PHARMACY S ROLE IN EMERGENCY PREPAREDNESS- HOW YOU CAN BECOME INVOLVED Kentucky Pharmacists Association Leah Tolliver Pharm.D. Director of Pharmacy Emergency Preparedness
Pharmacy s Role in Emergency Preparedness-How YOU Can Become Involved Objectives Describe the pharmacist s role in emergency preparedness. Describe the pharmacy technician s role in emergency preparedness. Describe a situation in which a mobile pharmacy unit would be beneficial in the event of a disaster. Describe ways to become involved in the emergency preparedness program
KPhA Director of Pharmacy Emergency Preparedness Responsibilities include: Manage pharmaceutical assets for the Kentucky Department for Public Health (KDPH), Emergency Preparedness Branch Engage pharmacists to serve special populations following a disaster. Develop and implement an emergency preparedness operations plan for pharmacies Develop program for utilization of mobile pharmacy
Kentucky Ranking Ranks 8 th in number of declared disasters since 1960s Kentucky averages a disaster every three months Disasters include natural, biological, fire and epidemics Ranks 26 th in population Ranks 36 th in land area
Vision Public health prepared; Kentuckians protected Mission Kentucky Public Health Preparedness enhances the capacity of the Kentucky Department for Public Health, local public health departments and the health care system to prevent, prepare for, respond to, and recover from the adverse health effects of public health emergencies and disasters.
Incident Command Structure (ICS) Command, control and coordination of the emergency response Subcomponent of the National Incident Management System (NIMS) First on scene structure Includes incident commander, safety officer, PIO officer, liaison officer, and section chiefs for operations, planning, logistics and administration/finance
National Incident Management System (NIMS) Comprehensive, nationwide systematic approach to incident management Components include: Preparedness Communications and information management Resource management Command and management Ongoing management and maintenance
FEMA/KY Emergency Support Function 8 Address disaster medical needs associated with Public health Medical needs Mental and behavioral health Substance abuse considerations At-risk and functional needs populations Veterinary and animal health issues Mass fatality management Long-term care
Emergency Operations Center (EOC) EOCs are activated for incident coordination and management EOCs coordinate resources for events that require multiple agencies from different jurisdictions Activated at federal, state and local levels
Department Operations Center (DOC) ESF-8 manages the health and medical component of an event Support EOC missions through the ESF-8 liaison KDPH DOC coordinates with local health department operation centers Operate under ICS KPhA s Director of Pharmacy Emergency Preparedness will work with ESF-8 liaison in the DOC
Mass dispensing (SNS) Vaccinations Pharmacist s Role Point(s) of Dispensing (POD) Pharmacy district coordinator MOBILE PHARMACY Pharmacy Surge Unit #1 Kentucky Health Emergency Listing of Professionals for Surge (K HELPS) registry Medical Reserve Corp volunteers Drug shortages
Pharmacy Technician s Role Pharmacy technicians will not be left out when a pharmacy or health-system is faced with responding to and managing a major crisis event. They are the day-today support for pharmacists, and will certainly play a pivotal role in the response to a crisis event. QS1 computer system support-mobile pharmacy
Public Health Goal Examples of Pharmacy Role Prevent epidemics and the spread of disease Recognize early signs of an outbreak Provide immunizations for disaster responders, relief workers, and displaced individuals Provide post exposure prophylaxis (work in a POD) Protect against environmental hazards Educate the public on topics such as food and water safety, proper medication storage, sanitation, mold cleanup, and carbon monoxide poisoning Prevent injuries Provide postexposure vaccinations (tetanus) Minimize medication related side effects
Public Health Goal Examples of Pharmacy Role Promote and encourage healthy behaviors Encourage routine vaccination Maximize appropriate use of medication for management of chronic medical conditions Encourage healthy lifestyles Respond to disasters and assist communities in recovery Participate in mass dispensing/vaccination clinics (PODs) Assist with triage, recognition, and treatment of mental health conditions Ensure the quality and accessibility of health services extend pharmacy hours during recovery Use intact pharmaceutical supply chains to assist local and nearby disaster response teams, when possible Provide vaccinations and post exposure prophylaxis to at risk or vulnerable populations
Strategic National Stockpile (SNS) National repository of lifesaving pharmaceuticals and medical supplies used to augment federal, state and local public health and emergency response agencies supplies in the event of a terrorist attack, emergency or natural disaster.
