Seasonal Flu Clinic – Emergency Dispensing Site
Full Scale Exercise Funding Program FY 2007


The Massachusetts Department of Public Health (MDPH) is providing competitive grants 
of $3,000 to municipalities that hold Emergency Dispensing Site (EDS) exercises in 
conjunction with seasonal flu clinics. 

The purpose of the grant is to support municipalities in exercising the EDS portion of the 
community’s all hazard plans, demonstrating the mass prophylaxis/vaccination 
throughput and functionality of their plan. 

The Centers for Disease Control and Prevention (CDC) Pandemic Influenza 
Supplemental Guidance, Phase 2 requires each state and local government that receives 
funds to exercise anti-viral drug distribution plans, using seasonal flu clinics. In order to 
avoid interrupting the normal flow of planning for the seasonal flu clinics, grants will be 
provided as reimbursement upon full completion of the exercise process. There will be a 
total of 20 grants at $3,000 each, for a total of $60,000. Grants will be distributed through 
the regional host agency/fiscal agent. 

MDPH will maintain the normal flow of flu vaccine delivery and no part of this exercise 
program will alter the existing seasonal flu vaccine delivery mechanism, i.e., local health 
will receive flu vaccine allocations as available through the regional office vaccine 
depots. For information about flu vaccine availability, please contact your regional 
immunization department. 

Inclusion Criteria 

In order for an exercise to meet the state and federal grant requirements, the exercise 
must meet the following criteria: 

1. Public health agencies which have the responsibility to run EDS operation during 
a public health emergency must conduct the exercise, and will be the recipient of 
the grant. 
2. Exercises must collect at least the required performance measurements (a and b) 
listed below. Exercises which also include the optional performance measures (c 
and d) help Massachusetts meet its local and state obligations under the CDC 
Cooperative Agreement. 
3. The exercise must be consistent with the Homeland Security Exercise Evaluation 
Program (HSEEP). Details of this program can be found on Department of 
Homeland Security (DHS) website at www.ojp.usdoj.gov/odp/docs/hseep.htm. To 
meet these requirements for this grant you must complete the following: 
A. Use either the standard HSEEP templates (available on the HSEEP 
website) or the MDPH templates for exercise documents including after 
action reports (AAR) and Exercise Evaluation Guides (EEGs). 
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B. An HSEEP compliant After Action Report (AAR) and Improvement Plan 
Matrix must be presented to the MDPH Exercise and Training Coordinator 
within 60 calendar days of the conclusion of the exercise. (With the 
permission of the grant recipient, this document may be posted on the 
HHAN. If there is a public and a secure version, only the public version 
will be posted.) 
C. All participating or affected jurisdictions should be given the opportunity 
to provide input in the development of After Action Report and 
Improvement plans. 
i. Setup/Exercise - describe the exercise, provide facilitators and 
evaluators. Collect performance measures as described in #2. 
ii. Conduct a debriefing/hotwash after the exercise; write an After 
Action Report and an Improvement Plan based upon identified 
strengths and weaknesses. Data collected from the exercise must 
be recorded. Action items for inclusion in the improvement plan 
must be measurable, have a deadline, a designated lead (either by 
name or by agency) and are tracked to completion. 
D. To the extent that your plan is NIMS compliant, your exercise must also 
be NIMS compliant. If you plan is not NIMS compliant, that should be 
reflected in the AAR and improvement plan. 
4. Provide a signed letter of intent on municipal letterhead to the MDPH Exercise & 
Training Coordinator by close of business on November 3, 2006. This letter 
should affirm the organizer’s intent to comply with the HSEEP criteria listed 
above and should provide available exercise information, such as date, time, and 
location, and, if known, performance measures to be exercised. 
5. Exercises must occur between November 1, 2006 and February 1, 2007. 
6. The exercise data collected for the performance measurements must be 
transmitted electronically to the MDPH CEP Exercise and Training Coordinator 
within 60 calendar days of the conclusion of the exercise. 
Exercise Criteria/Performance Measurements 

CDC Pandemic supplemental guidance, phase 2 outlines specific performance measures 
that must be reported for each of the Target Capabilities that must be met in Fiscal Year 
2007. For Target Capability 6C, Mass Prophylaxis, seasonal flu clinics must be used to 
exercise the mass distribution of vaccine or anti-virals. The exercise requirements are as 
follows: 

Performance measure data must be collected for clinic throughput and target 
demographic coverage (see pgs 20 - 23 of CDC pandemic supplemental phase 2 for more 
detail). Optional performance measures listed below provide data for the FY07 CDC 
Cooperative Agreement guidance requirements for local health and the State: 

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1) Required - Measure clinic throughput - Intent is to meet or exceed projected 
throughput. 

