Reception Centers and Sheltering

Community Reception Centers and Volunteer StaffingJohn A. Williamson

AdministratorEnvironmental Radiation Programs

March 23, 2011

What’s Next?

Call the Feds?

NRF Nuclear Radiological Incident AnnexResponse Activity Federal Agency

Capabilities/Responsibilities

Population Monitoring The Department of Health and Human Services (HHS), through

ESF #8 – Public Health and Medical Services and in consultation with the coordinating agency, coordinates Federal support for external monitoring of people.

HHS assists local and State health departments in establishing a registry of potentially exposed individuals, performing dose reconstruction, and conducting long-term monitoring of this population for potential long-term health effects.

NRF Nuclear Radiological Incident AnnexResponse Activity Federal Agency

Capabilities/Responsibilities

Population Decontamination Decontamination of possibly affected victims is accomplished locally

and is the responsibility of State, tribal, and local governments. Federal resources are provided at the request of, and in support of,

the affected State(s). HHS, through ESF #8 and in consultation with the coordinating agency, coordinates Federal support for population decontamination.

HHS assists and supports State, tribal, and local governments in performing monitoring for internal contamination and administering available pharmaceuticals for internal decontamination, as deemed necessary by State health officials.

Population Monitoring and Decontamination

Limited Federal resources for monitoring/decontamination of the public.

Federal resources will take time to arrive.

Should the state radiation program do this monitoring?

70% of the state radiation programs in the US are part of the health department

Do they have the resources?

What about the ones that are not part of health?

What am I (State of Florida) expected to do? Monitor population for radiological contamination

Onsite-Typically done by Fire Rescue Decon Teams Offsite-Emergency Mgmt, Health, First Receivers

Hospitals (Should be injured personnel only-contamination alone is not considered a medical emergency)

CRC (Stadium, shelters, reception centers, etc.)

How many people may require monitoring? Depends on type of event, type of notification

Goiania, Brazil Cs-137 exposure >100,000 requested monitoring, 237 found contaminated

Tokyo, Japan-Sarin Gas attack in subway >5500 reported to hospitals, ~1000 mild injury, 37 severe and 17 critical.

Community Reception CentersLocal response strategy for conducting population monitoring

Multi-agency effort, public health lead Staffed by government officials and organized volunteers Opened 6-48 hours post event Located outside of hot zone Comparable to PODs, NEHCs

Community Reception Centers

Services include: External contamination screening External decontamination Limited medical care

Services may include: Assessment of internal contamination Assessment of need for bioassay Collection of bioassay

Main purpose is to prioritize people for further care Ease burden on hospitals Manage scarce medical resources

HomeHome

Public ShelterPublic

Shelter

Hospital or Alternate Care Site

Hospital or Alternate Care Site

Affected AreaAffected Area

Surrounding CommunitySurrounding Community

CRC EndpointOrigin

Evaluate Needs and Resources Technical - Procedural Guidance/suggestions Equipment Needs:

GM friskers for small numbersGM or Scintillation portal monitors for large numbers (can you effectively screen 100K people with handheld

instruments?)Floor coveringanti-cclothing changes/personal possession bagscomputers/bar code software/wristbands

Facilities - Where can/should I set up a CRC? Personnel - How many surveyors are needed for large

event? Admin/medical/logistical support?

Technical Resources

The Best Place to Start! CDC’s Virtual Community Reception Center

http://www.orau.gov/rsb/vcrc/ Provides overview of CRC process Provides flow charts for CRC Aids in determining resources required for specific circumstances

Community Reception Center Process Flow

7 Stations:

Contamination Control Zone

Initial Sorting First Aid Contamination Screening Wash

Clean Zone Registration Radiation Dose Assessment Discharge

Equipment Resources and Needs Florida Equipment Resources: (2006)

~20 portal monitors, primarily in power plant counties. Hundreds of GM friskers, also primarily in power plant

counties. Emergency Dosimetry

Equipment Resources and Needs Florida Equipment Needs

More Portal Monitors (20+ for statewide distribution) Friskers Dosimetry Equipment for internal screening (friskers, NaI)

