State Decontamination Program Needs Assessment - Minnesota

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Minnesota Department of Public Safety State Decontamination Program Needs Assessment March 2011 Minnesota Management & Budget, 203 Administration Building, 50 Sherburne Avenue, St. Paul, MN 55155 Telephone: 651-259-3800 Fax: 651-797-1311 TTY: 800-627-3529

Project team Peter Butler Mark Scipioni Division director Bill Clausen Assistant director Kristin Batson Contact information Voice: 651-259-3800 E-mail: Fax: 651-797-1311 Website: Address: 203 Administration Building 50 Sherburne Avenue St. Paul, Minnesota 55155 Other formats To obtain these materials in an alternative format, — for example, large print or cassette tape — call voice 651-259-3800 or Minnesota relay, 7-1-1 or 800-627-3529 (voice, TTY, ASCII). Copies of this report For more information or copies of this report, contact the Minnesota Department of Public Safety – Homeland Security and Emergency Management. Management Analysis & Development Management Analysis & Development is Minnesota government’s in-house fee-forservice management consulting group. We are in our 26th year of helping public managers increase their organization’s effectiveness and efficiency. We provide quality management consultation services to local, regional, state, and federal government agencies, and public institutions.

Contents Executive Summary Introduction 1 2 Decontamination Basics 3 State Decon Program Assessment 4 National Guard Decon Capabilities 14 Hospital System Decon Capabilities Geographic Analysis 15 18 Potential Equipment Options 21 Conclusions and Recommendations 24 Appendices Hospital Equipment Detail 25 Map 3: Potential Locations for Fire Department Decontamination Equipment Based on Population Concentrations 32 Map 4: Minnesota Fire Department and Hospital Decontamination Equipment 33

Executive Summary The Minnesota Department of Public Safety – Homeland Security and Emergency Management (HSEM) requested a statewide needs assessment of the fire service’s decontamination (decon) capabilities. In 2004, HSEM distributed 19 decontamination trailers to 15 fire service regions. From the beginning, the trailers’ mechanical problems have limited their use and undermined fire chiefs’ confidence. Additionally, many interviewees believe that the trailers only benefit their immediate locations because they will not arrive quickly enough to most areas to assist in an incident. Many fire service personnel stated that decontamination training is the most pressing issue rather than equipment. Mass decon events are extremely unlikely and many small, volunteer fire departments often lack time and funds for general training. Since 2004, Minnesota hospitals and the National Guard have significantly expanded their decon capacities. Additional investment in fire service decon equipment will create a parallel system unlikely to be used. Supplementing standard fire hoses and nozzles with gross decon supplies could be the most cost effective preparation for on-scene decon, but requires transporting victims to hospitals for secondary decon. Thirteen counties lack any fire service or hospital decon equipment. Seven counties are located in northwest Minnesota, three in the southeast corner, and three in east central Minnesota. These counties have almost 300,000 people total. A hypothetical scenario siting equipment in county seats over 3,000 people would require 28 tents or trailers. Recommendations 1. HSEM should provide statewide leadership to ensure that fire departments are trained on mass decon; that basic, standard gross and mass decon procedures are developed and distributed, and that fire departments know how to request decon resources from a larger department or hospital through the state duty officer. This leadership role includes communicating the state program’s intentions for the next several years. 2. As a coordinator and planner, HSEM should work with the Minnesota Department of Health’s Office of Emergency Preparedness to develop a unified response plan for hospitals and fire departments to follow during a decon event. The plan would specify on-scene decon capabilities and transporting victims to the hospital for more thorough decontamination. 3. HSEM should determine the number of state decon trailers to support based on their other potential uses, desired response time, and HSEM’s willingness to provide annual funding. The trailers are more likely to be used as shower units for responders or community members affected by fire or a natural disaster. For example, perhaps the state would only require three trailers outside the Twin Cities Metro area for an ongoing support role if a three to four hour response time is acceptable. 4. Trailer repairs should be evaluated from a total cost and opportunity cost solution. For example, removing heavy components may reduce a trailer’s weight and cost less than adding reinforcements that require a department to purchase a 40,000 tow vehicle. Or, limited funds could purchase tents rather than pay for trailer repairs. 1

