HomeMy WebLinkAboutAgreement A-19-212 with Providers.pdf Agreement No. 19-212
Memorandum of Understanding (MOU)
between Providers and the
County of Fresno
Regarding
Provision of Medical Prophylaxis in a Closed Point of Dispensing (CPOD)
Definitions:
1. Point of Dispensing (POD): A mass dispensing site that is capable of providing
prophylactic medications to protect the population from biological threats.
Prophylactic medications are dispensed to persons who may have been exposed
to a pathogen, but who do not display symptoms. Routine medical care is not
provided in a POD.
2. Closed POD (CPOD): A CPOD that is operated by a government agency, non-
profit organization, private business or other entity for its own members,
employees, clients, contractors and their respective family members, etc., and is
not open to the general public.
3. Strategic National Stockpile (SNS): A national repository of medicines and
medical supplies designed to supplement and re-supply state and local public
health agencies in the event of a national emergency anywhere and at anytime
within the U.S. or its territories.
4. Provider: Organization serving as a CPOD.
5. Prophylaxis: A measure taken to maintain health and prevent the spread of
disease. For the purposes of this MOU, prophylaxis are prophylactic medications
provided by COUNTY for dispensing at a CPOD.
6. Provider Population: PROVIDER'S members, employees, contractors and clients
associated with PROVIDER'S facility/facilities located within Fresno County.
7. PREP Act: The Public Readiness and Emergency Preparation Act
8. PREP Declaration: A Declaration issued by the U.S. Secretary of Health and
Human Services that authorizes the release of medications from the SNS for
distribution, and provides immunity, except in the case of willful misconduct, from
legal liability to persons and entities involved in the distribution, administration,
and dispensing of SNS medications.
I. Purpose
This Memorandum of Understanding (MOU) is made and entered into by and
between the County of Fresno, a political subdivision of the State of California,
hereinafter referred to as "COUNTY", and its CPOD partners, hereinafter referred to
singularly as "PROVIDER" and identified more particularly in Exhibit A, attached
hereto and by reference incorporated herein, as it relates to the deployment and
dispensing of prophylactic medications and medical supplies made available from
the Centers for Disease Control and Prevention's (CDC) Strategic National Stockpile
(SNS), through the California Department of Public Health (CDPH), or prophylactic
medications and medical supplies already within the control of CDPH.
WHEREAS, the COUNTY's Department of Public Health intends to utilize this MOU
only in the event of a duly proclaimed State of Emergency or Local Emergency as
defined in Government Code §8558(b) & (c) where distribution of medical
prophylaxis has been determined to be an appropriate response to a particular
public health emergency; a duly declared Local Health Emergency as defined in
Health and Safety Code §101080; and/or a PREP Declaration has been issued by
the U.S. Secretary of Health and Human Services; and
WHEREAS, the COUNTY's Department of Public Health will receive prophylactic
medications and/or medical supplies following a particular public health emergency
from the CDC SNS and/or directly from CDPH; and,
WHEREAS, the COUNTY's Department of Public Health will provide resources,
which include medications and medical supplies, to the PROVIDER in the County of
Fresno, CA; and,
WHEREAS, the COUNTY intends to transfer a pre-determined quantity of the
aforementioned medication and/or medical supplies to the PROVIDER, as needed,
to respond to a particular public health emergency, in accordance with the COUNTY
Department of Public Health policies and procedures and PROVIDER Mass
Prophylaxis Dispensing Plan; and,
WHEREAS, the PROVIDER will use the medical prophylaxis for internal distribution
to its members, employees, contractors, and their family members, as part of the
activation of the CPOD; and,
WHEREAS, the COUNTY wishes to join forces with the PROVIDER to enhance its
ability to respond to a catastrophic biological incident or other public health
emergency requiring mass dispensing of medications and/or medical supplies.
NOW THEREFORE, the parties understand and mutually agree to the extent
possible, with consideration to available resources, current federal, state, and local
laws, PROVIDER policies, regulations, and procedures, to provide assistance in
accordance with the provisions of this Agreement.
