1. August 2, 2016 Jefferson County Public Health, Lakewood, CO
MFHCC Meeting
August 2, 2016
Jefferson County Public Health, Lakewood, CO

2. Welcome and Introductions
Please state your name and the agency you represent
Please avoid using acronyms

3. Agenda Welcome & Introductions - Janelle
Review Previous Action Items - Janelle
MFHCC Website Resources, New Member Spotlight Pages – Lisa F.
DaVita Village Emergency Response Team (DaVERT) – Alexis Garcia and Greg Adams
Medical Countermeasures (MCM) Training for Community and Response Partners – Christine Billings
Advisory Group Update – Janelle W.
Upcoming Trainings: – Lisa F.
Agency Updates - All
Review New Action Items - Janelle
No workgroups are scheduled to meet today
Networking

4. Review Previous Action Items
Person responsible
Deadline
Contact Christine/Cali if interested in becoming a JCPH or Denver Closed POD.
All
On-going
Call your local non-emergency dispatch, introduce yourself and ask what situations they would like you to use this number instead of 911. Prepare to report back at the next meeting.
There is a statewide need for blood donors so please spread the word.
Janelle or Lisa to sign up for workgroups of interest
Janelle or Lisa to volunteer as secretary
Member Spotlight - Janelle and Lisa if you would like to be featured on the website.
Send info on the active shooter follow-up program at an emergency preparedness seminar in Keystone to Janelle and Lisa who will pass it on to the MFHCC. DONE
Simon Schwartz
3/15/16

5. MFHCC Website Updates
Lisa Filipczak

6. MFHCC Website Updates URL: www.metrofoothillshcc.com Features:
Organizational structure (charter, operational structure)
Meeting details (dates, times, location, minutes)
Membership (new member registration, member roster spreadsheet)
Training and Exercise opportunities
Resources (Zika Virus)
Volunteers for new member spotlight pages

7. DaVita Village Emergency Response Team (DaVERT)
Alexis Garcia and Greg Adams

8. Medical Countermeasures (MCM) Training for Community and Response Partners
Christine Billings

9. Anthrax The Threat Our Vulnerability
U.S. intelligence agencies assess that a large-scale aerosol release of anthrax is “well within the technical capability of al-Qa’ida and other foreign or domestic terrorist organizations.”
Our Vulnerability
Bacillus anthracis can be grown in a relatively simple laboratory setup using basic microbiology techniques. Aerial dispersion of anthrax over a large geographic area can be accomplished with commercially-available equipment.

10. At Risk
“…it is more likely than not that a weapon of mass destruction (WMD) will be used in a terrorist attack somewhere in the world by the end of That weapon is more likely to be biological than nuclear.”
The Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism. World at Risk. December 2, Page: XV. Accessed May 2, 2010.

11. Cities Readiness Initiative
Purpose: to effectively respond to a large scale bioterrorist event, local authorities must build the capacity to dispense antibiotics and other medical supplies to the entire identified population within 48 hours of the decision to do so.

12. Events Start Locally Something bad happens (the event)
Public POD Sites
Public receives prophylaxis
Locals respond to the event
Closed POD Sites
Locals receive SNS, send the SNS to the Points of Dispensing (POD)
Local resources are insufficient
Local request resources from the State
State receives the SNS site and sends it the Locals
The first thing that is going to happen is that something bad is going to happen. At the local level we write all-hazard plans, so our plan is written so that it can apply to anything from the Anthrax attack to an influenza epidemic. We do however use the anthrax scenario because it has the fastest response time required. So, something bad happens.
All emergencies start local, however, which I'm sure comes as no surprise, local resources are likely to be insufficient to respond to a large event like providing medication to treat a mass anthrax exposure. We at the local level would then request resources like medications from the state. Depending on the size of the incident, the state would see if they have sufficient resources. It’s likely that won’t, so they will then request resources, like the SNS from the federal level. The feds will send the resources to the State, who will receive them and send them to the local level, where they will get sent off to the points of dispensing or PODS, which includes both public PODS and Closed POD, which I’ll talk about in a moment. From there, the medication will get distributed to the public.
At the local level, the majority of the response to an anthrax attack or other event that requires mass dispensing is the POD operation.
State requests resources (the SNS) from the Federal level
Federal sends the SNS to State

13. Strategic National Stockpile
Program created in 1999
$3.5 billion portfolio of antibiotics, medical supplies, antidotes, antitoxins, antivirals, vaccines and other pharmaceuticals
Network of strategically located repositories
Mission - Create pathways to move the materiel to the area of need in the timeframe that is clinically relevant

14. (Receive, Stage, & Store)
Flow of SNS Assets
RSS Warehouse
(Receive, Stage, & Store)
Federal Level
State Level
Local Level
SNS Assets
PODs &
Treatment Ctrs
Regional
Dist. Sites
DO: Review the previous hidden slide and determine which slide (this or the next) is most appropriate to use. If the state uses regional distribution sites, then use this slide.
SAY: Maybe you’ve already seen this flow chart. It shows how SNS assets are deployed to the affected area.
Again, the need is determined at the local level, then the state requests federal assistance in part based on the local inventories available and the anticipated size of the event.
Assets will go from the Federal government, to the state-run RSS warehouse, to a regional distribution site(s) – similar to the RSS – to the PODs and treatment centers.
The actual flow of materiel distribution to closed PODs in your area is determined by your state’s SNS plans.

