**Chapter 0. The Basics**

-   Acronyms

-   Financing Childhood Immunizations

-   Funding Categories and Redirection Guidance

-   Allowable Expenses with 317 and VFC FA Operations Funds

-   Allocation Process for Section 317 Immunization Grant Program Funds

-   Section 317: Operational Funding Principles

-   Guidelines for Writing Grant Objectives and Differentiating Between
    Objectives, Activities, and Evaluation Measures

-   Role of the Project Officer/Program Consultant in the Program
    Operations Branch

-   CDC/NCIRD Expectations and Responsibilities for Field Assignees and
    Host Agencies

-   Immunization Services Division Organizational Chart

-   Immunization Program "Seasons"

-   How to Interpret the Subject Heading of NCIRD Immunization Grantee
    Mailbox Email Messages

-   Key Immunization Websites

**Acronyms**

AAFP American Academy of Family Physicians

AAP American Academy of Pediatrics

Ab-negative Antibody negative

ACIP Advisory Committee on Immunization Practices

ACOG American College of Obstetricians and Gynecologists

ACP American College of Physicians

AFIX Assessment, Feedback, Incentive, and eXchange

AI/AN American Indian and Alaska Native

AIM Association of Immunization Managers

APhA American Pharmacists Association

ASTHO Association of State and Territorial Health Officials

AVA Anthrax vaccine adsorbed

BCG Bacillus of calmette and guérin (tuberculosis) vaccine

BRFSS Behavioral Risk Factor Surveillance System

CCID Coordinating Center for Infectious Diseases

CDC Centers for Disease Control and Prevention

CE Continuing Education

CMS Centers for Medicare and Medicaid Services

CNRA Community Needs and Resource Assessment

CoCASA Comprehensive Clinical Assessment Software Application

CQI Continuous quality improvement

CRS Congenital rubella syndrome

CSTE Council of State and Territorial Epidemiologists

CY Calendar year

DA Direct Assistance

DHHS Department of Health and Human Services

DT Diphtheria and tetanus toxoids vaccine (for children)

DTaP Diphtheria and tetanus toxoids and acellular pertussis vaccine

EIPB Education, Information, and Partnership Branch

EPSDT Early Periodic Screening Diagnosis and Treatment Program

ERISA Employee Retirement Income Security Act

FA Financial assistance

FDA Food and Drug Administration

FQHC Federally Qualified Health Center

FMO Financial Management Office

FSR Financial status report

FTE Full-time Equivalent

FY Fiscal year

GIS Geographic Information System

GSA General Services Administration

HAV Hepatitis A virus

HBsAg Hepatitis B surface antigen

HBIG Hepatitis B immune globulin

HBV Hepatitis B virus

HEDIS Health Plan Employers Data and Information Set

Hib Haemophilus influenzae type B conjugate vaccine

HIPAA Health Insurance Portability and Accountability Act

HIV Human immunodeficiency virus

HL7 Health Level 7

HP 2010 Healthy People 2010

HPV Human papillomavirus vaccine

HRSA Health Resources and Services Administration

HSREB Health Services Research and Evaluation Branch

IAC Immunization Action Coalition

IgM anti-HAV IgM anti-hepatitis A virus

IgM anti-HBc IgM anti-hepatitis B core antigen

IHS Indian Health Service

IIS Immunization Information System

IISAR Immunization Information System Annual Report

IM Intramuscular

IOM Institute of Medicine

IPOM Immunization Program Operations Manual

IPV Trivalent inactivated polio vaccine (killed Salk type)

ISD Immunization Services Division

ISO Immunization Safety Office

IV Intravenous

JE Japanese encephalitis

LAIV Live attenuated influenza vaccine

LQA Lot quality assurance

LTC Long-term care

M/CHC Migrant/community health center

MCO Managed care organization

MCV4 Meningococcal conjugate vaccine (quadravalent)

MDS Minimum data set

MMR Measles, mumps, and rubella vaccine

MMR2 Measles, mumps, and rubella vaccine second dose

MMRV Measles, mumps, rubella, and varicella vaccine

MMWR Morbidity and Mortality Weekly Report

MOU Memorandum of understanding

MPSV4 Meningococcal polysaccharide vaccine (quadravalent)

MVP Monthly voucher pickup

NACCHO National Association of County and City Health Officials

NCIRD National Center for Immunization and Respiratory Diseases

NCVIA National Childhood Vaccine Injury Act

NEDSS National Electronic Disease Surveillance System

NETSS National Electronic Telecommunications System for Surveillance

NIC National Immunization Conference

NIIW National Infant Immunization Week

NIP National Immunization Program

NIPVAC (not an acronym; name of software that tracks vaccine target
balances)

NIS National Immunization Survey

NIVW National Influenza Vaccination Week

NNDSS National Notifiable Disease Surveillance System

NoA Notice of Award

NVAC National Vaccine Advisory Committee

NVPO National Vaccine Program Office

OMB Office of Management and Budget

OPV Trivalent oral polio vaccine (live Sabin type)

PCV7 Pneumococcal conjugate vaccine (7-valent)

PGO Procurement and Grants Office

PHIN Public Health Information Network

PHTN Public Health Training Network

POB Program Operations Branch

PON Pockets of need

PPO Preferred Provider Organization

PPV23 Pneumococcal polysaccharide vaccine (23-valent)

PQA Provider Quality Assurance

PRAMS Pregnancy Risk Assessment Monitoring System

PRV Pentavalent rotavirus vaccine

QA Quality assurance

QIO Quality Improvement Organization

RHC Rural Health Clinic

SCHIP State Children's Health Insurance Program

SMART Specific, measurable, achievable, realistic, and time-phased
(objective)

SOP Standard operating procedure

STD Sexually transmitted disease

STI Sexually transmitted infection

SubQ Subcutaneous

TANF Temporary Assistance for Needy Families

Td Tetanus and diphtheria toxoids adsorbed for adult use

Tdap Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
vaccine

TDY Temporary duty

TIV Trivalent (inactivated) influenza vaccine

TT Tetanus toxoid

USDA United States Department of Agriculture

UTD Up-to-date

VAERS Vaccine Adverse Events Reporting System

VACMAN (not an acronym; name of vaccine ordering software)

VAR Varicella vaccine

VaX.NET Vaccine eXchange NETwork

VFC Vaccines for Children Program

VICP National Vaccine Injury Compensation Program

VIS Vaccine Information Statement

VMBIP Vaccine Management Business Improvement Project

VOFA Vaccine Ordering Forecast Application

VPD Vaccine-preventable disease

VSAB Vaccine Supply and Assurance Branch

VZV Varicella zoster virus

WIC Women, Infants and Children Program

YF Yellow fever

ZOS Varicella zoster virus vaccine

**Financing Childhood Immunizations**

**Types of coverage for immunizations for any child under age 19:**

-   Vaccines for Children (VFC) program: provides free vaccinations to
    Medicaid-eligible children, Alaska Natives, American Indians,
    children who have no health insurance, and privately insured
    children with no coverage for vaccinations (called underinsured
    children) who are served at a Rural Health Center (RHC) or Federally
    Qualified Health Center (FQHC).

-   Section 317 program: provides free vaccinations to populations
    determined by the grantee. Most grantees use 317 to provide
    vaccinations to the underinsured seeking services at health
    departments and/or their medical home.

-   State or locally funded vaccine program: provides free vaccinations
    to populations determined by the grantee.

-   Private health insurance.