II. Liability
Under the Public Readiness and Emergency Preparedness (PREP) Act, the
Secretary of Health and Human Services is authorized to issue a PREP Declaration
in the event of a public health emergency which requires the manufacture,
distribution, and dispensing of certain medical countermeasures (MCM). Among the
provisions of a PREP Declaration is authorization for the distribution of MCM from
the Strategic National Stockpile (SNS) to local agencies for dispensing to the public.
Under the PREP Act, persons and organizations involved in the distribution and
dispensing of medications pursuant to PREP Declaration, such as those
contemplated by this MOU, are given immunity from liability for claims of loss
caused by or arising from their actions, except in the case of willful misconduct. As
used in the PREP Act, loss includes death, or physical or emotional injury.
It is understood that none of the parties to this agreement waive any of their
sovereign or statutory immunities that are otherwise available under United States or
California law, or provide any liability protections or indemnification to one another
under this agreement.
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III. scope
For planning purposes, it is assumed the PROVIDER will disclose to COUNTY the
number of its members, employees, clients and/or contractors affiliated with the
PROVIDER. The PROVIDER population will be calculated by taking that number
and multiplying by 5 to give a reasonably accurate provider population number which
now includes family members.
IV. Responsibilities
A. COUNTY
Planning
1. COUNTY will supply draft protocols and supporting documents for planning,
activation, pickup/delivery, and dispensing operations to support the
development of the PROVIDER response plans.
2. COUNTY will meet with the PROVIDER to review prophylactic medication
receipt and dispensing plans.
3. COUNTY will notify the PROVIDER of any state or Federal planning changes
that would affect developed plans.
4. COUNTY will participate in mass dispensing drills and exercises as requested
by the PROVIDER, as deemed feasible by COUNTY.
Activation and Operation
1. COUNTY will coordinate the request and receipt of SNS prophylactic
medications from the CDC.
2. COUNTY will notify the PROVIDER of the decision to provide medical
prophylaxis to an exposed population. COUNTY will request confirmation of
current PROVIDER population, designated receiving agent, and
pickup/delivery location.
3. COUNTY will determine the apportionment based on: current and expected
supply levels, pre-defined or updated PROVIDER population numbers, and
the prevailing epidemiology and medical directives as prescribed by the
COUNTY Health Officer.
4. COUNTY will provide any updated scenario information and coordinate
pickup/delivery of medications and supporting information and forms to the
designated PROVIDER location as identified on Exhibit A, Provider
Information Sheet.
Recovery
COUNTY will coordinate with the PROVIDER for pickup/delivery of remaining
materials.
B. PROVIDER
Planning
1. The PROVIDER will provide the COUNTY with the population estimates at
the time of execution and at least annually thereafter.
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2. The PROVIDER will plan for a safe and efficient method to pick up medical
prophylaxis materials from a secure location designated by the COUNTY and
transport them back to PROVIDER's premises.
3. The PROVIDER will designate and plan for a secure location to receive and
store medical prophylaxis materials received from the COUNTY on
PROVIDER's premises while it is being dispensed.
4. The PROVIDER will develop plans and identify internal resources to support
the dispensing of emergency medical prophylaxis to the populations outlined
in the information sheet.
5. PROVIDER shall ensure that a sufficient number of its employees are trained
and prepared to carry out the dispensing plan in the event that a CPOD is
activated.
6. The PROVIDER will follow all appropriate laws, regulations, and policies
applicable to it.
Activation and Operation
1. The PROVIDER will provide for the proper receipt and storage of prophylactic
medications from COUNTY.
2. The PROVIDER will dispense medications consistent with current directives
from the COUNTY Health Officer and consistent with agreed upon plans and
protocols, inclusive of providing the appropriate patient information and
screening.
3. Upon request from COUNTY, the PROVIDER will provide reports of: the
number of prophylactic regimens that have been dispensed, the amount of
remaining supplies, and any expected resupply needs.
4. In the event PROVIDER is unable to pick up medical prophylactic materials
from the designated location, the PROVIDER will grant COUNTY access to
deliver emergency prophylactic materials, upon mutual agreement at the time
of the event. Given the nature and scope of such an event, each situation is
unique and will require consideration and approval on a case-by-case basis.
