Mission Mission Building healthy communities through Building - - PDF document

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Mission Mission Building healthy communities through Building - - PDF document

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7/12/2010 Louisiana Department of Health and Hospitals Office of Public Health Louisiana Department of Health and Hospitals Office of Public Health Mission Mission Building healthy communities through Building healthy communities

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SLIDE 1

7/12/2010 1

Louisiana Department of Health and Hospitals – Office of Public Health

DHH Emergency Preparedness Update DHH Emergency Preparedness Update

Center for Community Preparedness

Doris Brown, MS, M. Ed, RN CNS Doris Brown, MS, M. Ed, RN CNS Public Health Executive Director Public Health Executive Director Department of Health and Hospitals Department of Health and Hospitals Office of Public Health Office of Public Health Center for Community Preparedness Center for Community Preparedness

Pharmacy Emergency Management Pharmacy Emergency Management

Louisiana Department of Health and Hospitals – Office of Public Health

Mission Mission

“Building healthy communities through Building healthy communities through prevention prevention preparedness preparedness and and response response ” ”

Center for Community Preparedness

prevention prevention, , preparedness preparedness and and response response.

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy Objectives Pharmacy Objectives

  • Discuss Louisiana Department of Health and

Hospitals-Office of Public Health's roles and responsibilities in an Emergency Response.

  • Discuss the role of Pharmacy personnel in

Center for Community Preparedness

  • Discuss the role of Pharmacy personnel in

disaster preparedness

  • Provide participants with information to

enhance knowledge, performance, and response during a disaster event.

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy Technician Objectives Pharmacy Technician Objectives

  • Discuss Louisiana Department of Health and

Hospitals-Office of Public Health's roles and responsibilities in an Emergency Response.

  • Assist Pharmacist and leading staff in directing

Center for Community Preparedness

  • Assist Pharmacist and leading staff in directing

pharmacy personnel in disaster preparedness

  • Provide participants with information to

enhance knowledge, performance, and response during a disaster event.

Louisiana Department of Health and Hospitals – Office of Public Health

Purpose Purpose

  • Louisiana Emergency Operations Plan establishes the

policies and structure for state government management of emergencies and disasters

  • Safety and welfare of our citizens is outlined in this

Center for Community Preparedness

y all hazards plan

  • Growing vulnerable population in Louisiana the goal

is to work with all State government agencies, parishes, private, non-profit organizations, and volunteer groups to provide the most effective and efficient care for emergencies and disasters

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Support Function Emergency Support Function

Center for Community Preparedness

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SLIDE 2

7/12/2010 2

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Support Function Emergency Support Function

  • The Emergency Support Functions (ESFs)

provide the structure for coordinating response to an incident.

  • The Incident Command System provides for

Center for Community Preparedness

  • The Incident Command System provides for

the flexibility to assign ESF and other stakeholder resources according to their capabilities, taskings, and requirements to augment and support a response.

Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana Department of Health and Hospitals Louisiana Department of Health and Hospitals – Office of Public Health Office of Public Health

What is ESF‐8

Center for Community Preparedness

Center for Community Preparedness Center for Community Preparedness

Louisiana Department of Health and Hospitals – Office of Public Health

ESF Supporting Functions ESF Supporting Functions

  • ESF

ESF‐1 Transportation Transportation

  • ESF

ESF‐2 Communications Communications

  • ESF

ESF‐3 Public Works and Engineering Public Works and Engineering

  • ESF

ESF‐ 4 Fi fi hti Fi fi hti

  • ESF

ESF-

  • 8

8 Public Health and Medical Services Public Health and Medical Services

  • ESF

ESF-

  • 9

9 Search Search and and Rescue Rescue

  • ESF

ESF-

  • 10

10 Oil Spill, Hazardous Materials and Oil Spill, Hazardous Materials and Radiological Radiological

  • ESF

ESF 11 11 Center for Community Preparedness Firefighting Firefighting

  • ESF

ESF‐5 Emergency Management Emergency Management

  • ESF

ESF‐6 6 Mass Care, Housing and Human Mass Care, Housing and Human Services Services

  • ESF

ESF‐7 7 Resource Support Resource Support

  • ESF

ESF-11 11 Agriculture Agriculture

  • ESF

ESF-

  • 14

14 Community Recovery, Mitigation, and Community Recovery, Mitigation, and Economic Stabilization Economic Stabilization

  • ESF

ESF-

  • 15

15 Emergency Public Information Emergency Public Information

  • ESF

ESF-

  • 16

16 Military Support to Civil Affairs Military Support to Civil Affairs Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Support Function 8 Emergency Support Function 8

  • DHH has the lead role for providing leadership

for planning, directing and coordinating the

  • verall State efforts to provide public health

and medical assistance.

