Reception Centers and Sheltering Community Reception Centers and Volunteer Staffing

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Reception Centers and ShelteringCommunity
Reception Centers and Volunteer Staffing

• John A. Williamson
• Administrator
• Environmental Radiation Programs
• March 23, 2011

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Whats Next?
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Call the Feds?
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NRF Nuclear Radiological Incident Annex

• Response 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.

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NRF Nuclear Radiological Incident Annex

• Response 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.

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Population Monitoring and Decontamination

• Limited Federal resources for monitoring/decontami
  nation of the public.
• Federal resources will take time to arrive.

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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?

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• 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.)

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• How many people may require monitoring?
• Depends on type of event, type of notification
• Goiania, Brazil Cs-137 exposure gt100,000
  requested monitoring, 237 found contaminated
• Tokyo, Japan-Sarin Gas attack in subway gt5500
  reported to hospitals, 1000 mild injury, 37
  severe and 17 critical.

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Community Reception Centers

• Local 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

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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

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Evaluate Needs and Resources

• Technical - Procedural Guidance/suggestions
• Equipment Needs GM friskers for small
  numbers GM or Scintillation portal monitors for
  large numbers (can you effectively screen 100K
  people with handheld instruments?) Floor
  covering anti-c clothing changes/personal
  possession bags computers/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?

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Technical Resources
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The Best Place to Start!

• CDCs 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

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Community Reception Center Process Flow

• 7 Stations
• Contamination Control Zone
• Initial Sorting
• First Aid
• Contamination Screening
• Wash
• Clean Zone
• Registration
• Radiation Dose Assessment
• Discharge

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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

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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)

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• 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)

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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

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Personnel Resources

• 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
  

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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.

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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

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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.

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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?

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Volunteers!

• gt22K 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
  HPs and RSOs
• 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!

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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

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Additional CRC Staffing needs

• Greeters
• Special Needs
• Medical
• Registration
• EPI
• Counseling
• Security

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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

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Questions?

• John Williamson
• Administrator, Environmental Radiation Programs
• Bureau of Radiation Control
• Florida Department of Health
• 407-297-2096
• John_Williamson_at_doh.state.fl.us
• http//www.doh.state.fl.us/Environment/radiation/i
  ndex.html