&EPA
United States
Environmental Protection
Agency
        WORKSHOP ON

        National Water Security Risk
        Communication Symposium
        Office of Research and Development
        National Homeland Security
        Research Center

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                    SUMMARY REPORT


National Water Security Risk Communication Symposium
                      San Francisco, CA
                       May 20-21, 2004
               United States Environmental Protection Agency

                   Office of Research and Development
               National Homeland Security Research Center
                          Cincinnati, OH

                          Office of Water
                       Water Security Division
                          Washington, DC

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National Water Security Risk Communication Symposium                               May 20-21, 2004


                                  Table of Contents

Section                                                                                 Page
Executive Summary	  iii

Introduction and Statement of Goals	  1
Session 1: Risk Communication During and Following A Crisis	   2
    Opening Presentations	  2
    Keynote Presentation	  3
    Stakeholder Panel on Risk Communication During a Crisis	  3
       Risk Communication During the 2003 Southern California Fires	  3
       The Psychology of Risk Perception	  5
       Communicating During A Crisis: Creating a Framework in the State of Washington	  6
       Case Study of Communication During a Drinking Water System Contamination
       Event	  7
       Lessons Learned from the New York City Experience	  7
       Facilitated Panelist Question and Answer Session	  8
    Case Study- 1993 Cryptosporidium Outbreak in Milwaukee, Wisconsin	  9
    Facilitated Audience Discussion	  12
    Risk Communication Tools Demonstration Session	  13
Session 2: Risk Communication in Preparation for a Potential Crisis Event	  14
    Opening Presentations	  14
    Keynote Presentation	  15
    Case Study: Synopsis of Risk Communication Issues from Multiple Crisis Tabletop
    Exercises	  15
    Panel on Water Security Communication Initiatives	  17
       Communication for Emerging Contaminants and Water-Related Health Risk	  17
       Emergency Communication with Local Governments and Communities	  18
       Response Protocol Toolbox: Public Health Response Guide	  19
    Stakeholder Panel on Best Practices for Planning	  19
       Risk Communication in Washington Township, New Jersey	  19
       Risk Communication at the Los Angeles Department of Water and Power	  20
       Communication Initiatives at the Connecticut Department of Public Health	  22
       Crisis and Emergency Risk Communication at the Cincinnati Fire Department, Ohio	  23
       Communication and Response Planning at the Newport News Waterworks, Virginia	  24
       Facilitated Panelist Question and Answer Session	  25
    Case Study: Massive Power Grid Outage in 2003 in Cleveland, Ohio	  25
    Facilitated Audience Discussion	  28
    Symposium Close-Out	  29
Appendix A	  30
Appendix B	  33

Appendix C	49

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National Water Security Risk Communication Symposium                                May 20-21, 2004


                                  Executive Summary

The U.S. Environmental Protection Agency (EPA) hosted a 2-day Symposium about communicating risks
to drinking and waste water systems on May 20-21, 2004, in San Francisco, California. The Symposium
provided an opportunity to inform key water security stakeholder groups about the state-of-the-art in
crisis risk communication; a forum to share effective risk communication strategies, best practices, tools,
and existing projects; and an opportunity to gather information and advice to support activities in
developing and implementing successful risk communication strategies, tools, and plans. More than 100
participants attended the Symposium, from drinking water and wastewater utilities, public health
agencies, state and local drinking water and wastewater agencies, local emergency response
organizations, elected officials, and the media.

The Symposium began with opening remarks by Scott Minamyer, Symposium Chair, EPA Office of
Research and Development  (ORD); Wayne Nastri, Administrator for EPA Region 9; Jonathan Herrmann,
National Homeland  Security Research Center (NHSRC); Steve Dennis, Alameda County Water District,
California;  and Susan Dolgin-Ruggles, EPA Office  of Water, Water Security Division.

Session 1 on May 20, "Risk Communication During and Following A Crisis," began with an
informative keynote presentation by Peter Sandman of key elements in crisis and risk communication, 25
fundamental steps in message planning and delivery, how the construction and delivery of a message
influences public reaction, and strategies for effective communication and media interaction that build
public reassurance, confidence, cooperation, and trust. (Refer to web site at  www.psandman.com/).

A stakeholder panel on risk  communication during a crisis, moderated by Ms. Kerry Kirk Pflugh,
Manager, Office of Outreach and Education, Division of Watershed Management, New Jersey
Department of Environmental Protection, focused on the lessons learned by various organizations upon
implementing their risk communication plans. Terri Stratton, Risk Communication Co-Lead, California
Department of Health Services (DHS), discussed risk communication planning actions taken by the State
of California and lessons learned during the fires that occurred in Southern California during October-
November 2003. David Ropiek, with the Harvard Center for Risk Analysis, discussed the psychology of
risk perception and provided examples from his long previous experience as a journalist. Denise Clifford,
with the Washington State Department of Health, Office of Drinking Water, discussed the use of risk
communication to support efforts to assure safe and reliable drinking water. Steve Frew, Manager of
Security and Emergency Preparedness, East Bay Municipal Utility District in California, discussed the
communications and interactions that occurred with the media and public throughout a significant water
supply contamination incident.  Ed Welch, Chief, New York City Department of Environmental
Protection (DEP) Environmental Police, provided insights on communication as  experienced in the
largest rescue operation in New York City history on September 11, 2001.  An audience question and
answer period followed the panelist presentations and addressed a variety of lessons learned from these
experiences, clarification of experiences during the risk communication process, risk communication
planning, and effective methods for interaction.

Paul Biedrzycki, Manager, Disease Control and Prevention for the City of Milwaukee, provided an in-
depth case study discussion  of the 1993 cryptosporidium outbreak, including a chronology of events, risk
communication methods, lessons learned, corrective actions taken for the water system and risk
communication, planned activities, and a question and answer session. An important issue still being
addressed is the loss of public confidence in the safety of drinking water that meets regulatory standards.
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Following this case study, Ms. Pflugh facilitated an audience discussion on Session 1 topics, other crisis
and post-crisis event issues, needs, and emerging tools. Day 1 of the Symposium ended with a
demonstration of a variety of risk communication tools and websites.

Session 2, on May 21, "Risk Communication in Preparation for a Potential Crisis Event," began
with opening remarks from Scott Minamyer, EPA ORD, and a presentation by Marsha Vanderford,
Acting Director, Office of Communication, at the Centers for Disease Control and Prevention (CDC), on
her experiences with and lessons learned from CDC risk communication activities during the anthrax
contamination events in October 2001.

Vincent Covello, Director, Center for Risk Communication, New York City, provided an informative
keynote presentation of key risk communication and message techniques and skills to consider using
during a potential crisis and how the message impacts human behavior. (Refer to
www. centerforriskcommunication. org).

Stanley States, Water Quality Manager with the Pittsburgh Water and Sewer Authority, discussed a
variety of incident response training sessions conducted nationwide and the risk communication lessons
learned from the tabletop and live exercises included in this training. Dr. States also provided two case
studies (pre- and post-9/11) of risk communication and response for water supply contamination threats.
A question and answer session addressed the role of the spokesperson, dealing with multiple points of
view by responders, and the importance of a unified command system focused on consensus.

A panel on water security communication initiatives, lead by Linda Reekie, American Water Works
Association Research Foundation (AwwaRF), presented several research projects underway in the areas
of risk communication and planning. Dr. Rebecca Parkin, with George Washington University, discussed
the development of a systematic, science-based approach to anticipate and communicate  about emerging
contaminants and their risks.  Dr. Parkin also discussed a second research project focused on three-way
collaborations and the development of a framework for action to help build such collaborations. Dr.
Thomas Rockaway, with the University of Louisville, discussed efforts underway to build a large
database of utility knowledge on responses to certain types of events that can support risk communication
and response planning. Susan Dolgin-Ruggles, with the EPA Office of Water, Water Security Division,
discussed the newly released module of the EPA Response Protocol Toolbox - Public Health Response
Module 5, which addresses the steps involved in the public health response to a contamination threat or
incident (http://www.epa.gov/safewater/watersecurity/pubs/guide_response_module5.pdf).

A stakeholder panel on best practices for planning, moderated by Kerry Kirk Pflugh with the New Jersey
Department of Environmental Protection, focused on the experiences of various organizations in risk
communication planning, processes, and tools. Mayor John Horensky, Washington Township, New
Jersey, discussed the challenges of risk communication planning in a small municipality and his
experiences as an employee of the health department.  James McDaniel, Deputy Assistant Manager, Los
Angeles Department of Water and Power, presented the risk communication challenges faced by a large
water utility serving a diverse population and the risk communication planning and tools  that have
resulted from these experiences. Scott Szalkiewicz, with the Connecticut Department of Public Health,
discussed current efforts to implement emergency response planning and risk communication throughout
the State of Connecticut. Edward Dadosky, District Chief with the Cincinnati, Ohio, Fire Department,
discussed a number of examples of incidents requiring crisis  and/or emergency risk communication and
the lessons learned from these experiences.  Tom Kahler, with the Newport News Waterworks, addressed
post-9/11 communications planning; the importance of identifying, developing, and maintaining
relationships with potential responders; and experiences in recovering from the damage caused by
Hurricane Isabel in 2003. An audience question and answer period followed the panelist presentations and
                                               IV

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National Water Security Risk Communication Symposium                                 May 20-21, 2004


addressed the incident command system, notification systems, and the role of law enforcement during
incident response.

Robin Halperin, Risk Manager with the Division of Water in Cleveland, Ohio, provided a case study of
the experience of this water utility during the massive power grid outage in 2003. Topics included a
chronology of the power outage, water utility responses, and water supply changes to customers; risk
communication activities throughout the event; challenges faced in both returning the water system to
service, effectively communicating with the public, and the role of elected  officials; and lessons learned
that are being translated into preparedness planning for future events.  A question and answer session
examined responses to a post-event customer survey, reactions of hospitals to loss of water supply, and
future plans for use of water buffaloes (portable drinking water storage tanks) as a temporary water
supply for the public.

Following this case study, Ms. Pflugh facilitated an audience discussion on Session 2 topics. The
Symposium ended with a request for post-meeting feedback on risk communication needs that EPA
should be addressing.

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National Water Security Risk Communication Symposium                                May 20-21, 2004


                         Introduction and Statement of Goals
The U.S. Environmental Protection Agency (EPA) hosted a 2-day Symposium about communicating risks
to drinking and waste water systems on May 20-21, 2004, in San Francisco, California. Risk
communication is a process to develop two-way communication between various parties that meets the
needs and addresses the concerns of all potentially affected parties. It is an important component of the
risk management scheme and should be factored into every step of the risk management process.

The Symposium objectives were to:
•   Inform participants of the state-of-the-art in risk communication
•   Provide a forum to share effective risk communication strategies, best practices, tools, and existing
    projects
•   Gather information and advice that would inform the subsequent development of a framework or
    similar product by EPA that local stakeholders can use to develop and implement successful risk
    communication strategies and tools.

Attending the Symposium were more than 100 participants, primarily from the following key water
security stakeholder groups: drinking water and wastewater utilities, public health agencies, state and
local drinking water and wastewater agencies, local emergency response organizations, elected officials,
and the media.

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National Water Security Risk Communication Symposium                                May 20-21, 2004


         Session 1: Risk Communication During and Following a Crisis


Opening Presentations

Scott Minamyer, Symposium Chair, with EPA Office of Research and Development (ORD), opened the
Symposium, thanked the audience for attending, the speakers for their participation, and the organizing
committee.

Wayne Nastri, Administrator for EPA Region 9, thanked everyone for the opportunity to host this
Symposium and noted that EPA takes the role of protecting drinking water very seriously and this
Symposium is one of the many first steps to prepare for a host of potential events that hopefully will
never happen. Communication during such events is critical and information must be presented in as
timely and accurate manner as possible.  He noted that many in attendance may be called upon to provide
information to those who are scared, concerned, or panicked. How these events transpire and how the
different agencies communicate during such times is critical to the outcome. The program for this
Symposium brings together premier players in risk communication, and emphasizes that effective risk
communication is absolutely critical and requires training and rehearsal. Mr. Nastri also noted how much
has been accomplished and so quickly since the events of September 11, 2001; such as completion of
many water vulnerability assessments.

Jonathan Herrmann, National Homeland Security Research Center (NHSRC), also thanked everyone
involved in putting together this Symposium and recognized the contributions of the Office of Water,
which has responsibility for implementing many of the activities identified by NHSRC and ORD. Mr.
Herrmann noted that many things changed after September 11th and one of those was the need to be
prepared, not only from the perspective of physical protection, but also being able to respond to the
public's concerns about the water they use every day. Over the next couple of days, participants would be
learning from the experiences of others and from case studies. Mr. Herrmann requested feedback from
participants on what EPA activities are working best and what products for risk/crisis communication will
be most helpful for EPA to develop.

Steve Dennis with the Alameda County Water District, CA, offered a local perspective on risk
communication and welcomed all the participants on behalf of all of the water districts in the San
Francisco area. He emphasized that the importance of understanding, preparing for, and practicing for
crisis communication cannot be overstated. Emergency response plans have recently been updated to
address potential acts of terrorism and other intentional acts to contaminate U.S. water systems.  Such
plans traditionally addressed fire, power outages, and other California-specific issues. Communication is
very critical in this new area of response planning and when transitioning from day-to-day water
management into crisis management, it is imperative to understand the "who, what, when, where, and
how" of crisis communications, because  effective emergency response requires effective crisis
communication.

Mr. Dennis also described how, following September 11th, the large San Francisco Bay area water utilities
began to address  these challenges by forming a collaborative organization, the Bay Area Security
Information Collaborative (BASIC), in recognition of the need to exchange information, understand the
stakeholders, and unify responses to threats. The original group has grown from six to eight members
that service a total of 6 million customers; EPA, California Department of Health Services (DHS), and the
Federal Bureau of Investigation (FBI) have also been included.  Communication occurs throughout the
response to a threat and there may be no other element of an emergency response more important than
how to communicate with the public in a crisis.

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National Water Security Risk Communication Symposium                                May 20-21, 2004
Susan Dolgin-Ruggles with the EPA Office of Water, Water Security Division, discussed the role of good
communication in emergency planning; with the goal being to protect public health and safety in the
event of a crisis, whether an unforeseen natural disaster or a terrorist attack.  Ms. Dolgin-Ruggles
suggested the participants consider the five P's  when planning for emergencies:
•   Partner - with emergency responders, law  enforcement officials, health practitioners/officials, other
    utilities, local government, and the community
•   Plan - conduct emergency response planning and learn from existing guidance; work together
    cooperatively; hold exercises/drills to ensure preparedness; reach out to new, nontraditional partners
    such as law enforcement; and call on neighborhood watch to assist in detection
•   Procure - information such as guidance available from EPA (e.g., for small/medium water supply
    systems, a response protocol tool box, and other readily available information), tools developed by
    the Centers for Disease Control and Prevention (CDC), and through participation in conferences such
    as this one
•   Practice - hold drills to test strategy and communication (include media and concerned citizens); take
    advantage of lessons learned, such as  those presented in this forum; be an advocate for
    communication; build networks; and help EPA to identify gaps (what is needed and how to  fill them).
•   Promote


Keynote Presentation

Dr. Peter Sandman provided an informative discussion of key considerations in crisis communication.
Because the material presented by Dr. Sandman is copyrighted, we cannot directly include it in the
Proceedings.  Details of his presentation are, however, provided in a video summary by Dr. Sandman
under "Keynote Speakers" on the Proceedings Main Menu. Materials covered are also available free of
charge from Dr. Sandman's web site at www.psandman.com.

Stakeholder Panel on Risk Communication during a Crisis

Kerry Kirk Pflugh, Manager, Office of Outreach and Education, Division of Watershed Management,
New Jersey Department of Environmental Protection, served as moderator for a  panel session focused on
the experience of various organizations when their risk communication plan was implemented either in a
real or practice scenario - how communication  was accomplished, what was learned, what worked, what
did not work,  and what might be done different for the next time. The session consisted of five
presentations followed by a question and answer period.

Risk Communication during the 2003 Southern California Fires

Terri Stratton, Risk Communication Co-Lead, California Department of Health Services (DHS),
Emergency Preparedness Office, noted the importance of knowing your community before a crisis occurs
and how this may be done as an assessment in the very beginning of the planning process. She used
California as example, noting that communication goals are to: be prepared  in advance of an event, instill
public confidence in the ability to respond, practice response to emergencies in order to build skills and
the ability to utilize knowledge/training in an emergency situation, and work in collaboration or in
partnerships with local, state, and federal agencies.

The preparation strategy in California involved:
•   Transparency of the planning process and in all press releases and public information materials

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National Water Security Risk Communication Symposium                                 May 20-21, 2004


•   Use of an echo strategy to ensure consistency in the message to the public (e.g., state echoes CDC,
    local health department echoes state agency, etc.)
•   Multi-language focus to be able to communicate with the public in a way that they will understand
    and in a way that will ensure that they receive the message
•   Use of partnerships and collaboration, which are very important during a crisis but must be built in
    advance of a crisis
•   Tools and training with examples provided of the CDC website and the state website
    (www.dhs.ca.gov)
•   Coordination of all efforts by a team, which in this case involved a Public Information Officer (PIO),
    Department of Mental Health, emergency services, multicultural health, and others that can help
    guide the development of messages and plans

Recommendations for emergency preparedness and response planning activities include:
•   Develop a public relations/media plan in advance to keep actions during an emergency focused;
    California requires all local health departments to have a risk communication plan
•   Educate using more than the press, such as websites and hotlines
•   Train a spokesperson so they are prepared to be in front of a camera in a crisis
•   Conduct outreach to local health departments since all emergencies happen at the local level (e.g.,
    water district, county, etc.)
•   Develop a message and have a series of pre-messages in advance of an actual emergency as this helps
    to maintain credibility with the public and helps the public prepare; focus on how to prepare, what to
    do to protect, and what public can do in the emergency
•   Conduct risk communication training
•   Develop partner and stakeholder relations as well as conduct state agency outreach

An example of the application of crisis and risk communication actions is the response to the fires in
October-November 2003, the largest in California history. Planning efforts at the time focused on
bioterrorism and other emergencies rather than fire with loss of property and resources.  Some
observations resulting from this experience include:
•   Involve risk communicators early in the response (from the beginning)
•   Issue public health messages that give the public clear guidance on what to do (e.g.,  how to boil water
    effectively); the public did not want to hear a series of options on how to boil water
•   Use press releases to get out information on early actions taken, indicate if conditions are uncertain
    and what might happen, and target messages to specific audiences (such as toward parents regarding
    concerns about children)
•   Address the issues that are  in the mind of the public, such as notifications that emergency operations
    center is being opened, to establish involvement and credibility
•   Provide  consistency in the message by sending press releases to partners at same time as they are sent
    to the press
•   Build the partnerships now for those resources that may be needed in an emergency, such as
    assistance from Department of Education or  Mental Health for assistance in crafting messages to
    address stress or other public concerns.

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National Water Security Risk Communication Symposium                                 May 20-21, 2004


Overall lessons learned from this experience include:
•   Involve risk communication early in the process
•   Pre-establish a quick approval mechanism for press releases, materials, and documents in an
    emergency so information is timely
•   Involve partners from the beginning of the planning process
•   Hold to core strategies in the emergency and provide as much information as possible
•   Collaborate with others involved in the response

The Psychology of Risk Perception

David Ropiek, a former journalist with the Harvard Center for Risk Analysis, discussed his interest in the
psychology of risk perception with examples drawn from real world experience. He noted that there is an
emotional component to events and that component may be even more important than the risk of the
situation itself.  Risk communication is all about that emotional component - the outrage not the hazard,
how we react to the event, and what fuels "high" or "low" outrage during a crisis.

The first and most important factor is trust. The more people can trust, the less afraid they are, and vice
versa.  This is real and should not be dismissed as irrational. Therefore, risk communication can be more
about what is done rather than what is said. An example of this was a series of press releases about
government response to an incident of mad cow disease that began with statements that this was an
isolated incident, then saying that the affected cow was not processed into food for other cattle, and then
finding out that was also incorrect.

Trust comes from honesty and this means many things - constant communication, openness, availability.
An important aspect is to avoid over-reassuring; acknowledging and respecting public fear is also
important. Despite the richness of psychology and other studies of fear and risk, there persists  a common
assumption in the scientific community that if the public is given the scientific information,  they will
think the way the scientists do.  Personal risk decision making is not always a rational process.

Trust can come from competence if it can be seen from a person's past that they are able to handle a
situation.  Trust also comes from shared control and stakeholder input enabling everyone to  feel involved
and a part of what is being done and said. Therefore, how much a person is trusted in a crisis depends on
what they do  day-to-day. This type of trust is hard to build and easy to  destroy.

Other relevant risk perception factors include:
•   Personal risk, which differs from person to person, and whether you are the one who is asked to drink
    the bottle of contaminated water - the only acceptable personal risk is zero
•   How awareness increases concern and vice versa, which enables a person to focus on something that
    might otherwise be ignored
•   Lack of control causes certain responses (such as building bomb shelters) to assert some control,
    which is often viewed as irrational but is in reality a very personal response
•   Uncertainty, which can be scary, particularly with a new technology, disease, or catastrophe
•   Affective underpinnings, such as risk to children being perceived as worse than the same risk to
    adults

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National Water Security Risk Communication Symposium                                 May 20-21, 2004


The concluding thought is to make the messages and actions more trustworthy and the public will be
more receptive to the messages and move in the desired direction. Using top-down monologues to tell
people what to think will not work.

