Chemical Laboratory Response Network Explain the relationship of PHEP Program to the Laboratory Response Network - Chemical Program (LRN-C) Describe the current status of the LRN-C Discuss options to sustain the capability of the LRN-C to test human samples and report accurate, actionable results during a chemical emergency

PHEP Program Relationship to the LRN-C In partnership with the CDC National Center for Environmental Health (NCEH), the CDC PHEP Program sustains a state/territorial based Chemical Laboratory Response Network The CDC PHEP Program has provided targeted funding to sustain the LRN-C since 2002 The LRN-C comprises a total of 45 state/territorial-based laboratories with three levels of capability $11.5M per year is currently carved out from the PHEP cooperative agreement for Level 1 capability PHEP Program awardees utilize additional state/local/territorial discretionary and grant funds to sustain the network* * Use of discretionary (state/local) and other grant funding to support the network has been anecdotally communicated to the CDC

Laboratory Response Network – Chemical Overview VT WA ME MT ND MN NH OR WI NY SD MA ID MI CT RI WY PA IA NJ NE OH New York City NV IL IN WV DE UT VA MD CO KS MO KY CA NC Washington, DC TN OK AZ NM AR SC MS AL GA TX LA Los Angeles FL # of Labs Toxic Metal Capacity Level 1 10 Up to 1000 Level 2 35 Up to 500 Level 3 9 ---- Alaska Hawaii Puerto Rico

Recent Chemical and Toxicant Threats

Expiring LRN-C Toxic Metal Equipment   Expiring LRN-C Toxic Metal Equipment ISSUE In 2017, LRN-C Toxic Metal Equipment (ICP-MS) will no longer have service support from the manufacturer LRN-C’S NETWORK IMPACT ~30% of local and state programs affected: Chemical Emergency Response Exposures in children and at-risk populations (i.e. Blood Lead, Mercury, Arsenic, etc.) Food and environmental testing programs Exposures to First Responders in call of duty http://phil.cdc.gov/phil/details.asp Courtesy of James Gathany http://phil.cdc.gov/phil/details.asp Courtesy of Aaron Sussell

Michigan Toxic Metal Response FY 16 Michigan’s SPHL Sample Matrix Blood Lead Program   Filter Paper Whole Blood Total Specimens 17,935 2,607 City of Flint 701 59 Environmental Lead Program Soil Dust Wipes 357 61 488 http://www.mlive.com/news/flint/index.ssf/2015/09/lower_tthm_levels_moves_flint.html Courtesy of Jake May

Colorado Toxic Metal Response                                                                                                                                                                                                                                                                                                Colorado Toxic Metal Response August 2015 Colorado’s SPHL Gold King Mine toxic waste water spills into Cement Creek and Anima River affecting towns of Durango (pop. 16,887) and Silverton (pop. 637) In August 2015 Colorado’s SPHL analyzed: 146 samples environmental samples The SPHL were able to respond within 36 hours of the incident (net cost of approx. $30,000) to help make rapid health related decisions Chemical Threat program staff and resources were utilized for this activity

Discussion The initiative to replace toxic metal and nerve agent testing equipment must be completed by 2020, and additional partnerships are vital to sustain capability Request that NGA, NEMA, ASTHO and NACCHO members and constituents promote the LRN-C equipment refresh initiative Stimulate joint decision-making between Governors, Homeland Security Advisors, Emergency Managers and Senior Health Officials to determine jurisdictional LRN-C sustainment priorities Consider special emphasis on sustainment within high-priority UASI jurisdictions and assure they are factored within jurisdictional risk assessments (e.g., THIRA) Coordinate language within interagency preparedness grants and cooperative agreements