**Vaccine Supply Policies:**

**Universal:**

All children, regardless of insurance status, receive all
ACIP-recommended vaccines free of charge via the immunization program.
The immunization program uses a combination of VFC, 317, and state/local
funds to purchase vaccine for all children in the state. Children may be
vaccinated by any VFC-enrolled provider (public and private).

**Universal Select:**

All children, regardless of insurance status, receive all
ACIP-recommended vaccines for free via the immunization program, except
for one or more of the newer, more expensive vaccines such as PCV7,
Varicella, MCV4, and Tdap. With universal select states, only
VFC-eligible children receive all the newer vaccines free-of-charge at
any VFC-enrolled provider (public and private). Therefore, universal
select grantees must implement two-tiered systems in order for providers
to be able to identify and then vaccinate the VFC-eligible children with
the new vaccines. The immunization program tries to cover the non
VFC-eligible children with 317 and state/local funds to the greatest
extent possible, but most states' 317 and state/local funding fall short
of the funds needed to reach all non VFC-eligible children. They are
therefore left with the difficult decision to ask providers to turn away
non VFC-eligible children or ask these children to pay for these newer
vaccines out-of-pocket.

**VFC & Underinsured:**

All children who are underinsured are treated like VFC-eligible
children, because the immunization program uses 317 and/or state/local
funding for all ACIP-recommended vaccines, including the newer more
expensive vaccines, to cover the underinsured. This enables the
underinsured to receive all ACIP-recommended vaccines at any VFC
enrolled provider (instead of having to refer the underinsured to an
FQHC or RHC for vaccinations).

**VFC & Underinsured Select:**

All children who are underinsured are served by the immunization
program, because the immunization program uses 317 and/or state/local
funding to cover the underinsured. However, the underinsured must be
referred to an FQHC or RHC to receive one or more of the newer, more
expensive vaccines. They may receive the older routine antigens at any
VFC-enrolled provider.

**VFC Only:**

The immunization program provides all vaccines to private providers only
for VFC-eligible children. The private providers do not receive 317 or
state/local funded vaccine for non-VFC eligible children. However, non
VFC-eligible children may be served via 317 and/or state/local funds in
public clinics.

**Funding Categories and\
Redirection Guidance**

**Vaccine Funding Categories**

**VFC vaccine target**: For grantees to purchase vaccines covered under
federal contract, to be administered to VFC eligible population.

**317 vaccine target**: For grantees to purchase vaccines covered under
federal contract, to be administered to anyone not eligible for VFC,
including adult population. Each grantee determines which populations
can receive 317 vaccine.

**317 financial assistance (FA) vaccine**: For grantees to purchase
vaccines that are not covered under federal contract as well as
biologics, to be administered to children and adults, such as: DT, HBIG,
IG for Hepatitis A, MPSV4, influenza purchases (if VFC and 317 vaccine
target funding is insufficient), and any new vaccine for which a VFC
resolution has been passed but a federal contract does not yet exist.

**Operations Funding Categories**

**\
[Financial Assistance]{.underline}**

**Financial Assistance (FA) - A category of funding that goes directly
to the grantee, similar to a "check**."

**317 FA - Operations Funds**. Funding directly to the grantee for
program operations expenses. These funds are maintained by the grantee.

**VFC Financial Assistance (FA) - Operations Funds**. Funding directly
to the grantee for VFC program operations expenses. These funds are
maintained by the grantee.

**VFC/AFIX - Operations Funds**. Funding directly to the grantee for
VFC/AFIX program operations expenses. These funds are maintained by the
grantee.

**[Direct Assistance]{.underline}**

**Direct Assistance (DA) - A category of funding in lieu of financial
assistance.**

**317 DA -** **Operations Funds**. In lieu of financial assistance, an
account maintained by CDC that allocates funds to procure products and
services, and cover salaries and travel expenses for federal assignees
(e.g., Public Health Advisors assigned to immunization programs).

**317 DA Other -** **Operations Funds**. In lieu of financial
assistance, funds used for GSA contracts for immunization information
system (IIS) development and maintenance. This funding is included in
the grantee's total operations budget. It appears as a separate line
item on the operations budget spreadsheet. If a grantee wants to
establish a GSA contract, a GSA schedule is available with a list of
approved GSA contractors/vendors. Various task orders or IIS services
must be chosen from this listing in order to enter into a contractual
agreement. Otherwise, the grantee must use other (state or FA) funds for
other contractors not approved on the GSA schedule. Statements of work
for GSA contracts must be initiated annually by March 1. The process of
obligating funds must be completed by August 31. Any redirections of 317
DA-Other to FA must occur by June 1.

**Redirections**

Grantees have latitude in making programmatic changes and budget
revisions after funds have been awarded. Redirection of funds is the
shifting of funds from one object class category to another. However,
depending upon the object class category and the amount of funding being
redirected, a formal request to PGO is required. In other situations,
grantees are expected to send a courtesy notification by email to the
grantee's project officer. Grantees are strongly encouraged to redirect
funds within the same budget year. The criteria for formal redirections
and courtesy emails are described below:

**Criteria for sending a formal request to PGO:**

-   If request is \>25% or [\>]{.underline}\$250,000 of the total award
    (whichever is less)

-   If moving funds to and from contracts

-   If moving funds to and from key personnel

-   If moving funds between FA & DA or FA operations & FA vaccine

> The reason why CDC discourages the movement to and from FA to DA is
> because these are fundamentally different accounts that are tracked
> separately.

A formal request to PGO should include

-   Justification that includes where monies are being moved to and from

-   For personnel, include resume of individual to fill Key Position

-   Signature of both Business Office Manager and Principal Investigator
    or Program Director

-   All original documentation should be forwarded to PGO: 

    **Elmira Benson, Grants Management Officer**

> **Attn:  (Constance Palmer or Peaches Brown), Grants Management
> Specialist**
>
> Procurement and Grants Office, CDC
>
> 2920 Brandywine Road, NE, Suite 3000, MS-E15
>
> Atlanta, GA  30341

**Criteria for sending a courtesy e-mail to the grantee's project
officer:**

-   If request is \<10% of total operations award

-   If request is not a new contract nor changes an existing contract's
    scope of work

-   If request does not add personnel

**Allowable Expenses with\
317 and VFC FA Operations Funds**

POB developed the following to assist grantees in preparing budgets that
are in compliance with federal grants policies. The information was
developed using a combination of the OMB Circular A-87, PHS Grants
Policy Statement 9505, and POB identified program priorities.

