state decontamination program needs assessment€¦ · decon tents and trailers are designed to...

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 • www.mad.state.mn.us/

Minnesota Department of Public Safety

State Decontamination Program Needs Assessment March 2011

Project team Peter Butler

Mark Scipioni

Division director Bill Clausen

Assistant director Kristin Batson

Contact information Voice: 651-259-3800

E-mail: [email protected]

Fax: 651-797-1311

Website: www.mad.state.mn.us

Address:

203 Administration Building

50 Sherburne Avenue

St. Paul, Minnesota 55155

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Public Safety – Homeland Security and Emergency Management.

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Contents

Executive Summary 1

Introduction 2

Decontamination Basics 3

State Decon Program Assessment 4

National Guard Decon Capabilities 14

Hospital System Decon Capabilities 15

Geographic Analysis 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

1

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.

2

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.

3

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:

http://www.reevesems.com/sheltersystems/DecontaminationSystems.aspx

http://www.acsi-us.com/emergency-decon-trailers.asp

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,

http://firechief.com/tactics/firefighting_cold_shock/, www.ceep.ca/education/DecontaminationandPPE.ppt

and http://en.wikipedia.org/wiki/Human_decontamination. 3 Noll, Gregory G. and James Yvorra, Hazardous Materials: Managing the Incident, International Fire

Service Training Association (2005), page 541.

http://www.reevesems.com/sheltersystems/DecontaminationSystems.aspx

http://www.acsi-us.com/emergency-decon-trailers.asp

http://firechief.com/tactics/firefighting_cold_shock/

http://www.ceep.ca/education/DecontaminationandPPE.ppt

http://en.wikipedia.org/wiki/Human_decontamination

4

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

(http://www.acsi-us.com/). 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.

http://www.acsi-us.com/

5

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.

6

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.‖

7

―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.‖

8

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.‖

9

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.

10

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.

11

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.‖

12

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, including the state trailers and any

CAT equipment capable of deconning 20 to 30 people per hour. The table lists equipment

regardless of functional status.

Table 1. Location and type of fire service mass decon equipment

City location County Type Description

Anoka Anoka Trailer State trailer

Bloomington Hennepin Trailer State trailer

Brainerd Crow Wing Trailer State trailer

Detroit Lakes Becker Trailer State trailer

Dodge Center Dodge Trailer State trailer

Duluth St. Louis Trailer State trailer

Duluth St. Louis Tent CAT equipment

Eden Prairie Hennepin Tent Zumro inflatable decon shelter, two lanes, water

heater, portable heater, grey water bladder

Excelsior Hennepin Tent Zumro inflatable decon shelter, two lanes, water


Farmington Dakota Tent

Forest Lake Washington Tent A two-stage decon tent and a large rehab

(dressing) tent.

Glencoe McLeod Shower A cargo van/delivery truck with a portable

shower.

Golden Valley Hennepin Tent Zumro inflatable decon shelter, two lanes, water


Hopkins Hennepin Tent CAT equipment

Hutchinson McLeod Trailer Two shower stall decon trailer (built in-house)

Int’l Falls Koochiching Trailer State trailer

Litchfield Meeker Trailer State trailer

Luverne Rock Tent Mult-use tent with multi-compartments, 30' x 15'.

Can decon people 5 to 6 per pack in 20 minutes.

Mahtomedi Washington Tent

13

City location County Type Description

Maple Lake Wright Tent Wright County Chiefs Association is owner.

Minneapolis Hennepin Trailer

Two self-contained decon trailers: 24 ft. and 50 ft.

The 50 ft. trailer is tracker drawn with four

corridors (lines) and a three phase system.

Minneapolis Hennepin Tents Four Zumro inflatable tents, plus portable

showers.

Montevideo Chippewa Trailer State trailer

Moorhead Clay Tent CAT equipment

Mound Hennepin Tent Zumro inflatable decon shelter, two lanes, water


New Hope Hennepin Tent Zumro inflatable decon shelter, two lanes, water


North Branch Chisago Trailer State trailer

North Mankato Nicollet Trailer State trailer

Richfield Hennepin Tent Zumro inflatable decon shelter, two lanes, water


Rogers Hennepin Tent Zumro inflatable decon shelter, two lanes, water


Rosemount Dakota Trailer Dakota County bought same model as state trailer

St. Louis Park Hennepin Tent Zumro inflatable decon shelter, two lanes, water


St. Paul Ramsey Trailer State trailer

St. Paul Ramsey Tent CAT equipment

Thief Rvr Falls Pennington Trailer State trailer

Waseca Waseca Trailer State trailer

Willmar Kandiyohi Trailer State trailer

Windom Cottonwood Shower Trailer with two portable shower units. Owned by

county but used by fire department.

Worthington Nobles Shower Portable shower, 2 units

Worthington Nobles Trailer State trailer

Source: Interviewees with confirmation calls to some departments. This list is not necessarily

comprehensive. The Grand Forks, ND, Fire Department has mass decon capabilities but the chief stated

that the equipment could not be deployed to Minnesota without the mayor’s approval, excluding mutual aid

assistance to East Grand Forks, MN, so his equipment should not be considered an asset for Minnesota.