Recovery
The PROVIDER will notify COUNTY of completion of operations and of the on-
hand remaining materials. The PROVIDER will package the remaining materials
for pickup and will store them in an appropriate and secure environment until
materials can be returned to COUNTY.
C. Mutual Agreement
It is mutually agreed that:
1. The confidentiality of patients and patient information will be maintained as
written and enforced by the Health Insurance Portability and Accountability Act
(HIPAA), as applicable, and any applicable State law.
2. This Memorandum will not supersede any laws, rules, or polices of either party.
3. Activation of the PROVIDER CPOD as described in this MOU will go into effect
only at the request and direction of the COUNTY.
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4. The PROVIDER will be considered a CPOD in that it will not dispense
medications to the "general public" but to PROVIDER population as outlined in
the PROVIDER Mass Prophylaxis Dispensing Plan.
5. It is understood that the PROVIDER participation is completely voluntary, and
that CPOD activation may not be available/utilized at the time of a public health
emergency. If a CPOD is not used, prophylactic medications may be made
available to PROVIDER employees and members of their households under the
same terms as they are made available to the general public.
6. The PROVIDER will follow the dispensing directives of COUNTY during Mass
Dispensing Operations.
V. Points of Contact for County
• Fresno County Department of Public Health
Primary Point of Contact:
Name: Darrel Schmidt
Title: Public Health Emergency Preparedness Coordinator
Office: (559) 600-3473
E-mail: dschmidt(c�.fresnocountyca.gov
Alternate Point of Contact:
Name: Naomi Wooten
Title: Staff Analyst
Office: (559) 600-3473
E-mail: nwooten(o)_fresnocountyca.gov
After Business Hours Contact:
Fresno County Sheriff's Dispatch: (559) 600-3111
VI. Duration of the MOU
The effective period of this MOU begins on the date of execution and shall renew
automatically for continuous one-year periods, unless written notice of nonrenewal is
given by either PROVIDER or COUNTY or COUNTY'S DPH Director, or designee,
not later than sixty (60) days prior to the close of the current MOU term.
This MOU may be terminated by COUNTY or COUNTY'S DPH Director, or
designee, or PROVIDER upon giving sixty (60) days advance written notice of an
intention to terminate to the other party.
VII. Modification, Chancre, Amendment, or Termination
Any modifications, changes, or amendments to this MOU must be in writing, and are
contingent upon approval by both the COUNTY and PROVIDER. Either party may
request review of the MOU at any time, if so desired.
Vill. Miscellaneous
This MOU is not intended, and should not be construed, to create any right or
benefit, substantive or procedural, enforceable at law or otherwise by any party
against the parties, their parent agencies, the United States, or the officers,
employees, agents or other associated personnel thereof.
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This MOU is not an obligation or commitment of funds, nor a basis for transfer of
funds, but rather is a basic statement of the understanding between the parties
hereto of the tasks and methods for performing the tasks herein. Unless otherwise
agreed in writing, each party shall bear its own costs in relation to this MOU.
Expenditures by each party will be subject to its budgetary processes and to the
availability of funds and resources pursuant to applicable laws, regulations, and
policies. The parties expressly acknowledge that this in no way implies that the
United States Congress will appropriate funds for such expenditures.
IX. Concurrence
It is agreed that this written statement embodies the entire agreement of the parties
regarding this affiliation, and no other agreements exist between the parties except
as expressed in this document. All parties to this MOU concur with the level of
support and resource commitments that are documented herein.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of
the day and year first hereinabove written.
