Push Partners Aid Medicine Distribution Following an Emergency

The first models for mass dispensing of medications during a crisis used a “pull” strategy, such as community members traveling to a large point of dispensing like a local gym. Used alone, pull strategies put an unreasonable burden on public health resources and may have raised barriers for the public to access care. 

That’s why the Portland, Ore., Metropolitan Region turned its attention to “push” strategies — distributing medication by asking community partners to give it to their staff and families. The Push

Partner Registry was developed to quickly dispense emergency medication in the 48 hours following a major public health emergency.

The partners in the Portland Metropolitan Region include:

• Large employers — Private and public organizations with large numbers of employees on centrally located campuses. They currently reach 19,215 people with 70,000 pending enrollment.
   
• Vulnerable population service providers — Organizations that help people who cannot (such as residents of long-term care facilities), are unlikely to (the homeless) or should not (jails) attend public health medication distribution sites. This group serves employees and their families plus clients in their care and reaches 107,482 people with 50,000 pending enrollment.
   
• Planned responders — Organizations with a written or implied role in emergency plans (i.e., first responders and critical infrastructure agencies). This group reaches 36,297 people with 1,650 pending enrollment.

In a three-day, full-scale exercise in June, 26 push partner sites in five Oregon and three southwest Washington counties simultaneously activated their mass dispensing plans in coordination with federal, state and local governments. Oregon’s Public Health Division exercised its close partnerships with the Oregon Department of Transportation and State Police in receiving and distributing the Centers for Disease Control and Prevention/Division of Strategic National Stockpile exercise training package (simulated emergency medical assets). Once allocated, medical assets were delivered to local warehouses where push partners picked up the “medication,” which was actually playing cards donated by a local casino and repurposed for the exercise.

The objective of the exercise was to test how well the program operated under the adverse simulated conditions of an intentional release of aerosolized anthrax. Such a release would probably be discovered late in the window for effective treatment or prophylaxis. The delay in discovery would mean that traditional disease investigation techniques would be inadequate to determine exposure and that the region’s entire population, more than 2 million people, would need antibiotics immediately.

The strengths listed by participants in the post-exercise evaluation survey were flexibility, organization, communication and cooperation among the players. The exercise provided important information to improve its design, execution and emergency response plans.

After the exercise, many push partners reported feeling confident that their agency could successfully dispense medication to clients and employees during an actual emergency — a critical piece for the Cities Readiness Initiative Region.

The next step is to understand what agencies can contribute. An emergency management office can offer significant assistance with logistics. Large employers, vulnerable population service providers and planned responders can learn more about becoming a push partner and become a spokesperson to their peers.


Cristin Corcoran is the Portland Metropolitan Regional Push Partner program coordinator.