1. Strategic National Stockpile (SNS)
Confidential Not For Public Release

2. Learning Objectives Understanding of SNS Strategic National Stockpile
RSS Receiving, Staging and
Storage
POD Point of Distribution

3. Ocean County Health Department Emergency Preparedness and Response
Our Mission:
Ensure a coordinated, timely, and effective response to a bioterrorist event, natural disaster, or other public health emergency in Ocean County.

4. Current Threats Man-made (CBRNE) Chemical, Biological, Radiological,
Nuclear, Explosive
Naturally occurring
Influenza pandemic, SARS, anthrax,
natural disasters
A natural disaster
After the flooding caused by Hurricane Katrina along the Gulf Coast, a number of people received emergency vaccinations against diseases like Hepatitis A and Hepatitis B at mass distribution sites.
An act of terrorism
Terrorism can take the form of biological, chemical or radiological agents. For instance, some people who worked in places where the anthrax-contaminated envelopes were received in fall 2001 received the antibiotic Ciprofloxacin to try and prevent their developing anthrax.

5. Public Health Threat is Identified
In order to respond effectively to an outbreak, the threat needs to be identified
Surveillance ( ED, Epicenter, etc)
Bio Watch (bio- surveillance , 30 metros)

6. Local Government Responds
Local jurisdiction will attempt to manage a public health emergency by first utilizing local resources
If local resources are or are believed to be insufficient then a request will be made by Ocean County for the deployment of state assets

7. State Government Responds
State government will respond by providing additional resources
May include antibiotics, equipment, medical supplies and other supplies
If state assets are believed to become insufficient then a request is made for the deployment of federal assets ie SNS

8. The Strategic National Stockpile, or “SNS,” was previously known as the National Pharmaceutical Stockpile. The SNS is a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration, airway maintenance supplies, and medical/surgical items. The SNS is designed to supplement and re-supply state and local public health agencies in the event of a national emergency anywhere and at anytime within the U.S. or its territories.

9. Strategic National Stockpile
Pre-positioned pharmaceutical stockpiles located throughout the United States

10. What does the Stockpile Contain?
Pharmaceuticals
Medical Supplies
Medical Equipment
Vaccines
Antitoxins
Antidotes

11. Strategic National Stockpile (SNS)
12 Hour Push Package
Vendor Managed Inventory
The SNS program is comprised of two possible deliveries in response to an event. Components to a Two-Tiered Response:
12-Hour Push Packages:
Ready for deployment to reach designated airfield within 12 hours of Federal activation
Pre-positioned in environmentally controlled and secured facilities
Pre-configured for rapid identification and ease of distribution
Vendor Managed Inventory:
Are comprised of pharmaceuticals and supplies that are delivered from one or more VMI sources
Will be shipped to arrive within 24 and 36-hour periods
“Tailored" to provide specific material depending upon suspected or confirmed agent 11 11

12. 12- Hour Push Package 12 because it will arrive in 12 hours or less
push because a state need only ask for help not for specific items and
package because the Program will ship a complete package of medical material to include nearly everything a state will need to respond to a broad range of threats.
The SNS is organized for flexible response. The first line of support lies within the immediate response 12 hour Push Packages. These are caches of pharmaceuticals, antidotes, and medical supplies designed to provide rapid delivery of a broad spectrum of assets for an ill defined threat in the early hours of an event. These Push Packages are positioned in strategically located, secure warehouses ready for immediate deployment to a designated site within 12 hours of the decision to deploy SNS assets.
READ SLIDE

13. Strategic National Stockpile
Each Push-Pack…
Occupies 130 cargo containers
Weighs 94,424 pounds
Measures 10,329 cubic feet
Requires 5,000 square feet
THE CDC IS RESPONSIBLE FOR THE MOBILIZATION AND DELIVERY OF THE NPS TO AN OPEN COMMERCIAL AIRPORT CLOSEST TO THE AFFECTED AREA.
THE STATE OR LOCAL AUTHORITIES ARE SUBSEQUENTLY RESPONSIBLE FOR THE MOVEMENT AND DISTRIBUTION OF NPS material FROM THE AIRFIELD TO THAT AFFECTED AREA.
BUT CDC WILL ASSIST IN THE DISTRIBUTION OF MEDICAL material.
EACH AIR CARGO CONTAINER WILL BE CLEARLY LABELED AND CODED TO EASE DISTRIBUTION AT THE AIRFIELD. 13 13

14. Vendor Managed Inventory (VMI)
arrive within 24 to 36 hours
tailored to provide pharmaceuticals supplies and/or products specific to the suspected or confirmed agent
If the incident requires additional pharmaceuticals and /or medical supplies, follow-on vendor managed inventory (VMI) supplies will be shipped to arrive within 24 to 36 hours. If the agent is well defined, VMI can be tailored to provide pharmaceuticals, supplies and/or products specific to the suspected or confirmed agent. In this case, the VMI could act as the first option for immediate response from the SNS program.