Introduction Minnesota fire departments are the primary responders to hazardous materials incidents, and must have decontamination capabilities to protect exposed citizens from death and injury. The Homeland Security and Emergency Management Division’s Decontamination (Decon) Program acquired 19 decontamination trailers six years ago and transferred ownership to local host departments. The trailers became a significant part of the state’s mobile decontamination capabilities but have not performed as expected and state staff is concerned about their effectiveness and readiness. Homeland Security and Emergency Management (HSEM) leadership contracted with Management Analysis & Development to perform a statewide needs assessment to identify gaps in decontamination response capabilities and possible solutions. Data was collected through: Web research and document review on decontamination equipment, procedures, the Minnesota State Fire Chiefs Association – Emergency Management Committee’s 2006 trailer planning efforts and the state program’s history. In-person interviews with personnel from the State Fire Marshal’s Office, Minnesota State Colleges and University’s Fire/EMS/Safety Center, and the Minnesota National Guard’s emergency response units. In-person and telephone interviews with the 11 Chemical Assessment Teams (CAT)1 leaders, the Bloomington, Minneapolis, St. Paul, and Crow Wing County bomb-squad commanders, and the Excelsior and International Falls fire chiefs. Telephone interviews with the 30 regional representatives from the Minnesota State Fire Department Association and Minnesota State Fire Chiefs Association and each association’s president and vice president, leadership of the Minnesota Professional Fire Fighters, Minnesota State Volunteer Firefighters Association, and trailer host departments’ fire chiefs. Day and evening focus groups in Grand Rapids (five participants) and Owatonna (15 participants). Perspectives included fire departments, local emergency management, chemical assessment teams, and MnSCU fire trainers. Telephone and e-mail communication with the healthcare system preparedness supervisor and seven regional healthcare preparedness coordinators from the Minnesota Department of Health – Office of Emergency Preparedness. The project team gave brief presentations at the Metro Fire Chiefs Association’s August 2010 meeting, the Minnesota State Fire Chiefs Association’s 2010 annual conference, and the Fire Service Advisory Committee’s September 2010 meeting. The Minnesota Geospatial Information Office produced two maps showing decon equipment locations and population concentrations. 1 Ten city fire departments and one contractor staff are each assigned to a region and supported with state funds. Their primary responsibility is assessment and technical assistance for local fire departments in incidents that exceed the departments’ capabilities and knowledge. 2

Decontamination Basics Decontamination is the physical and/or chemical removal of hazardous materials from people and equipment to prevent health effects and re-contamination.2 Types of decon Gross (primary) decon is the initial phase that significantly reduces the surface contaminate. Fire departments can perform gross decon using their fire hoses and nozzles to create a low-pressure shower for victims to walk through. Key problems are inability to contain the runoff and cold weather. However, large amounts of water dilutes runoff and ―victims can be washed off in cold weather and survive hypothermia if they are moved to a warm building or vehicle as soon as possible.‖ 3 Portable showers, swimming pools, building fire sprinkler systems and school or health club group-showers can also decon victims. The extent of the decon process depends on the victims’ pain level, exposure area (hands only, for example) and the hazardous materials’ severity, reactive properties, and physical form (vapor, liquid or solid). De-clothing removes about 80 percent of most solid and liquid contaminants and is 100 percent effective for vapors. Mass (secondary) decon is decontaminating large numbers of people at the scene as quickly as possible and is more thorough than gross decon. A three-step process requires removing and bagging contaminated clothes, showering, and drying and re-clothing with temporary gowns. Responders carry non-ambulatory victims or tracks with rollers are set up. Decon tents and trailers are designed to facilitate the three-step process. Technical decon is for emergency responders and hazardous materials teams, and is a planned process supporting hazardous materials mitigation. Dry decon uses non-aqueous methods to remove the contaminant. Techniques include brushing off or vacuuming the materials or using absorbent towels, decon foam or lotions, or electro-static tools. Equipment This report frequently discusses tents/deployable shelters and decon trailers. Both provide a three-step decon process. Descriptions and photographs are available at: ationSystems.aspx p 2 This section is based on Noll, Gregory G. and James Yvorra, Hazardous Materials: Managing the Incident, International Fire Service Training Association (2005), CAT leader and fire chief interviews, cold shock/, and decontamination. 3 Noll, Gregory G. and James Yvorra, Hazardous Materials: Managing the Incident, International Fire Service Training Association (2005), page 541. 3

