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Exercise Overview�

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Darren Verrette

Disaster Program Manager

Los Angeles County EMS Agency

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2026 AMHE

Critical Infrastructure: Targeted Violence and Power Outage Exercise.

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Program Priorities

2026 AMHE:

  • MRSE Requirement: Patient Surge (MCI)
  • LA28 Summer Olympics: MCI at Summer Olympic Venue
  • Hazard Vulnerability Analysis (HVA): #3 Power Outage

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�Critical Infrastructure Sectors

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Pre-exercise (2-3 days before exercise): Heighten security posture following threats to the following critical infrastructure sectors in the Los Angeles area:

  1. Commercial Facilities Sector (Sports Arena / Stadiums)
  2. Energy Sector (Power Plants / Electric Sub-stations)
  3. Healthcare and Public Health Sector

Scenario

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�Critical Infrastructure Sectors

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Pre-Exercise: 2028 Olympic Games are underway.

Local law enforcement has issued a “Be on the Lookout” (BOLO) alert to the community requesting anyone observing suspicious Unmanned Aircraft System (UAS) - drone activity to report it to authorities.

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Scenario

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Mystery Drones

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Mystery Drones Over Military Bases

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Mystery Drones Over New Jersey

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Day of Exercise: Unmanned Aircraft System (UAS) drone strike at Olympic event near you or multiple sites

  • No central location for MCI. This allows everyone in County to play
  • Central MCI location only for Fire and Provider Agencies to test FOAC
  • Many victims self dispatch to nearby clinics and hospitals
  • Fire arrives on scene and initiates MCI with MAC on V-MED28
  • Victims are transported to ED resulting in patient surge (MRSE Requirement)

Scenario

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MRSE Requirement

  • ASPR grant requirements; specifically, the Medical Response and Surge Exercise (MRSE) requirements.
  • Surge Capacity Requirements
  • Performance Measures
  • Data Collection Requirements

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MRSE Requirement: Patient Surge �

  • The Healthcare Coalition (HCC) must surge to 10% of its licensed bed capacity
  • L.A. County has approx. 21,159 licensed beds. 10% = 2,160 surge patients
  • At a minimum we will surge to 3,350 patients

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Patient Allocation Table

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ReddiNet Assessment Poll:��Hospital Capacity Survey�

MRSE Requirement: Performance Measures �

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Day of Exercise: At 9:00am a targeted UAS strike at a local electric sub-station…

  • Grid power failure impacting area around your facility
  • Power to the area around your facility is down (ATM’s, homes, schools, stores, streetlights, etc.).

Scenario

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2003 Northeastern US – Blackout

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2022 Substation Attack in North Carolina - Power Outage

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May 2026 - Philadelphia Hospital Evacuated after Power Outage

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Day of Exercise: …forcing your facility on back-up generator or resulting in total power loss.

  • Each facility self-determine if on back-up power or no power
  • DRC Region-8 hospitals and SNFs to test emergency power playbook with MCC
  • All others outside Region-8 also use ReddiNet “pill” and answer questions. Answers to reflect green or yellow risk level. Not red or orange risk level.
  • LTC MAP coordination
  • Emergency fuel for designated provider agency

Scenario

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Power failure provides the opportunity to evaluate many areas. Here are some suggested areas to consider:

  • Assessment of power needs
  • Back-up communications / ARES
  • Back-up power system failure
  • Business continuity plan
  • Cancel procedures / surgeries
  • Cash needs for purchases
  • Charging stations for phones and laptops
  • Connecting portable power banks / extension cords
  • Downtime procedures
  • Electric fuel fleet charging needs
  • Elevators down / Med-Sled use
  • Emergency fuel for response vehicles
  • Emergency supplies (flashlights / batteries)
  • Evacuation / relocation
  • Fuel for back-up generators (How to acquire / MOU)
  • HVAC system failure (Emergency cooling or warming)
  • Identify vendors that provide back-up power (How to acquire / MOU)
  • Identify which essential systems that are not on back-up power
  • IT network down
  • Medical gas failure
  • Quick connect capability
  • Robotic systems that require charging
  • Secure parking ingress / egress
  • Supporting the Community
  • Utility failure (water, etc.)

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Power Outage

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�Emergency Power Resilience Playbook

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�Emergency Power Resilience Playbook

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ReddiNet Generator Pill

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Region-8 Facilities (*Generator Pill) and other sectors��911 Receiving Hospitals in DRC Region-8 will simulate Internal Disaster.