  • The Secretary of Health and Human Services

through the Office of Public Health

Center for Community Preparedness

through the Office of Public Health Emergency Preparedness is responsible for the federal coordination.

  • The command and control of operations are

consistent with the National Response Framework and compliant with National Incident Management System requirements.

Louisiana Department of Health and Hospitals – Office of Public Health

Medical Operations Medical Operations

Medical Special Needs Shelter (MSNS)- A shelter for persons with special medical needs and their caregivers. Critical Special Needs Shelter (CTNS)- A non- medical shelter operated for those persons evacuated by local governments from affected areas. These are

Center for Community Preparedness

y g not general population shelters for those who self-

  • evacuate. These consist of both state and parish run

shelters. Federal Medical Station (FMS)- A shelter operated when the state request federal medical support for health and medical care to people with non acute medical, mental health, or other health related needs.

Louisiana Department of Health and Hospitals – Office of Public Health

Medical Operations Medical Operations

Temporary Medical Operations Staging Area (TMOSA)- It is a mobile operation post event that has the capability to treat and stabilize patients suffering from emergent medical conditions including but not limited to all hazards. T t ti T i A di l i

Center for Community Preparedness

Transportation Triage- A medical screening

  • peration to determine the level of care needed by

evacuees in the CTNS evacuation operation. Personnel determine if an evacuee can continue on to a CTNS site or needs placement in an MSNS site

  • r further definitive care.
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SLIDE 3

7/12/2010 3

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Support Function 6 Emergency Support Function 6

Center for Community Preparedness

Department of Social Services

Louisiana Department of Health and Hospitals – Office of Public Health

Mission Mission

  • Create a unified long-term plan for reliable

transportation and sheltering through a collaborative effort between the state

Center for Community Preparedness

agencies, evacuating and sheltering parishes, the federal government, non- governmental organizations and sheltering host states.

Louisiana Department of Health and Hospitals – Office of Public Health

Sheltering Standards Sheltering Standards

Sleep Space

  • 30 sq ft (CTNS and caregiver)
  • 45 sq ft (MSNS)

Showers

  • 1 : 25 persons

Toilets & Hand Wash Stations

Center for Community Preparedness

  • 1 : 20 Persons

Feeding

  • 2 hot, 1 cold meals per day
  • Snacks
  • Baby formula

Medical Support at CTNS

  • Medical Monitoring
  • LPCA

Louisiana Department of Health and Hospitals – Office of Public Health

Medical Special Needs Shelters Medical Special Needs Shelters (MSNS) (MSNS)

Center for Community Preparedness

(MSNS) (MSNS)

Louisiana Department of Health and Hospitals – Office of Public Health

MSNS MSNS

  • Medical Special Needs Shelters are specially

staffed and equipped shelters that may be activated during a disaster.

Center for Community Preparedness

  • Medical Special Needs Shelters are designed for

individuals who may require assistance with Activities of Daily Living or may require special equipment or medication in order to sustain life. Long journeys for these individuals may be harmful to their health.

Louisiana Department of Health and Hospitals – Office of Public Health

State Level Command Organizational Chart State Level Command Organizational Chart

State Unified Command DHH EOC DSS EOC Center for Community Preparedness Regional MSNS1 Federal Medical Station2 Federal Medical Station IRCT

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7/12/2010 4

Louisiana Department of Health and Hospitals – Office of Public Health

Medical Special Needs Shelters Triage Medical Special Needs Shelters Triage Categories Categories

  • Level 0: persons who have no medical needs, but

require transportation assistance for evacuation

  • Level 1: Persons dependent on others or in need
  • f others for routine care (eating walking

Center for Community Preparedness

  • f others for routine care (eating, walking,

toileting, children under 18 without adult supervision, etc.)

  • Level 2: Persons with disabilities such as

someone who is blind, hearing impaired or an amputee.