14

National Guard Decon Capabilities

The Minnesota National Guard has a full-time technical decon unit and a part-time mass

decon unit. But, few interviewees were familiar with the Guard’s mass decon capabilities

and how the units can support local departments.

Technical decon

The 84th

Troop Command/55th

Civil Support Team responds to events that result in, or

could result in, catastrophic loss of life or property. The unit’s mission is to:

Identify chemical, biological, radiological, nuclear, and explosive (CBRNE)

agents.

Assess a suspected CBRNE event in support of a local incident report.

Advise civilian responders.

Facilitate requests for assistance for additional state and federal assets.

The unit has 22 full-time National Guard members who are hazmat technician certified.

Their services are available 24/7/365, and contacted through the state duty officer. The

unit does not perform mass decon.

Mass decon

The Guard’s CBRNE Enhanced Response Force Package (CERF-P) is comprised of 200

traditional National Guard members from existing units with dual missions.5 When

ordered by the Governor, MNCERF-P will respond to all-hazards incidents and support

local, state, and federal agencies with casualty/patient decontamination, medical support,

and casualty search and extraction. Members are ready to travel to the scene within six

hours of notification.

Seventy-five members are devoted to mass decon, and half can be deployed to a single

incident. As traditional guard members, the unit has two five-day training periods

annually, and potential joint exercises with fire departments must occur on weekends.

5 MNCERF-P draws members from the 133

rd Medical Group, 148

th Fighter Wing, 434

th Chemical

Company, and other guard units.

15

Hospital System Decon Capabilities

In 2002, the Minnesota Department of Health’s Office of Emergency Preparedness was

created as a response to the 2001 Sept. 11 terrorist attacks and anthrax events. Its

Healthcare System Preparedness Program works to ensure that Minnesota hospitals and

healthcare systems can respond to terrorism and other public health emergencies through

an ―adequate portable and fixed decontamination system capability.‖6 Planning occurs

through eight regions and by June 2011, the office will:

Determine if facility and regional decontamination capacity meets benchmarks;

Update regional plans for patient decontamination capability;

Train first-receiver staff expected to perform hands-on decontamination services

to OSHA operations level (8 hours or to competency); and

Document decon capability, including hourly capacity for managing victims. 7

Map 2. Minnesota Public Health, Healthcare, and Behavioral

Health Preparedness Regions

Source: http://www.health.state.mn.us/oep/contact/teamsregions.html

6 Minnesota Department of Health, Minnesota FY 2009 Hospital Preparedness Program, page 3.

http://www.health.state.mn.us/oep/healthcare/09narrative.pdf. Decon is one of several system components. 7 Minnesota Department of Health, Minnesota FY 2009 Hospital Preparedness Program, pages 63-64.

http://www.health.state.mn.us/oep/contact/teamsregions.html

http://www.health.state.mn.us/oep/healthcare/09narrative.pdf

16

Since 2002, Minnesota hospitals have significantly expanded their decontamination

capabilities. One hundred twenty-three (123) of Minnesota’s 141 hospitals have decon

capabilities for persons entering the facility (Table 2). Tents range from three lines to

single lines and shower units are typically single ones. Like fire departments, some

hospitals conduct annual training and drills; others lack trained personnel due to turnover.

Table 2. Number of hospitals with decon equipment

Type of equipment Hospitals

Decon tent 84

Portable shower or single fixed shower 41

Decon room or multi-showers 31 Source: Regional health preparedness coordinators. Some hospitals

have more than one type of equipment.

Fire service interviewees and focus group participants were generally skeptical of

hospitals’ willingness to arrive on scene and perform decon as first responders. They

stated that:

Hospitals focus on deconning walk-ins, while fire departments are responsible for

on-scene decon.

Hospitals assume arriving victims have been deconned first.

Transporting contaminated victims to the hospital will spread the hazardous

materials and remove ambulances from service.

Some chiefs said their hospital is ill prepared to help and others said hospitals have good

decon plans. One fire service expert stated, ―Hospitals have to be a leader on the decon

plans. They have decon plans, but they don’t have the personnel to do it. They may be

private companies, but they plan and work with fire departments.‖ Four fire chiefs

reported that they can use their local hospital’s decon tent and two hospitals store their

equipment at the fire station. However, one hospital’s equipment cannot leave the city.

