Qualitative Analysis of Public Health Emergency Response Site Visits Assessing Use of 2009 H1N1 Funds and Activities

Issue: CDC distributed $1.4 billion in Public Health Emergency Response funds to health departments through a cooperative agreement between July 2009 and April 2010. To assess whether the funds were used appropriately, CDC's Division of State and Local Readiness and Influenza Coordination Unit conducted site visits in 2010 and 2011 to review the impact of H1N1 funding on response activities, confirm appropriate use of funds, and identify barriers. Site visits were conducted between June 2010- September 2011. Data provided in site visit reports and questionnaires were used to assess the impact of PHER funds.

Description: Forty states across the U.S. were selected in 2010 based on specific criteria including greatest overall PHER funding, amount of expended funds, and percent of unobligated funds. In 2011 states were selected if they had not undergone a site visit in 2010. Analyses of questionnaires and reports were conducted using qualitative data analysis with information coded into the most commonly identified categories for each question.

Lessons Learned: While the majority of PHER funds were allocated to dispensing vaccine, grantees reported difficulties in reaching certain high-risk and vulnerable population groups. A streamlined budget preparedness mechanism for long-term emergency responses is needed. Few states determined the most efficient method for communicating with specific audiences. The experience with school-based vaccination clinics during the 2009 H1N1 response could be used to improve seasonal vaccination rates.

Recommendations: States should consider identified gaps during the pandemic response when revising All Hazards Plans. Issues identified during the 2009 response can be applied to other emergency responses.