Want to welcome everyone to our September 17th uh work session.

Have a couple of items.

Mr.

Manager, please.

Thank you, Mr.

Mayor.

Two items uh for your information today.

First up, I'll turn it over to Chief Gulisano to talk about our new pharmacy uh program implementation.

All right, uh good afternoon, Mr.

Mayor, uh Vice Mayor, members of the city council, and uh Mr.

Manager, thank you for the opportunity to uh present an initiative that we're moving forward on in regards to a pharmacy program uh for the fire department, and this is uh be specifically so we can continue to provide medications to our patients in the field.

Uh so this afternoon we're gonna brief you on that, kind of give you a little bit of history of how we handle medications in the field currently, uh, some of the changes that we have to make to be compliant with uh uh several regulatory agencies, and then uh the steps that we're taking as we move forward.

All right, so uh how we currently operate our system is we carry uh we carry basically two boxes that we'll focus in on this this afternoon that have one box has our medications, we call that our drug box, and then we have another box that has our IV equipment that helps us administer those those medications.

So we get the that drug and IV box and everything that's in them from the local hospitals.

Uh they provide that to us, we put that uh equipment on our medic units or and or our engine companies, and then we re when we have those on the units, then we get a uh an emergency call, we respond to that call, we provide patient care while we're there.

If uh that patient needs medication of any sort that we carry, then we administer that medication on the scene.

We transport the patient to the hospital.

Uh when we get to the hospital, we then uh there's a whole process of how we transfer care from our folks to the hospital staff.

Uh once that's done, we then take the that drug and IV box that we utilize for that patient, and we bring that to the hospital pharmacy.

Now at the pharmacy, we then do an exchange.

We give them the old box with uh the opened box with the medications that we used.

We give that to the pharmacist.

There's a process for how they check that in, and then they give us a brand new sealed boxes with uh a new set of drugs and a new set of IV uh equipment and supplies.

So that system has worked for many, many years.

Uh and actually uh for our department, we've been doing that for over 50 years now.

Uh it's a very common system uh throughout the United States, but specifically in the commonwealth of Virginia.

That's uh that's the primary way that EMS agencies obtain and um how they get their their drug and IV supplies and equipment.

supplies so that system has worked for many many years and actually uh for our department we've been doing that for over 50 years now it's a very common system uh throughout the United States but specifically in the Commonwealth of Virginia that's a that's the primary way that EMS agencies obtain and how they get their their drug and IV supplies and equipment so when we're talking about the medications that we utilize uh they are split into different schedules um schedule two through five medications are are heavily regulated uh they're they're very regulated by a bunch of different organizations uh these five uh medications that we carry the the morphine fentanyl versed ketamine and how dahl uh they are very effective in treating patients for a wide variety of of uh medical ailments that they're having but you've you may recognize that these five medications are also they're they're ripe for abuse uh so there's there's been a lot of um a lot of research on it a lot of discussion about it uh that these these schedule two through five medications are uh very effective in treating medical issues but they are also very susceptible to abuse uh so that's why there are a lot of regulations that that have to be adhered to when you're uh storing or utilizing these these types of medications so these these uh five medications aren't the only ones that we carry we also carry 18 other medications uh that are that classified as schedule six uh they're not as heavily regulated as two through five however there are a lot of um processes and regulations that we do have to follow when we're uh storing and administering these medications as well so that's a little bit of the history of kind of where we're at um how we do our our med how we obtain the medications how we work with the hospitals to do that there's change though so uh I won't get into too much of the details of the legislation what I will point out is on this slide in the top five boxes it does list out some of and I apologize it's a little sm small print but it does address some of the legislative changes that have occurred specifically to address the opioid epidemic these top five boxes that's it's legislations or it's regulations that have changed to address the abuse specifically of those those top five or those schedule two through five medications.

