Program Purpose

The mission of the Lincoln-Lancaster County Health Department (LLCHD) is to protect and promote the health of the people and the environment of Lincoln and Lancaster County. To fulfill that mission, the Department responds to emergency situations involving chemicals which pose a threat to the health of citizens or the environment. The Department's role is to assess the level of risk to the public, emergency responders, and others at the scene who may have been exposed. Second, the Department provides advice to the public, emergency responders, and health care personnel about how to minimize risk and treat exposed individuals and the environment. Last, the Department takes whatever emergency action is required to assure the protection of the public.

Program Overview

The Environmental Health Division emergency response team responds to chemical releases into the air, water or land. These releases may involve accidental chemical spills, transportation accidents, indoor air releases of hazardous vapors, and illegal dumping of hazardous materials, any of which pose a significant health risk. In situations which involve broad emergency response, the emergency response team becomes a part of the Integrated Response Incident Command System. In Lincoln the system is most often commanded by a District Chief of the Lincoln Fire Department. In the rural areas, the system is commanded by the superior officer of the rural fire district in which the event occurs. In larger events, the LLCHD staff work together with other agencies such as the Nebraska Department of Environmental Quality, City of Lincoln Fire Inspectors, Deputy State Fire Marshals and various law enforcement agencies who participate in isolation, control and remediation of the hazard creating the emergency. The responsibilities of the LLCHD emergency response team in such events are:

• Assessing the health and environmental risks posed by the situation and advising responding agencies, medical facilities, and the public of measures needed to protect the public health and the environment;

• Authorizing evacuation or other emergency measures to protect the public;

• Assuring the protection of emergency responders from both identified and unidentified hazards by advising the incident commander;

• Assessing the incident for possible delayed hazards and take the necessary steps to prevent delayed hazards from adversely affecting the public health;

• Coordinating environmental sampling;

• Determining best procedures for cleanup and disposal of waste products; and

• Assuring that cleanup is carried out in a timely manner using proper techniques and practices designed for the continued protection of the public health and the environment.

LLCHD is represented by an Assistant Chief of the Environmental Health Division on the Local Emergency Planning Committee (LEPC) as established under SARA Title III and the Community Right To Know federal regulations. The LLCHD supports state legislation which will provide clearer responsibilities and authority for the State Emergency Response Commission (SERC) and the LEPC's in the state.

The Assistant Chief of the Division also represents the LLCHD on the Lincoln-Lancaster County Emergency Management Committee. The committee members represent city and county governmental agencies, emergency services volunteer agencies, law enforcement, rural fire districts, hospitals, and military installations. With support from the Lincoln/Lancaster County Emergency Management Office (formerly Civil Defense), the committee maintains the Lancaster County Local Emergency Operations Plan (LEOP). The LEOP describes the role and function of each entity represented on the committee, in the event of a major disaster within the community.

Hazardous Incident Response

Prior to 1995, those situations for which a fire department requested assistance from the LLCHD were considered emergency responses. In 1995, the procedure for response to calls from the public regarding emergent threats were reviewed. The review process indicated that some citizen reports which were handled as routine complaints should, because of the potential for serious public health risk posed by the situation, be classified as an emergency situation and responded to as such. The principal criteria used to make that determination is the potential or perceived health effects of an incident on the citizens in the area. Consequently, the protocol was written to include all incidents where people are reporting adverse health effects. Depending on the scope of the emergency the response would include the fire department, emergency medical services and LLCHD.

Types of Emergency Responses

Remediation of Spills and Dumping

In most of the response incidents, a responsible party is immediately identified and takes the responsibility for clean up. For those response incidents where a significant risk to public health or the environment is present and no responsible party is readily found, LLCHD staff initiates a spill clean up which assures the protection of the public. In these cases, LLCHD takes responsibility for the cost of the clean up. LLCHD staff then attempt to locate the responsible party and recover the clean up costs. During the 1996-97 year, LLCHD contracted for clean up of 13 dumpings at a cost of $21,721.45. Of those costs, staff was able to recover $18,354.45 leaving a balance of $3367.00 paid by the LLCHD.

Resources, Funding and Program Costs

The LLCHD Emergency Response Team consists of two primary responders, an Environmental Health Specialist and Environmental Engineer who serve as secondary responders, an Environmental Health Assistant Chief who provides toxicologic support, the Epidemiologist and the Health Director. Other LLCHD staff who have expertise in specific areas are called upon to support the team. Staff are available twenty four hours a day to respond. In 1996-97, staff spent 965 hours on emergency responses.