15. CHEMPACK in New Jersey Fielded 58 CHEMPACKS.
Primarily in acute care hospitals.
Provide State-wide coverage housed at (34) sites with the ability to treat up to 40,000 victims.
Requires ongoing coordination with CDC and management by NJDOH.

16. Receiving, Staging, and Storage (RSS)
The Strategic National Stockpile is shipped to a Receiving, Staging, and Storage facility for distribution.

17. RSS Locations Ocean County has identified two locations
Primary: Lakewood Public Works
Back-up: Ocean County Voter Technology Building, Lakewood
The locations have the appropriate size and layout to accommodate the SNS assets
Each location can be secured (security assessment)

18. Ocean County RSS Site Reallocate & Repack Distribute
2 Sites (primary and alternate
OCHD personnel, Sheriff’s Officers, MRC/CERT Volunteers

20. What is a POD?
Point Of Distribution (POD) - a place where a vaccine, antibiotic or other medication is dispensed quickly to a large group of people in the event of a Public Health Emergency

21. Ocean County Points of Distribution
6- PODs ( MOU with Schools)
POD for prevention not treatment
OCHD employees
MRC/CERT/DRCC
Sheriff’s Officers

22. Ocean County POD Site Selection
Location
Security
Parking (accessible by public transport)
Refrigeration
Triage area
Restrooms, Water, Electricity
Heat/Air Conditioning (68°-77°F)
Work station area

23. POD Layout Sample
Registration: Here individuals check in. They are given forms to complete that include their medical history.
 Registration: Here individuals check in. They are given forms to complete that include their medical history.
 Registration: Here individuals check in. They are given forms to complete that include their medical history
Triage: At this station staff members review the patient-completed forms to identify people who require further medical and/or mental health evaluation. Generally if they check 'yes' for any of the medical conditions listed on the medical history form, they are sent to the medical evaluation station. People who do not need further evaluation can proceed directly to the distribution station.
Medical evaluation: Appropriately credentialed providers (physician, nurse practitioner, physician assistant) determine whether the person should receive the medication or vaccination, should receive an alternative medication or vaccination, or should not receive any medication or vaccination. Those who are to receive a medication or vaccination would go to the distribution station. Others would exit
distribution: Staff members at this station give the medications or vaccinations. This process may be fairly simple or more complicated depending on the nature of the POD
Education: Staff members give individuals information about how to take medications, what side effects they might expect, what follow-up they need to do, etc. This information may be in writing, verbally, or both. In some PODs, education will be done before registration as well as after distribution.

24. Roles and Responsibilities Ocean County Health Department
Develop, maintain and update SNS Plan
Train and or Exercise SNS Plan at least every year(call-down, RSS site setup, POD setup, etc)
Ensure training of assigned primary and backup personnel in key positions
Organize and Chair multi disciplinary planning meeting to review and update SNS Plan

25. County of Ocean Department of Human Services
Provide psychological first aid to public/first responders (DRCC)
Provide support to first line staff at medical facilities
Provide online/hotline crisis response resources to general population

26. Ocean County Prosecutor’s Office
Conduct site assessment for primary and secondary RSS and POD sites
Assist with joint security for RSS/POD sites
Coordinate law enforcement activities with County and local law enforcement agencies.

27. County of Ocean Sheriff’s Office
Assist with coordination of law enforcement officers with OC Prosecutors office/local law enforcement
Assist with joint security of primary and secondary RSS site
Assist with escort of SNS supplies between RSS and PODs

28. County of Ocean Sheriff’s Office of Emergency Management
Activate OC EOC on public health emergency declaration
Assist with coordination and support for Incident Management
Assist with providing multi level agency coordination
Assist with identification of at- risk homebound/special needs population

29. County of Ocean Sheriff’s Office of Emergency Management
Activate OC EOC on public health emergency declaration
Assist with coordination and support for Incident Management
Assist with providing multi level agency coordination
Assist with identification of at- risk homebound/special needs population

30. County of Ocean (Transportation Needs)
Assist in the transport of target population/special needs to PODS (Ocean Ride)
Assist in transport of supplies to the PODs
Assist with medication distribution to PODs

31. Lakewood Township Public Works
Provide access to primary RSS Site
Ensure all equipment and supplies related to RSS operations are available (pallet jacks, fork lift, etc)
Ensure assigned staff is trained and available