Louisiana Department of Health and Hospitals – Office of Public Health

Medical Special Needs Shelters Categories

  • Level 3: Persons requiring assistance with

Level 3: Persons requiring assistance with medical care administration or assistance with medical care administration or assistance with taking their medications. Someone who requires taking their medications. Someone who requires monitoring by a nurse or dependent on monitoring by a nurse or dependent on

  • equipment. As well as, persons with mental
  • equipment. As well as, persons with mental

Center for Community Preparedness

health disorders. (Admission to MSNS) health disorders. (Admission to MSNS)

  • Level 4: May require urgent medical support;

stabilized

  • Level 5: Acutely ill; requires hospital admission

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Louisiana Department of Health and Hospitals – Office of Public Health

MSNS Services Provided MSNS Services Provided

  • TRIAGE
  • MEDICAL ASSESSMENT AND

TREATMENT

  • PHARMACY (MINIMAL OVER THE

COUNTER MEDICATIONS)

Center for Community Preparedness

  • DISCHARGE PLANNING
  • SECURITY
  • MEALS
  • BEHAVIORAL HEALTH

COUNSELING

  • TRANSPORTATION(DIALYSIS)

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Prescription Emergency Prescription Assistance Program (EPAP) Assistance Program (EPAP)

Center for Community Preparedness

Assistance Program (EPAP) Assistance Program (EPAP)

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Prescription Assistance Program Emergency Prescription Assistance Program

  • A joint FEMA-HHS program that processes

prescription drug and Durable Medical Equipment (DME) claims for eligible participants

Center for Community Preparedness

  • Allows community pharmacies to dispense

medications to individuals who:

– Are from an affected area – Have a valid prescription – Have no private prescription drug or DME coverage

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7/12/2010 5

Louisiana Department of Health and Hospitals – Office of Public Health

EPAP Process EPAP Process

  • The President must first issue a Major Disaster

Declaration or issue an Emergency Declaration

Center for Community Preparedness

  • Affected state requests prescription assistance

from the federal government through US DHHS

Louisiana Department of Health and Hospitals – Office of Public Health

EPAP Coverage EPAP Coverage

  • Eligible individuals can present at any enrolled

pharmacy with a valid prescription

  • The pharmacy performs initial check for other third

party coverage If h i h h h ld bill

Center for Community Preparedness

– If other coverage exists, the pharmacy should bill the existing payer – If no other coverage exists, the pharmacy captures the patient’s address to make sure they are from the affected area

Louisiana Department of Health and Hospitals – Office of Public Health

EPAP Coverage Limitations EPAP Coverage Limitations

  • Coverage is limited up to a one-time 30 day

supply of drugs

  • Pharmacy Participation

O 000 i h i fill

Center for Community Preparedness

– Over 55,000 community pharmacies can fill claims under this program – Non-participating pharmacies can sign-up during an emergency

Louisiana Department of Health and Hospitals – Office of Public Health

Sheltering for Children: Sheltering for Children:

Center for Community Preparedness

Pharmacy Updates Pharmacy Updates

Louisiana Department of Health and Hospitals – Office of Public Health

Sheltering Updates for Children Sheltering Updates for Children

Medical Special Needs Shelters

  • Over-the-Counter (OTC) medications are available in the

shelters to include pediatrics.

  • Poison Control Numbers are accessible by MSNS care

providers in the event guidance/advice is needed on pediatric dosages

Center for Community Preparedness

pediatric dosages

  • Poison Control also provides advice to providers on

Adverse drug reactions Chemical Response Plan

  • Pediatric auto-injectors for atropine

Biohazards Response Plan

  • Tamiflu and doxycline are in dosing ranges for pediatrics

Louisiana Department of Health and Hospitals – Office of Public Health

Sheltering Update for Children Sheltering Update for Children

Mass Casualty

  • Contract with Morris and Dickson for a cache of drugs

and pharmaceuticals that may be needed in a mass casualty event that includes pediatric drugs. Bureau of EMS – Emergency Medical Services Grant for

Center for Community Preparedness

Bureau of EMS – Emergency Medical Services Grant for Children (EMS-C)

  • OPH/BEMS receives a grant entitled Emergency

Medical Services for Children. BEMS has an advisory council for EMS-C established in law to support, facilitate, implement emergency care specific to children

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7/12/2010 6

Louisiana Department of Health and Hospitals – Office of Public Health

Federal Medical Stations Federal Medical Stations

Center for Community Preparedness Louisiana Department of Health and Hospitals – Office of Public Health

Federal Medical Shelters (FMS) Federal Medical Shelters (FMS)

Region Region Parish Parish City City 2 East Baton Rouge Baton Rouge (500) 6 Rapides Alexandria (450-2 sites) 8 Lincoln Grambling (200)

  • Each medical station has beds s pplies and medicine

Center for Community Preparedness

  • Each medical station has beds, supplies, and medicine

to treat 250 people and special federal teams that are deployed with the stations to provide set-up assistance.

