1. BECOMING A DISPENSING
PARTNER
Organizations helping
to protect their
business, clients,
employees, and their
families in a Public
Health Emergency

2. INTRODUCTION
 Marin County Department of Health and Human Services, Division
of Public Health, Public Health Preparedness Program
 Work with a variety of multijurisdictional partners to increase
community preparedness for all types of emergencies and disasters
including Bio-Terrorism

3. Public Health Preparedness
History
 1999 CDC awarded 1st funding for Bioterrorism Preparedness (some states
funded)
 9/11/2001 AND Anthrax Attacks (2001), Increased Focus
 More appreciation for the role of Public Health in emergency preparedness
response (surge)
 Congress allocated funds and CDC awarded counties in all 50 states for BT
preparedness and response
 2005 Hurricane Katrina/New Orleans Disaster
 much greater understanding of Public Health and how it pertains to an All
Hazards Response
 Emergency Preparedness went from BT focus to an All Hazards with Public
Health approach over time

4. What is mass prophylaxis?
 Prophylaxis is the prevention of disease prior to or after exposure
to an etiologic agent through the use of antibiotics or antiviral
medications (chemoprophylaxis), or vaccination
(immunoprophylaxis).
 “Mass” prophylaxis describes the dispensing of prophylaxis on a
large scale.

5. When might we activate mass
prophylaxis?
 Bioterrorist agent
 e.g., anthrax, smallpox, plague
 Overt or covert release
 Naturally occurring disease outbreak
 Meningococcal disease
 Pandemic influenza

6. Marin County’s Response
 Will be opening multiple Public Points of Dispensing
(Public PODs) for the general public
 Considerations:
 Individuals with access and functional needs may not be able to
attend a public POD
 If we work with organizations who have large populations, serve
large populations, and/or serve those with access and functional
needs, we can lessen the burden on the Public POD systems
and account for Marin County’s most vulnerable citizens as well

7. Value of Partnering
 Incorporating organizations that serve large populations and their families,
or those with access and functional needs, we can ensure that they receive
life-saving medications quickly and efficiently
 Offers your organization the ability to get medications out to your
employees, clients, and family members in the quickest and most effective
manner.
 Your employees are less likely to miss work if they can receive medication
directly from their employer and do not need to attend a public POD for
themselves or their families, meaning better continuity of operations for
your organization.

8. How to Become a Dispensing
Partner
 Step #1 Educate/Training
 Dispensing Partner Presentation: This power point will introduce you to the
idea of becoming a dispensing partner and how it may be useful for your
organization.
 Closed POD Partner Online Training: Please view the first 2 Modules of
training at http://closedpodpartners.org/
 Incident Command Online Training: Please view the FEMA ICS 100. b. training
at http://closedpodpartners.org/

9. How to Become a Dispensing
Partner
 Step #2- Register
 Pre-Registration Form: Please complete this form if you would like to become a
Dispensing Partner (also referred to as Push Partner). This form is meant to be
completed electronically at
http://www.co.marin.ca.us/depts/HH/main/hs/dispensingpartners/; however it can
be filled out by hand, as well. The information filled out on the registration form
will be used to develop the official agreement in the form of the Memorandum of
Understanding.
 Memorandum of Understanding (MOU): This form is meant to be completed
with the information that is provided on the pre-registration form. Once completed
the original must be sent into the county for approval. Please make a copy to
keep at your facility.

10. How to Become a Dispensing
Partner
 Step#3- Develop Plan
 Partner Kit: This document will tell you almost everything that you need to know
about becoming a Dispensing Partner. It will also serve as a valuable resource
when developing your organization specific Dispensing Plan, as well as during an
actual event.
 Dispensing Plan:
 Each organization will develop a dispensing plan that works for them
 This plain is designed to meet the needs of your facility in terms of delivering
medication directly to your employees, family members, and clients
 We can help you come up with a plan that meets your needs!
 We can provide a template that should serve as a guide to assist you in
developing your dispensing plan.

