite. This tool allows for real-time alerts, updates, and coordination during critical events.
• Meetings: Regular communication is maintained through monthly Board of Directors meetings and monthly general membership meetings. These platforms serve as a venue to discuss updates, challenges, and upcoming initiatives.
• Newsletters: The R1HCC monthly newsletter, dispatched via email, keeps our membership abreast of regular updates, upcoming events, and other relevant information.
• Call Tree: The R1HCC Coordinator will reach out via text as a secondary route of communication.

Information Classification

• General Communications: Regular updates, like our monthly newsletter, fall under this category.
• Urgent/Emergency Alerts: Sent out in real-time as emergencies or significant events unfold, ensuring that all relevant entities are promptly informed and can take necessary actions.

Backup Communication Systems

In the event of communication channel failures, the R1HCC is equipped with a communications cache. This backup system includes:

• Portable radios to ensure intra-agency communication.
• A portable wireless internet hub (Plum Case), enabling online communications during outages.
• An all-band amateur (HAM) radio, ensuring broad-spectrum communication capabilities even in isolated scenarios.

Record Keeping

While the establishment of a central repository is ongoing, the R1HCC maintains a digital drive containing all essential documents. The Board of Directors can readily access this drive, ensuring continuity of information. Distribution of these documents can be executed as needed.

Feedback and Reviews

To continuously refine our communications and response processes, the R1HCC implements after-action reviews (AAR) post every exercise and real-world event. This system allows for reflection, feedback, and identification of areas for improvement.

Training and Familiarization

Though there isn't a formalized training for new members regarding communication protocols currently, the R1HCC aims to institute this in the future, ensuring all members are well-acquainted with communication standards and tools.

Review of Communication Protocols

Annually, the R1HCC reviews its communication plan, ensuring it remains updated and effective in addressing the ever-evolving challenges and needs of the organization.

Challenges

The predominant challenge in communications stems from the geographic remoteness of the region. However, through technology, regular meetings, and backup communication systems, the R1HCC endeavors to bridge this gap, ensuring seamless information flow irrespective of the distance.

External Communications

The effective dissemination of information and coordination with external entities is crucial for R1HCC to function optimally. Our principal external communications partner is the WDH, which bridges the connection between our coalition and both state and federal entities. During large-scale emergencies, WDH assumes the role of Emergency Support Function #8 (ESF #8): Public Health and Medical Services within the overarching FEMA structure.

Objectives

• Liaison and Coordination: The primary goal of our external communications is to ensure seamless liaising and coordination. Through our communication, we aim to ensure that all partners are on the same page and that resources and information are optimally utilized.

Communication Channels

• Primary Channels: The main channels of communication with external entities include telephone and email. These ensure quick and direct interactions.
• Emergency Communications Cache: Our communications cache, which consists of portable radios, a portable wireless internet hub, and an all-band HAM radio, serves as a versatile tool, beneficial for both internal and external communications, especially during emergencies.

Public Relations

While R1HCC does not have a designated Public Information Officer (PIO) at present, discussions are underway to establish such a role. This would ensure that the coalition has a dedicated representative for handling media inquiries, official statements, and ensuring consistent messaging.

Protocols and Practices

• Information Sharing: We firmly believe in the power of information sharing, especially during emergencies. The coalition operates under the premise that rapid dissemination of information, even if not fully verified, can be more beneficial than its withholding. This approach is founded on the belief that prompt information sharing carries more advantages than associated risks. However, the coalition highlights that the information shared can be sensitive and might not always be completely accurate due to the urgency of certain situations. Members should exercise sound judgment when considering sharing information externally.
• Confidentiality: While there isn't an explicit confidentiality protocol, members are urged to respect the sensitive nature of disseminated information. Miscommunication can have significant repercussions, hence the emphasis on sensitivity.
• Review and Updates: The Communications Plan undergoes a thorough review at least annually. If circumstances or insights from experiences demand, the review frequency can be increased.

Engagement with External Entities

External agencies are invited to participate in our after-action reviews (AARs) when deemed appropriate. This inclusion ensures a comprehensive evaluation of situations and reinforces the collaborative spirit of the R1HCC's mission.

Training and Familiarization

Presently, specific training for members on handling external communications, particularly in emergency or sensitive situations, is not in place. However, as the coalition evolves and the need arises, this can be an area of future development.

In sum, the R1HCC's approach to external communications is built on a foundation of rapid information sharing, collaboration, and transparency. By working closely with entities like WDH and others, we aim to create a cohesive response mechanism to address any patient surge event.

Continuity Operations

The R1HCC's primary mission revolves around planning for, responding to, and recovering from patient surge events, ensuring that healthcare provisions and services remain unbroken and efficient even in the face of unforeseen challenges. Given the region's unique geographical constraints and potential for system saturation, coupled with threats ranging from communication failures to natural disasters and pandemics, the establishment of a comprehensive Continuity of Operations Plan is paramount. While R1HCC continues to shape its pivotal role in the larger emergency response ecosystem, implicit expectations from stakeholders focus on the coalition's capability to serve as a reliable communication and liaison hub during crises. This COOP is designed to be versatile, equipped to address emergencies of varied durations—whether a few hours or extended over months. It intricately interweaves with our Preparedness Plan, Response Plan, Communications Plan, and specialized annexes, ensuring that even when normal operations are disrupted, the core essence of R1HCC's mission remains intact and actionable.

Activation of the COOP

The COOP stands as a vigilant safeguard to ensure that the R1HCC remains a robust and resilient coordinating force, even in the face of significant adversities. Its activation ensures that the R1HCC's vital operations and mission objectives continue without disruption.

Activation Triggers

While the R1HCC does not operate on a fixed set of triggers, the principle is clear: any event that disrupts or is perceived to threaten the normal functioning of the coalition should be considered a potential trigger for the COOP. Events can range from natural disasters, pandemics, communications failures, system saturation due to geographic remoteness, to unforeseen challenges that might arise. Proactivity is paramount. Regular evaluations and threat assessments can be a mechanism to refine potential triggers in the future.

Activation Authority

Authority to activate the COOP rests with any member of the Board of Directors or the HRRC. Every R1HCC member can and should raise concerns about potential disruptions, and they are encouraged to contact the HRRC promptly should they believe COOP activation is warranted.

Notification Process

Upon determination of COOP activation, immediate notification will be made using the Juvare software suite. This ensures a swift, efficient, and coordinated approach to communication among all R1HCC members and stakeholders.

