Closed POD Partnerships:

1. Closed POD Partnerships: A Community Resource for Mass Prophylaxis 2012 Integrated Public Health and Medical Preparedness Summit Concurrent Session Wed., June 20th, 2012 12:30 – 1:45 pm Speakers: Susan Albee, Cathy Coverston Anderson, Mick Humer, Shay Simmons

2. Cathy Coverston Anderson, McLean County Health Department Susan Albee, McLean County Health Department Mick Humer, Town of Normal Fire Department Shay Simmons, McLean County Health Department

3. Learning Objectives Upon completion of this session, participants should be able to: List 4 planning principles for closed POD partnerships. Identify organizations, agencies and businesses that are most suitable to become potential POD partners. Identify 3 barriers to potential POD partnerships and how these can be overcome.

4. McLean County Health DepartmentRecruitment Effort of June 2011 • Hosted a Closed POD Partner Recruitment Event on 6/22/2011 using IDPH PHEP extension grant funding. • Sent invitations to 22 organizations/agencies. • Results: • 14 attended • 13 interested in an agreement • 5 have signed an agreement

5. Event Participants Were Given: • CLOSED POD PARTNER PLANNING WORKBOOK • MCHD used a template created by a CRI jurisdiction and offered online at the CDC website. • BROCHURE: “Protecting Your Organization During Public Health Emergencies” • POWERPOINT HANDOUTS • POST CARD TO COMPLETE: “Interest Indicator” • LUNCH

6. Closed PODs—Why Bother? The numbers add up: McLean County HD has 5 Closed POD agreements signed as of 6/1/2012. This does not include hospitals and universities. These 5 agreements represent a total of approx. 5,000 individuals . 3% of the McLean County population. If all of the organizations recruited to be Closed POD partners signed an Closed POD agreement: These 9 additional agreements would represent over 25 % of the county population. Closed POD partners may agree to be an Open POD as well.

7. Closed POD Partnerships: Planning Principle #1: Recruit “Pacesetters”

8. Identifying Potential Partners Responders/Medical Facilities Municipalities within McLean County Residential facilities, including long term care and retirement facilities Healthcare providers Organizations with response roles (NGOs, FBOs) Major Employers The “top twenty”: check listings in your local Economic Development Council or Regional Planning Office annual report. Schools School districts Universities and colleges

9. The Final List for McLean County State Farm Illinois State University Country Financial Unit 5 School district Mitsubishi Motors AFNI, Inc District 87Schools Evergreen Village City of Bloomington Town of Normal Illinois Wesleyan Growmark, Inc American Red Cross Chestnut Healthcare Systems *Two county hospitals are existing closed PODs

10. Sample Of the PowerPoint Presentation Given at the Closed POD Partner Recruitment Event 6/22/2011

11. Public Health Emergency Preparedness Public Health Emergencies An “All-Hazards Approach” Roles in preparedness: Federal State Local Tribal Private Sector Non-Governmental Organizations ADD A VISUAL

12. Our Problem Planning Scenarios Aerosolized release of: Anthrax Plague Tularemia Smallpox release Pandemic Influenza Goal 48-hour response time for the aerosolized agents. ADD A VISUAL

13. CDC Category “A” Agents

14. Strategic National Stockpile (SNS) • Contents: antibiotics; antidotes; antitoxins; medical supplies for hospitals. • Placed, by the Centers for Disease Control and Prevention (CDC), across the country in strategic locations. • Ready to be moved to Illinois if needed. • Requires local emergency responders to work togetherto set up vaccination or medication dispensing sites quickly. • May require the dispensing of oral medications to the entire county within 48-hours.

15. Public Health’s Response Request SNS for local use. Anticipate arrival in Illinois within 12-hours of CDC’s approval of our request. Set up Points of Dispensing (PODs) with our partners: Primary method to dispense medications to the public Common areas located throughout the community (gyms, civic centers, community centers) Managed and operated by local public health departments

16. Public Health’s Response What this means to McLean County: 169,572 residents (2010 census) 25,000 post-secondary students (during the school year) To dispense medication to 194,000+ residents is a monumental task We can’t do it alone

17. Medication Dispensing/Vaccination Sites (Points of Dispensing—PODs) • Vaccinations and/or Medications to: • First Responders: including MRC and other Volunteers • General Public • Homebound Individuals • Residential Care • Occupational Health Staff • We need to utilize both open and closed PODS.

18. Two Categories of PODs • “Open” POD • H1N1: Sale Barn; Interstate Center; US Cellular Coliseum • “Closed” POD • H1N1: State Farm; ISU Clinic at Redbird Arena

19. “Open” PODs • Open to the general public; usually offered in large facilities. • May be restricted to target groups identified by the CDC. • Require large numbers of staff, volunteers, and support from community partners in order to operate 24/7; 12-hour shifts. • Number Open PODs needed for a 48-hour dispensing event = at least 4, serving 420-500 people per hour; 12,000 people/day/open POD.

20. “Closed” PODs • Not available to the general public. • Closed POD option may be available to first responders. • Usually offered at work sites; businesses; health facilities; and/or faith-based organizations. • May require only moderate numbers of staff, volunteers, and support from community partners; smaller facilities (such as nursing homes) may only need small amounts of outside assistance. • Staffing 24/7 may not be needed for many sites.

21. The $64,000 Question: Is your organization ready to partnerwith the McLean County Health Department to become a Closed POD?

