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Appendix B Summary of Recommendations I. If CDC intends to use scenarios as a planning tool, the committee recommencis that the scenarios represent a range of possible situations, be user! to help guicle state and local planning activities, and facilitate state and local assessment of their level of preparedness. tT]he committee recommends that a flexible, incremental, science-basect decision- making ant] management structure for smallpox response that includes all levels of government be developer! and communicated to state and local agencies so that the consequences of a smallpox outbreak can be managed effectively. tT]he committee recommencis that CDC consider conclucting the preparedness assessments on a multi-year basis. The committee recommends that CDC acIdress its immediate need of measuring cooperative agreement compliance with a concise and simple set of indicators, and then use this set of indicators as the foundation of a concert cleliberative. .. . .. .. ~ .. ~ , national process to develop measures that actoress the butt range and appropriate balance of preparedness activities. The committee recommencis that federal agencies and CDC, specifically, be helc! accountable for their unique fecleral responsibilities in an emergency response and assessed on their progress in facilitating national public health emergency preparedness. 6. The committee recommends that CDC consoler utilizing the Ten Essential Public Health Services as a framework for the readiness indicators. 1. tT]he committee recommencis that CDC collaborate with HRSA to integrate the preparedness indicators into one document, in order to help the health care and public health communities work hand-in-hancl to plan, implement plans, and evaluate their readiness to respond to threats (inclucling, but not limited to, a smallpox attack) and to avoid requiring cluplicate reporting from states. . ~ . . . . . 31