Explore the 2016 Index Data

Drawing data from 59 sources, the NHSPI is the most comprehensive look at states preparedness to date. It is also the first national index that looks at the nation’s health security by collectively measuring the preparedness of the states. States face varying threats, apply preparedness principles in locally relevant ways, and have unique interdependencies. The display of results on the NHSPI website takes into account both preparedness and model complexities.

By Domain By State

Pennsylvania

The overall preparedness level in Pennsylvania stands at 7 for the 2017 Index release. The national average is 6.8.

7
6.8 National average
0 10
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2013
2014
2015
2016
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Select a state profile below
State Domain Scores

Health Security Surveillance

7.6
7.9 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 7.7 - 8.1

Community Planning & Engagement

6.1
5.8 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 5.4 - 6.1

Incident & Information Management

9.4
8.2 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 7.9 - 8.4

Healthcare Delivery

6.3
5.3 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 4.9 - 5.6

Countermeasure Management

7.1
7 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 6.8 - 7.2

Environmental & Occupational Health

4.3
7 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 6.4 - 7.5

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Incident & Information Management

immac: incident management multi agency coordination

epiw: emergency public information warning

la: legal administrative

This is best viewed on desktop.

The ability to establish and maintain a unified and coordinated operational structure with processes that appropriately integrate all critical stakeholders and support the execution of core capabilities and incident objectives. This sub-domain includes the capability to direct and support an event or incident with public health or medical implications by establishing a standardized, scalable management system consistent with the National Incident Management System and coordinating activities above the field level by sharing information, developing strategy and tactics, and managing resources to assist with coordination of operations in the field.

9.7
Measure
Measure Description
Score
m10
Have you utilized a rapid method (e.g., Health Alert Network (HAN) blast e-mail or fax) to send messages to your sentinel clinical laboratories and other partners?
Measure Name

M10

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure does not reflect the frequency with which a rapid method may be used regularly and/or in emergencies or whether this function has been tested by a jurisdiction. It mainly reflects an existing capacity to communicate via a single medium (electronic) and in one direction (outward).

Score

Foundational

m70
Degree to which state has a dispensing prophylaxis plan in place that accounts for all operational elements of a local mass prophylaxis/dispensing plan
Measure Name

M70

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure focuses narrowly on operational coordination topics and does not include other items such as mutual aid and resource planning. The measure is also incident-specific.

Score

100

m71
Degree to which a state has a hospital and alternate care facilities coordination plan in place on how to procure emergency medical material
Measure Name

M71

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure only focuses on procurement of materiel and does not address additional multi-agency coordination facets such as information sharing between the public health and healthcare systems. Additionally, this measure is only a measure of the planning component of such coordination, not the implementation or quality of such a plan.

Score

100

m84
State is Emergency Management Accreditation Program (EMAP)-accredited
Measure Name

M84

Measure Source

Emergency Management Accreditation Program (EMAP), Who Is Accredited?

Data date(s)

2014 - 2016

Limitations

Accreditation is voluntary. Some jurisdictions choose to not seek Emergency Management Accreditation Program (EMAP) accreditation for various state and local reasons. States with conditional accreditation are not considered as accredited for this measure.

Score

1

m333
State has an animal (livestock and pet) disaster preparedness plan
Measure Name

M333

Measure Source

American Veterinary Medical Association (AVMA), Animal Disaster Plans and Resources by State

Data date(s)

2014 - 2016

Limitations

While a "yes" response regarding a state animal disaster preparedness plan indicates a commitment by the state to address the needs and other important considerations for animals during and following an emergency, the source data also captures additional information related to addressing animal needs that represent a commitment beyond a plan. This additional information varies from state to state and is not captured by "yes/no" responses; the information has the potential for a more quantifiable response.

Score

1

m107
Percentage of local health departments with an emergency preparedness coordinator for states with local health departments, excludes Rhode Island and Hawaii
Measure Name

M107

Measure Source

National Association of County and City Health Officials (NACCHO), 2013 National Profile of Local Health Departments

Data date(s)

2013 & 2016

Limitations

The measure is collected less frequently than annually. Additionally, some states do not have local health departments and therefore no local health department emergency management coordinators. Lastly, leadership roles themselves do not determine the quality or robustness of an emergency management system.

Score

100

m222
State health agency participates in the Water Information Sharing and Analysis Center (WaterISAC)
Measure Name

M222

Measure Source

Water Information Sharing and Analysis Center (WaterISAC), State Agencies Participating in WaterISAC

Data date(s)

2013 & 2016

Limitations

The measure itself focuses narrowly on information sharing pertaining to water-related incidents rather than intelligence information overall. The measure has no published target that specifically identifies that a state public health agency should participate. It does not take into account the other government or public/private water systems that participate in this program.

Score

1

m229
In case of an emergency, does your state public health laboratory have a 24/7/365 contact system in place?
Measure Name

M229

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure narrowly focuses on a system only for the state public health laboratory and does not include the quality of the system in place.

Score

Foundational

m150
State participates in Hospital Available Beds for Emergencies and Disasters (HAvBED) Program
Measure Name

M150

Measure Source

Assistant Secretary for Preparedness and Response (ASPR), National Hospital Available Beds for Emergencies and Disasters (HAvBED) System

Data date(s)

2012

Limitations

The measure requires data entry into the secure platform from existing state and local reporting systems used to measure bed counts during emergencies. The measure does not replace the need to evaluate state and local bed count system development and implementation.

Score

Foundational

m334
Does state have a climate change adaptation plan?
Measure Name

M334

Measure Source

Center for Climate and Energy Solutions (C2ES), State and Local Climate Adaptation

Data date(s)

2014 - 2016

Limitations

The measure is an indicator of state planning for climate change; however, it only indicates if a state has a plan. The quality of the plan is not evaluated. The degree to which the plan is being implemented is also not evaluated.

Score

1

m72
Degree to which training, exercise, and evaluation plans are compliant with guidelines set forth by the Homeland Security Exercise and Evaluation Program
Measure Name

M72

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure does not address if adequate preparedness plans are in place. It also does not determine the degree to which response plans are tested and evaluated.

Score

100

m335
State has statewide and/or county animal response team(s)
Measure Name

M335

Measure Source

RedRover, Animal Response Teams

Data date(s)

2013 - 2016

Limitations

While a "yes" response indicates a state's commitment to addressing the issues that arise regarding animals and pets during and following an emergency, the extent to which a team is integrated into the overall state plan and activities is not clearly indicated, nor is the resource commitment toward this team and this issue. There may be some ambiguity when considering this measure. The title implies a yes/no with regard to "a state team," but the source listings include a mix of state, county, and local teams. In a few cases, it appears no state level team is indicated but one or more county teams are listed. A state that has answered "yes" should be interpreted to mean a state has any combination of state, regional, or county/local teams.

Score

1

m701
Average number of minutes for state public health staff with incident management lead roles to report for immediate duty
Measure Name

M701

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

The measure has no apparent limitations.

