Orientation to Connecticut Mass Dispensing Clinics

1
Orientation to ConnecticutMass Dispensing
Clinics
This curriculum was supported by Cooperative
Agreement Number U90/CCU116996 from CDC. Its
contents are solely the responsibility of the
authors and do not necessarily represent the
official views of CDC.
2
Welcome

• This session is to help you prepare for your
  role during a public health emergency and the
  activation of a general mass dispensing clinic.
• These guidelines are anticipatory and are subject
  to modification as experience with an actual
  event unfolds.

3
Session Objectives

• The goal of this session is to help you
  understand your role as a volunteer or staff
  member at a mass dispensing clinic.
• Following successful completion of this session,
  you will
• be able to
• Describe the personal planning steps to prepare
  for a public health emergency
• Understand the purpose of a mass dispensing
  clinic
• Understand the mass dispensing clinic operation,
  structure, and layout
• Describe job functions needed to operate a mass
  dispensing clinic
• Locate additional resource material

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Session Format

• The session is divided into six content area
  sections
• Within each section exists core subject material
  and optional supplemental material
• Learner questions have been inserted to highlight
  key topics
• Some slides are marked optional and address
  more detailed information appropriate use of
  these may depend on the background of the
  audience

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Session Topics

• Introduction
• Course Overview
• Section 1 What is a Public Health Emergency?
• Section 2 Responding to the Call Staffing a
  Clinic
• Section 3 Clinic Leadership and Command
• Section 4 Clinic Layout and Setup
• Section 5 Training for Clinic Assignments
• Section 6 Clinic Operations
• Appendix 1 - Internet Resources and References

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A Call to Respond

• Recent events have made it clear that our nation
  needs to be ready to respond in the event of a
  public health emergency.
• Federal, state, and local government agencies,
  medical and private non-medical sectors are
  planning response efforts for potential health
  threats.
• Local health departments across the country and
  in Connecticut are among the lead agencies
  coordinating local preparedness and response
  efforts.

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Mass Dispensing Clinic Planning

• All local health departments across Connecticut
  have been asked to develop plans to respond
  quickly and effectively should there ever be a
  need. This includes a plan to
• Operate mass dispensing clinics if necessary
• Recruit medical and non-medical volunteers to
  staff positions in mass dispensing clinics in the
  event of a public health emergency

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Mass Dispensing Clinics

• In the event of a public health emergency, there
  may be a need to provide vaccinations or
  medications to a significant number of people
  during a very short time period.
• Temporary clinics would be created to provide
  these services to our population.
• These clinics, referred to as mass dispensing
  clinics, may be set-up in schools, town halls,
  or other community facilities. These clinics are

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What is a Public Health Emergency?
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Definition of a Public Health Emergency

• A Public Health Emergency is defined as an
  occurrence or imminent
• threat of a
• communicable disease, except sexually transmitted
  disease
• contamination caused or believed to be caused by
  bioterrorism, an epidemic or pandemic disease
  linkage to Critical Agent List- category A
• natural disaster
• chemical attack or accidental release
• nuclear attack
• accident that poses a substantial risk of a
  significant number of human fatalities or
  incidents of permanent or long-term disability.
• Public Act No. 03-236, CT Public Health
  Emergency Response Act of 2003 (PHERA)

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Critical biological agent categories for public
health preparedness
Optional slide more advanced detail

• Table 1. Critical biological agent categories for
  public health preparedness
• Category A Biological agent(s) Disease
• Smallpox Variola major
• Anthrax Bacillus anthracis
• Plague Yersinia pestis
• Botulism Clostridium botulinum (botulinum
  toxins)
• Tularemia Francisella tularensis
• Viral hemorrhagic fevers Filoviruses and
  Arenaviruses
• (e.g., Ebola virus, Lassa virus)
• Source Komar N, Lanciotti R, Bowen R, Langevin
  S, Bunning M. Detection of West Nile virus in
  oral and cloacal swabs collected from bird
  carcasses. Emerg Infect Dis serial on the
  Internet. 2002 Jul cited 2002 May 30.
  Available from http//www.cdc.gov/ncidod/EID/vol8n
  o7/02-0157.htm

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ConnecticutPublic Health Emergency Response Act
(PHERA)

• In 2003, Connecticut enacted a law that makes
  sure that the Governor and all of the individuals
  that respond to the emergency
• Can act without unnecessary delay
• Can take measures to protect the publics health
• Authorities and provisions for action in the
  event of a public health emergency are delineated
  in the Connecticut Public Health Emergency
  Response Act or, PHERA.

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Immunity from Liabilityunder PHERA

• PHERA also
• Protects staff and volunteers from liability when
  they are acting on behalf of the state or local
  health department during a declared Public Health
  Emergency.

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Authority for Mass Dispensing

• Under each level of government, mass dispensing
  is authorized, supported and further specified
  with legal memoranda of agreement.
• The chief elected official of a local
  jurisdiction is responsible for emergency
  response in that jurisdiction, however, their
  power and duty does not supercede that of the
  governor.
• Specific licensed personnel can dispense
  medications within their scope of practice.

