IGA AMD RE EMERGENCY PREPAREDNESS PRGM WITH ADHS.PDF

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
Emergency Preparedness Program
Effective upon signature, it is mutually agreed that the Agreement referenced above is amended as follows:
1. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, the Scope of Work is revised to add the Scope of Work of this Amendment Three (3).
2. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, The Contract Price Sheet is revised to include the Price Sheet of this Amendment Three (3).
3. Pursuant to Terms and Conditions, Provision 6. Contract Changes, Section 6.1 Amendments, Purchase Orders and
Change Orders, Attachment A is added to the Scope of Work of this Amendment Three (3).
All other provisions shall remain in their entirety.
Maricopa County by and through its, CONTRACTOR SIGNATURE
Maricopa County Public Health
Contractor Name Contractor Authorized Signature
Denny Barney
4041 N. Central Ave. Suite 1400
Address Printed Name
Phoenix, Az 85012 Chairman, Maricopa County Board of Supervisors
City State Zip Title
CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be
Pursuant to A.R.S. § 11-952, the undersigned public effective the date indicated. The Public Agency is hereby
agency attorney has determined that this cautioned not to commence any billable work or provide
Intergovernmental Agreement is in proper form and is any material, service or construction under this IGA until
within the powers and authority granted under the laws of the IGA has been executed by an authorized ADHS
the State of Arizona. signatory.
State of Arizona
Signed this _________ day of _________________ 2017
Signature Date
Printed Name Procurement Officer
Attorney General Contract No. P0012014000078, which
is an Agreement between public agencies, has been
reviewed pursuant to A.R.S. § 11-952 by the undersigned
Assistant Attorney General, who has determined that it is
in proper form and is within the powers and authority
granted under the laws of the State of Arizona.
Signature Date
Assistant Attorney General
Printed Name:
ATTEST:
_______________________________________________
Clerk of the Board Date Page 1 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
1. BACKGROUND
1.1. The Arizona Department of Health Services (ADHS) receives supplemental funding from the Centers for
Disease Control and Prevention (CDC) to further develop and enhance the State of Arizona, Bureau of
Public Health Emergency Preparedness (PHEP). These funds are used to support development and
implementation of Tasks in this Scope of Work. The ADHS has determined that the most expeditious
methodology to enhance these Tasks is to partner with the County Health Departments.
1.2. ADHS continues to look at ways to expand our preparedness capabilities based on our Five-Year Plan and
the Capability planning Guide (CPG) data. Based on that information and the guidance set forth by the
Center for Disease Control (CDC) ADHS has developed this PHEP grant agreement.
2. OBJECTIVE
Develop plans along with the timetables and necessary activities to fully implement the Contractor's partnership role
in response to the CDC capabilities and the programmatic methodology requirements of the Scope of Work.
3. SCOPE OF WORK
3.1. The Scope of Work is outlined in the following Provision Four (4). Tasks.
3.2. In addition, the Annual Performance Requirements are outlined in the Attachment A incorporated herein.
Attachment A will change every year, as well as the estimated budget for the period of July 1st through June
30th.
3.3. The Contractor shall submit a detailed Budget based upon their estimated cost associated with continuation
of the programmatic Annual Performance Requirements through the Contract period, unless terminated,
canceled or extended as otherwise provided herein. This Budget shall be submitted in the online Budget Tool
format as provided by PHEP. The Contractor shall have the flexibility of making adjustments to the Budget
categories of the budgeted amount provided on the approved budget. However, any change shall be
requested in writing on the Budget Tool and shall not be implemented until approved electronically by the
ADHS. It is the responsibility of the Contractor to coordinate and manage funds under this Contract.
3.4. Additional tasks, reporting, deliverables and program information can be found in Attachment A; Grant
Guidance – Budget Period 1.
4. TASKS
The Contractor shall:
4.1. Maintain a person appointed as liaison and PHEP coordinator for this grant funding;
4.2. Maintain a detailed plan for 24/7 response to Public Health Emergencies along the guidelines and
deliverables for the current year;
4.3. Maintain a timeline for the development of county-wide plans for Public Health Emergencies,
preparedness for a bioterrorism event, infectious disease outbreak, or other public health emergency;
4.4. Maintain a timeline and a plan to identify personnel to be trained, to receive and distribute critical stockpile
items and manage a mass distribution of vaccine and/or antibiotics on a twenty-four (24) hours a day, seven
(7) days a week basis;
4.5. Maintain a plan to receive and evaluate urgent disease reports from all parts of the jurisdiction on twenty-four
(24) hours a day, seven (7) days a week basis. Maintenance of the plan shall include participation in state-
Page 2 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
wide electronic disease surveillance initiatives;
4.6. Maintain a plan to enhance risk communication and information dissemination to educate the public
regarding exposure risks and effective public health response;
4.7. Submit an annual Budget based upon the cost reimbursement budgetary guidelines and the Budget Tool
provided online at Health Services Portal;
4.8. Submit the completed Budget on or before a date determined annually by the CDC and the ADHS;
4.9. Be advised by correspondence from the ADHS PHEP on the available funding amounts on or before June
30th;
4.10. The funding shall be based on required critical and enhanced capacities for the Contractor's geographical
area; and
4.11. Prepare and submit a detailed budget for the period of July 1st through the following June 30th of each
Budget year. The Contractor shall meet all reporting requirements for federal funding, including those years
in which a match requirement is established.
5. ANNUAL PERFORMANCE REQUIREMENTS
The Contractor shall:
5.1. Perform the requirements as outlined in the Attachment A, Deliverables;
5.2. Attend at Sponsored Grant Meetings (two (2) events annually);
5.3. Attend Healthcare Coalition Meetings
5.3.1. Recommend participation by the designated preparedness coordinator or representative during HCC
meetings (regions listed below). These meetings provide an opportunity for collaboration with
healthcare facilities, county, state, tribal, and other response partners.
5.3.1.1. Coalitions shall continue to plan, develop, and maintain memorandums of understanding
(MOU) to share assets, personnel and information; and
5.3.1.2. Coalitions shall develop plans to unify ESF-8 management of healthcare during a public
health emergency, and integrate communication with jurisdictional command in the area.
5.3.2. Regions are defined as follows:
5.3.2.1. AzCHER Northern:
5.3.2.1.1. County Representatives: Apache, Coconino, Navajo, and Yavapai.
5.3.2.1.2. Tribal Representatives: Hopi Tribe, Kaibab-Paiute Tribe & Navajo Nation.
5.3.2.2. AzCHER Western:
5.3.2.2.1. County Representatives: La Paz, Mohave and Yuma.
5.3.2.2.2. Tribal Representatives: Colorado River Indian Tribe & Fort Mojave Indian Tribe,
Cocopah Tribe and Fort Yuma Quechan Tribe.
5.3.2.3. AzCHER Central:
Page 3 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
5.3.2.3.1. County Representatives: Gila, Maricopa and Pinal.
5.3.2.3.2. Tribal Representatives: Gila River Indian Community, San Carlos Apache Tribe
and White Mountain Apache Tribe.
5.3.2.4. AzCHER Southern:
5.3.2.4.1. County Representatives: Cochise, Graham, Greenlee, Pima, and Santa Cruz.
5.3.2.4.2. Tribal Representatives: Pascua Yaqui Tribe and Tohono O’odham Nation.
5.3.3. CITIES READINESS INIATIVE REQUIREMENTS (CRI Counties):
5.3.3.1. Those sub-recipients receiving CRI funding shall complete the following:
5.3.3.1.1. Participate in one medical countermeasure (MCM) Dispensing Full-Scale
Exercise or Mass Vaccination Full-Scale Exercise. The exercise will include at
least one Point of Dispensing (POD) in each CRI planning Jurisdiction;
5.3.3.1.2. Attend quarterly Action Plan meetings each budget period;
5.3.3.1.3. Participate in scheduled Operational Readiness Review (ORR);
5.3.3.1.4. Complete three annual drills by June of the budget period;
5.3.3.1.4.1. Facility Setup;
5.3.3.1.4.2. Site activation.
5.3.3.2. Throughput estimation is now a component of the dispensing full-scale exercise (FSE).
If a site does not participate in the dispensing FSE, oral MCM throughput will be
measured and information submitted at least once during the five year project period.
5.3.3.3. CRI jurisdictions not conducting an ORR shall complete Jurisdictional Worksheet as part of
the midyear report.
6. FINANCIAL REQUIREMENTS
6.1. Match Requirement
The PHEP award requires a ten percent (10%) “in-kind” or “soft” match from all the grant participants. Each
recipient must include in their budget submission the format they will use to cover the match and method of
documentation. Failure to include the match formula will preclude funding.
6.2. Inventory
Upon request, the Contractor shall provide an inventory list to ADHS as part of the midyear report. Inventory
List shall include all capital equipment (items over $5,000.00 each).
6.3. Budget Allocation and Work Plan
6.3.1. The Contractor shall complete the budget tool provided by ADHS, and return to ADHS for review and
approval. Funding will not be released until the budget has been approved by ADHS; and
Page 4 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
6.3.2. All activities and procurements funded through the PHEP grant shall be aligned with the
budget/spend plan and work plan. These tools shall help the Contractor reach the goals and
objectives outlined in the Capability Deliverables section of this document.