Score

36

The ability to develop systems and procedures that facilitate the communication of timely, accurate, and accessible information, alerts, warnings, and notifications to the public using a whole-community approach. This sub-domain includes using risk communication methods to support the use of clear, consistent, accessible, and culturally and linguistically appropriate methods to effectively relay information regarding any threat or hazard, the actions taken, and the assistance available.

5.6
Measure
Measure Description
Score
m64
Degree to which a state has a public information and communication plan developed for a mass prophylaxis campaign
Measure Name

M64

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 & 2013

Limitations

The measure only accounts for pre-event planning during a mass dispensing scenario and does not account for planning towards broader emergency scenarios. In addition, the measures does not account for emergent, response-driven public information and risk communication strategies or the implementation of previously developed frameworks.

Score

Foundational

m228
Percentage of households with broadband in the home
Measure Name

M228

Measure Source

American Community Survey (ACS), 1-year estimate (GCT2801) and Current Population Survey (CPS), Computer and Internet Supplement data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The measure itself only focuses on fixed connections and in the health security context therefore relies upon the assumption that during a public health emergency broadband remain operational.

Score

73.5

The capabilities and capacities responsible for assisting in the execution of preparedness and response activities, incident management systems, and decision-making authority. This sub-domain includes: improving efficiencies in daily operations; reducing administrative barriers during response operations; ensuring efficient acquisition of resources, use of emergency funds, and implementation of legal and liability protective measures needed to take action during an incident affecting health security.

5
Measure
Measure Description
Score
m338
State requires facility reporting of healthcare-associated infections to the Centers for Disease Control and Prevention's (CDC's) National Health Safety Network (NHSN) or other systems
Measure Name

M338

Measure Source

Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN), Healthcare - Associated Infections (HAI) Progress Report

Data date(s)

2012 & 2013

Limitations

The measure evaluates whether healthcare facilities are required to report healthcare associated infections to the NHSN. The measure does not evaluate the healthcare facilities' compliance with the reporting requirements.

Score

Foundational

m340
Who must report foodborne illness within the state? Number out of the following reporting source types: clinical laboratories, physicians, hospitals, nurses, physician assistants, and/or other healthcare provides (e.g., chiropractors, veterinarians)
Measure Name

M340

Measure Source

Public Health Law Research (PHLR), Temple University. Robert Wood Johnson Foundation (RWJF), LawAtlas: State Foodborne Illness Reporting Laws Map

Data date(s)

2013

Limitations

The measure is limited to if the state has a specific law that requires foodborne illnesses or related conditions be reported by these providers. The measure does not evaluate the completeness or timeliness of the disease reporting.

Score

6

m341
State law includes a general provision regulating the release of personally identifiable information (PII) held by the health department
Measure Name

M341

Measure Source

Public Health Law Research (PHLR), Temple University. Robert Wood Johnson Foundation (RWJF), LawAtlas: State Foodborne Illness Reporting Laws Map

Data date(s)

2013

Limitations

The measure only assesses whether or not a law is in place. It does not capture the scope of the authorization. It does not measure the infrastructure in place to implement investigation, control, and other response strategies.

Score

Foundational

m342
State law requires communicable diseases to be reported to a health department
Measure Name

M342

Measure Source

Public Health Law Research (PHLR), Temple University. Robert Wood Johnson Foundation (RWJF), LawAtlas: State Foodborne Illness Reporting Laws Map

Data date(s)

2013

Limitations

The measure only evaluates whether a state requires communicable disease reporting to state or local health officials. The measure does not evaluate the timeliness or completeness of the required reporting, nor how effective the state is in monitoring and enforcing the requirements. It does not evaluate the ability of the health department to receive and use the reported information.

Score

Foundational

m344
State has adopted the Nurse Licensure Compact (NLC)
Measure Name

M344

Measure Source

National Council of State Boards of Nursing (NCSBN), Nurse Licensure Compact (NLC) Member States

Data date(s)

2014 - 2016

Limitations

The measure covers only the reduced administrative burden states gain from membership in the Nurse Licensure Compact. It does not measure individual state capacity to incorporate out-of-state nurses into medical surge responses. Additionally, some states may have existing agreements in place, similar to but smaller in scope, than the Nurse Licensure Compact.

Score

Data Missing

m345
State has adopted Emergency Management Assistance Compact (EMAC) legislation
Measure Name

M345

Measure Source

National Emergency Management Association (NEMA), What is EMAC?

Data date(s)

2014

Limitations

All states are signatory to the EMAC; therefore, this score cannot be improved.

Score

Foundational

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Healthcare Delivery

pc: prehospital care

hps: hospital and physician services

ltc: long term care

mbh: mental behavioral healthcare

hc: home care

This is best viewed on desktop.

Prehospital care is generally provided by emergency medical services (EMS) and, includes 911 and dispatch, emergency medical response, field assessment and care, and transport (usually by ambulance or helicopter) to a hospital and between healthcare facilities.

6.8
Measure
Measure Description
Score
m140
Number of emergency medical technicians (EMTs) and paramedics per 100,000 population
Measure Name

M140

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

The measure may not distinguish licensed EMTs and paramedics from those that are licensed, practicing, and affiliated.

Score

108.4

m331
What percentage of the state's local emergency medical services (EMS) agencies submit National EMS Information System (NEMSIS) compliant data to the state?
Measure Name

M331

Measure Source

National Highway Traffic Safety Administration (NHTSA), State NEMIS Progress Reports: State & Territory Version 2 Information

Data date(s)

2014 - 2016

Limitations

Some states may collect local and regional EMS data that provide some of the data in the national data set. These states may have the capability to conduct limited quality improvement and process improvement activities, but will be unable to compare themselves to national data.

Score

90

Hospital and physician services refers to care for a patient who is formally admitted (or “hospitalized”) to an institution for treatment and/or care and stays for a minimum of one night in the hospital or other institution.

5.2
Measure
Measure Description
Score
m147
Median time in minutes from emergency department (ED) arrival to ED departure for admitted ED patients (identifier ED-1)
Measure Name

M147

Measure Source

Centers for Medicare & Medicaid Services (CMS), Timely and Effective Care - State

Data date(s)

2013 - 2016

Limitations

There is unknown information about the nature of treatment between emergency department arrival and discharge.

Score

272

m148
Median admit decision time in minutes to emergency department (ED) departure time for admitted patients (identifier ED-2)
Measure Name

M148

Measure Source

Centers for Medicare & Medicaid Services (CMS), Timely and Effective Care - State

Data date(s)

2013 - 2016

Limitations

The measure describes the pre-event capability to move patients from the emergency department to inpatient care but it does not describe the hospital's capabilities during a mass casualty or other event.

Score

97

m149
Number of staffed beds per 100,000 population
Measure Name

M149

Measure Source

American Hospital Directory (AHD), Inc. American Hospital Directory

Data date(s)

2013 - 2016

Limitations

The measure does not include the total licensed beds for which a healthcare facility maintains a license to operate. The measure also does not consider plans for creating additional beds through hospital surge plans.