  • As part of the Disaster Medical Assistance Team

(DMAT), a Pharmacist and a pharmacy cache will be deployed to the FMS.

Louisiana Department of Health and Hospitals – Office of Public Health

Shelter for Unique Populations Shelter for Unique Populations (S Off d Sh lt (S Off d Sh lt SOS) SOS)

Center for Community Preparedness

(Sex Offender Shelter (Sex Offender Shelter-

  • SOS)

SOS)

Louisiana Department of Health and Hospitals – Office of Public Health

SOS SOS

  • Located at the Wade Correctional Facility in

Homer, Louisiana

Center for Community Preparedness

  • DHH will be the lead in providing any medical

monitoring needed

Louisiana Department of Health and Hospitals – Office of Public Health

Medical Institution Evacuation Medical Institution Evacuation Plan (MIEP) Plan (MIEP)

Center for Community Preparedness

Plan (MIEP) Plan (MIEP)

Louisiana Department of Health and Hospitals – Office of Public Health

Planning Assumptions: Which areas are vulnerable?

Center for Community Preparedness Out of the 35 Parishes within the six coastal regions, only 12 Parishes are vulnerable to storm surges: Jefferson Orleans Plaquemines

  • St. Bernard

Calcasieu Cameron Vermillion Iberia

  • St. Mary

Terrebonne Lafourche

  • St. Tammany
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7/12/2010 7

Louisiana Department of Health and Hospitals – Office of Public Health

MIEP-Hospitals

  • Federal and state partners support the strategy of

sheltering in place when it can be accomplished safely

  • Sheltering in Place plans must be developed and

supplies must be adequate

Center for Community Preparedness

  • Hospitals are responsible for developing their own

evacuation plans

  • In the event hospitals request assistance for

evacuation from State/Federal assets, the evacuating hospital will transported from an aeromedical marshalling point(AMP) to a National Disaster Medical System (NDMS) hospital

Louisiana Department of Health and Hospitals – Office of Public Health

MIEP-Nursing Homes

  • Nursing homes have transportation agreements

in place and alternate facility locations

  • In the event of a large scale disaster affecting

multiple Parishes, nursing homes may require

Center for Community Preparedness

p , g y q State/Federal assistance

  • Patients and staff will be transported
  • Coach buses with wheelchair lifts
  • paratransit vans
  • ambulance for medically fragile patients

Louisiana Department of Health and Hospitals – Office of Public Health

CONCEPT OF OPERATIONS

Hospital Aero-Medical Marshalling Point (AMP) National Disaster Medical System (NDMS) destination hospital

Safety-Net Plan

Center for Community Preparedness

Relay 1 LANG and Contracted air/ground ambulances through ESF-8 Relay 2 Department of Defense (DOD) Air Assets GPMRC for patient placement via NDMS.

Site A Site B

Louisiana Department of Health and Hospitals – Office of Public Health

Transportation Triage Transportation Triage

Center for Community Preparedness

p g p g

Louisiana Department of Health and Hospitals – Office of Public Health

Transportation Triage Transportation Triage

  • To evaluate pre-identified at-risk evacuees on

evacuating buses and quickly determine if it is medically safe for them to continue on their journey

  • n the bus to a designated:

Center for Community Preparedness

Critical Transportation Needs Shelters Medical Special Needs Shelters (MSNS) Hospital

Louisiana Department of Health and Hospitals – Office of Public Health

Transportation Triage Transportation Triage

  • Clients with no other means of transportation

will undergo “embarkation” triage prior to evacuation from affected areas on mass transit vehicles

Center for Community Preparedness

transit vehicles.

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7/12/2010 8

Louisiana Department of Health and Hospitals – Office of Public Health

Temporary Medical Operations Temporary Medical Operations Staging Area (TMOSA) Staging Area (TMOSA)

Center for Community Preparedness

Staging Area (TMOSA) Staging Area (TMOSA)

Louisiana Department of Health and Hospitals – Office of Public Health

Command Structure

  • TMOSA operations are under the guidance

and leadership of Department of Health and Hospitals (DHH) and is part of ESF 8

  • perations

Center for Community Preparedness

  • perations.
  • Louisiana State Health Officer will give orders to

stage and/or deploy TMOSA operations in response to an event or potential event.

