At-Risk Populations and Pandemic Influenza: Planning Guidance for State, Territorial, Tribal, and Local Health Departments
1	•    Isolation and Quarantine: Assess the organization's ability to successfully isolate or quarantine
2	individuals, if necessary
 3	Recommended Planning Activities
 4	The primary recommendations for public health planners to implement are included here. Additional
 5	recommendations that should be undertaken as time and resources allow are follow.
6	•    Include at-risk populations in evaluation as planners, participants, and part of scenario
7	development in exercise design, implementation, and evaluation.
8	•    Implement a quality assurance program for at-risk populations and pandemic influenza
9	planning that tests, evaluates, exercises, and improves the process of providing care for at-
10	risk populations.
 11	Staff and funding vary tremendously among state, territorial, tribal and local entities, so not all of the
 12	potential planning activities listed below will be feasible for all agencies. However, preparedness
 13	planners should identify which of the following steps would help them achieve the recommendation
 14	listed above.
 15	general evaluation recommendations

 16	•    Allocate dedicated funding for evaluation activities.
 17	•    Incorporate evaluation into current planning and routine organizational activities.
 18	•    Define which entities are responsible for conducting evaluation activities, analyzing data, and
19	reporting results.
 20	•    Gather both quantitative and qualitative data to complement and focus data.
 21	•    Identify a standard set of questions to measure preparedness levels across all audiences,
22	modifying questions to address the needs of at-risk populations.
23	•    Develop pandemic influenza-specific measures for at-risk populations that address the
 24	varying degrees of pandemic severity, the estimated time-span of a pandemic, and pandemic
 25	influenza preparedness activities.
26	•    Use the same tool consistently to compare preparedness over time. Acknowledge variables
27	that may change or arise over time; therefore, potentially affecting your tool and data.
 28	•    Use trusted messengers when conducting assessments.
 29	•    Include caregivers or conduct household-level surveys if you suspect individuals may have
30	- - barriers to completing the survey tool.
31	•,   Gather baseline data on objectives for exercise activities and programs wherever possible in
32	: order to measure improvement over time.
 33	•    Adopt or adapt existing evaluation templates to exercises and programs.
 34	•    Address collaborative barriers, such as requiring certain planning activities of state-funded

 35	agencies; awarding grants to agencies to assist with program continuity; offering technical
 36	assistance to organizations; and taking time to directly meet and establish relationships with
 37	organizations.
38	HSEEP specific recommendations
 39	•    Use HSEEP as a framework for exercise design, implementation, and evaluation.
 40	•    Add exercise objectives, exercise injects, and customized exercise evaluation guides to
41	HSEEP exercises to address the needs of at-risk populations at the local level.
42	•    Specifically address the long-term nature of an influenza pandemic in measures for exercises
43	and scenarios.
44	•    Conduct after-action reviews with exercise participants.
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