Initial Actions

While specifics may vary depending on the nature of the disruption, initial actions should prioritize:

• Assessment of the nature and extent of the disruption.
• Communication of the COOP activation to all stakeholders.
• Mobilization of resources, if necessary.
• Liaising with the Wyoming Department of Health and other key external entities.
• Continuous monitoring of the situation to adapt responses accordingly.

COOP Duration

The duration of COOP activation will be contingent on the specific situation and the assessment of the leaders involved. It remains in effect until the coalition deems its operations can resume as usual or when adjustments have been made to adapt to long-term changes.

Integration with Other Plans

During its activation, the COOP is instrumental in ensuring that R1HCC's Preparedness Plan, Response Plan, and other critical plans remain actionable. The COOP provides a blueprint for managing and mitigating disruptions while allowing other plans to function seamlessly.

Deactivation

Deciding to deactivate the COOP should be based on a set of criteria including, but not limited to:

• Restoration of core operations and functions.
• Evaluation of the environment and confirmation of stabilized conditions.
• Consultation and consensus among key leadership figures. The exact process for deactivation will warrant a comprehensive review of the prevailing circumstances and conditions.

Training & Drills

To maintain the effectiveness and familiarity of the COOP among coalition members, it will be tested at least annually. These drills will serve as a mechanism to identify potential areas of improvement, refine activation and deactivation protocols, and ensure continuous preparedness.

Relocation Strategies and Alternate Facilities

Recognizing the unique operational model of the R1HCC, which doesn't rely on a fixed physical location but rather utilizes the facilities of its management contractor, there's an inherent flexibility in our approach to crisis relocation. The R1HCC's strength lies in its ability to rapidly adapt, potentially utilizing any of its member agencies' facilities or collaborating with local governments to secure operational spaces during emergencies. This agile approach ensures that our primary mission of managing patient surge events remains consistent, irrespective of physical constraints.

Criteria for Relocation

The decision to initiate a relocation is immediately overseen by the incident command team. For extended events, the WDH may be able to dispatch site assessment teams to evaluate suitable facilities using event-specific criteria. Our diverse member agencies offer a plethora of potential relocation sites, each bringing its own set of advantages.

Geographic Preference for Relocation

While Gillette (Campbell County) offers a strategic advantage due to its population density and central location, our relocation decisions are flexible, encompassing the unique advantages of each member agency's location. This dynamic approach ensures that the most strategically advantageous location is chosen based on the nature and scope of the emergency.

Logistical Support

Our relocation strategy acknowledges the criticality of transport and logistics, especially given the expansive geographic regions under the R1HCC's purview. Collaborative efforts with member agencies and local governments will be instrumental in formulating and executing a responsive logistics plan.

Operational Continuity

Our coalition’s operational adaptability means we can sustain our mission from varied facilities. While the precise duration at alternate locations remains an area of exploration, our primary focus is to maintain operational continuity and uphold our core functions.

Transitioning Back

Post-crisis, transitioning operations back to the management contractor’s facilities—or another suitable location—requires a structured approach. While we're still in the process of defining these protocols, the importance of stakeholder feedback, viability assessments, and effective communication cannot be overstated.

Communication Protocols

The Juvare software suite remains pivotal, serving as our chief communication tool during relocation processes, ensuring that stakeholders are consistently updated and aligned.

Drills and Simulations

Given the flexible nature of our operational base, annual relocation drills and simulations are imperative. This practical testing ensures the robustness of our strategies and highlights potential areas of refinement.

Integration with Statewide Plans

In alignment with the Wyoming Department of Health's statewide initiatives, our relocation strategies must integrate seamlessly. Collaborative discussions and iterative reviews will be essential in this alignment.

Embracing our operational flexibility, R1HCC is determined to remain steadfast in its commitment, ensuring that even in disruptive scenarios, our dedication to managing patient surges is uncompromised.

Continuity of Leadership

Ensuring uninterrupted leadership is paramount during any crisis, as it directly impacts the R1HCC’s ability to uphold its mission. The following details the R1HCC’s plan for maintaining continuous leadership during disruptive events.

Leadership Hierarchy and Delegation

Board of Directors: The primary governing body, which holds the utmost authority within R1HCC. It consists of the President, Vice President, Secretary, and Treasurer, accompanied by up to three Members-at-Large.

Healthcare Response and Recovery Coordinator (HRRC): Entrusted with considerable discretion to make day-to-day decisions within the parameters set by the Board.

Incident Action Plans (IAPs)

To ensure consistent decision-making and actions during emergencies, the R1HCC is in the process of developing adaptable IAPs. These plans will serve as templates for various scenarios, providing clear guidelines while allowing for flexibility based on the specific situation. These IAPs will be integrated into eICS, a specialized tool from Juvare, enhancing real-time incident management.

Communication of Leadership Changes

Internal Communication: Leadership shifts or changes will be announced via the monthly newsletter and during regular monthly meetings.

External Communication: Leadership changes will be communicated to external stakeholders during the monthly meetings between all HRRCs in the state and the Wyoming Department of Health leadership.

Review and Updates

The continuity of leadership plan, like all other R1HCC plans, will undergo a minimum annual review. This ensures that the guidelines remain updated and consistent with the coalition's evolving requirements.

Integration with Other COOP Components

The continuity of leadership is inherently tied to other COOP elements. For instance, effective communication strategies from section 2 ensure that leadership changes or directives are promptly disseminated. Moreover, the relocation strategies in section 3.2 might play a role in deciding where leadership operations are temporarily based during a disruption.

Mission Essential Functions

Mission essential functions, for the purposes of the R1HCC COOP, are defined as the primary tasks and duties that are imperative to the purpose, vision, and goals of the organization. These functions remain crucial during and post disruptions to ensure seamless continuity of the coalition's efforts in healthcare preparedness and response.

Definition of Mission Essential Functions

The R1HCC, although in the early stages of pinpointing its specific essential functions via a strategic planning process, is anchored to the four overarching functions as set out by the Healthcare Preparedness Program (HPP). These are:

• Prepare: Equip and train stakeholders for potential healthcare crises.
• Mitigate: Take proactive measures to reduce the severity or prevent potential health crises.
• Respond: Act promptly and efficiently during an emergency, ensuring the best possible patient outcomes.
• Recover: Restore regular healthcare operations and services post-disruption, learning and evolving from the event.

Essential Resources

Human capital stands as the primary pillar supporting the R1HCC's mission essential functions. The knowledge, experience, and dedication of our members drive the execution of the core functions. In addition, our communications cache, consisting of various communication tools, acts as a linchpin, especially in scenarios where conventional communication lines may be disrupted or overloaded.