How am I going to make up the difference?Homeland Security Grants 22 portal monitors (Spring 2008) 200 instrument kits (Spring 2008) 40 Digital ratemeter/scalers with pancake GM and NaI (in

process)

GM friskers (Ludlum 2401P) EC GM high range instrument

(Canberra Ultra-radiac) Electronic dosimeters (Thermo EPD) 22 Scintillation based mobile portals

(20 Johnson AM-801, 2 Canberra Mini-sentry)

Facilities Stadiums, schools, community centers Facilities used for E shelters, PODs, NEHCs Need to consider special needs and pets Showers (decon) available or brought in Need to direct (not capture) flow of runoff from decon Coordinate in advance with local health/EM/Red Cross Controlled clean area for breaks/meals for staff Securable facility

Most state radiation programs have limited personnel resources

FL DOH Radiation Control has 80 technical personnel (FL is a large program!) deployed to:

SEOC 6 personnel County EOC 6 personnel Mobile Lab 21 personnel Field Teams 23 personnel Incident Command Facility 24 personnel Available for population monitoring -0- personnel

Personnel Resources

FDOH Assets Environmental Health Strike Teams

“Army of 160” At least one team per region (seven

regions, eight teams). Already trained for other types of

emergency response situations. There is already a generic “typing”

for teams. Rad training added as a credential

for the team. BRC “Advanced” response course -

16 hour training All teams trained (~90 personnel),

and supplied with radiation kit, refresher training continues.

FDOH Assets FDOH county env. health staff

Hundreds of environmental specialists.

All trained in ICS, NIMS, hazmat awareness.

Many have extensive experience in emergency response for hurricanes.

Training “Advanced” response

course 8-16 hours training

Fundamentals course – 4 hour training

Concerns

Many other responsibilities of strike teams and CHD staff mean training/exercise time not likely to increase.

Limited radiation training to enable critical decision making about contamination issues.

Very little professional experience in DOH or state government in general with radioactive contamination.

Importance of having knowledgeable personnel to reassure public at reception centers is critical.

Volunteers?

Post Hurricane Andrew ‘92 - Florida requires volunteers to register – unregistered (spontaneous) volunteers will not be used in emergencies

Registration allows the state to assure that volunteers are qualified Registration allows the state to assure that only those needed will

be called Registered volunteers are covered by state liability insurance and

Good Samaritan laws But what type of volunteers should we be recruiting? And how? Training needs?

Volunteers! >22K certified radiographers, xray techs, medical health physicists,

nuclear med techs, radiation therapists form a large potential pool of volunteers

Many other industrial, governmental and academic HP’s and RSO’s Already trained in basic rad safety Many with experience in personnel decon Use Medical Reserve Corps to set up a subset: Radiation Response

Volunteer Corps Outreach to FL Chapters of HPS, AAPM, FL NMT Society, FL

Society of Rad Techs Start Registering Volunteers!

RRVC Training Use local MRC regions to set up training (CDC-CRCPD grant

funded) Use Training staff of BRC to develop curriculum (4 hour didactic/3 hr

hands on) Hands on uses equipment Use Training staff and Professional staff to present training to MRCs To Date: 320+ personnel trained Saturday March 19, Internal Dose Measurement course delivered

Additional CRC Staffing needs

Greeters Special Needs Medical Registration EPI Counseling Security

Summary - Building a Population Monitoring Program Technical - Develop SOPs for population monitoring

CHD POD modelCDC vCRC for setup of flow, equipment, personnel needs

Equipment ResourcesDOH Radiation Control provides rad equipment and proceduresLocal health provides tracking software, computers

TrainingDOH Radiation Control provides training for MRC/RRVC

Facilities/other equipmentCHD/EM provides locations, logistics, supplies

PersonnelMRC RRVC, local health, EPI strike teams, DMAT, env health strike teams, CERT

Questions?

John WilliamsonAdministrator, Environmental Radiation Programs

Bureau of Radiation Control

Florida Department of Health

407-297-2096

John_Williamson@doh.state.fl.us

http://www.doh.state.fl.us/Environment/radiation/index.html