6.4. Grant Activity Oversight
6.4.1. Each PHEP grant recipient shall maintain an appointed Preparedness Coordinator that will be
responsible for oversight of all grant related activities. The Coordinator shall be the main point of
contact in regard to the grant. The Coordinator shall work closely with ADHS to ensure all
deliverables and requirements are met: and
6.4.2. Pursuant to, and in compliance with, Standard Operating Procedures for Monitoring, ADHS shall
coordinate with the appointed Preparedness Coordinator responsible for oversight of grant activities
to include compliance with sub-recipient monitoring.
6.5. Failure to meet the performance measures or deliverables may result in withholding from a portion of
subsequent awards.
7. EXERCISE Recommendations
7.1. MULTI-YEAR TRAINING AND EXERCISE PLAN (MYTEP) PHEP-HPP capabilities (and grant funded
training/exercises).
The Contractor shall:
7.1.1. Participate in the Statewide Training and Exercise Planning Workshop/Webinar;
7.1.2. Update and maintain a Multi-Year Training and Exercise Plan, inclusive dates are July 01, 2016 through
June 30, 2021. Multi-Year plan shall be provided to ADHS upon request; and
7.1.3. Exercise and trainings shall meet implementation criteria and follow evaluation guidance. All grant
funded trainings and exercises must be gap based. Gap based indicates an area of a capability to be
built, or an area of improvement from a previous exercise/real-world response, address jurisdictional or
local risk assessment, or other source (e.g. CPG data) to support achieving operational readiness.
7.2. EXERCISE IMPLEMENTATION CRITERIA
Homeland Security Exercise and Evaluation Program. The contractor shall:
7.2.1. Conduct preparedness exercises when appropriate, in accordance with the Homeland Security Exercise
and Evaluation Program (HSEEP) fundamentals including:
7.2.1.1. Exercise Design and Development;
7.2.1.2. Exercise Conduct;
7.2.1.3. Exercise Evaluation; and
7.2.1.4. Improvement Planning.
7.2.2. Find more information on the April 2013 HSEEP guidelines and exercise policy available at
https://www.preptoolkit.org/web/hseep-resources .
7.2.3. Assure provisions and needs of at-risk individuals are included within the design of exercises. The
Contractor shall report on the strengths and areas for improvement identified through the coalition based
exercise After Action Report and Improvement Plan (AAR/IP). To learn more about the U.S. Department
of Health and Human Services’ definition of “at-risk” population visit this website:
Page 5 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
http://www.phe.gov/preparedness/pages/default.aspx
7.2.4. Exemption: A real incident may be substituted for a qualifying coalition based exercise; however the
after- action report (AAR) shall document how the HCC members met qualifying criteria (both
implementation and evaluation criteria).This scenario will be discussed on an as-requested basis.
7.3. EXERCISE EVALUATION CRITERIA
The Contractor Shall:
7.3.1. Address Capability 3: Emergency Operations Coordination, Capability 6: Information Sharing, and
Capability 10: Medical Surge. The exercises shall also address Recovery/Continuity of operations within
Capability 2: Healthcare System Recovery;
7.3.1.1. Qualifying exercises at a minimum shall include the community emergency management
partner and/or incident management, the community public health partner and the EMS
agency during the design, development, and implementation;
7.3.2. Ensure the functional needs of at-risk individuals are included in response and are identified and
addressed in operational plans;
7.3.2.1. After Action Reports;
7.3.2.2. After Action Reports shall be submitted to ADHS within sixty (60) days after the exercise;
7.3.3. Attend ADHS Sponsored Events.
7.3.3.1. The Contractor shall participate in ADHS sponsored events throughout BP1 (July 1, 2017
through June 30, 2018).
8. REPORTING DELIVERABLES
Progress on the deliverables, performance measures and activities funded through the PHEP/HPP grant shall be
reported in a timely manner to ensure ADHS has adequate time to compile the information and prepare if for submission
at the federal level.
8.1. Mid-Year Report (dates covered: July 1 – December 31)
8.1.1. ADHS shall send out the Mid-Year report template in advance of the Due Date.
8.1.2. Due Date will be determined.
8.2. ADHS shall provide the Performance Measures templates (if applicable) in advance of the Due Date.
8.3. The Contractor shall provide ADHS with updated Public Health Emergency Contact list on a template provided
by ADHS. The list should include contact information for the primary, secondary, and tertiary individuals for the
Public Health Incident Management System (e.g. Incident Commander, Operations, etc.) and posted on the
HSP.
8.3.1. Due Date: At time of midyear reporting.
8.4. End-of-Year Report (dates covered: January 1 – June 30)
8.4.1. ADHS shall send out the End-of-Year report template in advance of the Due Date.
Page 6 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
8.4.2. Due Date will be determined.
8.5. Public Health Emergency Preparedness (PHEP) And Hospital Preparedness Program (HPP)
8.5.1. See Attachment A for deliverable requirements.
9. NOTICES, CORRESPONDENCE AND REPORTS
9.1. Notices, Correspondence and Reports from the Contractor to ADHS shall be sent to:
Arizona Department of Health Services
Public Health Emergency Preparedness
Bureau Chief
150 N 18 th Avenue Ste.150
Phoenix, AZ 85007
9.2. Notices, Correspondence and Payments from the ADHS to the Contractor shall be sent to:
Maricopa County Health Department
4041 N. Central Ave. Suite 1400
Phoenix, AZ 85012
Attn: Matthew Juan
Phone: 602-372-0675
mattjuan@mail.maricopa.gov
Page 7 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
PHEP Budget Period One (1)
July 1, 2017 through June 30, 2018
Cost Reimbursement
Description Quantity Unit Rate Total Cost
Additional funds to enhance current PHEP activities
1 $1,721,122.00 $1,721,122.00
per the deliverables in Attachment A.
Cities Readiness Initiative (CRI). 1 $1,003,189.50 $1,003,189.50
TOTAL $2,724,311.50
Page 8 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
Attachment A
2017-2018 Public Health Emergency Preparedness
GRANT GUIDANCE
BUDGET PERIOD 1
PERIOD OF PERFORMANCE
(July 1, 2017 – June 30, 2018)
Page 9 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
INTRODUCTION
As we enter into a new Public Health and Emergency Preparedness Cooperative Agreement Project Period 2017-2022,
in PHEP Budget Period 1 (BP1) (July 1, 2017-June 30, 2018), we continue to look at ways to expand our preparedness to
show measurable and sustainable progress.
The Arizona Department of Health Services (ADHS) BP1 PHEP Grant Guidance has been developed based on that
information and the guidance set forth in the Centers for Disease Control and Prevention’s Office of Public health
Preparedness and Reponses funding opportunity announcement 2017-2022 Hospital Preparedness program (HPP)-
PHEP Cooperative Agreement CDC-RFA-TP17-1701. In the new cooperative agreement guidance, the awardee (Arizona
Department of Health Services) and sub-recipients (Tribal and County HealthDepartments) will increase or maintain
their levels of effectiveness across six key preparedness domains using the logic model to achieve a prepared public
health system (to be attached). These domains are:
1. Community Resilience
a. Capability 1: Community Preparedness
b. Capability 2: Community Recovery
2. Strengthen Incident Management
a. Capability 3: Emergency Operation Coordination
3. Strengthen Information Management
a. Capability 4: Emergency Public Information and Warning
b. Capability 6: Information Sharing
4. Strengthen Countermeasures and Mitigation
a. Capability 8: Medical Countermeasure Dispensing
b. Capability 9: Medical Materiel Management and Distribution
c. Capability 11: Non-Pharmaceutical Interventions
d. Capability 14: Responder health and Safety Health
5. Strengthen Surge Management
a. Capability 5: Fatality Management
b. Capability 7: Mass Care
c. Capability 10: Medical Surge
d. Capability 15: Volunteer Management
6. Strengthen Biosurveillance.
a. Capability 12: Public Health Laboratory Testing
b. Capability 13: Public Health Surveillance and Epidemiological Investigation
Awardees and sub-recipients will develop and strengthen six domains through the implementation of the strategies and
activities during the project period. ADHS can provide technical assistance upon request and encourage all sub-
recipients to actively coordinate preparedness activities in their jurisdictions.
Page 10 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
STRATEGIES AND ACTVTIIES
Domain 1 Strategy: Strengthen Community Resilience
Resilient communities develop, maintain, and leverage collaborative relationships among government, community
organizations, and individual households that enable them to more effectively respond to and recover from disasters
and emergencies. Sub-recipient will conduct the following activities that sustain or expand community resilience. These
activities will be actionable, realistic, and support the achievement of readiness outputs and intended outcomes.
• Characterize the probable risks to the jurisdiction and the HCC
• Characterize populations at risk
• Engage communities and health care systems
• Operationalize response plans.
Activity 2: Characterize the Probable Risks to the Jurisdiction and the HCC
Joint Requirements
1. Sub-recipient will participate in or complete a jurisdictional risk assessment (JRA) at least once every five years.
The five-year period can extend from one project period to the next, ADHS requires sub-recipient conduct at
least one JRA in this project period. For instance, if a JRA was conducted in Budget Period 4 during the previous
project period, one is not necessary until Budget Period 4 of this project period. ADHS sub-recipient should
coordinate risk assessment activities with each other and with relevant emergency management and homeland
security programs in their jurisdictions. In addition, risk assessment activities will be coordinated as possible
with relevant emergency management and homeland security programs to support jurisdictional Threat and
Hazard Identification and Risk Assessment (THIRA) efforts.
