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At Residential Associations And Home Owners Associations As Points of Dispensing Palm Beach County Health Department Office of Emergency Preparedness Mass.

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Presentation on theme: "At Residential Associations And Home Owners Associations As Points of Dispensing Palm Beach County Health Department Office of Emergency Preparedness Mass."— Presentation transcript:

1 At Residential Associations And Home Owners Associations As Points of Dispensing Palm Beach County Health Department Office of Emergency Preparedness Mass Antibiotics Dispensing

2 The Unthinkable Has Already Happened in the United States….

3 Do You Spend Any Time Thinking About Them?

4 Or Them?

5 Could This Happen, Again?

6 Extraordinary magnitude of harm Ecological disruption Disproportionate impact on vulnerable communities Demand for response that exceed communitys ability to cope Necessity for outside assistance Characteristics of Disasters

7 What If Anthrax Was Dusted on Boca Center or The Gardens Mall?

8 PB County Health Department Plan In the Anthrax episode of October 2001, Palm Beach County requested assistance from the CDCs Strategic National Stockpile Antibiotics (Cipro) were provided from CDCs Strategic National Stockpile and Vendor Managed Inventory

9 National Impact of Fall 2001 Anthrax Mailings Cases of Anthrax 23 people were infected (Inhalation + Cutaneous) 5 individuals died Antibiotic Prophylaxis Approximately 32,000 people received antibiotics Hoaxes/False Alarms Approximately 7,000 per month (nationwide)

10 In A Biological Emergency the Strategic National Stockpile Will Be Activated The Strategic National Stockpile (SNS) is: Prepackaged medical materials Pre-positioned by CDC To augment state/local medical needs Responds to a wide range of expected problems associated with a chemical and/or biological incident/event.

11 Components of Strategic National Stockpile - 12 hour push package (Phase I ) Contains large quantities of antibiotics, antidotes, medical supplies, and equipment to immediately treat or provide antibiotics or preventative medication to thousands of affected or symptomatic individuals

12 Other Components - Managed Inventory (MI) Large quantities of specific items to combat one or more specific threats. The MI provides shipments of large and continuous quantities once the threat is known. MI shipments will arrive in the state within 24- 36 hours of an approved request.

13

14 August 2005: CDC Designates PB County As A CRI County As a Cities Readiness Initiative (CRI) Area we must provide preventative medication to our entire population of about 1.3 million people, in 48 hours. We will need 45 Points of Dispensing (PODs) with 5,400 volunteers. Each POD will have to dispense meds at the rate of 625 people per hour.

15 7 Days 1 Day 2 Days 3 Days 4 Days 5 Days 6 Days Immed. 10 Days 84%78%71%62%54%45%36%28% 7 Days 95%91%85%78%69%59%49%39% 6 Days 97%94%89%83%75%65%54%43% 5 Days 98%96%92%87%80%71%60%49% 4 Days 99%98%95%91%85%76%66%54% 3 Days 100%99%97%94%89%81%72%60% 2 Days 100%99%98%9692%86%77%66% 1 Day 100% 99%97%94%89%82%72% DELAY in Initiation DURATION of Campaign AnthraxExposure: ProportionofPopulationSaved Anthrax Exposure: Proportion of Population Saved

16 Anthrax: Fatal Case Review

17 Points of Dispensing (PODs) PODs are simply pre-identified sites where drugs are dispensed or administered to the affected population. PODs are predetermined by the County Health Department and the local Emergency Operations Center. The number of PODs is dictated by the magnitude of the event and the number of support staff available.

18 Points of Dispensing (PODs) Virtually all drugs will come in pre- packaged bottles (10-day supply) for rapid dispensing. Instruction will be provided for the mixing of drugs in solution/ suspension form for those who cannot take medication in pill- form. Counseling on use of medication will be provided at POD.

19 Hypothetical Description of Staging Area and Community PODs (Law Enforcement Sensitive) Boynton Beach Mall Staging Area #2 Atlantic High School 15 34 Park Vista High School 24 67 Santaluces High School 13 62

20 Incident Command System - PODs POD Manager Planning Chief Greeter Situational Briefing Briefing Education Operations Chief Triage EMS Med Screening Eval Pharm Dispen Super Med Vaccine Disp Mental Health Sp Logistics Chief Staging Support Security Leader Patient Traffic Transportation Ldr Admin Chief Forms & Info Dist Communication/IT Communications Lead Public Info Liaison -PIC Safety Officer Liaison Officer

21 Three Types of PODs To Provide Preventative Meds To The 1.3 Million People of PB County PBCHD Directs Distribution to: First Responders, Nursing Homes, ALFs and PODs University and College PODs Business PODs 1,000+ 45 Community PODs Residential Association & HOA PODs

22 Establishing PODs At Residential Associations or HOAs A Memorandum of Agreement (MOA), signed by PBCHD and the Board President of a Residential Association or HOA, will establish a Residential POD (R-POD). MOA will delineate responsibilities of PBCHD and the Residential Association or HOA for activities related to providing medication and other medical supplies to the residents and employees of the Association.

