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Annual Medical and Health Exercise �Thursday, November 20, 2025

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Exercise Overview

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Darren Verrette

Disaster Program Manager

Los Angeles County EMS Agency

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Healthcare Coalition (HCC) Members Participating in the Exercise:��

  • Amateur Radio Emergency Services (ARES)
  • Ambulatory Surgery Center Sector (ASC)
  • Clinic Sector (Clinic)
  • Dialysis Sector (Dialysis)
  • EMS Agency (MAC/MCC/MHOAC)
  • Fire Department (Fire)
  • Home Health & Hospice Sector (HHH)
  • Hospital Sector (Hospital)
  • Long Term Care Sector (LTC)
  • Mental Health (DMH)
  • Office of Emergency Management (OEM)
  • Provider Agency Sector (Ambulance)
  • Public Health (DPH, LBHHS, Pasadena PH)
  • Urgent Care Sector (UC)

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Threat / Hazard

EARTHQUAKE

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2019 Ridgecrest Earthquake

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2019 Ridgecrest Earthquake

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�United States Geological Survey (USGS)��M6.3 Scenario�

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�United States Geological Survey (USGS)��M6.8 Scenario�

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Scenario��

At 7:30 a.m., a M6.3 earthquake occurred on a section of the Palos Verdes fault. The entire Los Angeles region experienced shaking, with stronger tremors felt in Long Beach, Terminal Island, San Pedro, Carson, Lomita, Torrance, and Redondo Beach.

No reports of any significant damage occurring to any facility in the County. All facilities remain operational.

Emergency Departments, Clinics, and Urgent Care facilities in the County are receiving an influx of patients by walk-in. Emergency Departments are also receiving patients due to an MCI. Victims sustained mild to moderate injuries. Very few require admission.

Two hours later at 9:30 a.m., a M6.8 earthquake occurred along the Newport-Inglewood fault. Once again, the entire Los Angeles region experienced shaking, with particularly intense shaking in the Long Beach and South Bay areas of Los Angeles County.

Consequently, facilities are receiving and influx of patients by walk-in. Emergency Departments are receiving patients due to an MCI resulting in a second and larger patient surge.

Also, received reports that facilities in the Long Beach and South Bay areas require evacuation (partial or complete) due to structural and/or other infrastructure damage.

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Earthquake�Exercise��

The exercise will test patient surge, evacuation plans, transportation coordination, and other pertinent plans and processes related to earthquakes.

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Patient Surge and Evacuation��

Patient Surge:

The initial M6.3 earthquake is intended to cause a mild surge to drive play to meet surge requirements.

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Patient Surge:

The subsequent M6.8 earthquake is intended to cause another patient surge to drive play to meet surge requirements.

Evacuation:

The M6.8 earthquake is also intended to cause facility evacuations to test various evacuation plans and procedures, including the Hospital Evacuation Policy, Reference 1112.

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�Hospital Evacuation�Plan�

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Evacuating Hospitals��12 Hospitals in the severely impacted areas will be required to evacuate but can self-determine scale (full vs. partial):

  • Cedars Sinai Marina Del Rey (Cedars)
  • College Medical Center (College)
  • Saint Mary Medical Center (Dignity)
  • Harbor UCLA (DHS)
  • Kaiser South Bay (Kaiser)
  • Long Beach Memorial / Miller’s Children’s (Memorial Care)
  • LCM San Pedro (Providence)
  • LCM Torrance (Providence)
  • Torrance Memorial (Cedars)
  • Gardena Memorial (Pipeline)
  • Centinela Medical Center (Prime Health)
  • Kindred South Bay (Kindred)

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Evacuating Long Term Care (LTC) Facilities��3 Long Term Care facilities in the severely impacted areas will also evacuate:

  • Long Term Care Facility 1
  • Long Term Care Facility 2
  • Long Term Care Facility 3

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Hospital Patient Evacuation Plan (10% Minimum)��

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Evac. Hospital: 2024 License:

    • Cedars Marina Del Rey 133 13
    • College 221 22
    • St. Mary 360 36
    • Harbor UCLA 453 45
    • Kaiser South Bay 257 26
    • LBM / Millers Child. 453 / 357 45 / 36
    • LCM SP 356 36
    • LCM Torrance 442 44
    • Gardena Mem. 172 17
    • Centinela 362 36
    • Torrance Mem. 533 53
    • Kindred South Bay 54 5

Total 414

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Hospital Actions �

Evacuating Hospital (Actions):

  • External Notifications (MAC / CDPH)
  • Identify how many patients need evacuation
  • Identify type of bed (ICU, Tele, etc.) and service (Surgery, Cardiology, etc.) needed
  • Identify what ambulances are needed by type (BLS, ALS, CCT, etc.)
  • Contact Network “Sister” Hospitals
  • Contact contracted ambulance providers (SimCell)

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Hospital Actions �

Network “Sister” Hospital (Actions):

  • Direct call to appropriate person / location (Command Ctr., Transfer Ctr., etc.) for processing
  • Determine how many, if any, patients can accept using internal transfer policy and surge criteria
  • Inform evacuating hospital of how many patients can accept