COUNTY OF FRESNO
Nathan Magsig, Chairman -of-the Board of
Supervisors of the County of Fresno
ATTEST:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
By:
Dep
FOR ACCOUNTING USE ONLY:
ORG No.:
Account No.:
Requisition No.:
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Exhibit A
PROVIDER INFORMATION SHEET
Provider Name:
Signature:
Printed name and title of signee:
Address:
Phone number:
Cell number:
Email address:
Closed POD Location (if multiple locations exist, please attach separate sheets with
the same information listed below for each location)
Name of facility:
Address:
Number of staff being served: x 5 = estimated total medication regimens to be
supplied:
Primary Point of Contact for CPOD:
Name:
Title:
Office number:
Mobile number:
Email:
Alternate Points of Contact:
Name: Name:
Title: Title:
Office number: Office number:
Mobile number: Mobile number:
Email: Email:
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Exhibit A
PROVIDER INFORMATION SHEET
Provider Name: t�cy cC Ck6QC
Signature:
Printed name and title of signee:
Address: C6u%,5 4-ir� 17j-_
Ctovtis , CA
Phone number: ,4,. �2c{ _ 2z ►
Cell number: 57 - 5'g15 - Is z$a-\
Email address.-
Closed POD Location (if multiple locations exist, please attach separate sheets with
the same information listed below for each location)
Name of facility: tlyrQ Pk% N-e�?
Address: 1Z33 S� , C(oJ 3 , C A q3G 12
Number of staff being served: 2D x 5 = estimated total medication regimens to be
supplied: a, t5-Go
Primary Point of Contact for CPOD:
Name: G6e-'2>
Title: t-tCe. S4�ev� GV1 �c�e MaAAV jr.
Office number: G�5ej - 3zq Z21�
Mobile number: SSy- S-, 3 - 3Z4?
Email: C,-e C i�rq a( clouts .cow.
Alternate Points of Contact:
Name: Name: 7Ya ws OAV
Title: �_I r¢ Ck c¢q Title: h SSv5"V
Office number: `SSrt - 3zcf' Z?Do Office number: S-S?j- Z - ZO-7Z
Mobile number: 575-1 Mobile number: S52; -- Cl-7q- 3310
Email �OLAVI bi @ Ciitt(e4 Email: -JdnV+1n CD C&40-fG0MNZ, -cow
Page 8 of 8
Exhibit A
PROVIDER INFORMATION SHEET
Provider Name: rre4�'""
Signature:
Printed name and title of signee. ��ma Quan-Schecter, City Manager
Address: Office of the Mayor & City Manager
2600 Fresno Street
Fresno, CA 93721
Phone number: (559)621-7768
Cell number: (559)903-5085
Email address: Wilma.Quan(Z�fresno.gov
Closed POD Location (if multiple locations exist, please attach separate sheets with
the same information listed below for each location)
Name of facility:
Address:
Number of staff being served: 3,363 x 5 = estimated total medication regimens to be
supplied: 16,815 (Note: In addition, we have 791 "Temporary" Services Aides who
serve in a part-time, temporary status at various times throughout the year.)
Primary Point of Contact for CPOD:
Name: Daniel Vasquez
Title: Fire Captain/Emergency Preparedness Officer
Office number: (559)621-7796
Mobile number: (559)970-8873
Email: Daniel.Vasquezp_fresno.gov
Alternate Points of Contact:
Name: Name:
Title: Title:
Office number: Office number:
Mobile number: Mobile number:
Email: Email:
Page 8 of 8
Exhibit A
PROVIDER INFORMATION SHEET
Provider Name: MU.(* {ti(er At n
Signature:
Printed name and title of signee:
Address: �--1�-' I_tc t I'�GL�►t �'�11.1.E
Phone number:
Cell number: 5� - C�,�,
Email address: `w ms-eLI oh Lti
Closed POD Location (if multiple locations exist, please attach separate sheets with
the same information listed bellow for each location)
Name of facility: oe ,-l )`j �' -�� Tnkta Vk� k�&j 4 t'I DZL
Address: ��� (' I1 l�u'l ; ( /(,V j 51 (1) l T
Number of staff being served: 12DL) x 5 = estimated total medication regimens to be
supplied: its
Primary Point of Contact for CPOD:
Name: jLL Kli�1A1-e j
Title: C t��
Office number:=14� XI q - �1 /V 11'�
Mobile number: �;�?
Email: i I(01lQC. (0 o 1,)iI, ,
J L, /)
Alternate Points of Contact-
Name: I jc�,��U.� bdnf�Name: �Li � , Name:
Title: Title: i ( �L
�I L
Office number:- ��1�_ X f� Office number. c - c,--
Mobile number: Mobile number-
Email. ��� , ;'� Email ta L(Lt r6-)CV. h the
J J
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