BECOMING A DISPENSINGPARTNER Organizations helping to protect their business, clients, employees, and their families in a Public Health Emergency
INTRODUCTION Marin County Department of Health and Human Services, Division of Public Health, Public Health Preparedness Program Work with a variety of multijurisdictional partners to increase community preparedness for all types of emergencies and disasters including Bio-Terrorism
Public Health PreparednessHistory 1999 CDC awarded 1st funding for Bioterrorism Preparedness (some states funded) 9/11/2001 AND Anthrax Attacks (2001), Increased Focus More appreciation for the role of Public Health in emergency preparedness response (surge) Congress allocated funds and CDC awarded counties in all 50 states for BT preparedness and response 2005 Hurricane Katrina/New Orleans Disaster much greater understanding of Public Health and how it pertains to an All Hazards Response Emergency Preparedness went from BT focus to an All Hazards with Public Health approach over time
What is mass prophylaxis? Prophylaxis is the prevention of disease prior to or after exposure to an etiologic agent through the use of antibiotics or antiviral medications (chemoprophylaxis), or vaccination (immunoprophylaxis). “Mass” prophylaxis describes the dispensing of prophylaxis on a large scale.
When might we activate massprophylaxis? Bioterrorist agent e.g., anthrax, smallpox, plague Overt or covert release Naturally occurring disease outbreak Meningococcal disease Pandemic influenza
Marin County’s Response Will be opening multiple Public Points of Dispensing (Public PODs) for the general public Considerations: Individuals with access and functional needs may not be able to attend a public POD If we work with organizations who have large populations, serve large populations, and/or serve those with access and functional needs, we can lessen the burden on the Public POD systems and account for Marin County’s most vulnerable citizens as well
Value of Partnering Incorporating organizations that serve large populations and their families, or those with access and functional needs, we can ensure that they receive life-saving medications quickly and efficiently Offers your organization the ability to get medications out to your employees, clients, and family members in the quickest and most effective manner. Your employees are less likely to miss work if they can receive medication directly from their employer and do not need to attend a public POD for themselves or their families, meaning better continuity of operations for your organization.
How to Become a DispensingPartner Step #1 Educate/Training Dispensing Partner Presentation: This power point will introduce you to the idea of becoming a dispensing partner and how it may be useful for your organization. Closed POD Partner Online Training: Please view the first 2 Modules of training at http://closedpodpartners.org/ Incident Command Online Training: Please view the FEMA ICS 100. b. training at http://closedpodpartners.org/
How to Become a DispensingPartner Step #2- Register Pre-Registration Form: Please complete this form if you would like to become a Dispensing Partner (also referred to as Push Partner). This form is meant to be completed electronically at http://www.co.marin.ca.us/depts/HH/main/hs/dispensingpartners/; however it can be filled out by hand, as well. The information filled out on the registration form will be used to develop the official agreement in the form of the Memorandum of Understanding. Memorandum of Understanding (MOU): This form is meant to be completed with the information that is provided on the pre-registration form. Once completed the original must be sent into the county for approval. Please make a copy to keep at your facility.
How to Become a DispensingPartner Step#3- Develop Plan Partner Kit: This document will tell you almost everything that you need to know about becoming a Dispensing Partner. It will also serve as a valuable resource when developing your organization specific Dispensing Plan, as well as during an actual event. Dispensing Plan: Each organization will develop a dispensing plan that works for them This plain is designed to meet the needs of your facility in terms of delivering medication directly to your employees, family members, and clients We can help you come up with a plan that meets your needs! We can provide a template that should serve as a guide to assist you in developing your dispensing plan.
