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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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Suggested Citation:"Appendix B: Workshop Agenda." Institute of Medicine. 2008. Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12221.
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B Workshop Agenda Day 1 Monday, March 3, 2008 The Barbara Jordan Conference Center Kaiser Family Foundation 1330 G Street, NW Washington, DC Workshop Objectives • Identify and discuss the most promising near-term opportunities for improving the efficiency and effectiveness of frameworks designed for medical countermeasure dispensing. o What specific challenges arise in the dispensing of antibiotics? • Discuss what innovations, tools, technologies, and frameworks are available from sectors outside the traditional public health system. o What existent resources and infrastructure in medical countermeasure dispensing should be maintained, improved, or serve as a foundation on which to build? o What existent resources and infrastructure have potential for application or adaptation to a disaster incident? What action steps are required to integrate these strategies into the current public health system? o What resources and further infrastructure investments will be necessary in the short and long terms? 35

36 DISPENSING MEDICAL COUNTERMEASURES o How might innovative antibiotic countermeasure dispensing strategies be leveraged and expanded on to improve models for antiviral and vaccine dispensing? • Explore potential partnerships that are needed to support and conduct improvements of dispensing medical countermeasures. o What are the current opportunities and barriers to creating stronger partnerships and how can these issues be addressed? 8:00 am Welcome and Introductions LYNNE KIDDER, Workshop Co-Chair Senior Vice President Business Force Business Executives for National Security MATTHEW MINSON, Workshop Co-Chair Senior Medical Advisor Office of Policy, Strategic Planning, and Communications Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services OPENING REMARKS: PRINCIPAL DEPUTY TO THE ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE 8:15 am Medical Countermeasure Dispensing: Goals, Progress, and Challenges GERALD PARKER Principal Deputy Assistant Secretary Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services

APPENDIX B 37 SESSION I: OVERVIEW AND CURRENT PLAN FOR DISPENSING MEDICAL COUNTERMEASURES Session Objective: Provide an overview of the current threats, progress made, and remaining vulnerabilities in the public health system as they pertain to the dispensing of medical countermeasures, in particular antibiotics. Special attention will be made to the identification of associated gaps in dispensing medical countermeasures in the most effective and efficient manner, including the needs of special populations. 8:35 am Session Overview and Objectives RICHARD BESSER, Session Chair Director Coordinating Office for Terrorism Preparedness and Emergency Response Centers for Disease Control and Prevention 8:40 am Overview of the Current Threat PRASITH (SID) BACCAM Senior Scientist Innovative Emergency Management 8:55 am Overview of Cities Readiness Initiative: Current Dispensing Framework and Gaps GREGORY BUREL Director Strategic National Stockpile Coordinating Office for Terrorism Preparedness and Emergency Response Centers for Disease Control and Prevention

38 DISPENSING MEDICAL COUNTERMEASURES 9:10 am Modeling Integrated Public Health and Health Care Delivery System Response to Anthrax NATHANIEL HUPERT Assistant Professor of Clinical Public Health Assistant Professor of Clinical Medicine Weill Medical College of Cornell University 9:25 am Overview of Challenges Experienced by State Officials DAVID HENRY Policy Analyst Homeland Security and Technology Center for Best Practices National Governors Association 9:40 am Overview of Challenges Experienced by the Local Officials: Special Population Needs CHRISTOPHER HOFF Emergency Response Coordinator Kane County, IL, Health Department 9:55 am Creative Solutions Using Existing Tools MICHAEL SCHRAGE Fellow, Center for Digital Business/Sloan School Senior Advisor, Security Studies Program Massachusetts Institute of Technology 10:15 am Discussion RICHARD BESSER, Session Chair Director Coordinating Office for Terrorism Preparedness and Emergency Response Centers for Disease Control and Prevention 10:30 am BREAK

