Practical Considerations for Setting Up a Community Reception Center

1. Practical Considerations for Setting Upa Community Reception Center Part 2 Setting up a Community Reception Center During the Empire 09 Radiological Exercise

2. Setting up a Community Reception Center During the Empire 09 Radiological Exercise Adela Salame-Alfie, Ph.D. New York State Department of Health Center for Environmental Health

3. KEY ELEMENT COLLABORATION • Between Radiation Control and Public Health • With Emergency Response Organization • With the Medical Reserve Corp/Red Cross • With local HAZMAT • With Law Enforcement • With Volunteers • Etc.

4. Need to Collaborate and Develop Partnerships Emergency Response Points of Dispensing Hospital Preparedness Radiation Protection Epidemiology Shelters Public Health Preparedness Environmental Sampling Local Public Health Hazmat Why Partner ?

5. Why do we need to partner? • Radiological emergency preparedness is not just for the “Big Cities” • A radiological incident/event can happen anywhere, anytime (a truck accident involving radioactive material) • If a radiological incident happens at a big City, adjacent, and even “far away”, “smaller” localities would have to deal with the aftermath (evacuations after Katrina)

6. The Need • Multiple types of expertise needed • Many (most) local health departments do not handle radiation issues • Radiation is not a required program • Competing priorities (H1N1?) • Loss of experienced staff due to retirement

7. The strengths • Multiple types of expertise available at the state and local levels • Funding for preparedness has strengthen many local and state programs • POD exercises have encouraged partnerships with Medical Reserve Corp, Red Cross, other volunteers

8. Examples Where Public Health and Radiation Control can Partner • Setting up Community Reception Centers • Collection of bioassay samples to assess internal contamination and possible administration of “radioprotective drugs” • Developing/collecting vital information from victims for “registry” • Preparing key messages to inform and educate the public

9. Examples of Partnerships in NY • Within the New York State Department of Health (NYSDOH) • With other NYS Agencies (Environmental Conservation, Fire Prevention and Control, Emergency Management) • With Local Health Departments • With the School of Public Health • Hospitals • Medical Reserve Corps

10. Emergency Response Points of Dispensing Hospital Preparedness Radiation Protection Epidemiology Shelters Public Health Preparedness Environmental Sampling Local Public Health Partnership

11. EMPIRE 09 HIGHLIGHTS

12. EMPIRE 09 Setup • National Level Radiological Exercise in Albany, NY • Mid-size urban area • Involve local response • Involve multiple states • Require federal assistance • Two “small” dirty bombs (Cesium-137, Americium 241) • Localized structural damage • Need for evacuation/decontamination/relocation

13. Overview Conducted in Three Phases • Phase IThe first 48 hours Table-top Exercise: May 14-15 • Phase II48 hours - 120 hours Full Scale Exercise: June 2-4 • Phase III45+ days Facilitated Discussion: June 16-17

14. Phase I (0-48 hours) Table-top Exercise Objectives • Address operational and strategic decision making • Address policy issues that develop after life-saving operations • Emphasis on local (city, county) and state response and federal support process

15. Phase II Full Scale Exercise Real-time field play • Strategic, policy-level play at various sites throughout the nation, including senior-level play in DC • City of Albany, Albany County, Rensselaer County, NY State Agencies, Vermont, New England Radiological Compact and Federal Agencies

16. Phase III Facilitated Discussion Long term recovery activities • Transfer coordination from Department of Energy to Environmental Protection Agency • Stafford Act Declaration ($) • Long-term Health Issues • Determination of clean-up levels • Re-entry, return, etc.

17. DOH Activities in Preparation for Empire 09 • Planning Meetings (18 months!) • With County and State Agencies, with FRMAC and other Local, State and Federal Agencies • Training, training, training • Field Sampling, surveying, ICS, etc. • Developing Message Maps • Identifying needs and developing materials for use at the Community Reception Center • Developed victim intake forms, worker job action sheets, need for urinalysis, laboratory prioritization (collaboration with CDC) • Victim scripts (in collaboration with CDC) • Adapted CRC protocols from LA County

18. Examples of DOH Roles and Responsibilities • Lead agency for response to radiological emergencies • Assessment and evaluation of radiation doses to members of the public and issuance of protective action recommendations • Collection of field samples and measurements of environmental radiation levels • Analysis of field samples • Analysis of biological samples • Staffing of Community Reception Center (CRC) to screen non-injured potentially contaminated individuals

19. Examples of DOH Roles and Responsibilities • Technical assistance to hospitals regarding contaminated victims • Technical assistance (in collaboration with CDC) for administration of counter-measures • Setting up a registry (in collaboration with CDC) • Risk communication at JIC, State EOC, CRC, etc. • Provide advise on health and safety of workers • Support the activities at Health Operations Center • Assistance to county health departments as needed • Etc.

20. Locations where DOH was involved • State Emergency Operations Center (EOC) • Unified Command • Assessment and Evaluation (Co-located with FRMAC • Health Operations Center (HOC) • Joint Information Center (JIC)

21. Locations where DOH was involved • Wadsworth Laboratory (WC) and DOH mobile laboratory • Field Teams - at various locations around the Capital District • Several Hospitals • Community Reception Center

22. Phase II Exercise Recap • Players - 660 • Controllers/Evaluators-150 • Foreign Observers - 65 • Domestic VIPs - 52 • Number of injects • 329 total injects • 61 were contingency injects • Data points – more than 2000 • Major Exercise Venues – 13!

23. Operating a CRC During Empire 09

24. CRC A Bird's Eye View

25. Set-up Prior to Start

26. Screening Area To “Special Needs” Area Contaminated lane - to showers Express Lane - Clean

27. "Special Needs" Area

28. Area designated to handle “Special needs population”, pets and people with medical issues

29. Clean ? Following Initial Screening – No need for Decontamination

30. Or Dirty ? Changing and Shower Areas - Used for Decontamination

31. Information Hand-outs Showers Clean side Contaminated side

32. Instructions Changing/Shower Area

33. Getting Ready ! Whole body screening using portal monitors (training prior to start-up)

34. Whole body screening using portal monitors (training prior to start-up) Ready?

35. Briefing Prior to Start of Operation Get Set

36. Briefing on use of hand-held equipment for screening Office of Fire Prevention and Control Assisted

37. “Just in Time” training for CRC staff Everybody Ready?

38. Shower Area Changing Area Health & Safety Officer

39. Paperwork is Important ! Form drop-off station

40. Let's Go !

41. Do We Have Any Victims?

42. International Visitors Volunteered as “Victims”

43. Keep 'em Moving “Victims” waiting for initial screening survey

44. Check for Alpha & Gamma Initial contamination survey (for alpha and gamma) prior to walking through the portal monitor

45. Check for Alpha & Gamma Initial contamination survey (for alpha and gamma) prior to walking through the portal monitor

46. Special Attention “Special Needs” victim with hearing-guide dog

47. Post-decontamination Survey Are you Clean? Clean clothes provided after shower

48. Health Commissioner participates in post-decontamination screening Everybody Gets Checked

49. Completing survey forms after screening and/or decontamination Keep Track of Paperwork

50. Need Help With Paperwork? Completing survey forms after screening and/or decontamination