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Instructions to States to Amend State Plans with Emergency Operational Planning for Pandemic Influenza

State Letter #06-10

Published: March 17, 2006
Health and Medical
State Letter


FROM: Martha E. Newton
Office of Refugee Resettlement

SUBJECT: Instructions to States to Amend State Plans with Emergency Operational Planning for Pandemic Influenza


As Director of the Office of Refugee Resettlement (ORR), I am establishing a priority in FY 2006, per 45 CFR §400.5(i)(4), that State and Wilson/Fish refugee resettlement program plans provide ORR assurance that refugee programs, services and populations are included in State pandemic influenza emergency operational plans. Statewide refugee programs should coordinate with pandemic planning activities already occurring in your State to ensure maintenance of service provision to refugees and, to the extent possible, prevention of the spread of infectious disease among refugees, their families and the community in the event of pandemic influenza. ORR believes that pandemic influenza planning will promote the continuity of the U.S. Refugee Program.

This letter is intended to provide instruction to States and Wilson/Fish agencies and replacement designees responsible for statewide refugee programs to document your role in State emergency operations that ensure sufficient authority and infrastructure to maintain refugee service delivery and coordination of mainstream service access to refugee clients in the event of pandemic influenza. Such "All Hazards Planning" may be useful in the event of other catastrophic events such as was experienced with Hurricane Katrina in 2005; however, this communication establishes the priority of pandemic influenza planning.


In conformity with Health and Human Services (HHS) Secretary Leavitt's 500 Day Plan and his Priority for Securing the Homeland, specifically with the strategy for preparing for a potential influenza pandemic1, ORR developed a plan that describes the participation of Federal, State and partner agencies in handling refugees who have been identified either overseas or within the continental United States as possibly infected with pandemic influenza. The plan specifies domestic responsibilities and outlines a working relationship among these agencies. In light of this priority for refugee programs, ORR has consulted with State governments and their partners from voluntary resettlement agencies and ethnic organizations regarding the potential impact of pandemic influenza on the Refugee Resettlement Program.


The ORR Pandemic Influenza Task Force has implemented a plan of activities for ensuring ORR's preparedness for pandemic influenza. We have submitted ORR's planning assumptions and emergency operations to the Administration for Children and Families' (ACF) Pandemic Continuity of Operations Plan (COOP), addressing, among other concerns, workforce and alternative procedures and communications.

It is ORR's priority to ensure that State refugee programs are coordinating with their States' emergency planning in the event of pandemic influenza. The purpose of such coordination would be to protect refugee clients and their communities from possible infection, to ensure refugee clients' access to public health services and information regarding the pandemic, and, using all available means, to maintain service provision through a COOP. ORR will facilitate teleconferences to assist States in sharing ideas and competencies regarding pandemic planning, e.g., how to bring the refugee program into State and local planning, identifying and developing resources, language and media access and other planning notions.


HHS has developed planning checklists targeted to State and local governments, businesses, community- and faith-based organizations (attached). These and other pandemic planning documents can be found at http://pandemicflu.gov. The "State and Local Pandemic Influenza Planning Checklist" specifically targets these focal points:

  • Community Preparedness Leadership and Networking
  • Surveillance
  • Public Health and Clinical Laboratories
  • Healthcare and Public Health Partners
  • Infection Control and Clinical Guidelines
  • Vaccine Distribution and Use
  • Antiviral Drug Distribution and Use
  • Community Disease Control and Prevention
  • Public Health Communications
  • Workforce Support: Psychosocial Considerations and Information Needs

It is specifically stated in the Community Preparedness Leadership and Networking focus area that planners must ensure the existence of a demographic profile, including special needs of populations and language minorities. This planning character opens the door for bringing refugees' interests and needs to State planners and decision makers, as they are generally minorities and indeed have language issues.

Each State must submit an amendment to your State Plan that addresses steps you are taking to achieve preparedness for pandemic influenza. I encourage you to work with your designated ORR State Analyst to document emergency planning with your State. ORR health-related resources are Dr. David Smith, Office of Global Health Affairs (OGHA) at 301-675-1920, and Captain John Tuskan, Substance Abuse and Mental Health Services Administration (SAMHSA) at 240-276-1845. Consider sharing drafts as necessary with ORR staff and your peers among other State refugee programs toward submitting a Plan amendment that meets ORR's approval.

At a minimum, your pandemic planning amendment must address the following:

  1. Describe your program's access to and involvement in governmental planning, including official designation or, in the case of a State government not engaged in pandemic planning, describe the scope of your refugee program planning.
  2. Describe your role in ensuring that current and anticipated refugee populations are clearly represented in your State's demographic profiling for pandemic planning.
  3. Describe avenues for refugee populations to participate in preparedness planning.
  4. Describe the active role of the refugee health program in designing and implementing public health measures such as personal hygiene, surveillance, containment procedures, infection control (vaccine distribution) and treatment (antiviral use).
  5. Describe how you will address information dissemination needs through appropriate media-video, translated materials, Public Service Announcements (PSA) or other-to ensure that refugee clients have access to and understand pandemic preparedness activities including when an influenza pandemic is declared and emergency operations are in effect.
  6. Provide a Continuity of Operations Plan (COOP) that delegates authority among refugee program and State and/or County departmental staff and provides contact information and emergency communications media for ORR, service providers and refugee clients.

If your State is not currently engaged in pandemic planning, please contact your State Analyst or Marta Brenden at 202-205-3589 (mbrenden@acf.hhs.gov) for assistance. The target date for submitting your State Plan amendment for pandemic influenza planning is June 1, 2006. Please submit your amendment to:

Martha Newton, Director
Office of Refugee Resettlement
Administration for Children and Families
Mary E. Switzer Building
330 C Street, SW
Washington DC 20201

Thank you.

Last Reviewed: May 15, 2018
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