**Allowable only with 317 operations funds:**

Service delivery activities

Consumer information activities

Consumer/provider board participation

Surveillance activities

Population assessment activities

Perinatal hepatitis B activities

Advertising (restricted to recruitment of staff or trainees, procurement
of goods and services, disposal of scrap or surplus materials)

Locks/security devices for providers

Translations

Vaccine administration supplies

Building rearrangement/alteration costs (not construction)

Registry (all other registry-related activities)

Publication/printing costs (all other immunization related publication
and printing expenses)

Memberships/subscriptions

Public relations

Vehicle lease (restricted to grantees with policies that prohibit local
travel reimbursement)

**Allowable with all funding sources:**

Pagers/cell phones

Maintenance operation/repairs

Malpractice insurance for volunteers

Local meetings/conferences (excluding meals)

Professional service costs (limited term staff)

Communication (electronic/computer transmittal, messenger, postage,
local and long distance telephone)

Compensation/fringe benefits

Indirect costs

Contracts

Data processing

Office supplies

Training costs

In-state travel costs

Out-of-state travel costs (restricted to NIC, Program Manager's/PHA
Meeting, ACIP meetings, and other CDC sponsored immunization program
meetings specified in each year's grant guidance)

Publication/printing costs (restricted to VFC program-specific needs;
excludes VIS printing expenses)

Salary/wages

Service charges

Rent on buildings and equipment (restricted to non-government owned
building)

Accounting services

Personal computers

Printers

**Allowable with 317 operations, VFC operations, and VFC ordering
funds:**

Registry (restricted to one-time development support, inventory module
design/development, adding fields and reports to collect VFC eligibility
screening data, data entry personnel salary for VFC portion of entering
vaccine histories, other enhancements with VFC-specific documentation)

VFC specific training

**Allowable with 317 operations, VFC operations, and VFC/AFIX funds:**

Shipping (other than vaccine)

VFC promotional and recruitment materials

**Allowable with 317 operations and VFC operations funds:**

VIS camera ready copies

VFC-only site visits

Temperature monitors

Laptops

VFC provider feedback surveys

**Allowable with 317 operations and VFC ordering funds:**

Toll-free phone lines for vaccine ordering

Fax machines for vaccine ordering

Printing of vaccine accountability forms

Data entry for VACMAN

**Allowable with 317 operations and VFC distribution funds:**

Vaccine warehouse needs

Vaccine cold chain supplies

Vaccine shipping supplies/shipping costs

Third party distribution contracts

Equipment for public clinic sites for vaccine distribution

Vaccine storage and distribution supplies for provider sites

**Not allowable with 317 or VFC funds:**

Honoraria

Advertising costs (conventions, displays, exhibits, meetings,
memorabilia, gifts, souvenirs)

Alcoholic beverages

Building purchases, construction, capital improvements

Entertainment

Land purchases

Legislative/lobbying activities

Bad debts

Vehicle purchase

Bonding

Construction

Depreciation on use charges

Vaccine (exception: vaccines not on the federal contract may be
purchased with 317 FA operations; this request must be reflected in
VOFA)

Research

Dry cleaning

Fundraising

Interest on loans for the acquisition and/or modernization of an
existing building

**Allocation Process for Section 317 Immunization Grant Program Funds**

**Background**

Federal funding for the Immunization Grant Program (also called the
Section 317 grant program) was launched in 1963. In 2003, CDC awarded
\$408 million in federal grants to 50 states, six large urban areas, and
eight U.S. territories and island nations' public health agencies for
program operations and vaccine purchases. The majority of Section 317
program funding is dedicated to routine childhood programs, with a
smaller portion remaining for adult immunization programs. The amount of
funding available to be awarded to grantees varies depending upon the
annual amount appropriated by Congress as well as any unobligated funds
carried forward from one year to the next. Continuation awards are made
within an approved project period (typically lasting five years) on the
basis of satisfactory progress as evidenced by a review of required
reports and the availability of funds.

The Section 317 grant program provides federal funds to supplement state
and local resources to help ensure that children, adolescents, and
adults receive appropriate immunizations. The program supports a
partnership between public health and immunization providers in both the
public and private sectors by helping them to implement effective
immunization practices and proper use of vaccines to achieve high
immunization coverage. It also supports infrastructure for essential
activities such as immunization information systems, outreach, disease
surveillance, outbreak control, education, and service delivery. A
strong immunization infrastructure ensures optimal coverage with
routinely recommended vaccines.

The Institute of Medicine (IOM), which reviewed funding for immunization
infrastructure in the United States in its 2000 report *Calling the
Shots:  Immunization Finance Policies and Practices* recognized the
importance of developing a rational, clear and standard approach for
awarding section 317 grant funds. This report documented a combination
of new challenges and reduced resources that have led to instability in
the public health infrastructure that supports the U.S. immunization
system. The IOM concluded that a renewal and strengthening of the
federal and state immunization partnership was necessary and recommended
the development of a consistent funding allocation strategy, additional
funds, and a multi-year financing plan. The goals of this partnership
are to expedite the delivery of new vaccines; strengthen the
immunization assessment, assurance, and policy development functions in
each state; and adapt childhood immunization programs to serve the needs
of new age groups in different healthcare environments.

**Purpose of Document**

The purpose of this document is to establish criteria by which the
Immunization Services Division awards 317 operations funding equitably
across all immunization program grantees.

**Assumptions**

-   The Section 317 immunization grant program is a non-competitive
    discretionary grant program (Source: OMB Circular A-133 CFDA
    93.268), with only state health departments and certain other
    jurisdictions eligible to apply for the funds. Because this is a
    discretionary grant program, CDC, as the federal awarding agency,
    can exercise judgment (discretion) in determining the award
    recipient and the amount of funding awarded (Source: CDC Assistance
    Management Manual Part I.C.1-2).

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-   Available Section 317 funds are usually less than the total funds
    requested by grantees in their annual budget requests. When a
    significant discrepancy exists between grantees' budget requests and
    available funds, an allocation methodology is necessary to determine
    a fair and equitable funding amount for each grantee.

-   Population and birth cohort should not be used as the sole factors
    in determining funding. States with smaller populations and a large
    proportion of the population living in rural areas may require
    additional resources needed to implement their programs that are not
    adequately addressed through a purely population-based methodology.

-   A noncompetitive discretionary grant does not preclude the use of an
    allocation model to award funding fairly and equitably across
    grantees.

**Methodology**

1.  After CDC's appropriation bill is signed into law^1^, the Treasury
    Department transfers appropriated dollars from the general fund into
    a CDC-specific account by issuing a treasury warrant. These accounts
    are managed by the Office of Management and Budget (OMB). Within ten
    days after approval of the appropriations bill, CDC issues a request
    for an apportionment to OMB. An apportionment outlines the amount of
    money available for obligation and the time of its receipt. Upon
    receipt of an apportionment, CDC's Financial Management Office,
    (FMO) issues resource allocations to Coordinating Centers and
    Offices in the form of budget ceiling letters. Upon receipt of a
    budget ceiling letter, the Coordinating Center for Infectious
    Diseases (CCID) makes funding decisions and distributes a second
    budget ceiling letter to the National Center for Immunization and
    Respiratory Diseases (NCIRD). The Immunization Services Division
    (ISD) then determines the total amount of funds available to award
    to grantees for the fiscal year in which awards will be made.

2.  The funding methodology addresses and quantifies three criteria for
    grantees as defined by the IOM: need, capacity, and performance. A
    grantee's need is determined by population, birth cohort, number of
    non-English speaking individuals, number of individuals living in
    poverty, number of individuals living in rural areas, and number of
    under-immunized children. Need accounts for 82% of the funding model
    \[population and birth cohort accounts for 50% of the funding model;
    number of non-English speaking individuals (a surrogate for the
    number of non-legal residents) accounts for 8% of the model; number
    of individuals living in poverty accounts for 12%; number of
    under-immunized children accounts for 8%; and number of individuals
    living in rural areas accounts for 4%\].

> Capacity is further defined as the minimum personnel and
> other-than-personnel costs required to implement an immunization
> program. Capacity accounts for 13% of the model.
>
> Performance is defined as childhood vaccination and adult influenza
> vaccination coverage in each grantee location. Performance accounts
> for 5% of the model; within that, childhood vaccination coverage
> accounts for 4%, and adult influenza vaccination coverage accounts for
> 1% of the model.
>
> This model establishes a benchmark funding level for each grantee.
> Adjustment factors are applied to the model to account for variations
> in salaries and cost of living among the grantees. The U.S.
> Territories, and Island Nations do not currently receive funding
> according to this model because of their geographic locations,
> physical size (both land area and country/territory borders), small
> populations, limited resources, special needs, and unique challenges.
>
> The individual factors and their weights may be adjusted as necessary
> to reflect changes in program or funding priorities.