Health preparedness coordinators’ viewpoints mostly concurred with the fire chiefs’, with

a couple of exceptions:

―Many hospitals have worked with local fire departments and have

[memorandums of understanding] with local departments if they have to do mass

decon. If there was an incident, it’s unlikely the hospitals would have staffing to

go with the equipment. Hospitals are first receivers and are unlikely to go to the

scene.‖

―Hospitals assets are supposed to be used for patients if they need to

decontaminate. The equipment is for people brought in and is it not intended for

fire department’s use.‖

―Fire will help hospitals with decon (bring the personnel).‖

―If there was a problem, the hospital could go to the site.‖

―Our tents are available for any situation.‖

17

A 2003 report noted that the majority of healthcare facilities ―provide decontamination

services for self-referred contaminated patients and those transported from the scene‖ but

not on scene, and that few healthcare facilities can provide ―simultaneous facility and

release site response.‖ 8

Northwest Minnesota’s planning effort

In early November 2010, the region held a one-day meeting for emergency medical

services, hospitals, fire departments and other first responder agencies to assess local and

regional response capabilities for an incident requiring decon. The goal was to better

understand how the public safety and responder disciplines work together during a

hazmat event. Participants identified strengths, gaps and next steps in planning,

communication, training, drills and equipment. Some examples follow.9

Strengths:

Safety officer conducts training throughout county.

Fire department knows who to call for hazard evaluation - quarterly meeting.

Small enough so responders know each other.

Actions documented in check lists and standard operating procedures.

Notification to hospital is strong.

Clinics/hospital plans in place for patients.

Staff take this seriously.

Presumed agreement with hospital that fire department does decon at incident site.

Gaps:

Address local/regional/state response: unified command.

Hazmat awareness (all responders).

Hazmat training in operations level.

More fire department, public health, and city and county emergency management

exercise drills and plans.

State Patrol left out of plans. Suggest more emphasis on law enforcement.

Lack of training on regional plans and resources.

Lack of fire chiefs’ group and cross-agency coordination.

Next Steps:

Easy training on refreshing staff for donning/doffing protective gear.

What are the risks in this region?

Train together with other local partners.

Involve more agencies in exercises.

Indoor winter drill.

Leadership training for department heads.

8 Hick, John L., M.D. and others, Establishing and Training Healthcare Facility Decontamination Teams,

Annals of Emergency Medicine 2003 Sep;42(3):381-90.

http://www.health.state.mn.us/oep/healthcare/deconteam.pdf 9 The HSEM’s northwest regional program coordinator provided the conference’s assessment spreadsheets.

http://www.health.state.mn.us/oep/healthcare/deconteam.pdf

18

Geographic Analysis

The trailers’ locations are based on which department was willing to host them. Some

trailers are located within 30 to 50 miles of each other and one region’s trailer is located

in a neighboring county. Several larger departments or counties have purchased their own

equipment, as well.

Potential siting criteria

Many interviewees said the key criteria are population densities, the nature of an area’s

risks, and proximity to highways and rail lines. Response time – arrival onsite, set up and

starting decontamination – must also be considered. A few people suggested response

times from 30 to 60 minutes, or ones that are similar to CAT requirements or based on

―how long can people wait?‖ Less expensive decon tents could be distributed more

closely together than more expensive trailers. Some interviewees suggested that tents

serve a 20 to 30 mile radius or be located in every county seat.

Equipment should be dispersed regionally, but few interviewees could specify the ―right‖

number of regions, or had contrasting views about the appropriate number and size.

Geographically smaller regions allow quicker response times, but require more

equipment and some departments’ mutual aid agreements cross fire region boundaries.

The number of regions does not have to equal the number of equipment units; one person

suggested placing equipment in his large region’s four corners.

Several chiefs mentioned the fire service’s new emphasis on shared services and mutual

aid agreements. They recommended outfitting clusters of 10-12 neighboring departments

in a sub-region or allocating equipment based on mutual aid agreements. Locating

equipment should recognize that training often occurs on the regional level or by mutual

aid agreements.

A few interviewees advocated for regional decisions on the locations. Some also thought

the trailers should align with the CAT regions and be more closely connected with each

team’s operations. Other potential configurations are the HSEM’s six regions and

congressional district boundaries, which have equal populations. Dividing northern

Minnesota’s larger fire regions was also suggested.

Hypothetical county- seat scenario

Some interviewees suggested that tents serve a 20 to 30-mile radius or be located in every

county seat. Map 3 (appendix) shows how many tents or trailers are necessary if the state

decon program outfitted the fire department in every county seat over 3,000 people. If

two county seats’ 20 mile radii overlap significantly, then Map 3 shows only one county

seat with equipment. Of the state’s 56 county seats with more than 3,000 people:

Eleven host a state trailer, have their own trailer, or have CAT tents large enough

for mass decon.

Seventeen county seats would not require equipment because they are located

19

within 20 to 25 miles of another county seat. Three of the seats have state trailers.

Twenty-eight county seats would require equipment.

Thirty-one county seats have fewer than 3,000 people. Additionally, Map 3 shows the

city of Virginia with a 20-mile radius because of St. Louis County’s size.