2. Sub-recipient should use the JRA to identify the potential hazards, vulnerabilities, and risks facing their
jurisdiction and their HCCs. Sub-recipient should incorporate the impact from incidents that may have occurred
since the last JRA. Sub-recipient will ensure HCCs have the opportunity to provide input into the JRA for this
project period. Further, Sub-recipient will provide their HCC with the date the JRA was completed or is
projected to be completed.
3. ADHS recommends more frequent analyses of hazards and vulnerabilities to maintain progress toward
improving community resilience. Sub-recipient should incorporate impact from incidents that may have
occurred since the last JRA for which public health or health care had a lead role in mitigating identified disaster
health risks. In addition, ADHS recommends sub-recipient review current findings of the National Health
Security Preparedness Index (NHSPI) and the Arizona’s State Preparedness Reports (SPR) to help gauge risks
and gaps. NHSPI is intended to help guide efforts to improve state and local public health systems and achieve a
higher level of health security preparedness. HPP and PHEP awardees should use NHSPI results to help them
assess their jurisdictional strengths and weaknesses. The results should be analyzed, along with other data
sources such as the HHS Capabilities Planning Guide, jurisdictional risk assessments, incident after-action
Page 11 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
reports and improvement plans, site visit observations, and other jurisdictional priorities and strategies, to help
determine their strategic priorities, identify program gaps, and, ultimately, prioritize preparedness investments.
More information on the NHSPI can be found at http://www.nhspi.org/.
Activity 3: Characterize Populations at Risk
Joint Requirements:
1. Certain individuals may require additional assistance before, during, and after an emergency. Sub-recipients will
conduct inclusive risk planning for the whole community, including for children; pregnant women; senior
citizens; individuals with access and functional needs, including people with disabilities; individuals with pre-
existing, serious behavioral health conditions; and others with unique needs throughout the five year project
period. In conducting this risk planning, Sub-recipients will involve their local HCC and its HCC members. In
addition, Sub-recipients are encouraged to involve experts in non-infectious diseases (chronic conditions and
maternal and child health experts) in risk planning.
2. Sub-recipients will describe the structure or processes in place to integrate the access and functional needs of
at-risk individuals. Recommended strategies involve inclusion in public health, health care, and behavioral
health response activities; furthermore, these strategies should be identified and addressed in operational work
plans. ADHS encourages Sub-recipients and HCCs to identify community partners with established relationships
with diverse at-risk populations, such as social services organizations and Federally Qualified Health Centers.
PHEP Requirements/Recommendations:
1. In addition to the JRA assessment requirements, Sub-recipients will work with their HCCs to meet the needs of
those in the community with unique health care needs or those that have electricity-dependent medical
devices. Sub-recipients should also have processes in place for identifying individuals with disabilities and
others with access and functional needs that might require special assistance from the emergency management
system. Sub-recipients will address the unique needs of these at-risk populations in their plans, exercises, and
responses. ADHS will provide Sub-recipients with specific tools, resources, and guidance documents for
addressing the unique needs of at-risk populations. One planning resource is CDC’s Public Health Workbook to
Define, Locate, and Reach Special, Vulnerable, and At-risk Populations in an Emergency. Available at
http://emergency.cdc.gov/workbook/pdf/ph_workbookfinal.pdf, the workbook identifies five categories that
should be considered in planning:
a. Economic Disadvantage (using poverty as a criteria may help reach a large number of people)
b. Language and Literacy (includes people who have limited ability to read, speak, write or understand
English or their native language)
c. Medical Issues and/or Disability (Persons with any impairment that substantially limits a major life
activity or physical, mental, cognitive, or sensory issues)
d. Isolation (cultural, geographic, or social)
e. Older adults (with chronic health issues or other impeding factors)
Page 12 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
f. Infants and children 18 years or younger can also be at risk, particularly if they are separated from their
parents or guardians.
To address the needs of infants and children, awardees should collaborate with child-serving institutions such
as schools and daycare centers to assure crisis preparedness plans are in place. In addition, ADHS recommends
sub-recipients consider family reunification plans for schools and day care centers, either as part of crisis
preparedness plans or separate plans for reunification. ADHS also strongly recommends that sub-recipients use
the Agency for Toxic Substances and Disease Registry (ATSDR)’s Social Vulnerability Index, which helps identify
risk factors and at-risk populations by geographic area.
2. Response Plans for Chemical, Biological, Radiological, Nuclear, and Explosive Threats
Sub-recipients will develop response plans for chemical, biological, radiological, nuclear, and explosive (CBRNE)
threats. This includes conducting bio-surveillance activities to develop or update response plans as necessary to
meet preparedness goals with respect to CBRNE threats, whether naturally occurring, unintentional, or
deliberate. Awardees should also consider active shooter and other threats. ADHS encourages sub-recipients to
design response plans that focus on assessing medical surge needs and to work with their HCCs and health care
systems to coordinate activities and to provide surge support as needed. Plans should highlight the importance
of using a “systems” approach to manage scarce resources, including limited medical countermeasures,
decontamination and contamination control, staff, and medical resources.
3. Community Assessment for Public Health Emergency Response (CASPER)
The Community Assessment for Public Health Emergency Response (CASPER) is a rapid needs assessment
methodology designed to quickly gather household-based information from a community. Although originally
designed for disaster response, CASPER is now used by health departments for preparedness activities such as
assessments of chronic respiratory conditions, determining perceived health impact of proposed coal
gasification plants, knowledge of mosquito prevention, and projected vaccination behaviors. As all jurisdictions
are at risk for environmental emergencies, PHEP funding can be used for CASPER training and for conducting
CASPER assessments. Subject to jurisdictional priorities and training availability, ADHS recommends that sub-
recipients should either attend in-person CASPER trainings conducted by CDC subject matter experts (SME) or
conduct a CASPER with technical assistance from CDC SMEs. Awardees can find more detailed information and
resources at https://www.cdc.gov/nceh/hsb/disaster/casper/training.htm
4. Environmental Public Health Tracking
Sub-recipients may use PHEP funds to collaborate with the state and local environmental tracking programs to
support activities related to environmental public health tracking. Potential areas for collaboration between the
sub-recipients environmental health programs include:
 Identifying and providing essential data (health and environmental), information, and tools and
methodologies to help conduct environmental health surveillance, spatial temporal analysis, and data
visualization to help key state and local emergency response partners facilitate situational awareness
and mitigate negative environmental health effects before, during, and after an emergency response.
Page 13 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
 Improving awareness of local environmental impacts on health among community members and
responders before, during, and after an event.
 Identifying population groups at highest risk for natural, chemical, and radiological events to target
preparedness strategies and monitor response and recovery impacts.
More information is available at http://www.cdc.gov/nceh/tracking/.
Activity 4: Engage Communities and Health Care Systems
Joint Requirements:
1. Sub-recipients will continue to build and sustain community partnerships to support health care preparedness
and response to ensure that activities have the widest possible reach with the strongest possible ties to the
community.
2. Sub-recipients will describe the structure or processes in place to integrate the access and functional needs of
at-risk individuals. Recommended strategies to integrate the access and functional needs of at-risk individuals
involve inclusion in public health, healthcare, and behavioral health response strategies within work plans.
ADHS recommends sub-recipients and their HCC identify community partners with established relationships
with diverse at-risk populations, such as social services organizations, and use available tools to better
anticipate the potential access and functional needs of at-risk community members before, during, and after an
emergency. Helpful tools include the CDC Public Health Workbook To Define, Locate, and Reach Special,
Vulnerable, and At-risk Populations in an Emergency and ATSDR’s Social Vulnerability Index
https://svi.cdc.gov/), which helps identify risk factors and at-risk populations by geographic area.
3. Local Health Department Participation in HCCs
Sub-recipients will participate in their jurisdictions HCC. Sub-recipients should also ensure partnership and
engagement with fusion centers, poison control centers, and other community-based organizations.
Activity 5: Operationalize Response Plans
Joint Requirements:
1. Sub-recipient, as part of a coordinated statewide effort, will participate in a joint statewide exercise (functional
or full-scale exercise) once during the project period to test progress toward achieving the capabilities outlined
in the 2017-2022 Health Care Preparedness and Response Capabilities and the Public Health Preparedness
Capabilities: National Standards for State and Local Planning.
Domain 2 Strategy: Strengthen Incident Management
Sub-recipients will conduct the following activities to strengthen emergency operations management throughout all
phases of an incident.
 Coordinate emergency operations
Page 14 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
 Standardize the incident command structure (ICS) for public health
 Establish incident command structures for health care organizations and HCCs
 Ensure HCC integration and collaboration with ESF-8
 Expedite fiscal and administrative preparedness procedures
Activity 1: Coordinate Emergency Operations
Joint Requirements
1. All-hazards Emergency Preparedness and Response Plan –
a. Sub-recipients will maintain a current all-hazards public health and medical emergency preparedness
and response plan.
b. Sub-recipients will submit their plans to ADHS when requested and make it available for review during
site visits.
c. Sub-recipients will provide an opportunity for their HCC in their jurisdictions to review and provide
updates to their preparedness and response plans.
d. In addition, sub-recipients will obtain public comment and input on public health and medical
emergency preparedness and response plans and their implementation using existing advisory
committees or a similar mechanism to ensure continuous input from other state, local, and tribal
stakeholders, the health care delivery system, and the general public, including members of at-risk
populations and those with an expertise integrating the access and functional needs of at-risk
individuals.