3.  The model is being applied gradually to available funding to
    determine the 317 operations award for each grantee.

This approach considers the necessity of awarding funds fairly and
equitably across grantees, and at the same time includes the importance
of considering a grantee's budget request and proposed use of funds to
implement immunization activities.

Final decisions for awarding funds rest with ISD.

^1^When Congress has not approved a budget, we operate under a
Continuing Resolution, which is defined as "legislation passed by both
the House and the Senate permitting specific Executive Branch agencies
to continue operating even though funds have yet to be appropriated for
the following fiscal year."

**Section 317:\
Operational Funding Principles**

**Scope and Purpose of Federal Immunization Grant Funds**

The Centers for Disease Control and Prevention (CDC) provides federal
Section 317 immunization grant funds to ensure that children,
adolescents, and adults receive appropriate immunizations by partnering
with health providers in the public and private sectors. These funds
support the 50 states, six large urban areas, and eight U.S. territories
and island nations, hereafter referred to as grantees, in their efforts
to plan, implement, and maintain a public health infrastructure that
assures the existence of an effective national immunization system. The
objective of the immunization grant program is to reduce and ultimately
eliminate vaccine-preventable diseases by increasing and maintaining
high immunization coverage.  Emphasis is placed on populations at
highest risk for under-immunization and disease. The funds help assure
the implementation of effective immunization practices and proper use of
vaccines by supporting infrastructure for essential activities such as
outreach, disease surveillance, outbreak control, education, service
delivery, and immunization information systems.

This approach of providing federal government funds in the form of
financial assistance directly to the grantees is designed to supplement
and not supplant state and local resources and assist grantees in
implementing activities proven to be effective in raising vaccination
coverage levels and reducing vaccine-preventable disease morbidity and
mortality. This financial assistance is distributed to grantees as
Section 317 operations funding. The grant funds are awarded for a
12-month budget period with a project period of five years. The amount
of funding available to be awarded to the grantees varies depending upon
the annual amount appropriated by Congress as well as carryover.
Carryover funds are awarded in lieu of new funds in an effort to
minimize carryover. Continuation awards are made within an approved
project period on the basis of satisfactory progress as evidenced by a
review of required reports and the availability of funds.

**Assumptions**

-   The immunization grant program is a discretionary grant program, and
    only state health departments and certain jurisdictions are eligible
    to apply for the funds.

-   When there is a significant discrepancy between grantees' budget
    requests and available funds, CDC uses an allocation methodology to
    determine how much funding each grantee should receive.

**Funding Principles**

1.  Section 317 operations funds will be awarded in a manner that is
    equitable and is responsive to the Institute of Medicine's
    recommendations in *Calling the Shots*.

2.  A core funding amount for each grantee, based on essential program
    operations, population-based program need, population-based
    performance, and jurisdictional capacity, will be considered when
    making decisions about award allocations.

3.  Specific factors used to determine core funding will include:
    population size, birth cohort, proportion under-immunized,
    proportion living in rural areas, proportion living in poverty,
    vaccination coverage levels, essential personnel requirements, cost
    of living increases, and salary and fringe rates.

4.  All grantees will be funded at the core funding level adjusted to
    reflect the amount of funds appropriated by Congress and made
    available to the Immunization Services Division.

5.  In the event that additional funds become available, they may be
    awarded, within the constraints of available funds, based on the
    degree to which grant applications meet the awarding criteria as
    defined in the grant guidance, the degree to which proposed
    activities have been demonstrated to be effective, and the degree to
    which progress in meeting established objectives and performance
    measures is demonstrated.

6.  If the amount awarded differs from the amount requested by the
    grantee, the grantee shall submit a revised project implementation
    plan and budget based on the approved funding amount.

7.  Subject to the availability of funds including appropriations and
    carryover, each year a grantee should receive at least 95% of its
    previous year\'s funding in order to avoid disruption of existing
    programs.

8.  Final decisions concerning funding and allocation are the
    responsibility of the Immunization Services Division (ISD).

**Guidelines for Writing Grant Objectives and Differentiating Between
Objectives, Activities, and Evaluation Measures**

The purpose of this document is to provide immunization program grantees
with guidelines on how to write objectives, activities, and evaluation
measures to meet grant requirements and program priorities.

**All objectives must be SMART:**

**S**pecific (focused)

**M**easurable

**A**chievable (results-oriented)

**R**ealistic

**T**ime-phased

SMART objectives should be narrow and precise. You should be able to
state an objective in one sentence that specifies what will be
accomplished. A common problem is to write an objective that is too vast
or complex and not achievable within a given time frame. If so, split it
into two or more smaller objectives that will be SMART. If the objective
is ongoing from the previous year, baseline data should be included, and
the objective should state a specific percent increase or improvement
that will be accomplished in the next budget period.

**Objective:**

**SMART statement that tells what major project will be accomplished
within a one-year budget period.**

The following are two examples of SMART Provider Quality Assurance
objectives as part of a perinatal hepatitis B prevention program:

If, for example, your program has never determined HBsAg screening
rates, you might develop the following process objective:

*Example: By December 31, 2006, HBsAg screening rates will be assessed
by reviewing 100 charts in each of the three largest birthing
hospitals.*

If, however, your program has already conducted a screening assessment
and has determined that Hospital X has a screening rate below 90%, you
could develop an outcome objective for the next budget year as follows:

*Example: By December 31, 2006, the HBsAg screening rate for Hospital X
will increase from 83% to at least 90%.*

It is acceptable to write objective statements without explicitly
stating who will do the work because the activities statements
(described next) clarify who will complete each task needed to achieve
the objective.

**Activities:**

**Small action steps that, when combined, lead to the achievement of the
objective. Activities tell who will do how much of what by when and
where and how.** Action steps are listed chronologically.

The following are example activities statements that support the sample
perinatal process objective above:

*1. Perinatal Hepatitis B Program Coordinator will determine appropriate
sampling methodology for hospital delivery records by January 20, 2006.*

2.  *Coordinator will determine which hospitals will be selected for a
    hospital record review based on sampling method identified in
    activity #1 by January 25, 2006.*

3.  *Coordinator will either revise an existing data collection tool or
    develop a new one by February 1, 2006.*

4.  *Coordinator and assistant coordinator will contact the Directors of
    Labor and Delivery in the selected X, Y, and Z hospitals by February
    28, 2006 to plan visit dates to review charts.*

5.  *Coordinator and assistant coordinator will visit hospitals to
    conduct record reviews between April 1 and June 30, 2006.*

6.  *Coordinator and assistant coordinator will analyze data by July 31,
    2006 to determine HBsAg screening rates for each of the hospitals.*

7.  *Coordinator will provide feedback to hospitals X, Y, and Z with
    follow-up recommendations by November 30, 2006.*

**Evaluation Measure:**

**The evaluation measure tells what will be used and how it will be used
to determine whether or not the objective was met.** **Your statement
must explain the process for using a specific instrument to assess the
extent to which the objective was achieved.** A common error in writing
evaluation measures is to turn them into objective statements instead.