15. Points of Dispensing (PODs)
The purpose of the POD is to dispense prophylaxis quickly to a large group of people.
So, what is a POD?
The purpose of the POD is to dispense prophylaxis quickly to a large group of people. Prophylaxis is the use of medicine for the prevention of disease or the control of its possible spread.
Vaccine, antibiotics, antiviral and other medications
Prevent or treat illness in exposed persons
PODs are basically like a community flu shot clinic, with a huge sense of urgency.

16. Points of Dispensing (PODs)
Open POD Site
Close POD Site
Operated by JCPH, with volunteers
Open to the entire public
Located in common community areas
E.g. gyms, community centers
JCPH has plans for ~8 Open POD sites
Operated by a private agency
Open to a specific population
E.g. employees
Located in common area for the specific population
E.g. office space
JCPH has agreements for ~11 Closed POD sites
Including the Denver Federal Center
We have both Open or Public POD Sites and Closed POD Sites.
Open POD sites are
Operated by JCPH, with volunteers
Open to the entire public
Located in common community areas
E.g. gyms, community centers
JCPH has plans for ~8 Open POD sites
Closed POD sites
Operated by a private agency
Open to a specific population
E.g. employees
Located in common area for the specific population
E.g. office space
JCPH has agreements for ~11 Closed POD sites
Including the Denver Federal Center
So that’s the different between the two, but what is the point of a closed POD?

17. The POD Process Basically it’s a simplified vaccination clinic.
Patient is greeted at the POD site, directed where to go
Patient completes forms, can ask questions, is given info.
Patient forms are reviewed
Receives evaluation, recommendation for medications (if any)
Complicated dispensing
Great, so what does the POD process look like?
First the patient is greeted and directed where to go. Then the patient will complete some forms, like a basic medication questionnaire. Their forms are reviewed and depending on their situation they may be sent for further evaluation or they may go straight to receive their medication. If they do receive screening a trained medical staff member will determine it is appropriate for them to receive the medication. If it is they will be directed that way, if it not they will be directed to exit POD and they may be directed to visit their primary care doctor or physician.
In a nut shell, that’s it!
Standard dispensing
Receives medication and information
Exit, asks any last questions

18. Community and Response Partner Roles
Information Sharing
Closed PODs
Dispensing Staff
Security
Transportation
Access and Functional Needs
Behavioral Health
Hard to Reach Populations
Training and Exercising

19. How You Can Help
Partner with your local health department and become a Closed Point of Dispensing (POD)
Medications dispensed to a specific group designated by the organization
Not open to the public*
Managed by organization’s staff
Participate in upcoming communication and information sharing exercises.
Participate in the Statewide Full-Scale Exercise in June 2017.

20. Advisory Group Update
Janelle Worthington

21. Upcoming Meetings and Trainings
Lisa Filipczak

22. Upcoming Trainings: – Lisa
Aug. 17, 6:15 am - 4:00 pm – National Disaster Medical System (NDMS) exercise “FCC Denver Reception DIA
Sept. 6, 12:00 - 1:30 pm – Responder Resiliency Training (regular MFHCC meeting but Arvada location)
Oct. 4, pm – Healthcare Coalition Medical Countermeasure (MCM) Workshop (regular MFHCC meeting)
Nov. 3, 9:30 am - 2:30 pm – Ebola Tabletop JCPH
1. Optional exercise scenario involving an Earthquake out-of-state that caused severe damage and injuries, requiring the transportation of approximately 150 patients to the Denver area. These patients will be disbursed to 10 metro-area hospitals utilizing ground ambulances and Colorado Army Air National Guard helicopters.
2. One of the most requested training topics this year. Please invite responders and staff who might benefit from this training.
3. This training will focus on the HCC agency/member integration into the SNS-Medical Counter Measure (MCM) Ordering and Distribution System as it relates to the 2017 full scale exercise.
4. Ebola tabletop exercise which meets one of the Ebola plan deliverables.

23. Agency Updates - Lisa
Please mention brief updates you would like to share with the entire group
Include your name and agency name
High level reports applicable to various agencies
Updates requiring in depth discussions may transition into workgroups

24. Agency Updates Epi Update Hospitals Public Health EMS Provider
Emergency Management
Long Term Care
Mental/ Behavioral Health
Outpatient Medical Services (Example: community health center, clinic, dialysis, etc.)
Other HCC Partner (Example: education, private, federal entity, coroner, etc.).

25. Agency Updates
Denver Public Health - Epi Update – FoodNet Cases

26. Agency Updates
Denver Public Health – May-July 2016

27. Jefferson County, CO- 2016 Outbreaks
Etiology of Outbreak
Facility Type
Influenza
Noro
Suspect noro
Grand Total
Child Care Center/Camp 1 2
Long Term Care Facility 4 7 15
Retail Food Establishment 3
Grand Total of outbreaks 9 20
Etiology
Confirmed Cases*
Total Cases*
Influenza 10 30
Noro 23
247
Suspect noro 75
Grand Total 33
352
*No case counts for 3 outbreaks, final reports not received
Clear Creek County, CO Outbreaks
Etiology of Outbreak
Facility Type
Influenza
Noro
Suspect noro
Grand Total
Child Care Center/Camp 1
Long Term Care Facility
Retail Food Establishment
Grand Total of outbreaks
Etiology
Confirmed Cases
Total Cases
Influenza
Noro 1 40
Suspect noro
Grand Total
August 1, 2016

28. Agency Updates Epi Update Hospitals Public Health EMS Provider
Emergency Management
Long Term Care
Mental/ Behavioral Health
Outpatient Medical Services (Example: community health center, clinic, dialysis, etc.)
Other HCC Partner (Example: education, private, federal entity, coroner, etc.).

29. Review New Action Items
Janelle Worthington

30. Thank you! Networking