Strategical National Stockpile 15 Staff PHEP 10 FTE and 2 LTE HPP 3 FTE

Wisconsin Strategic National Stockpile Joe Cordova Emergency Response Coordinator/Threat Liaison Officer Kay Mittelstadt-Lock Medical Countermeasures Coordinator Office of Preparedness and Emergency Health Care October 2018

Strategic National Stockpile Centers for Disease Control and Prevention Office of Public Health Preparedness and Response Division of Strategic National Stockpile Medical Countermeasures Antibiotics and antivirals Medical equipment and supplies Vaccines and antitoxins Radiologic cleating agents Nerve agent antidotes

State MCM Operations Plan Annex to ESF-8 Outlines the roles and responsibilities within the State of Wisconsin for the allocation of medical countermeasures in a public health emergency event and for the request, reception and use of the assets from the Strategic National Stockpile Reviewed by CDC yearly

State SNS Plan Responsibilities Tasked State Agencies Office of the Governor Department of Health Services (Lead) Division of Public Health Department of Military Affairs Wisconsin Emergency Management Department of Transportation Division of State Patrol

State SNS Plan Responsibilities Support State Agencies Department of Corrections Department of Administration County, Tribal, and Municipal Public health Emergency management Law enforcement

State SNS Plan Activation An incident that has or will overwhelm local and state medical resources CDC is the only source of the countermeasure For bioterrorism direct request to CDC by the Governor Other incidents requested same as other federal resources Wisconsin Statute 250 provides authority

SNS Aerosolized Anthrax

SNS Aerosolized Anthrax 48 hours to dispense 10 days of antibiotics to exposed population Followed by 3 Doses of anthrax vaccine 50 days of antibiotics

SNS Operations Request Receive Distribute Dispense Recovery

SNS Operations – Request Appendix B – Recommendation to Request the Strategic National Stockpile Checklist Consultation points Decision algorithm Appendix C – Local Strategic National Stockpile Request Type of incident, threat agent, numbers exposed

SNS Containers

SNS Operations – Receive WDHS works with two private warehouses to be the Receive, Stage and Store (RSS) warehouse CDC reviews and approves all RSS warehouses US Marshals conduct security assessments MOA with local law enforcement for security Staffed by warehouse company and WDHS

SNS Operations – Receive Ready RSS warehouse Local law enforcement establishes security WEM sets up redundant communications CDC delivers to our RSS warehouse US Marshals Service escorts to RSS warehouse State Patrol assists escort in Wisconsin State health official signs for SNS Offload and inventory Secure controlled substances

RSS Communications

Communications Pathways State Emergency Operation Center Madison Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF ACU-1000 HAM Sat-Phone DOT Traffic Control Center Milwaukee Phone Cell/text Fax E-mail WEB EOC VHF 800MHz Sat-Phone Dept Health Services DOC Madison Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF County EOCs Phone Cell/text Fax E-mail WEB EOC VHF HAM Sat-Phone RSS Warehouse Dane County Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF Sat-Phone Hospitals Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF HAM Sat-Phone Tribes/Public Health Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF HAM Sat-Phone RSS Warehouse Eau Claire County Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF Sat-Phone Points of Dispensing Phone Cell/text Fax E-mail WEB EOC WI Trac WIR/SNS VHF 800 MHz HAM Sat-Phone Fleet Madison Phone Cell/text Fax E-mail WEB EOC VHF

SNS Operation – Distribution

SNS Operations – Distribution Points of dispensing (PODs) have been pre-identified by tribal and local public health agencies Geocoded for route planning Each site has detailed plans Local law enforcement have security plans Routes developed using TourSolver®

SNS Operations – Distribution Transportation from RSS warehouse to points of dispensing by commercial trucking companies WI State Patrol escorts each truck Security Communication Tracking Routes are planned based on number of trucks and number of points of dispensing SNS products are pushed

SNS Operations – Dispensing

SNS Operations – Dispensing All Tribal and local public health agencies are required to have a dispensing plan Open point of dispensing operates 24 hours WDHS provides medical order for what is to be dispensed, to who and for how long Head of household dispensing can be authorize Local health officer has authority to delegate dispensing to closed points of dispensing

SNS Operations – Dispensing Hospitals receive treatments and prophylaxis Large businesses and universities can dispense with a local health officer approved closed point of dispensing plan Online screening is available to assist Federal and state laws provide liability protection

SNS Operations – Recovery Phase 1 reduce operations Phase 2 cease operations Pick up all unused medications Return all medical equipment Monitor public health

National Guard Assist Warehouse operations Distribution Dispensing Unloading Picking inventory Inventory control Security Distribution National guard vehicles Dispensing

For more information Joe Cordova Joseph.cordova@wisconsin.gov Kay Mittelstadt-Lock Kay.mittelstadtlock@wisconsin.gov DHSStockpile@wisconsin.gov