Interdependencies and Backups

While there aren’t explicit interdependencies among the mission essential functions, the harmonious interplay of all four ensures a holistic approach to healthcare crises. Presently, specific backup procedures are not in place; however, the continual refinement and enhancement of our COOP will aim to address this gap.

Duration of Function Disruptions

The R1HCC is in the process of determining the maximum tolerable periods of disruption for each mission essential function. This analysis will provide insights into the criticality of each function and inform strategic decisions around resource allocation.

Training and Exercises

Although there are no exclusive training programs focusing on these mission essential functions at this time, the coalition understands the importance of training. It remains committed to incorporating such programs in the future to ensure a robust continuity posture.

Regular Review

Consistent with our commitment to continuous improvement, the mission essential functions, like all components of our planning documents, will undergo at least an annual review. This ensures that the R1HCC remains adaptable to the changing healthcare landscape and the unique challenges of the region.

External Support

The WDH stands as a beacon of support for the R1HCC. Their expertise, resources, and collaborative spirit bolster our efforts, especially in the execution of our mission essential functions.

Access to Vital Records and Databases

Ensuring uninterrupted access to essential records and databases is paramount for R1HCC's seamless operations, especially during emergencies. These vital resources provide the foundation upon which R1HCC conducts its essential functions, fosters communication, and ensures informed decision-making.

Vital Records Identification

The most crucial records for the R1HCC encompass our various plans and incident action plans (IAPs). These records guide our responses, strategies, and processes during emergencies and other pivotal operational periods.

Storage and Retrieval

All essential digital records are stored securely on cloud-based Google Drive servers. This facilitates global accessibility, ensuring R1HCC leadership can access the records whenever required, irrespective of their geographical location. Physical copies of these records are safely archived at the Infield Vector offices located in Gillette.

Access Protocols

Only members of the Board of Directors and employees of the HRRC management company have the authorization to access these records on Google Drive. The forthcoming transition to an R1HCC website will see the integration of a protected document center. This center will be structured to grant all members access to documents based on their credentials, although the current vision is to offer equal document access to all members.

Backup and Recovery

Given the critical nature of these records, they are backed up on the robust Google Drive infrastructure, which offers advanced data recovery solutions. In the unlikely event of data loss or integrity issues, Google Drive's team usually initiates automatic data recovery processes. Hard copies available at the Infield Vector offices in Gillette serve as an additional layer of data security.

Security Measures

Access to the Google Drive storage is strictly restricted to authorized individuals. As we transition to the R1HCC website, members will require specific credentials to log in and access the document center. While the architecture is designed to protect sensitive data, it also promotes transparency among members by ensuring equal access to documents.

Regular Updates

To maintain the accuracy and relevance of these records, they are reviewed and updated annually or as needed. Once finalized and approved, the HRRC is responsible for uploading the most recent versions to the digital storage solutions.

Challenges and Future Direction

Some members have found accessing records via Google Drive to be less than optimal for their needs. To enhance user experience and access efficiency, R1HCC is contemplating transitioning to a dedicated website with a members-only document center, ensuring a more streamlined and secure access system.

Resource Management

Effective management of resources is paramount to the R1HCC's ability to respond appropriately to continuity events and maintain its critical operations. These resources encompass our valuable personnel, facilities, and equipment.

Definition of Resources

For the R1HCC, resources are categorized into three major components:

• Personnel: They are the backbone of our operations and serve as the foundation of our mission to foster relationships during emergencies.
• Facilities: While not fixed in a single location, these are places where our operations take place, especially during emergencies.
• Equipment: Our equipment, notably our communications cache, becomes even more critical during emergencies when regular communication lines may be disrupted.

Resource Inventory

Our up-to-date inventory is maintained through EMSupply, part of the Juvare software suite. Beyond spontaneous updates, a thorough review of this inventory is conducted annually.

Resource Prioritization

Currently, the prioritization of resources during crisis situations is managed by R1HCC leadership on an ad hoc basis. We recognize the need to develop comprehensive protocols to streamline this process in future.

Resource Acquisition

When additional resources are required, the R1HCC utilizes funds from the Wyoming HPP to acquire necessary supplies and equipment. While we have the capability for direct procurement, we are looking into establishing partnerships for rapid acquisitions.

Resource Distribution & Redeployment

Resource logistics, from deployment to retrieval, are handled by the HRRC. The EMSupply system aids in tracking equipment locations and statuses, ensuring resources are utilized efficiently and as needed.

Resource Tracking

EMSupply serves as our primary tool for monitoring the whereabouts and condition of our equipment resources.

Training & Awareness

While the R1HCC currently lacks a structured training program for resource management, it is an area we aim to develop, ensuring all stakeholders understand and can execute their roles effectively.

Collaboration with External Entities

In emergencies exceeding Region 1's scope, predefined protocols are activated to liaise with the Wyoming Department of Health to request additional resources, ensuring a harmonized response across agencies.

Resource Restoration

Post-event restoration, replenishment, or replacement of resources is facilitated using funds procured through the Wyoming HPP.

Continuous Improvement

Although a formal mechanism is not yet in place, the R1HCC is committed to refining its resource management strategies. Feedback from after-action reviews (AARs) is a potential avenue for guiding enhancements in resource handling and deployment.

Communication Protocols During Disruption

In times of disruption or emergencies, the capability to communicate effectively is paramount. The R1HCC recognizes that ensuring uninterrupted, accurate, and swift communication among its members and other relevant stakeholders is critical to the coalition's overarching mission. Whether it's the early stages of a potential crisis or during the peak of an emergency, having reliable and versatile communication protocols in place is crucial. This section outlines the tools, responsibilities, and protocols designed to keep the communication lines open, even when faced with the most challenging scenarios.

Primary Communication Tools

• Juvare Software Suite: The main platform for emergency communication. Allows for real-time information sharing, member alerts, and incident tracking.
• Communications Cache: A dedicated set of communication equipment that ensures uninterrupted communication during major disruptions.

Backup Communication Systems

In the event of primary communication failures:

• The communications cache will be activated to bridge the communication gap.
• Traditional means, including phone, SMS, and email, will be employed for information dissemination.

Roles and Responsibilities

While there isn't a dedicated communication team, the HRRC takes the lead in coordinating communication during disruptions, ensuring timely information flow and addressing member queries.

Initial Notification

The foremost priority during an emergency is to inform all members about the developing situation. This helps them brace for potential impacts and activate their emergency response protocols.