Host departments

In general, interviewees said that the larger departments are the best hosts: they have the

resources to pay for maintenance, storage, insurance, and other costs and can keep a

sufficient number of people trained to deploy the equipment. Smaller departments would

call the large ones for assistance. One interviewee stated, ―If lots of departments get

equipment, they must be committed to keeping the right number of people trained and

available.‖

Most of the discussions assumed the equipment is decon trailers. The discussion might be

much different with simpler and less costly equipment, such as decon tents. Whatever the

equipment type, the host department must be willing to assume the responsibilities and

costs. The most significant objection to hosting the state trailers was absorbing all

ongoing costs.

Several interviewees discussed whether CATs should take charge of mass decon.

Advantages include one group of people controlling the equipment, greater coordination

and more decon expertise. However, CAT leaders stated mass decon is beyond their

statutory mission and would divert their attention from hazard mitigation.

Twin Cities Metro Area

Interviewees generally agree that the Metro area is well equipped for mass decon, citing

the larger career departments, more decon equipment and shorter travel distances. One

metro area chief noted that well equipped does not mean well prepared, explaining the

lack of understanding on how to request equipment.

Greater Minnesota

Greater Minnesota is even less likely than the Twin Cities to have a large mass decon

incident, with exceptions for a few cities near major traffic and rail corridors. Duluth,

Rochester and St. Cloud are seen as well prepared for the same reasons as the Twin Cities

are. A few people said mass decon is not a priority for small departments. Several people

recommended fewer outstate trailers, given less population density and fewer risks.

Fewer trailers are easier to support financially, too. Comments include:

―It is a dilemma because it is such a rare event. The 15 trailers are well

distributed, but they have to be equipped and maintained. Cut back on the trailers

to a smaller number.‖

―The outstate trailers seem excessive, that number of them.‖

20

―Someone has to help with the costs if it is a benefit to the region and state.

Maybe there should be less of them [trailers].‖

―Two trailers are close to each other: 30 miles apart.‖

Thirteen Greater Minnesota 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 (Table

3). Benton, Fillmore Houston and Sherburne counties do not have hospitals, but Benton

and Sherburne’s largest cities are near other county hospitals with decon equipment.

Table 3. Counties without fire service or hospital mass

decon equipment.

County Population Region of state

Aitkin 15,737 East Central

Benton 40,145 East Central

Cass 28,338 Northwest

Fillmore 20,828 Southeast

Houston 19,381 Southeast

Kittson 4,475 Northwest

Le Sueur 28,068 Southeast

Mahnomen 5,025 Northwest

Marshall 9,477 Northwest

Norman 6,628 Northwest

Red Lake 4,157 Northwest

Sherburne 88,122 East Central

Wadena 13,381 Northwest

Total 283,762

Source: See Map 4 in appendix.

21

Potential Equipment Options

Many interviewees recommended keeping future solutions ―simple‖ so that the training is

sufficient but minimal, especially given the challenges of volunteer departments: little

training time, personnel turnover, and little time for equipment maintenance. Some

recommended specific approaches:

―Standardized equipment in all regions plus special equipment as needed,‖ such

as near ethanol plants.

―A group of departments decides how much equipment and how big. That is,

local decisions.‖

―Need a tiered system for response to decon incidents: entities must be able to

handle things of x order of magnitude or type, then piggyback on the next level as

needed. More capable entities arrive later.‖

―Metro departments work off hydrants, often outstate departments can’t. What

works for metro doesn’t always work for outstate.‖

―Not one solution statewide – easy solution for small populations and automatic

solutions for big areas.‖

The two most frequently mentioned alternatives or additions to trailers were ―go packs‖

for gross decon and tents for mass decon. Interviewees also discussed additional state

trailer uses.

Go packs

Fire trucks are equipped with the necessary hoses, nozzles, and other equipment for gross

decon, and departments can hose down victims before other decon equipment arrives. A

go pack provides the ancillary supplies – for example, detergents and tarps. Training is

basic and relatively easy, but departments need a standard instruction sheet for line setup

and water flows for effective gross decon. A few departments store their gross decon

equipment, gowns, towels and other supplies in a small trailer. Four interviewees

described their own preparations or potential ones:

―We have some heated pressure washers at the fire station, so we can bring

contaminated persons to the fire station and decon people in a stall.‖

―We carry totes on the trucks - large garbage bags for privacy. Decon kits for

$100, that is doable.‖

―All ladder companies were trained for mass decon. Each rig had tarps and garden

hoses. The tarps separate people by gender. Mass decon can be done easily with

the fire engines and booster lines. Then you need the tiebacks and blankets to

clothe people. Put the equipment in a tote bag. Total cost is $200. Set up requires

15 minutes.‖

―Have a decon process that uses something they can get quickly from a hardware

store. Develop early on with your local store what it has and you would need.‖

22

Several CAT leaders recommended developing simple, standard gross decon procedures

or guidelines on:

Setting up the decon lines (position of fire trucks, hoses and tarps);

What detergent to use;

How much water to pump through the hoses; and

How to provide privacy.

While most interviewees recommended simple procedures, some people noted that

different levels and types of exposure require different responses. For example, a simple

solution is to brush off solid contaminates rather than hose them off.