APPENDIX B 39 SESSION II: INTEGRATING STRATEGIES: FRAMEWORKS, TECHNOLOGIES, TOOLS, AND INNOVATIONS Session Objective: Review the innovations, tools, technologies, and frameworks (e.g., inventorying control and tracking, and registries) that are being used by sectors not traditionally included in the public health system. Discuss what action steps are required to integrate these strategies into the current public health system. Examine potential solutions to address: 1. Generate potential strategies to address improvement in current methods of dispensing countermeasures; 2. Explore feasibility of “outsourcing” the dispensing operation to a private-sector entity; and 3. Identify current business capabilities/solutions to develop novel dispensing methods. 10:45 am Session Overview and Objectives LISA KOONIN, Session Chair Senior Advisor Influenza Coordination Unit Centers for Disease Control and Prevention 10:50 am Panel Discussion #1: What current systems and strategies could be adapted to improve the currently planned dispensing methods for countermeasures? JEFFREY HOLMES, Panel Leader Director Global Public Sector Practice PRTM DAN GUINN Founder Director of Compliance Dispensing Solutions, Inc.

40 DISPENSING MEDICAL COUNTERMEASURES KEVIN SMITH National Disaster Services Specialist America’s Second Harvest The Nation’s Food Bank Network KAREN DRENKARD Chief Nurse Executive Senior Vice President Inova Nursing Inova Health System MICHAEL KODY Vice President Supply Chain Solutions AmerisourceBergen 11:45 am WORKING LUNCH • Review opportunity and challenges identified during the morning sessions. • Participate in informal discussions regarding mechanisms to integrate new strategies into current frameworks. 12:30 pm Panel Discussion #2: What novel dispensing methods could be developed harnessing current business capabilities? JAMES SHORTAL, Panel Leader Director Business Continuity Cox Communications, Inc. JOHN MURRAY Vice President Circulation Marketing Newspaper Association of America CHRISTOPHER HETHERINGTON Corporate Crisis Management Officer Office of Business Continuity Citigroup, Inc.

APPENDIX B 41 NOAH GLASS Chief Executive Officer GoMobo, Inc. NATHANIEL HUPERT Assistant Professor of Clinical Public Health Assistant Professor of Clinical Medicine Weill Medical College of Cornell University BRUCE BAKER Strategic National Stockpile Coordinator Maryland Department of Health and Mental Hygiene 1:30 pm Panel Discussion #3: Explore feasibility of “outsourcing” the dispensing operation to a private- sector entity. DONNA GARREN, Panel Leader Vice President Health and Safety Regulatory Affairs National Restaurant Association JASON JACKSON (via telecom) Director of Emergency Management Wal-Mart Stores, Inc. MICHAEL SCHRAGE Fellow, Center for Digital Business/Sloan School Senior Advisor, Security Studies Program Massachusetts Institute of Technology EVA LEE Associate Professor, H. Milton Stewart School of Industrial and Systems Engineering Director, Center for Operations Research in Medicine and HealthCare Georgia Institute of Technology MARY STEINER Preparedness and Response Nurse Coordinator Oklahoma City–County Health Department

42 DISPENSING MEDICAL COUNTERMEASURES 2:30 pm General Discussion LISA KOONIN, Session Chair Senior Advisor Influenza Coordination Unit Centers for Disease Control and Prevention 2:45 pm BREAK SESSION III: DISPENSING CONSIDERATIONS: PUSH MECHANISMS AND PULL MECHANISMS Session Objective: Discuss benefits, challenges, and strategies presented by dispensing countermeasures through either push or pull mechanisms. 3:00 pm Session Objectives STEPHANIE DULIN, Session Chair Chief of the Program Preparedness Branch Division of Strategic National Stockpile Coordinating Office for Terrorism Preparedness and Emergency Response Centers for Disease Control and Prevention 3:05 pm Panel Discussion LINDA NEFF Senior Science Advisor Division of Strategic National Stockpile Coordinating Office for Terrorism Preparedness and Emergency Response Centers for Disease Control and Prevention MARK KEELER State Coordinator Strategic National Stockpile Program Ohio Department of Health