Communicating During a Crisis: Creating a Framework in the State of Washington

Denise Clifford, Office of Drinking Water, Washington State Department of Health, discussed the use of
risk communication to support efforts to assure safe and reliable drinking water. Communication is
critical when an emergency is underway, regardless of the type of emergency or whether the situation
represents an acute health risk. The concepts are the same and the key is to practice in advance. We often
find that communication has not occurred or we only begin to think about risk communication during the
event where such skills are needed. Therefore, it is useful to put the strategies and communication ideas
in place before an event occurs so everyone will be ready.

Ms. Clifford discussed the differences between risk and crisis communication. Crisis communication
occurs during an emergency, such as when a pipeline exploded in the City of Bellingham.  Risk
communication includes non-emergency situations and is used for both risk and crisis situations, such as
explaining about lead in drinking water.

Ms. Clifford offered a case study involving the City of Seattle where vandalism occurred in a downtown
reservoir.  The first responders arrived in HazMat suits, which implied to residents that the water might
not be safe.  Also, many agencies were involved, including the City of Seattle, the Washington
Department of Health, and public health agencies for Seattle-King County.  Each organization had
different ideas on how to approach the situation as well as different messages they desired to deliver to
the public - some wanted to be open with the public and others wanted to say nothing. Key questions to
consider in such circumstances are: What are the facts? What are the messages? What will the
perception be? Who makes decisions? Of particular importance is being clear on what the risks are to
health.

The various agencies met after the incident to establish a framework—Public Health Emergency
Response Relationships—that outlined objectives, roles/responsibilities, coordinated roles/responsibilities
(outside of collective relationships), emergency response  and who to notify, communications strategies,
and agreements. This laid out objectives for assuring timely response, making timely health decisions,
and specifying roles/responsibilities (e.g., epidemiologists, water utility, those overseeing response).

Another step being taken is to link important players together such as the State Department of Health,
local health department and health officers, and the water utility.  Supporting this will be workshops
conducted across the State of Washington to explore cross-jurisdictional coordination and communication
issues, among other goals. In addition, three table top exercises are being conducted across the State  of
Washington to practice coordination between agencies, identify gaps in emergency response plans, and
better understand the roles/responsibilities of each responder. Anticipated benefits are improved
emergency response, partnerships, and an overall strategy for better communication.

Ms. Clifford stressed the need to be diligent about risk communication and integrating it into every aspect
of work and planning for a variety of issues - proactive management of the political environment, water
resource management (a big issue in the State of Washington), customer concerns regarding their water,
and establishing budgets and priorities of government organizations.  This requires preparation to address
and lower the outrage levels of the public and others.  Ms. Clifford ended the session noting that risk
communication is a constant learning experience.

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National Water Security Risk Communication Symposium                                May 20-21, 2004


Case Study of Communication during a Drinking Water System Contamination Event

Steve Frew, Manager of Security and Emergency Preparedness with East Bay Municipal Utility District
(MUD), has responsibilities for keeping the emergency response process flowing and keeping all
responding parties informed during an emergency; communicating with the public is the responsibility of
the public relations personnel. Mr. Frew discussed a significant water supply contamination incident and
the communications that occurred throughout with the media and public.

The event began on the afternoon of Friday, December 22, just before the Christmas holidays, and
employees had been allowed to leave early. The roof on the Piedmont reservoir collapsed and 200,000
gallons of contaminated water were introduced into the water supply. The initial information came from
a resident near the reservoir who witnessed the event. Initially, East Bay MUD did not know if
contaminated water was in fact being supplied to Oakland consumers. Initial responses were to summon
the emergency team and send workers to isolate the water supply, take samples that were rushed to
laboratories for analysis, examine maps to determine where water from the reservoir might have gone and
how to address it, and contact the California DHS for guidance.

Upon determining that it was necessary to issue "Boil Water" orders to 15,000 people, two radio stations
were notified and agreed to provide the announcement live. A version was also drafted for the media to
distribute with the challenge to make the distribution as wide as possible yet without causing undue
alarm. By 5 pm that day, the utility was being contacted by the television stations who wanted to help get
the word out and did so in a clear, serious, and calm manner using veteran reporters who did not overplay
or underplay the situation, did not create panic, and followed the East Bay MUD  lead on tone -  all of
which was a tremendous help. At the same time, the call center began receiving many telephone calls,
which required a quick briefing of call center staff on a standard script to use and what could or could not
be said. All this occurred in parallel with trying to develop a sound sampling and analysis strategy for the
reservoir.

By evening, the source had been isolated and fire hydrants had been flushed. While it was believed that
contaminants had not reached customers, more testing was conducted to verify.  All testing was
completed within 36 hours and by Sunday, December 24, the test results and follow-up results indicated
no contamination, so a media release was prepared rescinding the "Boil Water" order and reporters issued
it promptly.

This case study is a classic example of how an emergency team worked together with the trust of the
public, who did not panic.

Lessons Learned from the New York City Experience

Ed Welch, Chief, New York City Department of Environmental Protection (DEP) Environmental Police,
provided insights on communication as experienced in the largest rescue operation in New York City
history on September 11, 2001. Key aspects in effective response are planning, procedures,
communication, and information.

In an emergency, someone must assume command and make decisions as they see fit. This can only be
done through practice. Information must be communicated in both directions, and the process must
provide for factual  decision. Lessons can be learned either by making our own mistakes or learning from
the mistakes of others. As an example, Mr. Welch discussed the many errors that occurred in responding
to the Chernobyl incident - by workers, managers, the government, and the responders.

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National Water Security Risk Communication Symposium                                 May 20-21, 2004


Proper training and education of the public is essential to smooth evacuation and response. On
September 11, 2001, people in the twin towers were initially told not to leave. In another incident
involving a chlorine spill drill, participants were directed to assemble in an area that was downwind of the
incident.

Since September 11th, there has been no higher priority than water supply security and New York
developed a three-tiered strategic framework designed to secure, protect, and defend the water supply.
His organization has both a Detective Bureau and Intelligence Division that are involved in all long-term
investigations relating to pollution, crime,  and  terrorism, and also assist in the vital role of prevention
through the gathering of intelligence and information sharing.  A part of these efforts involves hardening
physical boundaries (protection) and implementing an identification program to badge visitors,
employees, and contractors. Other actions  include protection of infrastructure through canine units
(looking for bombs), patrols by boat and bicycle, and, soon, a trained scuba team.

Other recommendations include:
•   Subscribe to WaterlSAC, an excellent resource
•   Draw on anglers, hunters, and others who use the water supply to call in their observations as they are
    a useful source of detailed information
•   Provide security training drawing on police academies with a note that many are not focused on water
    security and the environment, which can be addressed through supplemental training
•   Provide security training agency-wide and tailored to each level to have everyone understand the
    importance  of security
•   Practice speaking on the radio or other emergency communications equipment in advance to be able
    to communicate clearly
•   In an emergency, prepare in advance what to say  and deliver the  message in a  calm manner
•   Develop a culture of cooperation within the organization and build trust with the local community
•   Prepare the  public for emergencies such as developing a citizen's guide for emergency preparedness
•   Anticipate system failures (such as lack of telephones or radios) in emergency planning so there are
    redundant communications and people available to deliver messages if needed

Communication is the most important dynamic of any organization. The New York DEP regularly holds
large- and small-scale drills, and communication is often a primary problem. Communication is essential
to timely, accurate information flow not only to keep  an emergency response functional, but also to
relieve stress  and panic. An important aspect is to be able to communicate with specialized teams -
scientists, health/medical professionals - in a common language.

Facilitated Panelist Question and Answer Session

Kerry Kirk Pflugh, with the New Jersey Department of Environmental Protection, facilitated the question
and answer session following the panelists' presentations.  Topics addressed include:
•   How the incident at the Atlanta Olympics was well-handled from an emergency response perspective
    in that the response was quick and allayed  fear, but perhaps not so well-handled from an investigation
    perspective
•   The need to work with law enforcement during an incident to understand what kind of evidence may
    be needed

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•   How to identify the transition from crisis to risk communication, which is an incremental process that
    begins with the release of initial facts (and how to release them), moves to releasing new information
    as it becomes available, and is identifiable by the transition from the initial chaos into a mode of
    operational recovery/back to business
•   The importance of anticipating questions about an incident prior to the actual crisis, use of focus
    groups to determine what they might ask, and working with communications personnel to develop
    strategies to release information
•   The need to train the call center staff on how to effectively communicate with the public during a
    crisis
•   Alternate approaches (such as use of mini-test kits) in the first response to incidents in residential
    areas other than full HazMat personal protective equipment (PPE), which may elevate concerns
    unnecessarily
•   The importance of media preparation beyond just the message—for example, where to park their
    equipment, strategies for each type of media interaction (e.g., print, local television, national
    television), the usefulness of involving the local media in conducting this planning, and the need to
    tailor the message for each media type
•   How to handle effectively the initial contact by the media if the message  is not yet available, such as
    telling them the message is in preparation, asking for their deadline time, telling them you will get
    back with them, and preparing an initial message (in conjunction with your media person) that
    includes several facts
•   Factors that are different for a bioterrorism event than natural disasters, such as a higher level of
    public outrage, greater fear of a human-made risk, and greater fear of a risk that is imposed by others
•   Differences today in response to the City of Seattle's potential reservoir contamination event include
    a different response communication that would be prepared by the State Health Department,
    communication to the public that vandalism is now taken very seriously with serious consequences,
    and preparedness in how to respond to the media and talk to the community
•   How to handle questions from the public for which the communicator is not prepared or does not
    have the information, such as honestly stating what is and is not known; relating concern and
    identifying what is being done to find our more information; speaking in a reassuring manner; and
    interacting respectfully
•   Use of the topic of bioterrorism to obtain media interest in reporting on efforts to prepare for such
    incidents, what is or is not known, efforts to harden the infrastructure, and other pre-event actions to
    help build public  confidence


Case Study - 1993 Cryptosporidium Outbreak in Milwaukee, Wisconsin

Paul Biedrzycki, Manager of Disease Control and Prevention for the City of Milwaukee, discussed the
largest documented waterborne disease outbreak in the United States.  A key message is to connect with
local agencies because many of the health departments have developed protocols for communication and
have received significant amounts of funding post-9/11 for these types of actions.

Contaminants in the water supply were initially suspected because of the magnitude of the outbreak
(indicating massive exposure), symptoms were consistent with ingestion, there were recent and persistent
water quality complaints (to the water authority but not to the health department) in the two weeks before
the outbreak, and no other plausible theory. Almost two weeks passed after the initial outbreak before the
problem was determined. This time period needs to be shortened to reduce morbidity and mortality from

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the event. There were many impacts, including hospitalization, more than 100 deaths, lost time from work
and school, as well as settlements for various lawsuits filed in the aftermath.

Of particular note was that the water in the area most heavily impacted by the outbreak was in total
compliance with all requirements; although some changes in water had been noted (e.g., turbidity).
Corrective actions taken after the event to prevent its recurrence include the addition of treatment with
ozone, coagulation, then enhanced filtration, and extending the affected intake to avoid possible
watershed effects.

The news media was the biggest risk communication method at the time even for the health department
and water utility personnel. Yet, this is a classic story of breakdown or absence of communications
between the water utility and public health organizations (i.e., the water utility assumed this was the flu, a
respiratory disease), between public health and health care providers (first report came from a doctor
seeing multiple cryptosporidium cases), and between government and consumers (ignoring two weeks of
complaints about the water). In 1993, they did not have an emergency communications plan, a PIO, pre-
identified audiences, pre-established channels of communication, clear and authoritative message content,
or identified community resources. At the time, they lacked a relationship between the Milwaukee Water
Works (MWW) and the Milwaukee Health Department, had no response protocols, were not tracking
over-the-counter (OTC) sales  of anti-diarrheal and other medications, and lacked efficient data
collection/reporting. Response efforts  were also affected by professional arrogance and cultural gaps
(e.g., distrust, lack of respect for other  disciplines, trying to appear expert in another discipline), over-
reliance or focus on regulatory compliance, and insensitivity to customers. As a result of these findings,
current practices now include  the issuance of Consumer Confidence Reports, sending special advisories to
targeted audiences, developing press releases, development and implementation of training modules, and
investigation/application of community-wide surveillance networks  and other methods to support trend
analysis, centralized disease reporting, and emergency notifications.

By working  with health agencies or emergency department, it is possible to leverage existing notification
systems and tools such as blast FAX in addition to website, hotline,  and media releases of information.
Other tools include SURVNET (to  support trend analysis of disease in large areas that are inclusive of the
water system), EMSystem to help post health advisories (have used  it for SARS), and CDC-funded
Health Alert Network for the states. Public notification considerations include the importance of
identifying target  audiences, incorporating multi-cultural considerations (e.g., one message may not work
for all populations), using multimedia approaches, and being clear and authoritative.

An interdepartmental work group at the operational level was key to bringing together issues, building
consensus, and  focusing on the same mission. The work group includes Milwaukee Water Works
(operations,  engineering), public health (laboratory, environmental,  epidemiological), Department of
Public Works (storm/sewer infrastructure), Wisconsin Department of Natural Resources, Milwaukee
Metropolitan Sewer District, and policymakers (e.g., Mayor, others). When convened, the work group
reviews data, develops  consensus on response, conducts public notification, initiates interventions, and
performs after-action review.  This work group has convened for ozone outages, SDWA Tier 3 violation,
intake rupture, and a potential finding of cryptosporidium.

Lessons learned from this contamination event include:
•   Build and foster relationships between water utilities and public health agencies in advance, including
    professional respect
•   Routinely share data and expertise
•   Develop a broad, diverse public notification strategy using tiered approaches so no one is left out
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•   Pre-identify community resources and partners to help craft the message
•   Establish a PIO, joint information center, and a plan centered on a single point of contact and one
    voice during communication
•   Engage the media early, often, and at your schedule not theirs
•   Be up front and forthright in what is or is not known
•   Have emergency notification and response protocols in place
•   Use multiple, perhaps redundant, methods of communicating to the public
•   Cross-train and prepare through exercises
•   Be prepared for the unexpected

New actions being taken include:
•   Combining syndromic and environmental surveillance data to compare water quality information
    against diarrheal data reported during the same time period
•   Joint training and exercises enabling response members to work together
•   Jointly redefining risk by comparing watershed and beach data with wastewater treatment plant
    effluent data on specific cryptosporidium species since they do  not all have the same impact on
    humans

Future considerations in the planning effort include: interfacing the SCADA (supervisory control and
data acquisition) system with public health in real-time, assessing new disinfection technologies as well
as the risk/benefit of their by-products, and developing new partnerships to include law enforcement such
as the FBI and the new discipline of forensic epidemiology as a joint investigative technique.

A question and answer session followed the presentation to clarify the outbreak, the response, and lessons
learned.  Topics addressed included:
•   Calls to the MWW from the public during the first two weeks that primarily focused on the color,
    odor, and taste of the water with some reporting that the water was making them sick
•   Conduct of syndromic surveillance using multi-faceted biological surveillance (e.g., ambulances,
    poison control, health care hotline, OTC sales) that are put together so results of all sources can be
    viewed at once, with a key difficulty being to establish a threshold for the community
•   Difficulties in overcoming consumer confidence and continued allegations that the water is not of
    high enough quality despite data that indicate the water is of high quality, and the need to engage
    other partners to assist in overcoming this hurdle
•   Whether bottled or filtered water is better than drinking tap water and that there are no current state
    regulations for certifying bottled or filtered water as there are for tap water
•   Measurement of individual filter turbidities (in raw water and post-filter water), which was done as a
    once per shift grab sample  with effluent turbidity measuring higher than that of raw water
•   Genotyping of crytosporidium by strain or source (e.g., wild animal, domestic animal, human) as part
    of a CDC study of water and wastewater streams to determine which are important as a human
    pathogen
•   Loss of public confidence in compliance because of this outbreak demonstrated that regulatory
    compliance is not always sufficient to protect the public all of the time
•   Use of the public health organization to serve as the primary spokesperson and to interface with the
    media, which enabled the water utility to  focus on their activities
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•   Potential for use of SURVNET (a Milwaukee tool) and EMSystem (commercially-available) for
    bioterrorism, water security, and other possible alert needs
•   Interest in strategies to standardize tools and communication methodologies to help communities be
    more proactive with reference to the three-prong CDC approach—strategic positioning of supplies,
    monitoring, and syndromic surveillance
•   Reductions in combined sewer outflow (CSO) incidents (from 40 to 2) along with declines in the
    slaughterhouses and related industries that reduce possible recurrence, while influences continue from
    suburban and agricultural runoff upstream that are outside the Milwaukee agencies'  areas of
    responsibility

Facilitated Audience Discussion

Kerry Kirk Pflugh, with the New Jersey Department of Environmental Protection, facilitated an audience
discussion of other crisis and post-crisis event issues not covered in Session 1, needs, and emerging tools.
Key topics  included:
•   Use of Maximum Contaminant Level Goals (MCLGs) that may be more stringent than Maximum
    Contaminant Levels (MCLs) and whether educating the public on the difference would achieve
    greater public acceptance of existing water treatment, which MWW noted was unlikely to occur
•   How to help the public understand acceptable risk (and that zero risk does not exist), including the
    timing  of such educational efforts, which is not productive to do following an event that is
    endangering the water consumer
•   How to obtain and/or set up a program for training on risk communication, including upcoming
    American Water Works Association (AWWA) workshops on crisis communication; training offered
    by the State of Washington and EPA; resources available through CDC, including a  website with
    names of certified trainers and a CD-ROM with tools (CDCynergy); California DHS tool kit currently
    in development; templates, guidance, and workshops provided by EPA; and contacting public health
    departments  whose programs are expanding through bioterrorism funding
•   The use of preplanning  to understand potential audiences, to identify their issues/concerns, and to
    otherwise anticipate their questions
•   The value of identifying ethnic backgrounds and language skills, how they obtain their information,
    who they trust, what their priorities are, and their prior experience with agencies potentially involved
    in a crisis, so as to design effective communication strategies and avoid repeating past mistakes
•   Addressing bold water filtration claims of technology providers by: (1) involving the health
    department and/or State Attorney General rather than the water utility responding itself, (2) never
    claiming that drinking water is safe as that implies zero risk, and (3) possibly developing a message
    involving a sequence of true statements about the water or the state/status of water treatment
•   The need to balance full disclosure and honesty in risk communication with the need to safeguard
    information, noting the  public's distrust through past experience of the validity of such claims made
    by the government and  a more preferable path of telling the public what it wants to know and
    omitting what the terrorists may want to know, which are usually sufficiently different
•   The need to consider risk communication training, which can be expensive, as a cost of doing
    business, to build those costs into budgets, to consider bringing in an expert to conduct training rather
    than sending personnel  to training, and to form partnerships, joint initiatives, or other co-sponsorship
    of training or drill activities to help reduce costs
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•   The importance of understanding both the delivery and receipt of information in order to be an
    effective communicator, noting that no matter how well orchestrated the plan, there is no guarantee
    that the same message will be equally perceived by everyone
•   The desire to have a manual that covers, in a simple, understandable way, all of the risks (perhaps in
    checklist form) and what can be done to prevent or respond, noting that one process cannot address
    every situation and good planning requires going into the community and understanding them, their
    frame of reference, their economic background, and other factors
•   The majority of the value of a communications plan comes from the planning process rather than the
    plan itself, and the learning and connections that are made when going through the planning process
    are important to long-term  success—there are many nuances that cannot be anticipated by simply
    following a canned formula

Risk Communication Tools Demonstration Evening Session

A variety of website demonstrations, CD-ROMs, handouts, and posters were made available to
Symposium participants, including:
•   Physician preparedness for acts of water terrorism and the clinician role in community readiness and
    risk communication; demonstrating the Physician On-Line Reference Guide (see
    www.WaterHealthConnection.org)
•   EPA National Homeland Security Research Center (see www.epa.gov/nhsrc)
•   Risk communication with Dr. Peter Sandman (see www.psandman.com)
•   CDC toolkit on CD-ROM — CDCynergy, Your Guide to Effective Emergency Risk Communication
    Planning (see www.cdc.gov/communication/cdcynergy.htm)
•   EPA Water Security Division (see www.epa.gov/watersecurity)
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                Session 2:  Risk Communication in Preparation for a

                                   Potential Crisis Event


Opening Presentations

Scott Minamyer, Symposium Chair, opened the second day of the Symposium by thanking the audience
for attending and the Association of State Drinking Water Agencies for their support to this symposium.

Marsha Vanderford, Acting Director, Office of Communication, at the Centers for Disease Control and
Prevention (CDC), discussed the CDC experience with water security and general principles of
communication that are often overlooked in haste; such as the content element and relational element of a
message. An illustrative example involved the anthrax events in Washington, DC, in October 2001.
Early on, CDC had been criticized for acting too slowly and appearing to contradict itself.  When postal
workers started becoming ill, an emergency communication was developed in the late evening for
immediate release. The internal review/approval process prior to release focused on whether the message
was factually correct and clearly understandable.  Overlooked was the fact that this was the first time
doxycycline was to be recommended rather than Cipro (which had been specified to U.S. Senators as the
preferred medication). CDC had just determined that doxycycline is a good alternative to Cipro since it is
just as  effective, has fewer side effects, and is more available and less expensive. The next morning,  CDC
received many angry telephone calls and emails and the postal workers  understandably felt
disenfranchised. CDC had, in its haste, not taken into account what the postal workers had already heard
(i.e., that Cipro  was the preferred medication). The emergency message focused on content and ignored
the relational aspects - respect, caring, and the implied relationship/power between the message sender
and receiver.  This is relayed in tone, use of personal pronouns,  and taking into account the cares/concerns
of the audience  to be reached.

Trust is a big part of any message and this  was known as far back as Aristotle. People consider the
following to assess whether someone is a reliable source: Do you care about my concerns? Are you
honest? Do you know what you are talking about? Do you have the power and authority to do what you
say you will do? If any parts of this are missing, it will be difficult for the communicator to be believed.