The following is an example evaluation measure that assesses achievement
of the sample perinatal process objective:

*Progress toward achievement of this objective will be determined by
using a data collection tool that will indicate the number of charts
pulled from each of the three hospitals, compared with the number of
charts that indicated HBsAg screening.*

**Sample objectives from each of the other program components:**

[Program Management]{.underline}:

*Example: By July 1, 2006, 100% of the new contracts with local health
departments will be finalized to include measurable performance
deliverables that cover priority activities identified by the
immunization program.*

This is a process objective which is appropriate as an initial
short-term objective, but over time, program managers would want to
migrate toward more outcome-oriented objectives. For example, in the
following year, this program manager, while maintaining the focus on
counties with contracts having measurable performance deliverables,
would want to develop an objective around the proportion of local health
departments that can document the achievement of a specified percentage
of their deliverables.

[Vaccine Management]{.underline}:

*Example: By October 31, 2006, vaccine wastage and unaccounted for doses
will decrease from 5% to no more than 3%.*

[Immunization Registries]{.underline}:

*Example: By December 31, 2006, private provider registry participation
levels will increase from 50% to 55%.*

[Service Delivery]{.underline}:

*Example: By September 30, 2006, WIC staff in XYZ counties will screen
at least 95% of visiting WIC children for up-to-date immunization status
and refer all children who are not up-to-date to appropriate provider
sites for needed vaccinations.*

[Consumer Information]{.underline}:

*Example: By August 31, 2006, the communications unit will develop and
finalize a* *culturally sensitive pneumococcal immunization brochure
targeted to Hispanic residents aged 65+ in zip code X.*

[Surveillance]{.underline}:

*Example: By December 31, 2006, at least 90% of the HBsAg positive tests
from all laboratories and clinics will be reported to the surveillance
unit within 7 calendar days from the time that the test results are
available.*

[Population Assessment]{.underline}:

*Example: By May 31, 2006, the assessment coordinator will identify the
top three pockets of need for the 4:3:1:3:3 series using GIS mapping.*

**Examples of immunization objectives from prior year applications**

Below are examples of some objectives that were included in previous
year grant applications. The statements below were modified for
anonymity, and all dates were changed to 2006 for consistency, but the
content remains unchanged. The examples are provided for your review to
help you identify areas for improvement, and to help you distinguish
between objectives, activities, and evaluation measures.

**Critique the Objectives**

1)  *Improve procedures for promoting immunizations for children and
    adults.*

Critique: This is a vague statement of intent to do something regarding
promotion of childhood and adult immunization. It does not have any of
the 5 SMART elements.

2)  *Facilitate active and passive surveillance of childhood
    vaccine-preventable diseases.*

Critique: Unspecific, non-measurable words like "promote, work toward,
ensure, improve, facilitate" should be avoided. This statement does not
have any of the 5 SMART elements. Possible outcome-oriented variations:

By \_\_\_\_, 2006, the weekly response rate of participants in the
influenza sentinel site surveillance system will be increased from
\_\_\_% to at least \_\_\_%.

By \_\_\_\_, 2006, field epidemiologists will complete investigations on
\_\_% of suspected cases of vaccine-preventable diseases reported to the
surveillance system within \_\_\_hours/days of receipt by the
immunization program.

3)  *Pneumococcal coverage rates for residents in long-term care
    facilities will increase to at least 75%.*

Critique: The T in SMART is missing in this outcome objective and the
statement could be more S as well:

By December 31, 2006, pneumococcal polysaccharide vaccine coverage rates
for all residents of all (or an identified portion of) nursing homes in
XYZ state will increase from \_\_\_% to \_\_\_%.

This format assumes that baseline data exist and that the program has a
way to acquire new data for 2006. If no baseline data are available,
then the end of the statement could be phrased "will equal or exceed
\_\_\_%" instead of "increase from \_\_\_% to \_\_\_%."

4)  *Surveys of the immunization status of children attending day care
    facilities will be conducted to identify children who are not
    up-to-date.*

Critique: The A exists but the SMRT do not. Examples of more
outcome-oriented versions could include:

By \_\_\_, 2006, assessments of immunization coverage in (all/select
target population) licensed day care facilities will be completed by
(whom).

By \_\_\_, 2006, series complete immunization coverage will increase to
90% among licensed day care centers with coverage rates in 2005 of less
than 80%.

By \_\_\_, 2006, series complete immunization coverage will increase
from \_\_% to \_\_% among all children attending licensed day care
centers in (specific geographic region).

5)  *The immunization program will have a written, finalized strategic
    plan for implementation of the AFIX program.*

Critique: This process objective lacks T but otherwise is acceptable.

**Is it an activity, objective, or evaluation measure?**

1)  *Distribute new VISs to VFC providers and inform professional
    medical organizations about the availability of new VISs within 30
    days of notification from NIP.*

This statement is an activity. The grantee that submitted this
erroneously considered it an objective.

2)  *Download all reported hepatitis B cases in females 12--50 years of
    age from the state registry every month and compare download list
    with those perinatal hepatitis B cases that are already identified.*

This statement is an evaluation measure.

3)  *Compare the number of privacy/confidentiality agreements with the
    total number of enrolled registry users.*

This statement is an evaluation measure.

4)  *By December 31, 2006, at least 90% of all residents in long-term
    care facilities are immunized for influenza and pneumococcal
    disease.*

This statement is an objective. The grantee that submitted this
erroneously considered it an evaluation measure.

5)  *By January 1, 2006 and ongoing, immunization services are available
    for underserved populations of all age groups, in every county,
    through public health clinics and private providers as evidenced by
    low vaccine-preventable disease rates.*

This statement is an attempt at an objective, but it is not SMART. Also,
even though the T is provided, all objectives must be too large in scope
to be achieved on the first day of the year.

6)  *Review the scope of the comprehensive influenza pandemic
    preparedness plan and the date each review was completed*.

This statement can be an evaluation measure if the term "scope" and the
criteria for review are defined.

**Role of the Project Officer/\
Program Consultant in the\
Program Operations Branch**

The Project Officer in the Program Operations Branch (POB), Immunization
Services Division (ISD), National Center for Immunization and
Respiratory Diseases (NCIRD) has direct responsibility for providing
guidance, technical support and consultation regarding immunization
program implementation and grant funding to assigned grantees throughout
the United States, its territories and freely associated countries. The
Project Officer (also known as the Program Consultant) serves as the
primary liaison and first point of contact between the grantee and other
branches, offices and staff within ISD. As POB representatives, Project
Officers:

-   Serve as a recognized authority or consultant for immunization grant
    programs and promote the overall improvement of health and safety of
    children and adults through immunization and efforts to reduce
    and/or eliminate morbidity and mortality from vaccine-preventable
    diseases

-   Serve as an immunization grant project officer with full
    responsibility for carrying out all required project officer
    monitoring and management duties

-   Foster the design and operation of innovative methods to promote
    information dissemination and exchange among state/local health
    agencies and organizations, research sites, and/or among CDC program
    offices

-   Provide public health program support through discussions and
    analysis of barriers, identifying needs and recommending
    modifications or improvements to immunization programs

-   Have a responsibility to be professional, timely and courteous in
    all of their interactions and in responding to grantee requests by
    providing the most accurate information available

More specifically, a Project Officer has the following responsibilities:

**Technical Assistance**

-   Assists immunization grantees in the development of their annual
    grant applications. This includes, but is not limited to, providing
    advice and assistance in the development of overall program goals
    and objectives, task delineation, staffing patterns, scope of
    services, and program management systems to ensure that national
    program requirements are addressed as grantees plan and conduct
    activities within many different state and local programs