22. End of Sample Of the PowerPoint Presentation Given at the Closed POD Partner Recruitment Event 6/22/2011

23. Closed POD Partnerships: Planning Principle #2: Promote the Benefits of Becoming a Closed POD Partner

24. What’s In It For Me? Benefits to the community: Helps achieve community dispensing goal more rapidly Decreases the number of people going to open PODs May help maintain economic stability Benefits to the organization: Medications dispensed to a specific group designated by the organization Not open to the public, so no long lines Managed by organization’s staff Keeps employees working Communicates care for employees and their families

25. “Most of us in risk management jobs know the best time to address a problem is before it starts. The worst time to meet the fire chief is when you’re smelling smoke. The same old adage holds for true for public health. Talking to the public health officials about a POD after the mortality rate is front page news is too late. You’ve lost your credibility, and likely the trust of the very people you wish to protect…”

26. “…..From a purely business perspective, are you better off having your people stand in line in your building for a vaccination or a medication, or do you want them taking off the better part of the day to go to a remote clinic for the same treatment? “ Mike Claver, State Farm Insurance Companies.

27. Closed POD Partnerships: Planning Principle #3: Provide Guidance and Clarify Roles and Responsibilities

28. Responsibilities: McLean County Health Department Develop guidelines to ensure safe dispensing of medication or vaccine administration. Assist in development of organization’s Closed POD plan Provide all medications or vaccine supplies and accompanying information sheets Provide training and exercise support Provide tools, templates and ongoing technical assistance

29. Responsibilities :Closed POD Partner Designate liaisons to coordinate with public health officials Develop a Closed POD plan Determine POD location(s) Develop procedures Activation and recall procedures Security planning Receipt of medication or vaccination Dispensing/vaccination procedures Provide staff Provide non-medical supplies (such as tables, chairs, printers, office supplies) Participate in training and exercise opportunities Operate a Closed POD during an emergency

30. Understanding the Process Four Key Steps: Fill Out Form Show Form Pick Up Medicines (or Get Vaccination) Exit

31. Provide Guidance by Acknowledging and Addressing Barriers to Becoming a Closed POD Partner: Lack of Support by Administration Lack of Medical Staff Liability Concerns

32. Lack of Support from Administration: Offer to attend meetings Provide materials Invite to local planning meetings Provide statistics regarding workforce availability during pandemics Assist with Continuity of Operations planning

33. Medical Issues Dispensing Medications or Administering Vaccines: Use of medical professionals: The State of Illinois currently mandates use of the medical model . Medical Model: only licensed personnel can give meds during a public health emergency. Non-Medical Model: unlicensed personnel can give meds during a public health emergency. Possible “Fixes”: Does the agency have an Occupational Health provider/contract? Consider contractual arrangements with local providers.

34. Liability Issues Liability Protection Federal legislation Public Readiness and Emergency Preparedness (PREP) Act State/Local legislation 745 ILCS 49/68: Good Samaritan Act for Disaster Relief Pharmacy laws related to dispensing medication or providing vaccinations Adverse Events Agreements

35. Overview of the The Planning Process Used byMcLean County Health Department

36. Next Steps for the Partners Assure and secure support from administrators. Consult legal counsel and review liability and insurance coverage issues. Appoint a committee to work on a plan. Complete a Memorandum of Understanding with the McLean County Health Department. Assess resources: Personnel: Medical personnel Support personnel POD equipment

37. Next Steps for the Partners, cont’d. Determine who the POD site will serve: Employees only? Employees and their household members? Prepare the facility: Assemble equipment Educate your leaders Educate other personnel Develop procedures. Practice the plan. Exercise the plan with others.

38. Partner Planning – Appoint a Committee Committee members (recommended) Primary Coordinator/Closed POD Mgr Backup Coordinator Security Coordinator Logistics Coordinator Human Resources Business Continuity Mgr Legal Counsel Medical Advisor Public Health Liaison

39. Partner Planning – Appoint a Committee Committee members (actual) Primary Coordinator/Closed POD Mgr Backup Coordinator Security Coordinator Logistics Coordinator Human Resources/Legal Medical Advisor (outsourced)

40. Partner Planning – Determine the Dispensing Population

41. Partner Planning – Determine the Dispensing Population, cont’d Full time employees Part time employees Contractors Seasonal employees Families Estimated numbers or actual? *Estimates of family members can be calculated by multiplying the number of employees by 2.5 (average # persons per household).

42. Partner Planning – Organize POD Staff

43. Partner Planning – Identify Facilities

44. Partner Planning – Identify Facilities, cont’d. Site Considerations Adequate Parking Restrooms ADA accessibility HVAC/Power/Backup Power Communications (Telephone) Separate entrances/exits Staff break rooms Medication storage Lockable storage area (if required) Refrigeration (if required)

45. Partner Planning – Assemble Equipment Office supplies Tables/chairs Computers Copier/printer Janitorial supplies Extension cords Wastebaskets/trashbags Signage PPE (if required) 1st Aid/AED

46. Partner Planning – Signage Entrance Four Simple Steps Step 1: Fill Out Form  Step 2: Show Form  Step 3: Pick Up Medicine Step 4: Turn In Form & Exit Thank you for your cooperation Please Wait Exit First Aid No Entrance No Exit

47. Partner Planning – Communications How do we communicate with our employees/staff? Telephone/call-down list Text Website posting Radio

48. Partner Planning – Receiving/Dispensing Medication Receiving Inventory management and tracking Re-supply Return Dispensing POD Staff Designated population

49. Partner Planning – Receiving/Dispensing Medication, cont’d. Storage Secure storage area Refrigeration Security Physical Security Personnel Protection Law Enforcement/EMS personnel

50. Partner Planning – Exercising the Plan March 14th TTX Anthrax release on campus Multiple PODs Participants Law Enforcement Universities Hospitals NGOs Businesses