Prioritization of Communication

Organizations directly impacted by the disruption are given precedence in communication, ensuring they receive critical information without delay.

Verification and Sensitivity

R1HCC values the speed of communication during emergencies, even if it comes at the cost of absolute accuracy. Members are advised to treat early information as preliminary, sensitive, and potentially inaccurate. The emphasis is on the principle that the benefits of rapid information sharing outweigh the risks associated with minor inaccuracies.

Feedback Mechanism

Juvare provides features that allow members to acknowledge the receipt of messages. Members can log into Juvare eICS to access incident updates, communicate with the incident command team, or convey ground-level information. Direct communication channels like email, phone, or SMS with the HRRC are always open for members to share updates or seek clarifications.

Training

Currently, no specialized training is provided on communication protocols during disruptions. However, members are familiarized with the general communication tools and expected procedures.

Post-Disruption Communication Evaluation

After every disruption, an After-Action Review (AAR) is conducted. This review assesses the efficacy of the communication protocols, identifies any gaps or challenges faced, and recommends improvements for future incidents.

Demobilization and Return to Normal Operations

Effective demobilization and transition back to regular operations are essential components of emergency management. Ensuring a structured approach to returning to standard procedures not only boosts the morale of stakeholders but also aids in the evaluation and improvement of emergency preparedness for future events.

Decision Making

The decision to initiate the demobilization process rests with the incident command team. The Board of Directors holds the authority for approving the transition from emergency operations back to normalcy.

Transition Protocols

While there isn't a predefined checklist for transitioning back to standard operations, the consistent documentation and record-keeping practices through Juvare eICS offer a foundation. These records can be used to guide the process and ensure that all emergency measures are systematically reverted.

Documentation

Post-emergency, a detailed report generated from Juvare eICS serves as the official record of the event. After demobilization, an After Action Review (AAR) is conducted to evaluate the emergency response's effectiveness, gather insights, and plan improvements for future events.

Personnel Health and Well-being

While specific protocols aren't in place, considering the intensity of emergency situations, it's vital to ensure the well-being of personnel. Recommendations include:

• Conducting structured debriefing sessions to allow team members to communicate their experiences.
• Providing access to counseling or support services, especially after prolonged or particularly traumatic events.
• Ensuring a defined rest period post-demobilization to help personnel recover physically and mentally.

Resource Restoration

Post-demobilization, the HRRC is responsible for inspecting all R1HCC-owned equipment. Necessary repairs or replacements are identified and arrangements are made to ensure equipment readiness for any future events.

Communication Protocols

Members, stakeholders, and related entities are informed about the end of emergency operations and the transition back to regular functions through Juvare.

Resumption of Services

While specific protocols are not in place for prioritizing the resumption of services, leveraging insights from the incident command team and the documentation from Juvare eICS can guide decision-making.

External Support

Even though there are no established plans for managing external assets post-emergency, consistent communication and acknowledgment of their support can lay the foundation for sustained partnerships.

Training and Exercises

The value of a COOP isn't just in its existence but in the understanding and confidence of its stakeholders in its execution. The R1HCC emphasizes regular training and exercises not merely as a perfunctory requirement but as a fundamental building block for resilience and efficiency during emergencies. This commitment to training ensures that all R1HCC members are familiar with the COOP, its procedures, and its expectations.

Objectives

The R1HCC training and exercise program aims to:

• Validate the COOP and identify areas for refinement.
• Ensure R1HCC members can seamlessly and effectively implement the COOP during disruptions.

Training Program

While the R1HCC is yet to establish a recurrent training curriculum, the foundation is set to launch annual training sessions once this COOP is finalized. The training content and modules, while yet to be determined, will be rooted in After Action Reports (AARs) and specific requests from members, ensuring that it remains pertinent and timely.

Exercise Types

The R1HCC embraces a multifaceted approach to exercises:

• Tabletop Exercises: Regular simulations where stakeholders discuss scenarios in an informal setting.
• Functional Exercises: Real-time, interactive simulations that test specific functions of the COOP.
• Full-Scale Exercises: Comprehensive, fully immersive simulations involving real-world actions.

At least one full-scale exercise is conducted annually, with numerous tabletop exercises scattered throughout the year. Functional exercises are scheduled based on need and relevance.

Participation

The primary participants of these exercises are R1HCC members. However, understanding the interwoven nature of emergencies, relevant external partners are frequently invited to participate, enhancing the realism and value of each exercise.

Continuous Improvement

After every exercise and, indeed, after any real-world activation of the COOP, an AAR is conducted. These AARs aren't just procedural; they form the cornerstone of our training content, ensuring that the R1HCC always learns, evolves, and improves.

Maintenance and Revision of the COOP

Maintaining the vitality and relevancy of the COOP is a dynamic process that reflects the ever-evolving challenges faced by the R1HCC and its member organizations. This section outlines the process by which the R1HCC ensures that the COOP remains current and functional.

Annual Review

The COOP is reviewed on an annual basis. This process is designed to ensure the plan remains updated to reflect changes in organizational structure, technology, procedures, and key personnel. Additionally, unforeseen threats or vulnerabilities may arise, requiring an update of the COOP's protocols.

Stakeholder Involvement

The R1HCC believes in the collective wisdom of its members. As such, every member of the R1HCC is invited to participate in the annual review process. This collaborative approach guarantees a wealth of expertise and insight, making the COOP as comprehensive and effective as possible.

Change Control Process

The R1HCC is in the process of establishing a change control protocol. This system will meticulously document alterations to the COOP, ensuring that changes and approvals are systematically recorded. Feedback on structuring this protocol is actively sought.

Triggers for Unscheduled Review

While the scheduled annual review forms the backbone of our maintenance strategy, there might be situations or member requests that necessitate an unscheduled review. Such adaptability ensures the COOP remains fit-for-purpose even in rapidly changing scenarios.

Communication of Updates

Any updates or changes to the COOP will be discussed at regular monthly meetings. Additionally, updates will be disseminated to all members through the regular monthly email newsletters, ensuring that all stakeholders are informed in a timely manner.

Document Control

To ensure the most recent version of the COOP is easily accessible, it is stored on the online R1HCC Library.

Feedback Mechanism

Open channels of communication are fundamental to the R1HCC's approach. The annual review process provides an opportunity for members to share feedback and suggestions on the COOP. The spirit of collaboration is essential in our pursuit of continuous improvement.