-   Responds to requests for, collects and disseminates information in a
    timely manner

-   Assists in the development, dissemination and collection of grantee
    surveys or questionnaires

**Financial Consultation and Recommendations**

-   Reviews grant applications to ensure budgets are reasonable and
    planned activities are within the scope of program requirements and
    makes recommendations regarding financial assistance to grantees

-   Works closely with the Procurement and Grants Office (PGO) regarding
    budgetary matters and makes recommendations involving funding
    restrictions, redirection requests, supplemental funding, and
    vaccine issues

-   Reviews and approves population estimates and vaccine needs for
    assigned grantees

-   Reviews and recommends operations grant awards

-   Reviews and recommends VFC budgets

-   Recommends funding for special projects

-   Recommends funding for registry activities in collaboration with the
    Immunization Information Systems Support Branch

-   Transmits vaccine balances to grantees from NIPVAC upon request

**Monitoring**

-   Monitors grantee activities through site visits to substantiate that
    progress is being made toward achieving program goals and
    objectives, ensures that grant funds are appropriately used, and
    provides appropriate post-award technical assistance

    -   Site visits (317, VFC, AFIX and perinatal hepatitis B prevention
        activities) should be conducted annually using the site visit
        tool developed by the Program Operations Branch

    -   To the extent possible, site visits should be conducted between
        January and August so that project officers have current grantee
        information when reviewing grant applications

    -   Project officers should take advantage of opportunities to meet
        with program managers for their assigned grantees at the
        National Immunization Conference and the Program Managers'
        Meeting

    -   Follow-up visits within the same year may be appropriate for
        grantees for which specific corrective recommendations have been
        made or to provide additional technical assistance

    -   Reports of all site visits should include responses to all
        questions in the site visit questionnaire and be completed and
        sent to the grantee within one month of completion of the visit

    -   De-briefings are to be scheduled with the Branch Chief and
        Deputy no more than five business days following completion of
        the visit

-   Evaluates programmatic performance, progress, and any requested
    changes in scope or objectives from the approved application using
    information in progress and financial reports, site visits,
    correspondence, and other sources. Identifies potential or existing
    problems, whether programmatic or business management, and informs
    appropriate National Center staff and PGO of these findings

-   Analyzes data from grantees and follows up on any discrepancies

-   Monitors grantee vaccine purchases and analyzes purchases with
    respect to the grantee's vaccine spending plan

-   Assists in closing out completed projects to include review and
    programmatic evaluation of the final grantee progress and financial
    reports and other required documentation

**Immunization Program Support**

-   Assists with the development of POB internal policies and procedures

-   Participates in internal special projects/workgroups as needed

-   Drafts appropriate responses to immunization-related inquiries
    received from Congress, state legislators, private physicians,
    hospitals, other federal, state and local agencies and other public
    and private organizations as necessary

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-   Assists with the selection of field-assigned Public Health Advisors

-   Assists with performance evaluations for field-assigned Public
    Health Advisors

-   Makes recommendations for field-assigned Public Health Advisor
    incentive awards

**Working Relationships**

-   Develops and maintains close working relationships with appropriate
    staff in state and local public health agencies as well as other
    groups and individuals within jurisdictional assignments concerned
    with immunization programs and issues

-   Serves as resource to other divisions within CDC, internal staff,
    field-assigned Public Health Advisors and other agencies

-   Works collaboratively with consultants from the Immunization
    Information Systems Support Branch on issues related to funding
    requests and site visits

**Performance Expectations**

-   Project Officers have the responsibility to exercise professional
    judgment and ensure prudent stewardship of CDC funds in accordance
    with the highest standards of professional and ethical conduct.

-   Project Officers must consider the significance and impact of their
    actions not only on established program goals and objectives but
    also on CDC as a whole and its use and management of resources.

-   Project Officers must be sufficiently knowledgeable of issues and
    needs that transcend the programmatic aspects of the individual
    project to coordinate with affected staff in ISD, other National
    Centers or PGO, when appropriate.

-   Project Officers must carry out in a professional, fair, objective,
    timely, and consistent manner all functions for which they are
    responsible, whether in a primary capacity or in support of other
    CDC staff including other project officers for whom they serve as
    back-up support.

-   Project Officers must respond promptly (usually within 24 hours) to
    voice mail and e-mail messages and to manage such messages in a
    manner that enables them to be knowledgeable of message content and
    to provide appropriate follow-up as needed

*CDC Core Values: Accountability, Respect, Integrity*

**CDC/NCIRD Expectations and Responsibilities for Field Assignees and
Host Agencies**

## 

## Introduction

The role of a Public Health Advisor or Commissioned Corps Officer in a
field assignment for the National Center for Immunization and
Respiratory Diseases (NCIRD) is to represent NCIRD and serve the host
agency based on the Core Values of the Centers for Disease Control and
Prevention (CDC). The Core Values are as follows:

> **Accountability** - As diligent stewards of public trust and public
> funds, we act decisively and compassionately in service to the
> people's health. We ensure that our research and our services are
> based on sound science and meet real public needs to achieve our
> public health goals.
>
> **Respect** - We respect and understand our interdependence with all
> people both inside the agency and throughout the world treating them
> and their contributions with dignity and valuing individual and
> cultural diversity. We are committed to achieving a diverse workforce
> at all levels of the organization.
>
> **Integrity** - We are honest and ethical in all we do. We will do
> what we say. We prize scientific integrity and professional
> excellence.

**[Background]{.underline}**

NCIRD provides assistance to state and local health department grantees
by detailing NCIRD staff to state and local health department
immunization programs. Field Staff are expected to assist grantees in
achieving immunization program goals that are aligned with CDC's mission
to control and prevent vaccine-preventable diseases. Because the state
or local health department's satisfaction with field assignees is
important, field staff are usually appointed to an immunization program
that, in the opinion of the Program Operations Branch (POB) management,
will ensure a strong partnership and a high likelihood of success. To
facilitate a continued positive relationship between state/local
immunization programs and CDC/NCIRD, the host immunization program will
have input into the assignment of field staff.

Because all field staff are federal employees, they cannot lobby federal
or state legislatures or advocate for bills or legislative actions. With
that exception, the roles and positions in which field staff can serve
during a detail to a state or local immunization program are not
restricted and will generally be determined by the state or local
program to which they are assigned.

**[Expectations of Field-Assigned Staff]{.underline}**

The following are NCIRD's expectations of field assignees:

-   Represent CDC and the host agency in a professional manner at all
    times.

-   Maintain a professional appearance at all times.

-   Assist host agencies in understanding CDC policies, requirements,
    and program components.

-   Assist CDC in understanding the needs of state and local
    immunization programs.

-   Assist others beyond the host agency to understand the role that CDC
    plays in public health.

-   Promote and enhance capacity building through consultation and
    technical advice.

-   Communicate clearly, thoughtfully, and considerately, both orally
    and in writing, at all times.

-   Maintain regular contact with the project officer for the host
    program.

-   Communicate problems to the POB deputy branch chief or the branch
    chief.

-   Take pride in the organizations being served (CDC and the host
    agency) and in the role of a Public Health Advisor or Commissioned
    Corps Officer.

-   Whenever possible, field assignees should

    -   Act generously,

    -   Offer compassion,

    -   Seek to understand, and

    -   Forgive when needed.

