Closed PODs for the Federal Work Force - A Collaborative Practice

State: MO Type: Model Practice Year: 2011

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Every LPHA faces the challenge of identifying strategies for providing mass prophylaxis during public health emergencies. To achieve success, local public health must partner with employers in establishing closed dispensing sites and elicit assistance to operate and staff public dispensing sites.<p> As one of ten Federal Regional Centers, Kansas City's largest employer is the federal government. Thirty federal agencies have offices in the metropolitan area. By entering into one mutual aid agreement with the FEB, numerous agencies will consolidate operations into four closed dispensing sites. A plan for securing, transporting and dispensing medical materials has abeen developed and federal employees have been polled to identify volunteers within the federal workforce. Joint Federal and local teams have toured each federal dispensing site to identify best areas for dispensing operations as well as securing and offloading materials.

Alternate sites have been identified and added to the plan. <p>By providing mass prophylaxis to federal employees and household members along with contractors working on federal property, as many as 100,000 people will not seek medications from public dispensing sites. Additionally, federal volunteers that operate closed dispensing sites will be assist in public dispensing operations, further reducing the load on local public health. Each federal POD site is an operational agent of the KCHD. The National Incident Management System is used in each POD and the POD Site Commander coordinates with KCHD and the KCMO Emergency Operations Center.<p>Target Population: Federal employees, Federal contractors and family, Up to 10% of the City's daytime population.

Goal: Create a partnership between the Kansas City, Mo Health Department and the Kansas City Federal Executive Board in order to establish Federal Points of Dispensing for all Kansas City area federal employees, federal contract employees and household and family members.

Objective 1: Establish a process for identifying and staffing federal closed PODs.

Objective 2: Develop a plan for federal work force prophylaxis using both medical and non-medical dispensing models.

Objective 3: Demonstrate POD planning successes and document examples of pitfalls to avoid. Implemented in 2009 - all objectives were met. Successes are attributed to the willingness of the Kansas City Health Department and the FEB to collaborate.