  • *Adventist Health White Memorial - Montebello
  • *Coast Plaza Doctors Hospital
  • *Greater El Monte Community Hospital
  • *Norwalk Community Hospital
  • *PIH Health Hospital – Downey
  • *PIH Health Hospital - Whittier
  • *Rancho Los Amigos Rehabilitation Hospital
  • *Saint Francis Medical Center
  • *Whittier Hospital Medical Center

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  • *Skilled Nursing Facilities
  • Ambulatory Surgery Centers
  • Clinics
  • Dialysis
  • HHH
  • Urgent Care

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�Region-8 Long Term Care - Skilled Nursing Facilities�

  • SNFs to Test Patient Surge and Power Outage
  • Long-term Care Mutual Aid Program (LTC-MAP) Coordination
  • The LTC-MAP group will test team communication, notification, activation, and coordination.
  • The group pre-identified a skilled nursing facility (SNF) in Region-8 to evacuate
  • In addition to testing power outage other SNFs in LA County will be asked to set-up their surge capacity areas if they were to receive an influx of residents

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Ambulance Emergency Fuel�

  • EMS Agency will work with a designated ambulance provider to test emergency fueling process

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  • Ambulance provider will contact the EMS Agency and submit a RR for fuel

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  • The ambulance provider will be given a location (ISD yard, Fire Department, Sheriff, etc.) and temporary credentials to access fuel

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Exercise Essentials�

  • Scenario
  • Scope
  • Assumptions
  • MSEL
  • Resource Requesting
  • ARES
  • Conclusion of Exercise
  • Documentation
  • Registration

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Scenario�

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Pre-Exercise: 2028 Summer Olympics are underway. Local law enforcement has issued a “Be on the Lookout” (BOLO) alert to the community requesting anyone observing suspicious Unmanned Aircraft System (UAS) - drone activity to report it to authorities. There has been an increase in threats to critical infrastructure sectors in the Los Angeles area. Specifically, to power plants, sports stadiums, and the medical and health sector. The BOLO is to remain in place for the duration of the Olympic Games.

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Day of Exercise: An Unmanned Aircraft System (UAS) drone attack at Olympic event near your facility. Many victims with mild to moderate injuries self-dispatch to nearby clinics and hospitals. The Fire Department arrives on scene and initiates an MCI with the Medical Alert Center (MAC) and activates a FOAC. Victims are transported by ground ambulance resulting in a patient surge to emergency departments.

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This is immediately followed by a targeted UAS strike at a local electric sub-station resulting in grid power failure and forcing your facility on back-up power or resulting in total power loss.

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Exercise Scope�

  • Command center activation is encouraged.
  • There will be no actual movement of patients.
  • Play will take place in the live ReddiNet system and V-MED28.
  • The exercise will begin at 8:00 a.m. and end at 12:00 p.m.

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Exercise Assumptions��

The scenario is plausible and meets criteria to activate applicable plans.

The time during the exercise is not reflective of actual time.

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Master Scenario Event List (MSEL)��

  • MSEL is a chronological list of simulated events (injects) that participants (players) will be asked to respond to during an exercise
  • Some injects are for all players such as the Service Level Poll
  • Some injects are for specific sectors and players such as Long-Term Care Bed availability Poll
  • It is okay to remove non-pertinent injects or add additional if needed to meet your objectives

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Resource Requesting��

MCC will open a resource request incident to support the exercise titled:

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“2026 AMHE Exercise”

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Use this incident in ReddiNet for exercise related resource requests

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Resource Requesting��

  • We (EMS Agency) process RR via ReddiNet
  • We only process medical and health resource requests except for shelters, HVACs, and generators.
  • We do not process RR for fuel except for emergency fuel requests from ambulance provider agencies.
  • Contact vendors then your local city EOC or DMAC coordinator for non-medical and health resource requests.

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EMS Agency Generator Fleet

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Amateur Radio Emergency Service (ARES)��

  • Great opportunity to invite ARES to your hospital to test back-up communications
  • ARES will setup Net Control at the MAC
  • ARES can transmit and receive messages, resource requests, bed availability reports, and more via HAM radio

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Conclusion of Exercise��

  • Recommend hot-wash (debrief) with players
  • Participant Feedback Forms
  • 60 days to complete and submit AAR/IP
  • Exercise Evaluation Conference 12/8/26

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Documentation��

  • Exercise Plan (ExPlan)
  • Exercise Objectives (Sector Specific)
  • Situation Manual (SitMan)
  • Controller Evaluator Handbook
  • Exercise Evaluation Guide (Sector Specific)
  • Victim Cards
  • Master Scenario Event List (MSEL)
  • Participant Feedback Form
  • After-Action Report / Improvement Plan - Template

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Websites:

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L.A. County Healthcare Coalition Website:

https://www.lacountyhcc.org/trainings-exercises-drills/amhe-annual-medical-health-exercise/2026-amhe -

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EMS Agency Website:

https://dhs.lacounty.gov/emergency-medical-services-agency/home/disaster-programs/exercise-drills/

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Exercise Registration��https://forms.cloud.microsoft/Pages/ResponsePage.aspx?id=SHJZBzjqG0WKvqY47dusgeAx3rhTCttAiemAxAwTrD9UMTFDREpKMVpDVFMzMU1ZVjRXU05KS1UyNC4u��

  • Please register your facility for the exercise
  • Registration will confirm your facility is planning to participate
  • Registration will provide point-of-contact information to EMS

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Questions

Type questions in chat or unmute

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Thank you!

Darren Verrette

dverrette@dhs.lacounty.gov

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