Score

284.4

m152
Percentage of a state's population who live within 50 miles of a trauma center (including trauma centers from neighboring states)
Measure Name

M152

Measure Source

American Hospital Association (AHA), AHA Annual Survey of Hospitals data and U.S. Census population data analyzed by PMO personnel.

Data date(s)

2011 - 2013

Limitations

The quality of care provided by the trauma centers is not considered in this measure.

Score

1

m160
Number of physicians and surgeons per 100,000 population
Measure Name

M160

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

This measure may not reflect that healthcare facilities and jurisdictions may have mutual aid plans in place to supplement the number of physicians and surgeons in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to under-count certain types of physicians. Specifically, BLS estimates may differ considerably from the estimates available from state medical licensing boards. These measurement errors in the national BLS data are expected to be relatively consistent across states, and therefore they should not cause significant bias in the Index state and national results.

Score

291.8

m167
Number of active registered nurse (RN) and licensed practical nurse (LPN) licenses per 100,000 population
Measure Name

M167

Measure Source

National Council of State Boards of Nursing (NCSBN), National Nursing Database

Data date(s)

2013 - 2016

Limitations

The measure may underrepresent the number of RNs or LPNs available to surge to provide care during an emergency. States that do not participate in the National Council of State Boards of Nursing include Alaska, Hawaii, and Oklahoma. Louisiana does not report data regarding PNs. Further, mutual aid protocols may exist to bring additional RNs and PNs into the jurisdiction to respond to an emergency requiring medical surge.

Score

2151.5

m168
Percent of population who live within 100 miles of a burn center (includes burn centers in other states)
Measure Name

M168

Measure Source

American Burn Association (ABA) data on Burn Care Facilities analyzed by PMO personnel.

Data date(s)

2014

Limitations

The measure may underrepresent the specialized resources needed for an emergency that requires mass care of burn patients.

Score

1

m296
Percentage of hospital facilities in the state that provide geriatric services (includes general as well as specialized geriatic services, such as psychiatric geriatric services/Alzheimer care)
Measure Name

M296

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

The measure considers geriatric services that are owned or provided by the hospital or by the hospital's health system (i.e., doesn't require a contractual agreement). Hospitals may provide competent care to geriatric patients without having a specialty care program.

Score

0.5

m297
Percentage of hospital facilities in the state that provide palliative care programs (includes both palliative care program and/or palliative care inpatient unit, but excludes pain management program, patient-controlled analgesia, and hospice program)
Measure Name

M297

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

The measure only evaluates whether or not a hospital provides the service. The quality of care and the capacity of the program to provide services during an emergency are not considered.

Score

0.3

m298
Number of airborne infection isolation room (AIIR) beds per 100,000 population (including hospitals with AIIR rooms within 50 miles from neighboring states)
Measure Name

M298

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

There are no obvious limitations to this measure.

Score

30.2

m299
Risk-adjusted 30-day mortality among Medicare beneficiaries hospitalized for heart attack, heart failure, or pneumonia
Measure Name

M299

Measure Source

The Commonwealth Fund, Aiming Higher: Results from a Scorecard on State health System Performance

Data date(s)

2008-11, 2009-12, 2010-13

Limitations

Variations in state populations (e.g., obesity or smoking rates) may have a greater effect on this measure than public health programs, mitigating the measure's use for this purpose.

Score

12.6

m300
Percentage of grade "A" hospitals in a state for Hospital Safety Score
Measure Name

M300

Measure Source

The Leapfrog Group, Hospital Safety Score (HSS)

Data date(s)

2013 - 2016

Limitations

More than 2,600 hospitals received a score. Hospitals excluded from receiving a score include critical access hospitals, specialty hospitals, pediatric hospitals, hospitals in Maryland, territories exempt from public reporting to CMS, and others.

Score

20

m906
The percentage of short-term general and Critical Access hospitals that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare and Medicaid EHR Incentive Programs. Critical Access hospitals are facilities with no more than 25 beds and located in a rural area further than 35 miles from the nearest hospital, and/or are located in a mountainous region.
Measure Name

M906

Measure Source

The Office of the National Coordinator for Health Information Technology, a division of the U.S. Department of Health and Human Services

Data date(s)

2013 - 2015

Limitations

This is a survey estimate.

Score

0.9

m907
The percentage of all office-based medical doctors and doctors of osteopathy that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare and Medicaid EHR Incentive Programs.
Measure Name

M907

Measure Source

The Office of the National Coordinator for Health Information Technology, a division of the U.S. Department of Health and Human Services

Data date(s)

2013 - 2015

Limitations

This is a survey estimate.

Score

0.4

Long-term care refers to a continuum of medical and social services designed to support the needs of people living permanently or for an extended period in a residential setting with chronic health problems that affect their ability to perform everyday activities. This includes skilled nursing facilities, rehabilitation services, etc.

5.9
Measure
Measure Description
Score
m303
State requires that long-term care and nursing home facilities must have a written disaster plan
Measure Name

M303

Measure Source

American College of Emergency Physicians (ACEP), America's Emergency Care Environment, A State-by-State Report Card

Data date(s)

2013

Limitations

The measure does not evaluate the quality or feasibility of the emergency preparedness plan. Simply having a plan is a not enough; it is the quality and detail of the plan and actively planning with the community that provides a deeper context. Also, according to state public health personnel in Vermont, this 2013-2014 data source does not accurately reflect that state's administrative regulations dating to 2000-2001. The ACEP Report indicates that Vermont does not require a written disaster plan for long-term care and nursing home facilities, but in fact this was a requirement when the ACEP Report was published. We have changed Vermont's item measure value for M303 from "0" to "1" according to this feedback.

Score

1

m308
State average reported registered nurse (RN) staffing hours per resident per day
Measure Name

M308

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2014 - 2016

Limitations

The measure is an average that does not include more detail on the range/distribution, thus limiting its descriptive value. Data are collected during a specific two-week period; variations related to season, region, resident acuity, skill mix of other care providers, and other factors are not taken into account.

Score

0.9

m309
State average reported certified nursing assistant (CNA) staffing hours per resident per day
Measure Name

M309

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2014 - 2016

Limitations

The CNA capacity in a state does not guarantee that they are available during a disaster. Those CNAs that are available also need to have disaster-specific education.

Score

2.3

m307
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
Measure Name

M307

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2013 - 2016

Limitations

The additional protection gained and the reduced demand on the healthcare system is of some value but may be marginal in the context of a major disaster. Also, the effectiveness of the vaccine varies as a function of the accuracy in predicting the strains used to make each year's vaccine.

Score

0.9

m310
State average reported licensed practical nurse (LPN) staffing hours per resident per day
Measure Name

M310

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2014 - 2016

Limitations

The measure is an average that does not include more detail on the range/distribution, thus limiting its descriptive value. Data are collected during a specific two-week period; variations related to season, region, resident acuity, skill mix of other care providers, and other factors are not taken into account.