Tents or shelters

Interviewees generally favored tents/shelters for cost and operational advantages, but

cold weather operation was the most often noted potential problem. Sometimes fire chiefs

and experts had contrary viewpoints about tents, reflecting previous experiences

(inflatable versus erectable tents) or assumed problems. Compared to trailers, a tent’s

advantages are:

Lower purchase cost and could be available to more departments.

Easier to transport, store and maintain.

Multi-purpose uses, such as a personnel rehab or command post.

Greater frequency of use keeps personnel proficient in transport and setup.

Easier training because the equipment components are much simpler.

Greater decon capacity (number of people) per hour.

A ―scalable‖ solution to any event; additional tents from nearby departments

increase response capacity.

Better suited for non-ambulatory people.

Can be used outdoors and indoors.

Easier to fix plumbing problems onsite due to simplicity.

Easier to decontaminate after use.

A number of tent owners said tents are easily portable in smaller trailers and can be set up

within 30 minutes. Prices range from $10,000 to $75,000, depending on size and

equipment. Some interviewees said cold weather is not a significant problem, given

portable space and water heaters’ power, availability of dry decon techniques, and low

temperatures that neutralize some materials. One northern fire department decon leader

reported that space and water heaters can operate in below-zero weather, while another

decon team leader said the equipment is not effective at 10 to 20 degrees above zero.

23

Trailers were seen as either easy or difficult to set-up. Their space and water heat

capabilities were the biggest advantage over tents, which might be susceptible to freezing

water and condensation. However, trailers may be harder to decontaminate and are

difficult for non-ambulatory people.

State trailer uses

Interviewees recommended modifying the trailers to support multiple uses. Several

mentioned that the trailers must remain available for decon, per the federal grant, but

more capabilities would increase their use and visibility. Other public safety agencies

could also use the trailer. Additional uses include:

Mobile command or operations center;

Training simulator;

Regional cache of fire fighter supplies and materials;

Rest and rehab support unit at wildfires, natural disasters and other events; and

Environmental catastrophe response unit.

Modification may require removing plumbing and other components to reduce weight or

adding a third axle. One person recommended ―taking out the trailer parts that are hard to

maintain and use the stalls with portable plumbing equipment.‖ A couple of people

suggested the trailers are not worth spending additional funds. One person said each

region should decide how to reconfigure the trailers to ensure it fulfills a regional need.

Many people suggested that the trailers’ best role is pre-positioning for a potential, large

scale event, like the Republican National Convention, or for a long-term response

situation, such as a wildfire. Some interviewees recommended moving the trailers to

high-population areas. The trailers could also travel with and be used for CAT decon.

One person recommended housing the trailers at large hospitals.

Shower units

Hospital emergency departments may have one or more shower units installed or a full

decon room. Both hospitals and fire departments also have portable showers, ranging

from a single unit to three-line, tent-like structures. Pictures and descriptions are available

at http://www.labsafety.com/store/Public_Safety/Fire_-

_Rescue/Hazmat_Equipment/?noredirect=true&Nao=15

Decon vehicles

A couple of interviewees mentioned that decon trucks carry all the necessary equipment,

require little on-scene setup, and can travel at higher speeds than a truck and trailer.

However, the vehicle may cost several hundred thousand dollars.

http://www.labsafety.com/store/Public_Safety/Fire_-_Rescue/Hazmat_Equipment/?noredirect=true&Nao=15

http://www.labsafety.com/store/Public_Safety/Fire_-_Rescue/Hazmat_Equipment/?noredirect=true&Nao=15

24

Conclusions and Recommendations

Most interviewees describe haz mat incidents requiring gross and mass decon as a very

low probability but potentially high risk. An event’s randomness creates great uncertainty

for allocating resources. No one could cite a mass decon incident that used the trailers,

which are considered ―insurance‖ against disasters and catastrophic events.

The state trailers have been plagued with mechanical and logistical problems, and many

interviewees do not view them as an effective solution. Some interviewees saw a role for

trailers in populous areas, in cities with immediate hazards, or fewer ones outstate.

However, funding trailer repairs is not necessarily the most cost effective choice. Many

interviewees’ support other options, such as decon tents or simple gross decon

techniques, equipments and supplies, and saw training as critical to the program’s

effectiveness as a whole.

Since the state decon program’s start, Minnesota hospitals and the National Guard have

significantly expanded their decon capacities. Significant investment in fire service decon

capacity 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.

Interviewees recommended that HSEM define its role in sustaining local departments’

decon capability, including defining the state decon program’s purpose. Training support,

communication and coordination are equally important, or more so, than equipment.

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.

25

Appendix: Hospital Equipment Detail

Minnesota Department of Health – Office of Emergency Preparedness’ regional

healthcare preparedness coordinators provided information on Minnesota hospitals’

decon equipment. The table formats reflect how the coordinator supplied the information.

The Northwest and South Central regions’ information was provided via telephone, and

the other coordinators e-mailed spreadsheets.