APPENDIX B 43 ROBERT HOLMAN, III Senior Planner Dallas County Health and Human Services GREG SCIARRA Director Pharmacy Operations CVS Pharmacy MICHAEL ROBBINS Pharmacist Medical Countermeasures Public Health Preparedness and Response Chicago Department of Public Health 3:30 pm Discussion STEPHANIE DULIN, Session Chair Chief of the Program Preparedness Branch Division of Strategic National Stockpile Coordinating Office for Terrorism Preparedness and Emergency Response Centers for Disease Control and Prevention SESSION IV: OPPORTUNITIES AND BARRIERS TO PARTNERING WITH THE PRIVATE SECTOR Session Objective: Explore potential models to improve partnerships between the private sector and federal, territorial, state, and local jurisdictions. Discuss the current opportunities and barriers to facilitating improved partnerships and how barriers may be overcome. 4:00 pm Session Objectives SCOTT MUGNO, Session Chair Managing Director Corporate Safety Health and Fire Protection FedEx Express

44 DISPENSING MEDICAL COUNTERMEASURES 4:05 pm Panel Discussion ANTHONY BEGANDO Chief Executive Officer Tenon Consulting, Inc. MIKE SIMKO Corporate Manager Pharmacy Health Information Technology Walgreens Co. ROBERT MAUSKAPF Director Emergency Operations, Planning and Logistics Virginia Department of Health TERESA BATES Strategic National Stockpile Coordinator Department of Public Health Tarrant County, TX PAUL FREIBERT Public Health Planner Office of Emergency & Public Health Preparedness Louisville Metro Health Department 4:25 pm Discussion SCOTT MUGNO, Session Chair Managing Director Corporate Safety Health and Fire Protection FedEx Express

APPENDIX B 45 SESSION V: GENERAL DISCUSSION WITH WORKSHOP PARTICIPANTS AND ATTENDEES Session Objective: Discuss what opportunities and constraints exist to implementing the frameworks and models discussed during day 1 of the workshop. What resources are required to implement the changes necessary to ensure that the most efficient and effective frameworks are in place for medical countermeasure dispensing? What new ideas have surfaced in this meeting today that should be explored further? 5:00 pm General Discussion with Workshop Participants and Guests LYNNE KIDDER, Workshop Co-Chair Senior Vice President, Business Force Business Executives for National Security MATTHEW MINSON, Workshop Co-Chair Senior Medical Advisor Office of Policy, Strategic Planning, and Communications Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services 5:30 pm ADJOURN

46 DISPENSING MEDICAL COUNTERMEASURES Day 2 Tuesday, March 4, 2008 The Barbara Jordan Conference Center Kaiser Family Foundation 1330 G Street, NW Washington, DC 8:30 am Day 1 Review and Day 2 Objectives LYNNE KIDDER, Workshop Co-Chair Senior Vice President, Business Force Business Executives for National Security MATTHEW MINSON, Workshop Co-Chair Senior Medical Advisor Office of Policy, Strategic Planning, and Communications Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services SESSION VI: WORKFORCE REQUIREMENTS Session Objective: Discuss the current workforce constraints on the existing public health system, how human resources from other sectors can be leveraged to ensure adequate capacity to dispense medical countermeasures in response to a catastrophic health event, and what measures, including personal protective equipment, are required to ensure the health safety of the workforce. Identify and discuss technologies or system designs that may be used to minimize workforce requirements, while ensuring workforce safety. 8:40 am Session Objectives JAYNE LUX, Session Chair Director Global Health Benefits Institute National Business Group on Health

APPENDIX B 47 8:45 am Panel Discussion JONATHAN MEANS Senior Vice President General Manager Central Operations and Businesses Kelly Services, Inc. WESLEY MCDERMOTT Public Health Emergency Preparedness Coordinator Fairfax, VA, Department of Health DAVID BROWN Director Global Employee Relations Strategy The Coca-Cola Company PAMELA BLACKWELL Director Center for Emergency Preparedness and Response Cobb & Douglas Public Health 9:05 am Discussion JAYNE LUX, Session Chair Director Global Health Benefits Institute National Business Group on Health SESSION VII: LIABILITY CONSTRAINTS, CONCERNS, AND UNKNOWNS Session Objective: Explore how liability constraints, concerns, and unknowns may limit the partnerships with the private sector in the dispensing of medical countermeasures. What liability and antitrust protections do existing state and federal laws already provide, and what changes may be necessary?