11. How to Become a Dispensing
Partner
 Step #4- Additional Resources
 Inventory Control Form: is a brief form that you will complete when you are
receiving, distributing, or returning antibiotics.
 Final Summary Form: is a brief form that you will complete when you have
finished dispensing antibiotics. It provides a brief summary of your Push Partner
effort.
 Cipro drug sheet & Doxy drug sheets: These drug information sheets should
be handed out to individuals or families based on which drug they received.
 Screening Forms: These will be used for those who cannot or choose not to use
the online screening form. Also attached is a screening key to assist screeners
and dispensers in dispensing the appropriate medication. One screening form
can be used for up to 10 family members. The following link can be used to
access online screening through the Bay Area Mass Prophylaxis Working Group:
http://bayareadisastermeds.org/medicine.html

12. CRI Coordinator
 Please contact the Public Health Preparedness Program’s CRI Coordinator,
Kristen McClymer, at kmcclymer@co.marin.ca.us or 415-473-3880 if you
have any additional questions.
 The CRI Coordinator will answer any questions you have about becoming a
Dispensing Partner and will assist you in developing a dispensing plan that
will work for your organization.

13. Legal Considerations
 In the event of an emergency there are many laws that
will protect individuals and organizations dispensing life-
saving medications.
 Public Readiness and Emergency Preparedness (PREP) Act
 HIPAA

14. Legal Considerations (continued)
 PREP Act:
 Secretary may issue a declaration to provide immunity from liability
(except for willful misconduct) for claims:
 Death; physical, mental, emotional injury, illness, disability, condition, fear thereof;
medical monitoring, property damage or loss, business interruption
 Causally related to development, distribution, administration or use of “covered
countermeasures”
 Against “covered persons”, 42 U.S.C. 247d-6d

15. Legal Considerations (continued)
 Covered Persons Under the Prep-Act
 Manufacturers
 Distributors
 Program Planners (State, local government, tribe, others who supervise or
administer countermeasure programs, which can include private sector)
 Qualified Persons (licensed health professionals and others identified by the
Secretary who prescribe, administer, or dispense countermeasures)
 Officials, Agents, Employees of all of the above
 United States

16. Legal Considerations
(continued)
 HIPAA
 In the event of an emergency organizations with
signed MOUs become an extension of the
government and become exempt to HIPAA policies
 Signed MOU
 Designated as volunteer
 Incorporated into state response plans
 Are unable to charge for services rendered

17. Legal Considerations (Continued)
 For more information:
 Public Readiness and Emergency Preparedness (PREP) Act
 PREP Act declarations:
 http://publichealthemergency.hhs.gov/preparedness/legal/prepact/Pages/default.
aspx
 HIPAA
 HHS Online HIPAA Q&A:
 http://www.hhs.gov/ocr/privacy/hipaa/faq/disclosures_in_emergency_situations/in
dex.html
 CDC
 http://www2a.cdc.gov/phlp/emergencyprep/FPHELfaq.asp

18. FAQS

19. Q: How will we be alerted/notified
during the event of an incident?
 Health Department  Dispensing Partner
 CAHAN (automated alerting system)
 Phone Tree (to contact staff)
 Fax (for sending paperwork)
 Dispensing Partner  Staff and Family
 Phone Tree
 Email
 Fax
 Other
 Dispensing Partner can request medication from
the MHOAC or the MHOAC will contact the Partner
directly

20. Q: How will we know what
medication to give out?
 A: All Bay Area counties have developed a
screening algorithm. Individuals can complete an
online form that will tell them which medication is
appropriate for them. We will also provide you
with a paper version in case some individuals
will not have access to the online version.
 You can access the online version at
http://bayareadisastermeds.org//medicine.html

21. Q: Can we dispense the medication
to volunteers, as well as family
members of patients or of clinical
staff?
 A: Yes. You just need to let the health
department know how many individuals you
are requesting medication for.

22. Q: Are we required to recruit
medical staff to dispense
medications to our employees?
 A: No. During a declared public health emergency when
a life-threatening event has occurred and the whole
county, region or state population need to receive
preventive medications (prophylaxis) in a very brief
period of time, the Governor is expected to waive
dispensing regulations to allow non-medical staff to help
dispense medications. Sufficient licensed medical
personnel to do this dispensing would not be available.

23. Q: Where do we refer employees if
they have medical problems or
medical questions about the
medications we are handing out?
 A: We will provide you with scripted questions and
answers and procedures to follow (you will be educated
on this process in more detail). Those who are “iffy”
about whether or not they should take the medication will
be given the life-saving medications to take home with
them and told to consult with their own doctor. They are
also able to come to a Public POD to discuss their
medical issues with medical personnel.

24. Q: Will people be allowed to pick up
packets for their family?
 A: Yes. However, there is a limit of 10 packets
per pick-up person.

25. Q: Are the medications in unit
dosages?
 A: Yes. You will be given the medications
already packaged with clear instructions and
precautions just like any other medication
received at a local pharmacy.