2. Emergency Management Assistance Compact (EMAC)
a. Sub-recipients will describe in their all-hazards public health and medical emergency preparedness and
response plans how they will use EMAC or other mutual aid agreements for medical and public health
mutual aid to support coordinated activities and to share resources, facilities, services, and other
potential support required when responding to emergencies that impact the public’s health.
b. Sub-recipients should work with state emergency management organizations and other related
agencies to incorporate EMAC into training and exercises as a way to gain familiarity with processes for
requesting and deploying resources through the EMAC system.
PHEP Requirements/Recommendations
1. Sub-recipients will conduct training for incident command and support personnel and drill and exercise the
public health jurisdictional incident command structure. When possible, such training should include
emergency management partners. In addition, awardees will ensure that local jurisdictions are involved in drills
and exercises to improve implementation of the incident command structure as it applies to responding to
public health threats and emergencies.
2. Infectious Disease Response – ADHS recommends that sub-recipients develop and implement plans and
protocols for rapid and appropriate public health actions, such as controlled movement, isolation, quarantine,
Page 15 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
or public health orders pursuant to applicable statutes and regulations. ADHS also recommends that sub-
recipients collaborate with designing, developing, and distributing coordinated laboratory guidance, plans and
protocols regarding laboratory biosafety during emergency responses to infectious diseases. This includes the
safe handling and containment of infectious microorganisms and hazardous biological materials such as
infectious waste.
Activity 2: Standardize Incident Command Structure for Public Health
PHEP Requirements/Recommendations
1. Sub-recipients will develop and establish an incident management framework consistent with the National
Incident Management System (NIMS). Sub-recipients will use the National Response Framework (NRF) to guide
governments at all levels including state, local, territorial, and tribal government planning. All levels of
government will be prepared under NRF to conduct an all-hazards incident response. Emergency operations
plans should use incident command to implement elements of the NRF in scalable and flexible ways.
2. In addition, sub-recipients will coordinate emergency operations with appropriate staff to address all potential
hazards.
3. In addition to command staff and support function staff, sub-recipients will have available lists of staff who
have been identified in advance for a medical or public health response.
4. Sub-recipients will also have operational plans or annexes that address resource management; communications
and information management; emergency public warning and information; medical surge and non-
pharmaceutical interventions; and first responder and volunteer management.
Activity 5: Expedited Fiscal Procedures Are in Place for Ensuring Funding Reaches Impacted Public
Health Departments, HCCs, and their Members during an Emergency Response
Joint Requirements
1. Sub-recipients will have expedited fiscal procedures that ensure the funding provided through the ADHS
funding mechanisms reach the impacted communities in an expedited manner, especially during an emergency
response. Sub-recipients will ensure that these systems are routinely tested.
PHEP Requirements/Recommendations
1. Sub-recipients will document the time it takes to move funds from the state to local public health, both during
emergencies and during routine grant administration. Sub-recipients will develop and submit plans to ADHS no
later than July 30, 2018, that address the following components:
a. Emergency Legal Authority: describe and provide awardee citations for emergency legal authorities
applicable to the Public Health Emergency Law Competency Model, including authorities addressing:
 Procedures for the declaration of disasters or emergencies and accompanying emergency
authorities for designated officials;
Page 16 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
 Expedited procedures for receiving, allocating, and spending emergency funds, including the
ability to quickly move emergency funds from the state level to local governments;
 Powers and procedures for the use of public health interventions including isolation,
quarantine, and the seizure and reallocation of supplies;
 Suspensions (http://lawatlas.org/datasets/emergency-powers), waivers, or similar legal
processes that can be used to minimize the potential conflicts between federal authorities
applicable to medical countermeasures and state-based pharmaceutical, prescribing, labeling,
and other drug-related laws; if no waivers or similar legal processes exist, awardees will
describe laws that may potentially conflict with Emergency Use Authorizations (EUA)s,
Emergency Use Instructions (EUI), Investigational New Drug, and Investigational Device
Exemption;
 Formal memoranda of understanding or agreement (MOU/MOA) between health authorities
and other preparedness partners including law enforcement for implementation of public
health activities, such as joint investigations of intentional threats or incidents that impact the
public’s health, signed and executed between the appropriate Federal Bureau of Investigation
field office and state public health departments, including local public health departments
where relevant (such as in home rule states); and
 Sub-recipients should have documentation in their plans for the protection of volunteers
against tort liability and licensure penalties, and the provision of Workers’ Compensation claims
(excluding federal mechanisms such as the Public Readiness and Emergency Preparedness Act).
b. Fiscal and Administrative Emergency Processes: describe expedited fiscal and other administrative
processes and identify procedures to test fiscal preparedness planning for such activities, including:
 Emergency procurement and contracting authorities and processes and how they differ from
day-to-day business processes;
 Receiving emergency funds during a real incident or exercise, as well as reducing the cycle time
for contracting or procurement during a real incident or exercise;
 Emergency hiring processes (workforce surge) and how they differ from customary hiring
processes;
 Reporting/monitoring methodology to ensure payment efficiency and funding accountability;
and
 Implemented internal controls related to sub-recipient monitoring and any negative audit
findings resulting from suboptimal internal controls.
2. ADHS encourages sub-recipients to exercise their fiscal processes at least once during the five-year project
period. Sub-recipients should identify priorities for exercising, considering examples such as:
 Receiving emergency funds,
 Reducing the cycle time for contracting and procurement,
 Hiring, and
Page 17 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
 Financial reporting, budget management and administration systems, and regulations.
Domain 3 Strategy: Strengthen Information Management
Sub-recipients will conduct the following activities to strengthen information sharing among public health and medical
preparedness and response partners and enhance emergency public information and warning.
 Share situational awareness across the health care and public health systems
 Share emergency information and warnings across disciplines, jurisdictions, and HCCs and their members.
 Conduct external communication with the public.
Activity 1: Share Situational Awareness across the Health Care and Public Health Systems
Joint Requirements:
1. Common Operating Picture
a. Sub-recipients will work together to establish a common operating picture, or situational awareness
tool, that facilitates coordinated information sharing among all public health, health care, HCCs, and
relevant stakeholders. This includes state, local, and tribal public health agencies and their respective
preparedness programs, public health laboratories, communicable disease programs, and programs
addressing health care-acquired infections. Information sharing is the ability to share real-time
information related to the emergency, such as capacity, capability, and stress on health care facilities
and situational awareness across the various response organizations and levels of government.
Accomplishing these activities will enable the health care delivery systems, public health, and other
organizations that contribute to responses to coordinate efforts before, during, and after emergencies;
maintain situational awareness; and effectively communicate with the public.
b. Given the need to establish a common operating picture for effective response, sub-recipients and
HCCs will provide situational awareness data to ADHS emergency response operations and at other
times, as requested.
c. Sub-recipients, the HCC, and their members will agree to participate in current and future federal
health care situational awareness initiatives for the duration of the five-year project period.
PHEP Requirements/Recommendations:
1. Sustain or Enhance Public Health Information Systems
a. Sub-recipients using PHEP funding to sustain or enhance public health informatics will seek to increase
interoperability and functionality by ensuring that properly functioning public health information
systems are available. Such systems, whether they are internally managed or externally hosted or
shared platforms, will be capable of supporting syndromic surveillance, integrated surveillance, public
health registries, situational awareness dashboards, and other public health and preparedness
activities. See Domain 6 - Biosurveillance for more information.
Page 18 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
Activity 2: Share Emergency Information and Warnings across Disciplines, Jurisdictions, and HCCs and
their Members
Joint Requirements:
Coordinate Emergency Information Sharing between Public Health and Health Care
1. Sub-recipients will identify reliable, resilient, interoperable, and redundant information and communication
systems and platforms, including those for bed availability, EMS data, and patient tracking, and provide access
to HCC members and other stakeholders.
The following are factors that HCCs, in coordination with sub-recipients and other public health agency
members, should consider when developing processes and procedures to rapidly acquire and share clinical
knowledge.
 Processes and procedures should address a variety of emergencies such as chemical, biological,
radiological, nuclear, or explosive (CBRNE), trauma, burn, pediatrics, or highly infectious disease
outbreaks
 Approaches to improve patient management, particularly at facilities that may not care for certain
types of patients regularly
Sharing accurate and timely information is critical during an emergency. Sub-recipient should assist, as needed,
the local HCC with its members with developing the ability to rapidly alert and notify their employees, patients,
and visitors. Alerts and notifications should update stakeholders on the emergency situation, protect
stakeholders’ health and safety, and facilitate provider-to-provider communication.
By the end of the five-year project period, the local HCC, in coordination with the sub-recipient, will develop
processes and procedures to rapidly acquire and share clinical knowledge between health care providers and
between health care organizations during responses.
More information about sharing emergency information procedures and platforms can be found in Capability 2,
Objectives 2 and 3 of the 2017-2022 Health Care Preparedness and Response Capabilities.