48 DISPENSING MEDICAL COUNTERMEASURES 9:40 am Session Objectives ERIN MULLEN, Session Chair Assistant Vice President Rx Response Pharmaceutical Research and Manufacturers of America 9:45 am Review of the Public Readiness and Emergency Preparedness Act (PREP Act) MARGARET BINZER Partner Government Affairs McKenna Long & Aldridge, LLP 10:00 am Panel Discussion SCOTT MUGNO Managing Director Corporate Safety Health and Fire Protection FedEx Express GUY FARMER Partner Labor and Employment Group Holland and Knight, LLP SHARONA HOFFMAN Professor of Law and Bioethics Co-Director Law-Medicine Center Senior Associate Dean for Academic Affairs Case Western Reserve University, School of Law

APPENDIX B 49 10:20 am Discussion ERIN MULLEN, Session Chair Assistant Vice President Rx Response Pharmaceutical Research and Manufacturers of America SESSION VIII: SECURITY CHALLENGES AND OPPORTUNITIES Session Objective: Review current security plans and examine the resources available, as well as those that are needed, to ensure appropriate safety and security of assets and individuals during the dispensing of medical countermeasures. 10:50 am Session Objectives KENNETH KUNCHICK, Session Chair Senior Inspector U.S. Marshals Service 10:55 am Panel Discussion HARVEY RUBIN Director, Institute for Strategic Threat Analysis and Response Professor of Medicine, Microbiology, and Computer Science University of Pennsylvania BOYD STEPHENSON Manager Security and Cross-Border Operations American Trucking Association JERRY ELLSWORTH Public Health Security Coordinator Michigan Office of Public Health Preparedness LARRY SABBATH Executive Director National Armored Car Association

50 DISPENSING MEDICAL COUNTERMEASURES 11:20 am Discussion KENNETH KUNCHICK, Session Chair Senior Inspector U.S. Marshals Service SESSION IX: FUTURE DIRECTIONS AND RESOURCE CONSTRAINTS: DISCUSSION WITH WORKSHOP PARTICIPANTS AND ATTENDEES Session Objective: Discuss what opportunities and constraints exist to implementing the frameworks and models discussed throughout the workshop. What resources are required to implement the changes necessary to ensure that the most efficient and effective frameworks are in place for medical countermeasure dispensing? What new ideas have surfaced in this meeting that should be explored further? Who is not at the table now and needs to be included in further discussions? How can we capture the innovation and ideas discussed during the meeting to rapidly proceed with developing next steps? 11:50 am Panel Discussion: Overview of Opportunities, Priorities, and Resource Requirements Identified During the Workshop JAMES BLUMENSTOCK Chief Program Officer Public Health Practice Association of State and Territorial Health Officials LYNN GOLDMAN Chair, Interdepartmental Program in Applied Public Health Johns Hopkins Bloomberg School of Public Health JACK HERRMANN Senior Advisor Public Health Preparedness National Association of County and City Health Officials

APPENDIX B 51 LYNNE KIDDER, Workshop Co-Chair Senior Vice President, Business Force Business Executives for National Security CARTER MECHER Director Medical Preparedness Policy White House Homeland Security Council MATTHEW MINSON, Workshop Co-Chair Senior Medical Advisor Office of Policy, Strategic Planning, and Communications Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services 12:15 pm Discussion With Attendees LYNNE KIDDER, Workshop Co-Chair Senior Vice President, Business Force Business Executives for National Security MATTHEW MINSON, Workshop Co-Chair Senior Medical Advisor Office of Policy, Strategic Planning, and Communications Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services 12:45 pm Closing Remarks GERALD PARKER Principal Deputy Assistant Secretary Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services 1:00 pm ADJOURN

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On March 3-4, 2008, the Institute of Medicine (IOM) Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a workshop titled "Medical Countermeasures Dispensing." The overall objective was to discuss a range of solutions to rapidly provide medical countermeasures to protect large numbers of people prior to or during a public health emergency, such as a bioterrorist attack or infectious disease outbreak. The United States is currently unprepared to confront the range of threats it is facing, such as an intentional anthrax release, severe acute respiratory syndrome (SARS), or pandemic influenza, and it must plan aggressively to counteract the threat of these and other future public health emergencies.

Countermeasure dispensing must harness all types of imaginative partnerships between public and private institutions, working together in ways tailored to meet individual community needs. This workshop summary highlights the presentations and subsequent discussion that occurred at the workshop.

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