Point of Dispensing (POD) Staff Orientation

1. Point of Dispensing (POD) Staff Orientation What You Should Know Insert Local Health Department Logo Here Insert CADH Logo Here Supported by CDC Cooperative Agreement No. U90/CCU124251-01

2. At the end of this session you should be able to describe: • A POD and when it may be established • The role of the Strategic National Stockpile in a POD • Incident Command System • Basic POD operations: Communication, Job Action Sheet, Legal Protections, Safety/Security, Clinic Flow • Preparations for working in a POD: Family/household planning, further training opportunities

3. Overview • Points of Dispensing • Strategic National Stockpile • Incident Command System • POD Operations • Preparing to Work at a POD • Additional Training Resources • Information on the Upcoming SNS Exercise

4. What is a POD? A site where medications or vaccines intended to prevent disease may be given quickly to a large number of people in the event of a public health emergency.

5. Public Health Emergency That May Require a POD • Many people have been exposed to an infection that may make them sick AND • Disease from that infection may be prevented by antibiotics or a vaccine

6. All CT Local Health Departments Have Been Asked: To contribute to the: • Development of plans to rapidly establish and operate CT PODs • Recruitment and training of POD staff.

7. North Canaan Hartland Colebrook Somers Union Suffield Enfield Norfolk Stafford Salisbury Woodstock Thompson Granby Canaan East Granby Windsor Locks Barkhamsted Ellington Putnam Winchester East Windsor Ashford Eastford Willington Simsbury Tolland Pomfret Windsor Sharon Cornwall Canton Goshen Bloomfield Torrington New Hartford South Windsor Killingly Vernon Avon Brooklyn Chaplin Mansfield Hampton Coventry West Hartford Manchester East Hartford Bolton Burlington Harwinton Litchfield Hartford Warren Andover Kent Farmington Windham Wethersfield Plainfield Scotland Columbia Sterling Canterbury Newington Glastonbury Morris Plainville New Britain Thomaston Bristol Plymouth Rocky Hill Washington Hebron Bethlehem Marlborough Sprague Lebanon Franklin Berlin Cromwell Watertown Southington Wolcott Portland Lisbon New Milford Griswold Voluntown East Hampton Colchester Woodbury Roxbury Waterbury Bozrah Sherman Norwich Meriden Middletown Middlebury Preston Bridgewater Middlefield Prospect Cheshire New Fairfield Naugatuck Salem East Haddam Southbury Brookfield Haddam Durham North Stonington Wallingford Montville Bethany Beacon Falls Oxford Ledyard Danbury Chester Waterford Lyme Newtown North Haven Killingworth Seymour Deep River Stonington East Lyme Bethel North Branford Groton Woodbridge New London Hamden Essex Ansonia Monroe Guilford Derby Old Lyme New Haven Redding Westbrook Ridgefield Old Saybrook Clinton Shelton East Haven Branford Madison Orange West Haven Easton Trumbull Milford Weston Wilton Stratford Bridgeport Fairfield New Canaan Westport Norwalk Stamford Darien Greenwich State of Connecticut Mass Dispensing Areas and Department of Emergency Management and Homeland Security Planning Regions MDA Lead Health Number Department/ District 01 Greenwich HD 02 Stamford HD 03 Norwalk HD 04 Westport HD 24 05 Danbury HD 34 06 Bethel HD 07 Newtown HD 41 31 08 New Milford HD 40 09 Torrington Area HD 29 10 Fairfield HD 30 9 11 Bridgeport HD 32 12 Stratford HD 13 Naugatuck Valley HD 33 14 Pomperaug HD 25 34 15 Waterbury HD 40 27 16 Chesprocott HD 28 17 Milford HD 18 West Haven HD 26 19 New Haven HD 8 20 Quinnipiack Valley HD 21 Guilford HD 38 15 36 22 Meriden HD 22 23 Wallingford HD 24 Farmington Valley HD 16 35 14 25 Bristol/ Burlington HD 26 Southington HD 23 27 New Britain HD 28 Central Connecticut HD 29 WH/ Bloomfield HD 5 37 7 20 37a 30 Hartford HD 31 Windsor HD 32 East Hartford HD 33 Manchester HD 13 21 34 North Central HD 35 Chatham HD 12 36 Middletown HD 6 19 37 New London HD 17 18 37a Ledgelight HD 10 11 38 Uncas HD DEMHS Regions 40 Eastern Highlands HD 4 Legend 41 Northeast HD 3 2 1 1 2 3 ± 4 Miles 5 November 14th, 2005 0 3 6 12 18 24