In summary, the maintenance and revision of the COOP is an ongoing collaborative process that guarantees its effectiveness and relevance. Through regular reviews, member engagement, and adaptive change management, the R1HCC is poised to respond effectively to any disruption, ensuring the continuity of operations and services to our community.

Challenges and Solutions

The R1HCC has been proactive in its approach to ensure that the healthcare systems in Region 1 have the necessary tools and resources to respond efficiently to emergencies. Like any entity, challenges arise; however, the ability to pinpoint these challenges and develop feasible solutions demonstrates the organization's commitment to improvement.

Primary Challenges

• Human Resources Constraints: A prominent challenge is the potential strain on human resources during large-scale emergencies. Given that members of the R1HCC primarily serve in local healthcare, public health, or emergency management capacities, they are expected to fulfill multiple roles in their primary job functions, in addition to their roles within the R1HCC.
• Geographical Limitations: The vast and expansive geographical spread of Region 1 poses a unique challenge. This spread makes coordination, transportation, and communication between different entities a more prolonged process than in more densely populated areas.
• Resource Limitations: Scarcity of resources, from funding to personnel, has been an ongoing challenge. Given the remote nature of the region and the distances between healthcare facilities, logistical concerns such as transporting equipment or providing consistent training can be significant hurdles.

Solutions and Ongoing Efforts

• Resource Allocation: The R1HCC is in the process of strategizing ways to optimize the allocation of its available resources. A balanced approach, ensuring that no single facility or area is disproportionately disadvantaged, is pivotal.
• Engaging External Partners: In situations where internal resources might be limited or stretched thin, the R1HCC has a practice of reaching out to external partners. This collaborative approach ensures that no stone remains unturned in the search for solutions.
• Software and Equipment: With the aid of tools like the Juvare suite and equipment such as the Communications Cache, the R1HCC is well-equipped technologically to respond to challenges.

Future Outlook

The R1HCC is on a trajectory of rapid growth and evolution. While growth is beneficial, it is invariably accompanied by new challenges. The focus remains on remaining agile, adaptable, and ever-responsive to the changing needs of the region's healthcare landscape. Through collective effort, mutual support, and a forward-thinking approach, the R1HCC is poised to face future challenges head-on and continue its mission of safeguarding the health and well-being of the region's residents.

Roles, Responsibilities, and Governance

In a dynamic environment where rapid response is essential, clarity of roles and governance becomes paramount. The R1HCC Board of Directors stands at the apex of our governance structure, directing our actions in alignment with our bylaws and ensuring that our mission to promote effective responses to patient surge emergencies is consistently upheld. This section delineates the roles, responsibilities, and the governance framework of the R1HCC, emphasizing the pivotal role of the Board of Directors and the significant day-to-day authority delegated to the Healthcare Regional Response Coordinator (HRRC). By clearly defining these roles and responsibilities, the R1HCC ensures an organized, efficient, and conflict-free approach during emergencies, allowing the coalition to concentrate its energies on managing the crisis rather than grappling with administrative intricacies.

Key Personnel and Roles

The R1HCC operates with a well-defined leadership structure, prioritizing clear lines of authority and responsibility. This ensures that during times of crisis or an activated COOP, all members know who to turn to and what responsibilities each role carries.

Board of Directors

The governance and oversight of R1HCC is primarily vested in the Board of Directors. Comprised of elected members from the R1HCC membership, the Board plays a pivotal role in guiding the direction, policies, and strategic goals of the coalition. The Board's specific officer roles include:

• President: As the primary leadership figure, the President oversees and directs all the activities of the R1HCC. They serve as the primary point of contact for external partners and stakeholders, and often represent R1HCC in public and media communications.
• Vice President: Assisting the President, the Vice President steps in when the President is unavailable. They also often spearhead specific projects or initiatives as deemed appropriate.
• Secretary: Responsible for the official documentation, meeting minutes (as delegated), and general administrative duties to ensure the smooth functioning of the R1HCC Board meetings.
• Treasurer: Handles the financial affairs of the R1HCC, overseeing the budget, and ensuring transparency and accountability in all monetary matters.
• Members-at-Large (up to three): These members contribute by voicing the concerns and interests of the broader R1HCC membership. They may also take on specific responsibilities or projects as determined by the Board.

Officers on the Board of Directors are elected to serve for two-year terms.

Healthcare Readiness and Response Coordinator (HRRC)

Acting as the primary point for operational activities, the HRRC manages the day-to-day functions of the R1HCC. Empowered by the Board of Directors, the HRRC is essential for liaising with members, organizing events and trainings, and managing the various resources and tools available to the R1HCC.

Integration and Responsibilities

While the exact integration of R1HCC within the broader local emergency response framework is still under consideration, the general expectation is that clear communication and collaboration will be paramount. The specific responsibilities of each role during an activated COOP are being defined. However, a crucial component will be the usage of eICS during emergencies, which will detail the command structure accessible by all R1HCC members.

Vacancy Protocols

In the event of an unexpected vacancy in a key role, it's anticipated that the President will appoint an interim member to ensure continuity in operations until a more permanent solution can be established.

Governance Structure

The governance of the R1HCC is established through its Board of Directors, which provides direction, oversight, and leadership for the organization.

Foundational Documents

The Board's roles, responsibilities, and procedures are well-defined in the organization's foundational documents: the articles of incorporation and the bylaws.

Meetings

The Board convenes monthly meetings to discuss, deliberate, and decide on matters relevant to the R1HCC's mission. All R1HCC members are welcome to attend these meetings unless stated otherwise.

Decision-making Protocol

Standard parliamentary procedures guide the Board's operations, specifically following Robert's Rules of Order. This ensures a structured and transparent approach to discussions, voting, and the resolution of disagreements.

Cohesion and Committees

Given its size, the Board primarily functions as a single cohesive entity. However, when required, ad hoc committees are formed to address specific issues or tasks.

Voting

For most matters not related to governance, a simple majority vote suffices for decisions. This streamlined approach ensures that actions and decisions can be made efficiently.

Feedback Mechanisms

Although there isn't a structured feedback mechanism, the Board remains in constant communication with the general R1HCC membership. During the monthly R1HCC meetings, the Board communicates its actions and is receptive to feedback, ensuring members' voices are considered in decision-making.

Transparency

Commitment to transparency is evident as the President reports on Board activities during the monthly R1HCC general membership meetings. This open communication ensures that all members are apprised of Board decisions and the rationale behind them.