## Field Assignee Responsibilities

Field assignees are, first and foremost, employees of CDC and not
employees of the state/local immunization program. Field staff are
expected to assist CDC and the state/local immunization program in
carrying out disease prevention, health promotion and protection, and
other public health activities; providing assistance to host agencies to
develop, implement, and evaluate public health programs; and promoting
and enhancing capacity-building through consultation, demonstration, and
technical expertise. CDC recognizes that field assignees must be
sensitive to the state/local immunization program's policies and needs,
and NCIRD recognizes the sometimes difficult position and competing
roles in which field assignees may be placed. From time to time, field
assignees may make recommendations to host agencies that are counter to
the host agency's standard operating procedures. NCIRD encourages field
assignees to discuss such recommendations openly and honestly with both
the host agency program management and the Program Operations Branch
project officer.

Field Assignees are responsible for identifying themselves as CDC
employees despite the role that the field assignee fills in the
state/local program. Some examples of how a CDC field assignee may
represent him/herself are as follows:

> Jane Doe, CDC Senior Public Health Advisor, Deputy Program Manager,
> Immunization Program, Los Angeles County Department of Health;

John Jay, CDC Public Health Advisor, VFC Coordinator, Immunization
Branch, North Carolina Department of Health and Human Services;

> Susan B. Anthony, MPH, Nurse Officer, USPHS, Immunization Program,
> City of New York, Department of Health & Mental Hygiene.

## Field Assignee Evaluations 

NCIRD/ISD/POB will provide broad guidance, technical consultation, and
official supervision to field assignees. Each assignee's performance
will be formally assessed in accordance with established CDC performance
management systems for civil service and Commissioned Corps employees.
In completing an assignee's evaluations (both at mid-year and year-end)
CDC will encourage, solicit, and use input from appropriate state/local
immunization program staff regarding the assignee's performance.

## Publications and Presentations 

Field Assignees are encouraged to publish and give presentations at
scientific meetings. However, any publication, presentation, or abstract
that includes the name of a CDC assignee must be submitted for and
receive CDC clearance prior to submission for publication or
presentation. The publication must include the assignee's CDC
affiliation as well as local affiliation. Standard guidelines for
authorship should be followed when determining whether a CDC assignee's
name should be included as an author on a publication (General
Administration No. CDC-69).

## Leave and Hours of Duty

Civil Service field assignees are required to work 80-hours during the
two-week pay period. The state/local immunization program will determine
hours of duty. Commissioned Corps field assignees are required to work a
40-hour week and must be available for duty 24 hours per day, 7 days a
week. The state/local immunization program will determine regular hours
of duty.

On Federal Holidays that are not observed by the host agency, field
assignees that are not required to work by the host agency will be
excused from duty without charge to accrued leave balances. If a field
assignee is required to work on a Federal holiday, premium pay will be
paid under Federal regulations for work on a holiday. Assignees will be
excused without charge to accrued leave balances on state and local
holidays that are not also Federal holidays. The assignee's federal
supervisor must give prior written approval for the absence.

Assignees will be entitled to use annual and sick leave in accordance
with Federal laws, regulations, and procedures. Earning and using
overtime or credit time will be subject to the local rules and
procedures of the host agency.

The on-site supervisor, whether another Federal assignee or host agency
staff person, should review any leave request. The on-site supervisor
may choose to initial the assignee's leave slips to indicate approval of
the leave request. Final written approval for leave (signature on leave
slips) is the responsibility of the assignee's Federal supervisor.

## Training

Field assignees are expected to attend CDC programmatic and career
development training, meetings, seminars and conferences, including
national seminars and regional staff conferences. Assignees may attend
optional training and professional development activities after first
obtaining the consent of the host agency and the federal supervisor.

## Reassignment Requirement 

Changes in field staff assignments are frequently desirable and
sometimes necessary, and field assignees must be available for
relocation as a normal condition of employment. NCIRD expects that field
assignees recognize that program needs, fiscal conditions, employee
development needs, or circumstances beyond administrative control may
occasionally necessitate reassignment to different positions and
different locations. If a reassignment is necessary, the assignee can
make personal preferences concerning desired location known, with the
understanding that POB management reserves the right to make assignments
and reassignment decisions based on the staffing needs of NCIRD.

Field assignees should expect to serve in a number of assignments in
different locations throughout their employment with CDC. Each
assignment provides opportunities for growth, new experiences, and
expanded knowledge about immunization programs and about ways those
programs can be served. As such, field assignees are encouraged to apply
for openings as they become available. Openings for field staff
positions that result from assignment changes or newly created positions
will normally be announced competitively so that interested field staff
have an opportunity for a promotion or lateral move. In exceptional
instances, competition may not be possible, advisable or warranted, and
management may make assignments without competition.

**Host Agency Activities and Interaction with ISD and POB**

Requests for assignment of a field assignee should be sent by letter
from the host agency to the POB Chief. Requests will be considered based
on availability of full-time equivalents (FTEs).

The POB Chief will discuss any federal assignee re-assignments with the
host agency as soon as a re-assignment is being considered.

The POB project officer will provide the host agency with updates on the
recruitment efforts to fill vacant field staff positions.

Host agency supervisors will work closely with assignees to resolve any
routine questions or issues that arise regarding the assignment or the
assignee's performance.

Host agencies will be asked to provide input regarding the field
assignee's performance.

The host agency will promptly advise the POB Branch Chief or Deputy
Branch Chief of any performance or behavioral concerns about an
assignee. In these cases, host agency and POB staff will work together
to attempt to resolve such concerns with the assignee, either informally
or formally, depending upon the nature and degree of the concern. Other
CDC resources may be called upon by the immediate POB supervisor to help
resolve the issues.

If a host agency determines that a field assignee is no longer an asset
to the program, the host agency should send a letter to the POB Chief
requesting removal of the federal field assignee.

The host agency may make available to assignee(s) any training
opportunities sponsored by the State or locality.

Reference documents: *Agreement to Detail, 12/2004; Acknowledgment of
Understanding of Reassignment Requirement*

**Immunization Services Division Organizational Chart**

**National Center for Immunization and Respiratory Diseases**

**Centers for Disease Control and Prevention**

**Atlanta, Georgia 30329**

Lance E. Rodewald, M.D.

Director

Jeanne M. Santoli, M.D, M.P.H.

Deputy Director

Julie L. Smith

Acting, Associate Director for

Management and Operations

Vanda M. Kelly

Associate Director for

Policy, Planning, and Legislation

Abigail M. Shefer, M.D.

Associate Director for Science

Gina Mootrey, D.O., M.P.H.

Associate Director for Adult

Immunization

Immunization

Information Systems

Support Branch

Gary Urquhart

Acting Chief

Deputy: Position Vacant

Health Services Research and

Evaluation Branch

Pascale Wortley, M.D.

Chief

Gary Edgar

Deputy

Program Operations Branch

Nancy Fasano

Chief

Robert Cicatello

Deputy

Vaccine Supply and

Assurance Branch

Gregory Wallace, M.D.

Chief

Sandra Gambescia

Deputy

Education, Information

and Partnership Branch

Kathy Towers-Solis, Ph.D.