Furthermore, trust is built on long-term relationships, like an investment bank to draw on in an
emergency. This relies on understanding what the audience already knows, what misconceptions they
might have that need to be addressed,  and what their concerns might be. This is difficult to do during a
crisis; therefore, it is important to develop  such materials with an audience ahead of time. For water
security, this means considering what are the likely water security scenarios, the likely agents to be added,
etc.,  and generally thinking ahead to what people would want to know in those circumstances.

CDC has gone through this process involving 55 focus groups for different hazards - biotoxins,
radioactive, and others.  Initially,  participants' first concerns were the location and safety of their families,
followed by wanting to know about the agent, where it is, whether they can be exposed, what it will do,
and what can the individual do if infected/exposed. This feedback formed the basis  of a series of First
Line Fact Sheets, some of which are posted on the CDC website or are available should an event occur.
While it is not possible to anticipate everything needed, preparing for some of this in advance will help
CDC focus on the event itself and the  unanticipated rather than  conducting communication research at the
same time.
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Keynote Presentation

Vincent Covello provided an informative overview of key risk communication issues to consider in
preparing for a potential crisis. Because the material presented by Dr. Covello is copyrighted, we cannot
directly include it in the Proceedings. Details of his presentation are, however, provided in a video
summary by Dr. Covello under "Keynote Speakers" on the Proceedings Main Menu; along with a related
presentation and article on Message Mapping authored by Dr. Covello, which he provided as handout
materials at the Symposium.

Case Study:  Synopsis of Risk Communication Issues from Multiple Crisis
Tabletop Exercises

Stanley States, Water Quality Manager with the Pittsburgh Water and Sewer Authority, discussed lessons
learned from a variety of training courses that include tabletop exercises conducted throughout the United
States in the last P/2 years. The scope of the various exercises varies, but typically involves classroom
training, group discussion, tabletop exercises (participants play various roles then discuss responses,
interpretations, etc.), full staff exercises (individuals from specific organizations fulfill their roles as they
would in a real situation), and a full-scale exercise. Almost all of the training course scenarios involve the
use of weapons of mass destruction (WMD) (biological or chemical) or the intentional introduction of a
contaminant into drinking water that results in injuries and fatalities. The goal in each case is to obtain
hands-on training utilizing recently published response guidance such as the EPA Response Protocol
Toolbox and the National Incident Management System (NIMS) for incident command and emergency
operations. All of the training includes a public information aspect, regardless of scope and with/without
a professional Public Information Officer (PIO).

Lessons learned from these exercises include the following:
•   All participants appreciate the importance of effective crisis communications and recognize how
    critical this is to effective  response
•   Participants readily understand the need for a common message and a single spokesperson, and
    realize the confusion that  can result from contradictory messages from different agencies
•   Participants understand the necessity for being honest and forthright with the media and the public as
    well as the consequences of not being honest
•   Many participants view the relationship with the media as adversarial, which can interfere with
    effective communication to the public
•   Some participants may be overly reluctant to share information with the public, particularly the water
    industry which tends to be conservative and focused on delivering safe water
•   Participants have difficulty in sharing information with the public that has the shock value of
    terrorism and WMD agents
•   Various  agencies have difficulty determining "who is in charge" during various phases of the incident
    and therefore  who is responsible for delivering the message  to the public
•   Difficulties in maintaining a balance between the risk of overreacting to a false alarm and the risk of
    under reacting to a real situation, particularly when there is a very short time period for issuing public
    notifications and health alerts

Two real past events were also offered as learning experiences.  The first occurred in December  1980 in
an area outside of Pittsburgh where a water utility strike was underway. Someone injected chlordane (a
pesticide) through an air vent  into the municipal water supply system, and starting that evening, people
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began claiming that the water smelled like gasoline (which is common since chlordane is often carried in
a kerosene container). Most people did not drink the water because of the smell, but some got sick, and
the utility had to replace hundreds of hot water tanks and portions of the distribution system that could not
be flushed adequately. The incident was reported, people were advised of what happened and what to do,
and the public did not perceive the incident as dire.

A second incident occurred two days into the Iraqi war and the threat level had been raised to orange
(indicating high risk of attack). A call came in that a yellow substance had been placed into an open
reservoir. While responders were on the way to the reservoir, efforts were initiated to isolate the reservoir
and the health department was asked to meet the utility personnel at the reservoir. Upon arrival of the
responders at the reservoir 10 minutes after the call, they discovered that members of the media were
already present. The incident appeared to involve a heavy deposition of pollen. A real challenge from a
public information perspective was to hold private conversations among the various responders (utility,
public health, emergency medicine, police, fire) to discuss the possible problem and solution with the
media present.  In this case, media personnel were respectful and stayed away from the discussions; but it
was all in view  of the cameras.  Samples were collected in plain clothes, and an emergency analysis was
done that substantiated that the substance was pollen.  All communications involved a single voice and
when laboratory results were available an hour later, the results were immediately released.  The situation
was covered well by the media.

A question and  answer session followed the case  study presentation.  Topics addressed included:
•   When encountering difficulty in balancing the "reaction" to an incident during training, participants
    tend a bit toward over-reaction, but under-reaction happens as well
•   The choice  between under-reacting (and people getting sick) and over-reacting (and people becoming
    concerned)  is difficult, particularly because there is a limited amount of time for decision-making
•   The need to involve more risk communicators (e.g., Public Information Officers) in these training
    exercises, which is a challenge in that many utilities, particularly small utilities, do not have them and
    many that are invited do not attend
•   The importance of tabletop drills to practice the command center operation and to stay focused on
    who the appropriate speaker should be, noting that elected officials often want to take control of the
    situation and use their PIOs for public communication
•   Uncertainties of whether a single spokesperson is possible or desirable as there may be value in
    showing the public that there are diverse agency opinions and there is perhaps a need to  warn the
    public that they will hear different opinions—An alternate viewpoint was that the goal of incident
    command is to integrate  these various opinions and develop a consensus
•   Use of a sole spokesperson that presents what the stakeholders have agreed upon and who also hands
    off specific questions to  other stakeholders (such as technical experts) for the answer
•   The need for the decision makers and elected officials to participate in the tabletop exercises
•   Clarification of the concept of single voice rather than single spokesperson and the confusion that the
    public can have when different persons provide different opinions at the same time
•   The difficulty of handling differing opinions and whether to fake a consensus to have one message or
    go with honesty and have several messages, and the experience in training that participants prefer not
    to be dishonest and strive toward consensus for the public good
•   Unified incident command as a successful method for working out disagreements behind the scenes
    and agreeing on a unified message given the importance of credibility and avoiding confusion of the
    public early in the crisis, which may lose their support and make managing the crisis difficult
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•   The need to recognize limitations in spokesperson representation, such as inappropriateness of the
    health department speaking for the Department of Defense
•   How communication is a large part of the effort in an actual incident and that the public cannot be left
    for a long period of time with nothing being said


Panel on Water Security Communication Initiatives

Linda Reekie, American Water Works Association Research Foundation (AwwaRF), Panel Chair,
provided a brief overview of AwwaRF and introduced the panelists. AwwaRF is a member-sponsored
organization whose mission is to make drinking water safer and more affordable. The organization
conducts research on improving, protecting, and treating drinking water to improve quality, as well as
water security and improved communications.  This panel provided an overview of research underway in
communications and drinking water, and consisted of three presentations.

Communication for Emerging Contaminants and Water-Related Health Risk

Dr. Rebecca Parkin, with George Washington University, discussed several research projects currently
underway with AwwaRF. The first involves the development of a systematic, science-based approach to
anticipate and communicate emerging contaminants and their risks. The research activities included a
literature review, case studies, application of mental models (neural networks) and a classification model,
and development of a strategic decision making aid.

Key findings from this emerging contaminants  research project include:
•   Risk communication is a different type of communication and is an integral part of risk management
•   Strategies must be based on scientifically-derived information rather than guesses, and must be
    specific to a particular area
•   Plant managers are viewed as being responsible for providing information and they need clear,
    visible, open support by their senior management as well as the training and support to interact with
    the community and understand what the community is able to understand
•   Communication activities must fit with the community's interests and preferences, which requires
    interaction to develop this understanding as well as establishment of a visible, positive presence
    before a crisis occurs
•   Risk communication is a part of every step of the risk management process

The literature review showed that risk perceptions are affected by gender, ethnicity,  education,
socioeconomic status, geographic location, and sensory perception. Those who will be most worried
about water problems include women, minorities, lower educational levels, and those who  are poor or live
in stressed urban neighborhoods, and these groups require different outreach and communication efforts.
Also,  in more heterogeneous communities, the  media is more likely to frame issues as problems without
solutions and this requires more complex, creative communication methods.

Recommendations for the corporate level of water utilities as an outcome of the research include:
•   Base strategies on facts not guesses
•   Plant managers are responsible and need support
•   Be visibly present in the community
•   Proactively initiate dialogues
•   Build professional capacity
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A second study is an effort to advance three-way collaborations for addressing water-related risk and
communication.  A primary output is a framework for action to help develop collaborations. Only two-
way collaborations were noted in the literature, even though three-way collaborations are also known to
exist.  Surveys were conducted of 98 water utilities, 150 public health agencies, and numerous clinicians
across the United States. Most of the utilities had worked with a local or state health agency, and many
health agencies had worked with clinicians on water security. The findings overall were that (1) each
entity has many other parties to consider and they have incomplete knowledge about each other—perhaps
only assumptions, and (2) utilities and clinicians have much more contact with health agencies than each
other.

This project has just begun. Key points and lessons learned to date include:
•   The various parties have limited knowledge of what risk communication is or how to use it
    strategically
•   Scientific knowledge is available but under-utilized
•   Experience with collaboration is limited
•   Knowing community concerns builds trust
•   Preparing for strategic risk communication is important

Emergency Communication with Local Governments and Communities

Thomas Rockaway, with the University of Louisville, discussed a research project jointly sponsored by
EPA,  WERF, and AwwaRF on emergency response planning. Dr. Rockaway noted that having one set
plan usable by all organizations is not feasible as each plan must be adapted to the local community and
much is learned in the planning process.

A lesson learned is that a utility is most likely to be prepared for more common or anticipated events.
Examples included annual spring flooding in Louisville and annual fire threat each summer in Southern
California.  The area of difficulty for utilities is dealing with unexpected events such as wildfires
experienced three years ago in Eastern Kentucky where it would have been useful to tap into the Southern
California experience to  help with planning and response.

The goal of this research project is to build a large database of utility knowledge on large and small
events.  Some utilities are very good at being prepared for certain types of events. However, when
Louisville handled notification of a water main break by hanging a notice on the doorknobs of homes,
they found that many did not get the message; but they did when a sign was placed in their yard. Another
finding was that it was important to state information that seemed obvious, such as "even if you have
water at your tap, this [boil water order] applies to you."  The goal of this database is to help distribute
these  experiences.

Other products anticipated from  this research effort include the development of an emergency
communication management system, a template to assist utilities in the decision making process, and a
template for an action plan for emergency  communications. Research activities will include reviewing
communication plans of a small  sample of utility companies, determining a set of probable crisis events
and creating scenarios, and determining the effectiveness of warning and emergency messages to local
government and the public. The  focus of these efforts is on communications and ways to assist, but not
perform, response planning.
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Response Protocol Toolbox: Public Health Response Guide

Susan Dolgin-Ruggles, with the EPA Office of Water, Water Security Division, discussed the newest
module to be released for the EPA Response Protocol Toolbox - Public Health Response Module 5
(www.epa.gov/safewater/watersecurity/pubs/guide_response_module5.pdf). Ms. Dolgin-Ruggles
presented the process that the toolbox sets forth and noted that this particular module is used when a
threat is considered credible and public health response actions should be underway.

The main components of Module 5 are consequence analysis, containment options, public notification,
and alternate water supply. The process is not linear and there are times when consequences are such that
it is necessary to move right to the public notification step. There is a decision tree for public notification
and the issuance of specific actions (e.g., boil water advisory). The Module emphasizes the need for
collaboration.

Public health consequences to be considered include contaminant properties (health effects,
toxic/infectious dose, routes of exposure, fate/transport) and spread of contaminant through the water
system (manual estimation methods and models). Public notification guidance includes content, format
(short, simple, all languages common in the area), and delivery vehicles. In addition, short-term alternate
water supply considerations include water for consumption and sanitation (bottled, emergency supply
stored by consumers, bulk water hauled in) and water for fire fighting.

Overall, the Module discusses the public health response to a contamination threat or incident, and helps
the user to think through the actions necessary to protect public health in a progressive manner. The
overall toolbox has been released in draft final form and can be found at www.epa.gov/safewater/security.
EPA is working on an electronic format to enable the user to quickly get to the information needed since
parts of the module are quite long. There are also plans to develop a simplified document, develop and
conduct training, and develop support tools.

Stakeholder Panel on Best Practices for Planning

Kerry Kirk Pflugh, with the New Jersey Department of Environmental Protection, served as moderator for
a panel session focused on the experience of various organizations in risk management planning,
processes, and tools. She noted that there is  a tendency to ask for a specific tool, a quick fix, and whether
there is an existing plan or exercise that will provide the answer for risk communication; noting that many
view risk communication planning as something added at the end. Quite the opposite, risk communication
planning is part of the entire effort and must address constituent groups throughout the community, earn
trust and credibility, and be able to explain risk. There are many models and tools and in her experience,
she has found most useful the 7-step process that begins with issue identification and goal setting, and
continues through developing messages and methods to evaluating outcome. To be successful, a risk
communication plan must be in place in advance of an incident with all involved parties knowing in
advance what is expected and what their roles are. This approach yields a more positive risk
communication outcome. The panel consisted of five presentations followed by a question and answer
period.

Risk Communication in Washington Township, New Jersey

Mayor John  Horensky, Washington Township, NJ, discussed the challenges of risk communication
planning in a small municipality with five part-time elected officials,  four full-time personnel, and 25
municipal employees. Washington Township is incorporated, consists of 14.5  square miles, and is a split
suburban (large lot) and rural area. The water source is primarily groundwater so there are no reservoirs
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or open water supply issues. For emergency and bioterrorism planning, there is little threat except to
wellheads.  The distribution system is privately owned.

Mayor Horensky also holds a full time job with the health department and, unlike many elected officials,
deals with risk communication on a daily basis, including message mapping. He noted that without this
experience and training, there would be very little risk communication occurring at the municipal level
and that it is important to rely on the utilities and have the risk communicators work with them when
there is a water problem. Incident command training is not required for local government, although
Mayor Horensky has had such training as a result of his job. He has begun developing relationships with
adjacent mayors to address such issues.

In his area, there is a strong belief that the water supply must be protected because of increased demand
for a limited water supply (groundwater) as a result of growth in the Township. As mayor, his goals for
the Township are to provide accurate information and reduce the risk of panic. Objectives in such
circumstances are to identify credible information sources, provide timely updates,  convey concern (built
up through a lot of government interaction with citizens of the Township), and establish trust and
confidence that their best interests are at heart and the information/services required can be provided.

In building relationships, there is a need to identify partners and advocates, the stakeholders (e.g.,
residents and businesses), adversaries (those who wish to derail the risk management program by trying to
make it work for them the way they want), and the apathetic people, which is largely the general public
until an event occurs. Once an event occurs, the apathetic population may move to denial and refuse to
understand that there is a major risk to address,  so it is important to communicate with them in advance.
In Washington Township, the water company goes into the schools, secures grants for schools, and is
viewed as a credible resource that will assist in a crisis.

Examples of where risk communication has been used effectively in his area include:
•   Recent droughts where information was distributed to the local community about water conservation
    measures
•   Pollution episodes that caused discharges to recreational swimming and fishing sites
•   Siltation from construction activities that polluted waterways
•   Elevated levels of naturally-occurring radium and mercury in water
•   How to protect wellheads in their area as part of enhanced security

A key component of successful risk communication is developing partnerships.  This provides a
mechanism for sharing  accurate information, understanding who knows what, and who to go to for what
type of information.  This in turn helps to establish credibility; without credibility, the public will not
believe the message.

Risk Communication at the Los Angeles Department of Water and Power

James McDaniel, Deputy Assistant Manager, Los Angeles  Department of Water and Power (LADWP),
presented risk communication from a big city perspective.  LADWP is California's largest retail water
supplier, serving 3.8 million people over 465 square miles of service area.

LADWP has recent experience with risk communication through a number of incidents:  high chlorine in
the system due to misfeed from a chlorine injector (issued "Do Not Use" alert), Northridge earthquake
(issued "Boil Water" advisory), incidents of noncompliance (sent required health notices that raised
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questions requiring explanation), and post-9/11 issues and precautions. In addition, when taking steps for
their system in response to the cryptosporidium outbreak in Milwaukee, LADWP found a large
potentially impacted population involving immuno-compromised individuals (e.g., having AIDS or
undergoing chemotherapy) that required communication with care givers rather than the affected
individual.

From this response experience, LADWP has evolved a series of response steps that include a risk
communication component:
•   What happened - where, when, who is affected, why
•   Utility response - assessment, actions to take, expected outcome, and outreach to pre-identified
    community partners, including feedback at early stages of expected outcomes
•   Advice for consumers - notice of risk, options to manage risk, mechanisms for feedback or customer
    access, periodic/scheduled updates via the media, and return to service notice
•   Wrap-up - evaluations for internal improvement and external messages

Some lessons learned include the need to begin planning for lifting a "Boil Water"  advisory upon
issuance, giving the public a context for risk management options (e.g., this is like  we did for the
earthquake last year), and working with the media on their news cycle schedules. Another challenge was
that people other than the PIO often want to deliver the messages to the public and  LADWP has had good
experience in having the various PIOs discuss this together and strategize on how to get the message out
to the public.

Tools used to assist in communicating the risk message have included:
•   Signage and road barriers to cover a large affected area
•   Stand-by and contracted language translators to  cover 16 languages, minimum, in the service area
•   Mapping tools for hard copy and electronic delivery, including pre-planning to identify pressure
    zones  and identifying geographic boundaries to use in notifications and return to service messages
•   Standard templates for "Boil Water," "Do Not Use," and "Return to Service"

Also important is the identification of special subpopulations that either need special information or
require special methods to get the information to them. Therefore,  it is necessary to understand how these
special subpopulations get their information and who they trust.  One approach is to build on networks
such as caregivers for the immune-compromised,  schools, hospitals, senior centers, restaurants, large
commercial water users, and those who distribute low flow toilets in the community. Other avenues for
accessing consumers include putting information in the annual report and current actions to create  120
neighborhood councils who can be notified by email.

Partnerships are not easy to maintain, but they are worth the investment of time to do so and to keep up
with changes over time. Partnerships for the water community include regulators (EPA, state/local health
departments), WaterlSAC (for fact sheets on contaminants that are specific to the water industry), rapid
response providers (neighboring utilities and wholesalers), local law enforcement, first responders
(county sheriff, county health, State OES, State Department of Justice), and referral services with other
utilities to share information on laboratories  and mutual aid.

Credibility of the message is critical. Water utilities must resist the pressure to appear to be medical
professionals and should enlist the health department to address such issues.  Water utilities must also
resist the pressure by elected officials to be over-reassuring in messages to the public. A more productive
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strategy is to select the right spokesperson from the most credible institution, avoid discussion of
comparative risks, and be timely, accurate, and useful in all communications.

Communication Initiatives at the Connecticut Department of Public Health

Scott Szalkiewicz, with the Connecticut Department of Public Health, discussed current efforts to
implement emergency response planning and risk communication throughout the State of Connecticut,
which has over 3,000 regulated public water systems, of which 618 are community water systems. After
the events of September 11, 2001, there has been a dramatic change in the number and types of
organizations with which the Department of Health must interact.

The incident command system (ICS) is recognized as the foundation for an effective all-risk emergency
planning and response capability, with a modular organization and consensus orientation in which all
opinions will be heard.  Three key steps in building this capability are to communicate (achieve real-time,
two-way communication), coordinate, and cooperate. Connecticut has held four regional workshops for
first responders and public drinking water  system personnel, formed a Security Advisory Committee (to
develop lines  of communication), and formed an Emergency Response Group (to build skills). Cross-
training is becoming very important to eliminate pre-conceptions and lack of understanding, such as law
enforcement personnel thinking fire hydrants are controls or utility personnel understanding that a break-
in must be handled as a crime scene. In addition, Connecticut has targeted all community water systems
for vulnerability assessments and has not limited the effort to those meeting the EPA minimum criterion.

In conducting these activities, a number of issues have arisen that must be addressed:
•  Lack of continuity for all who need to  receive security and other training
•  Importance of having law enforcement attend training/workshops, which has been difficult
•  Lack of electronic communications access by all entities
•  Apathy from burnout
•  Numerous conflicting activities
•  Independent ("cowboy") behavior, most commonly by law enforcement and water utilities

A key lesson learned is that there is no substitute for professional accountability in providing good, safe
drinking water that has the trust of the consumer, particularly if the health department is brought into the
water utility message. Another critical piece is to coordinate with law enforcement and water suppliers.

To date, over 600 have attended four regional drinking water security workshops, including elected
officials, emergency coordinators, law enforcement, and others.  The focus of the workshops was on a
small pocket guide being given to operators with telephone numbers and other information. This was a
Washington State product that Connecticut refocused to meet its needs.

