Strategic National Stockpile Overview

1. Strategic National Stockpile Overview Brian M. Moyer Emergency Preparedness & Response Manager Office of Public Health Preparedness

2. SNS Mission • “The SNS is a national repository of life-saving pharmaceuticals, antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration, airway maintenance supplies, and medical/surgical items. …is designed to supplement and re-supply state and local public health agencies in the event of a national emergency anywhere and at anytime within the U.S. or its territories to reduce morbidity and mortality in civilian populations.”

3. SNS Assumptions • Mass casualty incident (MCI), natural disaster, bioterrorism event, or disease outbreak • Population requires mass prophylaxis within 48 hours • State/local resources will be rapidly depleted

4. How is it Requested? • State makes request to FEMA and Centers for Disease Control and Prevention (CDC) • Governor’s Emergency Declaration • Delivered <12 hours to a pre designated state Receipt, Store, and Stage (RSS) warehouse facility in PA

5. Concept of Operations – Tiered Response Program • 12 Hour Push Packages • Managed Inventory (MI) • Storage and rapid deployment of vaccines, antivirals, and antitoxins • Surge capacity/buying power • Technical Assistance • Technical Assistance Response Unit (TARU)

6. 12-Hour Push Package • Package containing all items within SNS formulary • Updated/refined periodically • 130 cargo containers (50 tons) • 8 tractor trailer loads • Strategically located throughout U.S. • Delivered <12 hours by ground or air

7. What’s In All Those Containers? • Pharmaceuticals • Antibiotics • Vaccines, antitoxins, antivirals • Other emergency medications • Medical/surgical supplies • Other medical equipment

8. Managed Inventory (MI) • Represents 97% of SNS assets • Product is “federally owned” • SNS partners monitor for lot expiration and rotate stock • QA inspections by SNS personnel (100% annual inventory) • Re supply the Push Package • Order special supplies not stocked by SNS and may be shipped directly to affected area

9. Deployment Process • Step 1 – Local, county, state resources are being depleted • Step 2 – SNS is shipped to PA • Step 3 – Apportionment and distribution preparation • Step 4 – Distribution • Step 5 – SNS assets received at PODs and hospitals • Step 6 – Resupply

10. Limitations During Deployment • There will not be enough medications in the 12 hour Push Package to treat everyone • There will be staffing shortages • Volunteers are critical • Hospitals will receive “worried well” • Need to provide planning for mass prophylaxis of essential personnel

11. Plan Changes - State • State SNS Plan to reflect additional partnerships and identifying resources available • Conduct periodic SNS planning Stakeholders meeting • Increased involvement with Commonwealth Stakeholders in specific focus areas • Public Information • Security (RSS through POD planning) • Inventory Management • Distribution • Hospital Coordination • Training / Exercise / Evaluation process

12. Plan Changes - State • Reorganization of SNS Plan format. • Applying standardized planning concept: • Base Plan, Annexes, Appendices, Attachments • Enhance standardization of NIMS compliance. • Contacts List moved out of Base Plan. • PA DOH Department Operations Center (DOC) • Senior Policy Group to monitor situation and provide policy decisions to DOC. • DOC focus Operations, Logistics, Planning, Admin/Finance • To include communications process, system, and information flow.

13. Plan Changes - Transportation • Distribution/Transportation – State Lead • Department of General Services (DGS) developing emergency use contracts with trucking firms (Regional Basis) • Provide trucks and drivers to augment and support current plans • Utilize State Agency vehicles to supplement / back-up DGS-contracted services. • Department of Corrections, DGS, other State Fleet vehicles. • Augment/Support - Task Force plan

14. Plan Changes - RSS • Continue to evaluate RSS locations • Utilize RSS Response Team concept for key RSS functions. • Identifying Team personnel and sponsoring RSS-specific training. • Will look toward matching normal day-to-day responsibilities with RSS functional positions.

15. Plan Changes – SNS Staffing • Challenges with identifying and notifying volunteers • More involvement in volunteer recruitment • Developed a Volunteer Management Annex • VOAD, Nursing, MRCs, CERT, SERV PA, etc. • Local areas (Task Forces / Counties) have provided lists/rosters of POD training • Train more SERVEPA Administrators • Standardized POD leadership training

16. Plan Changes – POD Planning • Use of Push Sites to reduce volume at PODs - reducing number of PODs necessary. • Use of the “Closed POD” concept for State workers. • Use of Local Logistics Nodes to reduce load at RSS • Exercise PODs to demonstrate POD Flow • State will revise Planning Template and POD Manual as regional/county resource

17. Future Changes – Training/Exercises • Identify NIMS/ICS levels for functional area positions and provide training based on needs. • Develop additional courses / programs for the Learning Management System (LMS). • Develop and provide function-specific training. • Coordinated development/documentation of Mass Prophylaxis training/exercises • Regional SNS Resource Request Exercise

18. Planning Considerations • Recommendation - Local EM Coordinators (municipal / township level) education on mass Prophylaxis/SNS • SNS planning Standardization – SNS planning varies by Task Force/county • Flexibility within the Plan to accommodate differences in the various Regions • Increased planning coordination and support between State/Region/County/Local • Start conducting SNS planning reviews outside of CRI Regions

19. Key Players Assignment of responsibilities outlined in State SNS plan

20. CDC Responsibilities • Transport SNS to designated RSS warehouse • FedEx and UPS partners • Security during transport • U.S. Marshals • Technical Assistance Response Unit (TARU)

21. PA Department of Health • State SNS Plan, DOH EOP, State ESF#8 Plan • Overall command, control, coordination • Advise governor – public health issues • Coordination/planning assistance with partners • Accepts and signs for SNS • Responsible for RSS warehouse operations • Transportation/Distribution of SNS resources • Educate stakeholders/partners • Review and Comment on local/regional plans

22. PA Emergency Management Agency • Activates State EOC • Coordination with state agencies • Fill unmet needs • Activate Joint Information Center (JIC) • Requests SNS from FEMA…as directed by governor • Coordinates the Declaration of Disaster Emergency • Notifies task forces, EMA’s, State agencies, etc

23. Regional Task Forces • Participate in SNS planning/coordination Regionally • Activate Task Force Regional Operations Plan (if applicable) • Coordinate activation/notification of County EOC’s • Activate Multi-Agency Coordination Center (MACC) (if applicable) • Coordinate regional unmet needs with PEMA

24. County EMA • Participate in SNS planning/coordination at county level • Assist with education of county and local stakeholders • Include PODs/SNS in exercise program • Receive and process resource/unmet need requests

25. Bob LongStrategic National Stockpile CoordinatorBrian M. MoyerEmergency Preparedness & Response ManagerOffice of Public Health Preparedness(717) 346-0640 Questions?