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Hospital Actions �

Evacuating Hospital (Actions):

  • If additional beds needed, contact EMS MCC
  • Provide how many patients need evacuation
  • Provide type of bed and service needed
  • If additional transport resources needed, contact EMS MCC

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EEG:�Evacuating Hospitals and Network Hospitals

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Evacuating Hospital / LTC�Transportation Coordination

  • SimCell (private ambulance providers)
  • Representatives from private ambulance companies serving as SimCell
  • Will have SimCell Directory
  • Limited resources, will not have sufficient resources to manage incident

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  • Evacuating Facilities (Actions):
  • Contact contracted ambulance providers
  • Request quantity and type of ambulances needed
  • If need additional transport resources, contact MAC

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  • EMS MCC (Actions):
  • Will process requests for transportation
  • FOAC, RDMHS/State AST, etc.
  • EMS MCC will assign transport resources to facility (facility will manage resources)

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SimCell Directory

Will utilize Simulation Cell (SimCell) for Ambulance Providers and CDPH

Ambulance Simulation Cell (SimCell) Directory

 

Simulating Agency

Phone

BLS

ALS

CCT

Gurney Van

Bariatric

Other

1

All Town Ambulance

TBD

X

X

X

 

X

RT, HF O2

2

Ambulife Ambulance, Inc.

TBD

X

 

 

 

 

 

3

AmbuServe

TBD

X

X

X

 

X

RT

4

American Professional Ambulance

TBD

X

X

X

 

 

RT

5

AMR / GMR

TBD

X

X

 

 

 

 

6

Amwest Ambulance

TBD

X

X

X

 

X

RT

7

Antelope Ambulance

TBD

X

X

 

 

 

 

8

Brougham Ambulance

TBD

X

 

 

 

 

 

9

California Medical Response Inc. DBA Cal-Med Ambulance

TBD

X

X

X

 

X

RT, HF O2

10

Citywide Ambulance

TBD

X

 

 

 

 

 

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College Coastal Care

TBD

X

 

 

 

 

 

12

East West Proto

TBD

X

 

 

 

 

 

13

Emergency Ambulance Services

TBD

X

 

 

 

 

 

14

Falck Ambulance

TBD

X

 

 

 

 

 

15

First Rescue Ambulance

TBD

X

X

X

 

X

RT

16

Firstmed

TBD

X

X

X

 

X

RT, HF O2

17

Gentile Ride

TBD

X

 

 

 

 

 

18

HEART Ambulance Corporation

TBD

X

 

 

 

 

 

19

Horizon Ambulance

TBD

X

 

 

 

 

 

20

Journey Ambulance

TBD

X

 

 

 

 

 

21

Lynch Ambulance

TBD

X

 

 

 

 

 

22

Mauran Ambulance

TBD

X

 

 

 

 

 

23

McCormick Ambulance

TBD

X

X

 

 

 

 

24

MedReach Ambulance Service

TBD

X

 

 

 

 

 

25

MedResponse

TBD

X

 

 

 

 

 

26

Medtrans

TBD

X

 

X

X

 

WC VAN

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Mercury Ambulance

TBD

X

 

 

 

 

 

28

Premier Ambulance

TBD

X

X

X

 

X

RT, HF O2

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PRN Ambulance

TBD

X

X

X

 

 

RT, HF O2

30

Rescue Service International Medic-1

TBD

X

X

X

 

X

RT

31

Royalty Ambulance

TBD

X

X

X

 

X

 

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Symons Emergency Specialties Inc dba Symbiosis

TBD

X

X

X

 

X

RT, HF O2

33

Viewpoint Ambulance

TBD

X

X

X

 

 

RT, HF O2

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Vital Care Ambulance

TBD

X

 

 

 

 

 

35

West Coast Ambulance

TBD

X

 

X

X

 

WC VAN

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Zoom Medical Transportation

TBD

X

 

 

X

 

WC VAN

 

 

 

 

 

 

 

 

 

Public Health SimCell Directory

1

Public Health - CDPH Licensing

TBD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Patient Allocation Table

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MRSE Components

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

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Surge Capacity �

  • 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 3,195 patients

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ReddiNet Assessment Poll:��Hospital Capacity Survey�

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Exercise Essentials�

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

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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.
  • 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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“2025 AMHE Exercise”

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Use this incident in ReddiNet for exercise related resource requests

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Great ShakeOut��

  • Great ShakeOut is Thursday, October 16, 2025
  • Good opportunity to expand/extend earthquake preparedness
  • Can use resources from the Great ShakeOut for November exercise (audio, video, etc.)

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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

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Documentation��

  • Exercise Objectives (Sector Specific)
  • Exercise Plan (ExPlan)
  • 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
  • USGS Earthquake Resources

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Websites:

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L.A. County Healthcare Coalition Website:

https://www.lacountyhcc.org/trainings-exercises-drills/mrse-medical-response-surge-exercise/2025-mrse

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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��

  • 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
  • Registration will provide needed information from Evacuating facilities
  • Facility registration not individual players / participants

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Exercise Registration��https://www.surveymonkey.com/r/YS5KGSL�

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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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