Activity 3: Conduct External Communication with the Public
Joint Requirements
1. Coordinate Public Messaging
a. Accurate and timely communication with the public is important during a response to a public health
emergency. Accordingly, by the end of Budget Period 2, each HCC and its members, in collaboration
with Sub-recipients, should agree upon and plan for the type of information that will be disseminated
by either the HCC or its individual members to the public during an emergency.
b. Additionally, by the end of the five year project period, the HCC, in collaboration with Sub-recipients,
should provide public information officer (PIO) training to those who are designated to act in that
Page 19 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
capacity during an emergency for HCC members and are in need of such training. This training should
include health risk communication training.
c. Health care organizations, as well as HCCs and Sub-recipients, should work with their community’s Joint
Information Center (JIC) to ensure information is accurate, consistent, linguistically and culturally
appropriate, and disseminated to the community using one voice during an emergency.
d. ADHS recommends that sub-recipients coordinate public messaging and information sharing regarding
monitoring and tracking of cases of persons under investigation during infectious disease outbreaks
with PIOs for various response partners to ensure maximum coordination and consistency of
messaging.
More information about communicating with the public during an emergency can be found in Capability 2, Objective 3
of the 2017-2022 Health Care Preparedness and Response Capabilities.
PHEP Requirements/Recommendations
1. Sub-recipients will ensure information sharing systems are in place. These systems will include redundant
equipment, appropriately trained public health information officers (PIOs) and other personnel, procedures for
media notification, message development, and plans describing how the public can contact the public health
department for up-to-date information on incidents. This can include call centers, help desks, and other
available communication platforms.
Domain 4 Strategy: Strengthen Countermeasures and Mitigation
Sub-recipients should conduct the following activities that strengthen access to and administration of medical and
other countermeasures for pharmaceutical and non-pharmaceutical interventions and strengthen mitigation strategies.
 Manage access to and administration of pharmaceutical and non-pharmaceutical interventions
 Ensure safety and health of responders
 Operationalize response plans.
Activity 1: Manage Access to and Administration of Pharmaceutical and Non-Pharmaceutical
Interventions
Joint Requirements
Following an emergency, effective care cannot be delivered without available staff and appropriate countermeasures.
Accordingly, managing access to and administration of countermeasures and ensuring the safety and health of clinical
and other personnel are important priorities for preparedness and continuity of operations. While PHEP funding plays
an important role in medical countermeasure (MCM) planning and procuring and dispensing MCMs for the community,
including at-risk populations, HPP funding assists in planning for closed POD and ensuring that health care workers and
their families are protected during emergencies.
Page 20 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
MCM Distribution and Dispensing Plans
A number of federally funded programs exist to enhance preparedness for and response to a public health emergency,
including CDC’s Strategic National Stockpile (SNS), CHEMPACK program, and Cities Readiness Initiative (CRI). Sub-
recipients, including HCCs and their members, will understand their jurisdictional MCM distribution plans by the end of
Budget Period 1, either through participation in jurisdictional MCM operational readiness reviews or briefings provided
by the jurisdiction’s MCM coordinator.
Sub-recipients participating in the CHEMPACK program, CRI, or other local and state plans for maintaining treatment or
prophylaxis caches, sub-recipients and HCC will be engaged in the development, training, and exercising of these MCM
distribution and dispensing plans by the end of Budget Period 1. Additionally by the end of Budget Period 1, Sub-
recipients should collaborate with their HCC to assist its members with closed points of dispensing (POD) plans. Sub-
recipients are responsible for general population POD planning with assistance from the state.
MCM Operational Readiness Reviews
Sub-recipient and local CRI jurisdictions will submit initial ORR self-assessment data in Budget Period 1 using the updated ORR
tool to assess their continued progress in advancing MCM capabilities. This self-assessment is not rated or scored but will be used
to obtain baseline information for the MCM Technical Assistance Plan and programmatic planning and development.
MCM Technical Assistance Action Plans
Sub-recipients will submit two MCM Action Plans during each budget period. Non-CRI jurisdictions will include these
Action Plans as supplements to the Mid-Year and End-of-Year grant reports submitted to the state. CRI jurisdictions will
participate in quarterly Action Plan conference calls and submit their Action Plans directly to the state’s MCM
Coordinator.
The action plans focus on activities designed to address prioritized MCM operational gaps identified through the
Capability Planning Guide or the sub-recipient’s most recent ORRs.
RSS Site Surveys
Sub-recipient will participate in one state led regional distribution sites (RDS) visit during the project period. Site visits
will focus on both the primary and secondary RDS locations.
Sub-recipient will update RDS survey information annually on the HSP to include the primary and secondary RDS
locations.
Critical Contacts
Sub-recipient will have available online in the HSP current operational information that identifies points of contact to
facilitate time-sensitive, accurate information sharing before a public health emergency. Sub-recipients will review and
update the operational critical contact information at least every six months or as changes occur.
Page 21 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
Inventory Management Tracking System and Data Exchange Annual Tests
Sub-recipient will participate in the ADHS MCM inventory tracking system test to demonstrate capability to receive and
report inventory data from the ADHS. The test will include the sub-recipient’s primary and secondary inventory
tracking systems.
Cities Readiness Initiative (CRI) Jurisdiction Requirements (Maricopa and Pinal Counties)
Those sub-recipients receiving CRI funding will complete the following:
o Participant in one MCM Dispensing Full-scale Exercise or Mass Vaccination Full-scale Exercise. The exercise
will include at least one POD in each CRI planning jurisdiction.
o Attend quarterly Action Plan meetings each budget period
o Participate in scheduled ORRs
o Complete three annual drills by June of the budget period
1) Staff Notification and Assembly;
2) Facility Setup;
3) Site activation
Note: Throughput estimation is now a component of the dispensing full-scale exercise (FSE). If a site does not
participate in the dispensing FSE, oral MCM throughput will be measured and information submitted at least
once during the five year project period.
Non-Pharmaceutical Interventions
Sub-recipients should coordinate non-pharmaceutical interventions by developing and updating plans that include
documentation of the applicable jurisdictional, legal, and regulatory authorities necessary for implementation in routing
and incident-specific situations. Such plans will include necessary authorization for interventions with the following
elements: individuals, groups, facilities, animals, food products, public works/utilities, and travel through ports of entry
for state, local and territorial jurisdictions as appropriate. Plans should include consideration of the legal and planning
issues for interventions such as isolation, quarantine, school and child care closures, workplace and community
organization/event closure, and restrictions on movement.
Activity 2: Ensure the Safety and Health of Responders
Joint Requirements
1. Sub-recipients, HCCs, and their members will equip, train, and provide resources necessary to protect
responders, employees, and their families from hazards during response and recovery operations. Personal
protective equipment (PPE), MCMs, workplace violence training, psychological first aid training, and other
interventions specific to an emergency are all necessary to protect responders and health care workers from
illness or injury and should be readily available to the health care workforce.
2. Personal Protective Equipment - Sub-recipients and HCCs should manage PPE resources, including stockpiling
considerations, vendor-managed inventory, and the potential reuse of equipment; this includes consistent
policies regarding the type of PPE necessary for various infectious pathogens, and sharing information about
PPE supplies across HCCs, EMS, public health agencies, and other members.
Page 22 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
PHEP Requirements/Recommendations
1. Sub-recipients are responsible for ensuring the safety and health of public health department staff who
respond to an incident, including a large-scale incident that may require significant personnel from outside the
health department. More information is available in Capability 14: Responder Safety and Health in the Public
Health Preparedness Capabilities: National Standards for State and Local Planning. Sub-recipients will ensure
the health and safety of responders through the following activities.
 Distribute and dispense medical and nonmedical countermeasures to public health first responders.
 Purchase PPE, support fit testing, and maintain respiratory protection programs for public and health care
sector workforce.
 Promote coordinated training and maintenance of competencies among public health first responders,
health care providers (including EMS), and others as appropriate, on the use of PPE and environmental
decontamination. Training should follow Occupational Safety and Health Administration (OSHA) guidelines
and state regulations.
 Collaborate, develop, and implement strategies to ensure availability of effective supplies of PPE by working
with suppliers and coalitions to develop plans for caching or redistribution/sharing.
Activity 3: Operationalize Response Plans
Joint Requirements
Implementing MCM response plans requires sufficient staffing to set up and sustain prolonged dispensing operations,
as well as security personnel to effectively secure assets, facilities, and personnel through all phases of MCM planning
and operations. In recognition of the staffing challenges jurisdictions face as the public health workforce continues to
shrink, sub-recipients will consider other staffing resources to effectively mobilize MCM dispensing operations.
Sub-recipients will proactively integrate all components of their local governments in MCM response planning and
consider inclusion of the following strategies in their MCM plans.
 Consider voluntary reassignment local employees to participate in MCM mission areas
 The Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA) provides the
Secretary of the Department of Health and Human Services (HHS) with discretion to authorize the
temporary reassignment of federally funded state, tribal, and local personnel during a declared federal
public health emergency upon request by a state or tribal organization; the temporary reassignment
provision is applicable to state, tribal, and local public health department or agency personnel whose
positions are funded, in full or part, under PHS programs and allows such personnel to immediately
respond to the public health emergency in the affected jurisdiction. ADHS will work with sub-
recipients to identify PHS positions and procedure to utilize in them during events.
Page 23 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
PHEP Recommendations
1. Community Reception Centers (Radiation Preparedness) As an option for exercising, ADHS encourages sub-
recipients to consider developing or enhancing Community Reception Center (RCC) plans/exercises for
sheltering and monitoring those that were potentially exposed to radioactive material. See
https://emergency.cdc.gov/radiation/toolkits.asp for more information. Sub-recipients using PHEP funds to
support RCC activities will include these activities in their work plans.
