DATE: May 7, 2019
TO: Board of Supervisors
SUBMITTED BY: David Pomaville, Director, Department of Public Health
SUBJECT: Memorandum of Understanding for the Distribution of Medical Prophylaxis and Supplies in a Closed Point of Dispensing Site
RECOMMENDED ACTIONS:
TITLE
1. Approve and authorize the Chairman to execute a Memorandum of Understanding with Providers (public agencies and private organizations) for Medical Prophylaxis in a Closed Point of Dispensing, effective upon execution with unlimited one-year auto-renewals, unless terminated by either party ($0); and
2. Approve and authorize the Director of the Department of Public Health, or designee, to add and/or delete Providers to/from the Memorandum of Understanding, as necessary.
REPORT
Approval of the first recommended action will allow the Department of Public Health to designate and train public agencies and private organizations (Providers) that have entered into the recommended Memorandum of Understanding (MOU), as designated dispensing sites of medical prophylaxis and supplies. The prophylaxis and supplies would be distributed by the Providers to their internal self-identified population, which may include employees, students, contractors, clients, and family members in the event of a proclaimed State or Local Emergency as defined in Government Code, section 8558(b) & (c) or Health and Safety Code, section 101080 requiring distribution of medical prophylaxis. Approval of the second recommended action will allow the Department Director, or designee, to add and/or delete Providers to the MOU. Supplies for the Closed Point of Dispensing (CPOD) and training for the CPOD staff would be funded with the Public Health Emergency Preparedness (PHEP) grants, and the Providers are responsible to pay their staff’s salaries, with no increase in Net County Cost. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended actions, the Department would revise its Medical Countermeasures Emergency Response Base Plan to eliminate CPODs from the dispensation in the event of a large public health emergency, impacting the timeliness of distributing medical prophylaxis and supplies to County residents.
FISCAL IMPACT:
There is no Net County Cost associated with the recommended actions. The CPODs would be funded by the PHEP grant. The medical prophylaxis and supplies are provided by Centers for Disease Control and Prevention’s (CDC) Strategic National Stockpile (SNS) and/or California Department of Public Health (CDPH) to the Department.
DISCUSSION:
On August 8, 2017, your Board approved Agreement No. 17-416 with CDPH for public health emergency preparedness and response activities. The PHEP grant includes the Cities Readiness Initiative (CRI) Program, a federally funded effort to prepare major U.S. cities and metropolitan areas to respond effectively to a large public health emergency by dispensing medical countermeasures. The countermeasures would be obtained through the CDC’s SNS and distributed to the entire identified population in the CRI’s jurisdiction within 48 hours of the decision to activate through issuance of a PREP Declaration. The County is a CRI jurisdiction and has the responsibility to be prepared to protect the entire County population of approximately one million using medical countermeasures available from the CDC’s SNS through CDPH.
Medical countermeasures, such as antibiotics in a bioterrorist event, would be dispensed from PODs, which are strategically and centrally located throughout metropolitan Fresno and its surrounding incorporated jurisdictions and unincorporated areas. PODs are designated dispensing locations for healthy persons who may have been exposed and need medical prophylaxis. The CDC and CDPH strongly recommend the use of Open PODs (OPODs) and CPODs to provide prophylaxis to large segments of the population. PODs designated as “Open” would serve the public and be operated by County and other public agencies’ staff. PODs designated as “Closed” would be operated by an organization, business, or other entity; collectively referred to as “Providers” in the proposed MOU, for its internal self-identified population, potentially including employees, students, contractors, clients, and their family members and are not accessible by the public.
The Medical Countermeasures Response Base Plan, developed and approved by the Department of Public Health in 2016 in accordance with grant requirements following consultation with subject matter experts in other health departments and CDPH, addresses how medication and supplies would be dispensed countywide, including the use of OPODs and CPOD sites. CPODs are critical to meeting the goal of providing medical prophylaxis to the entire County population in 48 hours as CPODs have the potential to significantly reduce the number of people reporting to an OPOD to receive medication. The resources of the County and other public agencies would be significantly tested to meet the demand at OPODs in such a limited time.
Approval of the recommended MOU will allow the Department to supply participating Providers with medical prophylaxis and supplies received from the CDC’s SNS following a public health emergency. Providers, with an activated CPOD, will use the medical prophylaxis for internal distribution to internal self-identified population. The Department will provide training and assist Providers in the development of their individual CPOD plans.
The County entered into Purchasing Agreement P-17-399-I in 2017 with Constant & Associates, Inc., a consultant in emergency management, to assist the Department in its efforts to recruit and train potential CPOD Providers.
The City of Fresno, City of Clovis, and Central Valley Indian Health have entered into the recommended MOU as Providers awaiting your Board’s approval. If the recommended action is approved by your Board, the Department will pursue additional Providers.
REFERENCE MATERIAL:
BAI #41, August 8, 2017
Purchasing Agreement, P-17-399-I, July 25, 2017
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - MOU
CAO ANALYST:
Sonia M. De La Rosa