Table 1. Central Region

Hospital City County

3-Line

Tent

1-Line

Tent

Albany Area Hospital Albany Stearns

1

St. Joseph Medical Center Brainerd Crow Wing 1

Buffalo Hospital Buffalo Wright

1

Cambridge Medical Center Cambridge Isanti

1

Cuyuna Regional Medical Center Crosby Crow Wing

1

St. Gabriel's Hospital Little Falls Morrison

1

Long Prairie Memorial Long Prairie Todd

1

Melrose Area Hospital Melrose Stearns

1

New River Medical Center Monticello Wright 1

Kanabec Hospital Mora Kanabec

1

Mille Lacs Health System Onamia Mille Lacs

1

Paynesville Area Health Care System Paynesville Stearns

1

Fairview Northland Medical Center Princeton Sherburne

1

Pine Medical Center Sandstone Pine

1

St. Michael's Hospital Sauk Centre Stearns

1

St. Cloud Hospital10

St. Cloud Stearns 1

Lakewood Health System Staples Todd

Fairview Lakes Regional Health Care Wyoming Chisago

1

Table 2. West Central Region

Hospital City County

3-Line

Tent

1-Line

Tent

Douglas County Hospital Alexandria Douglas 1

St. Francis Healthcare Campus11

Breckenridge Wilkin 1

Prairie Ridge Medical Center Elbow Lake Grant 1

Lake Region Healthcare Fergus Falls Ottertail 1

Glacial Ridge Health System Glenwood Pope 1

Stevens Community Medical Center Morris Stevens 1

Perham Memorial Hospital Perham Ottertail 1

Wheaton Community Hospital Wheaton Traverse 1

10

The hospital also has four fixed showerheads. 11

The hospital also has two fixed showerheads.

26

Table 3. Metropolitan Region12

Facility City

Equip

ment

Hourly

Rate

Trained

staff

Staff to

train Needs

Fairview Ridges

Hosp. Burnsville F,P 70 15 20 Training, PPE

Mercy Hosp. Coon Rapids F 16 75 0

Radiological

Decon

Fairview Southdale

Hosp. Edina F,P 65 3 50 Training, PPE

Unity Hosp. Fridley F 16 60 0

Radiological

Decon

Regina Medical

Center Hastings F 8 3 5

Training, PPE,

willing staff,

improved fac.

Maple Grove Hosp. Maple Grove P

St. John’s Hosp. Maplewood F 30 33 30

Train security

and ER staff

Abbott

Northwestern Hosp. Minneapolis P 40 40 40

PPE, Training,

and drills

Children’s Hosp.

and Clinics Minneapolis F 28 44 0 Training

Riverside Campus Minneapolis F,P 36 150 50 Working tents

Hennepin County

Medical Center Minneapolis F,P 72 42 20

Training/Radio

logical decon

training

Phillips Eye Minneapolis P 8 2 6 Training

University Campus Minneapolis F,P 36 150 50 Working tents

Vet Affairs MC Minneapolis F,P 40 24 24 Training

Northfield Hosp. Northfield F,P 36 3 9 Training

North Memorial

Medical Center Robbinsdale F,P 90 30 0

Donning/

doffing skills

St. Francis

Regional Medical Shakopee F,P 31 20 18

Competency

based training

Methodist Hosp. St. Louis Prk F 40 10 37 Training

Children’s Hosp.

and Clinics St. Paul P 28 32 0 Training

Regions Hosp. St. Paul F 40 40 20 Training, PPE

St. Joseph’s Hosp. St. Paul F 75 23 30

Train security

and ER staff

United Hosp. St. Paul F,P 20 30 40

Training $,

FR-57 Filters,

Pt. decon kits

Lakeview Hosp. Stillwater P 24 17 3

Staff for tent

set-up,

12

The Minnesota Department of Health’s Mortuary Science Section has one decon tent in St. Paul.

27

Facility City

Equip

ment

Hourly

Rate

Trained

staff

Staff to

train Needs

Ridgeview Hosp. -

Waconia Waconia F,P 24 4 10

Nursing Srv.

cooperation

with training

Woodwinds Hosp. Woodbury F 15 17 20

Train security

and ER staff F=Fixed (room), P=Portable (tent), PPE=Personal Protection Equipment, ER= Emergency Room. Data

based on 2008 survey, except Maple Grove Hospital (phone call).

Table 4. Northeast Region

Facility City County Tent At hospital Procedures

Essentia

Health – N.

Pines Center Aurora

St.

Louis

One large tent

and a single

shower. Indoor shower

Water collected in

small pool.

Bigfork

Valley

Hospital Bigfork Itasca

Decon room w/

appropriate

supplies.

Training/live

exercises are lacking

Community

Memorial

Hospital Cloquet Carlton

11x15 tent w/

heat and

water

One person

decon

Cook

Hospital Cook

St.

Louis

Large tent and

attachments

in a trailer.

Small decon

shelter on cart

in the hospital

training room.