So the Drug Supply Chain and Securities Act the DEA protecting patient access ambulance restocking safe harbor under the anti-kickback statutes uh the Board of Pharmacy regulations and FDA regulations all these over a period of time have changed to increase the accountability that's required for those types of medications that we carry so essentially when a when somebody obtains a medication these regulations now require them to maintain an accountability of that medication from the time they purchase it or the time they own it until the time it's administered to the patient so if you think about our current process of the hospital owns that medication they own that that IV supplies they own those boxes and when they hand them over to us we can account for them but the hospital as the owner of the medication can no longer do that.

They've they've essentially they've lost control of it.

So based on the legislation that have that has been passed that is no longer an acceptable practice to be able to do so the the the intent of the legislation is to again put tighter controls on those specifically those schedule two through five medications to make sure that they don't fall into the wrong hands I mentioned a little bit earlier that this has a it impacts well it impacts the entire country I mean these are federal laws that that we're not that we're under we have to be compliant with those specifically in the commonwealth of Virginia this pharmacy exchange program with the hospitals has been in existence for many many many years and just about every jurisdiction in the commonwealth of Virginia follows that that process of getting their drug and IV supplies from the area hospitals so every fire chief right now is having the same conversation that that we're having this afternoon this again it it really impacted Virginia probably more significantly than other states because some states had moved away from this this process but in the Commonwealth of Virginia again just about every every city council every city manager is having this conversation with their fire chief right now in the region there's been a lot of partnership and really working together as a region to make sure that all of our systems are as we move forward they're they're they're pretty they're very similar they're very similar for all the fire departments as they transition and away from a hospital based medical exchange program to a an EMS agency based medical program so some timelines we got guidance on this in May of 2024 so just a few short months ago since then staff has been working exceedingly hard to make sure that we're getting everything in place to make sure we're compliant with the regulations that next bullet slide the bullet point is is probably the one that we've uh myself and Chief Reynolds and I apologize for not introducing him I

So some timelines.

Um we got guidance on this in May of 2024, so just a few short months ago.

Uh since then, uh staff has been working exceedingly hard to make sure that we're getting everything in place to make sure we're compliant with the regulations.

Uh that next bullet slide, the bullet point is is probably the one that we've uh myself and Chief Reynolds, and I apologize for not introducing him.

I know most of you know him.

Uh Division Chief J.R.

Reynolds, he's our uh he he he leads our EMS division in the department.

He's really been taking point on making sure that we're uh compliant with our uh the federal regulations and we're ready to go uh before this November 27th, 2024 deadline.

Uh so credit to him and and the team that we put together to really pull this thing together.

And I'll talk a little bit about more about that in in just a few minutes.

So issued at 5 07 p.m.

The National Weather Service in Wakefield has issued a flash flood warning for current.

The county in northeastern North Carolina until 8 15 p.m.

At 5 07 p.m.

Broadcast media reported extensive street flooding in coastal curve county.

Between four and six point five inches of rain have fallen.

The expected rainfall rate is one to one point five inches in one hour through 6 30 p.m.

Flash flooding is already occurring.

Hazard, life-threatening flash flooding, heavy rain producing flash flooding, source, public reported impact, life-threatening flash flooding of creeks and streams, urban areas, highways, streets, and underpasses.

Some locations that will experience flash flooding include Grandy, Kerala, Point Harbor, Poplar Branch, Bertha, Adelit, Jarvisburg, Coinjoff, Waterlily, Powell's Point, mainly Barco spot, and Harbinger.

Turn around.

Don't drown when encountering flooded roads.

Most flood deaths occur in vehicles.

Please report flooding by calling 757-899-2415, posting to the National Weather Service Wakefield Facebook page or using Twitter at NWS Wakefield VA.

Repeating a flash flood warning has been issued until 8 15 p.m.

for the following county, Curdock, North Carolina.

On the details on this, um, but I'll I'll kind of start with just an overview of some of the things that we have to put in place to be compliant with the regulations.

Um thankfully, uh in Chesapeake, we we are we are already kind of ahead of the game a little bit when it came to being ready for something like this.

Um first point is that our logistics center.