Tenure and Succession

Each director shall be elected by the Board of Directors for a term to be determined by the Board at the time of election, which shall not exceed three (3) years unless the director is filling an unexpired term of another director. After the expiration of a director's initial three (3) year term, the director may serve a second three (3) year term with the approval of the Board. If a Director is elected as an officer, the officer shall remain on the Board, regardless of the number of years served, until the Director’s successor is elected. Immediate Past Presidents who have already served two consecutive terms as board members may remain on the Board at their option until they are no longer the immediate Past President, or until their resignation or removal in accordance with these Bylaws. New and renewing board members shall be approved by a majority of those board members at a board meeting at which a quorum is present.

Risk Assessment and Management

The R1HCC acknowledges the critical importance of understanding and assessing potential risks to ensure optimal preparedness and response during emergencies. Historically, our risk assessment foundation has been built on the insights provided by the Hazard Vulnerability Analysis (HVA). However, we recognize that our current HVA is outdated and does not necessarily capture the evolving risk landscape that the R1HCC may face. In line with our commitment to continuous improvement and providing the most up-to-date guidance to our members, we are in the process of comprehensively overhauling our HVA. Once this revamp is complete, this section will be updated to reflect our current risk assessment and management strategies. We appreciate the understanding and patience of our members and stakeholders as we undertake this vital initiative.

Additional sub-sections to be completed after the HVA is ready include:

Preventive Measures and Mitigation Strategies

Proactive Protocols

The R1HCC emphasizes the importance of preparedness, ensuring that in the face of potential disruptions or emergencies, all member organizations and their representatives have a solid foundation of knowledge and resources on which to act. As we understand, predictability in crises is often an illusion, but a strong foundation of proactive measures can significantly mitigate risks.

Hazard Vulnerability Analysis

At the heart of our proactive measures is the Hazard Vulnerability Analysis (HVA). This tool allows us to understand general hazards, anticipate potential threats, and assess how they might impact our operations and our community. By analyzing the vulnerabilities, we can direct our efforts towards strengthening the weakest links.

Drills and Exercises

Hands-on practice remains one of the most effective ways to ensure readiness. The R1HCC is committed to conducting at least two drills or exercises annually. These events not only bolster our readiness but often bring to light areas that need improvement.

Communication Channels

Utilizing the Juvare software suite, we can disseminate essential information and updates seamlessly among our member organizations. This tool is not only used for resource management but also plays a pivotal role in our communication strategy.

Engagement with Member Organizations

The R1HCC takes pride in its diverse member base, comprising entities specializing in hospitals, EMS, public health, and emergency management. This diversity means a vast reservoir of expertise and information, ensuring that the coalition remains updated with the latest advisories, guidelines, and safety standards. Regular monthly meetings serve as a platform for members to share insights, provide updates, and collaborate on strategies.

Resource Management

Using Juvare EMResource, we meticulously track our inventory, ensuring that all equipment and facilities are ready to be deployed at a moment's notice. Regular checks and preventive maintenance tasks are scheduled and logged in this system, providing a clear overview of our resource status at any given time.

While the foundation of our proactive protocols is strong, we acknowledge there are areas for improvement. As we move forward, the R1HCC remains committed to refining its strategies, exploring potential collaborations, and ensuring that our preparedness measures are always a step ahead of potential threats.

Mitigation Approaches

The R1HCC is in the early stages of its proactive efforts towards risk mitigation. Currently, our primary mitigation strategies are rooted in planning and conducting occasional exercises. These are foundational activities that aim to prepare R1HCC and its member agencies for potential emergencies, albeit in a generalized context.

While we have not yet developed targeted mitigation approaches for specific threats, the completion of our Hazard Vulnerability Analysis (HVA) will inform future mitigation strategies. Using the HVA's risk matrix, we will prioritize threats and vulnerabilities, guiding our focus and efforts towards the most critical areas.

Collaboration is a cornerstone of our mitigation efforts. Every member agency plays an active role in these strategies. Their collective experiences and insights help to shape our understanding of the regional threats and the ways we can address them.

Budget constraints, however, play a significant role in our mitigation initiatives. Although we do not have a dedicated fund specifically for mitigation, we allocate resources annually from our general fund. It is imperative that expenditure requests directly address identified vulnerabilities or gaps.

All R1HCC members are consistently informed of our mitigation strategies through published plans and regular communications. They are encouraged to provide feedback and contribute to strategy development by participating in our regular meetings, After Action Reviews (AARs), and ad hoc committees focused on plan creation, review, and revision.

One of the significant challenges we face in mitigation is the deeply ingrained culture of self-sufficiency within many organizations in the region. The remoteness of Wyoming and historical funding constraints have led many to develop their own methods of addressing threats. While this has its strengths, fostering collaboration can be a challenge. R1HCC continually works to bridge these gaps, emphasizing the power of collective effort over isolated actions.

Response and Recovery Protocols

The R1HCC recognizes the challenges posed by Wyoming's expansive geography and potential for extreme weather. Our response and recovery protocols are designed to ensure a well-coordinated response to emergencies and to restore standard operations promptly. It's important to note that while these protocols provide guidance, they complement our existing Preparedness and Response Plans. They do not replace or replicate them. The primary aim is to continuously support our key members, including hospitals, EMS agencies, public health departments, and emergency management agencies, during disruptions to our usual continuity of operations.

Immediate Response

Activation Criteria

The immediate response protocols of the R1HCC are triggered based on the best judgment and consensus of the Board of Directors, HRRC, and any members directly involved in the incident.

Notification System

Upon determination that the immediate response protocols need to be activated, all relevant entities and members will be notified through the Juvare eICS platform, ensuring that all stakeholders are promptly informed of the unfolding situation.

Decision-Making

The authority to decide the scale, nature, and direction of the immediate response lies with the Board of Directors. They will evaluate the situation, gather input from relevant stakeholders, and determine the best course of action.

Primary Response Actions

The R1HCC recognizes the need for predefined steps during an immediate response. While these steps have yet to be formally established, the emphasis remains on flexible and adaptive measures tailored to the specifics of each incident.

Resources

At this time, there are no dedicated resources specifically earmarked for immediate response. Resources are allocated based on the needs of the situation, drawing from the collective assets of the R1HCC and its members.

Coordination with Members

R1HCC maintains open lines of communication with the involved agencies. Depending on the circumstances of the incident, the mode of communication will be tailored to best suit the needs and capabilities of those agencies.

Integration with Other Plans

The COOP comes into play when there's an occurrence during a patient surge event that threatens the standard mode of operations. The Preparedness Plan, which outlines the R1HCC's ongoing preparations for emergencies, remains continuously active. In contrast, the Response Plan is triggered when there is an activation of the R1HCC due to a patient surge event.