State Decon Program Assessment In summer 2004, federal Office of Domestic Preparedness funds allowed Minnesota to purchase 19 trailers for mass decontamination in a weapons-of-mass-destruction event or hazardous materials spill. Minnesota State Fire Department Association (MSFDA) regional representatives helped design the bid specifications and the state awarded the trailer contract to Advanced Containment Systems, Inc., of Houston, Texas ( Each trailer cost 85,000. One department in each of the 15 MSFDA regions was asked to own, store and maintain a trailer. The cities of Bloomington, St. Paul and International Falls and the Metropolitan Airports Commission (MAC) also received trailers. A region can deploy its trailer for any mission as long as it can be reconfigured quickly for decontamination. Each region or host pays for the trailer’s insurance and maintenance costs and consumable supplies; the state provides no ongoing funding for annual costs. Map 1. State Decon Trailers locations Source: Homeland Security and Emergency Management, August 2010. The MAC/Airport trailer was totaled and the Mora trailer was moved to North Branch. 4

Assessment Interviewees and focus group participants consistently described the state trailer program’s shortcomings. Most said the trailers’ mechanical and design problems and distance from most locations make them ineffective for mass decon. They stated that training and communication about processes and procedures are critical to address. Low confidence in trailers Mechanical and design problems have limited the trailers’ effectiveness and undermined confidence in the program. Many people stated that the trailer program was a good idea, but the trailers have serious problems. Some comments include: ―Trailers were a good idea or concept, but too many problems.‖ ―Trailers were tried and haven’t worked: load limits, speed limits, modified many times, broken parts. Still ended up not good; really bad reputation.‖ ―Program is in chaos. How many of the trailers are functional? Trailer design flawed from start: weight, towing, axle, tongue, more. And fixes were poor. Now there’s a credibility problem.‖ ―I like the concept of the decon program and regional response. Question is whether to scrap the trailers and start over. They are unsafe to haul around.‖ ―Trailers are generally worthwhile but the state trailer model was not good. Problems with towing, freezing, size.‖ ―All I’ve heard is problems. Designed improperly, not okay for what was intended.‖ ―People equate the decon program with these trailers. Biggest hurdle will be getting buy-in again.‖ ―People have given up on trailers – no training, liability [concerns with towing].‖ ―Great concept but logistics not thought through.‖ ―The idea of the trailers is an excellent one if we had trailers built as they should have been.‖ The mechanical and design problems were evident early. HSEM’s June and December 2004 correspondence to the host departments refer to ―mechanical problems‖ and ―axle and tire ratings‖ concerns. In 2006, the Minnesota State Fire Chiefs Association – Emergency Management Committee examined solutions to the trailers’ mechanical problems. The committee also developed standard operating procedures for deployment, training, use, and maintenance and cost reimbursement methods for host departments, but none were implemented. HSEM staff recently determined that four trailers are not operational. Some design problems have or can be resolved by adding a third axle and other structural modifications. 5