Score

0.8

Mental and behavioral healthcare is the provision and facilitation of access to medical and mental/behavioral health services including: medical treatment, substance abuse treatment, stress management, and medication with the intent to restore and improve the resilience and sustainability of health, mental and behavioral health, and social services networks. It includes access to information regarding available mass care services for at-risk individuals and the entire affected population.

5.9
Measure
Measure Description
Score
m315
Percentage of hospital facilities in the state that provide chaplaincy/pastoral care services
Measure Name

M315

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

Chaplaincy/pastoral care services may not be available in adequate numbers to respond to a surge and services are not solely focused on fatalities.

Score

0.5

m316
Percentage of hospital facilities in the state that provide psychiatric emergency services
Measure Name

M316

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

Respondents to the American Hospital Association (AHA) survey (the source for this measure) may have varying definitions of emergency psychiatric services covering a broad range. In effect, all hospitals that provide emergency medical services provide emergency psychiatric services. At the same time, fewer may have more complete, specialty-staffed, comprehensive psychiatric emergency services. Positive responses to this measure will cover a very wide range of capability. A negative may reflect the complete absence of emergency psychiatric services or the respondent's view that a positive response requires a separate, identifiable, comprehensive service when, in fact, some capacity exists. The measure does not indicate the extent of the hospital's or emergency psychiatric services integration with other disaster preparedness and response efforts (including health). It does not measure the type of services provided such as at hospital, mobile crisis response capacity, telephone-based crisis services, etc. In some cases, this measure may tend to duplicate and/or overlap with another measure that asks about licensing and certification of behavioral health and substance abuse providers.

Score

0.3

m317
Percentage of need met in mental health professional shortage areas in the state
Measure Name

M317

Measure Source

The Henry J. Kaiser Family Foundation, Mental Health Care Health Professional Shortage Areas (HPSA)

Data date(s)

2014 & 2016

Limitations

This measure is based solely on the availability of psychiatrists. While psychiatrists often play an important role in the array of services provided following disasters, the vast majority of behavioral health services following disasters are provided by behavioral health professionals other than psychiatrists (e.g., psychologists, social workers, licensed counselors, pastoral counselors, psychiatric nurses). The extent to which this measure serves as a proxy for shortages in these other professional groups will likely vary across jurisdictions. The measure does not account for the ability of a state to temporarily move mental health resources within the state in times of disasters. For example, many states have established trained and certified crisis teams that can be activated and deployed to disaster zones, thus enabling rapid supplementation of local resources. The measure does not reflect the availability of existing resources (many providers have waiting lists and/or are legally and contractually obligated to serve particular populations and may not be available for alternative service in times of disasters). The measure does not reflect the status of skills and training necessary for optimal performance in disasters.

Score

61.9

m800
Population (% of state total) living in a HRSA-designated Mental Health Professional Shortage Area
Measure Name

M800

Measure Source

U.S. Census Bureau and Health Resources & Services Administration (HRSA) data analyzed by PMO personnel.

Data date(s)

2015 & 2016

Limitations

While this measure has no apparent limitations, it can be difficult to estimate.

Score

0.1

Home care is clinical and nonclinical care that allows a person with special needs to stay in their home. It may also be assumed to include the management of patient care needs for those patients not sick enough to require hospitalization or long-term care, or for whom hospitalization is not deemed to be of benefit. Other examples of home care include, but are not limited to: skilled nursing visits, respiratory care services, provision of durable medical equipment, hospice, and pharmacist services.

6.4
Measure
Measure Description
Score
m291
How often the home health team determined whether the patient received a flu shot for the current flu season as an average percentage of home health episodes of care in the state
Measure Name

M291

Measure Source

Centers for Medicare & Medicaid Services (CMS), Home Health Care-State by State Data

Data date(s)

2013 - 2016

Limitations

How often average percentage of home health episodes of care in the state the home health team determined whether the patient received a flu shot for the current flu season as an average percentage of home health episodes of care in the state is not in itself useful to determine population-level health resiliency.

Score

0.8

m292
How often the home health team began their patients' care in a timely manner as an average percentage of home health episodes of care in the state
Measure Name

M292

Measure Source

Centers for Medicare & Medicaid Services (CMS), Home Health Care-State by State Data

Data date(s)

2014 - 2016

Limitations

The measure is a statewide average and does not indicate the lengths of delays, nor does it identify if this is a regional or statewide problem. These issues limit the usefulness of the measure.

Score

0.9

m293
Number of home health and personal care aides per 1,000 population aged 65 or older
Measure Name

M293

Measure Source

American Community Survey (ACS), 1-year Public Use Microsample (PUMS) data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The number of home health and personal care aides per 1,000 population aged 65 and older gives an indication of the total capacity of home health aides available. However, that information in itself does not describe their availability during a health emergency or the number of providers that have emergency care plans for their clients.

Score

32.4

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Environmental & Occupational Health

fws: food water security

em: environmental monitoring

This is best viewed on desktop.

The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health.

6.4
Measure
Measure Description
Score
m275_dw
Does your laboratory provide or assure testing for the following environmental matrices (Drinking water)?
Measure Name

M275_DW

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_pww
Does your laboratory provide or assure testing for the following environmental matrices (Private well water)?
Measure Name

M275_PWW

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_rec
Does your laboratory provide or assure testing for the following environmental matrices (Recreational water)?
Measure Name

M275_REC

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_sur
Does your laboratory provide or assure testing for the following environmental matrices (Surface water)?
Measure Name

M275_SUR

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_ust
Does your laboratory provide or assure testing for the following environmental matrices (Underground storage tanks)?
Measure Name

M275_UST

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_wst
Does your laboratory provide or assure testing for the following environmental matrices (Waste water)?
Measure Name

M275_WST

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m276
For which of the following organisms or their toxins does your state public health laboratory provide or assure testing for food and or water samples to assist with foodborne disease outbreak investigations: Bacillus cereus, Brucella sp., Campylobacter sp., Clostridium botulinum, Clostridium perfringens, Cryptosporidium sp., Cyclospora cayetanensis, Listeria monocytogenes, norovirus, Salmonella, Shigella, Staphylococcus aureus, STEC non-O157, STEC O157, Vibrio sp., Yersinia enterocolitica. The state's value is equal to the percentage of these tests performed.
Measure Name

M276

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure indicates that the state public health laboratory either has these testing capabilities or assures that the tests can be done by agreement with another laboratory. Agreement laboratories may not be located to facilitate rapid transport and timely testing.

Score

1

m195
Percent of population in the state whose community water systems meet all applicable health-based standards through approaches that include effective treatment and source water protection
Measure Name

M195

Measure Source

Environmental Protection Agency (EPA), Safe Drinking Water Information System Federal (SDWIS/FED) Drinking Water Data

Data date(s)

2013 & 2014

Limitations

The measure does not cover drinking water supplies that are non-public (private) and does not directly provide information on community water supplies that were adversely affected by emergencies or disasters.