Louisiana Department of Health and Hospitals – Office of Public Health

TMOSA TMOSA Concept of Operations Concept of Operations

  • Post-event mobile operation
  • Acute care medical facility able to sustain itself

up to (3) days

Center for Community Preparedness

up to (3) days

  • Capability to treat & stabilize patients suffering

from emergent medical conditions including but not limited to all hazards (explosive, natural, biological, chemical, nuclear)

Louisiana Department of Health and Hospitals – Office of Public Health

Strategic National Stockpile Strategic National Stockpile

Center for Community Preparedness Louisiana Department of Health and Hospitals – Office of Public Health

Strategic National Stockpile Strategic National Stockpile

Cache of medical assets for response to a public health incident

  • Medical assets:
  • Medicines and vaccines to prevent and treat disease
  • Medical supplies and equipment needed for disaster

Center for Community Preparedness

response

– Medicines

  • Antibiotics, antivirals…

– Vaccines – Supplies and equipment

  • Masks, tubing…
  • Ventilators…

Louisiana Department of Health and Hospitals – Office of Public Health

SNS Response SNS Response

Public health incidents: intentional, accidental or natural

  • Biological terrorism

– Antibiotics, antitoxins and vaccines

  • Chemical terrorism

Center for Community Preparedness

– Nerve agents antidotes

  • Nuclear/Radiological incidents

– Protective medications

  • Explosive incidents

– Supplies and medications

  • Pandemic Influenza

– Antivirals, supplies and equipment

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7/12/2010 9

Louisiana Department of Health and Hospitals – Office of Public Health

SNS Assets and Deployments SNS Assets and Deployments

  • SNS 12 Push Packs
  • Managed Inventory
  • Surge capacity and

federal purchasing

Center for Community Preparedness

  • World Trade Center Attack, September 2001
  • Anthrax letter mailings,

October 2001

  • Hurricanes Katrina, Rita and

Wilma, August 2005

  • H1N1 Pandemic Flu April 2009

Louisiana Department of Health and Hospitals – Office of Public Health

Threats and SNS Formulary Threats and SNS Formulary

  • Biological Threat Diseases

– Anthrax – Botulism – Plague – Smallpox – Tularemia – Viral hemorrhagic fevers

Center for Community Preparedness

  • Chemical Threat Agents

– Biotoxins – Nerve Agents – Cyanides – Blister Agents/Vesicants – Lung/Choking/Pulmonary Agents – Riot Agents It is important to know what SNS is, but even more important to know what the SNS isn’t!

Louisiana Department of Health and Hospitals – Office of Public Health

Need exceeds capacity State requests SNS

Region State Incident Local Response

Center for Community Preparedness

State requests SNS

Others POD Hospitals Health Units Nursing Homes Industry

CDC delivers SNS to State RSS site

Indian tribes Prisons Military

Louisiana Department of Health and Hospitals – Office of Public Health

Assets arrive by ground or air

  • Supported by

– Louisiana State Police and local law enforcement – State and Parish Office of Homeland Security and Emergency Preparedness – DHH OPH and others

Center for Community Preparedness

  • Receiving, Staging and Storing (RSS) Sites
  • Large, secure temperature

controlled warehouses

  • Staffed

– Louisiana National Guard – DHH personnel – Private companies and volunteers

Louisiana Department of Health and Hospitals – Office of Public Health

Point of Dispensing (POD) sites Point of Dispensing (POD) sites

  • Location where medications/vaccines are provided to the

public to prevent disease

  • Range from small clinics to very large facilities
  • Specific timelines to get the medicines to the public

– National guidance for anthrax response recommends

Center for Community Preparedness

g p

  • ral antibiotics within 48 hours

Louisiana Department of Health and Hospitals – Office of Public Health

Occupational and Residential PODs Occupational and Residential PODs

  • Hospitals would be caring for the ill

– POD for patients, staff and staff families, but not a POD for the public

  • Nursing homes, prisons, universities and large industry

with health care professionals can provide medication

Center for Community Preparedness

with health care professionals can provide medication at their location with planning

– Limits transportation – Supports infrastructure – Promotes continuity of operations – Decreases the number of PODs – Requires pre-event planning

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7/12/2010 10

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy/SNS Pharmacy/SNS

  • Antiviral Program

– Pre-staged 25% of Federal allotment during the H1N1 pandemic – Antivirals was sent to Hospitals Nursing homes

Center for Community Preparedness

Antivirals was sent to Hospitals, Nursing homes, Primary care facilities, and participating Community Pharmacists (helped to cover those individuals who were under/uninsured

Louisiana Department of Health and Hospitals – Office of Public Health Days

DELAY

Time is Critical! Time is Critical!