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Kansas City Health Department
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Closed PODs for the Federal Work Force - A Collaborative Practice
Every LPHA faces the challenge of identifying strategies for providing mass prophylaxis during public health emergencies. To achieve success, local public health must partner with employers in establishing closed dispensing sites and elicit assistance to operate and staff public dispensing sites.<p> As one of ten Federal Regional Centers, Kansas City's largest employer is the federal government. Thirty federal agencies have offices in the metropolitan area. By entering into one mutual aid agreement with the FEB, numerous agencies will consolidate operations into four closed dispensing sites. A plan for securing, transporting and dispensing medical materials has abeen developed and federal employees have been polled to identify volunteers within the federal workforce. Joint Federal and local teams have toured each federal dispensing site to identify best areas for dispensing operations as well as securing and offloading materials. Alternate sites have been identified and added to the plan. <p>By providing mass prophylaxis to federal employees and household members along with contractors working on federal property, as many as 100,000 people will not seek medications from public dispensing sites. Additionally, federal volunteers that operate closed dispensing sites will be assist in public dispensing operations, further reducing the load on local public health. Each federal POD site is an operational agent of the KCHD. The National Incident Management System is used in each POD and the POD Site Commander coordinates with KCHD and the KCMO Emergency Operations Center.<p>Target Population: Federal employees, Federal contractors and family, Up to 10% of the City's daytime population. Goal: Create a partnership between the Kansas City, Mo Health Department and the Kansas City Federal Executive Board in order to establish Federal Points of Dispensing for all Kansas City area federal employees, federal contract employees and household and family members. Objective 1: Establish a process for identifying and staffing federal closed PODs. Objective 2: Develop a plan for federal work force prophylaxis using both medical and non-medical dispensing models. Objective 3: Demonstrate POD planning successes and document examples of pitfalls to avoid. Implemented in 2009 - all objectives were met. Successes are attributed to the willingness of the Kansas City Health Department and the FEB to collaborate.
The U.S. was attacked with anthrax in October 2001; since then, the Federal Government has been planning against a scenario for a larger-scale, wide-area anthrax attack. In the event of an anthrax attack, medical countermeasures must be dispensed widely and quickly in order to minimize the loss of life. In 2003, CDC conducted a gap analysis among the most populous cites to assess readiness levels and learned that many local jurisdictions faced challenges in establishing an adequate infrastructure and necessary capabilities to sustain a mass prophylaxis campaign. Kansas City is identified as a Cities Readiness Initiative core city. The challenge the City faces is to dispense antibiotics to a residential population of approximately 500,000 people and a daytime population of more than 1 million people. The City is working toward establishing closed dispensing sites for the largest employers and vulnerable populations and providing technical assistance to ensure that personnel at those sites are capable of dispensing medications to lessen the demand on public dispensing sites.
Agency Community RolesKCHD has provided planning templates, drafted the MOU, and provided sample standing orders and medical protocols for Category A agents. The Department uses an IT Solution called MEDSPOD clinical diagnosing issuing prescriptions and is currently investing in the expansion of this technology for federal closed PODs. Additionally, KCHD has provided technical assistance on plan development and joint local/federal tours of each primary and alternate dispensing site to identify the best areas for dispensing, secure storage and dock access. KCHD is designing and controlling a full scale exercise in April, 2011 and one of the closed federal PODs will be activated. KCHD, along with DHSS will train federal POD volunteers in a newly developed six-hour dispensing course that will allow federal volunteers to dispense medical countermeasures under the supervision of licensed medical professionals. KCHD has participated in dispensing exercises at the IRS facility for the past two years. Costs and ExpendituresEvery LPHA faces the challenge of identifying strategies for providing mass prophylaxis during public health emergencies. To achieve success, local public health must partner with employers in establishing closed dispensing sites and elicit assistance to operate and staff public dispensing sites. As one of ten Federal Regional Centers, Kansas City's largest employer is the federal government. Thirty federal agencies have offices in the metropolitan area. By entering into one mutual aid agreement with the FEB, numerous agencies will consolidate operations into four closed dispensing sites. A plan for securing, transporting and dispensing medical materials has abeen developed and federal employees have been polled to identify volunteers within the federal workforce. Joint Federal and local teams have toured each federal dispensing site to identify best areas for dispensing operations as well as securing and offloading materials. Alternate sites have been identified and added to the plan. By providing mass prophylaxis to federal employees and household members along with contractors working on federal property, as many as 100,000 people will not seek medications from public dispensing sites. Additionally, federal volunteers that operate closed dispensing sites will be assist in public dispensing operations, further reducing the load on local public health. Each federal POD site is an operational agent of the KCHD. The National Incident Management System is used in each POD and the POD Site Commander coordinates with KCHD and the KCMO Emergency Operations Center. Implementation• KCHD first presented the concept of federal closed PODs to the Federal Executive Board (FEB) in 2003. That relationship continued to grow as KCHD was included in National level exercise design efforts and through participation in Regional Homeland Security Coordination Committee activities. In June, 2009, CDC briefed the FEB about closed dispensing