No one assigned blame for the problems. Many interviewees noted that fire service personnel worked carefully to develop the trailer specifications, but said that the winning contract failed to meet them. One person said the trailers were a knee-jerk reaction after the Sept. 11 terrorist attacks. Another stated, ―Priority for decon has dissipated. At first, everyone jumped on board, then it went downhill.‖ Several mentioned the well-known shortcoming of equipment grants: no ongoing funding for maintenance and upkeep. Impractical to wait for trailers Many interviewees said decon must begin quickly and the trailers will not arrive soon enough unless they were pre-positioned: ―State trailer would work only if it’s in close proximity to the event.‖ ―But I question if it is realistic to use them. Can they arrive in a timely manner?‖ ―We can’t wait for the trailer to show up.‖ ―With response time – what good would it do?‖ ―I like the idea that all regions are covered with decon. But you can’t regionalize decon. We can’t wait an hour for a trailer.‖ ―Where there is mass exposure, people won’t wait around. They will transport themselves to hospitals. So what is the scenario for using trailers with the public? Trailers are not rapidly deployable so may be waste of time.‖ ―From our point of view, if it’s not here, we won’t use it. If we have a mass decon situation, we will be making arrangements for people. If something big happens, victims shouldn’t wait an hour breathing something in.‖ ―The trailers are not very practical. By the time a fire department calls its people and gets the trailer out, is there a need still?‖ A December 2004 HSEM letter states, ―The trailers are not intended for initial gross decontamination, that responsibility lies with the Incident Commander and must be provided for immediately at the scene. Waiting for the decontamination trailer to arrive and be pre-positioned for initial decontamination would not be effective in limiting the exposure of persons that are contaminated at the scene.‖ Burden on host department Many interviewees noted that the host departments pay for all associated personnel and non-personnel costs, including heated storage. If deployed or requested for training, host department personnel must transport the trailer. Another concern was the potential liability of hauling overweight trailers. Comments include: ―We used it for training the first year we got it and but couldn’t get any money from other departments to pay us for the training, so we stopped.‖ ―There are a fair number of requirements: storage, tow vehicle, money. Those are all challenges and when they requested hosts, no one stepped forward.‖ 6

―The biggest problem is maintenance and keeping them operationally ready. You have to exercise them; run water through the lines or they get gunked up.‖ ―If [city] didn’t take the trailer, nobody else would take it.‖ ―Most cities are spending money to keep the trailer viable.‖ ―[If I bring the trailer to another part of the region] for training, there is 100 miles of travel and manpower time.‖ As a result of their experience, two fire departments transferred their trailers to the St. Paul Fire Department after the Republican National Convention deployment and seven host departments no longer want theirs: ―If HSEM decided to move our trailer to another part of the state, we’re okay with that. To spread it out around the state. We’re tight on storage space.‖ ―If anyone would like to house it after we’ve fixed the coil, it’s available.‖ ―We wouldn’t miss it. We don’t need this many trailers.‖ ―I’d like to sell it.‖ We don’t want it and [city] doesn’t want. The trailer was originally assigned to [fire department]. They would like to give it back.‖ ―The crew would say get it out of the fire hall if it’s not going to be fixed.‖ ―We no longer want to be responsible for our trailer.‖ Other host departments embrace their role. One interviewee said a ―couple people took ownership [of the region’s trailer] and it’s been maintained well.‖ Several fire chiefs spoke favorably of the trailers, likely due to their immediate proximity: ―Definitely a need for it so we don’t have to wait for another one to arrive.‖ ―I have a need for that type of capability, given the risks in my city.‖ ―Going forward, this trailer will be part of any future response.‖ ―It’s a solution for us in this corner of the state.‖ ―There is a place for the trailer. Of the 11 departments in [this county with a trailer], the decon preparation is minimal.‖ ―The trailers are an important part of the system and I can see something happening in a small community and the local fire department could be overwhelmed until the CAT arrives.‖ ―If they could resolve the problem with the trailers, that would be great.‖ ―I like the trailer idea as long as it can be moved efficiently and the host doesn’t have to foot the expense for it.‖ 7