Other preparation activities underway include:
•  Tying all  systems (Wide Area Notification System, broadcast FAX, telephones, etc.) into a broad
   structure to help spread emergency messages with a focus on calling 911
•  Eliminating mass mailings and placing all information on the Health Department website
•  Making organizational changes

Mr. Szalkiewicz concluded by noting that the keys to success are professionalism, responsibility, and
accountability.
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Crisis and Emergency Risk Communication at the Cincinnati, Ohio Fire Department

Edward Dadosky, District Chief, with the Cincinnati, OH, Fire Department, presented a number of
examples of incidents requiring crisis and/or emergency risk communication and the lessons learned from
these experiences.  In his area, there is involvement in both response and response planning not only by
the City of Cincinnati and Hamilton County, but other parts of Ohio, Kentucky, and Indiana as well.
Hazard sources in the area come from fixed facilities (80 percent) and transportation (rail, highway,
barge, and pipeline).

Some of the communication lessons learned from incidents and drills in the area include:
•   Effective communication is two-way between local and federal entities and each has responsibility to
    communicate with each other whether addressing a rumor or a true emergency
•   The importance of obtaining facts about a situation before proceeding into crisis management mode,
    such as a report by a local company of an inventory shortage of a chemical that could contaminate the
    water supply that turned out to be an inventory error rather than theft
•   Use of effective,  rather than disruptive, communication strategies with the public as demonstrated by
    a 3 am notification for an oleum spill using the air raid siren only to wake up nearby residents and
    then tell them to shelter in place
•   The need to work with the media in advance to address potential communication needs and strategies
•   Use of the health department in the lead communication role in a water contamination event because
    the head of the water utility may not be credible to the public
•   Communication failures can severely limit the response

Notification techniques currently in use include:
•   Outdoor warning sirens, with usage to be modified as described in the example above
•   Emergency alert system, which recently had difficulties in properly delivering a message to the
    television system
•   Telephone trees, blast FAXes, and blast emails
•   NOAA weather radio, which can be used for non-weather-related emergencies
•   Disaster Radio Network to notify hospitals of the types/number of casualties to expect

Learning continues from drills and exercises, which  has resulted in reorganization of equipment (e.g.,
what is being bought), changes in how people are processed (e.g., not separating parent and child
regardless of gender difference), and the need to upgrade speakers in SCBA. In another drill, they learned
that people responded better to direction than general statements such as "fire" or "don't panic." Using
state-of-the-art sound systems and messages that follow the 27/9/3 rule enabled better control of the
crowd as well as credibility  with the crowd.

Plans for future incidents include  drawing on the system of community councils,  cities, and townships in
the area as  focal points for communications and providing central locations for the communicators,
media, and the public to assemble and share information. A Terrorism Early Warning Group is in
development that will include all emergency responders and establish one point-of-contact in each
discipline (e.g., police) that will keep all counterparts in that discipline apprised of the situation and
actions. Also in development is an encrypted communication device (e.g., text messaging, secure
messaging) for use by all emergency responders.
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Communication and Response Planning at the Newport News Waterworks, Virginia

Tom Kahler, Operations Support Manager, with the Newport News Waterworks, discussed post-9/11
communications planning and the importance of developing and maintaining relationships with potential
responders and those who may be affected by the loss of the water supply.  The Newport News
Waterworks is in a unique position of being located in the middle of the largest military-industrial
complex in the world, including weapons, military installations, and nuclear-powered vessels as well as
being only three hours from another potential major target, Washington, DC.

Key questions raised during the events of 9/11 included:  From whom will we get our help? As Security
Manager for the utility, who do I need to talk to? He identified the initial emergency responders (fire
department, law enforcement, emergency management services), and began meeting with the various
organizations to develop both communications and assistance should an event occur. Recommendations
from this process and experience include:
•   Meet and brief law enforcement in all service jurisdictions, including the military
•   Help the SWAT and bomb squads get to know your plants, how to get through them, how to
    communicate with the plants and law enforcement within the plant, which may include provision of
    maps, briefing patrol commanders/officers on how to get around within the plants, etc.
•   Provide tours, information on who to contact within the utility, GIS maps, and the dispatch number in
    case they find something you need to know about (e.g., pipe bomb near a dam)
•   Educate them on the consequences that could exist for the public and vital services should the water
    supply be disrupted, as law enforcement needs to know this to be able to help the water utility in an
    emergency
•   Develop relationships, brief uniformed personnel, and provide HazMat and security information and
    maps


All of these activities are a matter of education and it is important to regularly visit/brief these
organizations to let them know of concerns found through vulnerability assessments, what actions are to
be taken in an emergency, etc. His experience demonstrated that none of the law enforcement personnel
had any knowledge of water system vulnerabilities or that the water system is one of the eight critical
infrastructures (identified in the Bioterrorism Act). Conducting this education and building these
relationships is critical because the water utility must rely on law enforcement assistance in an
emergency. Recommended pre-event actions for a water utility include:
•   Discuss risks and consequences with municipal government(s) as well as areas of mutual assistance
•   Review Memoranda of Understanding with signatory organizations and address with them the unique
    problems that may be encountered for response and recovery
•   Conduct tabletops and other live exercises
•   Interface with first responders and incident commanders regularly since personnel may change over
    time
•   Convey to the public and to large utility users (in his case, two military and one brewery) what to
    expect in an attack

Another important element is communicating with interdependent utilities and vendors to understand
service restoration priorities (for example, whether electrical power is restored to hospitals first and water
utilities second); to get to know key players for water utility recovery such as electrical, gas,
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telecommunications, and other critical suppliers; and to develop the relationships and interface regularly.
In a crisis, having all the players know each other personally helps the response process.

A critical but often overlooked area is access and debris removal. Access to plants and other facilities is
essential for recovery. If debris cannot be removed, it may not be possible to get personnel to vital
facilities. Therefore, pre-planning for access is important, including pre-arrangement of support services
(whether it is by contractor or from the local public works department), and inclusion of all these services
in tabletop exercises.

A final point was to plan for having no functional communication systems and to develop alternatives in
advance for communication needs. Loss of electrical power can mean no landline telephones, no radios,
and no cell phones. After Hurricane Isabel, Newport News Waterworks went without all of these
communications systems for 7 days. Some organizations have generators, and Newport News
Waterworks was able to get messages to the local paper that had a generator and was able to go to print
and circulate information to the public.

Facilitated Panelist Question and Answer Session

Kerry Kirk Pflugh, with the New Jersey Department of Environmental Protection, facilitated an audience
question and answer session on the panelist presentations. Key discussion topics included:
•   Elaboration on Incident Command Structure (ICS) training, which is provided by FEMA, instituted
    through the New Jersey State Police, and passed down to the local level through local emergency
    management offices. This ICS training is a multi-tiered program that takes the user through the
    various stages of incident command.
•   Several panelists discussed automated telephone notification systems. The Los Angeles Department
    of Water and Power (LADWP) is also looking into such a system, recognizing that there are concerns
    about the ability to keep the information current, the desire to use their own database of customer
    accounts/contacts, and plans to test out concepts through the Request for Proposal (RFP) process.
•   Methods to draw local elected officials into the risk communication process, such as inclusion of the
    Mayor of Los Angeles in an  annual workshop with LADWP.
•   Concerns over the role of law enforcement in incident response and how the incident command
    system is an interdisciplinary process that does not allow for control by one entity such as law
    enforcement.  Difficulties have been encountered in the interactions between water utilities and law
    enforcement where  law enforcement initially directed the utility to take certain actions that were  not
    feasible (e.g., translation of potential contamination of one open aqueduct into a response to shut off
    the entire water supply for 9  million people). This further emphasized the need to develop
    interdisciplinary understanding in advance of actual events.


Case Study: Massive Power Grid Outage in 2003  in Cleveland, Ohio

Robin Halperin, Risk Manager, Risk Management Group, Division of Water, Cleveland, OH, discussed
the experience of the water utility during a massive power grid outage, focusing on the risk
communication aspect.  The Division of Water services 72 surrounding suburbs through four service
areas and nine pressure  districts over 600 square miles. Of particular note is the reliance of this system on
pumps because  source water is Lake Erie, which is at a lower elevation than the water collection and
treatment system.

The power outage occurred late afternoon when water supplies were at their lowest.  All four water
treatment plants were reported out, which is very unusual for a system of this size and diversity.  Within


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one hour, the public was requested to begin conserving water. Not many in the public had made the
connection that if there is no power, eventually there is no water. At the same time, some customers
began losing water. By 10 pm, the question became whether to continue distributing water or conserve it
in case the  outage would last several more days. Overnight, more customers lost their water supply, the
Division of Water lost the ability to make more water, and "Boil Water" advisories had to be issued.
Power restoration to one water treatment plant at 4 am the next day began the road to recovery, with
setbacks encountered when the water system was caught in rolling blackouts.  Water system impacts
included extensive depressurization and dewatering, lots of air in the pipelines, water quality concerns,
and loss of water supply to hospitals, the fire department, and other critical customers.

The major difficulty in planning, implementing, and managing a response to this situation was the lack of
information on when the power would return, where Division of Water was on the priority list, and what
to restart first once power was available. Other difficulties encountered included:
•   Lack of response to telephone calls for information by the power company
•   Absence of the County Health Department during the response despite previous understanding that
    they would take over water distribution
•   Limited ability to find suppliers of potable water and obtain their support
•   Balancing the need to stop distribution and conserve water in strategic locations for later distribution
    if the power was out for several days (which would make system restart easier) with the need to
    continue the fire water supply
•   How to restart the depressurized water system
•   How to keep pumps from tripping when the system is dry
•   Whether to pump water before treating
•   Uncertainties as to when power would return to each part of the system, which directly affected
    restart efforts
•   Customers losing water after system restart because the water storage in their part of the system had
    run dry
•   Lack of system maps that had to be remedied during the crisis
•   Communication difficulties where cell phones  and pagers did not work
•   Broadcast information that provided limited utility or could not reach its intended audience (such as
    "Boil Water" advisories to individuals without power for their television/radios)
•   Whether to flush the system until clean water or any water is obtained
•   Whether to issue "Boil Water" advisories to just the customers in potentially affected areas or to all
    water customers

Lessons learned in the risk communication area included:
•   Bringing in all internal players to discuss the risks, how these risks affect the system and its
    customers, and to agree on the message to the public, was extremely important
•   Managing interpretation of the message by external participants, particularly elected officials, can be
    difficult and can result in misinformation (e.g., changing the standard templates for "Boil Water"
    advisories from a 3-4 minute boil time to a 45 minute time when issued to media)
•   Accepting the presence of the media and developing an appropriate frequency for press conferences
    or press releases as it is possible to have too many press interactions without new information
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•   Having elected officials defer specific questions to key personnel present such as was done by Mayor
    Giuliani of New York City, but recognizing that this is not always possible
•   Having an up-to-date and accurate point of contact list for local government, responders, and major
    customers is important
•   Developing a concise and clear message to keep the public informed, while recognizing that the
    media may still interpret or change it
•   Providing a 24-hour call center so that the public can talk to a live person while balancing the
    potential for misinformation through use of multiple call-in lines
•   Determining appropriate locations to stage water buffaloes (portable drinking water tanks)
A customer survey one month after the incident involved over 150 persons in each of the nine water
districts and addressed their experiences with the power outage, water outage, and "Boil Water"  advisory
as well as whether they would support an increase in their water bill to pay for backup generators.
Findings include:
•   Elderly customers were least likely to have heard about the "Boil Water" advisory
•   Television was the primary source of information
•   Less than 50 percent of those who knew of the water advisory followed the instructions (women and
    younger respondents were most likely to have done so)
•   Confusion over who had to comply with the "Boil Water" advisory, which implied the  message was
    not as clear as the Division of Water had thought
•   Confusion about the length of the "Boil Water" advisory
•   Little use of the water buffaloes despite fairly widespread knowledge that they were available
The next steps for the Division of Water in response to this experience include:
•   Improving the standard public relations language, scenarios, and communication plans
•   Coordinating more with the Mayor's press office
•   Developing more templates and scripts
•   Re-evaluating who should be presenting the message, for example, a doctor
•   Evaluating the use of a reverse-911 system to overcome communications issues
•   Developing a plan for water distribution in a crisis
•   Coordinating with county officials (health department, emergency management)
•   Maintaining up-to-date point-of-contact lists
•   Developing better ways to educate the public on what these water notifications mean in an emergency
    so that a "do not use" order is not taken as lightly as the "boil water" advisory was
•   Obtaining backup power for the water system
A question and answer session followed the presentation to clarify the response, survey results, and
lessons learned. Topics addressed included:
•   Finding significant customer willingness to pay additional fees for acquisition of a backup power
    supply
•   How Y2K planning did not help to address the challenges encountered in the power outage, such as
    Y2K budgetary decisions to not buy backup power generators (as power providers assured that would
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    not be a problem) and the technical inability of companies that distribute electricity to take on the role
    of power generation
•   When concerns began to recede (about 4-6 hours after the initial outage) upon recognition that this
    was not a terrorist event
•   Diverse reactions of hospitals to loss of the water supply or "Boil Water" advisory and the  absence of
    hospital plans/preparedness for such contingencies
•   The preference to use water buffaloes for longer-term (more than 30 hour) emergencies given the
    difficulties encountered in their use - instance of arrival full of sanitization solution rather than
    empty, required maneuvering space for delivery truck despite small size of an individual buffalo,
    refilling in place with potable water, and lack of authority to force potable water delivery by private
    companies

Facilitated Audience Discussion

Kerry Kirk Pflugh, with the New Jersey Department of Environmental Protection, facilitated an audience
discussion of other issues not covered in Session 2, as well as any other needs. Key topics included:
•   Public concerns in Cleveland over dirty water upon system restart were more significant than their
    understanding of why they needed to boil their water
•   Increased apathy and denial in New England that water security is an issue, which is making it more
    difficult to properly maintain the equipment and the procedures developed to address such issues
•   The need for water utilities to understand the importance of transparency, candor, and not being over-
    reassuring in their crisis communications, which is unfamiliar to many, and how to bring out more
    interest in the importance of these skills
•   Using a more personal approach to go beyond the Cleveland customer survey in order to understand
    from the general public why the communications during the event did not work as intended and to do
    this before developing the next round of educational materials
•   Obtaining customer feedback 3, 6, or even 12 months after an incident as a better source of
    information to help build a communications plan and budgets for communication
•   Seeking out local organizations who may be able or interested in helping to acquire the "why"
    information from the Cleveland experience or who may provide the funding  for the Division of Water
    to do so
•   Conserving water helped in some areas of the Cleveland power outage, yet the majority of water
    supply loss was the result of system design and the point of water usage for the day at which the
    power outage occurred, which could not be offset by conservation
•   Incorporating into crisis communication planning the concept that this is counter-intuitive and the
    importance of involving someone trained in crisis communication not only in the response but also in
    the post-crisis review and evaluation to help in learning from the experience
•   Increasing chlorination for a few days after restoration of the Cleveland water supply turned out to be
    inadequate additional protection because the chlorine demand of the system was underestimated as a
    result of the extensive depressurization; this led to the need to increase chlorination and for longer
    periods of time while not violating regulatory limits
•   The need to train speakers, particularly executives, and the near-term availability of an executive
    communication module developed by CDC that will be suitable for insertion into various programs
    that executives may attend
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Symposium Close-Out

Jonathan Herrmann, with the NHSRC, thanked everyone for attending and participating. He noted that
the Symposium involved much successful information exchange and interaction.  He offered to all
participants a homework assignment to be received shortly after the Symposium - to identify and
communicate to EPA three take-home messages from this Symposium and the three most challenging
issues that EPA should be addressing. (Send any input to minamyer.scott@epa.gov).

Susan Dolgin-Ruggles, with the EPA Office of Water, Water Security Division, also thanked everyone
for their attention and participation, expressed her interest in participants providing the feedback
requested by Mr. Herrmann, and offered the opportunity for interested Symposium participants to form a
working group to address the suggestions received.
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Appendix A  Agenda

       National Water Security Risk Communication Symposium, San Francisco, CA

Thursday, May 20, 2004

Session 1:        Risk Communication During and Following a Crisis

8:00-8:05        Opening and Introductions by Symposium Chair, Scott Minamyer, USEPA Office of
                 Research and Development

8:05-8:15        Welcome, Wayne Nastri, USEPA Regional Administrator for Region 9

8:15 - 8:20        USEPA Office of Research and Development, Jonathan Herrmann, National
                 Homeland Security Research Center

8:20 - 8:30        Local Risk Communication Perspective, Steve Dennis, Alameda County Water
                 District, CA

8:30 - 8:45        USEPA Office of Water, Susan Dolgin-Ruggles, Water Security Division

                 Keynote Presentation

8:45 - 10:00      Overview of key issues in crisis communication, Peter Sandman, Internationally
                 recognized risk communication expert and consultant (Refer to www.psandman.com)

10:00-10:20     Break

10:20 - 11:20     Peter Sandman overview—Continued

11:20 - 11:45     Facilitated Q&A for Peter Sandman

11:45 - 1:00      Lunch (on your own)


                 Stakeholder Panel on Risk Communication during  a Crisis

1:00 - 1:15        Facilitator Opening and Introductions, Kerry Kirk Pflugh, New Jersey Department of
                 Environmental Protection
1:15-1:30        Terri Stratton, California Department of Health Services
1:30 - 1:45        DavidRopeik, Harvard Center for Risk Analysis
1:45 - 2:00        Denise Clifford, Washington State Department of Health
2:00 - 2:15        Steve Frew, East Bay Municipal Utility District
2:15-2:30        Ed Welch, New York City DEP Environmental Police

2:30-3:00        Facilitated Q&A for Panelists

3:00-3:30        Break
                                             30

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National Water Security Risk Communication Symposium                                May 20-21, 2004


3:30-4:15        Case Study: 1993 Cryptosporidium Outbreak in Milwaukee, WI, Paul Biedrzycki,
                  Disease Control & Prevention,  City of Milwaukee Health Department (30-minute
                  talk and 15-minute facilitated Q&A)

4:15-5:00        Facilitated Open Discussion with Audience (What are other crisis/post crisis event
                  issues not covered today, what is needed, what are emerging tools?), Kerry Kirk
                  Pflugh

Risk Communication Tools Demonstration Session (5:00 - 7:00 PM)
Stations set up for Tools Information Sharing, Demonstrations, and Discussions

Friday, May 21, 2004

Session 2:         Risk Communication in Preparation for a Potential Crisis Event

8:00-8:05        Opening and Introductions, Scott Minamyer

8:05-8:15        Centers for Disease Control and Prevention, Marsha Vanderford

                  Keynote Presentation

8:15-9:15        Overview of Key Risk Communication Issues in Preparation for a Potential Crisis,
                  Vincent Covello, Director, Center for Risk Communication, New York City, NY
                  (Refer to www.centerforriskcommunication.org)

9:15 - 9:45        Facilitated Q&A for Vincent Covello

9:45-10:15       Break

10:15-11:00     Case Study: Synopsis of Risk Communication Issues from Multiple Crisis Tabletop
                  Exercises, Stanley States, Water Quality Manager, Pittsburgh Water and Sewer
                  Authority (30-minute talk and 15-minute facilitated Q&A)

11:00 - 11:45     Panel on Water Security Communication Initiatives
                  Susan Dolgin-Ruggles, USEPA  Office of Water, Water Security Division
                  Linda Reekie, American Water Works Association Research Foundation
                  Rebecca Parkin, George Washington University

11:45 - 1:00       Lunch (on your own)

                Stakeholder Panel on Best Practices for Planning

1:00 - 1:15        Facilitator Opening and Introductions, Kerry Kirk Pflugh

1:15-1:30        Mayor John Horensky, Washington Township, NJ
1:30 - 1:45        James McDaniel, LA Dept of Water
1:45 - 2:00        Scott Szalkiewicz, Connecticut Department of Public Health
2:00-2:15        Edward Dadosky, Cincinnati Fire Department
2:15-2:30        Tom Kahler, Newport News Waterworks

2:30-3:00        Facilitated Q&A for Panelists
                                              31

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National Water Security Risk Communication Symposium                                May 20-21, 2004
3:00-3:30        Break

3:30 - 4:15        Case Study: Massive Power Grid Outage in 2003, Robin Halperin, Division of Water,
                  Cleveland, Ohio (30-minute talk and 15-minute facilitated Q&A)

4:15-5:00        Facilitated Open Discussion with Audience (What are other issues not covered today,
                  what is needed?), Kerry Kirk Pflugh

5:00-5:10        Close Symposium, Scott Minamyer
                                              32

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
                        Appendix B List of Participants
Mr. Brad Addison
Program Manager
GA DNR EPD, Drinking Water
Compliance Program
2 MLK Jr. Dr., S.E., Suite 1362 East Tower
Atlanta, GA 30334-9000
Phone: 404-651-5155
E-mail: brad_addison@dnr.state.ga.us

Mr. Bob Alvey
Public Information Officer
Arkansas Department of Health,
External Communications Team
4815 West Markham, Slot 22
Little Rock, AR 72205-3966
Phone: 501-661-2743
E-mail: ralvey@healthyarkansas.com

Mr. Trevor Anderson
Senior Emergency Services Coordinator
Governor's Office of Emergency Services
3650 Schriever Ave.
Mather, CA 95655
Phone: 916-845-8788
E-mail: trevor.anderson@oes.ca.gov

Mr. Sumedh Bahl
Superintendent
City of Ann Arbor Water Treatment Plant
919 Sunset Rd.
Ann Arbor, MI 48103
Phone: 734-994-2805
E-mail: sbahl@ci.ann-arbor.mi.us

Mr. Roger S. Bailey, P.E.
Utilities Director
CityofGlendale
6210 W. Myrtle Ave., Suite 112
Glendale, AZ 85301
Phone: 623-930-2701
E-mail: rbailey@glendaleaz.com
Dr. Kalyanpur Baliga
Senior Sanitary Engineer
Drinking Water Program
2151 Berkeley Way, #458
Berkeley, CA 94704
Phone: 510-540-2153
E-mail: kbaliga@dhs.ca.gov

