1. NREP 2010 Practical Considerations for Setting Up a Community Reception Center Part 2 Setting up a Community Reception Center During the Empire 09 Radiological Exercise

2. NREP 2010 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. NREP 2010 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. NREP 2010 Need to Collaborate and Develop Partnerships Radiation Protection Local Public Health Epidemiology Emergency Response Points of Dispensing Environmental Sampling Public Health Preparedness Hospital Preparedness Shelters Hazmat

5. NREP 2010 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. NREP 2010 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. NREP 2010 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. NREP 2010 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. NREP 2010 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. NREP 2010 Radiation Protection Local Public Health Epidemiology Emergency Response Points of Dispensing Environmental Sampling Public Health Preparedness Hospital Preparedness Shelters

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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. NREP 2010 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. NREP 2010 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. NREP 2010 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 Phase II Full Scale Exercise

16. NREP 2010 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. Phase III Facilitated Discussion

17. NREP 2010 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. NREP 2010 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. NREP 2010 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. Examples of DOH Roles and Responsibilities

20. NREP 2010 State Emergency Operations Center (EOC) Unified Command Assessment and Evaluation (Co-located with FRMAC Health Operations Center (HOC) Joint Information Center (JIC) Locations where DOH was involved

21. NREP 2010 Wadsworth Laboratory (WC) and DOH mobile laboratory Field Teams - at various locations around the Capital District Several Hospitals Community Reception Center Locations where DOH was involved

22. NREP 2010 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!

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

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

29. NREP 2010 Following Initial Screening – No need for Decontamination

30. NREP 2010 Changing and Shower Areas - Used for Decontamination

31. NREP 2010 Contaminated side Clean side Showers

32. NREP 2010 Changing/Shower Area

33. NREP 2010 Whole body screening using portal monitors (training prior to start-up)

34. NREP 2010 Whole body screening using portal monitors (training prior to start-up)

35. NREP 2010 Briefing Prior to Start of Operation

36. NREP 2010 Briefing on use of hand-held equipment for screening Office of Fire Prevention and Control Assisted

37. NREP 2010 “Just in Time” training for CRC staff

38. NREP 2010 Shower Area Changing Area

39. NREP 2010 Form drop-off station

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42. International Visitors Volunteered as “Victims”

43. NREP 2010 “Victims” waiting for initial screening survey

44. NREP 2010 Initial contamination survey (for alpha and gamma) prior to walking through the portal monitor

45. NREP 2010 Initial contamination survey (for alpha and gamma) prior to walking through the portal monitor

46. NREP 2010 “Special Needs” victim with hearing- guide dog

47. NREP 2010 Post-decontamination Survey Clean clothes provided after shower

48. NREP 2010 Health Commissioner participates in post-decontamination screening

49. NREP 2010 Completing survey forms after screening and/or decontamination

50. NREP 2010 Completing survey forms after screening and/or decontamination

51. NREP 2010 Health and Safety Officer advising staff Shower Area

52. NREP 2010 Medical screening station Urine Cups Fact Sheets Medical Counseling

53. NREP 2010 Counselors Available to Help Victims

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55. Form drop-off station

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57. CRC Coordinator Prior to Start CRC Coordinator

58. NREP 2010 Albany and Rensselaer County Health Department BT - Coordinators

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