Center for Community Preparedness Shorter (1-2 Days) Longer (4+ Days)

DURATION

  • f Prophylaxis Campaign

Hours

DELAY

in Detection Louisiana Department of Health and Hospitals – Office of Public Health

CITIES READINESS CITIES READINESS INITIATIVE INITIATIVE

Center for Community Preparedness

(CRI) (CRI)

Louisiana Department of Health and Hospitals – Office of Public Health

Goal of CRI Goal of CRI

  • To minimize the loss of lives during a

catastrophic public health emergency by providing needed medication to 100% of the city’s identified population within a 48 hour

Center for Community Preparedness

city s identified population within a 48 hour time frame

Louisiana Department of Health and Hospitals – Office of Public Health

Purpose of CRI Purpose of CRI

  • To strengthen the preparedness capabilities of

largely populated cities and Metropolitan Statistical Areas

Center for Community Preparedness

  • To decrease the time it takes to dispense

medications by utilizing PODS with increased throughput coupled with alternate modes of dispensing

Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana’s Designated CRI Louisiana’s Designated CRI Metropolitan Areas Metropolitan Areas

  • 4 Metropolitan Areas that Congress has

selected Region 1

  • i

2

Center for Community Preparedness

Region 2 Region 3 Region 9

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7/12/2010 11

Louisiana Department of Health and Hospitals – Office of Public Health

Alternate Modes of Dispensing Alternate Modes of Dispensing

  • Large Corporations and other facilities
  • Drive-thru Point of Dispensing Sites
  • Use of United States Postal Service

Center for Community Preparedness

  • Delivering pills with instructions through the

daily newspaper

  • MedKit Pilot Project

Louisiana Department of Health and Hospitals – Office of Public Health

Reasons for CRI Reasons for CRI

  • Terrorist groups are capable of wide-dispersal
  • Current plans are inadequate

Center for Community Preparedness

  • Potential for loss of life is catastrophic

Louisiana Department of Health and Hospitals – Office of Public Health

CRI and SNS CRI and SNS

  • CRI is the mechanism for distributing SNS Assets by

way of PODs and Alternate Modes of Dispensing

  • CRI is part of all hazards preparedness

Center for Community Preparedness

  • CRI is part of all hazards preparedness
  • CRI has improved overall SNS readiness
  • CRI has increased availability of federal resources (SNS

assets) to local areas

Louisiana Department of Health and Hospitals – Office of Public Health

Partnerships are Essential Partnerships are Essential

Local State Center for Community Preparedness Federal Louisiana Department of Health and Hospitals – Office of Public Health

“White Powder” Incidents “White Powder” Incidents

  • Law enforcement will determine whether or not a

threat is credible

  • Public Safety will collect and transport samples to the

State Laboratory

  • Louisiana policy is to test suspected substances

Center for Community Preparedness

Louisiana policy is to test suspected substances whenever possible, not individuals

  • Collect names and contact information

– Who, When and Where

  • Plan and exercise for response to suspicious mail
  • Organizational participation in postal exercises

Louisiana Department of Health and Hospitals – Office of Public Health

  • Terrorist organizations have access to many different types
  • f chemical agents
  • Deliberate or accidental nerve agent release could occur

anywhere at anytime

  • Require large supplies of nerve agent antidotes
  • 30 CHEMPACK Containers

Chemical Terrorism Assumptions Chemical Terrorism Assumptions

Center for Community Preparedness

– Atropine, Pralidoxime and Diazepam – 15 Pre-hospital – 15 Hospital

  • CHEMPACK Sustainment

continues to improve response planning

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SLIDE 12

7/12/2010 12

Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana CHEMPACK Planning Louisiana CHEMPACK Planning

  • Louisiana Poison Center

– Consults with health care professionals and/or Incident Commanders to determine symptoms of poisoning – Direct Host Sites to open Containers – Direct allocation based on planning

Center for Community Preparedness

– Direct allocation based on planning – Coordinate transportation with Louisiana State Police

  • Regional CHEMPACK planning is an on-going

priority

  • Essential to protect the CHEMPACK Host Sites

Louisiana Department of Health and Hospitals – Office of Public Health

Radiological Medications Radiological Medications

  • Pre-position medications needed for radiological

response within Louisiana

  • Administered within 8-12 hours of known or

suspected internal contamination of plutonium

Center for Community Preparedness

suspected internal contamination of plutonium, americium, or curium

  • Receive at the Office of Public Health Pharmacy

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Use Authorization Emergency Use Authorization (EUA) (EUA)

Center for Community Preparedness

(EUA) (EUA)

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Use Authorization Emergency Use Authorization

  • Used for medical and public health communities and

is applicable for both civilian and military use.