Duration of Immediate Response

There's no predetermined duration for the immediate response phase. It's contingent on the nature and scale of the incident and the time it takes to stabilize the situation or transition to the next phase.

Communication with External Entities

The R1HCC's ethos is inclusivity, aiming to encompass all potential stakeholders as members. As such, there should be no external entities that need to be informed separately during an immediate response.

Feedback Loop

Currently, there is no formal real-time mechanism for evaluating and adjusting the immediate response actions. Feedback and adjustments are made based on collective expertise, situational analysis, and the evolving needs of the situation.

Long-Term Recovery

The aftermath of a significant disruption demands a meticulous and sustained approach to recovery. For R1HCC, the overarching objective of long-term recovery is straightforward: restore normalcy and operational continuity.

Scope

While there's no rigid definition for the duration encompassing 'long-term,' the emphasis is on ensuring comprehensive recovery rather than adhering to a strict timeline.

Primary Objective

Our primary focus is the reinstatement of regular operations. This restoration process often involves prioritizing certain vital services. While no formal hierarchy exists, an intuitive approach is taken, with emphasis often on revitalizing public health and safety operations initially, followed by restoring operational services like public utilities and communication infrastructures, and then advancing from there.

Coordination

While no single member assumes sole responsibility for oversight during this phase, the HRRC acts as the primary point of coordination, ensuring all activities align with our recovery goals.

Communication

Effective communication remains paramount, especially during the recovery phase. Utilizing the standardized ICS communication procedures, the R1HCC ensures consistent and accurate information dissemination. Our Juvare eICS software significantly aids this process, providing a platform for organized and effective communication.

Transition

Determining the end of the long-term recovery phase and transitioning back to regular operations remains a dynamic process. As of now, there are no strict criteria delineating this transition. The focus remains on ensuring the wellbeing and operational capacity of all our member organizations.

Training, Drills, and Preparedness

In the dynamic landscape of emergency response and healthcare, the R1HCC places significant emphasis on rigorous training and periodic drills. The primary objectives of these exercises are multifaceted: they serve to instill vital knowledge, fortify inter-agency relationships, identify potential operational gaps, and validate the efficacy of our established plans. With a commitment to conducting a minimum of two exercises annually, we anchor our training standards in the guidelines set by the Administration for Strategic Preparedness and Response (ASPR) and the Homeland Security Exercise and Evaluation Program (HSEEP). Crucially, the outcomes and feedback from each exercise are meticulously reviewed through after-action reviews (AARs), ensuring that our training evolves in response to new insights and remains consistently aligned with the needs and challenges of our member organizations.

Education and Training

In line with its commitment to ensure preparedness and an effective response during patient surge events, the R1HCC does not directly employ personnel but engages with professionals across various disciplines. These professionals, alongside the volunteer Board of Directors and the HRRC, undergo targeted training sessions designed to equip them with the knowledge and skills essential for their roles. The training framework, built around the feedback and needs of these participants, caters to the unique landscape and challenges posed by our region.

Annual Education Survey

Annually, the R1HCC conducts an education survey to discern the pressing educational requirements of its members. This survey plays a pivotal role in shaping the training agenda, ensuring that the educational modules are in tune with current demands.

Training Courses

The outcome of the survey typically paves the way for 2–4 standardized training classes each year. These classes mainly revolve around clinician training tailored for patient surge events and NIMS ICS training. While the frequency and exact nature of the classes can be influenced by evolving organizational needs, they remain rooted in the broader goal of optimizing emergency response efficacy.

Participant Feedback and Evaluation

Post-training, participants are encouraged to provide feedback through course evaluations. This feedback, combined with AARs, aids in assessing the effectiveness of the training and charting future improvements.

Collaborative Training Sessions

Understanding the value of collaborative and inter-disciplinary training, the R1HCC ensures that training sessions are open to all its members, irrespective of their primary disciplines. Such an inclusive approach fosters a richer learning environment and better equips members to respond to varied challenges. Additionally, relevant external partners are also invited to partake, ensuring a comprehensive preparedness environment.

Prerequisites and Recommendations

Certain standardized courses may have prerequisites set by the overseeing organization. However, the R1HCC itself does not mandate specific certifications. It emphasizes that members uphold the competencies and certifications germane to their respective professional domains.

Communication of Training Opportunities

Members are kept abreast of upcoming training opportunities through the R1HCC's regular monthly email newsletters and monthly meetings. This ensures that all members have the opportunity to plan and participate actively in these vital training sessions. Training opportunities will also be listed on the R1HCC website.

Scheduled Drills and Simulations

R1HCC understands the importance of hands-on training in the form of scheduled drills and simulations to validate the efficacy of our response strategies, improve member skills, and reinforce our collaborative approach to handling emergencies. Regularly scheduled simulations enable us to practice for potential real-world events, ensuring we're prepared to handle them with efficiency and effectiveness. This not only tests our strategies but helps to build cohesion and coordination among our members.

Frequency of Drills

The coalition conducts drills and simulations at least twice a year. Depending on the identified needs, feedback from members, and guidance from the Board, additional drills may be organized to address specific areas of concern.

Focus Areas

Each year, drills target one of our five response annexes, ensuring that over time, all aspects of our response strategy are rigorously tested. Beyond this annual focus, we adjust our drill themes based on comprehensive needs assessments, member insights, and directives from our Board.

Design and Oversight

All simulations are designed, planned, and executed internally, drawing from our collective expertise and understanding of the regional healthcare landscape.

Participation

We believe in inclusive training. While participation in these drills is not mandatory, it is open to and strongly encouraged for all R1HCC members, ensuring a diverse and comprehensive representation during simulations.

Technological Assistance

Currently, our drills rely on hands-on scenarios and do not utilize specific technological tools for execution.

Evaluation

Following each drill, we conduct an After-Action Review (AAR) to evaluate the effectiveness of the simulation, identify strengths and areas for improvement, and gather feedback from participants.

Sharing of Findings

We believe in the transparent sharing of insights. All members are invited to participate in the AAR sessions, and documents resulting from these sessions are shared with all, fostering a collective learning environment.

Collaboration

While most of our drills are region-centric, there are instances when we collaborate with the Wyoming HPP for statewide drills, which includes participation from the other four healthcare coalitions in Wyoming.

Regulatory Adherence

Our drills and simulations are designed with best practices in mind but are not tied to any specific regulatory or compliance requirements.

