Karen is involved in planning for the yearly Statewide Medical and Health Exercise, including the evacuation of a level three NICU in 2010 and functional exercise of the entire Children’s Hospital in 2011. Karen also created a design for new evacuation equipment for the premature and term NICU patient and worked to create the first Pediatric Disaster Reference Guide that bridges pre-hospital care for the sick newborn with critical care pediatric resources during a disaster. Karen was instrumental in assisting the California Association of Neonatologists in creating their new NICU Disaster Planning Toolkit.