The Oklahoma Department of Health developed a Push Partner Program in response to Homeland Security Presidential Directive 21, which asked all communities to be prepared to provide prophylaxis to their entire population within 48 hours. The "push" strategy involves distributing medications to partner agencies, which then dispense the medications to their employees, employees' family members, and the agencies' clients. Planning materials included in this practice focus on developing partnerships with community agencies who may act as "push partners." Significant emphasis is placed on ensuring the safety of institutionalized or "sheltered-in" populations (e.g., nursing homes, correctional facilities, psychiatric hospitals). The plan describes target populations; plans for inventory, dispensing, reporting, and deactivation; and medication-specific information. Tools include a dispensing plan template, job action sheets, patient handouts, a sample MOU for community organizations, inventory tools, and a post-incident summary form. An after-action report from a mass immunization exercise provides insight and lessons into how one county brought together diverse partners to test provision of medication at "sheltered-in" sites. One reviewer noted that this program may be one solution to fill the gap in reaching many vulnerable populations that might struggle to access a traditional point-of-dispensing (POD) site. The community-wide program also may have the additional benefit of reducing the number of people at each traditional POD site.