A) Use computer modeling (model found at 
www.isr.umd.edu/Labs/CIM/projects/clinic) to project expected clinic 
throughput. Record this number and use it as the target for the exercise 


i) Conduct the exercise and determine the actual clinic throughput. Record this 
number. 

ii) Identify if projected throughput was met; if not, develop improvement plan 

B) Meet or exceed target coverage levels - Intent is to determine if flu vaccine is 
provided to targeted demographic groups at or above recorded national average 
numbers. 

i) See target average numbers on pg 23 of CDC Pandemic Supplemental, Phase 
2 guidance. Use community demographic numbers to set target vaccination 
number, 

Example: There are 10,000 people at or above 65 years of age in Town A, and 
there is a target percentage of 90% vaccinated. Town A should aim to 
vaccinate 9,000 people at or above 65 years of age. 

ii) Record clinic demographic information, such as number of vaccinated people 
65 years of age or older. 

iii) Compare clinic demographic with target average demographic information to 
determine percentage of target groups vaccinated during exercise. 

2) Required - Demonstrate that clinic met the requirements of special populations. 

A) List ways in which the needs of special populations were identified and those 
needs provided for, e.g., information provided in languages other than English, 
long-term care facility residents, persons with a physical disability, persons who 
are deaf/hard of hearing, and persons who are visually-impaired, etc. 

B) AAR should describe current EDS plan provisions for special populations, how 
provisions are put in place, what provisions are still needed, what local resources 
were used, and what resources are needed in the community. 

3) Optional - Participate in State portion of EDS exercise. 

A) MDPH will conduct exercises which simulate the delivery of SNS materiel to 
EDS locations. Local responsibility in these exercises would be to provide a two 
person team (a police officer and the EDS manager) to accept the delivery. 

4) Optional – Collect outcomes with one of the MDPH Exercise Evaluation Guides. 

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Selection Process 

MDPH has a total of $60,000 (for 20 grants of $3,000/grant) for this project. It is 
MDPH’s intent to fund at least one exercise in each of the 15 coalitions. 

Applications will be evaluated to determine if it meets the above listed inclusion criteria, 
then graded using priority rankings listed below. 

Qualified applicants will be divided into lists by coalition and grade. The qualified 
applicant achieving the highest score in each coalition will be selected as grant recipient, 
pending completion of other exercise requirements. If a coalition has no qualified 
applicant, that coalition’s allotment will be awarded through the at-large selection 
process. 

The remaining grants will be distributed across the Commonwealth to the remaining 
applicants which receive the highest score. 

Once the 20 recipients have been selected, funding for these exercises will be allocated 
directly to the Regional Host Agency/Fiscal Agent, who will be responsible for 
distributing the funds to the successful applicants within their region. MDPH will notify 
Host/Fiscal Agents when requirements have been met to allow the grant funds to be 
awarded. 
Grant money must be spent and accounted for in accordance with CDC Pandemic 
Influenza Guidance Supplement to the 2006 Public Health Emergency preparedness 
Cooperative Agreement, Phase II. 

Scoring 

Only qualified applicants will be considered. However, to provide additional guidance for 
selecting grant applications, scores will be provided to each application as follows. 

A. One point will be given to those communities willing to partner with the state for 
conducting a SNS Receipt, Supply, and Staging (RSS) exercise. (optional 
performance measure D) 
B. One point will be given to communities willing to exercise special populations 
elements (performance measurement C) including demonstrating that provisions 
for disaster behavioral health services. 
C. One point will be given to regional exercises, incorporating participants from a 
minimum of three partners. (For this purpose, regional resources such as a 
hospital, community health center, or regional MRC would each be considered a 
separate partner. The determination of what will ‘count’ for this purpose is solely 
at the discretion of the MDPH Exercise & Training Coordinator.) 
D. One point will be given to those exercises which include the participation of the 
Regional Emergency Preparedness Coordinator at the start of the planning 
process. (As determined by the Regional Emergency Preparedness Coordinator) 
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E. One point will be given to those exercise sponsors who notify the MDPH CEP 
Exercise and Training Coordinator with an Evaluation Plan, and the Situation 
Manual 15 calendar days prior to the exercise. 
F. One point will be given to those exercises being conducted in a location that has 
been identified as Emergency Dispensing Site (EDS) as of October 11, 2006. 
G. Additional points will be given to those communities who have submitted plans 
under the local public health deliverables in the past three years. Each plan is 
provided one point, with a total of seven possible. Plans must have been 
submitted to the Emergency Preparedness Regional Coordinator prior to October 
31, 2006. The plans that will be considered under this item are: 
· All Hazard Plan 
· Continuity of Operations Plan (COOP) 
· Emergency Dispensing Site Plan 
· Special Populations Plan 
· Risk Communications Plan 
· Pandemic influenza Plan 
· 24/7 Emergency Contact Plan 
I. Priority will be given to the remaining qualified applicants in coalitions which 
have only one grant. 
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