  • Fills the need for timely and practical medical

treatment under emergency conditions and authorizes

Center for Community Preparedness

g y use of the best product available for treatment or prevention

  • Used when US Food and Drug Administration has not

already been approved or it is not indicated for the specific use

Louisiana Department of Health and Hospitals – Office of Public Health

Emergency Use Authorization Emergency Use Authorization

  • Must be a Declaration of Emergency that

justifies the authorization of the EUA by the secretary of Health and Human Services (HHS)

Center for Community Preparedness

(HHS)

  • Peramivir IV for H1N1 for treatment of 2009

H1N1 Influenza

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role in Emergency Pharmacy’s Role in Emergency

Center for Community Preparedness

Preparedness Preparedness

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SLIDE 13

7/12/2010 13

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role in Emergency Preparedness Pharmacy’s Role in Emergency Preparedness at the Federal Level at the Federal Level

  • Commander Michael P. Bourg is the Chief

Pharmacy Officer of Health and Human Services Preparedness and Emergency Operations

  • Pharmaceutical cache has been pre-staged in areas

Center for Community Preparedness

Pharmaceutical cache has been pre staged in areas that are at higher risk for disasters

  • This cache is used to supply a Disaster Medical

Assistance Team (DMAT) with the full of range

  • f pharmaceuticals needed for a disaster response

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role in Emergency Preparedness Pharmacy’s Role in Emergency Preparedness Planning Planning

  • Health system pharmacies are now more

involved in emergency planning

  • American Society of Health-System Pharmacy

conducted a survey in 2004 of Ambulatory

Center for Community Preparedness

conducted a survey in 2004 of Ambulatory care Pharmacy practices revealing 90% of Pharmacists were involved in Emergency Preparedness programs

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role in Emergency Preparedness Pharmacy’s Role in Emergency Preparedness Planning Planning

  • Institute plans/policies on responding to local

disasters for hospital pharmacies

  • Maintain pharmaceutical supplies
  • Knowing the appropriate pharmaceuticals to

Center for Community Preparedness

stockpile

  • Ensure deployment of pharmaceuticals within

your facilities

  • Being informed about National Incident

Management System(NIMS) and Incident Command Structure

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role in Emergency Preparedness Pharmacy’s Role in Emergency Preparedness Planning Planning

  • Implement/maintain an inventory system for

pharmaceutical distribution for emergency planning

  • Participate in your institution’s Emergency Plans

Center for Community Preparedness

  • JCAHO requires all hospitals to have external

and internal back up communication. Planning communication strategies when electricity is unavailable

  • Requirements for disposal of medications for

pharmacies in emergency situations

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role in Emergency Preparedness Pharmacy’s Role in Emergency Preparedness Planning Planning

  • Training pharmacy staff properly
  • Maintain emergency pharmacy staffing roster
  • Encourage staff to have an evacuation plan in

l f h i f ili

Center for Community Preparedness

place for their families

  • Exercise your facility emergency plans

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Role during an Event Pharmacy’s Role during an Event

  • Counseling, medication preparation, dispensing,

and distribution

  • Manage drug therapy of patients during a disaster
  • Assist the Medical team in recommending the best

Center for Community Preparedness

  • Assist the Medical team in recommending the best

medication alternative therapy during a disaster

  • Take care of yourself!!!
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7/12/2010 14

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Expanded Disaster Role Pharmacy’s Expanded Disaster Role

  • In Louisiana during the H1N1 Pandemic

Pharmacist were able to have temporary privileges to administer H1N1 influenza if they were trained and registered through DHH

Center for Community Preparedness

were trained and registered through DHH

  • Louisiana Board of Pharmacy and DHH

developed a standing protocol allowing Community Pharmacists to administer Seasonal/H1N1

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Expanded Disaster Role Pharmacy’s Expanded Disaster Role

  • Governor Jindal issued an emergency order

that allowed Pharmacist to administer the Seasonal influenza vaccine without a MD’s prescription

