Medical countermeasures (MCM) distribution guidance for local boards of health

What you need to know about how the Department of Public Health manages MCM products and how you can request and receive them

What are MCM?

MCM are products, as defined by the FDA, that may be used to diagnose, prevent, protect from, or treat conditions associated with a potential or actual public health emergency. 

• Consumable MCM includes:
  • Biologic products, such as vaccines, blood products, and antibodies
  • Drugs, such as antimicrobials or antivirals
  • Devices, including diagnostic tests to identify threat agents
  • Personal protective equipment (PPE), such as gloves and respirators
• Durable MCM includes:
  • Durable medical equipment (DME), such as ventilators and hospital beds
  • Other supplies, such as medication storage equipment and power banks

How are MCM distributed?

During a public health emergency, DPH may distribute MCM from a variety of sources, including the Strategic National Stockpile (SNS) and the State Public Health Warehouse. DPH uses two distribution facilities to support the distribution of MCM. These locations allow DPH to receive, stage, store, distribute, and track MCM.

• State Public Health Warehouse: the main entry point for MCM into DPH’s public health supply chain during public health emergencies. This is a nonconfidential location. MCM distributed from this location will be picked up by the requester.
• Receive, Stage, Store (RSS) Warehouse: the secondary, secure location for DPH’s emergency supply chain. This is a confidential location. MCM distributed from this location will be delivered to the requester.

Additionally, distribution may occur by:

• Direct shipment: MCM may be shipped to the municipality from the manufacturer, vendor, or other agency

How can local boards of health request MCM?

Local boards of health (LBOHs) in need of MCM should follow this process:

1. Use all options available through local mutual aid agreements
2. If unavailable via local mutual aid, contact the regional Health and Medical Coordinating Coalition (HMCC)
   • If the request can be fulfilled regionally, the HMCC will work with the LBOH to coordinate distribution
3. If unavailable within any region, DPH will work to fulfill the request and communicate directly with the LBOH

DPH may use different request processes during a public health emergency; these will be communicated to LBOHs by DPH in advance.

How do local boards of health receive MCM?

LBOHs may be expected to pick up from the State Public Health Warehouse or may have MCM delivered to them. DPH will let you know which process when we fulfill the request. 

Picking up

• Large orders may be packed on pallets and shrink-wrapped. You may need a van, box truck, or other large vehicle.
• Appropriate equipment should be available at the destination for unloading. This may include hand trucks, pallet jacks, and/or forklifts.
• The State Public Health Warehouse has standard-height loading docks. It also has equipment to load vehicles, both at dock height and lower.

Delivery

• Deliveries may arrive via parcel carrier (such as FedEx, UPS, and USPS), courier, or truck freight
• Facilities with loading docks and storage space are ideal for receiving

When is a loan agreement required?

Any durable equipment distributed by DPH must have an executed loan agreement between DPH and the receiver in place. This process will be coordinated by DPH before distribution. The loan agreement outlines the equipment and the duration of the loan. It also stipulates that DPH maintains ownership of all loaned equipment.

How should we store and transport MCM?

MCM must be secured during transportation and storage to prevent damage or unauthorized access. Additionally, some products may require cold chain management, which includes:

• Temperature monitoring: Regular monitoring of temperatures during transport and in storage to ensure MCM remain within the specified range
• Storage requirements: Proper storage facilities equipped with refrigeration units capable of maintaining the required temperature range
• Transportation: Use of temperature-controlled vehicles or containers to transport temperature-sensitive products
• Handling procedures: Proper handling techniques to prevent exposure to temperature extremes that could compromise product integrity
• Documentation: Keeping detailed records of temperature monitoring, storage conditions, and any deviations from protocol
• Training: Training staff in the importance of cold chain management and the specific protocols to be followed 
• Emergency planning: Developing contingency plans for power outages, equipment failure, or other emergencies that could affect the cold chain

DPH will notify LBOHs of any special handling considerations before the MCM is distributed.

What documentation and tracking is required for MCM?

LBOHs must track receipt, distribution, and dispensing of all MCM. Certain data must be captured and tracked for all MCM. These minimum data elements (MDEs) include SKU, lot, expiration, and serial number; we will provide you with a full list when processing your MCM request. At any time, DPH may request inventory data from LBOHs for any MCM distributed by DPH.

How do redistribution, demobilization, and returns work?

DPH may ask you, at any time, to redistribute or return the MCM that you received. This includes all durable equipment and any unused consumables.

It is your responsibility to store, use, and/or dispose of any consumable MCM that DPH doesn’t ask you to return. Waste management laws and rules govern disposal of any used or expired products.