No actual mass decon use No trailer has been used for mass decon. The trailers have been deployed as community and responder shower units after the 2007 35W bridge collapse, the 2007 Rushford and 2010 Pine Island floods, and 2010 Wadena tornado. Five trailers were pre-positioned in St. Paul during the 2008 Republican National Convention. Several host departments train on the trailers annually and maintain them, though improper winterization has damaged some trailers’ systems. Other host departments have not used or trained on the trailer for two to three years. Uncertainty about trailers’ availability Many interviewees were unfamiliar with the trailers’ locations, conditions and how to request assistance: ―Our region didn’t know of the state decon program in recent years, with staff changes.‖ ―Intent is that fire departments will be able to support technical teams: that is the goal. Lots of chiefs don’t know how to access state resources.‖ ―We know of their existence but are unclear of their status and location and confidence in their reliability, so that has created a perception of their availability.‖ ―The intent is to bring in the trailers but I’m not sure of their reliability and availability.‖ ―The trailer system is a good idea, but you have to make people aware of them and how they work.‖ ―You need someone committed to keep the trailers running. Will the trailers work if they are called in?‖ ―No one knows where all the trailers are.‖ ―The trailer we have in [city] hasn’t been moved. Directive to us was not to move them.‖ ―Can you guarantee that the trailer will be there when needed? If not, it won’t be in people’s plans.‖ A few fire chiefs and CAT leaders did not have current information about their region’s trailer: ―Trailer is at Montevideo. Don’t know the current status, but know that work was done on it.‖ ―Trailer is in Dodge Center. Not sure if it is usable.‖ ―Nearest state trailer was International Falls, but they don’t have it any more.‖ ―Not sure if the trailer is still in our region. Was in Litchfield.‖ 8

Training deficiencies One interviewee stated that the ―ability to use the decon equipment is only as good as the training.‖ Most interviewees said general training on decon techniques, or the trailers themselves, was the highest priority. Small departments, volunteer personnel, and rarity of mass decon events hinder ongoing decon training. One chief stated, ―Departments don’t face too many structural fires but more first responder incidents. Lots of these small towns have elevators with farm chemicals and railroads going through.‖ Chemical Assessment Teams4 and host departments will not bring enough personnel to perform mass decon. All departments should be trained in gross and mass decon and to properly use the equipment. One person noted that not every department needs decon equipment or in-depth knowledge but must understand the processes and be familiar with requirements. CAT leaders described their on-scene experiences: ―We need support on the scene: people we can count on to help with decon, be aware of hazards, and to contain people. We spend a lot of time advising commanders on-site on the basics.‖ ―Whenever our CAT responds, we have to do a quick class with the local fire department.‖ ―A lot of departments don’t understand what mass decon is. Most of our firefighters in the area are trained to identify the problem and call us in. They are not trained in decon itself.‖ While a few chiefs said their department trains on decon and the trailers, several chiefs said many departments do not: ―A lot of guys and towns I’ve talked to would have no idea how to run it.‖ ―A trailer arriving in [city] for an incident, will there be enough responders trained on that trailer?‖ ―Most everyone is training to the awareness level of haz mat but very few training to the operational level. The idea was that if the trailer comes, the locals must help with its operation.‖ ―The only people who’ve trained on the trailer is the department that has it.‖ ―We wouldn’t know what to do if the [city] trailer rolled into town.‖ ―The smaller departments are not trained at all. In Fire Fighter 2 certification, they are pushing for hazmat background, but if the department doesn’t require FF1 or FF2, then it doesn’t do you any good.‖ ―State trailer is in Worthington. Never had directions on how to use.‖ ―People don’t understand the trailers. I have never seen it functioning.‖ ―Trailers are like a secret: what can they, what can’t they do?‖ 4 CATs’ primary responsibility is assessment and technical assistance for local fire departments in incidents that exceed the departments’ capabilities and knowledge. 9

