1. Gaps & Useful Practices Los Angeles County Multi-Agency Radiological Response Plan (MARRP) Kathleen Kaufman Former Director, LA County Radiation Management

2. Gaps LA County has significant resources – Many are HazMat qualified – Generally, they’re more qualified for chemical issues, rather than radiation During exercises, there was confusion re which agency was responsible for an activity – Those with radiation expertise were all performing one activity, such as monitoring uninjured victims, leaving another activity w/o someone with radiation subject matter expertise – Incident commander and the media received conflicting information

3. Gap Every agency and organization has their own radiation response plan (fully or not fully developed) One “umbrella” plan would reduce responder confusion Avoid duplication of response efforts Eliminate gaps in response efforts

4. Gaps A more organized & effective response required clarification of the roles & responsibilities of response agencies Radiation Management had a “vision” for a plan that integrated responders’ activities, & clarified each agency’s role We received a grant from CDC to write an integrated radiation response plan – We hired a contractor to help

5. Process Had to have a name with a good acronym! – Multi-Agency Radiation Response Plan (MARRP) We conducted three planning committee meetings with all agencies, local, State, & federal, participating – Purpose, Objectives, Concept of Operations – Scope of Radiological Incidents – Role and Responsibilities – Radiological Dispersal Device Table-Top Exercise – Review of proposed Draft Plan Also conducted focused meetings – Los Angeles County Fire Department, Health Hazardous Materials Division – American Red Cross & Los Angeles County Department of Public Social Services

6. Who? 30 local, State, and federal agencies and organizations – Los Angeles County (LACo) Department of Public Health, LACO Fire & Health Hazardous Materials Division, LACo Coroner, LACo Department of Public Social Services, LACo Sheriff, Los Angeles (LA) City Fire & Police, LA Airport, LA Port, Long Beach Fire, Police & Port, California (CA) Department of Public Health, CA Office of Emergency Services, CA Highway Patrol, United States Environmental Protection Agency & Department of Energy, Federal Emergency Management Agency, Civil Support Team, Federal Bureau of Investigations, United States Coast Guard, American Red Cross 100 technical representatives experienced in emergency operations

7. What? Coordination plan for a significant radiological (not nuclear) incident Coordination of response actions between local, State, and federal agencies Does not replace, but supplements, existing plans! Provides guidance to responders and decision makers during an incident

8. Guidance Plan MARRP is not the law or regulation MARRP is not a mandatory plan for responding agencies/organizations MARRP is guidance with recommendations – Volume I is a responder’s field manual – Volume II is more in-depth Good for training

9. Volume I: Responder Field Manual Information Cards (3) Summary Tables (2) Position Job Aids (7) Activity Playbooks (13) Activity Playbooks (13) Standard Operating Guides (2) Instructions (3) Forms (3) Tables (15)

10. Forms and Tables Forms – 1. Contamination Survey – 2. Public Property Contamination Survey – 3. Responder Dose Log 15 Tables – Table 4: Radiation Incident Zones and Activities – Table 11: Responder Contamination Release Levels – Table 13: Victim and Public Contamination Release Levels – Others included in the manual

11. Table 1: Agencies Responsible for Playbooks Activity Playbook Rad Mgmt Fire Hazmat Fire Law Hazmat EPA 1: Exclusion Zone Operations NL12NLNL 2: Initial Incident Control Zones 12NL34 3: Monitoring Responders and Equipment for Contamination 12364 4: Monitoring Injured Victims for Contamination 123NL4 5: Monitoring Uninjured Victims for Contamination 123NL4

12. Playbooks 13 playbooks for major radiological related activities Designed as stand alone documents Content – Activity – Resources – What to do – Considerations – Tables – Standard Operating Guides – Instructions – Forms

13. 13 Playbooks 1. Exclusion zone operations 2. Initial incident control zones 3. Monitor responders and equipment for contamination 4. Monitor injured victims for contamination 5. Monitor uninjured victims for contamination 6. Conduct advanced radiation measurements 7. Determine presence or absence of alpha radiation

14. 13 Playbooks 8. Conduct crime scene investigations in the Exclusion Zone and Extreme Caution Areas 9. Monitor people for contamination at public reception centers 10. Monitor public property for contamination 11. Determine need for and recommend protective actions for the public, including advice for evacuation and shelter-in-place 12. Control traffic in contaminated areas, create responder access corridors, and establish evacuation routes 13. Conduct critical hospital-based operations

15. Table 6: Dose & Potential Health Effects Provides the potential health effects of exposure to levels of radiation Dose to have acute health effects Excess lifetime risk of fatal cancer correlated with radiation exposure

16. Table 7: Responder Alarm Levels Alarm Level Exposure Rate 1 (mR/hr) Cumulative Dose 2 (mrem) First Alarm 210 Second Alarm 10,000 (10 R/hr) 25,000 (25 rem)

17. Tables 11 & 12: Responder/Equipment Contamination Release Levels Provides contamination levels at which responders/equipment can be released Provides contamination levels at which responders/equipment can be released Includes the maximum background radiation level in which the measurement must be taken Includes the maximum background radiation level in which the measurement must be taken Provides decontamination instructions Provides decontamination instructions

18. Table 12: Responder Equipment Contamination Release Levels Radiation Type Contamination Range 1,2 Maximum Background Levels Decontamination Instructions Beta 3 or 100 cpm to 10,000 cpm 4 or Level 1 ≤10 % of Release Limit Decontaminate to lowest level practicable using routine field decontamination methods (wiping and washing) and release without restriction. Gamma 3 10 µR/hr to 100 µR/hr 5 (0.01 mR/hr to 0.1 mR/hr) Level 1 ≤10 % of Release Limit Decontaminate to lowest level practicable using routine field decontamination methods (wiping and washing) and release without restriction. Alpha 3 1 cpm to 1,000 cpm 6 Level 1 ≤10 % of Release Limit Decontaminate to lowest level practicable using routine field decontamination methods (wiping and washing) and release without restriction.

19. Beta 3 or 10,000 cpm to 100,000 cpm 4 or Level 2 ≤10 % of Release Limit Control large items, bag smaller items, and retain until evaluated by a Radiation Technical Specialist. Items returning to contaminated areas, including ambulances, may be reused during the incident with these contamination levels Gamma 3 100 µR/hr to 1,000 µR/hr 5 (0.1 mR/hr to 1 mR/hr) Level 2 ≤10 % of Release Limit Control large items, bag smaller items, and retain until evaluated by a Radiation Technical Specialist. Items returning to contaminated areas, including ambulances, may be reused during the incident with these contamination levels Alpha 3 1,000 cpm to 10,000 cpm 6 Level 2 ≤10 % of Release Limit Control large items, bag smaller items, and retain until evaluated by a Radiation Technical Specialist. Items returning to contaminated areas, including ambulances, may be reused during the incident with these contamination levels Beta 3 or 100,000 cpm and Greater 4 or Level 3 ≤10 % of Release Limit Do not reuse or release. Contact a Radiation Technical Specialist for determination of disposition. 9 Gamma 3 1,000 µR/hr or Greater 5 (1 mR/hr or Greater) Level 3 ≤10 % of Release Limit Do not reuse or release. Contact a Radiation Technical Specialist for determination of disposition. 9 Alpha 3 10,000 cpm and Greater 6 Level 3 ≤10 % of Release Limit Do not reuse or release. Contact a Radiation Technical Specialist for determination of disposition. 9 Table 12: Responder Equipment Contamination Release Levels, continued

20. Attachment 6: Reception Center Flow Diagrams

21. Thank you!