Procedures for

donning and doffing,

power point for set up

of both tents.

Deer River

Healthcare

Center

Deer

River Itasca Tent

Plans for set up.

SMDC

Health

System Duluth

St.

Louis

Two decon stations; one in the

4th Street Ramp for mass

decon. ED station is equipped

with ―in house‖ air hook ups for

the decon masks and does not

rely on batteries.

St. Luke’s

Hospital Duluth

St.

Louis

Two decon

tents. Can set

up in two

inside

locations.

One room with

three shower

heads in ER for

small events.

Have tested

procedures multiple

times. Projected

through-put is about

150/ hour ambulatory.

Ely

Bloomenson

Hospital Ely

St.

Louis Tent Shower Plans for set up.

North Shore

Hospital

Grand

Marais Cook

Large tent and

attachments

in a trailer.

Small decon

shelter.

Need more training in

decon, donning/

doffing

28

Facility City County Tent At hospital Procedures

Grand Itasca

Clinic and

Hospital

Grand

Rapids Itasca

Reeves Model

3SC shelter/

equipment in

trailer.

Single shower

system stored in

ED; built in

decon shower

in ED garage.

Fairview

Range Hibbing

St.

Louis

Tent stored at

Fire Dept.

Rainy Lake

Medical

Center

Inter-

national

Falls Kooch

Tent stored in

trailer.

Written deployment

plan with annual staff

training/competencies

Mercy Hosp

& Health

Care Center

Moose

Lake Carlton

Large Reeves

tent with all

attachments

Small, single

person shower

enclosure

Lake View

Memorial

Hospital

Two

Harbors Lake

Tent stored in

trailer

Procedures/instruction

for setup and staff

assigned and trained.

Virginia

Regional

Medical Ctr. Virginia

St.

Louis

Tent stored in

trailer. Decon shower

Policies and

procedures for in

house only ED= Emergency Department, ER=Emergency Room.

Table 5. Northwest Region

Facility City County Equipment

Clearwater Co

Memorial Hosp. Bagley Clearwater

Single-person portable shower.

Lakewood Health

Center Baudette

Lake of the

Woods

One person portable shower system.

North Country

Regional Hosp Bemidji Beltrami

A TVI three-line tent with trailer, air and

water heaters, and containment bladder.

Riverview Hospital &

Nsg Home Crookston Polk



Essentia Health-St.

Mary’s Detroit Lks Becker



St Josephs Area Hlth

Services

Park

Rapids Hubbard

Single-person portable shower.

Emergency room ramp with shower.

Lifecare Medical

Center Roseau Roseau



Sanford Medical

Center

Thief

River Falls Pennington



29

Table 6. South Central Region


Sibley Medical Center Arlington Sibley

TVI three-line decon tent,

20 PPE outfits

United Hospital District Blue Earth Faribault


20 PPE outfits

Fairmont Med Ctr Mayo Health Fairmont Martin


20 PPE outfits

Glencoe Regional Health Srvcs Glencoe McLeod


20 PPE outfits

Hutchinson Area Health Care Hutchinson McLeod


20 PPE outfits

Minnesota Valley Hlth Ctr Inc LeSueur Le Sueur


20 PPE outfits

Meeker Co Mem Hosp Litchfield Meeker


20 PPE outfits

Madelia Community Hospital Madelia Watonwan


20 PPE outfits

Immanuel St Josephs Mayo H Sys Mankato Blue Earth


20 PPE outfits

New Ulm Medical Center New Ulm Brown


20 PPE outfits

Sleepy Eye Medical Center Sleepy Eye Brown


20 PPE outfits

Springfield Med Ctr Mayo H Sys Springfield Brown


20 PPE outfits

St James Medical Center - Mayo St. James Watonwan


20 PPE outfits

River’s Edge St. Peter Nicollet


20 PPE outfits

Waseca Med Ctr Mayo Hlth Systm Waseca Waseca


20 PPE outfits The region conducts six initial training sessions each year and annual refresher training.

30

Table 7. Southeast Region


Albert Lea

Medical Center

Albert Lea Freeborn Three-line shower: two mobile lines and one-

non ambulatory. Hot water heater and unit

heater for mobile use. Single bay in ambulance

garage.

Austin Medical

Center

Austin Mower Single shower decon unit, Btyl Hd paprs x 4,

Emergency Dept garage has 15 shower heads.

Cannon Falls

Medical Center

Cannon

Falls

Goodhue Two decon showers, 4 PAPRS, decon personal

protective equipment, gloves, boot, and suits

for max of 6 patients.

District One

Hospital

Faribault Rice Single shower decon unit, Btyl Hd paprs x 6

Fairview Red

Wing Medical

Red Wing Goodhue Single shower decon unit x 5, BTYL HD

PAPRS x 4

Lake City

Medical Center

Lake City Wabasha Two single disposable decon showers, portable

H2O heater pump & pop up pool for

containment, Btyl Hd PAPRs x 6.