How to Become a DispensingPartner Step #4- Additional Resources Inventory Control Form: is a brief form that you will complete when you are receiving, distributing, or returning antibiotics. Final Summary Form: is a brief form that you will complete when you have finished dispensing antibiotics. It provides a brief summary of your Push Partner effort. Cipro drug sheet & Doxy drug sheets: These drug information sheets should be handed out to individuals or families based on which drug they received. Screening Forms: These will be used for those who cannot or choose not to use the online screening form. Also attached is a screening key to assist screeners and dispensers in dispensing the appropriate medication. One screening form can be used for up to 10 family members. The following link can be used to access online screening through the Bay Area Mass Prophylaxis Working Group: http://bayareadisastermeds.org/medicine.html
CRI Coordinator Please contact the Public Health Preparedness Program’s CRI Coordinator, Kristen McClymer, at email@example.com or 415-473-3880 if you have any additional questions. The CRI Coordinator will answer any questions you have about becoming a Dispensing Partner and will assist you in developing a dispensing plan that will work for your organization.
Legal Considerations In the event of an emergency there are many laws that will protect individuals and organizations dispensing life- saving medications. Public Readiness and Emergency Preparedness (PREP) Act HIPAA
Legal Considerations (continued) PREP Act: Secretary may issue a declaration to provide immunity from liability (except for willful misconduct) for claims: Death; physical, mental, emotional injury, illness, disability, condition, fear thereof; medical monitoring, property damage or loss, business interruption Causally related to development, distribution, administration or use of “covered countermeasures” Against “covered persons”, 42 U.S.C. 247d-6d
Legal Considerations (continued) Covered Persons Under the Prep-Act Manufacturers Distributors Program Planners (State, local government, tribe, others who supervise or administer countermeasure programs, which can include private sector) Qualified Persons (licensed health professionals and others identified by the Secretary who prescribe, administer, or dispense countermeasures) Officials, Agents, Employees of all of the above United States
Legal Considerations(continued) HIPAA In the event of an emergency organizations with signed MOUs become an extension of the government and become exempt to HIPAA policies Signed MOU Designated as volunteer Incorporated into state response plans Are unable to charge for services rendered
Legal Considerations (Continued) For more information: Public Readiness and Emergency Preparedness (PREP) Act PREP Act declarations: http://publichealthemergency.hhs.gov/preparedness/legal/prepact/Pages/default. aspx HIPAA HHS Online HIPAA Q&A: http://www.hhs.gov/ocr/privacy/hipaa/faq/disclosures_in_emergency_situations/in dex.html CDC http://www2a.cdc.gov/phlp/emergencyprep/FPHELfaq.asp
Q: How will we be alerted/notified during the event of an incident? Health Department Dispensing Partner CAHAN (automated alerting system) Phone Tree (to contact staff) Fax (for sending paperwork) Dispensing Partner Staff and Family Phone Tree Email Fax Other Dispensing Partner can request medication from the MHOAC or the MHOAC will contact the Partner directly
Q: How will we know whatmedication to give out? A: All Bay Area counties have developed a screening algorithm. Individuals can complete an online form that will tell them which medication is appropriate for them. We will also provide you with a paper version in case some individuals will not have access to the online version. You can access the online version at http://bayareadisastermeds.org//medicine.html
Q: Can we dispense the medicationto volunteers, as well as familymembers of patients or of clinicalstaff? A: Yes. You just need to let the health department know how many individuals you are requesting medication for.
Q: Are we required to recruitmedical staff to dispensemedications to our employees? A: No. During a declared public health emergency when a life-threatening event has occurred and the whole county, region or state population need to receive preventive medications (prophylaxis) in a very brief period of time, the Governor is expected to waive dispensing regulations to allow non-medical staff to help dispense medications. Sufficient licensed medical personnel to do this dispensing would not be available.
Q: Where do we refer employees ifthey have medical problems ormedical questions about themedications we are handing out? A: We will provide you with scripted questions and answers and procedures to follow (you will be educated on this process in more detail). Those who are “iffy” about whether or not they should take the medication will be given the life-saving medications to take home with them and told to consult with their own doctor. They are also able to come to a Public POD to discuss their medical issues with medical personnel.
Q: Will people be allowed to pick uppackets for their family? A: Yes. However, there is a limit of 10 packets per pick-up person.
Q: Are the medications in unitdosages? A: Yes. You will be given the medications already packaged with clear instructions and precautions just like any other medication received at a local pharmacy.