Memorandum of Understanding between Secretary of Health and Human Services Mike Leavitt and Governor John Lynch of New Hampshire

Whereas, influenza pandemics have occurred three times in the last century, and history and science suggest that the country and the world could face one or more pandemics in this century; and

Whereas, a pandemic can cause severe illness, death and disruption throughout the country and the world, and outbreaks can occur in many different locations at the same time; and

Whereas, preparation for an influenza pandemic requires coordinated action at all levels of government — federal, state, local, tribal — and all sectors of society, including businesses, schools, faith-based and community organizations, families and individuals; and

Whereas, the federal government has committed to taking a leadership role in creating a prepared Nation by monitoring international and domestic outbreaks, providing funding and technical assistance to foster local and state preparedness, stockpiling and distributing countermeasures, developing new treatments, and coordinating the national response; and

Whereas, the Secretary of the United States Department of Health and Human Services (HHS) has committed to holding pandemic planning summits in all 50 states, assisting states to improve their level of preparedness; and

Whereas, President George W. Bush has asked Congress for emergency spending authority to prepare the United States against the possibility of a pandemic and Congress has provided over $3 billion for that purpose in the Defense Appropriations Act for 2006, including funding for state and local planning purposes; and

Whereas, States and local communities are responsible under their own authorities for responding to an outbreak within their jurisdictions and having comprehensive pandemic preparedness plans and measures in place to protect their citizens; and

Whereas, HHS may provide additional resources for State and local influenza planning and preparedness activities, and require specific preparedness goals from States and localities as a condition of financial assistance, consistent with its authorities and availability of funding; and

Whereas, the State of New Hampshire has developed preparedness plans and conducted a statewide pandemic drill and recognizes plans must be continuously exercised and updated to make sure they work and to achieve a stronger level of preparedness; and

Whereas, pandemic preparedness will help communities deal with any type of medical emergency and will have lasting benefits for the health of our Nation.

HHS and New Hampshire share common goals, and have shared and independent responsibilities for influenza planning and preparedness.

Now Therefore, in recognition of the shared common goals and our shared and independent responsibilities, HHS and New Hampshire agree to the following:

1. HHS will:

Continue to provide substantial guidance and technical assistance to New Hampshire as it prepares to respond to a possible influenza pandemic. HHS will assist the State Department of Health and Human Services in coordinating pandemic response activities at the State, regional and local public health level; financially help support State pandemic planning efforts; communicate and disseminate timely influenza pandemic information and technical guidance to the State and local public health departments; and provide direct support and technical guidance for epidemiological investigations and diagnostic services.

Consistent with its statutory authorities, direction from Congress, and Departmental regulations and policy, and subject to available funding, HHS will provide New Hampshire an initial financial award for the purposes of engaging the State, regional and local health departments in coordinated pandemic planning. HHS will make subsequent financial assistance available, subject to the above conditions and based on New Hampshire achieving specific preparedness goals as jointly agreed to by HHS and New Hampshire in the initial financial award.

Within six months of the date of this Memorandum, HHS will review New Hampshire’s plans for use, storage and distribution of antivirals and notify the State of its portion of the federal stockpile of pandemic influenza antiviral drugs.

2. New Hampshire will:

Augment state and local planning with a State and Local Pandemic Preparedness Summit on May 26, 2006.

Assure that the operational plan for pandemic influenza response is an integral element of the overall state and local emergency response plan that will coordinate effectively with Emergency Support Function 8, Health and Medical Services, of the National Response Plan and the National Incident Management System.

The Governor will continue to meet with and receive regular updates from all the relevant stakeholders, including governmental, public health, healthcare, emergency response, agriculture, education, businesses, communication, communities, faith-based sectors, and subject matter experts.

New Hampshire will continue to work with CDC regarding pandemic influenza antiviral drugs.

New Hampshire will develop a plan to implement key recommendations based on the evaluation of the State’s Bio Response 2005 Exercises, the nation’s first drill to evaluate a multi-faceted, statewide response to a pandemic. New Hampshire will participate in a nationwide pandemic planning exercise to be consistent with updated guidance, subject to available funding and resources, and will test the implementation status of the key recommendations during the nationwide exercise.

Update state pandemic influenza plans based on guidance given in the HHS Pandemic Influenza Plan and the National Strategy for Pandemic Influenza both released in November 2005 and consistent with current guidance.

Achieve specific preparedness goals, targets, and timelines as agreed to by HHS, CDC and New Hampshire in order to receive additional funds referenced in 1.b).

Provide CDC a needs assessment of readiness on the part of New Hampshire to receive a portion of funds referenced in 1.b) immediately.

Dated this 26 day of May, 2006.

/s/ John Lynch /s/ Michael O. Leavitt