Some CAT leaders do not see a direct mass decon role for their team: ―CAT teams won’t be able to play a duel role at scenes: assessment, mitigation, and life-safety. We need someone else to do public decon so we can focus on the hazard itself. Mass decon is not our mission. We don’t have the resources.‖ ―The CAT can work with the local departments to set up decon but that takes away one team member and if the CAT is doing the mitigation (no emergency response team onsite), then you don’t have enough team members for entry and backup during mitigation. CATs will not get involved in mass decon. We can’t do it. We can gross decon 3-5 people using a booster hose, but we can’t contain the water.‖ ―We don’t have the mass decon knowledge. The CAT decides what their priorities are for equipment. The CAT has proficiency and training with its equipment.‖ However, some CAT leaders see their teams as potential trainers and several experts and chiefs said decon techniques are easy to teach: ―If there were funds for CAT teams to go to local departments on decon, we could show departments how to set up decon and use makeshift ways until CAT arrives.‖ ―The locals have to train with the CAT so CAT knows what the locals have for equipment and trained personnel.‖ ―Give the CAT teams extra money and market the teams to local departments and do a four-hour training session.‖ ―Once you explain the gear and that water and detergent take care of most problems, the locals become more confident in doing decon.‖ ―We can train others quickly to do decon tasks, if they have basic training and protective equipment.‖ ―Many departments don’t know how to use their own equipment. A trainer can figure out what the department can do with the equipment it has.‖ ―It is not rocket science to set up decon but you need to practice it. With all the other training requirements, hazmat and decon take a back seat.‖ One CAT leader said training should include drills to understand how many people can be deconned per hour. Another said that gross decon requires ―lots of thinking,‖ such as how to properly position the fire trucks, and that an actual test drill was ―not easy to do.‖ Potential state roles Interviewees often described the state’s role as ongoing financial and training assistance, leadership, communication and coordination. Several mentioned the state fire safety account as a funding source, if not diverted for the state’s budget shortfalls. Financial: State funds should support ongoing equipment maintenance and upgrades, replenish consumable and time-limited supplies, and provide initial and ongoing training. 10

A few interviewees said the state should purchase basic decon equipment, too, such as containment pools. A couple of host department staff members said the biggest expense is personnel time on maintaining and transporting the trailer for a decon or training event and want state reimbursement when deployed. A number of interviewees suggested that the state-supported CATs be a model for supporting the decon program. Training: Interviewees suggested that HSEM staff or the CATs provide training on general decon and on the specific decon equipment, or support the training through fire schools and MnSCU programs. Several noted that small departments’ personnel are trained to the awareness level for hazardous materials, not the operations level. A few people suggested mandating a certain number of hazmat training hours or setting a certification level. Interviewees also stated that many departments need to take advantage of free training opportunities. State funding would allow host departments to bring trailers to other departments for training, increasing familiarity and potentially leading to greater likelihood of use. State Program Leadership: Interviewees said that HSEM should define or clarify the state decon program’s purpose and direction. One interview asked ―whether the home [HSEM] for the decon program is correct.‖ Others complimented HSEM’s new staff with extensive fire service experience. Comments include: ―Biggest problem has been no directive from HSEM as to purpose of trailers.‖ ―Define scope – what are we trying to accomplish?‖ ―Who is going to take ownership and who is responsible? Decide whether to keep the trailers. Planning so we all understand roles and responsibilities.‖ ―Need consistent leadership to implement the program with follow-through and feedback. Make it all public so all departments know about it.‖ ―Must be a reliable oversight to the whole system. HSEM might be best oversight because they control resources.‖ ―Look at the immediate response needs and what resources already exist. How do they get used and how do we coordinate on a statewide basis and how do the trailers fit in?‖ Communication and coordination: The state should ensure that fire departments, CATs and the state duty officer ―know what’s expected of everyone.‖ Some interviewees stated that small fire departments are typically not aware of their decon responsibilities and the available equipment. People suggested that HSEM: Develop criteria for the trailers’ deployment (how deployed and what situations). Inventory fire departments’, CATs’ and others’ equipment to avoid duplication and for people to know what is available. Establish caches of clothing, gowns and towels to replace a department’s supply during an event or ―when numbers go to 100 or 1,000.‖ 11

Audit host departments’ readiness to ensure that they have the necessary number of trained personnel and working equipment. Work with many stakeholders, such as law enforcement, fire departments, and hospitals, on planning and drills. Publicize the state plan and how it augments local plans. Help departments understand the statewide decon capacity: supplies and system capacity (people per hour deconned). Provide written guidance on decon techniques, responder coordination, and regulatory requirements, such as disposing contaminated runoff. Fire service mass decon inventory Table 1 shows the fire services’ decon equipment,

decon supplies could be the most cost effective preparation for on-scene decon, but requires transporting victims to hospitals for secondary decon. Thirteen counties lack any fire service or hospital decon equipment. Seven counties are located in northwest Minnesota, three in the southeast corner, and three in east central Minnesota.

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