1. Security Overview Staff assigned to the Security Unit should be familiar with the job duties in all areas of the clinic where Security is assigned since they may be moved to different areas based on clinic needs

2. Security Traffic

3. Traffic Security Unit The Traffic Security Unit is external to the vaccination clinic building The primary function of the Traffic Security Unit is crowd control and checking identification of persons prior to entry into the vaccination clinic The secondary function of the Traffic Security Unit is dissemination of information

4. Traffic Security Unit continued Where and how the Traffic Unit duties are discharged is dependent on whether the clinic uses “off-site staging” or “direct access” “Off-site staging” means the public is directed to a neutral gathering site (such as a shopping center) and is transported to the clinic for vaccination and then back to the staging area “Direct Access” means the public arrives at the actual vaccination clinic site, leaves their vehicles in the parking lot and proceeds to the vaccination clinic building

5. Traffic Security Unit continued To avoid chaos, persons will only be permitted in the clinic on certain days based on the name of the Head of Household The algorithm for determining household and Head of Household will be discussed in upcoming slides

6. Traffic Security Unit continued In the “off-site staging” model, persons sick with a fever and rash are to be directed to seek care from medical care providers They should not be allowed to board the bus In the “direct access” model, persons sick with a fever and rash are to be directed to the Ill Evaluation Area

7. Traffic Security Unit continued In both the “off-site staging” and “direct access” models, persons who have been exposed to someone with smallpox but who are not yet sick with the disease (“contacts”) are to be directed to proceed immediately to the Contact Evaluation & Vaccination Area for assistance

8. Security Identification

9. Eligibility for vaccination will be based on the name of the Head of Household Once the Head of Household is qualified, all members of the household are qualified Head of Household is defined as the oldest person in the household Household is defined as all related persons living in the same house, apartment, trailer, etc. A household may consist of an adult male, adult female, children under age 18 and the parents or grandparents of the adult male/female

10. Identification continued Declaration of membership in a given household is sufficient – proof is not required The Head of Household must provide proof of identity using a photo ID A listing of acceptable forms of identification is contained in the handout materials Only households whose name match the criteria for the correct day or whose name matched the criterion for a previous day will be allowed to enter the clinic

11. Identification continued Households who cannot provide proof of identity should be refused admittance and told to return the 10 th day of the vaccination clinic or at such time as a Public Service Announcement is made that persons not already vaccinated can come to the clinic Regional policies may be developed to allow certain persons to come to the clinic even though their names don’t match the criteria One such example is to allow a senior citizen’s center to bring all residents on a bus one day instead of having to make a trip every day for 10 days

12. Security Triage

13. Triage Security Unit The Triage Security Unit is generally internal to the vaccination clinic building but may be external if coupled with Traffic in the “off-site staging” model The Triage Area is where persons are “screened” to identify and separate those who may be ill (fever and rash) or who have had contact with a possible or confirmed smallpox case

14. Triage Security Unit continued Persons who are ill with fever and rash should be directed to the Ill Evaluation Area for assistance Persons who have been exposed to someone with a confirmed or suspected case of smallpox should be directed to the Contact Evaluation & Vaccination Area for assistance All other persons should be directed to the Forms Distribution Area The primary function of the Triage Security Unit staff is to maintain order in and around the Triage Area and provide instructions to persons on how to proceed to the other areas

15. Security Forms Distribution

16. Forms Distribution Security Unit In the model, the Forms Distribution Security Unit is staffed with 2 persons - this number may be changed based on patient flow The Forms Distribution Security Unit is internal to the vaccination clinic building The Forms Distribution Area is where patients are given written materials explaining the smallpox disease, the vaccination process and an Informed Consent form to be completed prior to vaccination

17. Forms Distribution Security Unit continued Materials must be appropriate for the language read and spoken by the patient so there may be stations distributing forms in languages other than English The primary function of the Forms Distribution Security Unit staff is to maintain order in and around the Forms Distribution Area and provide instructions on how to proceed to the Video Area Forms Distribution may be a “pressure point” simply because of the volume of activity occurring

18. Security Video

20. Video Security Unit In the model, the Video Security Unit is staffed with 2 persons – this may change based on actual experience and clinic configuration In the model, the Video Area consists of 5 regular video stations and 1 Special Assistance Video stations The number of Video Area stations may change depending on clinic configuration – there may be multiple small stations as per the model or they may be replaced with fewer but larger stations The Video Security Unit is internal to the vaccination clinic building

21. Video Unit continued The Video Area is where patients are shown a video describing the smallpox disease, the vaccination process and procedures for monitoring the vaccination site for appropriate or adverse reactions Patients will be able to ask questions about the video, the vaccination process and the forms they were given in the Forms Distribution Area Video Area Security Staff are NOT responsible for answering questions about smallpox, vaccination procedures or reactions to vaccination

22. Video Unit continued Patients will be required to complete the medical assessment and Informed Consent forms in their packages before being allowed to proceed to the next step Non-Security staff in the Video Area are responsible for reviewing the completed forms and directing the patients to proceed to the Vaccination Area or the Medical Screening & Counseling Area Video Unit Security Staff are responsible for maintaining order in the Video Area and providing instructions on how to proceed to the Vaccination Area or the Medical Screening & Counseling Area

23. Security Vaccination

24. Vaccination Security Unit In the model, the Vaccination Security Unit is staffed with 10 persons – one for each of 10 vaccination stations This staffing number may be changed based on actual experience and clinic configuration The Vaccination Security Unit interior to the vaccination clinic building The Vaccination Area is where patients are administered the smallpox vaccination and their paperwork completed The primary function of Vaccination Unit Security Staff is to maintain order in the Vaccination Area and protect the supply of vaccine

25. Vaccination Unit continued The secondary function of Vaccination Area Security Staff is to make sure that no one, especially children, disturb the containers of waste generated in the Vaccination Area Waste generated in the Vaccination Area may contain trace amounts of vaccine virus which could cause accidental infection to non-vaccinated parts of the body and lead to blindness if spread to the eyes Vaccination Area Security Staff should be sensitive to persons possibly becoming apprehensive, fainting or worse and be prepared to summon the on-site EMT, if such occurs If the EMT is not immediately available, the Float Nurse may be summoned

26. Security Supply

27. Supply Security Staff In the model, there is 1 Security person per shift in the Supply Area The Supply Area is that part of the clinic where the smallpox vaccine and clinic supplies are stored The Supply Area is a non-public place within the clinic; therefore the primary responsibility of the Supply Security staff is to assure that only authorized persons are allowed into the supply area Supply Security Staff should monitor the refrigerator/freezer to be sure that proper temperature is being maintained Supply Security Staff are also responsible for security of other clinic supplies stored at the vaccination clinic

28. Other Security Staff

29. There will be 2 “after hours” security staff for each vaccination clinic One of these staff should guard the clinic site and the other should guard the vaccine supply Vaccine temperature should be periodically checked throughout the night and the Clinic Manager or his/her designee should be contacted if there is a problem The Clinic Manager (or his/her designee) should be notified immediately in case of a power failure

30. Other Security Staff If anyone attempts unauthorized entry into the clinic, Security should immediately notify local law enforcement officials and the Clinic Manager (or his/her designee)