Dispensing Medical Countermeasures in Public Health Emergencies via Home Health Agencies and Points of Distribution

A major concern regarding emergency preparedness on the state government level involves the handling and dispensing of the Strategic National Stockpile (SNS) of medicinal supplies. Each state is required to update and maintain a plan of action for dispensing SNS materials that would effectively provide care to the state’s population in times of distress. This research evaluates a state’s ability to dispense an adequate amount of medicine to her population in a timely manner, specifically after it has been received by the state government. Although simulation modeling has previously been utilized to replicate the dispensing process at pre-designated points of distribution (PODs), the impact of including home health agencies (HHAs) as dispensing agents remains an open question. This work utilizes traveling salesman heuristics and RealOpt simulation modeling software to determine if the use of HHAs would enable the provision of aid to impacted populations in a more timely fashion. Data for model input parameters is provided by a partner in the public health community and simulation results are utilized to compare the effectiveness of a dispensing operation that employs PODs to one that employs both PODs and HHAs. The inclusion of five home health agencies in the distribution of the Strategic National Stockpile in a case study area results in an increase in the population served by 2.4%, a decrease in personnel shortage (medical and non-medical) by 16 persons, and an increased access for the vulnerable home-bound population. While this research illustrates a potential increase in access to the home-bound population dependent on home health agencies, this growth is limited by the number of staffing levels and patient censuses of the home health agencies in question