Commissioner Thomas Belfiore
Commissioner-Sheriff
Westchester County
Department of Public Safety
1 Saw Mill River Parkway
Hawthorne, NY 10532
Phone: 914-864-7710
E-mail: tebl@westchestergov.com

Mr. Delbert  Bell
Environmental Health Division Manager
Klamath County Department of Public Health
403 Pine Street
Klamath Falls, OR 97601
Phone:541-883-1122
E-mail: dbell@co.klamath.or.us

Dr. Lisa D. Benton
Public Health Medical Officer
CA Department of Health Services, Division of
Environmental & Occupational Disease Control
1515 Clay Street, Suite 1700
Oakland, CA 94612
Phone: 510-622-4453
E-mail: lbenton@dhs.ca.gov

Mr. Paul A. Biedrzycki
Manager, Disease Control and Prevention
City of Milwaukee Health Department
841 N. Broadway, 3rd Floor
Milwaukee, WI 53202
Phone: 414-286-5787
E-mail: PBIEDR@milwaukee.gov
                                            33

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Mr. Frank Blanco
Asst. Water Supt.
City of Phoenix
6202 N. 24th Street
Phoenix, AZ 85016
Phone: 602-262-6081
E-mail: frank.blanco@phoenix.gov

Ms. Laura Blaske
Communication Systems Manager
Washington State Department of Health
P.O. Box 47980
Olympia, WA 98504-7890
Phone: 360-236-4070
E-mail: laura.blaske@doh.wa.gov

Mr. James Bourne
Chancellor, Drinking Water Academy
USEPA/OW/OGWDW
1200 Pennsylvania Ave., NW
Washington, DC 20560
Phone: 202-564-4905
E-mail: bourne.james@epa.gov

Mr. Clifford L. Bowen
Senior Homeland Security Engineer
California Department of Health Services,
Drinking Water Field Operations Branch
2151 Berkeley Way
Berkeley, CA 94704
Phone: 510-540-2173
E-mail: cbowenl@dhs.ca.gov

Ms. Eletha Brady-Roberts
Environmental Scientist
USEPA/ORD/NHSRC
26 W. Martin Luther King Drive
Cincinnati, OH 45268
Phone: 513-569-7662
E-mail: roberts.eletha@epa.gov

Kristi Branch
Sr. Program Manager
Battelle
1100 Dexter Ave. N, Suite 400
Seattle, WA 98109
Phone: 206-528-3336
E-mail: branch@battelle.org
Mrs. Sandy Briggs
Information Specialist
Dept. of Public Health
321 - East 12th Street
Des Moines, IA 50319-0075
Phone: 515-242-6023
E-mail: sbriggs@idph.state.ia.us

Ms. Kate Brophy
Water Quality Project Manager
California Water Service Company
2632 W 237th Street
Torrance, CA 90505
Phone:310-257-1486
E-mail: kbrophy@calwater.com

Captain Alvin Chun
Senior Environmental Health Policy Advisor
USEPA Region 9
75 Hawthorne Street, AIR-6
San Francisco, CA 94105
Phone: 415-947-4190
E-mail: chun.alvin@epa.gov

Ms. Denise Addotta Clifford
Director
Dept. of Health, Office of Drinking Water
7171 Cleanwater Lane
P.O. Box 47822
Olympia, WA 98504-7822
Phone:360-236-3110
E-mail: denise.clifford@doh.wa.gov

Dr. Vincent Covello
Center for Risk Communication
545 Eighth Avenue, Suite 401
New York, NY 10018
Phone: 646-654-1679
E-mail:
vcovello@centerforriskcommunication.org
Mr. Edward J. Dadosky
District Fire Chief
Cincinnati Fire Department
430 Central Avenue
Cincinnati, OH 45202
Phone: 513-357-7521
E-mail: edward.dadosky@cincinnati-oh.gov
                                             34

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Ms. Nicole Damin
Hazardous Materials Specialist
Stanislaus County - Department of
Environmental Resources
3800 Cornucopia Way, Suite C
Modesto, CA 95358
Phone: 209-525-6725
E-mail: ndamin@envres.org

Mr. Scott Damon
Health Education & Communication Specialist
Centers for Disease Control and Prevention
(CDC) Air Pollution and Respiratory Health
Branch
MS El7,  1600 Clifton Road
Atlanta, GA 30333
Phone:404-498-1825
E-mail: scd3@cdc.gov

Ms. Shannon Dean
Director of Corporate Communications
California Water Service Company
2632 W. 237th St.
Torrance, CA 90505
Phone:310-257-1435
E-mail: sdean@calwater.com

Mr. Arnold Den
Sr. Science Advisor
USEPA Region 9
75 Hawthorne Street
San Francisco, CA 94526
Phone: 415-947-4191
E-mail: den.arnold@epa.gov

Mr. Steve Dennis
Emergency Services Supervisor /
Security Manager
Alameda County Water District
43885 South Grimmer Boulevard
Fremont, CA 94538
Phone: 510-668-6530
E-mail: steve.dennis@acwd.com

Ms. Susan Dolgin-Ruggles
USEPA/Water Security Division
1200 Pennsylvania Ave, NW (4601M)
Washington, DC 20460
Phone: 202-564-9895
E-mail: dolgin.susan@epa.gov
Mr. Paul Ekstrom
V.P., Customer Service
California Water Service Company
1720 N. First Street
San Jose, CA 95112
Phone: 408-367-8348
E-mail: pekstrom@calwater.com

Mr. Jim Fay
General Manager
Champlain Water District
403 Queen City Park Road
South Burlington, VT 05403
Phone: 802-864-7454
E-mail: jimf@cwd-h2o.org

Mr. Richard Fontana, Jr.
Homeland Security Coordinator
City of West Haven, CT
281 Connecticut Ave.
West Haven, CT 06516
Phone: 203-996-3233
E-mail: richardfontana@sbcglobal.net

Mrs. Cindy A. Forbes
Southern California Branch Chief
California Drinking Water Program
1040E. Herndon, Suite 205
Fresno, CA 93720
Phone:559-447-3130
E-mail: cforbes@dhs.ca.gov

Mr. Steven G. Frew
Manager of Security and Emergency
Preparedness
East Bay Municipal Utility District
275 11th Street, P.O. Box 24055
Oakland, CA 94607-4240
Phone: 510-287-0881
E-mail: sfrew@ebmud.com

Ms. Diana Barth Gaines, P.E.
Emergency & Safety Program Manager
Zone 7 Water Agency
5997 Parkside Drive
Pleasanton, CA 94588
Phone: 925-447-6703 x225
E-mail: dgaines@zone7water.com
                                             35

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Mr. David Gilmartin
Emergency Operations Planner
Massachusetts Water Resources Authority
2 Griffin Way
Chelsea, MA 02150
Phone: 617-305-5917
E-mail: david.gilmartin@mwra.state.ma.us

Mr. Darren Greenwood
Water Resources Manager
City of Livermore
101 W. Jack London Blvd.
Livermore, CA 94551
Phone: 925-960-8120
E-mail: dggreenwood@ci.livermore.ca.us

Mr. Richard Haberman
Supervising Sanitary Engnieer
California Dept. of Health Services
1040 East Herndon
Fresno, CA 93720
Phone:559-447-3131
E-mail: rhaberma@dhs.ca.gov

Mr. Ed Hallock
Program Administrator
Division of Public Health
Blue Hen Corp. Center, #203 655 Bay Road
Dover, DE 19901
Phone: 302-739-5410
E-mail: edward.hallock@state.de.us

Mrs. Robin Halperin
Risk Manager
Cleveland Division of Water
1201 Lakeside Avenue
Cleveland, OH 44114
Phone: 216-664-2444 x5634
E-mail: rhalperin@clevelandwater.com

Mr. Jonathan (Jon) Herrmann
Water Security Team Leader
USEPA/ORD/NHSRC
26 W. Martin Luther King Dr.
Cincinnati, OH 45268
Phone: 513-569-7839
E-mail: herrmann.jonathan@epa.gov
Ms. Virginia Hodge
Assistant Vice President
SAIC
11251 Roger Bacon Drive, M/S R-4-3
Reston,VA20190
Phone:703-318-4621
E-mail: hodgev@saic.com

Mr. John A. Horensky
Mayor
Washington Township
350 Route 57 West
Washington, NJ 07882
Phone:908-231-7177
E-mail: horensky@co.somerset.nj.us

Mr. Jack Jacobs
Principal Consultant
EMA Inc.
3478 Buskirk Ave.,  Suite  1003
Pleasant Hill, CA 94523
Phone: 925-746-4230
E-mail: jjacobs@ema-inc.com

Mr. Matt Jaqua
Env. Health Supervisor
Yamhill County HandH Serv-Public Health
412 N. Ford St.
McMinnville, OR 97128
Phone: 503-434-7423
E-mail: jaquam@co.yamhill.or.us

Mr. Robert Johannessen
DHH Communications  Director
Louisiana Department of Health and Hospitals
1201 Capitol Access Road
Baton Rouge, LA 70802
Phone: 225-342-6039
E-mail: rjohanne@dhh.la.gov

Mr. John Johnson
Security Technician
Santa Clara Valley Water District -
Office of Security
5750 Almaden Expressway
San Jose, CA 95118
Phone: 408-265-2600
E-mail: jjohnson@valleywater.org
                                            36

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Mr. Thomas G. Kahler
Operations Support Manager
Newport News Waterworks (Virginia)
425 Industrial Park Drive
Newport News, VA 23608
Phone: 757-234-4832
E-mail: tkahler@nngov.com

Miss Nikki Kampen
Water Security Specialist
Department of Natural Resources
101 South Webster St. DG/2
Madison, WI 53702
Phone: 608-266-5240
E-mail: nikki.kampen@dnr.state.wi.us

Ms. Kerry Kirk Pflugh
Manager
Office of Outreach and Education, Division of
Watershed Management, NJDEP
401 East State Street, P.O. Box 418
Trenton, NJ 08625
Phone: 609-633-7242
E-mail: kerry.pflugh@dep.state.nj.us

Mr. Bryan Kunic
California Water Service Company
1712 North First St.
San Jose, CA  95112
Phone:408-367-8312
E-mail: bkunic@calwater.com

Ms. Ava Langston-Kenney
Regulatory Compliance Officer
City of Stockton, Municipal Utilities Dept.
2500 Navy Drive
Stockton, CA 95206
Phone: 209-937-8758
E-mail: Ava.Kenney@ci.stockton.ca.us

Kathryn Lawrence
Chief, Emergency Prevention and Preparedness
USEPA
75 Hawthorne St.
San Francisco, CA 94105
Phone: 415-972-3039
E-mail: lawrence.kathryn@epa.gov
Mr. Alex Leong
Risk Manager
Board of Water Supply,
City and County of Honolulu
630 South Beretania St.
Honolulu, HI 96843
Phone: 808-748-5191
E-mail: aleong@hbws.org

Ms. Carrie Lewis
Superintendent
Milwaukee Water Works
841 N. Broadway, Room 409
Milwaukee, WI 53202
Phone: 414-286-2801
E-mail: clewis@mpw.net

Ms. Helen Ling
Water Resources Regulatory
Compliance Officer
City of Livermore
101 W.Jack London Blvd.
Livermore, CA 94551-7632
Phone: 925-960-8168
E-mail: hfling@ci.livermore.ca.us

Mr. Thomas J. Linville
Assistant General Manager
Contra Costa Water District
1331 Concord Avenue
Concord, CA 94520
Phone: 925-688-8026
E-mail: tlinville@ccwater.com

Mr. Carl Lischeske
Chief, Northern California Section
California Dept. of Health Services,
Drinking Water Field Operations
1616 Capitol Avenue, MS 7404
Sacramento, CA 95899-7413
Phone: 916-449-5596
E-mail: clisches@dhs.ca.gov

Mrs. Andrea Littlefield
Information Specialist
Texas Department of Health
1100 W. 49th Street
Austin, TX 78756
Phone: 512-488-7111 x2916
E-mail: andrea.littlefield@tdh.state.tx.us
                                             37

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Ms. Pam Lowe
Associate Civil Engineer
City of Milpitas
455 E. Calaveras Blvd.
Milpitas, CA 95035
Phone: 408-586-3304
E-mail: plowe@ci.milpitas.ca.gov

Mr. Gary R. Lynch
Vice President - Water Quality
Park Water Company
9750 Washburn Rd., P.O. Box 7002
Downey, CA 90241
Phone: 562-923-0711x201
E-mail: gary@parkwater.com

Ms. Amy MacKenzie
Water Security Specialist
Montana Department of Environmental Quality
Lee Metcalf Building, 1520 East Sixth Avenue
Helena, MT 59620
Phone: 406-444-5360
E-mail: amackenzie@state.mt.us

Dr. Bruce A. Macler
National Microbial Risk Assessment Expert
USEPA Region 9
75 Hawthorne St., WTR-6
San Francisco, CA 94105
Phone: 415-972-3569
E-mail: macler.bruce@epa.gov

Mr. Dennis Mahr
Communications/Legislative Director
Coachella Valley Water District
85-995 Avenue 52, P.O. Box 1058
Coachella, CA 92236
Phone: 760-398-2651
E-mail: dmahr@cvwd.org

Mr. Chet Malewski
Safety and Emergency Response Coordinator
Trudkee Meadows Water Authority
1155 Corporate Blvd., P.O. Box 30013
Reno, NV 89520
Phone: 775-834-8036
E-mail: cmalewski@tmwa.net
Ms. Alina Martin
Environmental Specialist
SAIC
11251 Roger Bacon Drive
Reston,VA20190
Phone:703-318-4678
E-mail: martinali@saic.com

Ms. Deirdre Mason
Project Coordinator
Association of State Drinking Water
Administrators
1025 Connecticut Ave., NW, Suite 903
Washington, DC 20036
Phone: 202-293-4643
E-mail: dmason@asdwa.org

Ms. Maureen R. McClelland
Sr. Public Health Advisor
USEPA Region 1
One Congress Street
Boston, MA 02114-2023
Phone:617-918-1517
E-mail: mcclelland.maureen@epa.gov

Mr. John McCready
Computer Specialist
USEPA/ORD/NRMRL/TTSD/TIB
26 W Martin Luther King Dr.
Cincinnati, OH 45268
Phone: 513-569-7804
E-mail: mccready.john@epa.gov

Mr. James B. McDaniel
Deputy Assistant General Manager -
Water System
Los Angeles Department of Water and Power
111 North Hope  Street, Room 1455
Los Angeles, CA 90051
Phone: 213-367-1050
E-mail: james.mcdaniel@ladwp.com

Mr. Ian Michaels
Press Secretary
New York City Department of Environmental
Protection
59-17 Junction Blvd.
Flushing, NY 11368
Phone:718-595-6600
E-mail: imichaels@dep.nyc.gov
                                            38

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Ms. Marie Milkovich
Risk Communication Coordinator
Michigan Department of Community Health,
Office of Public Health Preparedness
3423 M.L. King Dr. Blvd.
Lansing, MI 48909
Phone: 517-335-9723
E-mail: milkovichm@michigan.gov

Ms. Johanna Miller
On-Scene Coordinator
USEPA Region 8, Office of Preparedness
Assessment and Emergency Response
999 18th Street, Suite 300, Mail Code EPR-ER
Denver, CO 80202
Phone:303-312-6804
E-mail: miller.johanna@epa.gov

Mr. Scott Minamyer
Environmental  Scientist
USEPA/ORD
26 W. Martin Luther King Dr., Mail Stop G-75
Cincinnati, OH 45268
Phone: 513-569-7175
E-mail: minamyer.scott@epa.gov

Mr. Kevin Morley
Regulatory Analyst
American Water Works Association
1401 New York Ave., NW, Suite 640
Washington, DC 20005
Phone: 202-628-8303
E-mail: kmorley@awwa.org

Ms. Katie Mullaly
Public Information Officer
Summit County Health Department
6505 N. Landmark Drive
Park City, UT 84098
Phone: 435-615-3951
E-mail: kmullaly@utah.gov

Mr. Wayne Nastri
Regional Administrator
USEPA Region 9
75 Hawthorne St.
San Francisco, CA 94105
Phone: 415-947-8702
E-mail: nastri.wayne@epa.gov
Ms. Jean M. Nicolai
Operations and Compliance Chief
Vermont Water Supply Division
Waterbury, VT 05671-0403
Phone: 802-241-3405
E-mail: jean.nicolai@anr.state.vt.us

Ms. Janice Okubo
Public Information Officer
Hawaii State Department of Health
1250 Punchbowl Street, Room 326
Honolulu, HI 96813
Phone: 808-586-4442
E-mail: jsokubo@health.state.hi.us

Mr. David Paris
Water Supply Administrator
Manchester Water Works
1581 Cake Shore Rd.
Manchester, NH 03109
Phone: 603-624-6482 x201
E-mail: dbparis@comcast.net

Dr. Rebecca Parkin
Associate Dean for Research
& Public Health Practice
The George Washington University
2100 M Street, NW, Suite 203
Washington,  DC 20052
Phone: 202-994-5482
E-mail: eohrtp@gwumc.edu

Ms. Connie S. Patterson
Communications Director
Missouri Department of Natural Resources
205 Jefferson St., P.O. Box 176
Jefferson City, MO 65102
Phone: 573-751-1010
E-mail: connie.patterson@dnr.mo.gov

Mr. Steve Pellei
Technical Services Administrator
Virginia Department of Health,
Office of Drinking Water
109 Governor St., Room 629
Richmond, VA 23219
Phone: 804-864-7489
E-mail: steve.pellei@vdh.virginia.gov
                                             39

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Dr. Dan Petersen
Biological Scientist
USEPA/ORD/NRMRL
26 W. Martin Luther King Drive
Cincinnati, OH 45268
Phone:513-569-7831
E-mail: petersen.dan@epa.gov

Mr. Marshall L. Racine, Jr.
Superintendent, Water Production &
Distribution
Corona Department of Water and Power
730 Corporation Yard Way
Corona, CA 92880-2051
Phone: 909-736-2479
E-mail: marshall.racine@discovercorona.com

Ms. Christine Reckelhoff
ASPH/EPA Fellow
USEPA/ORD/NRMRL
26 W. Martin Luther King Dr.
Cincinnati, OH 45268
Phone: 513-569-7655
E-mail: reckelhoff.chrissy@epa.gov

Linda Reekie
Project Manager
AWWARF
6666 W. Quincy Avenue
Denver, CO  80235
Phone: 303-734-3423
E-mail: lreekie@awwarf.org

Dr. Thomas D. Rockaway, P.E.
Infrastructure Research
University of Louisville
W. S. Speed Hall
Louisville, KY 40292
Phone: 502-852-3272
E-mail: rockaway@louisville.edu

Mr. John Rodgers
Emergency Planning Coordinator
San Francisco Public Utilities Commission
1155 Market Street, 4th Floor
San Francisco, CA 94103
Phone: 415-554-2458
E-mail: jrodgers@sfwater.org
Mr. David Ropeik
Director of Risk Communication
Harvard Center for Risk Analysis,
Harvard School of Public Health
718 Huntington Avenue
Boston, MA 02115-5924
Phone:617-432-6011
E-mail: dropeik@hsph.harvard.edu

SMSgt Kelly Ruff
Sr. Operations NCO
52nd WMD Civil Support Team
8202 S. Access Road
Columbus, OH 43217
Phone: 614-419-8898
E-mail: kelly.ruff@oh.ngb.army.mil

Dr. Peter M. Sandman
59 Ridgeview Rd.
Princeton, NJ 08540-7601
Phone: 609-683-4073
E-mail: peter@psandman.com

Mrs. Charlotte Smith
President
Charlotte Smith & Associates, Inc.
PO Box 629
Orinda, CA 94563
Phone:925-377-1891
E-mail: smith.csa@earthlink.net

Mr. Richard Staley
Emergency Planning Coordinator
Santa Clara Valley Water District -
Office of Emergency Services
5750 Almaden Expressway
San Jose, CA 95118
Phone: 408-265-2600
E-mail: rstaley@valleywater.org

Dr. Stanley States
Water Quality Manager
Pittsburgh Water and Sewer Authority
900 Freeport Road
Pittsburgh, PA 15238-3132
Phone: 412-782-7553
E-mail: sstates@pgh20.com
                                             40

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National Water Security Risk Communication Symposium
                           May 20-21, 2004
Mr. Jeffrey Stone, P.E.
Engineer Supervisor
Arkansas Department of Health,
Division of Engineering
4815 West Markham Street (MS37)
Little Rock, AR 72205-3867
Phone: 501-661-2623
E-mail: jstone@healthyarkansas.com

Ms. Terri Lee Stratton
Risk Communication Co-Lead
Emergency Preparedness
CA Department of Health Services -
Office of Emergency Preparedness
1500 Capitol Ave., MS 7002
Sacramento, CA 95670
Phone: 916-650-6457
E-mail: tstratto@dhs.ca.gov

Mr. Jeffrey Stuck
Safe  Drinking Water Program, Manager
AZ Department of Environmental Quality
1110 West Washington Street, 5415B-2
Phoenix, AZ 85007
Phone: 602-771-4617
E-mail: stuck.jeff@ev.state.az.us

Mr. Richard Sykes
Manager of Water System Department
East Bay Municipal Utility District
375 llth Street
Oakland, CA 94607
Phone: 510-287-1629
E-mail: rsykes@ebmud.com

Mr. Scott L. Szalkiewicz
Health Program Supervisor
State of Connecticut Department of Public
Health (Drinking Water Division)
410 Capital Avenue, MS#51 WAT
Hartford, CT 06134-3408
Phone: 860-509-7333
E-mail: scott.szalkiewicz@po.state.ct.us

