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 what the functions and tasks mean, linked to the performance measures. Please note that since the capabilities PDF document has come out, more performance measures have been developed. If performance measures have come out since the creation of the capabilities document below, they have been included in these tutorials following their function slide, even if the PDF lists that there are no measures for that function. For functions that still have no measures, questions for health departments to begin thinking about measures have been included instead. For exact lists of the capabilities and performance measures, and data collected for the measures, documents can be found at these links: For Capabilities, Functions, and Tasks: http://www.cdc.gov/phpr/capabilities/DSLR_capabilities_July.pdf For Performance Measures:

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. Function 1 Measurement How does the CDC measure if health departments have the most appropriate ways for dispensing countermeasures for their populations? 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).

8. Function 2: Receive medical countermeasures Tasks: What do health departments need to do to receive medical countermeasures? 1.Determine if the 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. Function 2 Measurement How does the CDC measure if health departments have completed all the necessary requirements for receiving medical countermeasures? 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).

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. Function 3 Measurement How does the CDC measure if health departments have successfully prepared to dispense the countermeasures? 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).

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.Track doses of medical countermeasures 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. Function 4 Measurement How does the CDC measure if health departments are addressing all the issues of dispensing countermeasures? 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).

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. Function 5 Measurement How does the CDC measure if health departments have accounted for adverse events appropriately? 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).

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