8. Strategic National Stockpile Medical supplies, drugs, and equipment.

9. Strategic National Stockpile – What Is It? A large stockpile of medicine and medical supplies to protect the American public if there is a public health emergency severe enough to cause local supplies to run out.

10. Strategic National Stockpile Components • 12 Hour Push Package • Vendor Managed Inventory

11. Incident Command System (ICS) Key to efficient operation and good communication flow

12. What is the ICS ? • Standardized • Can be applied to a wide variety of emergencies • Basic features • Common terminology in ‘plain talk’ • Modular organization (easy to grow or shrink) • Management by objectives • Reliance on an Incident Action Plan • Chain of Command • Unified Command • Manageable span of control

13. Command Operational Structure

14. ICS – Bottom Line • Each person at the POD has a specific and limited job • Each person within a POD reports to only one designated person • Each POD supervisor has a specific and limited number of positions reporting to him or her

15. Job Action Sheet: • Job Title • Job Mission • Supervisor Name • Immediate Duties • On-going Duties • Extended Duties

16. Internal POD Communication • Communication flow should follow the chain of command • Your communication role in POD operations will be described in your Job Action Sheet • Plain talk – no codes or acronyms • Communication equipment • Radio, cell phone, whistles, bull horn, walkie talkie • Clinic managers will ensure internal clinic communications are tested prior to opening • Make sure you know how to use any communication equipment assigned to you

17. Why Plain Talk? Many meanings of EMT - • Emergency Medical Treatment • Emergency Medical Technician • Emergency Management Team • Eastern Mediterranean Time • Effective Methods Team • Effects Management Team • El Monte, CA (airport code) • Electron Microscope Tomography • Email Money Transfer

18. POD Jobs

19. Data entry personnel Form distributors Translators Medical screeners (MD, PA, RN) Pharmacists Security personnel Food preparers Vaccinators Janitorial staff Mental health workers Traffic Control staff ID/Badging staff Runners Telecom / IT support staff EMS transfer personnel Examples of POD Jobs

20. CT Public Health Emergency Response Act (PHERA), 2003 Protects POD staff (employees and volunteers) from liability • when acting on behalf of the State or Local Health Department during a declared Public Health Emergency.

21. Operation of this POD

22. Operations Section Chief Operations Organizational Structure Triage Unit Leader Floater/Greeter Unit Leader Security Task Force 1 (Interior) Forms Distribution Unit Leader Pharmacy Unit Leader Security Task Force 2 (Exterior) Video Orientation Unit Leader (as required) Vaccine/Prophy Abx Unit Leader Interior Clinic Traffic Control Unit Child Care Unit Leader Exit/Evaluation Unit Leader EMS/Transfer Unit Leader

23. POD Clinic Flow

24. Call to Action If mass dispensing is required: • State and Local Health Departments will coordinate POD operations • You will be: • Contacted by telephone, fax or email • Asked about your availability to work at the POD • Informed about where and when to report and what to bring

25. Call to Action • Your Local Health Department maintains a list of POD staff. • Make sure you inform your Local Health Department about changes in your contact information.

