Application to Mass Dispensing

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Application to Mass Dispensing

• Hot Topics in Preparedness
• Northwest Center for Public Health Practice
• School of Public Health Community Medicine
• University of Washington
• July 27, 2004

Andy Stergachis, Ph.D., R.Ph. Professor,
University of Washington SNS Coordinator, Region 6
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Roughly how complete is your SNS plan?

1. 100
2. 75
3. 50
4. lt 50

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What do you need to plan for?

• Roles, responsibilities, policies
• Decision-making for requesting SNS
• Site selection
• Set-up and design
• Staffing
• Public information and communication

4
What is theStrategic National Stockpile?

• Federally managed logistical system created to
  supplement supplies of state and local systems
  during a major public health emergency

• 12 strategically located Push Packages (12hr
  PP)
• Vendor Managed Inventory (VMI)
• Stockpile Managed Inventory (SMI)
• Technical Assistance Response Unit (TARU)
• Chempack Program

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12-hour Push Package

• 50 tons of pharmaceuticals, equipment, and other
  medical supplies.
• Color coded for ease in identifying needed
  material
• Biological, Chemical Biological, All Scenarios,
  Chemical Antidotes, Bandages
• Antibiotics
• Unit of use 10-day courses
• Suspension
• Intravenous

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Vendor Managed Inventory

• Inventory owned by the SNS program and managed by
  pharmaceutical vendors
• Vendors maintain the VMI stock as a bulge within
  their pipeline and rotates stock to keep it
  current and eliminate waste.

• Represents 90 to 95 of the SNS inventory
• Used in Florida, re anthrax attack

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CHEMPACK Program

• The CHEMPACK program forward-deploys chemical
  antidotes
• Elements of the program
• Maintained locally and readily available to EMS
  and Hospital Emergency Departments
• Remotely monitored for environment and security
  by the SNS Program
• Washington was one of the three pilot programs

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Roles, Responsibilities, Policies

• Who has authority to request SNS?
• What are the relevant laws and authorities?
• What is the process for requesting SNS?
• How is the request coordinated with regular
  emergency management procedures?

?
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Responsibilities

• The state is responsible for receiving, storing,
  staging (RSS), distributing the SNS supplies to
  the points of distribution (PODs).
• Local health officials are responsible for
  setting up and operating dispensing or
  immunization clinics/sites.

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Decision-Making to Request SNS

• Identify Criteria, e.g.
• Suspected BT attack
• Chemical agent or ionizing radiation
• Hospitalization of large numbers of patients
• Determine if local supplies sufficient, e.g.
• Number of casualties
• Epidemiology of agent of concern
• Consultations
• Notifications

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Set-Up and Design

• Critical Components
• Incident Command
• Triage Registration
• Dispensing Express Other
• Counseling and Education
• Record Keeping
• Security
• Throughput Model

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Types of Patient Groups

• No Complications healthy
• Express dispensing
• Complications pre-existing illnesses/allergies,
  pregnant, etc.
• Assess and provide more involved counseling
• Persons with acute illnesses
• Transport
• Crisis counseling and mental health intervention

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Which of the following sites are you considering
for mass dispensing clinics?

1. Schools
2. Community Centers
3. Pharmacies
4. Other

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Site Selection

• How many?
• Where?
• Familiar Locations
• Accessible
• Size and Characteristics
• Hours of Operation
• Agreements

15
Do you have a plan for mobilizing volunteers for
mass dispensing clinics?

• Yes
• No

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Staffing

• Public Health Department
• Volunteers
• Recruit
• Train
• Call-Up Procedures
• Who can dispense?
• Prescribing physician

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Public Information and Communication

• Notifications to public of POD openings
• Coordinate through Public Health Information
  Officer and Joint Information Center (JIC)

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Lessons Learned from Exercises of SNS Planning

• Hold face-to-face meetings
• Establish and solidify mutual aid agreements
• Scale plans to accommodate scenarios
• Harmonize SNS plans with other plans
• Clarify roles
• Update contact information and make it accessible
  
• Emphasize regional planning

ASTHO 2004
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Resources

• www.bt.cdc.gov/stockpile/index.asp
• Mass Prophylaxis/Vaccination Campaign Staffing
  Model www.ahrq.gov/research/biomodel.htm
• www.phppo.cdc.gov/phtn/antibiotic
• Exercising the SNS Lessons learned and tools
  for application, www.astho.org