Mr. Mike Uhrhammer
Communications Manager
Padre Dam Municipal Water District
10887 Woodside Avenue
Santee, CA 92072
Phone: 619-258-4613
E-mail: muhrhammer@padre.org
Dr. Marsha L. Vanderford
Acting Associate Director for Communication
Centers for Disease Control and Prevention
1600 Clifton Road, NE, Mail Stop D-25
Atlanta, GA 30333
Phone: 404-639-7290
E-mail: mev7@cdc.gov

Chief Ed Vasques
Asst. Chief (Special Operations)
Sacramento Fire Dept.
3230 J St.
Sacramento, CA 95816
Phone: 916-264-7522
E-mail: evasques@sfd.cityofsacramento.org

Ms. Melissa C. Walker
Public Information Officer
Louisiana Department of Health and
Hospitals/Office of Public Health
6867 Bluebonnet Blvd.
Baton Rouge, LA 70810
Phone: 225-763-3558
E-mail: mwalker2@dhh.la.gov

Dr. Jeannette V. Weber
Water Quality/Laboratory Manager
California Water Service Company
1720 North First Street
San Jose, CA 95112
Phone:408-367-8319
E-mail: jweber@calwater.com

Mr. Lee Weislogel
Special Projects Coordinator
Tualatin Valley Water District
P.O. Box 745
Beaverton, OR 97075
Phone: 503-848-3064
E-mail: lee@tvwd.org

Mr. Edward J. Welch
Chief of Police
New York City Department of Environmental
Protection
465 Columbus Avenue
Valhalla, NY 10595
Phone: 914-742-2048
E-mail: ewelch@dep.nyc.gov
                                             41

-------
National Water Security Risk Communication Symposium
                           May 20-21, 2004
Mr. John Whitler
Environmental Protection Specialist
USEPA/OW/OGWDW/WSD/TAPPB
1200 Pennsylvania Ave., NW, (4601M)
Washington, DC 20460
Phone: 202-564-1929
E-mail: whitler.john@epa.gov

Ms. J. Lindsey Wolf
Program Manager - Public Affairs
City of San Jose Environmental Services
Department
777 No. First St.,  Suite 300
San Jose, CA 95112
Phone: 408-277-5597
E-mail: lindsey.wolf@sanjoseca.gov

Mr. Kelvin Yamada
Staff Environmental Scientist
California Department of Health Services
1616 Capitol Avenue, Suite 174
Sacramento, CA 95814
Phone: 916-552-9999
E-mail: kyamada@dhs.ca.gov
Dr. Marylynn Yates
Professor
University of California
4108HinderakerHall
Riverside, CA 92521
Phone: 909-787-2358
E-mail: marylynn.yates@ucr.edu

Mr. Doug Yoder
Asst. Director, Miami-Dade Environmental
Resources Mgmt. Dept.
PTI Sustainability Task Force
33 SW 2nd Ave.
Miami, FL 33146
Phone: 305-372-6766
E-mail: yoderd@miamidade.gov

Mr. Marvin Young
State Program Officer
USEPA Region 9, Drinking Water Office
75 Hawthorne Street, Mail Stop: WTR-6
San Francisco, CA 94105
Phone: 415-972-3561
E-mail: young.marvin@epa.gov
                                             42

-------
                                                                                             Messages
                                           ufTice  MeaiQ
Content Element
 » Explicit information
Relational Element
 »Implications about
  respect & caring
 »Implied statements
  about power
    Watzlawick, Beavin, &
    Jackson 1967

 SAFER-HEALTHIER- PEOPLE"
                         Credibility:
                         Can I trust you?
                           Do you care and my concerns?
                           Are you honest?

                           Do you know what you are talking
                           about?
                           Do you have the power and authority
                           and do what you say you will do?

                                 • Aristotle
                                 • Max Weber

                SAFER -HEALTHIER-PEOPLE
       Audience Analysis

 What competing beliefs do audiences hold?
 » What misconceptions need to be addressed?
 What are they most concerned about?
 » Addressing their concerns before expecting them
   to attend to other messages.
                                                                          SAFER-HEALTHIER-PEOPLE
CDC1

-------
                    /.rr.",!.    Lessons Learned

                    from Anthrax

                     Increase time available for developing incident-specific
                          ition by
                      „ , ,^-event development, audience testing, and clearing
                        public information
                          Non-incident specific information on bio, radiation, chemical
                          threats and shell documents
                     To decrease perception of contradictions
                        invironmental scanning: address changes/differences
                          What new information have we discovered?
                      » Anticipate changes to come
                          Acknowledge current uncertainties
                          Present guidelines and conclusions as "interim" or
                          "contingent"
                              EALTHIER
                           Information Needs:
                           Across all Agents

                 What is the agent?
                 Where is the agent found?
                 How could I have been exposed?
                 What are the health effects?
                 How can I protect myself and those I care about
                 from exposure/infection?
                 What should I do if I think I've been
                 exposed/infected?
                 Where can I get more information?
       First Line Fact Sheets


Chemicals: Abrin/Ricin, Lewisite, Sulfur Mustard,
Sarin, Cyanide, Paraquat, Phosgene, Sodium
Azide,  Soman, Tabun


Radiation


Biotoxins: Ricin,  Cholera, Ecoli, Typhoid Fever,
Tularemia


  SAFER-HEALTHIER- PEOPLE""
                       12 1 2  3 4  5 6  7 6 9 10 11 12 1  2 3  4 ' 5 6 7 ' 8 ' 9' 10 11

                                                   Hon. 17 May 2004

                   I SdiclBdDai
CDC1

-------
linpfovJntj CDininunJ'Jzitions -ffoin
                                                               Ths JVJJJw2iLJl«3 VViiisr VVorfe  fjyJVVVV)
                                                               business enterprise
                                                               The utility is operated 24 hours
                                                               a day, 365 days a year
                                                               In 2002, the utility pumped and
                                                               distributed 45 billion gallons of
                                                               water to 833,000 people in 15
                                                               communities
                                                               Average 126M gal/day (2003)
                                                               2000 miles of distribution line
                                                               "—oximately 350 employees
                                                                    ir purification, distribution,
                                                                    "'ing, customer service,
                                                                          •:eter installation
                                                                                    Microbe
                                                               ...                 Microbe
                                                               hiking DOdunOCS,  mgy well  '-"p?

                                                               i~-s*"t5 and cafes  htt again  "
                                                                       .•|»ll]j*4T I"LT1    m*_.
                                                               put t IK- kettles on
                          Raging virus
                          hits hard at
                          area schools
                                                               ill .il ,
                    Some will be told

^".irT"!!1!",. ^ to '3O'' c'*y water
                    Those with low resistance at risk
                                                             Crypto illness count raised to 403,000
                                                             sx&iS IspfeS
                                                                     ^Zre/az.'S^Sr .&._,—i *_-- — »uja&_.	•. -^-"—^^~"~

-------
                 j  si vsirjE^y us cor]
"Jrypiozp ofJdJuin
                                                                    4-7 microns in size
                                                                    Not sensitive to chlorin
                                                                    Removed from water primarily by coagulation and filtration
                                                                    Also can be impacted by ozone, UV, microfiltration
                                                                    Can be removed in 1 micron absolute filtration units,
                                                                                      1 minute.
              "Jrypiosp orJcJJosJs
            ngestion of as few as 30 oocysts (DuPont, et
  al,1995), usually C. parvum
  Little information regarding infectivity in
  immunocompromised
  Diarrheal illness with 1-12 day incubation
  Illness can last 30 days (usually 2 wks)
  ~--*-rred immunity unknown
• Magnitude of outbreak (massive exposure)
• Symptoms consistent with ingestion
• Recent and persistent water quality complaints
  (odor, color and taste)
• Absence of any other immediate and plausible

-------
Meteorologic conditions
(rain, snow melt)
Lake turnover and turbidity
(seasonal)
Water intake location
(depth and position)
p'occulant Efficacy
  lidentified f~-'
Howard Avenue plant recorded high turbidities
before and during outbreak, but all regulations m
No mechanical breakdown of flocculators or filters
No other obvious treatment plant failure
All existing MWW protocols followed
       ypj:o5{jorjdjLJjjj cli
                                                                 44,000 doctor visits,
                                                                 4,400 hospitalized,
                                                                 more than 100 deaths,
                                                                 725,000 lost work or school days,
                                                                 $96 million in lost wages and medical expenses
 > 4,000 people filed notices of injury
-1,400 filed claims seeking damages of $25
million
Consolidation into class-action lawsuit (about 540
total)
 City settled for $100,000
     ral Chemical Corp., settled for $1.5 mill'
     oases - $13,500 after attorneys' f«

-------
  Howard Avenue intake extended to avoid
  possible effects of watershed
  Ozone and enhanced filtration installed
  Routine watershed environmental monitor
  for pathogens began
  Water/Health Technical Subcommittee
  Disease Si
sntal monitoring
                                                              Between the water utility and public health
                                                              (where's the flu?)
                                                              Between public health and healthcare
                                                              providers (the "astute clinician")
                                                              Between government and consumers
                                                                omplaint log "insensitivity")
  emergency communications |^,
     die information officer or POC
Pre-identified audiences
Pre-established channels of communication
Clear and authoritative message content
  entified c
 ledia strategy
                                Lack of relationship between MWW and MHD
                                Lack of any response "protocols"
                                Lack of efficient data collection and reporting
                                Professional arrogance and cultural gaps
                                Over reliance/focus on regulatory compliance
                                Desensitr~t;-" *	-*	

-------
P u/jJj c JXJ o cj/j ca cj OTJ 0 OTJ 3J d era cj OTJ 3

-------
  jrkgroup at operational
evel
Joint Data Sharing &
Review
Emergency  Notification &
Response Protocols
'eview of alterations to
 aatment plant Practices
 rofessional and
 ommunity Presentations
Joint Emergency
Preparation & Planning
MWW (operations and engineering)
Public Health (lab, env. and epi)
DPW (storm and sewer infrastructure)
WDNR (regulatory)
MMSD (wastewater treatment)
Policymakers (Mayor and CC)
                                                                     rarrjapiim/jamiU rruiozt
                                                                    rch 2y, 2004 rJovyy/d Phmi
    •Ozone outages
    •Crypto that wasn't Cr/pfo (PCR tests
    negative, contracted Lab did original
    Crypto test—probably algae)
    •Cold Water Ozone Press  Release
     Immunocompromised Brochure)
     SDWA Violation (Tier 3), turbidit

-------
s'/y {Jiiriijijjjjs: Jj/J5irjijg
   'incj syndrornic sind sii/i
                                                      rLJiurB 0<
                                                Vulnerability Assessment  and
                                                Water Security
                                                SCADA system interface with PH
                                                New Disinfection Technologies (UV
                                                microfilitration)
                                                Disinfection By-Products (risk/benefit
                                                analysis)       ^^^^m
                                                New partnerships (EM, FBI,  HazMa
                                                DHS)

-------
                                              uistriDimon system
                                              Disinfectant resistant organisms
                                            • Emergency Response planning,
                                              protocols and training
                                              Hazardous Materials handling and storage
                                            • Cyber assaults
                                            • Deteriorating infrastructur
                                            a Inter-Utility Cooperation
Acl
-------
I
  Communicating During A Crisis:
  Creating a Framework in Washington

           Denise Addotta Clifford
           Office of Drinking Water
   PUBLtC HEAITHI
  I numim VUUIMTOK I
Health
                                                     Communication is Critical

                                                  "The biggest problem with
                                                    communication is the illusion that
                                                    it's been accomplished"
                                                           - George Bernard Shaw

-------
                                                    Risk vs. Crisis Communication

                                                    4 Crisis communication occurs during
                                                     an emergency

                                                     Risk communication includes non-
                                                     emergencies
                                                      • Used for both risk and crisis situations
  Drinking Water Examples


Water Quality Concerns
Health Advisories
Drought/ Floods
Emergencies
  Case in Point: City of Seattle
* Cross Jurisdictional Issues:
  • City of Seattle
  • WA Dept of Health
  • Public Health Seattle - King Co.
    • What are the facts?
    • What are the messages?
     What will the perception be?
     Who is on first?
     Who makes decisions?
  Establishing a Framework

Public Health Emergency Response
Relationship
  Objectives
 • Roles and Responsibilities
  Coordinated Roles and Responsibilities
  Emergency Response: Notification
  Communications
      Taking it on the Road
* Link Important Players Together
  • Department Of Health
  • Local Health - HEALTH OFFICERS
  • Water Utility
  Conduct Workshops Around the State
  • Explore cross-jurisdictional, coordination, and
    communication issues
  • Training on Risk Communications
  • Develop a template for a framework that will
    work for them

-------
I
                                 Office of Drinking Wat
     Emergency Response Tabletops
     Three exercises around the state:
       Coordination between agencies
       Identify the gaps in emergency response plans
       Better understand the roles / responsibilities of
       each responder
     Benefits
      • Growth
      • Partnerships
      • Better overall communications
     Constituent Relations:
  Risk Communication Everyday

  Proactive Issues Management
  Response to Political Environment
  • Fluoride - Supreme Court Ruling
   Water Resource Management
4 Customer Concerns
  • Aesthetic vs. Public Health Problems
4 Budget and Priorities of Government

-------
        tisk Communication:
         f  f  /   f   /    S
            Core Slides
          Vincent T. Covello, Ph.D.

     Director, Center for Risk Communication/

   Consortium for Risk and Crisis Communication

      29 Washington Square West, Suite 2A

          New York, New York 10011

      Tel.: 646-654-1679; Fax.: 212-749-3590

      email: vincentcovello@ix.netcom.com

   web site: www.centerf  ' '
                                         lence-based Approach for
                                     Communicating Effectively in:
                                      High-Concern
                                      High Stress
                                      Emotionally Charged, or
                                      Controversial Situation""
         :isk Communication:
            Kev Messaaes
                .  ,   .
      sk communication is a science
    .__.sed discipline

    High stress, high concern situations
    change the rules of communication
   '  ThaSujyit;
     is aniicipa
     practice
commi
             success
    pryparaiioi
                                      :isk Communication Science
•  8000 Articles in Peer Reviewed
  Scientific Journals
•  2000 Books
•  Reviews of the Literature by Major
  Scientific Organizations (e.g., US
  National Academy of Sciences; Royal
  Society of Great B~:"-:-*
since 9/11 were not just clinical,
epidemiological, technical, issues.
The major challenges were
communication. In fact, as we move
into the 21st century, communication
may well become the central science
of public health practice." (December,
2001)    Edward Baker, MD, MPH,
         Assistant Surgeon General
                                                          =i i iia <« r  iMT
                                                  Communication CDCvnen
                                    A Guide to Emeraencv Risk
                                                   tion Plannin

-------
         aae Develoment
95% R
"95% of all questions and
concerns that will be raised by
any stakeholder in any
controversy can be predicted in
advance."

Implicatio
    itifying Stakeholders and
   Jheir Specific Concerns

Historical Record (e.g., meeting
documents; media reports; logs)
 -Specific
-Related
-General
Subject-matter experts
Role Plavine

-------
          7/9/3 Tern Dlate
     7 words
   •  9 seconds
   •  3 messages
                        lates
      L-4 (clear messages)
2) 27/9/3 (concise messages)
3) Message Maps
                                                               Key Message/Fact
                                                                   3;
                                                              I conquered

-------
  Overarching Message Map (O Map)
 • Addresses:
    What should people know about "x"
    'Vhat you want them to know about
 /  "x" regardless of questions asked
   -What you would put in your opening
    statement about "x"
 • Be sure it gets delivered
   -"Bridge" to it if necessary: e.g., "I
    want to remind you again..."
 • Serves as a "A port in a storm"
             ssage Mr
                  Core, Kev
   Messages)
   Informational Maps
   Challenging Question Maps
                                               Information Forum
Risk Communication Templates
/J~*^LjT f   /  J'
      L-4 (clear messages)
 ) 27/9/3 (concise messages)
3) Message Maps
Risk Communication Template
     GL-4 (clear messages,
"/.
2) 27/9/3 (concise messages)
3) Message Maps
4) IDK

-------
I.D.K. (I Don't Know) Template:
                 I.D.K. (I Don't Know) Template
          Short Form
           Don't Know/Can't
  ri
   Give the Reason Why You Don't
   Know or Can't Answer*
   Indicate Follow Up
adline
   /  /
 .cknowledge/Repeat the Question

Say You Don't Know/Can't

Answer/Wish You Could Answe

Give the Reason(s) Why You Don't
Know or Can't Answer*

Indicate Follow Up with Deadline

Bridge to What You Can Say
     '.K. (I Don't Know) Template:
   , ou are not prepared to answer
  You are not the expert
          lot the responsible party
          t have information or data
  (e.g., it is being i
  You are limited in what can say (e.g.
   (nuiioniiJ security; Jiiicjuiion; privacy)
          Messenae
   'eople judge the messenger before
   he message
    /
   'eople judge the messenger primarily
   in terms of trust

   Information about trust comes from
   non-verbal communication, verbal
   communicatii

   Imolicatioi

-------
      L-4 (clear messages,
2) 27/9/3 (concise messages)
3) Message Maps
4) IDK

                       lates
      L-4 (clear messages)
2) 27/9/3 (concise messages)
3) Message Maps
4) IDK
 ) CCO
                                            isk Cornmunication-
                                        L~~~T ft   s  /—/ _
                                        Non-Verbal Communicatio
                                         Eyes
                                         -- Eye contact
                                         Hands
                                         -- Visible; waist level; small
                                         -- Slight lean forward; relaxed;
                                                                         6

-------
                                            vidge to known facts,
                                           processes procedures or
                                           actions - "Here's what I can
                                           guarantee (assure;
                                           promise...)"
     Guarantee Template
"What I can [guarantee; assure;
 tell; promise] you is..."
                                              isk Communication:
                                          / /^~~r        -T
                                                Kev Messaaes
Risk communication is a science
based discipline

High stress, high concern situations
change the rules of communication
                                                 o commi
                                                            m. and

-------
 Homeland Security — Fire Response Planning
2
                                     3 - NORTHEAST
                                     4 - NE CENTRAL
                                     5-WEST CENTRAL
                                     6- SOUTHWEST
                                     7-SOUHEAST(1)

                                          (2)
    Crisis and Emergency Risk
      Communication impacts
5 organizational concerns:
1. Execute response and recovery
   efforts
2. Decrease illness, injury, and deaths
3. Avoid misallocation of limited
   resources
4. Reduce rumors surrounding
   recovery
5. Avoid wasting resources
   '  Sources of Hazards/Toxics
   •

  Fixed Facilities 80%
  Transportation 20%
   - Rail
   - Highway
   - Barge
   - Pipeline

-------
                Hazardous  Materials
                     Emergencies
   Accidental or intentional
   spills, releases, or
   discharges into the
   environment

   Some are large and result
   in harm to  people and
   property

   Air dispersion modeling
   programs
    - Protective Action Decision
       • Evacuation
       • SIP
                CINCINNATI
    The public can be notified in the

    following ways:

     - NOAA weather radios

     - Outdoor warning sirens

     - TV/radio via Emergency Alert System

     - Door-to-door notification

     - ARTIMIS message boards

     - Email and fax system

        • Phone trees

     - Public address system from vehicles
       NOAA Weather Radios
All Hamilton County schools, licensed
day care centers and senior centers
have NOAA weather radios

Many citizens have weather radios
    (but not 100% coverage)    -_^_
            Disaster Network
The Hamilton County Disaster Radio
Network cpnsists of a series of radios
with a dedicated frequency issued to
Greater Cincinnati area hospitals. The
system is designed to facilitate the
distribution and flow of patients of
multi-casualty incidents to area
hospitals by providing a means of
communication among emergency
responders and receiving facilities.

Once activated, the "Net" links on-
scene command personnel with area
hospitals.

It alerts area hospitals that a mass
casualty incident has occurred,
provides hospital patient capability
information to scene personnel, and
provides incoming patient information
to receiving facilities.
                                                                         DISASTER NET WAS NEEDED
                         Who Concert - 1979
                                                                       Beverly Hills - 1977
                                                                                                  Air Canada - 1983

-------
     TERRORISM INCIDENTS
What Do People Feel Inside
   When
   a Disaster Looms or
   Occurs?


Psychological barriers:
   1. Denial
   2. Fear, anxiety, confusion,
     dread
   3. Hopelessness or
     helplessness
   4. Seldom panic
      TERRORISM  INCIDENTS
ON SCENE
  COMMUNICATIONS

  2002 Paul Brown
  Stadium Exercise
  -Victims confused and
  disoriented


  2003 SORTA Exercise
  -Sound system added to
  evolution
  -SCBA and APR 'speaker'
  upgrade
      5 communication steps that
   boost operational success
  1. Execute a solid communication plan

  2. Be the first source for information

  3. Express empathy early

  4. Show competence and expertise

  5. Remain honest and open
                                  red.',  ,YI
                                    IM
           Paul Brown Stadium
        PBS Tornado Warning
             TORNADO WARNING
      The National Weather Service has issued a
     TORNADO WARNING for the Cincinnati area.
   Conditions may exist that include lightening, heavy
   rain, and hail and a tornado. In an orderly manner,
    please take shelter immediately in the concourse
   area, restrooms and/or parking garage seeking the
    lowest level available. Stay away from all areas
     having windows. If necessary, public address
       announcements will be made with further
                 instructions.
                                                               Great American  Ball Park

                                                                SEVERE THUNDERSTORM WARNING
     The National Weather Service has issued a Severe
     Thunderstorm Warning for the Cincinnati area until.

     Conditions may exist that include lightning, heavy rain,
     and hail and/or high wind.

     In an orderly manner, please take shelter immediately in
     the concourse area, restrooms and/or parking garage.

     Stay away from all areas having windows.

     If necessary, public address announcements will be
     made with further instructions.