Olmsted Medical

Center

Rochester Olmsted Two single-line portable showers, 12 black

bag PAPR Units

Owatonna

Hospital

Owatonna Steele Four showers in garage and two showers in a

negative pressure room.

Winona Health

System

Winona Winona Built in decon shower in ambulance garage

and three-line decon tent stored in emergency

management trailer capable of handling a

couple hundred people.

Mayo Clinics Rochester Olmsted TVI three- line decon tent, heater, one decon

shower, one Zumro tent, 63 personnel kits,

St. Elizabeth’s

Hospital

Wabasha Wabasha One decon shower in Emergency Dept., Btyl

Hd PAPRs x 6. Btyl Hd paprs are 3M Breathe Easy Butyl Rubber Hood with Powered Air Purifying Respirator (PAPR).

Table 8. Southwest Region


Appleton Area

Clinic Appleton Swift Single shower decon unit, Btyl Hd paprs-4

Swift County

Benson Benson Swift Single shower decon unit, Btyl Hd paprs-4

Sanford Canby

Hospital Canby

Yellow

Medicine Single shower decon unit, Btyl Hd paprs-2

Johnson

Memorial Dawson Lac qui Parle

Three-line decon shelter, single shower

decon unit, Btyl Hd paprs-6

Graceville

Hospital Graceville Big Stone Single shower decon unit, Btyl Hd paprs-4

Granite Falls

Hospital

Granite

Falls

Yellow

Medicine Single shower decon unit, Btyl Hd paprs-4

31


Hendricks

Hospital Hendricks Lincoln Single shower decon unit, Btyl Hd paprs-4

Sanford Jackson

Hospital Jackson Jackson Single shower decon unit, Btyl Hd paprs-4 ,

Sanford Luverne

Hospital Luverne Rock Single shower decon unit, Btyl Hd paprs-4

Madison Hospital Madison Lac qui Parle

Single shower decon unit, Btyl Hd paprs-4

( 3M black bag)

Avera Marshall

Medical Center Marshall Lyon


decon unit x 2, Btyl Hd paprs-6

Chippewa

County Clinic Montevideo Chippewa Single shower decon unit, Btyl Hd paprs-3

Renville County

Hospital Olivia Renville Single shower decon unit, Btyl Hd paprs-4

Ortonville Area

Hospital Ortonville Big Stone


decon unit, btyl hd paprs (6)

Pipestone

Medical Center Pipestone Pipestone Single shower decon unit, Btyl Hd paprs-4

Redwood Falls

Area Hospital

Redwood

Falls Redwood Single shower decon unit, Btyl Hd paprs-4

Murray County

Medical Center Slayton Murray

Single shower decon unit, 2 line Decon

Shelter, Btyl Hd paprs-4

Tracy Medical

Hospital Tracy Lyon Btyl Hd paprs-4

Tyler Healthcare

Center Tyler Lincoln



Westbrook

Health Center Westbrook Cottonwood



Rice Memorial

Hospital Willmar Kandiyohi


decon units x2, Btyl Hd paprs-6

Windom Area

Hospital Windom Cottonwood Single shower decon unit, Btyl Hd paprs-4

Sanford

Worthington Worthington Nobles


decon unit, Btyl HD paprs-6 Btyl Hd paprs are 3M Breathe Easy Butyl Rubber Hood with Powered Air Purifying Respirator (PAPR).

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®

Potential Locations for FireDepartment Equipment Based on

Population Concentrations

10 0 105 Miles

20 0 2010 Kilometers

20 0 2010 Miles


Notes: Red symbols are fire department equipmentand blue symbols are hospital equipment. Symbolsare offset in cities with multiple equipment types.Labeled symbols for Minneapolis, St. Paul, MACAirport, Rochester and Duluth represent the totalnumber of units per owner/type. Symbols in all othercities represent one unit of equipment per owner/type.

Sources: Homeland Security and EmergencyManagement, fire departments, MinnesotaDepartment of Health-Office of EmergencyPreparedness.

Prepared for the Minnesota Management & Budget -Management Analysis & Development by the MinnesotaGeospatial Information Office (MnGeo)

Updated: January 13, 2011

Map 3

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®

Minnesota Fire Departmentand Hospital Decontamination

Equipment

10 0 105 Miles


50 0 5025 Miles


Notes: Red symbols are fire department equipmentand blue symbols are hospital equipment. Symbolsare offset in cities with multiple equipment types.Labeled symbols for Minneapolis, St. Paul, MACAirport, Rochester and Duluth represent the totalnumber of units per owner/type. Symbols in all othercities represent one unit of equipment per owner/type.

Sources: Homeland Security and EmergencyManagement, fire departments, MinnesotaDepartment of Health-Office of EmergencyPreparedness.

Prepared for the Minnesota Management & Budget -Management Analysis & Development by the MinnesotaGeospatial Information Office (MnGeo)

Updated: January 13, 2011

Map 4

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state decontamination program needs assessment€¦ · decon tents and trailers are designed to...

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