1. Capability Cliff Notes Series PHEP Capability 8—Medical Dispensing and Countermeasures What Is It And How Will We Measure It?

2. Learning Objectives Become familiar with Capability Functions Become familiar with Tasks that complete the Functions Understand how these Functions and Tasks are measured or may be measured in the future (Performance Measures)

3. Medical Dispensing Medical countermeasure dispensing is the ability to provide medical countermeasures (including vaccines, antiviral drugs, antibiotics, antitoxin, etc.) for treatment or prophylaxis to the population according to public health guidelines and recommendations. How can health departments ensure that they can dispense needed treatment or prophylaxis to people in the most efficient and correct way?

4. Medical Dispensing Functions What Can Health Departments Do to Dispense Medication or Prophylaxis Efficiently and Correctly? 1.Identify and initiate medical countermeasure dispensing strategies 2.Receive medical countermeasures 3.Activate dispensing modalities 4.Dispense medical countermeasures to identified population 5.Report adverse events

5. Capabilities and Measures Resources The presentation will be an overview of the functions and tasks. The measures for this capability can be found in the new MCM-ORR tool, at the following link: But the measurements overall consist of the following types of measures: The CDC conducts reviews that measure each of these activities annually. However, the composite score has been discontinued. Technical Assistance Review DSNS operational drills (annual requirement beginning 2011-2012) Compliance with programmatic standards (annual requirement beginning 2012-2013) – Points of dispensing standards – Medical countermeasure distribution standards Full-scale exercises (FSE) – Medical countermeasure distribution (one state-level FSE required during the 2011-2016 time period) – Medical countermeasure dispensing (one CRI-level FSE during the 2011-2016 time period).

6. Function 1: Identify and initiate medical countermeasure dispensing strategies How can health departments identify appropriate strategies for giving out needed treatment and prophylaxis? 1.Before an incident, and during an incident if needed, engage subject matter experts (e.g., epidemiology, laboratory, radiological, chemical, and biological), to determine what medical countermeasures are best suited and available for the incidents most likely to occur based on risk assessment information. 2.Before an incident, and during an incident if needed, engage other partners to identify and fill required response roles that cannot be met by public health.

7. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: SOPs to identify medical countermeasures required for the incident or potential incident Jurisdictional level, multidisciplinary planning groups Training on jurisdictional medical countermeasure dispensing requirements, plans, and procedures Training on responder group roles and procedures Reporting system to receive delivery orders and provide status reports to the EOC

8. Function 2: Receive medical countermeasures Tasks: What do health departments need to do to receive medical countermeasures? 1.Determine if the current jurisdictional medical inventories available can meet incident needs. 2.Request additional medical countermeasures from partners using established procedures, according to incident needs. 3.Identify and notify any intermediary distribution sites of the request for and upcoming arrival of supplies, based on the needs of the incident.

9. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Protocols to request additional medical countermeasures Protocols for medical countermeasure storage Inventory management system Material required to receive medical countermeasures

10. Function 3: Activate dispensing modalities Tasks: How should health departments activate pathways for dispensing? 1.Begin processes, such as notifying dispensing sites, tracking programs, and other strategies to enable medical countermeasures to be dispensed to the population that needs it. 2.Activate enough staff to support the dispensing activities. 3.If indicated by the incident, ensure medical countermeasures will be provided to responders, including public health responders, 211, critical infrastructure employees and their families. 4.Ensure site-specific security measures for dispensing locations, if needed. 5.Inform the public of dispensing operations including locations, time period of availability, and method of delivery.

11. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Written agreements to share resources, facilities, services, and other potential support Processes to govern the activation of dispensing modalities Security for dispensing site List of private partners for private sector dispensing Pre-defined communication messages Material required to dispense medical countermeasures Systems to support the development of staffing models

12. Function 4: Dispense medical countermeasures to identified population Tasks: What are the things health departments should do as part of dispensing the countermeasures? 1.Maintain an inventory management system to track quantity and type of medical countermeasures available at the dispensing site. 2.Screen and triage individuals to determine which medical countermeasure is appropriate to dispense to individuals, if more than one type of medical countermeasure is being provided at the site. 3.Distribute pre-printed drug/vaccine information sheets that include instructions on how to report adverse events. Tasks continued on next slide:

13. Function 4: Dispense medical countermeasures to identified population Tasks Cont’d: What are the things health departments should do as part of dispensing the countermeasures? 4.Monitor dispensing site throughput, and adjust staffing to dispense supplies to the population as quickly and thoroughly as possible. 5.Document doses of medical countermeasures dispensed or are being dispensed, including but not limited to: product name and lot number, date of dispensing, and location of dispensing (e.g., address and zip code). 6.Report aggregate inventory and dispensing information to authorities at least weekly during an incident, and as often as needed. 7.Determine what is left over and what should happen to those unused countermeasures, according to policies.

14. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Process to govern the dispensing of medical countermeasures Storage, distribution, disposal, or return of unused medical countermeasures Protocols to request additional staffing and supplies Security for dispensing modality Training on jurisdictional medical countermeasure dispensing systems Information sheets for the medical countermeasures dispensed Data forms and information sheets required by an Emergency Use Authorization Inventory management system to track dispensing

15. Function 5: Report adverse events Tasks: What are the things health departments need to do to report adverse events? 1.Activate mechanisms for individuals and healthcare providers to notify health departments about adverse events. 2.Report adverse event data to jurisdictional and federal agencies according to protocols.

16. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Processes to govern reporting of adverse events Written agreements to share resources for responding to, reporting to, and investigating adverse events Training on adverse event reporting system, processes, and protocols Access to national systems to report adverse events

17. Questions? For evaluation questions, please contact: Rachel Coles Program Evaluator--CDPHE 303-692-2764 rachel.coles@state.co.us For MCM-ORR or other SNS questions, please contact: Melanie Simons SNS Coordinator 303-692-2950 melanie.simons@state.co.us