1. Capability Cliff Notes Series PHEP Capability 9—Medical Materiel Management and Distribution 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 Materiel Management and Distribution Medical materiel management and distribution is the ability to acquire, maintain (e.g., cold chain storage or other storage protocol), transport, distribute, and track medical materiel (e.g., pharmaceuticals, gloves, masks, and ventilators) during an incident, and to recover and account for unused medical materiel, after an incident. How can health departments manage and distribute medical materiel efficiently and effectively?

4. Medical Materiel Management and Dispensing Functions What Are The Different Steps in Managing and Distributing Medical Materiel? 1.Direct and activate medical materiel management and distribution 2.Acquire medical materiel 3.Maintain updated inventory management and reporting system 4.Establish and maintain security 5.Distribute medical materiel 6.Recover medical materiel and demobilize distribution operations

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: Direct and activate medical materiel management and distribution Tasks: How can health departments get ready to distribute medical materiel? 1.Before an incident, identify receiving sites for shipments of different sizes and for different lengths of time. 2.Before an incident, identify transportation assets and partners from commercial and government sources, and create a list of available transportation resources. 3.Before and during an incident, identify and coordinate with suppliers and distributors to determine what materiel is available and what barriers will get in the way of distributing it (e.g., transport of materiel through restricted areas). Tasks continued on next slide:

7. Function 1: Direct and activate medical materiel management and distribution Tasks cont’d: How can health departments get ready to distribute medical materiel? 4.Before and during an incident, identify staffing needs for receiving sites (e.g., numbers and skills of personnel). 5.During an incident, collect information from medical and health-related organizations on what materiel they have available, at least once per week, and as often as needed. 6.During an incident, at the request of the incident commander, activate the receiving sites that are needed. 7.During an incident, at the request of the incident commander, select transportation from the pre-identified asset list.

8. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Documentation of primary and backup receiving sites Transportation strategy Protocol for reporting Medical materiel levels Supplier and distributor points of contact within jurisdiction Demographic analysis of jurisdiction Personnel activation process Stakeholder list and communication protocol Public Health role in Emergency response Job action sheets for medical materiel personnel Transportation and distribution assets Interoperable systems for coordinating distribution

9. Function 2: Acquire medical materiel Tasks: What do health departments need to do to acquire medical materiel? 1.Request and accept medical materiel from partners according to National Incident Management System standards and incident needs. 2.Maintain integrity of medical materiel according to manufacturer specifications for getting and storing materiel.

10. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Medical materiel request process Medical materiel storage protocol Protocols for requests, receiving and distribution training Cold chain management techniques Supply chain application training Pharmaceutical license and management identification Receiving site materiel-handling equipment Temperature maintenance and monitoring equipment

11. Function 3: Maintain updated inventory management and reporting system Tasks: What steps will ensure that health departments have the ability to keep track of and report inventory? 1.Conduct initial inventory and update the inventory management system with information about all incoming and outgoing medical materiel, and materiel that is dispose of, recovered, or returned. 2.Provide inventory status reports to authorities at least weekly during an incident, and as often as needed. 3.Track re-supply requests for medical materiel.

12. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Protocol for reporting to jurisdictional, state, regional, and federal authorities Protocol to request additional medical materiel at dispensing sites in accordance with NIMS Inventory management system training Inventory management system

13. Function 4: Establish and maintain security Tasks: What are the things health departments should do to maintain security over materiel? 1.Select receiving sites from pre-identified locations, and determine which sites may need increased security (such as controlled-substance storage areas). 2.At the time of the incident, if necessary, select additional receiving sites and determine which of those sites may need increased security. 3.Establish and maintain appropriate security measures at receiving sites and during transportation to points-of-dispensing.

14. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Protocols that address physical security of medical materiel Inventory of security measures at receiving sites Drug Enforcement Administration licensing identification Physical security measures (e.g., cages, locks, and alarms) for maintaining security of materiel

15. Function 5: Distribute medical materiel Tasks: What are the steps for distributing medical materiel? 1.Work out allocation and distribution strategies, including delivery locations, routes, and delivery schedule/frequency. 2.Maintain integrity of medical materiel according to established safety and manufacturer specifications during all phases of transport and distribution.

16. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Medical materiel allocation and distribution strategy Key stakeholders and protocol for communicating distribution strategy Agreements to ensure sites maintain cold-chain management standards Understanding of allocation and distribution strategy

17. Function 6: Recover medical materiel and demobilize distribution operations Tasks: What is the process for recovering and demobilizing distribution operations? 1.Recover materiel and equipment according to jurisdictional policies and federal regulations. 2.Determine what is left of unused (unopened) medical materiel, unused pharmaceuticals, and durable items. Decide what to do with the unused materiel, according to jurisdictional policies. 3.Dispose of biomedical waste materials created by operations, according to jurisdictional policies. 4.Deactivate receiving sites and release personnel as appropriate and according to National Incident Management System protocol. 5.Document incident findings as part of the after-action report process.

18. Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Protocols for unused medical material Protocols for demobilizing operations After-action report Understanding of protocols for disposal of unused medical materiel Understanding of after action reporting protocols

19. 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