Chief

Rick Nelson

Deputy

Assessment Branch

Jim Singleton

Chief

Larry Wilkinson

Deputy

**Immunization Program "Seasons"**

**Winter**

-   Influenza season

-   Pre-booking of influenza vaccine for next influenza season

**Spring**

-   National Immunization Conference (NIC)

-   Annual Report for previous calendar year -- due by end of March

-   Population Estimates Survey for next calendar year -- due in March
    or April

-   Financial Status Report (FSR) for previous calendar year -- due
    March 31

-   School assessment data for current school year -- due April 30

-   CDC contract influenza vaccine orders for next influenza season

**Summer**

-   Initial Vaccine Ordering Forecast Application (VOFA) submission for
    next fiscal year (VOFA software will be used until implementation of
    centralized ordering system)

-   Six-month progress report for current calendar year and continuing
    grant application and budget for next calendar year -- due in August

-   Back-to-school vaccination campaigns

**Fall**

-   National Immunization Survey (NIS) coverage rates published in
    Morbidity and Mortality Week Report (MMWR) for previous calendar
    year

-   Beginning of influenza vaccination season

-   Program Managers' Meeting (sometimes occurs at other times of the
    year)

**Year-round**

-   Grant awards for program operations (distributed in several rounds;
    Round 1 in January)

-   Vaccine target postings to grantees' NIPVAC accounts (posted
    quarterly along federal fiscal year calendar)

-   Vaccine order monitoring

-   Spend plan updates

-   Time-sensitive requests and general information via Immunization
    Grantee Mailbox

-   Association of Immunization Managers (AIM) conference calls

-   Returns of wasted vaccine for refund of federal excise tax

-   CDC technical assistance site visits to grantee immunization
    programs

**How to Interpret the Subject Heading of NCIRD Immunization Grantee
Mailbox\
Email Messages**

Email messages are sent to state and local grantees through the National
Center for Immunization and Respiratory Diseases (NCIRD) Immunization
Grantee Mailbox and distributed from the Program Operations Branch
(POB). A coding system has been developed to ease identification of
message content and response requirements. Each message is prioritized
according to the relevance to program operations and need for response.
The numbering system allows message recipients to refer to messages and
provides a system for archiving. Three levels (1, 2 and 3) are used to
code messages according to program content, response required by
recipient, and urgency of required response. The coding system is as
follows:

**Level** 1

**Program Content**

Programmatic, funding or policy issues containing controversial
information

**Response Required**

Yes, to POB

**Response Time**

5 working days

**Level** 2

**Program Content**

Programmatic, funding or policy issues containing controversial
information

**Response Required**

Yes or No, to POB

**Response Time**

None specified

**Level 3**

**Program Content**

General information, grantee requests to share or collect information,
trade vaccine, etc.

**Response Required**

No (May specify response to point of contact outside POB)

**Response Time**

None specified

(May be listed by point of contact outside POB)

The subject heading includes the message title, response date (if
needed), priority code (Level 1, 2, or 3). Example: Draft Grant
Guidance-Response Date-Level 2

**Key Immunization Websites**

*Note: Links to non-Federal organizations are provided solely as a
service to our users. These links do not constitute an endorsement of
these organizations or their programs by CDC or the Federal Government,
and none should be inferred. The CDC is not responsible for the content
of the individual organization web pages found at these links.*

"One-stop-shopping" site for immunization program managers

<http://www.cdc.gov/nip/home-partners.htm#progmgrs>

Program Managers contact list

<http://www2a.cdc.gov/nip/progmgr/fieldstaff.asp?rpt=pm>

VFC Coordinators contact list

<http://www.cdc.gov/nip/vfc/contacts_vfc_coord.htm>

Perinatal Hepatitis B coordinators contact list

<http://www.cdc.gov/nip/diseases/hepb/hepb_contacts.htm>

CDC immunizations homepage

<http://www.cdc.gov/nip>

Vaccine schedules

<http://www.cdc.gov/nip/recs/child-schedule.htm>

<http://www.cdc.gov/nip/recs/adult-schedule.htm>

Vaccines for Children (VFC) homepage

<http://www.cdc.gov/nip/vfc>

VFC Program Operations Guide\
<http://www.cdc.gov/nip/home-partners.htm#progmgrs>

VFC resolutions

<http://www.cdc.gov/nip/vfc/acip_vfc_resolutions.htm>

Advisory Committee on Immunization Practices (ACIP) recommendations

<http://www.cdc.gov/nip/publications/acip-list.htm>

CDC vaccine price list

<http://www.cdc.gov/nip/vfc/cdc_vac_price_list.htm>

VFC questions and answers document

<http://www.cdc.gov/nip/vfc/st_immz_proj/faqs_main.htm>

Vaccine Management Business Improvement Project (VMBIP)\
<http://www.cdc.gov/nip/vmbip/default.htm>

Vaccine storage and handling toolkit

<http://www2a.cdc.gov/nip/isd/shtoolkit/splash.html>

Users' guide for vaccine contracts

<http://www.cdc.gov/nip/policies/guide-vac-contracts-508.pdf>

Vaccine excise tax credits

<http://www.cdc.gov/nip/vfc/st_immz_proj/forms/excise_tax_credit.htm>

Assessment, Feedback, Incentive, and eXchange (AFIX) homepage

<http://www.cdc.gov/nip/afix/default.htm>

CoCASA homepage

<http://www.cdc.gov/nip/cocasa/>

Procurement and Grants Office (PGO) guidance on preparing a budget
request

<http://www.cdc.gov/od/pgo/funding/budgetguide.htm>

Website for downloading and submitting immunization grant application
and budget request:

[http://www.grants.gov](http://www.grants.gov/)

Manual for the Surveillance of Vaccine-Preventable Diseases

<http://www.cdc.gov/nip/publications/surv-manual/default.htm>

National Immunization Survey (NIS) Tables

<http://www.cdc.gov/nip/coverage/default.htm#NIS>

Influenza

<http://www.cdc.gov/flu>

Human papillomavirus vaccine

<http://www.cdc.gov/std/hpv>

Division of Viral Hepatitis

<http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm>

Framework for Program Evaluation in Public Health

<ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4811.pdf>

Healthy People 2010 Mid-Year Review immunization objectives

<http://www.healthypeople.gov/data/midcourse/comments/facontents.asp?id=14>

National Immunization Program Strategic Plan 2000-2005

<http://www.cdc.gov/nip/webutil/about/strategic-plan.pdf>

Community Guide: Vaccine-preventable disease summary page

<http://www.thecommunityguide.org/vaccine/vpd.pdf>

Core Competencies for Public Health Professionals

<http://www.phf.org/competencies.htm#view>

The Community Tool Box

<http://ctb.ku.edu/>

CDC immunization website for healthcare professionals

<http://www.cdc.gov/nip/home-hcp.htm>

National Network for Immunization Information

[http://www.immunizationinfo.org](http://www.immunizationinfo.org/)

Association of State and Territorial Health Officials (ASTHO) website's
immunization resources

<http://www.astho.org/templates/display_pub.php?pub_id=2344&admin=1>

Vaccine Information Statements

<http://www.cdc.gov/nip/publications/VIS/default.htm>

Red Book Online

[http://aapredbook.aappublications.org](http://aapredbook.aappublications.org/)

Health Insurance Portability and Accountability Act (HIPAA)

[http://www.hipaa.org](http://www.hipaa.org/)

Behavioral Risk Factor Surveillance System (BRFSS)

<http://www.cdc.gov/brfss/index.htm>

Immunization Action Coalition

[http://www.immunize.org](http://www.immunize.org/)

How to subscribe to Immunization Action Coalition (IAC) Express

<http://www.immunize.org/subscribe/>

How to subscribe to Morbidity and Mortality Weekly Report (MMWR)

<http://www.cdc.gov/mmwr/mmwrsubscribe.html>

Centers for Medicare and Medicaid Services (CMS) homepage

<http://www.cms.hhs.gov/default.asp>