Domain 5 Strategy: Strengthen Surge Management
Following a public health incident, Sub-recipients should coordinate to assess the public health and medical needs of
the affected community, with sub-recipients focusing on public health surge needs and their HCCs focusing on medical
surge needs. While the two programs may focus on different sectors within the community, sub-recipients will
coordinate these activities jointly.
The following four activities are used to manage public health surge.
 Address mass care needs, such as shelter monitoring
 Address surge needs, including family reunification
 Coordinate volunteers
 Prevent or mitigate injuries and fatalities
 Public health agencies, health care organizations, and other HCC members should inform each other and
integrate plans for purchasing, caching, and distributing PPE.
The following four activities are used to manage medical surge.
 Conduct health care facility evacuation planning and execute evacuations
 Address emergency department and inpatient surge
 Develop alternate care systems
 Address specialty surge, including pediatrics, chemical, radiation, burn, trauma, behavioral health, and highly
infectious diseases.
Activity 1: Address Mass Care Needs
Joint Requirements
1. Address Health Needs in Congregate Locations
a. Sub-recipients will coordinate with HCCs and their members to address the public health, medical, and
mental health needs of those impacted by an incident at congregate locations.
b. HCCs should serve as subject matter experts to Sub-recipients on the health care needs of those
impacted by an incident. For example, HCCs, and HCC members should serve as a planning resource to
Page 24 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
sub-recipients as they develop mass shelters. In particular, HCCs should provide their expertise on the
inclusion of medical care at shelter sites.
c. Activity 2: Address Surge Needs
Joint Requirements
1. Family Reunification
a. During a public health incident or crisis, families are at risk for becoming disconnected. HCCs will serve
as planning resources and subject matter experts to sub-recipients as they develop or augment existing
response plans for affected populations, including mechanisms for family reunification. These plans
should give consideration to:
 Information needed to facilitate reunification of families
 Reunification considerations for children
 Family notification and initiation of reunification processes.
2. Infectious Diseases
a. During an infectious disease outbreak, Sub-recipients, HCCs, and HCC members all have roles in
planning for and responding to outbreaks that stress either the capacity or the capability of the public
health or health care delivery systems. Sub-recipients and HCCs will coordinate the following activities
to ensure the ability to surge to meet the demands during a highly infectious disease response.
 Establish a common operating picture that facilitates coordinated infectious disease information
sharing among all HCC members and relevant stakeholders, including state, local, and territorial
public health agencies and their respective preparedness programs, state public health
laboratories, communicable disease programs, and health care-associated infections (HAI)
programs.
 Sub-recipients should ensure infectious disease response planning includes state and local
emergency management, partners responsible for airports and international points of entry into
the United States, including CDC quarantine stations of jurisdiction, public safety, and other
relevant agencies and community partners. Planning should include identification and management
of potentially infected interstate and international travelers and acquisition and deployment of
immunizations and prophylactic medication as appropriate.
 Develop or update plans to describe how sub-recipients will:
o Monitor known cases or exposed persons including how surveillance will be shared,
o Conduct short- and long-term follow-up of known or suspected households, and
o Ensure the security of storage and retrieval of sensitive information.
 Establish key indicators, critical information requirements, and EEI that will assist with timing of
notifications, alerting, and coordinating responses to emerging or re-emerging infectious disease
outbreaks of significant public health and health care importance, including novel or high-
consequence pathogens.
Page 25 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
 Provide real-time information through coordinated information sharing systems (see Capability 2,
Objective 3, Activity 4 of the 2017-2022 Health Care Preparedness and Response Capabilities and
Capability 6: Public Health Preparedness Capabilities: National Standards for State and Local
Planning) and ensure that information is directed to the public and to the many disciplines that
comprise the responder community.
 Coordinate public messaging and information sharing, including information related to monitoring
and tracking of persons under investigation (PUIs), among PIOs for sub-recipients, as well as PIOs at
HCCs and health care organizations.
 Ensure infectious disease response planning includes state and local emergency management,
transportation, public safety, and other relevant agencies and community partners.
 Continue planning with health care organizations and other stakeholders such as mortuary, autopsy
personnel, and medical examiners, to coordinate the management of the deceased when bodies
are considered infectious, including addressing the provision of body bags and other supplies,
defining assistance, and developing relationships with crematoriums, funeral directors, and other
partners to effectively plan for managing the deceased when bodies are considered infectious.
 Identify, leverage, and share leading practices to optimize infectious disease preparedness and
response activities.
ADHS also recommends the following joint activities.
1. HCCs and state HAI multidisciplinary advisory groups or similar infection control groups within the state
should partner to develop a statewide plan for improving infection control within health care organizations.
2. Jurisdictional public health infection control and prevention programs including HAI programs and
3. HCC members should jointly develop infectious disease response plans for managing individual cases and
larger emerging infectious disease outbreaks.
4. HPP and PHEP awardees, HCCs, and their members should collaborate on informatics initiatives to include
but are not limited to electronic laboratory reporting, electronic test ordering, electronic case reporting,
electronic death reporting, and syndromic surveillance.
5. HPP and PHEP awardees and HCCs should engage with the community to improve understanding of issues
related to infection prevention measures, such as:
a. Changes in hospital visitation policies,
b. Social distancing, and
c. Infection control practices in hospitals, such as:
i. PPE use,
ii. Hand hygiene,
iii. Source control, and
iv. Isolation of patients.
Page 26 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
6. HPP and PHEP awardees, HCCs, and their members should promote coordinated training and maintenance
of competencies among public health first responders, health care providers, EMS, and others as
appropriate, on the use of PPE, environmental decontamination, and management of infectious waste.
Training should follow OSHA and state regulations.
7. HPP and PHEP awardees, HCCs and their members should collaborate to develop and implement strategies
to ensure availability of effective supplies of PPE, including:
8. Working with suppliers and coalitions to develop plans for caching or redistribution and
9. sharing and
10. Informing each other and integrating plans for purchasing, caching, and distributing PPE.
11. HPP and PHEP awardees, HCCs, and their members should sustain planning for the management of PUIs to:
a. Monitor health care personnel who may have had a risk exposure to a PUI by directly treating or
caring for a PUI in a health care setting and
b. Clarify roles and responsibilities for key response activities related to the monitoring of PUIs, to
include:
i. Assisting or assessing readiness of health care organizations in the event of a PUI and
ii. Conducting AARs and testing plans for PUI management to identify opportunities to
improve local, state, and national response activities.
More information about addressing specialty medical surge for infectious diseases can be found in Capability 4,
Objective 9 of the 2017-2022 Health Care Preparedness and Response Capabilities.
PHEP Requirements/Recommendations
1. Conduct Activities Based on State Plans to Manage Public Health Surge
a. Sub-recipients will continuously assess and evaluate the medical and public health needs of the
affected community and identify areas where the response effort is not meeting the demands. Sub-
recipients will then implement surge plans to address the gaps.
Activity 3: Coordinate Volunteers
Joint Requirements
1. Sub-recipients will coordinate the identification, recruitment, registration, training, and engagement of
volunteers to support the jurisdiction’s response to incidents. To develop competency in implementing plans
involving volunteers, awardees should ensure volunteers are included in training, drills, and exercises
throughout the five-year project period.
PHEP Requirements/Recommendations
1. Implement Plans that support the Emergency System for Advance Registration of Volunteer Health
Professionals (ESAR-VHP)
Page 27 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
a. It is critical that Sub-recipients coordinate identification, recruitment, registration, training and
engagement of volunteers to support the jurisdictional public health agency’s response to incidents.
Sub-recipients will ensure volunteers are included in training, drills, and exercises to develop
competency at implementing plans as described in the Emergency System for Advance Registration of
Volunteer Health Professionals (ESAR-VHP) compliance requirements.
b. Sub-recipients in jurisdictions that do not use spontaneous or other volunteers due to state regulations
will describe in their plans how they plan to handle those types of volunteers during an incident.
Activity 4: Prevent or Mitigate Injuries and Fatalities
PHEP Requirements/Recommendations
1. Community Partnerships for Coordination
a. With regard to fatalities, Sub-recipients will coordinate with HCCs and other community partners,
including law enforcement, emergency management, and medical examiners or coroners to ensure
proper tracking, transportation, handling, and storage of human remains and ensure access to mental
and behavioral health services for responders and families impacted by an incident.
Domain 6 Strategy: Strengthen Biosurveillance (PHEP)
As defined by Homeland Security Presidential Directive 21 (HSPD-21), bio surveillance involves active data-gathering
with appropriate analysis and interpretation of biosphere data that might relate to disease activity and threats to
human or animal health — whether infectious, toxic, metabolic, or otherwise, and regardless of intentional or natural
origin — to achieve early warning of health threats, early detection of health events, and overall situational awareness
of disease activity. Sub-recipients will ensure coordination among preparedness, laboratory, and epidemiology
programs through the following activities to strengthen bio surveillance.