Incorporating Feedback

We prioritize learning from every drill. Feedback gathered during AAR sessions directly informs the design and focus of subsequent drills, ensuring that our training remains relevant and continually evolves based on our experiences.

Plan Maintenance and Periodic Review

To ensure the ongoing effectiveness and relevance of the COOP, the R1HCC commits to a structured, annual review overseen by the Board of Directors. Recognizing the ever-evolving landscape of risk management, changing regulations, and new best practices, this periodic review seeks to incorporate fresh insights and address emerging challenges. While the review is anchored in an annual timeline, the R1HCC remains responsive to the feedback from its members, and any significant suggestions might prompt an unscheduled assessment of the COOP. All updates and revisions stemming from these reviews are promptly communicated to all members and stakeholders through regular monthly email newsletters and meetings. In this continuous journey of refinement, the R1HCC remains steadfast in its pursuit of excellence, always aiming for the highest standards in preparedness and response.

Update Schedule

The R1HCC places a high emphasis on the continuous improvement of its operational plans, ensuring that they remain relevant, effective, and reflective of the coalition's dynamic needs. The following outlines the standard process for updating and maintaining this COOP:

Annual Review

Every plan under the R1HCC umbrella undergoes a systematic annual review. The reviews are spread throughout the year to ensure a balanced workload and timely consideration of each document.

Changelog Maintenance

To maintain transparency and traceability of updates, a changelog will be kept for the COOP. This log will record the nature of changes, the date of amendment, and any pertinent comments or reasons for the update.

Exceptional Updates

While the annual review is structured and scheduled, there may be situations that necessitate urgent updates outside this timetable. Such changes, prompted by significant events or feedback, are treated as exceptions. Regardless of their urgency, they will be documented in the changelog.

Board Approval

The R1HCC's Board of Directors holds the authority for final plan approval. Proposed updates or changes, whether arising from the annual review or exceptional circumstances, must be presented to and approved by the Board. The specific procedures for obtaining this approval are detailed in the coalition's bylaws.

By adhering to this structured update schedule, the R1HCC ensures that its COOP is a living document, always ready to guide the coalition in periods of disruption, ensuring continuity and resilience.

Feedback Integration

Open and transparent feedback is a cornerstone of the R1HCC's approach to ensuring the most comprehensive, effective, and actionable Continuity of Operations Plan. Such feedback ensures that the COOP remains adaptive to the evolving needs and challenges of our member organizations and the communities they serve.

Solicitation of Feedback

While R1HCC values continuous input from its members, it actively encourages contributions during the annual review process. This process provides a structured opportunity for members to give detailed feedback and suggests modifications based on their individual and collective experiences. Although we do not specifically solicit feedback from external partners, we acknowledge the potential value of their insights and are open to considering them when presented.

Feedback Submission

Members who wish to offer their feedback or insights outside of the annual review process are encouraged to contact the HRRC, who serves as the central point for collecting, recording, and initiating any subsequent action regarding the input received.

Categorization and Prioritization

While there isn't a rigid policy for categorizing or prioritizing feedback, the focus remains on the pertinence and relevance of the feedback to the R1HCC's mission and objectives. Feedback that directly impacts the safety, effectiveness, and operational integrity of the R1HCC and its member organizations is naturally of high priority.

Feedback Integration and Communication

Once feedback is evaluated and integrated, where appropriate, into the COOP, members are informed about these changes and their implications. This communication takes place via regular monthly email newsletters and is further discussed in the regular monthly meetings. The goal is to ensure that all stakeholders are informed of and aligned with any adjustments made to the COOP.

Resource Allocation and Management

In the vast and geographically diverse landscape that R1HCC serves, efficient and purpose-driven resource allocation is pivotal. The underlying philosophy of R1HCC's approach to resource management is grounded in a commitment to deploy resources where they are most critically needed, maximizing benefit for the broadest swath of our community. While our focus primarily encompasses the allocation of physical assets, the challenges of navigating extensive distances and the constraints of not having continuous personnel coverage emphasize the need for a robust and strategic resource management plan. Through this, R1HCC aims to ensure that there is minimal disruption in services, that available resources are optimized for use, and that we maintain a state of readiness to respond effectively in times of emergencies, always striving to provide the greatest good for the largest number.

Essential Resources List

The R1HCC, though not possessing a defined "essential resources" list, has various critical physical assets that can be of paramount importance during specific emergencies. These assets, which include items like ventilators, a communications cache, and training equipment, are not formally prioritized, but their importance is understood contextually, contingent on the nature and requirements of a given emergency. While some scenarios might necessitate the use of ventilators, others might render the communications cache invaluable, especially in situations of communication breakdowns.

Given the vast geographical area of our region, careful consideration has been given to the strategic deployment and storage of these assets. While efforts have been made to ensure assets are distributed throughout the region, assets singular in nature are usually housed in the Gillette office for its central geographic location. This placement strategy is designed to maximize accessibility and utility during times of emergency.

The R1HCC is aware of the need to periodically review and perhaps formalize its approach to identifying and managing essential resources. This will ensure that as the challenges we face evolve, our resources can be quickly mobilized and efficiently utilized to tackle them.

Future work in this area may entail the creation of a formal essential resources list, the establishment of protocols for updating and managing this list, and training on the optimal use and deployment of these resources.

Contact Directory

Effective communication is the backbone of coordinated emergency response efforts. The R1HCC maintains a digital member contact directory to ensure that relevant parties can be reached rapidly during emergencies or for critical coordination.

Directory Maintenance

The Healthcare Readiness and Response Coordinator (HRRC) is responsible for keeping the directory updated. All members are encouraged to communicate any changes in their contact details directly to the HRRC. This ensures that the directory is accurate and provides reliable contact details for crucial communication efforts.

Directory Access

At present, access to the contact directory is limited to the Board of Directors and the HRRC. Please refer to R1HCC Contact Information Policy.

Directory Details

Each entry in the directory includes:

• Name
• Organization
• Role
• Phone Number
• Email Address

Integration and Redundancy

The directory is integrated with the Juvare eICS system. This integration allows for immediate access to the contact details during emergencies, ensuring rapid communication and coordination. Furthermore, the integration with Juvare eICS provides a level of redundancy, guaranteeing that the contact details are always accessible even if the primary directory becomes temporarily unavailable.

Future Plans

The R1HCC recognizes the evolving needs of the coalition and the importance of streamlined communication. As such, a revision of the contact policy and directory is currently underway. This revision aims to optimize the communication channels within R1HCC, ensuring that every member can be reached effectively and efficiently when needed.