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A Public Health EmergencyLocal Health
Department Responsibility

• Local Health Departments have important public
  health responsibilities in their communities
  during both a declared emergency as well as
  during non-emergency times.
• Some of their primary responsibilties are
  measures to control and prevent disease by
  providing protection through
• Dispensing of medications
• Vaccination
• Conducting Isolation and Quarantine
• Educating the public about risks and reducing the
  risk of disease

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Clinics to Control and Prevent Disease

• Community Clinics
• These clinics routinely operate to prevent
  disease or control the spread of a disease in the
  community
• examples Influenza, Hepatitis A, Menningitis
• Emergency Clinics
• Clinics created during an epidemic, or a disease
  outbreak over a large geographic area, or to
  counteract a contamination by treating a large
  number of people in the community. These clinics
  are called by several names
• Mass Prophylaxis Clinics
• Mass Dispensing Clinics
• Mass Vaccination Clinics
• Smallpox Vaccination Clinics
• Point of Dispensing (POD)

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Local Health Department Planning

• Individuals are either vaccinated or given
  medications at Point of Dispensing POD clinics.
• Local Health Directors develop local and regional
  plans for the safe and efficient operation of
  community POD clinics. The POD clinic operates
  under the legal authority of the local health
  director.
• In an emergency the clinic may be initiated as
  part of a community wide emergency operations
  plan. When the emergency plan is activated all
  emergency resources can be called on to support
  the clinic.

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Who will come to a POD clinic?

• Some individuals in the community may come to a
  Point of Dispensing clinic if
• They have been exposed to a disease that can be
  prevented by medication, or
• They are at risk of a disease that can be
  prevented by medication, vaccination or other
  available treatment.
• Other individuals might receive medication or
  vaccination at other locations (i.e., hospitals,
  place of work, or in a group residence)
• Others might not need treatment at all.

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Learner Questions

• Local health departments across the country and
  in Connecticut are among the lead agencies
  coordinating local preparedness and response
  efforts, and have the legal authority to do so.
• True False
• A Public Health Emergency is defined as an
  occurrence or imminent threat of
• a) a communicable disease
• b) contamination
• c) natural disaster
• d) chemical or nuclear attack
• e) accident that poses a substantial risk
• f) all of the above
• 3. In the event of a public health
  emergency, there may be a need to provide
  vaccinations or medications to a significant
  number of people during a very short time period.
  
• True False

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Learner Questions

• 4. Connecticut has legislation in place to
  address the legal authority and liability issues
  related to declared public health emergencies.
• True False
• 5. In the event of a public health
  emergency, only non-medical volunteers would
  be recruited to staff positions in mass
  dispensing clinics.
• True False

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Responding to the Call -Staffing a Clinic
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Clinic Staffing and Partners

• The support of many partners are needed in order
  to effectively manage a clinic. This includes
• Emergency managers
• Hospitals
• American Red Cross
• Mental health providers
• EMTs and Paramedics
• Fire
• Police
• LHD Staff
• Volunteers

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Staffing a Clinic

• Everyone has the potential to contribute strength
  and resources in times of emergency.
• Volunteers can provide essential services both in
  a medical and non-medical capacity.
• Public Health staff provide the expertise and
  skills to support clinic functions.

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How to be prepared

• Events happen without warning and with very
  little time to respond, so pre-planning is
  important. Personal planning steps to prepare for
  a public health emergency include
• Creating a personal/household notification plan
• (for more info, go to http//ct.train.org,
  click on the Public Health Emergency
  Preparedness 101 course)
• Providing up-to-date contact numbers among
  household members
• Planning for
• Childcare/Elderly care
• Pet Care
• Home Security
• Transportation

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A Call to Action

• If there is a need to open a mass dispensing
  clinic, your state and local health department
  will coordinate a response.
• Local health departments will be responsible for
  clinic set-up and operations. They will begin a
  chain of calls necessary to reach every person
  who has made a commitment to serve in a public
  health emergency.
• You may be contacted by phone, email and/or fax.
  In this message, you will be given further
  instruction on where and when to report, as well
  as what you might need to bring with you when you
  come to volunteer.

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A Call for Action

• 4. Your local health department maintains a
  listing of volunteer contact information to
  facilitate this process.
• While the health department will be contacting
  you periodically to help ensure that records are
  kept up to date, volunteers are encouraged to
  please send any contact information changes of
  phone, fax, e-mail or address to your respective
  health departments to help keep the listing
  accurate and timely.
• For your local health department listing, go to
  www.dph.state.ct.us, click on the local health
  directory

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Responding to the Call -Plans for getting to the
clinic site

• Depending on the locally-determined plan, you
  will be advised of the details for getting to the
  clinic site or staging area
• Off-site Staging Areas
• To help control crowd flow to and from the clinic
  site, clinic personnel and volunteers may be
  transported to the clinic via buses from
  different staging areas depending on
  locally-determined plans.
• Transportation options
• Please plan to have a form of transportation
  available to reach clinic on-site parking or
  off-site staging areas.
• Identification and Check-in procedures
• Please bring a form of photo identification
  (e.g., drivers license, photo ID, and/or
  Volunteer ID for check-in to the POD clinic.
• You will report to the Volunteer Coordinator for
  check-in procedures, briefing, and job assignment.

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Responding to the Call What to Bring?

• When you are given specific instructions on your
  assignment and where to report, some important
  items to bring include
• Proper ID (e.g., Drivers license or picture ID,
  as well as a Volunteer ID if provided by the
  Local Health Department)
• Copy of CT-based professional practice license or
  certification, if applicable
• Minimal personal possessions
• Adequate clothing and protection for the elements

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Learner Questions

• Volunteers can provide essential services both in
  a medical and non-medical capacity.
• True False
• 2. Personal planning for an emergency
  includes
• a) Childcare/Elderly care
• b) Pet Care
• c) Home Security
• d) Transportation
• e) None of the above
• f) All of the above

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Learner Questions

• 3. If you have provided your contact
  information to your local health department, in
  an emergency you may be contacted by phone, email
  and/or fax.
• True False
• 4. When reporting for your assignment, an I.D.
  card is not necessary.
• True False
• 5. Public health staff provide expertise and
  skills to support mass dispensing clinic
  functions.
• True False