Score

1

The systematic collection and continuous or frequent standardized measurement and observation of: environmental specimens (air, water, land/soil, and plants) analyzing the presence of an indicator, exposure, or response (warning and control), including monitoring the environment for vectors of disease to give information about the environment to assess past and current status and predict future trends

0.1
Measure
Measure Description
Score
m202
Does your state public health laboratory provide or assure testing for air?
Measure Name

M202

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure is limited to one environmental matrix and does not specify what kind of testing should be performed. The measure does not address how many of these types of samples could be tested.

Score

Data Missing

m257_aiha
Does the American Industrial Hygiene Association (AIHA) provide certification or accreditation of your state public health laboratory?
Measure Name

M257_AIHA

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure has no apparent limitations.

Score

Data Missing

m257_epa
Does the U.S. Environmental Protection Agency (EPA) provide certification or accreditation of your state public health laboratory?
Measure Name

M257_EPA

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure has no apparent limitations.

Score

Data Missing

m257_nelac
Does the National Environmental Laboratory Accreditation Conference (NELAC) provide certification or accreditation of your state public health laboratory?
Measure Name

M257_NELAC

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure has no apparent limitations.

Score

Data Missing

m197
Does your state public health laboratory provide or assure testing for radiologic agents in environmental samples?
Measure Name

M197

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates if the state public health laboratory has the capability, or assures it through agreement with another laboratory. It does not measure the capacity of the laboratory to process the number of samples that would be required for a response. The measure does not indicate if the agreement laboratory is appropriately located to minimize sample transport time.

Score

Data Missing

m196
Does your state public health laboratory provide or assure testing for environmental samples in the event of suspected chemical terrorism?
Measure Name

M196

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure is based on a response to the Comprehensive Laboratory Services Survey distributed to the 51 state laboratories represented by the Association of Public Health Laboratories (APHL), and the response is subject to the objectivity of the survey responder. The survey question asks if the laboratory provides or assures testing of environmental samples in the event of suspected chemical terrorism, which may or may not include air, food, and/or water.

Score

Foundational

m272
Does your state public health laboratory test for contaminants in environmental samples: asbestos, explosives, gross alpha and gross beta, inorganic compounds (e.g., nitrates), metals, microbial, lead, persistent organic pollutants, pesticides (including organophosphates), pharmaceuticals, radon, or volatile organic compounds? The state's value is equal to the percentage of these tests performed.
Measure Name

M272

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates that a state public health laboratory has the ability to test these contaminants. The measure does not indicate the quality of the testing or the through-put or capacity of the laboratory testing. Because this measure only evaluates state public health laboratories, another laboratory in a state may provide these testing services.

Score

Data Missing

m273
Does your state public health laboratory provide or assure testing for hazardous waste?
Measure Name

M273

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only considers the ability to test for substances, not the overall capacity for timely response and characterization of the release of hazardous waste to the environment.

Score

Data Missing

m274
State participates in the National Plant Diagnostic Network (NPDN)
Measure Name

M274

Measure Source

National Plant Diagnostic Network (NPDN), National Plant Diagnostic website

Data date(s)

2014

Limitations

A "yes" response to this measure indicates that a state is participating in the NPDN. The limitation is that it there is no indication as to what level or how effectively the state is participating (i.e., how many resources has the state committed, or how successful the state is in meeting the goal of quickly detecting and identifying pathogens).

Score

Foundational

m904
Number of Environmental Scientists and Specialists, including Health per 100,000 population
Measure Name

M904

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES), OES 19-2041

Data date(s)

2012 - 2015

Limitations

This is not a measure of quality as environmental and health scientists can have varying levels of training and organizations may not always support sufficient continuing education. The measure does not include agency surge plans that can increase the number of environmental and health scientists available to respond to an event, nor mutual aid plans that can temporarily increase the number of environmental and health scientists.

Score

19.8

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Countermeasure Management

mmmdd: medical materiel management distribution dispensing

cue: countermeasure utilization effectiveness

npi: non pharmaceutical intervention

This is best viewed on desktop.

The ability to acquire, maintain (e.g., cold chain storage or other storage protocol), transport, distribute, and track medical materiel (e.g., pharmaceuticals, gloves, masks, and ventilators) before and during an incident and recover and account for unused medical materiel after an incident. This capability includes managing the research, development, and procurement of medical countermeasures in addition to the management and distribution of medical countermeasures.

8
Measure
Measure Description
Score
m60
Degree to which state has developed a plan including Strategic National Stockpile (SNS) elements
Measure Name

M60

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure only considers the content and adequacy of a written plan and does not evaluate if the state has the resources and ability to implement the plan in a timely and effective manner.

Score

Foundational

m61
Degree to which a state has demonstrated ability to manage the Strategic National Stockpile (SNS), including updated staffing, call-down exercises, Incident Command System (ICS) integration, testing, and notification of volunteers
Measure Name

M61

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure considers a roster and notification protocol for key staff and volunteers needed to implement the state's SNS plan. It does not measure the number of staff or volunteers that would actually be available during an emergency.

Score

100

m62
Level of completeness and utility of state plans and procedures in place for requesting Strategic National Stockpile (SNS) material from local authorities
Measure Name

M62

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure considers the completeness of state plans to distribute SNS assets to local health departments but it does not measure if the state and local health departments have the capacity to implement the plan.

Score

100

m63
Degree to which a state has communications plans in place for Strategic National Stockpile (SNS) usage
Measure Name

M63

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

A limitation of the measure, which is a state-level score reported by the Centers for Disease Control and Prevention (CDC) after conducting technical assistance reviews with states, is that important variations in local readiness across the state may not be readily apparent. Additionally, the measure indicates the degree to which the state has completed a plan, but it does not address the quality of that the plan or whether it has been tested and improved.

Score

83.3

m65
Degree to which a state has completed security planning for coordination of medical countermeasures dispensing, management, and mass prophylaxis
Measure Name

M65

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure indicates the degree to which the state has completed a plan, but it does not address the quality of that the plan or whether it has been tested and improved.

Score

100

m66
Degree to which a state has demonstrated receipt, stage, and store (RSS) plans and procedures developed to coordinate all logistics concerning Strategic National Stockpile (SNS) material
Measure Name

M66

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The bulk of on-the-ground work to receive, stage, store, move, track, and keep secure SNS supplies happens at the local level and depends on people and technology in many different places throughout the state. A limitation of the measure, which is a state-level score reported by the Centers for Disease Control and Prevention (CDC) after conducting technical assistance reviews with states, is that important variations in local readiness across the state may not be readily apparent.

Score

100

m67
Degree to which state is observed to have a controlling inventory procedure in place, including an Inventory Management System (IMS) to track Strategic National Stockpile (SNS) material
Measure Name

M67

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The bulk of on-the-ground work to receive, stage, store, move, track, and keep secure SNS supplies happens at the local level and depends on people and technology in many different places throughout the state. A limitation of the measure, which is a state-level score reported by the Center for Disease Control and Prevention (CDC) after conducting technical assistance reviews with states, is that important variations in local readiness across the state may not be readily apparent.