• Conduct epidemiological surveillance and investigation
• Detect emerging threats and injuries
• Conduct laboratory testing (not applicable to county health departments)
Activity 1: Conduct Epidemiological Surveillance and Investigation
PHEP Requirements/Recommendations
1. Sub-recipients will continue to create, maintain, support, and strengthen routine surveillance and detection
systems and epidemiological processes. In addition, sub-recipients will be able to surge these systems and
processes in response to incidents of public health significance.
a. Participate in ADHS Communicable Disease on-call system drills
b. Participate in ADHS epidemiology training and exercises including but not limited to Epidemiology
Surveillance and Capacity meeting, How to presentations, annual Arizona Infectious Disease Training
and Exercise meeting
Page 28 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
c. Conduct investigations of Arizona reportable diseases and public health incidents.
d. Report all outbreaks within 24 hours to ADHS utilizing the MEDSIS Outbreak Module including at a
minimum: Outbreak Name, Date Reported to sub-recipient, Morbidity, Type of Setting, and County of
Outbreak.
e. Submit outbreak summaries to ADHS in the MEDSIS Outbreak Module within 30 days of outbreak
closure
Public Health Informatics (Surveillance and Investigation)
Sub-recipients should consider updating essential systems that strengthen epidemiological surveillance and
investigation capability with modern technological tools and make them more versatile in meeting the demands for
timely, population-specific, and geographically specific surveillance information. To meet these expectations, ADHS
encourages sub-recipients to consider two key strategies:
• Enhance the public health information system workforce: Prioritize implementation of targeted cross-cutting
workforce training and development opportunities to maintain functionality and increase capacity of public
health information systems, such as electronic death registration systems.
• Advance electronic information exchange: Public health informatics capacity includes specific actions to both
receive and transmit data electronically using standards-based messaging; awardees should focus their efforts
on improving information sharing and coordinate information technology goals, investments, and work plans
with input from state laboratory directors, state epidemiologists, information technology or informatics
directors, or specifically designated individuals empowered by these authorities by:
a. Participating in CDC’s National Notifiable Diseases Surveillance System (NNDSS) Modernization to increase
NNDSS case reports submitted electronically to CDC using HL7 messaging (enter information into MEDSIS as
required and provide current contact information for MEDSIS liaison(s))
b. Advancing ELR to improve overall surveillance, timeliness, and accuracy of case reporting, confirmation to
state and local public health, and subsequent information sharing with CDC, (to be defined by ADHS EDC).
c. Participating in the National Syndromic Surveillance Program (NSSP) to increase the proportion of
emergency department visits monitored by jurisdictions, (to be defined by ADHS EDC).
d. Implementing electronic test ordering (ETOR) to accept electronic test orders and to return findings
electronically, (to be defined by ADHS EDC).and
e. Implementing electronic case reporting (eCR) consistent with national standards to accept and process
electronically transmitted reportable disease information from electronic health records (to be defined by
ADHS EDC).
Electronic Death Registration (EDR)
Sub-recipients using PHEP funds for EDR will ensure they are developing or advancing state-based EDR systems that can
provide more timely public health mortality surveillance information to CDC’s National Center for Health Statistics
(NCHS) and state epidemiologists. Awardees using PHEP funds to support existing EDR systems will prioritize goals and
objectives in their work plans that advance the use and geographic coverage of current death reporting systems.
Page 29 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
Awardees using PHEP funds to build operational EDR systems will prioritize development of scalable plans designed to
initially implement an EDR system.
Border Health Surveillance
Sub-recipients in jurisdictions located on the United States-Mexico border or the United States-Canada border will
conduct activities that enhance border health, particularly regarding disease detection, identification, investigation, and
preparedness and response activities related to emerging diseases and infectious disease outbreaks whether naturally
occurring or due to bioterrorism. This focus on cross- border preparedness reinforces the U.S. public health and health
system preparedness whole-of- community approach which is essential for local-to-global threat risk management and
response to actual events regardless of source or origin. Sub-recipients will use MEDSIS bi-national variable to identify
case or disease, as applicable.
Disaster Epidemiology Training
ADHS recommends that sub-recipients participate in disaster epidemiology training initiatives as determined by
jurisdictional priorities. Following are recommended activities and tools.
 Rapid Response Registry (RRR): RRR is used to quickly register victims of disasters and provide services,
information, or long-term monitoring. The RRR toolkit and technical support from SMEs with ATSDR are
available to assist with implementation.
• Emergency Responder Health Monitoring and Surveillance System (ERHMS): ERHMS is designed to provide real-
time data and recommendations on health and safety issues that arise among
Collaborate with Poison Control Centers
ADHS recommends that sub-recipients implement processes for using poison control center data for public health
surveillance. Such data can be particularly helpful in 1) providing situational awareness during a known public health
threat, 2) identifying an emerging public health threat, 3) identifying unmet public health communication needs
following a public health threat, or 4) providing surveillance for specific exposures or illnesses of concern to the health
department.
Activity 2: Detect Emerging Threats and Injuries
PHEP Requirements/Recommendations
1. Response Plans for Chemical, Biological, Radiological, Nuclear, and Explosive Threats
Sub-recipients can use PHEP funding to maintain personnel needed to address chemical, biological, radiological,
nuclear and explosive (CBRNE) threats through hiring, training, exercising, and otherwise implementing
response plans. In addition, sub-recipients should describe in their MYTEPs specific plans to address identified
gaps during the project period, and collaborate with HPP awardees to coordinate joint training and exercise
opportunities.
Page 30 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
Federal Requirements:
Annual:
• After-action Report/Improvement Plan (AAR/IP) Submission
• One Multiyear Training and Exercise Plan (MYTEP) Submission (joint plan)
• Three MCM drills. All CRI local jurisdictions will complete all 3 drills annually:
o staff notification and assembly;
o facility set-up; and
o site activation.
Throughput estimation is now completed as part of the dispensing full-scale exercise (FSE). However, if a site
does not participate in the dispensing FSE (for example, participates in immunization FSE in lieu of
dispensing FSE), oral MCM throughput will be measured and information submitted at least once during the
five-year period.
• One Exercise or Real Incident
• One Inventory Management and Tracking System (IMATS) or Inventory Data Exchange (IDE) Test
Project Period Requirement:
• One Functional or Full-scale Exercise (a real incident/event will be considered)
• One Fiscal Preparedness Tabletop Exercise
• One Medical Countermeasure (MCM) Distribution Full-scale Exercise
• One MCM Dispensing Full-scale Exercise or 1 Mass Vaccination Full-scale Exercise (One POD in each CRI local
planning jurisdiction in each of the 72 MSAs and four directly funded localities will be exercised.)
• AAR/IP Submission
Funding Restrictions
Restrictions that will be considered while planning the programs and writing the budget are:
• Awardees may not use funds for research.
• Awardees may not use funds for clinical care except as allowed by law. For the purposes of this FOA, clinical
care is defined as "directly managing the medical care and treatment of patients.”
• Awardees may use funds only for reasonable program purposes, including personnel, travel, supplies, and
services.
• Generally, awardees may not use funds to purchase furniture or equipment. Any such proposed spending will
be clearly identified in the budget.
• Reimbursement of pre-award costs generally is not allowed, unless the CDC provides written approval to the
awardee.
• Other than for normal and recognized executive-legislative relationships, no funds may be used for:
Page 31 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
o publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to
support or defeat the enactment of legislation before any legislative body
o the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to
any activity designed to influence the enactment of legislation, appropriations, regulation,
administrative action, or Executive order proposed or pending before any legislative body
o See Additional Requirement (AR) 12 for detailed guidance on this prohibition and additional guidance
on lobbying for CDC awardees (http://www.cdc.gov/grants/documents/Anti-
Lobbying_Restrictions_for_CDC_Grantees_July_2012.pdf).
• The direct and primary recipient in a cooperative agreement program will perform a substantial role in carrying
out project outcomes and not merely serve as a conduit for an award to another party or provider who is
ineligible.
• Awardees may not use funds for construction or major renovations.
• Awardees may supplement but not supplant existing state or federal funds for activities described in the
budget.
• Payment or reimbursement of backfilling costs for staff is not allowed.
• None of the funds awarded to these programs may be used to pay the salary of an individual at a rate in excess
of Executive Level II or $187,000 per year.
• Awardees may use funds only for reasonable program purposes, including travel, supplies, and services.
• Awardees may purchase basic (non-motorized) trailers with prior approval from the CDC OGS.
• HPP and PHEP funds may not be used to purchase clothing such as jeans, cargo pants, polo shirts, jumpsuits,
sweatshirts, or T-shirts
• HPP and PHEP funds may not be used to purchase or support (feed) animals for labs, including mice. Any
requests for such will receive prior approval of protocols from the Animal Control Office within CDC and
subsequent approval from the CDC OGS.
• Recipients may not use funds to purchase a house or other living quarters for those under quarantine.
• HPP and PHEP awardees may (with prior approval) use funds for overtime for individuals directly associated
(listed in personnel costs) with the award.
• PHEP awardees cannot use funds to purchase vehicles to be used as means of transportation for carrying
people or goods, such as passenger cars or trucks and electrical or gas-driven motorized carts.
• PHEP awardees can (with prior approval) use funds to lease vehicles to be used as means of transportation for
carrying people or goods, e.g., passenger cars or trucks and electrical or gas-driven motorized carts.
• PHEP awardees can (with prior approval) use funds to purchase material-handling equipment (MHE) such as
industrial or warehouse-use trucks to be used to move materials, such as forklifts, lift trucks, turret trucks, etc.
Vehicles will be of a type not licensed to travel on public roads.
• PHEP awardees can use funds to purchase caches of antibiotics for use by first responders and their families to
ensure the health and safety of the public health workforce.
Page 32 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
• PHEP awardees can use funds to support appropriate accreditation activities that meet the Public Health
Accreditation Board’s preparedness-related standards.