26. Before Your Shift • Supervisor will provide Just-In-Time training • A briefing on the specific situation and POD functioning • Training on your Job Action Sheet • Arrangements for food, rest, safety, communication with home • Local check in procedures

27. Signs of Stress and Fatigue in Self and Others • Lack of concentration • Increasing number of non-critical errors • Critical errors • Irritability • Worry • Feeling ill

28. Resources for Clinic Staff During Shift • Facilities to support staff • Food, rest • Mental health support for staff

29. End of Shift At the end of your shift or before you report off duty you will be asked to: • Brief your supervisor • Turn in all reports and equipment • Sign out procedure

30. Dealing with POD Challenges • If you need assistance, ask your supervisor • General rules for dealing with • Special needs populations, e.g. limited mobility, hearing, vision, literacy, non-English speakers • Those experiencing extreme distress • Conflict

31. Communicating Beyond the POD • Only the Public Information Officer should speak with the media • Respect the privacy of people working and attending the POD • Report any rumors to your supervisor • Follow your supervisor’s guidance on communication with friends and family

32. POD Security • Local security arrangements - know before event • Staff and volunteers will be briefed on specific security arrangements as part of Just-In-Time training for a drill or event

33. Personal Safety • Safety Officers will be on site to ensure a safe working environment • Your Job Action Sheet will describe safety precautions and equipment use • Local arrangement for priority prophylaxis of POD workers and family/household

34. Preparing to Work at the POD

35. Create A Family Disaster Plan www.redcross.org/static/file_cont36_lang0_23.pdf www.ready.gov/america/_downloads/family_communications_plan.pdf www.dph.state.ct.us/bt/ready/preparedness12pg.pdf

36. Make Prior Arrangements For • Communication between family members • Care of elders, children, pets • Home security • Medication • Transportation • Any verification of credentials

37. Training

38. Additional Training Opportunities • DPH online training in key content topic areas: • ICS/NIMS • Mass dispensing (PODs) operations • SNS overview • Diseases that could lead to mass dispensing • Psychosocial (mental health) • Legal • Specialized training for licensed professionals – Medical Screeners, Pharmacists • Just-In-Time training

39. TRAINConnecticut Online • Access these and other valuable training resources on the internet at http://ct.train.org • The manual and flyer show you how to register and start the training

40. April CT Exercise Information Full scale SNS exercise

41. SNS POD Exercises • When • April 18th and 19th (mainly the 19th) • Where • At 7 PODS and 4 hospitals throughout CT • Objective • To activate a POD and successfully distribute “medication” to residents served by that clinic in response to a simulated biological emergency.

42. What We Know • The drill will last approximately 4 hours. • It will take place during normal business hours. • Bring….. • Don’t bring • Food (We will feed you) • Drink (We will supply that too)

43. Remember • This is practice. • You are not being graded on you performance on the drill. • Everyone is learning together. • It’s okay to make mistakes. We expect it and we will learn from it. • It is okay to have fun!

44. Questions ???????????????????????????????

45. Sources • Connecticut Association of Health Directors. Orientation To Connecticut Mass Dispensing Clinics Parts 1 & 2. • Centers for Disease Control and Prevention. Strategic National Stockpile website. http://www.bt.cdc.gov/stockpile/ • FEMA IS Course Material Download: IS-100 Introduction to Incident Command System, I-100. http://www.training.fema.gov/EMIWeb/IS/is100lst.asp • POD training materials from Town of Manchester, Ledge Light Health District, Eastern Highlands Health District • Virginia Department of Health, Emergency Preparedness and Response Programs. Unit 1 – Dispensing / Vaccination Site Training • University of Minnesota Center for Public Health Preparedness. Mass dispensing sites: a primer for volunteers. http://www.sph.umn.edu/umncphp/massdisp/home.html • AHRQ “Community-based mass prophylaxis: a planning guide for public health preparedness.” http://www.ahrq.gov/research/cbmprophyl (figure 3).

46. Thank You • Thank you all for offering to be a POD worker. • Federal, State, and Local leaders recognize and appreciate the great service you are performing for your communities, the state, and the nation, and the sacrifices you are making to keep the people safe.