sites. The Kansas City Health Department (KCHD) Bi-State Emergency Response Planner as well as representatives from the Missouri Department of Health and Senior Services (DHSS) was present to address questions from FEB representatives and outline a strategy to proceed. • The following are activities that have occurred since briefing the FEB: 1. August, 2009 – Draft POD Standard Operating Procedure developed; 2. August, 2009 – 3 Federal sites (as well as the IRS closed campus as a stand-alone) were identified; 3. March, 2010 – Transportation plan drafted; 4. April, 2010 – Joint building tours conducted with KCHD, HHS and facility representatives; 5. April, 2010 – Met with DHS to discuss security and escorts for SNS; 6. July/Aug, 2010 – Jointly toured alternative sites; 7. July, 2010 – Joint presentation during DHSS sponsored CRI Showcase; 8. August 2010 – POD staffing plans developed; 9. August, 2010 – Federal Information Council Briefed; 10. August, 2010 – Transportation and Security plans finalized with DHS/GSA; 11. Sept/Oct, 2010 – COOP workgroup and co-chairs briefed; 12. November, 2010 – FEB executive briefing. 13. November, 2010 - Full scale exercise at IRS preceded by state-sanctioned POD Volunteer Training. 14. January, 2011 - POD Volunteer Training for multiple Agencies 15. February, 2011 - POD Volunteer Training for multiple Agencies 16. April, 2011 – Full Scale, 3-Day exercise with Federal involvement, including the operation of a Federal Closed POD staffed by multiple federal agencies 17. April 27, 2011 – A single Memorandum of Understanding is signed by between the FEB Leadership and the City of Kansas City, Mo.
Objective 1: Establish a process for identifying and staffing federal closed PODs in Kansas City. Performance Measures 1. Participate in two Federal Executive Board meetings (2003 and 2008) to present concepts to Board members and elicit support for the concept of federal closed dispensing sites under one Memorandum of Understanding and one mass prophylaxis dispensing plan. 2. Meet with FEB representatives to identify next steps, e.g. present concept to federal Continuity of Operations Planning group.] 3. Identify and meet with federal agencies with assets required to carry out operations, e.g. Federal Protection Services for security, Department of Agriculture for transportation assets, General Services Administration for buildings. 4. Select primary and alternate points of dispensing from the sites identified. 5. Identify categories of medical and non-medical federal personnel to conduct dispensing operations. 6. Elicit federal volunteers and establish a staffing plan in accordance with a medical dispensing model. Data Collection 1. Identify federal agencies in Kansas City. 2. Identify federal facilities in Kansas City. 3. Identify number of federal employees and federal contract employees working in Kansas City. 4. Estimate number of household and family members for whom each federal employee or contractor will collect and deliver medications. 5. Identify federal assets available for transporting, securing and dispensing SNS assets. Evaluation Results 1. There are approximately 25,000 federal employees and contract employees located on federal property. 2. Approximately 100,000 people including household and family members, equating to 10-15% of the City’s daytime population could receive prophylaxis at closed federal dispensing sites without the use of the city’s identified full time and volunteer work force. 3. Four primary facilities and four alternate facilities are identified as closed federal dispensing sites. 4. A federal employee mass prophylaxis volunteer process was established. Feedback The information identified in the data collection section for this objective is ever changing and will need to be revisited at least annually. Develop a plan for federal work force prophylaxis using a medical and non-medical dispensing model. Performance Measures 1. Draft one plan that addresses the provision of mass prophylaxis for employees, contract employees working on federal property and household members of all agencies that are members of the Kansas City Federal Executive Board. 2. The plan will be comprised of five annexes that outline how federal closed PODs will operate: 1) Command and Control; 2) Information and Communications; 3) Mass Prophylaxis and Immunization; 4) Standard Precautions and Hygiene; and 5) Security and Transportation. 3. The plan will include a process for revisions and assign responsibility for oversight of the revision and approval process. Data Collection 1. The federal closed POD plan was developed around items contained in CDC’s Technical Assistance Review for local health agencies. Each item was measured for relevance to a closed rather than open dispensing site. 2. The plan was developed around the data collected for Objective One including: • Number of federal agencies in Kansas City. • Number, capacity and location of federal facilities in Kansas City. • Number of federal employees and federal contract employees working in Kansas City. • Number of household and family members for whom each federal employee or contractor will collect and deliver medications. • Federal assets available for transporting, securing and dispensing SNS assets. Evaluation Results The federal closed POD Plan has been drafted and is in operational form. Feedback While processes, facilities and assets have been identified and established, additional options continue to present themselves and changes are reflected in the federal closed POD opera
Both the Kansas City Health Department and Kansas City Federal Executive Board have committed to the concept and plan for federal closed PODs. It continues to benefit the local health agencies in alleviating some of the burden from Open PODs as well as affording additional volunteers once closed federal PODs are demobilized. The practice is referred to in the Federal Interagency Operational Plan – Rapid Medical Countermeasures Dispensing and it is anticipated that other local public health agencies and FEBs in Federal Regional Centers will implement similar models. The Memorandum of Understanding between KCHD and the Kansas City FEB has received both Regional and National approval. KCHD and HHS continue to plan annual exercises and offer POD Volunteer training for federal Closed PODs. KCHD is also affording access to the same IT solution for mass prophylaxis dispensing. Local and regional stakeholders are committed to maintaining the closed federal POD plan that has been created through this process and performing the necessary revisions to maintain its currency.
 
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