Center for Community Preparedness

prescription

  • In Louisiana, Act 287 signed by Governor

Jindal (former House Bill 872) has passed that allows Pharmacist to administer influenza immunizations

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Expanded Disaster Role Pharmacy’s Expanded Disaster Role

  • Act 287

– An influenza immunization may be administered to any person 7 years of age or older without a prescription or medical order based upon the

Center for Community Preparedness

p p p following provisions

1. Shall be in conformance with the most current annual influenza vaccination administration protocol 2. Each vaccine shall be reported to the OPH Immunization Registry 3. Report all adverse events

Louisiana Department of Health and Hospitals – Office of Public Health

Pharmacy’s Expanded Disaster Role Pharmacy’s Expanded Disaster Role

  • 4. Shall maintain for at least 2 years a record of each

influenza immunization given

  • 5. Shall obtain the appropriate credential to

administer influenza immunizations from the

Center for Community Preparedness

board

Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana Office of Public Health Louisiana Office of Public Health Pharmacy Pharmacy

Center for Community Preparedness

Pharmacy Pharmacy

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7/12/2010 15

Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana’s DHH/OPH/Pharmacy Louisiana’s DHH/OPH/Pharmacy Emergency Role Emergency Role

  • Monitor Retail and Manufacturing supply of Antiviral

influenza medications during the H1N1 Response

  • Recruited Retail Independent and Chain Pharmacies statewide

to assist in the influenza vaccination campaign and antiviral medication distribution

Center for Community Preparedness

medication distribution

  • Partnered with the Louisiana Board of Pharmacy provided

updates on H1N1

  • Assisted in developing the State Pandemic Influenza Plan
  • Integral part of the DHH Emergency Operations Centers

during emergency activations

  • Support role in CHEMPACK, State Cache of Medications,

EPAP, Purchase of Medications for DHH, SNS/CRI

Louisiana Department of Health and Hospitals – Office of Public Health

Volunteer Management Volunteer Management

Center for Community Preparedness Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana Volunteers in Action Louisiana Volunteers in Action (LAVA)? (LAVA)?

Build local, state, and federal health workforce surge capacity during disasters through a state based national system for registering

Center for Community Preparedness

state-based, national system for registering health professional volunteers in advance of an emergency.

Louisiana Department of Health and Hospitals – Office of Public Health

Louisiana Volunteers in Action Louisiana Volunteers in Action (LAVA)? (LAVA)?

  • LAVA

LAVA is Louisiana’s approach to HHS federally mandated Emergency Systems for Advanced Registration

  • f Volunteer Health Professionals (ESAR-VHP) Program.

Center for Community Preparedness

  • LAVA works to recruit, credential, train, manage and

deploy volunteers (medical and non-medical). Website: www.lava.dhh.louisiana.gov

Louisiana Department of Health and Hospitals – Office of Public Health

“When planning for a year, plant “When planning for a year, plant

  • corn. When planning for a
  • corn. When planning for a

decade, plant trees. When decade, plant trees. When planning for life, train and planning for life, train and

Center for Community Preparedness

p g , p g , educate people.” educate people.” Chinese Proverb Chinese Proverb

Louisiana Department of Health and Hospitals – Office of Public Health

Resources/References

  • www.bt.cdc.gov (CDC)
  • www.hhs.gov/emergency (Human and Health

Services)

  • www.ashp.org (American Society of Health-

System Pharmacy)

Center for Community Preparedness

System Pharmacy)

  • Emergency.louisiana.gov (State of Louisiana)
  • www.cshp.org (California Journal of Health-

System Pharmacy)

  • www.dhh.louisiana.gov (Louisiana Dept of

Health and Hospitals)

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7/12/2010 16

Louisiana Department of Health and Hospitals – Office of Public Health Center for Community Preparedness

QUESTIONS? QUESTIONS?

Louisiana Department of Health and Hospitals – Office of Public Health

Contact Us Contact Us

Louisiana Department of Health and Hospitals Louisiana Department of Health and Hospitals Office of Public Health Office of Public Health Center for Community Preparedness Center for Community Preparedness 8919 World Ministry Ste B 8919 World Ministry Ste B

Center for Community Preparedness

8919 World Ministry, Ste. B 8919 World Ministry, Ste. B Baton Rouge, LA 70810 Baton Rouge, LA 70810 225 225‐763 763‐3503 3503 http://www.dhh.louisiana.gov http://www.dhh.louisiana.gov