23 MOA – PBCHD Agrees to: Arrange for the delivery of medication, antidotes and/or vaccines to the R-POD.* Assist in the training of resident volunteers for the various jobs needed to dispense these medical materials. Provide sample copies of Patient Registration Forms and documentation for the accountability of the medical materials. *PBCHD will need a census count of the residences – year round vs. seasonal - and estimates of the number of adults and children in the development.

24 MOA – RA or HOA Agrees to: Utilize their clubhouse or other building as the dispensing site. Recruit resident volunteers to assist in dispensing the antibiotics and other medical materials to all the residents and employees without prejudice. Dispensing to supervised by a volunteer who is authorized to prescribe or dispense pharmaceuticals (RPh/PharmD, MD/DO, PA, ARNP, DDS/DMD, DPM)

25 Location of R-PODs Will Be Disclosed Only To Their Residents Delivery of emergency medication will be done by Florida Department of Health, with security provided by the PB County Sheriffs Office (ESF-16). There will be NO public disclosure of the location of any of the PODs in PB County. PBCHD will communicate directly with R-PODs about activation. R-PODs will be provided necessary instructions to alert their residents.

26 What About Liability? State liability protection will be provided to ALL volunteers according to Florida Statute

27 Temporary Lease Agreement RA or HOA will donate a specified portion of property for temporary use by the PB County Health Department for a limited time to be specified and concurrent with a declared incident. As an active corporation, RA or HOA will be classified as a volunteer providing a service to the State of Florida (F.S. 110.501 and F.S. 1.01).

28 Volunteer Services Application Volunteers who sign DOH Volunteer Service Applications are provided: State liability protection under the Florida Volunteer Protection Act (F.S.768.28), and are Covered for Workmens Compensation (F.S. Chapter 110.504) Volunteers receive First Priority medication for themselves and their family members.

29 Early Planning – Letters to Physicians So that patients are informed of how to take antibiotics dispensed at PODs during an anthrax activation (Cipro, doxycycline, or amoxicillin). Particularly important for pregnant and lactating women. Equally important that parents of children have instructions on how to administer possible lower doses. Special needs patients (dialysis, etc.) also need special instruction.

30 Public Service Announcements (PSA) Newspapers and TV stations will be given information about the activation of General Public PODs and the locations of the Mall Staging Areas. The public will be instructed regarding the procedures for receiving FREE preventative medication. Copies of the Patient Registration Form with instructions about medication use and information about the biological episode at hand.

31 Following The Registration Form -1 Patient Registration Forms are distributed to all residents by the RA or HOA to be filled out prior to coming to the R-POD. Resident lists all members of household and possible others for whom medication will be picked up – for a maximum of 15 people. To minimize traffic flow and congestion, one Family Member drives to clubhouse (the R- POD) and is directed as to where to park.

32 Patient Registration Form LIneLIne (Fill in Contact Information for Person listed on Line 1 at bottom of this form.) Last Name, First Name Age If Age Under 19: Weight (in pounds) Females: Is she: Pregnant or Breast Feeding? PRINT First Letter of Symptom if Person had it in Last 7 Days: - Fever - Aches - Chills - Cough - Tiredness - Vomiting - No Symptoms PRINT First Letter of Medication to which Person is Allergic: - Cipro - Doxycycline - Amoxicillin - Penicillin - Other -No Known Drug Allergies 1 Yes No 2 3 4 12 Yes No 13 Yes No 14 Yes No

33 Following The Registration Form - 2 Patient Registration Form is reviewed by a Triage volunteer who directs resident to one of three lines. Family Member receives instruction on the medication to be provided for each member of household.

34 Following The Registration Form - 3 Family Member proceeds to Medication Check-Out line Antibiotics for entire household and other listed family members, neighbors or friends are picked up Family Member exits POD and departs for home.

35 At Medication Distribution Volunteers distribute antibiotics under supervision of a medical professional authorized to dispense medication. Strict inventory control is maintained at POD distribution. Distribution information is posted to Record Control sheets and forwarded to ESF-8 at Emergency Operations twice daily.

36 Having a Nice Day? …

37 Medical Emergencies EMS to be called to assist in the care or transport of any person to the hospital who is symptomatic of disease or is in need of emergency medical treatment.

38 Volunteers Needed To Help PB Countys Health Department Fulfill Its Mission: To save lives, prevent illness and facilitate basic healthcare services To aid in the distribution of antibiotics, medical triage, immunizations and other life saving procedures during a large-scale health emergency

39 For More Information On Establishing An R-POD At Your Residential Association Or Home Owners Association, Or To Find Out How To Volunteer, Please Call: Philip Levenstein PB County Health Department Office of Emergency Preparedness (561) 355-3150 E-mail: Philip_Levenstein@doh.state.fl.us There is nothing stronger than the heart of a volunteer

40 Some men see things as they are and ask – WHY Others dream of things that never were and ask – WHY NOT - George Bernard Shaw

41 Presented by The Office of Emergency Preparedness


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