Strategic National Stockpile (SNS) KPhA Director of Pharmacy Emergency Preparedness in conjunction with KDPH SNS Coordinator has responsibility for accountability, dating, relabeling, rotation and storage of SNS in Kentucky Products currently stored: Relenza, Tamiflu, Cipro
Receipt, Stage and Store (RSS) Receives federal medical assets Distributes assets to event 12 Hour Push Package Designed to be initial federal response for medical material Broad spectrum of medical assets Arrives within 12 hours of federal decision to deploy Weighs over 50 tons, 130 containers, 8-9 tractor trailers Requires 12-15,000 square feet of warehouse space 10 day antibiotic regimens for 500,000 people
Regional Distribution Site (RDS) Receives medical assets from state Distributes to Point(s) of Dispensing (POD) Distributes to hospitals
Point(s) of Dispensing (POD) Dispenses medications to public Closed PODs-military, business, healthcare facilities Open PODs-public Medical and non-medical models Non-medical model allows volunteers under pharmacist or physician supervision to dispense medications Repackaging Operations Packages bulk medications not available in unit of use package (mass dispensing)
KPhA Engagement with DPH in response to Disaster Events: Hurricane Gustav (September 2008) Winter Storm of 2009 (February) Tornadoes, Straight-line Winds & Flooding (March 2012)
March 2012 Disaster KPhA Activities BEFORE Worked with the Legislature to enact KRS 315.500, Emergency Authority for Pharmacists during a state of emergency Provided input into 201 KAR2:330 (regulations)
YOU Can Become Involved March 2012 Disaster KPhA Activities DURING Worked with DPH and Governor to implement Executive Order granting Emergency Authority for Pharmacists Coordinated with Board of Pharmacy Kept pharmacists informed
Pharmacy s Role in Emergency Preparedness-How YOU Can Become Involved March 2012 Disaster KPhA Activities AFTER Worked with DPH ESF-8 to monitor response efforts Gathered/reported data on the number of prescriptions filled under the EO Participated in partner/debriefing meetings
Pharmacy Surge Unit #1 Place for local pharmacist to dispense prescriptions when pharmacy is destroyed or damaged A place for additional personnel for surge capacity Will be deployed by KDPH if stand alone pharmaceutical services are needed during a disaster Inventory of medications will be delivered once mobile pharmacy is in assigned location Security Plan
Kentucky Health Emergency Listing of Professionals for Surge (K HELPS) Online database used to meet surge Registers medical professionals interested in volunteering to offer assistance during public health emergencies or disasters Standardizes MRC units in Kentucky through: Register in one county Credentialing Background check Pharmacist license Liability insurance required Training Orientation, Incident Command Structure, NIMS Policy/procedures KHELPS
Medical Reserve Corp (MRC) Network of community-based volunteers, committed to improving the health, safety, and resiliency of their community System used to identify, credential, and track training for community-level volunteers PRIOR to an emergency UK College of Pharmacy Sullivan University College of Pharmacy Health fairs, vaccination events www.medicalreservecorps.gov
Volunteer Roles: Health and Medical Professionals NURSES Med Screeners Assessment Triage PHYSICIANS Subject Matter Expert Diagnosing PHARMACISTS BEHAVIORAL HEALTH Repackaging Staff Compounding Public Medically Complex Cases Clinical Liaison
We NEED You! If SNS assets are deployed, THOUSANDS of volunteers may be needed.
TAKE CARE OF FAMILY FIRST! The first priority upon being called as a volunteer is to ensure your family and others that depend on you are taken care first. This includes an emergency supply kit Receiving first dose medications in the case of a flu or anthrax event Serving as a volunteer is not a requirement; it is optional and up to you upon being called
Drug Shortages Assist KDPH with drug shortages that treat health department patients Pharmacy sources include: Manufacturer Wholesaler Corporate chain pharmacy Independent pharmacy Hospital pharmacy Long-term care pharmacy Compounding pharmacy
Drug Shortages Examples include: Tuberculosis drugs (INH, Rifampin, Ethambutol, Pyrazinamide, PAS) Tuberculin skin test (Note: The Kentucky Tuberculosis Program does not recommend health care and longterm care facilities switch to Aplisol if there is a shortage of Tubersol. A change in product can lead to false positives. A second option to a shortage of Tubersol is interferon-γ release assay (IGRA) blood tests Tamiflu
Public Health Partners Regional Preparedness Coordinators Health Department Coordinators MRC Coordinators Pharmacy District Coordinators District Maps
Pharmacy District Associations Meeting with pharmacists, promoting the emergency preparedness program Recruiting pharmacists to serve as a volunteer Identifying pharmacy district coordinator Active districts -Bluegrass, JCAP, District 4 (Bowling Green), Northern KY Inactive districts-eastern KY, District 1 (Paducah), southern KY, Elizabethtown/Bardstown
Communication Plan KPhA Staff Pharmacy district coordinators Pharmacies Pharmacy Organizations Wholesale Distributors Department for Public Health Epidemiology Regional preparedness coordinators Hospital and long-term care coordinators Local health departments MRC Coordinators MRC volunteers Communication systems Health Alert Network (HAN) Television, radio, email blast, text blast, phone Car, horse and buggy, walk!
Emergency Preparedness Resources KPhA website http://kphanet.org/ Kentucky Department for Public Health website http://chfs.ky.gov/dph/ State boards of pharmacy (MI, NC, GA) Veterans Administration RxResponse http://www.rxresponse.org/ NABP Emergency and Disaster Preparedness and Response Planning: A Guide for Boards of Pharmacy APhA Pharmacist s Guide to Pandemic Preparedness CDC www.cdc.gov FEMA www.fema.gov ASTHO http://www.astho.org/
Future Programs Family emergency preparedness planning Pet emergency preparedness planning
QUESTIONS?
KPhA Emergency Preparedness Program Leah Tolliver Pharm.D. Director of Pharmacy Emergency Preparedness ltolliver@kphanet.org http://kphanet.org Office: 502-227-2303 Cell: 859-333-4748