-------
     Communication failures that
            operational success
-Mixed messages from multiple experts
-Information released late
-Paternalistic attitudes
-Not countering rumors and myths in real-time
-Public power struggles and confusion
       COMMUNITY COUNCIL
               NOTIFIER
  (52) Cincinnati Community Councils
  Hamilton County has (49) cities/townships
  Pre Incident
  Incident concurrent
  Post Incident
  - Local incident*
  - Terrorism threat level increase
  - Incident in another part of United States
  - World incident
       Community Relations
-Community acceptance through community
  involvement
-Resource multiplier for volunteer "door to door"
  communication
-Involving stakeholders is a way to advance trust
  through transparency
-Our communities, our social capital, are a critical
  element of a nation's security
          City of Cincinnati

  Terrorism Early Warning Group
  Mobile Data Computer Project
  - City/County Fire
  - City/County Health
  - City/County Police
  - Other City/County Departments
  - 33 Hospitals in Tri State Region
  - 8 Communications Centers

-------
Response Protocol Toolbox:
   Public Health Response
            Module 5

            Susan Dolgin
     USEPA, Water Security Division
           Risk Communication Symposium
     Acknowledgements

Steve Allgeier, project lead
SAIC staff
Technical reviewers:
 - Drinking water utilities and organizations
 -State drinking water programs
 -US EPA: OGWDW, NHSRC, OSWER
 - Centers for Disease Control & Prevention
            San Francisco, CA
                                                           Module 5 Overview

                                                       Consequence analysis
                                                       Containment options
                                                       Public notification
                                                       Short-term alternate water supply
             mplement Operational
             Response Actions
Public Health Consequences
Contaminant properties:
-Acute and chronic health effects
-Toxic or infectious dose
-Routes of exposure
- Fate and transport in treated water
Spread of contaminant through system:
-Manual estimation methods
- Distribution system models

-------
                                                            Public Notification Guidance

                                                            Content:
                                                            - Specific instructions to consumers
                                                            -Explanation of situation
                                                            -What is being done to address it
                                                            Format:
                                                            -Short and simple
                                                            - In all languages commonly used in area
                                                         -•Delivery vehicles
                                                            - Broadcast media
                                                               istribution through community centers
Short-Term Alternate Water Supply

 • Water for consumption and sanitation:
   - Bottled water
   - Emergency water stored by consumers
   - Bulk water hauled to distribution center
 • Water for firefighting:
   - Pumper trucks filled from neighboring
     supply
   - Untreated water
   - Contaminated water if no other
        lediately available alternative
            Summary
Public health response to a
contamination threat or incident:
-Actions to protect public health in response
  to a credible threat or confirmed incident
- Containment may be effective, alone or in
  combination with other actions
- Public notification may be necessary to
  prevent exposure
- Consider public health response actions in
  a progressive manr--
        RPTB - Next Steps

  Integrate all Modules into an e-RPTB
  Develop a "simplified" RPTB
  Develop and conduct training
  Develop tools to support the RPTB
     Availability of RPTB

-------
(kc eCcvcCand Division of Water's
            Experience
                           Robin Halperin
                            Risk Manager
               Cleveland Division of Water
                                                            'D System Overview
                                                     The Blackout - Sequence of
                                                     Events @ CWD
                                                     Water System Impacts
                                                     Lessons learned
                                                     Risk Communication Issues
                                                     Questions?
I— THE PLAIN IMiALKK -.-
  BLACKOUT
 Mil lull-- stniKKk' without |«HM1
            «*•
  .1    -          >
                                                       ICof* Systu* @ *:W PM. t/tt/09

-------
 VMm tyefo* @ IO.-W PJH. I/W03
VMM System @ 10:00 tun. IftffOt

-------

-------
                              Internally
                               •  Needed to fully evaluate
                                 impacts of Blackout on our
                                 system
                               •  Needed to agree on risks and
                                 message to customers
                              Externally
                               •  Effectively communicate risk to
                                 outside agencies
                               •  Limit "interpretation" of
                                 message
                              Media/Public
                               •  Needed to conduct Press
                                 Conferences & issue Press
                                 Releases
                                                                            Media &  PhMic Relations
   -yor's Office
   eveland Public Power
   lyahoga Coui
   hio EPA
 Suburban Governments
  • Police & Fire Departments
  • Mayors & Managers
  • Up-to-date & Accurate list?
  • Water Buffaloes
 Critical Customers
'Overall - CWD maintained good
 communications, except for with County
  riority - keep the public
 iformed in order to protect
public health
Primary Communication Route =
Media
 • Provide a clear & concise message
 • Regular Briefings with Media
 • Press Office "interpretation"
 • Media "interpretation" or
   "editorializing"
Established Call Center
 • Real Person to talk to for answers
 • Trained personnel?
    nserve Water
   i  Misreported only 2 hours
     water left
   oil Water Advisor;
   •  How to communicate wit
     many customers without,_
   •  Is anyone getting the message?
   •  Accuracy?
      • Boil water to wash dishes and
        brush teeth?
      • Boil for 45 minutes?
  Water Buffaloes

-------
                                                                                             Survey Resets
     Conducted in November 2003
     1200 Telephone Interviews
     Covered Entire Service Area
     Topics Covered:
        Electric Power Outage Experience
        Satisfaction with CWD
        Water Outage Experience
        Boil Advisory
        Water Buffaloes
        Support for Backup Power System
                 rf Boil Advisory
        stomers 65 and older were least likely to have
       jard about the boil advisory (87.4%)
   TV/news main source of info (83.2%)
   <50% reported having to boil their water
    • Females were more likely than males to say they
      had boiled water, as were younger respondents
   Confusion regarding who had to boil their water
    • 41.6% - only to customers who lost water service
      completely
    • 32.1.% - all customers
   Length of Boil Advisory varied from one day to
   longer than 2 days.
Customer Survey
Next Steps
   .gg^—,.	omers
   (53,2%) heard abo.
   water buffaloes
    •  Caucasian customers were
      significantly more aware of
      water buffaloes than African
      American customers
   Only 2.2% actually used
   them
   TV/news was most popular
   news source (87.7%)
                       Improvimg Standard PR Language &
                       Communication Plans
                        • Templetes & Scripts
                        • Consider all layers
                        • Who is sending the message?
                        • Call Center (Joint? Script? Expertise?)
                       Considering a Reverse 911 system
                       Develop (Real) Plan for Water Distribution
                       Coordinate with County Officials
                        • Health Department
                        • Emergency Management
                       Maintain up-to-date list of Suburban Police
                       &Fire
                     t Public Education?
                     • And, 48 MW Backup Power

-------
       W
   ter Security Risk
imunication Symposium
           San Francisco, CA
            May 21, 2004
                                              Types of v\
                                              W-ishirinrr
                                                    aier systems in
                                                    n Township
                                                        well water
                                                    y sources
     John Horensky, Mayor
     Washington Township
      Warren County,  NJ
           and community
       ns of water

      onsumption continues to
...-U-B-il
Water resources are being depleted
Water is safe to drink
Water resources need to be protected
                                        Risk CommunicBi
                                        Bine  Objectiv
                                                                     ion Goals
                                                  Provide Accurate Information and
                                                  Reduce Risk of Panic

                                             jeciives:
                                                  -Identify Credible Information
                                                   Sources
                                                  -Provide Timely Updates
                                                  -Convey Concern
                                                  -Establish Trust and Confidence
Building

  J VVhc
               iships
  no are your stakeholders?
Who are your adversaries?
Who are your apathetic people?
                                        Wrier) to J	
                                        Communication^
                                             Charges to recreational swimming/
                                           fishing sites
                                           Waterways polluted by construction
                                           activities
                                           Elevated levels of natural substances in
                                           water
                                           Security issues
                                           Water usage by other entities

-------

-------

   USEPA Water Security Risk
   Communication Symposium
   San Francisco, CA
   May 20-21,2004
   Tom Kahler, Operations Support Mgr
   Newport News Waterworks
   Newport News, Virginia
    Planning Communications
    Prior to an Event
Meet with Law Enforcement

* Meet and brief Law Enforcement in all
  service jurisdictions, regional JTTF, WMD
  Coordinator, Military
* Do SWAT, Bomb Squads know your plants
* Provide tours, who to contact in utility
* What consequences could exist for Public,
  Vital Services
* Develop relationship; brief uniformed patrol
  Supervisors—provide HazMat maps
 Local jurisdictions
» The Utility and Municinal Governments
  should discuss risks and consequences prior
  to event
* Review MOU's and unique problems for
  response and recovery
* Conduct Tabletops, exercises; interface with
  First Responders, Incident Commanders
* Convey to the public and large users what
  to expect in the event of attack
Communicate with
Interdependent Utilities, Vendors
* Interdependent Utilities - rjlans an<
  priorities to support response & recovery of
  vital services; Hospitals, Water, Fire, Roads
  Know key players personally: Electric,
  Gas, Telecommunications, and Critical
  Vendors
* Again, develop relationships, interface!
* In a crisis, knowing the person on the phone
  is a big advantage
Access/Debris Removal Support

 * Access to plants—facilities is essential
 * Debris Removal snnnort will be vital in
  recovery to plants and other facilities
 * Getting personnel to assigned locations for
  recovery is imperative
 * Have a listing of pre-arranged support
  Include in Tabletops, Exercises

-------
Plan for no Communications.
Loss of Power Means:
* No landline phones (digital, analog maybe)
* No radios
* No cell phones
* Develop Alternatives!
interest.

Thomas G. Kahler
Operations Support Manager
Newport News Waterworks, Virginia
tkahler(S)nneov.com 757-234-4832

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     Los Angeles Water and  Power
           Risk Communication
Jim McDaniel
Deputy Assistant General Manager
        L.A. Water System
4 LADWP's Water System:

     • 7,100 miles of pipeline

     • 106 reservoirs and tanks
     • 338 mile aqueduct system

     • MWD's Colorado River
      Aqueduct and State Water
      Project
     • Local groundwater, primarily
      in the San Fernando Valley
          L. A. Water System
    California's Largest Retail
    Water Supplier
       • $400+ million annually
       • Serving 3.8 million
       • 465 sq mile service area
  Open aqueducts
        Main Treatment Facility
By-Passing Distribution Reservoirs
                                                            Hollywood Reservoir
                                                                                       Stone Canyon Reservoir

-------
        Covering other Reservoirs
     Elysian Reservoir
                                   Sitvertake Reservoir
                                                                             Experiences
                                                                High chlorine - Do not use
                                                                - business district, restaurants Hollywood
                                                                Cryptosporidium - Check with Care Giver
                                                                - immune compromised
                                                                Northridge Earthquake - Boil Water
                                                                - Geographical sub area of city
                                                                SWTR Agreement - Mandatory Health Notice
                                                                - More disinfectant but safe
                                                                Post 9/11 preparations
     Communications Structure
   Communications Structure
  What happened
  - Where
  -When
  - Who is affected
  -Why
  Utility Response
  - Assessment
  - Actions being taken
  - Expected outcome
Advise for Consumers
 - Notice of risk and managing risk
 - Feedback/ customer access for concerns
 - Periodic/ scheduled updates via Media
 - Return to service notice
Wrap-up
 - Evaluations - internal
 - Opportunities for improvements - internal
 - Message on event - external
* Staffing
  - Communication manager and staff as partofWEC
  - 24/7 Field communication, door hangers, signage
  - Stand-by / contracted  Language translators
* Tools
  - Mapping tools for hard copy and electronic delivery
  - Standard templates...
     •  "Boil Water", "Do Not Use", "Return to Service"
     •  Multiple Language
                                                                            Best Practices
Customer considerations
   • Care givers for Immune-compromised
   • Kidney Dialysis, Fish Owners
   • Schools
   • Hospitals
   • Senior Centers
   • Restaurants
   • Large Commercial Water Users

-------
            Best Practices
Venues for access to consumers
 - Electronic, voice and fax ability
 -TV, RADIO, WEB-SITES
 - Updated partnerships contacts
   • Media contacts
 - Special sub-population contacts
   • Neighborhood watch groups, councils
 - Special phone call service for high volume Dial-out
            Best Practices
Partnerships (Other)
 - Local Law Enforcement,
 - First Responders
 - County Sheriff
 - County Health, public health monitoring
 - State OES
 - State Dept. of Justice, criminal investigations
       Tools and  Resources
Partnerships ( Water Community )
 - Regulatory - EPA, State Health
 - Referral Services - State Labs, Mutual Aid
 - ISAC... fact sheets on contaminants
 - RAPID RESPONSE., neighboring utilities and
  wholesaler
            Parting Words
Credibility of message
 - Select right spokesperson from most credible institution
 - "Timely"
 - "Accurate"
 - "Useful"
 - Past performance will influence

-------
       Strategic Health Risk
   Communication by Water
               Utilities

       Rebecca Parkin, PhD, MPH
   The George Washington University
            Washington, DC
              EPA Water Security Meeting
              Overview

Two AwwaRF projects
 - 2776: Identifying and Communicating about
  Emerging Contaminants
 -2851: Advancing Water-Related Health Risk
  Communication
Highlights
Key Points
2776: Emerging Contaminants

Goal = Develop systematic, science-based
methods for anticipating and communicating
about emerging contaminant risks
Project partners
 — Des Moines Water Works
 — Princeton University
 - Decision Partners, LLC.
Primary output = decision-making tools
          2776: Methods
  Literature reviews
   — Risk communication
   — Psychology
  Case studies
   — Chemical industry
   — Electric power
   - Military health
  Mental models
   - DMWW experts
   - DMWW customers
   - Website analysis
Classification model
 — Based on scientific
  results
 - Used DMWW data
 - Predictive of
  "emerging" issues
Strategic decision aid
 - Based on literature,
  cases, models
 — Assess probability of
  risk communication
   2776:  Case Study Lessons

Risk communication is not the same as
communication; it's integral to risk management
Strategies must be based on scientifically derived
information
Plant managers are responsible for local programs,
but they need clear senior management support
Activities must fit communities' interests and
preferences
A visible, positive presence must be in place
before a crisis occurs
                             Risk
                             Management
                             Paradigm
                             Adapted from CSA (1997)
                                  Decision Step
                                                                                                 Next Step or Take
                                                                                                    Action   6

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2776:  Literature Results
  Risk perceptions are
  affected by:
   — Gender
   — Ethnicity
   — Education
   - Socioeconomic status
   - Geographic location
   - Sensory perception
More heterogeneous
communities
 - Are more likely to have
   news coverage that
   frames issues as
   problems without
   solutions
 - Require more complex,
   creative communication
   methods to increase
   impacts
          2776: Mental Models

  Method                Key Findings
  Develop the expert model * Expert model expanded Team's views
   - DMWW Steering Team
   — One session, one follow up
     call
  Conduct mental models
  interviews
   — On the phone
   - In person for website
     analysis
of the i
Customers largely favorable about
DMWW
BUT "emerging" and "emergency"
get confused
In crisis, customers want a trusted,
local source of information
They want to know what they can do,
what utility will do
Trust of utility affected (+/-) by
website experience
2776: Strategic Risk  Communication
  Decision aids developed
   - Media data retrieval and
     archive system
   — Classification model
   - Diagnostic tool
  Major findings
   - Limited media content
     analysis is valuable
   — "Frequency" and
     "population" predicted
     DMWW's communication
     decisions
  Factors that increase the
  probability of "emerging"
  communications relate to
  - Contaminant
  — Concerns
  — Population
  - Society
  - Utility
  How these affect decisions
  may vary among utilities
                                                2776:  Major Recommendations
Drinking water industry
•  State risk communication duties
  publicly in values and professional
  code of conduct
•  Success  and credibility require
  vision - beyond tactics - to create
  and implement strategies
•  Study understanding of "emerging"
•  Validate our classification model in
  other areas
•  Test our diagnostic tool in other
  service areas
  Corporate level
  •  Base strategies on facts, not
     guesses
  •  Plant managers are
     responsible, need support
  •  Be visibly present in
     communities
  •  Proactively initiate dialogues
  •  Begin building professional
     risk communication capacity
     now
 2851:  Three-way Collaborations
  Goal = Advance
  collaborations for
  addressing water-related
  risk communication
  Project partners
   — Five water utilities
   - Natl. Asso. of County City
     Health Officials (NACCHO)
   — Asso. of Occupational and
     Environmental Clinics
     (AOEC)
      Three sets of
      collaborators
       - Water utilities (U)
       - Health agencies
         (H)
       - Clinicians (C)
      Primary output =
      Framework for
      Action
                                                             2851:  Methods
  Data collection
  Data analysis
  Framework for Action
  (Data application)
  Literature review
  Utility survey
  Health agency survey
  Clinician interviews
  In progress
  Pending

-------
      2851: Literature Review
  Three-way (U-H-C)
  not documented
  Two-way interactions
  reported generally
  Themes
   — Relevance
   — Longevity
   - Trust
   - Need
Various communication
tools found
 - CCRs
 — Fact sheets
 — Media reports, releases
 - Formal agreements
No peer-reviewed
evaluations of most
(except CCRs)
                                        2851: Utility Survey
98 utilities
 - All regions of the USA
 - 92% = public
 — 53% = over 20 employees
Respondents
 — Most = GMs, managers
 - 87% = male
 - 51 % over 20 years in the
   business
 — 65% lived in service area
 Population served
  - 31% under 10,000
  - 33% over 100,000
 Health agencies in
 service area
  - 15% = over 10
    agencies
  — 2% didn't know
   2851: Health Agency  Survey
  160 agencies
   -  All regions of the USA
   —  67% = county agencies
   -  53% = over 20 employees
   —  67% = environmental health
     unit handles water issues
  Respondents
   -  74% = male
   —  45% = directors of 2+ units
   —  48% = over 20 yrs work
   -  72% lived in service area
Population served
 - 5% up to 10,000
 - 44% over 100,000
84% =  more than one
utility in their area
 - 3 7% over 10 utilities
 — 4% didn't know
                                             2851: Clinician Interviews
Practices
 - All areas of the US A
 — 43 % practices with
   over 5 clinicians
30 participants
 - 87% = MDs
 - 63% = male
 - 43% had 20+ yrs work
 - 93% live in service
   area
Population served
 - 7% up to 100,000
 - 60% over 500,000
67% = more than 1
utility
 - 17% over 10 utilities
 - 23% =didn't know
   Utilities and Health Agencies
Nearly 90% U had worked
with local or state Health
agencies
 — 78% with specific person
   (most often, the director)
Half had formal
agreements
Want more collaboration
and more frequent
communication
 63% H had worked with
 a Utility
  - 28% with specific person
   (most often manager)
 Half had formal
 agreements
 Want more
 collaboration and more
 frequent communication
                                                Utilities and Clinicians
About 33% U had
worked with C
Nearly 67% U had C
in emergency plans
 - 17% worked with C
 - 83 % rely on H to be
  link with C
90% had no
experience working
withU
 - 60% had received CCR
100% willing to
collaborate with U
 — 53% said 4+ per year

-------
Health Agencies and Clinicians
 54% H had worked with C
 - Most with MDs
 — Others = nurses, dieticians,
   ^e;::^m^ ;knin;i!-> tic
 58% worked with C on
 emergency response plans
 62% worked with C on
 water security
Most had worked with H
agencies
 — About 33% once/year
 — 17% monthly
33% had worked on
emergency response plans
100% willing to work with
H agencies
 - 23% had been contacted by
   H
    Three-way Collaborations

Reported by 28% of the health agencies
16% worked on susceptible subpopulations
 — Children, pregnant women
 - Elderly
 - Immune compromised
 — Chronic gastrointestinal disease patients
 - Cancer patients
 - HIV/AIDS patients
Range of chemical and microbial topics addressed
             2851: Themes

Each entity has multiple entities in the other two
sectors to consider - where to start?
 — There is incomplete knowledge about each other
Utilities and clinicians have much more contact
with health agencies than with each other
 - Contacts focus on the top official
 — Relationships are usually reported as positive
Few three-way contacts have been documented
Sectors communicate about the same issues, but to
different extents
                                           2851: Workshop

                                           • March 2004
                                           • Representatives from
                                              - Five water utilities
                                              — Public health agencies
                                              — Medical facilities
                                              - Academic institutions
                                              — Elected officials
                                           • Presentations
                                           • Breakout sessions
                        Utilities, health agencies, and
                        clinicians
                         — Have limited knowledge of each
                           other, others' roles and routines
                         - Have multiple entities to work
                           with
                        Clinicians prefer contact by
                        clinicians or scientists
                        Health agencies best serve as
                        the clinician-utility link
                        Few organizations have formal
                        plans or means to communicate
                        with each other
           2851:  Next Steps

 Finalize the workshop results
 Draft Framework for Action
 Table top exercises
 Finalize the Framework
 Disseminate the results
                                                            Key Points
                                           Status quo:
                                           •  Limited knowledge of what risk communication is or how
                                             to use it strategically
                                           •  Scientific knowledge available is under-utilized
                                           •  Experience with collaborations is limited
                                           Lessons learned:
                                           •  Knowing, acknowledging and responding to concerns
                                             builds trust and visible, positive presence
                                           •  Preparation for strategic risk communication is crucial; it
                                             requires senior management support, time and partnerships
                                           •  Simple tools are developing to aid decision processes
                                           •  Risk communication is integral to risk management

-------
        Acknowledgment

The George Washington University gratefully
acknowledges that the Awwa Research
Foundation is the joint owner of the technical
information upon which this presentation is based.
The George Washington University thanks the
foundation for its financial, technical, and
administrative assistance in funding and managing
the project through which this information was
discovered.
LJ Oil

-------
    Emergency Communications with your
Local Government and Community, 03cts5s

Funded by the Water Environment Research Foundation (WERF) through
USEPA Homeland Security-Wastewater Security Agreement #83075101-0
and as a cooperative project with the American Water Works Association
                Research Foundation (AwwaRF)

                Principal Investigating Team
          University of Louisville Research Foundation
Thomas D. Rockaway Ph.D., P.E., Center for Infrastructure Research
  David M. Simpson, Ph.D., AICP, Center for Hazards Research and
                    Policy Development
                    Presentation to the
    National Water Security Risk Communication Symposium
                    San Francisco, CA
                     May 20-21, 2004
              Emergency Communications,
                    Project Objectives
   1 .  Determine optimal processes and systems for situational analysis,
     message creation, and information dissemination.
   2.  Evaluate the effectiveness of emergency communication messages,
     using established literature and a combination of survey and structured
     content analysis process methodologies for determining situational
     appropriate messages. Additionally, emergency messages will be
     evaluated for their efficacy and impact using representative head-of-
     household focus group methodology.
   3.  Create an emergency communication management system which
     includes: 1) a decision-tree template to assist utilities in the decision
     making process; and 2) a message storage and retrieval system, which
     would assist in the selection and implementation of a range of appropriate
     emergency messages
   4.  Create a template for an action plan that will increase public awareness
     of risks and the emergency communication process in the community.
          Emergency Communications,
                    Work Tasks

    1. Review communications plans of a small sample of utility
      companies
    2. Determine set of probable crisis events and create scenarios
    3. Determine effectiveness of warning and emergency
      messages to local government and the public.
    4. Review of existing systems and  content analysis of cross
      section of sample messages in use
    5. Create test messages for the scenarios
    6. Test the messages using intense focus groups
    7. Develop web enabled system for simplified distribution
                                                                                 j
Emergency
Communications,

Work Flow
Emergency
Communications,

Database
Management
  Center for Hazards
                                                                                   Metropolitan Sewer
                                                                                   Metro Louisville
                                                                                   Emergency
                                                                                   Bioterrorism
                                                                                                        mications. Project Investigating Tea
                                                                                                                    rarispcrtfiti

                                                                                                                    -J'"VERi: ;-•

-------
              Emergency Communications,
           Refining the  Research Approach


   > Project focus is Communications, not an Emergency
     Response Plan. However, results should add value to ERPs.