• HPP awardees cannot use funds to support standalone, single-facility exercises.
• HPP awardees cannot spend HPP funds on training courses, exercises, and planning resources when similar
offering are available at no cost.
PROGRAM REQUIREMENTS
MEETINGS
1. ADHS Sponsored Grant Meetings (2 events annually)
a. Attend semi-annual ADHS sponsored All-Partners Workshop
b. Attend your Regional ADHS sponsored Business Meeting
i. ADHS will hold one business meeting in each of the four Healthcare Coalition Regions within
the State.
2. Healthcare Coalition Meeting
a. Will attend Healthcare Coalition meetings in your region (see Regions below)
i. Northern Region:
1. County Representatives: Apache County, Coconino County, Navajo County, and
Yavapai County
2. Tribal Representatives: Hopi Tribe, Navajo Nation and White Mountain Apache Tribe
ii. Western Region:
1. County Representatives: La Paz County, Mohave County, and Yuma County
2. Tribal Representatives: Cocopah Indian Tribe, Fort Mojave Indian Tribe, Kaibab-Paiute
Tribe & Quechan Tribe
iii. Central Region:
1. County Representatives: Gila County, Maricopa County, and Pinal County
2. Tribal Representatives: Gila River Indian Community
iv. Southeastern Region:
1. County Representatives: Cochise County, Graham County, Greenlee County, Pima
County and Santa Cruz County
2. Tribal Representatives: Pascua Yaqui Tribe, San Carlos Apache Tribe, and Tohono
O’odham Nation
FINANCIAL REQUIREMENTS
1. Match Requirement
Page 33 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
a. The PHEP award requires a 10% “in-kind” or “soft” match from all the grant participants. Each recipient
will include in their budget submission the format they will use to cover the match and method of
documentation. Failure to include the match formula will preclude funding.
2. Inventory
a. Upon request provide an inventory list to ADHS. The Inventory List shall include all capital equipment.
3. Budget Allocation
a. Complete the budget tool developed by ADHS, sign the document, and return to ADHS for review and
approval. ADHS will not release funding to the County until ADHS has approved the budget.
b. All activities and procurements funded through the PHEP grant shall be aligned with your budget/spend
plan and work plan that will help you reach the goals and objectives outlined in this document. Any
items and activities that are not specifically tied to the PHEP program capabilities will be approved by
ADHS before PHEP funds can be utilized on those activities/items.
c. Counties will follow the applicable Office of Management and Budget (OMB) Circulars and Cost
Principles when developing the budget and throughout the period of performance.
4. Grant Activity Oversight
a. Each County will maintain a full-time, part-time, or appointed PHEP Coordinator that will have
responsibility for oversight of all grant related activities. The PHEP Coordinator will be the main point of
contact for ADHS with the County in regards to the PHEP grant. This individual will work closely with
ADHS to ensure all deliverables and requirements are met. They will also coordinate all activities
surrounding any onsite monitoring visits conducted by ADHS.
5. Employee Certifications
a. PHEP Recipients are required to adhere to all applicable federal laws and regulations, including
applicable OMB Circulars and semiannual certification of employees who work solely on a single federal
award. These certification forms will be prepared at least semiannually signed by the employee or a
supervisory official having firsthand knowledge of the work performed by the employee. Employees
that are split funded are required to maintain Labor Activity Reports (to be provided as requested).
These certification forms will be retained in accordance with 45 Code of Federal Regulation, Part 92.42
6. Performance
a. Failure to meet the deliverables and performance measures described in the Scope of Work may result
in withholding from a portion of subsequent awards.
EXERCISES
1. Emergency Operation Coordination
a. Maintain documentation of all collaborative efforts with local and State emergency management
b. The County PHEP program will establish and maintain a collaborative working relationship with
emergency management. This will include but not be limited to; Emergency communication plan,
Page 34 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
strategies for addressing emergency events, including the management of the consequences of power
failures, natural disasters and other events that would affect public health.
c. Jointly participate with emergency management in an ADHS sponsored table top, functional exercise or
other activity
d. Provide appropriate documentation and justification to support an order request via the Web EOC
order process.
2. Multi-Year Training and Exercise Workshop (MYTEP)
a. Each County will attend the annual ADHS Training and Exercise Planning Workshop
i. DATE: TBD
b. Each County shall submit their final training and exercise plans
i. DUE DATE: no later than : TBD
c. Training and exercise plans will contain proposed events from: TBD.
i. Plans will be submitted on the ADHS provided templates.
d. Trainings and exercises will be gap based.
i. This means that the proposed training and/or exercises will be based on an identified gap from
a previous exercise, response, risk assessment, or other documented source.
Exercise Implementation Criteria
1. Homeland Security Exercise and Evaluation Program
a. Sub-awardees will conduct preparedness exercises in accordance with the HSEEP fundamentals
including:
i. Exercise Design and Development
ii. Exercise Conduct
iii. Exercise Evaluation and
iv. Improvement Planning
v. More information on the April 2013 HSEEP guidelines and exercise policy is available at
https://www.llis.hseep.gov/hseep
2. ADHS Coordination
a. In order to meet the criteria to be a qualified exercise, all PHEP sub-awardee exercises will be
coordinated with ADHS and receive approval prior to the initial planning meeting. Continue to keep
ADHS updated throughout the remainder of the planning process.
b. The HSEEP process along with respective templates and guidance will be used to comply with exercise
implementation criteria.
3. Healthcare Coalition Exercises:
a. Each Healthcare Coalition (Northern, Central, Western, and Southeastern) will have an exercise in BP3
that will require the County’s participation.
i. DATE: TBD
4. At-Risk Individuals
Page 35 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
a. Will include provisions for the needs of at-risk individuals within each exercise. HPP-PHEP sub-awardees
will report on the strengths and areas for improvement identified though the coalition based exercise
After Action Report and Improvement Plan (AAR/IP). To learn more about the U.S. Department of
Health and Human Services’ definition of “at-risk” population visit this website:
http://www.phe.gov/Preparedness/planning/abc/Pages/at-risk.aspx
5. Exemption:
a. County response and recovery operations supporting real incidents could meet the criteria for this
annual exercise requirement if the response was sufficient in scope and the AAR/IPs adequately detail
which PHEP capabilities were tested and evaluated. This will be addressed on an as-requested basis.
Exercise Evaluation Criteria
1. PHEP exercises will address Public Health Preparedness (PHP) Capabilities in all qualifying exercises. If using
FEMA Core Capabilities, a cross-walk will be produced mapping PHP capabilities with core capabilities.
2. At a minimum, each County will demonstrate and validate healthcare coalition participation in resource and
information management as outlined in the HPP-PHEP aligned capabilities.
a. These capabilities are:
i. Capability 3: Emergency Operations Coordination and Capability 6: Information Sharing.
3. PHEP Qualifying Exercises:
a. An exercise that meets PHEP-specific qualifying exercise implementation criteria and the specific HPP
evaluation criteria.
INFORMATION SERVICES
1. Will have or have access to a secure alerting system that at a minimum has the ability to send email, faxes, and
phone/ text alerts.
2. Sub-recipient shall provide to ADHS a list of the system(s) that are utilized in EOC operations and for
information sharing during their midyear report.
3. Sub-recipient shall participate in the Communication Pathway scenarios developed and sent out by ADHS
Information Services Group.
4. Sub-recipient will be able to utilize the following Communication systems: HSP, EMResource, EMTrack, ESAR-
VHP, AZHAN, IRMS (or equivalent), 800 MHz radios, and WebEOC. ADHS will provide training on the systems
and platforms as needed.
REPORTING
Progress on the deliverables, performance measures, and activities funded through the PHEP grant will be reported on
in a timely manner to ensure ADHS has adequate time to compile the information and submit to CDC.
1. Mid-Year Report
Page 36 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Agreement No: ADHS17-133194 Amendment No: 3 Procurement Officer:
Russell Coplen
a. ADHS will send out the Mid-Year report templates in advance of the Due Date
i. DUE DATE: Est. TBD
b. ADHS will provide the CDC Performance Measures templates (if applicable) in advance of the Due Date
i. DUE DATE: TBD
c. Each County will provide ADHS with an updated Public Health Emergency Contact list semi-annually.
The list should include contact information for the primary, secondary, and tertiary individuals for the
Public Health Incident Management System (e.g. Incident Commander, Operations, etc.) and posted on
the HSP.
i. The contact information for each individual shall include:
1. Individual’s name
2. ICS title
3. Non-emergency position title
4. telephone numbers (Office, Mobile, & Home), and
5. primary email address
2. Annual Report
a. ADHS will send out the Annual Report template in advance of the Due Date
i. DUE DATE: TBD
3. After Action Report/Improvement Plan
a. Each County shall submit an AAR/IP for any public health emergency exercise or real world event in
which the public health entity participates and has a role.
b. After a stand-alone DSNS drill, an After Action Report and an Improvement Plan will be provided to the
ADHS SNS Coordinator
c. AARs will be submitted to ADHS within 120 days after the exercise.
4. Training Validation Reports
a. By the end of Budget Period 1, provide ADHS a training validation report using the ADHS template
located in the Health Service Portal (a summary report for trainings actually conducted in BP1).
Page 37 of 38

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT(IGA) 150 North 18th Avenue, Suite 260
AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Officer:
Agreement No: ADHS17-133194 Amendment No: 3
Russell Coplen
Page 38 of 38