Paterson-The Passaic County Department of Health (PCDH) and the Paterson Division of Health (PDOH), along with many other response agencies, on Aug. 10, took part in a simulated countywide tabletop exercise that involved a pneumonic plague outbreak. Prior to that, on May 13th, both agencies participated in another tabletop exercise that involved a simulated response to a smallpox outbreak. The exercises were sponsored and coordinated by the New Jersey Department of Health and Senior Services. "An overall goal of the tabletop exercise is to strengthen the county's collaborative approach to emergency response," said Deborah Rucki-Drake, Health Officer for the Passaic County Department of Health. Rucki-Drake further commented that in response to the goals of planning, "these exercises provide agencies a forum to refine our preparedness plans." Recent public health planning attention has been focused on making sure emergency response plans are ready to handle large-scale disease outbreaks. By definition, a tabletop exercise is a simulated event where specific groups can gather in person around the table to talk about their capabilities to achieve common goals during an emergency. Public health, along with various response agencies, such as hospitals, county sheriff, county and state government, local police, schools, hospitals, prosecutor's office, the county office of emergency management, the Red Cross and others have all participated together for the sake of ensuring the safety of our community. In the simulation, none of the participants are informed of the actual emergency ahead of time, and are only notified to review their response plans and be prepared to apply them to any situation or what is referred to as an "All Hazards" approach. However, the participants do know that it will involve a worst-case-scenario that requires a large-scale, countywide response, and will most likely be a potential act of bioterrorism. There is a host of the exercise in charge of leading the program by reading the scenario and asking specific questions of the various agency participants. It's less stressful than a real event, but there is still a noticeable amount of tension in the room due to the importance of the life and death theme. As well, the agencies are only given a certain amount of time to respond, which only increases the pressure. After going through the tabletops, group's responses are evaluated for corrective action and improvement by a variety of staff from state and local levels. The Passaic County Department of Health and Paterson Division of Health have been funded through the Centers for Disease Control and the New Jersey Department of Health and Senior Services to provide key staffing for bioterrorism preparedness.