Almost all emergency responses are handled with one or two responders. In an incident which poses a major health risk or impacts a large area, other staff are called to duty. In such events the Health Director is notified immediately. Staff from Health Promotion and Outreach may prepare news releases and advisories. Public Health Nursing may provide notification to health impaired individuals and assistance to ambulatory clients in the area. Clerical staff may assist in preparation and dissemination of information.

Funding for the Emergency Response Program is not directly budgeted but comes primarily from the Health Fund. Existing program staff from other budget areas are pulled into action for emergency response. Also much of the staff time spent on-call or in response is in addition to regular staff hours. Estimated cost of the program for 1996-97 was $44,750.

Progress on Goals For 1996-97

1. To continue to respond in an efficient manner to emergency incidents relating to chemical releases which pose a risk to the public health and the environment.

   To assure an efficient response, two staff responders are assigned as primary and secondary responders. The primary responder is responsible for the initial response and may call upon the secondary responder for assistance as needed. Because responders are available 24 hours each day for a fourteen day period, there is a need for flexibility to accommodate responders personal life and family responsibilities. The secondary responder also serves to cover the calls for the primary, if the primary has a personal obligation. The LLCHD has also expanded it's response capability by including more of the field staff in responses during regular working hours. This has allowed the primary responders to fulfill their other work responsibilities. The emergency response team has reformatted the incident report form to make it more efficient. Staff have also created two forms used to identify steps necessary for remediation of a spill. This will enhance cleanup operations and serve to better document the event.

2. To improve certain inefficiencies in the emergency notification system. During non working hours, the Emergency Response Team is notified through the University Centrex Operator using a paging system. This system is somewhat inefficient resulting in a delay in some responses.

   The major portion of the emergency response calls come for the 911 Emergency Operations Center. The efficiency of the notification system has been improved by developing a protocol with the 911 Center which allows the Center to directly page the primary responder. This has eliminated the call to Centrex. As a result, the amount of time required for notification is reduced nearly by one half, and because the primary responder talks directly to the 911 Center, better communications occurs.

3. To set up a better training program for LLCHD responders which will prepare them to provide a better response to emergencies.

   Although some training has been provided, this goal has not yet been achieved. The two staff who serve as primary responders have received their annual 8 hour refresher for emergency responders. Some training of other Environmental Health staff has also been accomplished including awareness training for clandestine drug manufacturing operations.

4. To continue the LLCHD's working relationship with fire departments, the Nebraska Department of Environmental Quality, and law enforcement to assure adequate response to chemical emergencies.

   LLCHD is seen as a significant player in dealing with hazardous chemical emergencies. We have an excellent relationship with the Lincoln Fire Department. Staff have worked successfully with the Nebraska Department of Environmental Quality on several incidents. The NDEQ now relies on the LLCHD to address all but the largest release incidents. LLCHD staff have worked successfully with the Lancaster County Sheriff's office on incidents that have occurred in the County.

5. To continue to support the LEPC by serving as a member and assisting the local Emergency Management Coordinator with matters pertaining to the LEPC activities.

   Progress in fulfilling this goal has been significant. The two primary response staff were on a legislative sub-committee that supported LB 374, legislation which established state statutes pertaining to the operation of the State Emergency Response Commission and the Local Emergency Preparedness Committees. Staff worked with the Lancaster Co. Emergency Management Office, to reform the Lancaster County LEPC. A LLCHD staff member was elected by the LEPC members to serve as it's Chairperson.

6. To assess equipment needs for emergency response to assure that LLCHD response staff are able to provide the highest level of knowledge about materials involved in emergency response incidents.

   The emergency response team continues to assess the need for equipment to respond to emergencies. During the year, staff acquired a Jerome Meter for measuring mercury in the air. LLCHD now has the only instrument in the area which can assess risk associated with mercury spills. It has been used several times during the year.

7. To secure the radios previously requested to assure effective communication during emergencies.

   Hand held radios have been acquired for nearly all Environmental Health field staff. Field staff have received the training in the use of the radio.

Program Goals for 1997-98

1. To continue to look for ways of making emergency responses more effective and efficient, particularly focusing on response to small fuel spills which pose minimal risk but take up significant amounts of response time .

2. To continue the goal of access to better training for response staff.

3. To complete the assessment and acquisition of emergency response equipment which assures that LLCHD response staff are able to provide the highest level of knowledge about materials involved in emergency responses.

4. To examine documentation procedures and develop policies and procedures for documentation of events.

5. To continue to work successfully with the various agencies who have a role in emergency response events.

Environmental Quality