Score

100

m69
Degree to which state has distribution plans and procedures in place for physical delivery of Strategic National Stockpile (SNS) assets from the receipt, stage, and store (RSS) facility to sites
Measure Name

M69

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The bulk of on-the-ground work to receive, stage, store, move, track, and keep secure SNS supplies happens at the local level and depends on people and technology in many different places throughout the state. Although the measure addresses the state's responsibility to tackle the cross-jurisdictional challenges and barriers, a limitation is that it is a state-level score reported by the Centers for Disease Control and Prevention (CDC) after conducting technical assistance reviews with states and important variations in local readiness across the state may not be readily apparent.

Score

78.6

m161
Number of pharmacists per 100,000 population
Measure Name

M161

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

The measure may underrepresent the number of pharmacists available to respond during an emergency. The measure is a ratio of the number of pharmacists per 100,000 people in the state, not the total number. It does not account for any mutual aid arrangements with neighboring states that could boost the number of pharmacists available for disaster response.

Score

97.2

m270
Percentage of hospital facilities in the state that participate in a group purchasing arrangement
Measure Name

M270

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

There is no single factor that affects shortages of drugs and/or other medical supplies. There are combinations of economic and non-economic factors that create gaps in the supply chain.

Score

0.6

The level to which the community has achieved preparedness for vaccination and immunization and the level to which the community completes a course of countermeasure usage or follows through in the use of an intervention. This also covers the resultant outcome from the appropriate use of the intervention.

5.4
Measure
Measure Description
Score
m24
The average percentage of children ages 19-35 months who have received these individual vaccinations: four or more doses of diphtheria, tetanus, and pertussis vaccine, three or more doses of poliovirus vaccine, one or more doses of any measles-containing vaccine, and three or more doses of Hepatitis B vaccine
Measure Name

M24

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHC), National Immunization Survey (NIS)

Data date(s)

2012 - 2015

Limitations

The measure is for routine vaccine preventable disease in pre-school age children and may not reflect the vaccination rates for a severe emerging disease.

Score

68.3

m32
Senior seasonal flu vaccination rate
Measure Name

M32

Measure Source

Centers for Disease Control and Prevention (CDC), National Immunization Survey (NIS) and the Behavioral Risk Surveillance System (BRFSS), FluVaxView State, Regional, and National Vaccination Report

Data date(s)

2013 - 2016

Limitations

The measure has no apparent limitations.

Score

64.6

m33
Senior pneumococcal vaccination rate
Measure Name

M33

Measure Source

Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System Survey Questionnaire (BRFSS). Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Survey data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The measure has no apparent limitations.

Score

0.7

m34
Pediatric seasonal flu vaccination rate
Measure Name

M34

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHC), National Immunization Survey (NIS)

Data date(s)

2012 - 2016

Limitations

This measure only includes children aged six months to four years old, so coverage of the pediatric population is incomplete. The measure is for routine seasonal influenza and may not reflect the coverage rates for a severe emerging disease.

Score

83.5

m35
Adult seasonal flu vaccination rate
Measure Name

M35

Measure Source

Centers for Disease Control and Prevention (CDC), National Immunization Survey (NIS) and the Behavioral Risk Surveillance System (BRFSS), FluVaxView State, Regional, and National Vaccination Report

Data date(s)

2013 - 2016

Limitations

This measure is for routine seasonal influenza and may not reflect vaccination coverage rates for a severe emerging disease.

Score

41.2

The guidance, recommendations, and resources to address all-hazards to contain the spread of communicable disease, injury, and exposure using community mitigation strategies such as: isolation and quarantine restrictions on movement and travel advisory/warnings; school closure; social distancing; external decontamination; hygiene; precautionary protective behaviors.

2.9
Measure
Measure Description
Score
m530
Percent of employed population with some type of paid time off (PTO) benefit
Measure Name

M530

Measure Source

Current Population Survey (CPS), Annual Social and Economic Supplement (ASEC) data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

This is survey data and can require special skill to estimate and interpret.

Score

0.5

m531
Percent of employed population engaging in some work from home by telecommuting
Measure Name

M531

Measure Source

Current Population Survey (CPS), Work Schedules Supplement data analyzed by PMO personnel.

Data date(s)

2011 - 2013, 2015

Limitations

This is survey data and can require special skill to estimate and interpret.

Score

0.1

m705
Percent of employed (16 and older) who work from home
Measure Name

M705

Measure Source

American Community Survey (ACS), 1-year estimate (Table B08128)

Data date(s)

2012 - 2015

Limitations

This measure might not fully capture the number of individuals who can work at home on a "part-time" basis.

Score

Data Missing

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Community Planning & Engagement

cscc: cross sector community collaboration

arp: children other at risk populations

mvde: management of volunteers during emergencies

scc: social capital cohesion

This is best viewed on desktop.

The coordination necessary to engage community-based organizations and social networks through collaboration among agencies primarily responsible for providing direct health-related services; partners include public health, healthcare, business, education, and emergency management in addition to federal and nonfederal entities necessary to facilitate an effective and efficient return to routine delivery of services.

4.9
Measure
Measure Description
Score
m87
Is the state-level health department accredited by the Public Health Accreditation Board (PHAB)?
Measure Name

M87

Measure Source

Public Health Accreditation Board (PHAB), Health Departments in e-PHAB

Data date(s)

2014 - 2016

Limitations

Accreditation is still in the early stages and the preparedness component is still being refined. Health departments "in process" are not considered as accredited in this measure.

Score

Data Missing

m501
Percent of population served by a comprehensive public health system (scope of services and inter_organizational connectedness)
Measure Name

M501

Measure Source

National Longitudinal Survey of Public Health Systems (NLSPHS), National Association of County and City Health Officials (NACCHO), and Area Resource File (ARF) data analyzed by PMO and affiliated personnel.

Data date(s)

2012, 2014 & 2016

Limitations

This measure is not easily estimated.

Score

0.4

m9031
Percentage of hospitals that participate in Health Care Coalitions supported through the federal Hospital Preparedness Program of the Office of the Assistant Secretary for Preparedness and Response.
Measure Name

M9031

Measure Source

Division of National Healthcare Preparedness Programs in the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services

Data date(s)

2013 - 2016

Limitations

This measures does not provide information about the intensity of cooperation or quality of the coalition.

Score

0.9

m9032
Percentage of emergency medical service agencies that participate in Health Care Coalitions supported through the federal Hospital Preparedness Program of the Office of the Assistant Secretary for Preparedness and Response.
Measure Name

M9032

Measure Source

Division of National Healthcare Preparedness Programs in the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services

Data date(s)

2013 - 2016

Limitations

This measures does not provide information about the intensity of cooperation or quality of the coalition.

Score

0.1

m9033
Percentage of emergency management agencies that participate in Health Care Coalitions supported through the federal Hospital Preparedness Program of the Office of the Assistant Secretary for Preparedness and Response.
Measure Name

M9033

Measure Source

Division of National Healthcare Preparedness Programs in the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services

Data date(s)

2013 - 2016

Limitations

This measures does not provide information about the intensity of cooperation or quality of the coalition.

