Emerging MCM Practices Revealed at the ASPR Regional Summits


By Raymond Purerini, NACCHO Senior Program Analyst

img_20160830_084917175Throughout the month of August the Office of the Assistant Secretary for Preparedness and Response (ASPR) hosted six regional medical countermeasure (MCM) summits across different regions of the nation including San Diego, CA, Providence, RI, Washington, DC, Salt Lake City, UT, Oklahoma City, OK, and Kansas City, MO.

These summits brought together federal, state, regional, local, tribal, and territorial public health preparedness representatives to identify, discuss, and share best practices in MCM planning. Federal and national agencies represented included ASPR, NACCHO, the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), U.S. Marshals Service, and the Federal Emergency Management Agency (FEMA). The program for each summit varied from region to region, based on local need, but each training focused on the exploration of four main topic areas:

  • Tribal Planning and Preparedness
  • Access and Functional Needs Populations
  • Federal and Closed Points of Dispensing (PODs)
  • Federal MCM Efforts

Representing the NACCHO Preparedness team, I had the opportunity to both attend and present at three of the six summits. Below are some of the highlights and promising practices attendees discussed within each of the four main topic areas.

Tribal Planning and Preparedness

  • Tribes may vary with respect to federal recognition and processes for requesting and distributing MCMs for tribal nations may vary from jurisdiction to jurisdiction.
  • Tribal nations may be able go directly to FEMA to seek assistance and may possess the powers of their own government.
  • Health department staff entering into partnerships with tribal nations should become familiar with specific histories of individual tribes and are encouraged to consider taking cultural sensitivity training.
  • FEMA has a tribal training course and has regional tribal liaisons that can support local health officials to make connections with tribes in and around  the community they serve.

Access and Functional Needs Populations

  • When facilitating POD and shelter exercises, agencies should strive to include individuals with access and functional needs rather than engaging actors or volunteers as representatives of this group. This approach helps to uncover planning gaps and weaknesses related to supporting individuals with these needs during public health emergencies.
  • One way to ensure the individuals with limited to low literacy skills are fully informed on public health emergency planning and response is to provide them with a recording of someone reading the relevant information out loud.
  • When developing POD plans, agencies should strive to include staff assignments focusing on assisting individuals with limited mobility in navigating through the POD (e.g. older adults, individuals with disabilities).
  • As an example, the Missouri State Department of Health employs Functional Assessment Support Teams, deployed to potential emergency response locations to specifically focus on assessing the potential barriers for community members with access and functional needs.

Federal and Closed PODs

  • When implementing Closed POD planning with different federal entities, partnering with the Federal Executive Board (FEB) is likely to be a strong asset, as they have administrative oversight over a number of federal entities.
  • Contacting local, regional, or state trade organizations or better business bureaus may be useful for determining and prioritizing which organizations to approach for Closed POD planning.
  • During Closed POD planning, the use of actual pallets, boxes, and bottles of pills while participating in discussion-based and functional exercises improves the development of medication transportation and distribution plans.
  • As an example, Dallas County, TX utilizes an “Alpha POD” concept by engaging volunteers at one large Closed POD site to accept and distribute MCMs to smaller Closed POD sites throughout the county. Volunteers or community members reporting to smaller sites also have the option of going to the larger site to receive MCMs.

Federal MCM Efforts

  • The CDC recently announced that it will be making several improvements to the MCM Operational Readiness Review electronic submission portal. These updates will include real-time report updating as data is entered, an option to print out reports for sharing purposes, and specific ORR elements assigned to particular jurisdictional levels (e.g. state, local, and island may have some different elements to complete).
  • In September, 2016, the CDC released “On-TRAC,” or the Online Technical Resource and Assistance Center, providing state and local health departments with direct access to request technical assistance, relevant resources, and opportunities to communicate/collaborate with other health departments.
  • PODs and warehouse sites may require a large contingent of security resources to secure sites and transport MCMs over the course of a response. Develop plans to manage and coordinate additional state and federal security assets that are likely to arrive from across jurisdictional lines and ensure there are staff included in response operations who have arresting authority.

Other Highlighted MCM Resources

  • ASPR TRACIE is an excellent resource to locate relevant MCM preparedness resources and seek technical assistance for MCM challenges.
  • Dispense Assist is a free-to-use online screening service, where individuals can enter in screening question information and receive automatically generated medication vouchers for MCM responses.
  • The NACCHO Toolbox contains a number of MCM resources to help build MCM capacity including those on sustained MCM operations (1, 2).

ASPR will be compiling the major lessons learned from all six regional summits to inform a national virtual tabletop exercise to be held later this fall. In addition, the information from the summits will be compiled into an MCM training course on FEMA’s Emergency Management Institute website. Check back on the NACCHO Preparedness Brief Blog through the next several months for more detailed updates on these upcoming opportunities.

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