   >  Determine an appropriate set of scenarios (i.e., flooding to
      bio-terrorism)
       • Is the determining factor the "agent" or "speed of onset"?
       • How many to do?

   > How do you create a guidebook generic enough to help most
     communities, but not so generic that it is meaningless?

   >  What are the most effective strategies for testing messages?
      focus groups? tabletop exercises? full drill? other?
              Emergency Communications

             Project Acknowledgements


                    WERF Project Subcommittee
   Frank Blaha, American Water Works Association Research Foundation
   Bob Adamski, Gannett Fleming Engineers and Architects
   Susan Dolgin, U.S. EPA
   Stephen Frank, APR, Denver MetroWastewater Reclamation District
   Paula Kehoe, San Francisco Public Utilities Commission
   Linda MacPherson, CH2M Hill
   Erica Michaels Brown, Assn of Metropolitan Water Agencies
This work was funded by the Water Environment Research Foundation (WERF)
through USEPA Homeland Security-Wastewater Security Agreement #83075101-0
and as a cooperative project with the American Water Works Association Research
Foundation (AwwaRF)
We welcome your comments and appreciate your interest! For additional information:
•  Bonnie Bailey, WERF Project Manager, bbaileviaiwerf.org. 703-684-2470x7540
•  Tom Rockav.'aj'. C<;iii:ef frr Infrastructure Research. Uriiv. of Louisville,
   502-852-3272, rockaway@louisville.edu
        Emergency Communications,
        Your Assistance Welcomed
>  Examples of good communications plans/systems that
   audience members are familiar with

>  Examples of warning messages that audience members
   think are particularly effective

>  Examples of communities that have been through an
   event and revised their message system or approach

-------
            AFETY
             Greater Risk
           AFETY
            Greater Risk
            SAFETY
             Greater Risk
  IT COMES M0RE FROM
WHAT YJDU DO THAI
FROM *₯HAT Yj
 POLICY, NOT PRESj
           "• 'reater Risk
 OPENNESS. CONSTANT
 COMMUNICATION.
> DONjf OVER
> ACK^OWLEDG
         PUBLIC
            AFETY
             Greater Risk
YOU DO AND SAY.
           AFETY
            Greater Risk
                                             evabt Risk Perception

-------
                 AFETY
                 Greater Risk
       rs
    sonal Risk
 Awarenes
                AFETY
                 Greater Risk
        levant Risk Perception
      irs
    rsonal Risk
'Lack of C
^Involuntary
                 AFETY
                 Greater Risk
                                                     evahl Risk Perception
                 AFETY
        levant Risk Perception
      )rs
   S-sonal Risk
              _JL
^Lack of Control
              ^^ Greater Risk
-X

-------
       SYNOPSIS OF  RISK
  COMMUNICATION ISSUES
   FROM  MULTIPLE CRISIS
    TABLE TOP EXERCISES
                     Stanley States
                     Water Quality Manager
                     Pittsburgh Water and
                       Sewer Authority
         Executive
         Operator/Distribution/Collection Personnel
         Small Utilities

    150 classes presented nationwide

    !1/2 hr. table top exercise
    WA 2-Day Course
  First Response Strategies and Protocol for
  Water Utilities and Public Health Staff'

  Denver CO, Atlanta GA
   hr. table top exercise
          , Security Committee
      msburgh, Philadelphia, Harrisburg,
      i hr. table top exercise

EPA Region III Security Workshop
     Baltimore, MD
     3 hr. table top exercise
     Table Top Workshop/Exercise
   ecurity Related Emergency Response for Water
   Utilities'
   2 cities nationwide
  ^ day training/1 day table top exercise

of Pittsburgh/Pittsburgh Pirates Full Scale Exercise
  August 2004
  Non water scenario
  5,000-10,000 participants
  1-day exercise

-------
  r/prr
  	iJ -^-J 1  -,
            raining utilizing recently
        ,ned response guidance
       PA - 'Response Protocol Toolbox'
       lational Incident Management System
        (NIMS)
           Incident Command System
           Emergency Operations Centers
         information A
         d - regardless of scope of exercise
         or without professional PIO's)
       risis Communications training provided prior to
     References -
          Literature
          Discussion with PIOs
          Films
              iservations D-
        Jcipants appreciate importance of effective
        communications in these scenarios.
       ility personnel            regulators
       2cted officials            health officials
     emergency responders
                                                            Positive
           Observations
fcont)
         icipants understand necessity for
        ••g honest/forthright with media an
2.  Participants understand need for common
   "pssanp anrl sinnlp snnkpsnprmn fnr nuhlir infn
     consequences of not being honest
        vations of Concern Duri
                    'iew relationship with m
       adversarial.
        ay interfere with ability to deliver effective
       risis communications
    Some players may be overly reluctant to share
    info with public
      Disseminating drinking water health info is
      mandated by "Public Notification Rule".
                                                            Observ
           tions of Concern
    CconL
         ants feel pressure in having to share ii
     h public having the shock value of terrorisn
     J WMD agents - without causing
    inecessary alarm.
4.  Various agencies have difficulty determining
   'who is in charge' during various phases of
   incident and therefore who is ultimately
   responsible for 'message' delivered to public.
                                                               (Suggests need for more ICS training)

-------
           s of Concern fcont.
  ng the uncertain Threat Evaluation' phase
  n incident - players feel challenge in
aintaining a balance between -
Risk of overreacting to a false alarm
Risk of underreactina to real incident
      e of security emergencies - Crisis
      ations in this situation may be even
     icult than for accidents and natural
     'terrorism' aspect of emergency

     shock value of WMD agents
          e.g.  Anthrax
               Ricin
Conclusi
Table t
  Crisis C
exercises can be very helpful for
jmmunications training
    .., Communications training and exercise
  exposure is also useful for personnel other
  than PIOs

-------
    RISK COMMUNICATIONS
  California Demographics
      .ornia's Risk Communication Efforts
      ing the 2003 Southern California Fires
                    Terri Lee Stratton, MPH
                    Emergency Preparedness Office
                    California Department of
                      Health Services (CDHS)
    One-seventh of country's population
    7th largest world economy
    Multi-national/multi-ethnic
    Long coast line and borders Mexico
    Los Angeles 2nd most populated U.S. city
    with many dense urban areas
    At risk from terrorism and natural disasters
    -fires, earthquakes, floods
California's Goal

• Communication Goals:
   » Be prepared for a potential outbreak of
    bioterrorism or other disaster in California.
      still public confidence in our ability to
      >pond to emergency situations.
      trough skill building, learn how to utilize
      iur knowledge and training in emergency
    ^tuations.
   » California and CDC and other partners working
    together in collaboration with local agencies
    (LHDs)
  California's Preparation Strategy
    Transparency
    Echo strategy (CDC) - Consistency in Message
    Multi-language focus
    Partnerships and collaboration
    Tools and training
    Coordinated by CDHS Risk Communication
  Emergency Preparedness and
              Response
  Develop public relations/media plan to prepare
  and respond
  Public preparedness education - web, hotline
  Spokesperson trainings
  Media relations
  LHD outreach activities
  Message development
  Risk Communication trainings
  Partner and stakeholder relations
  State agency outreach
Application of Crisis and Emergency
Risk Communication Actions in
Response to Southern CA Fires

  • Early Involvement in Process - Proactive
      jagement
    Early issuance of Public Health Messages:
    Boil Water Orders / Respiratory Safety
    Importance of consistency of message

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            NUMBER: 03-84
       FOR RELEASE: IMMEDIATE
     nttti- //V'.'V'.iw dhs ca.aov
     DATE: October 26, 2003
 CONTACT: Ken August
            or Lea Brooks
            (916)440-7660
             STATE HEALTH DIRECTOR WARNS OF
          SMOKE FROM SOUTHERN CALIFORNIA FIRES
 --ill! -.n-.i.. 'I-,:-!.' n li-i,FM  :•! F H , advi^ircf tudciy
Srnokv cc.ndrtiom can tr hOWwdo i~ rr.i vnun.1 rhiTjrrn, l-,r ,-U-Jerly. in-Jividi!-,l - with -,.-;art condition;
r-f-.-.iii-.-- ,-,r tl,.-- uiv .-it.--.int..' .-.I iiiP ,-,-,!-„ iihrri =, n,-,nt.=. srlvf =..=•-. i i==i.-)^nt r. rn^si (he tire; to t
Individuals with .rj^hma, bron:l".rti;, c-mpn1, cc-m.n ar.rt other lunq or hc.rjn niicc.nc-:-: ;ho»jld moke- sure that they
are on medication and fi.ave al It-ail a ti-.-c-.JHy =UPJJ[V ui i han.J. Individuals with asthma should consult their
physicianabci.it .-jr! .-j-inrr,.-, m-,n.-,,3,-17,,-nt r,l.-,n -jr.rl stich to rl rJiJinr. unusuollv smoky ,-,-,n,-lrti,-,n- Li=ten lor radio
i ecu crulstlng inilead of dr.riv/iriy =rnof,v air Iroin ijuldijuri Cunt,act your doctor if YOU have symptoms such as
chest pain, chest lightnp =-,.=-., =-,|-,i:n-|ne-= - OT l-,rf=*th, ,:.r -rvri * TRligi.p Thi= i=. important Tor nrit nnly people with
                                                                                       Early  Response
                                                         First Press Release sent out prior to EOC
                                                         ~-i;vation
                                                         Established involvement and credibility
                                                         Interface with partners
                                                                                        Consistency in Message

                                                                                        • Confirm that advice/guidance to public is
                                                                                          consistent.
                                                                                        • Share information with other responders
                                                                                          and partners
                                                                                          Provide follow up guidance to public to
                                                                                          facilitate recovery and credibility in
                                                                                          response efforts
            NUMBER: 03-88
       FOR RELEASE: IMMEDIATE
     httD://www.dhs.ca.aov
    DATE: Oct.31,2003
CONTACT: Ken August
          or Lea Brooks
          (916)440-7660
 STATE HEALTH DIRECTOR OFFERS ADVICE TO PARENTS ABOUT
CHILDREN'S HEALTH AND EMOTIONAL REACTIONS TO WILDFIRES
SACRAMENTO - ^!.:,:P He.^h hi POT T'lara M Bnnt.s, V H , D' P H, today advised Scn.rthPn L.3: rnm -i ;:aipr]s
to keep a watchful eve over their children;, reaction;' to the wilnitiie\ She al:u advi:ed jjarente to monftor
childish'; ui.rtdcui antivrty and take precaution: to Irt ;h? pinoi.nt ot a:n and p.ir:n: jlatp du:: ti r;r I, i?d intoir.-'
home
 ::'3|6~'. :"oi.ild re I'lprrMPi that this can be an alarming time for children," Bonta said. "The images of the
'/','ildtirei on television can be very frightening for children who often notice the tension and anxiety in adutts
s-' ound them P.si ents should be av/ai e ot the ph'-sicis; and enotional i e :pon :es ot theii chili:;i en to these
horrif
Lessons Learned

•  Place Emphasis on education/awareness as
   priority - early involvement in process
•  Quick Approvals in place for
   Materials/Documents
•  Involve Partners from Beginning
•  Hold to core strategies and provide as much
I   information as possible
   Collaborate with Others involved in Response

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Communication Issues for Public
  Health: Respiratory, Water Safety, Ash -
  tossessions, missing family members/pets,
     ;uation, needs of special populations
  children/elderly/disabled/non-English
  peakers)

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        Who's Who  In  Public
           Drinking Water?
Federal EPA
CT Department of Public Health
CT Department of Environmental Protection
CT Department of Public Utility Control
Drinking Water Systems Owners/Operators
          The Three    's
     ommunicate
  * New Communications Initiatives

     oordinate
  * Security Advisory Committee
  * DWD Emergency Response Group

     ooperate
  * EPA Funded Regional Workshops
 "Public Drinking Water Security Operations, Emergency
          Response and Communications"

  Four Regional Workshops for First Responders and Public
  Drinking Water System Personnel
  Networking (Developing Lines of Communication/Partnerships)
* CT's Division of Homeland Security (Structure and Mission)
* The DPH Incident Command System
* Cross Training ("Law Enforcement/Water 101")
  DPH Communication Systems (Wide Area Notification System
  (WANS), Health Alert Network (HAN))
* Vulnerability Assessment and Emergency Response Plan
  Preparation (Review of Emergency Response Handbook)
                                                                                          Drinking Water Division1

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                 Issues

4 Bumps in the Road
  * Lack of Continuity
  * Logistics
  * Electronic Communications
  * Apathy (Burnout)
  * Numerous Conflicting Activities
  * "Cowboys"               "
    THERE IS NO SUBSTITUTE FOR
             PROFESSIONAL
          ACCOUNTABILITY  IN

      "PROVIDING GOOD SAFE
   DRINKING WATER THAT HAS
          THE TRUST OF THE
              CONSUMER"
                         Drinking Water Dh
       Over 600 professionals participated in the
 four regional drinking water security workshops that were
recently conducted throughout Connecticut, where they used
the handbook, along with the DWD's Emergency Response
   Planning Guide for Public Drinking Water Systems.
  The goal of the workshops was to increase participants'
  awareness of security, communications, and response
  issues and initiate and promote networking among the
water utilities, law enforcement, the local health department,
       and emergency management personnel.

    Coordination of Enforcement and Water Supply Security
    Activities is critical for the "New Business of Water".
        Health Alert Network (HAN)
               Overall  Goal
  4 To securely facilitate communication of
   critical health, epidemiological and
   bioterrorism related information on a
   24/7 basis to local health departments,
   health organizations and other partners.

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  Reporting a Public Drinking Water
              Security Breach.
* NOTE: All and Any Emergencies involving: security
  violations, threats, suspicious circumstances or
  unusual activity relative to drinking water supplies
  and/or infrastructure, are to be reported immediately
  to law enforcement (911 or direct) and the
  Connecticut Department of Public Health.

                 Remember!
          to the Department of Public Health,
                           Drinking Water Division

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National Water Security Risk Communication Symposium


                 San Francisco, California


                     May 20, 2004

                 Since September 11, 2001
             there has been no higher priority at
                    The New York City
          Department of Environmental Protection
                 than water supply security.

 Our efforts to date have resulted in a broader and clearer
       strategy focusing on prevention, protection
             and consequence management
         This three tiered strategic framework has
        resulted in a systematic and comprehensive
               water supply protection plan.
The Police Division includes three major sub-divisions.
   Each plays a critical role providing the foundation
        designed to preserve, protect and defend
          the water supply and environment.
                                                                                         PREVENTION
        Detective Bureau and Intelligence Division

        Responsible for all long term investigations
         relating to pollution, crime and terrorism.
      Detectives also fulfill the vital role of prevention
through the gathering of intelligence and information sharing

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                       PROTECTION
           Environmental Enforcement Division
                 Performs environmental and
                    infrastructure protective
                          functions.
                         Monitors and
                  provides access control and
                      intrusion detection.
              CONSEQUENCE MANAGEMENT


                 Special Operations Division
                  Emergency Services Unit
                         Canine Unit
                        Aviation Unit
                    Strategic Patrol Unit
               COMMUNICATING THE RISK
            through aggressive training opportunities

              Environmental Police Academy
                 Recruit Training School
                     (1000 hour/6 month)
                NYS Mandated Police Training
              Environmental Enforcement Training
            Environmental & Infrastructure Protection
                    In Service Training
                 Weapons of Mass Destruction
                  Counter Terrorism Training
                    Domestic Preparedness
                  Ground Water Investigations
              Fire Arms Re-Qualifications Course
                  Bomb Recognition Courses
                 Security Awareness Training
                        Agency-wide
                   Outside Agency Training
                  Contractors and Consultants
Communication is the most important dynamic of any organization.

 Because of the important nature and sensitivity of the information
              we convey within our organizations,
               to communities and media outlets
        communication can become the primary problem.
          Emergency planning, practical exercises and
             building trust within the communities
                we serve are everyday activities.
          During a disaster, communication is essential
          to the timely and accurate flow of information
           as well as the coordination of relief efforts.
     Not only to keep emergency response systems functional
           but also to relieve stress and reduce panic.
        Lines of communication need to be in place so that
         emergency responders:  can talk to one another,
              communicate with specialized teams
                  and coordinate supply lines.
Police, fire and emergency medical technicians need to communicate,
           as quickly as possible, accurate information
      to scientists, engineers, health and medical professionals
        as well as to administrative and support personnel.
             These disaster relief professionals must
                 establish effective relationships
             so that they speak a common language,
 provide appropriate information and access resources, information
       and data bases not commonly queried on a daily basis.

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     PLANNING: Anticipate system failures
      Redundant communications include:
           High and low band radios
         Analog and digital telephones
       Priority access to wireless networks
          Intra-net and inter-net access
     Multiple cellular telephone technologies
           Broad paging capabilities
Electronic mail and broadcast facsimile machines
      Loudspeakers, bullhorns and runners
                                                                             Scene of Incident
                                                                                                                    Incident Command
                 Decontamination area
          Relief Area         Medical Triage
  Inner perimeter
Staging Areas
                    Outer perimeter

            Emergency Operations Center

                  Command Center
                                                                          Designated press area
                                                                                                                  Community Centers
        Develop a culture of cooperation
            Use existing resources
    Disorganization can easily lead to disaster
Communication and planning are the keys to success
           Plan for emergencies-twice
    Think out of the box, expect the unexpected
       Anticipate things will go wrong and
            Practice, practice practice

 Pre record all public and internal messages possible
                Communicating the risk
                   to communities
               nftmmuai^t^mm^1+^^*

      Preparing the public for emergencies

  "A citizens guide for emergency preparedness''

    Emergency Contact Telephone Numbers
                    Police
                     Fire
     Counter terrorism information sources
                       HOME

                 prepare a supply kit
     include water, food, firstaid, clothes, bedding,
flashlights, batteries, radios, kitchen and sanitary supplies.
          Plan where to meet family members,
      prepare for self reliant survival for four days
         include one gallon of water per person

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                         WORK

    Prepare a list of emergency contact telephone numbers
              for family, friends and neighbors
      include building security and police non emergency
                    telephone numbers.
   Create a phone chain to check on the safety of co-workers.
               Update these lists every month

                                                                                                        SCHOOL
        Know your school districts emergency action plans.
Consider ways to contact your children in the event of an emergency.
        Include cell phones, neighbors, friends and teachers.
                Communicate and work together.
                       While driving

                Have a plan and be prepared.
                    Know your options
                   Observe-React-Adapt
Investigate and try alternate routes to and from work and school.
         Explore the areas you drive most frequently.
           Keep a blanket or extra coat in the car,
           a first aid kit, water, flashlight and map.
                      During the Disaster
                          Stay calm
                     Operationalize plans
                      Stick to the Script
                            And
                          Stay calm
                           Because
                  You have prepared for this.
    Media briefings should be scheduled at regular intervals
                   Prepare your message
            Know what you want the public to hear
            and have three different ways to say it.
      Anticipate three questions you do not want to answer
        Know how you will respond to those questions
          Know that you do not have to answer them

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&ERA
       United States
       Environmental Protection
       Agency

       Office of Research and Development
       National Homeland Security Research Center
       Cincinnati, OH 45268

       Office Business
       Penalty for Private Use
       $300

       EPA 600/C-05/006
       November 2005
       www.epa.gov/nhsrc
PRESORTED STANDARD
POSTAGE & FEES PAID
      EPA
  PERMIT No. G-35
                                 Recycled/Recyclable
                                 Printed with vegetable-based ink on
                                 paper that contains a minimum of
                                 50% post-consumer fiber content
                                 processed chlorine free

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