Score

0.5

m9034
Percentage of local health departments that participate in Health Care Coalitions supported through the federal Hospital Preparedness Program of the Office of the Assistant Secretary for Preparedness and Response.
Measure Name

M9034

Measure Source

Division of National Healthcare Preparedness Programs in the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services

Data date(s)

2013 - 2016

Limitations

This measures does not provide information about the intensity of cooperation or quality of the coalition.

Score

1

Actions to protect individuals specifically recognized as at-risk in the Pandemic and All-Hazards Preparedness Act (i.e., children, senior citizens, and pregnant women), and those who may need additional response assistance including those who have disabilities, live in institutionalized settings, are from diverse cultures, have limited English proficiency (or are non-English-speaking), are transportation disadvantaged, have chronic medical disorders, and have pharmacological dependency; all of whom require additional needs before, during, and after an incident in the functional areas of communication, medical care, maintaining independence, supervision, and transportation.

6.3
Measure
Measure Description
Score
m52
State requires all child care providers to have a plan for children with disabilities and those with access and functional needs
Measure Name

M52

Measure Source

Save the Children, U.S. Report Card on Children in Disasters

Data date(s)

2013 - 2016

Limitations

The measure does not include nonlicensed providers. The measure does not reflect whether the plan has been tested or reviewed in the past two years or whether there are effective partnerships underpinning the plan.

Score

Data Missing

m53
Hazard plan for all K-12 schools
Measure Name

M53

Measure Source

Save the Children, U.S. Report Card on Children in Disasters

Data date(s)

2013 - 2016

Limitations

The measure does not reflect how comprehensively the plan may engage partners or truly indicate a state's ability to manage multiple hazards in a school environment for a more robust response. Also, possession of a state plan does not ensure that it has been used or tested within the past two years. There is a lack of definition around what entails "multiple types of hazards" and which may or may not be appropriate for a state to plan for (accounting for regional differences).

Score

1

m163
Number of pediatricians, general per 100,000 adolescent population
Measure Name

M163

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

The measure does not indicate how healthcare facilities and jurisdictions may have mutual aid plans in place to supplement the number of pediatricians in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to under-count certain types of physicians. Specifically, BLS estimates may differ considerably from the estimates available from state medical licensing boards. These measurement errors in the national BLS data are expected to be relatively consistent across states, and therefore they should not cause significant bias in the Index state and national results.

Score

15.3

m164
Number of obstetricians and gynecologists per 100,000 female population
Measure Name

M164

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

Healthcare facilities and jurisdictions may have mutual aid plans in place to supplement the number of obstetricians and gynecologists in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to under-count certain types of physicians. Specifically, BLS estimates may differ considerably from the estimates available from state medical licensing boards. These measurement errors in the national BLS data are expected to be relatively consistent across states, and therefore they should not cause significant bias in the Index state and national results.

Score

4.1

m170
Proportion of a state's children 19 and younger who reside within 50 miles of a pediatric trauma center (including pediatric trauma centers from neighboring states)
Measure Name

M170

Measure Source

American Hospital Association (AHA), AHA Annual Survey of Hospitals data and U.S. Census population data analyzed by PMO personnel.

Data date(s)

2011 - 2013

Limitations

The measure reflects a population-adjusted number of pediatric trauma centers, but it does not indicate the number of available pediatric trauma beds or inpatient treatment beds for the care of pediatric patients.

Score

0.9

m50
State requires that all childcare providers have a family-child reunification plan
Measure Name

M50

Measure Source

Save the Children, U.S. Report Card on Children in Disasters

Data date(s)

2013 - 2016

Limitations

There is a mix of templates/guidelines aimed at childcare centers/facility types and a variety of public website information intended for families. The target audience is not consistent and providing general information does not constitute having a family reunification plan in place.

Score

1

m51
State requires that all childcare providers have a plan for evacuating and safely moving children to an alternate site
Measure Name

M51

Measure Source

Save the Children, U.S. Report Card on Children in Disasters

Data date(s)

2013 - 2016

Limitations

There is a mix of templates/guidelines aimed at childcare centers/facility types and a variety of public website information aimed at families. The target audience is not consistent and providing general information is not necessarily an indicator that the childcare facility preparedness plans have identified an adequate alternate site in the event of an emergency evacuation.

Score

1

The ability to coordinate the identification, recruitment, registration, credential verification, training, and engagement of healthcare, medical, and support staff volunteers to support the jurisdiction’s response to incidents of health significance

3.6
Measure
Measure Description
Score
m36
State participates in Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) Program and has a state volunteer registry
Measure Name

M36

Measure Source

Assistant Secretary for Preparedness and Response (ASPR), The Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP)

Data date(s)

2014

Limitations

The measure reflects whether a mechanism for a state volunteer registry exists, but not whether it has been managed well (e.g., kept current), leveraged effectively, or used at all during exercises or responses. The measure also may or may not accurately reflect a state's capacity for volunteer surge during emergencies.

Score

Foundational

m266
Percent of a state's population who live in a county with a Community Emergency Response Teams (CERT)
Measure Name

M266

Measure Source

Federal Emergency Management Agency (FEMA), Citizen Corps Community Emergency Response Teams (CERT), and U.S. Census data analyzed by PMO personnel.

Data date(s)

2012 - 2014

Limitations

The success of volunteer efforts like Citizen Corps depends on strong leadership, support from local and governmental entities and agencies, and the engagement of multiple sectors. As such, the activity levels, outreach, breadth of training, and access to financial support for Citizen Corps efforts and councils will vary from location to location.

Score

0.5

m346
Medical Reserve Corps members per 100,000
Measure Name

M346

Measure Source

Medical Reserve Corps (MRC), MRC Units Database and Census Bureau data analyzed by PMO personnel.

Data date(s)

2012 - 2014, 2016

Limitations

The MRC is not the only source of health and medical volunteers. Many states have alternate systems of registering, credentialing, and managing health and medical volunteers, including ESAR-VHP (Emergency System for the Advance Registration of Volunteer Health Professionals), and/or have other local, regional, or state-sponsored health and medical teams of volunteers not registered as MRCs. There may also be overlap or integration of these systems (e.g., MRC volunteers registered through ESAR-VHP systems). The measure may over-represent the number of active MRC volunteers and credentials. MRC units vary with regard to how current their registries of volunteers are, how many trainings or exercises volunteers have participated in, and how frequently credentials/licenses are verified.

Score

39.1

m176
Proportion of Medical Reserve Corps members who are physicians
Measure Name

M176

Measure Source

Medical Reserve Corps (MRC), MRC Units Database and Census Bureau data analyzed by PMO personnel.

Data date(s)

2015 - 2016

Limitations

The measure may over-represent the number of active MRC volunteer physicians and credentials. MRC units vary with regard to how current their registries of volunteers are, how many trainings or exercises volunteers have participate in, and how frequently credentials/licenses are verified.

Score

0.1

m179
Percentage of Medical Reserve Corps volunteers who are nurses or advanced practice nurses
Measure Name

M179

Measure Source

Medical Reserve Corps (MRC), MRC Units Database and Census Bureau data analyzed by PMO personnel.

Data date(s)

2015 - 2016

Limitations

The measure may over-represent the number of active MRC nurses and their credentials. MRC units vary with regard to how current their registries of volunteers are, how many trainings or exercises their volunteers have participated in, and how frequently they verify volunteers' credentials/licenses.

Score

0.3

m186
Percentage of Medical Reserve Corps volunteers who are other health professionals
Measure Name

M186

Measure Source

Medical Reserve Corps (MRC), MRC Units Database and Census Bureau data analyzed by PMO personnel.

Data date(s)

2015 - 2016

Limitations

The measure may over-represent the number of active MRC volunteers and their credentials. MRC units vary with regard to how current their registries of volunteers are, how many trainings or exercises their volunteers have participated in, and how frequently they verify volunteers' credentials/licenses.

Score

0.5

The community social capital that helps society function effectively, including social networks between individuals, neighbors, organizations, and governments, and the degree of connection and sense of “belongingness” among residents.

5
Measure
Measure Description
Score
m172
Percentage of residents doing favors for neighbors
Measure Name

M172

Measure Source

Current Population Survey (CPS), Civic Engagement Supplement data analyzed by PMO personnel.

Data date(s)

2011 & 2013

Limitations

The measure is self-reported and may be subject to reporting bias; respondents may feel compelled to appear more connected to neighbors than they actually are.

Score

0.7

m175
Voting-eligible population highest office turnout rate
Measure Name

M175

Measure Source

United States Election Project, General Election Turnout Rates

Data date(s)

2012, 2014 & 2016

Limitations

No noted limitations. The measure has been used repeatedly in multiple areas to assess social cohesion and, specifically, civic engagement.

Score

0.6

m188
Annual adult volunteer rate
Measure Name

M188

Measure Source

Current Population Survey (CPS), Volunteer Supplement data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The measure may be subject to reporting bias; respondents may be inclined to over-report their rates of volunteerism. In addition, the measure doesn't reflect how often residents volunteer. The sustainability or regularity with which a person (or community) volunteers may translate into a stronger, more resilient community during and following a disaster.

Score

0.3

m189
Average volunteer hours per resident per year (15 years old and older)
Measure Name

M189

Measure Source

Current Population Survey (CPS), Volunteer Supplement data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The measure may be subject to reporting bias; respondents may be inclined to over-report the number of hours they perform volunteer work. Therefore, the benefits that extend to the rest of a community may not be accurate. In addition, this average may reflect lower numbers in certain communities that actually do have strong social cohesion, such as settings where both parents work full-time and may not have time to volunteer.

Score

28.5

Close Window

Health Security Surveillance

phsei: health surveillance epidemiological investigation

bmlt: biological monitoring laboratory testing

This is best viewed on desktop.

The creation, maintenance, support, and strengthening of passive and active surveillance to: identify, discover, locate, and monitor threats, disease agents, incidents, and outbreaks provide relevant information to stakeholders monitoring/investigating adverse events related to medical countermeasures. The sub-domain includes the ability to successfully expand these systems and processes in response to incidents of health significance.

5.1
Measure
Measure Description
Score
m17
State participates in the Behavioral Risk Factor Surveillance System (BRFSS)
Measure Name

M17

Measure Source

Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System Survey Questionnaire (BRFSS). Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Survey data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The BRFSS has significant challenges related to acquiring data on a local scale. Not all states participate in the BRFSS at the same level.

Score

Foundational

m18
Number of epidemiologists per 100,000 population
Measure Name

M18

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

This is not a measure of quality as epidemiologists can have varying levels of training and organizations may not always support sufficient continuing education. The measure does not include agency surge plans that can increase the number of epidemiologists available to respond to an event, nor mutual aid plans that can temporarily increase the number of epidemiologists.

Score

1.2

m19
State participates in the Epidemic Information Exchange (Epi-X) System
Measure Name

M19

Measure Source

Centers for Disease Control and Prevention (CDC), The Epidemic Information Exchange (Epi-X) Program

Data date(s)

2013

Limitations

Participation in the system is inferred from membership of staff and managers in a state, but it may not represent the actual level of attention the organization gives to alerts from the system.

Score

Foundational

m20
State participates in National Electronic Disease Surveillance System (NEDSS)
Measure Name

M20

Measure Source

Centers for Disease Control and Prevention (CDC), Division of Health Informatics and Surveillance (DHIS), National Electronic Disease Surveillance System (NEDSS)

Data date(s)

2013 - 2015

Limitations

The measure only considers a state's participation in the National Electronic Disease Surveillance System (NEDSS). The measure does not consider the quality of a state's disease surveillance system.

Score

Foundational

m22
State health department has an electronic syndromic surveillance system that can report and exchange information
Measure Name

M22

Measure Source

Association of State and Territorial Health Officials (ASTHO), ASTHO Profile of State Public Health: Volume Three

Data date(s)

2012

Limitations

Syndromic surveillance systems are an important tool for the early detection of potential disease outbreaks and other events. They rely on traditional disease surveillance and environmental monitoring systems to confirm events.

Score

1

m217
Has your state public health laboratory implemented the Laboratory Information Management System (LIMS) capability to electronically receive and report laboratory information (e.g., electronic test order and report with hospitals and clinical labs, surveillance data from public health laboratory to epidemiology)?
Measure Name

M217

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

Since the introduction of LIMS, newer technologies and standards have been introduced to laboratories, including policies requiring uptake of electronic laboratory reporting (ELR).

Score

Data Missing

m220
Does your state have any legal requirement for nongovernmental (e.g., clinical, hospital-based) laboratories within your state to send clinical isolates or specimens associated with reportable foodborne diseases to the state public health laboratory?
Measure Name

M220

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure does not collect data on what diseases are reportable. States also have requirements to submit the isolates of reportable diseases to public health laboratories.

Score

1

m256
Does your state public health laboratory participate in either of the following federal surveillance programs [Foodborne Diseases Active Surveillance Network (FoodNet) or National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet)]?
Measure Name

M256

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

Participation is a "yes" or "no" determination, though from state to state the scope and quality of participation can vary significantly.

Score

Foundational

m23
Proportion of foodborne illness outbreaks reported to Centers for Disease Control and Prevention (CDC) for which an etiologic agent is confirmed
Measure Name

M23

Measure Source

Centers for Disease Control and Prevention (CDC), Foodborne Online Outbreak Database (FOOD)

Data date(s)

2012 - 2015

Limitations

Certain states identify and report foodborne illness outbreaks more frequently than other states. This may increase the denominator and lower the state's percentage, creating a misleading view of the state's foodborne disease investigation program.

Score

0.5

m289
State health department participates in a broad prevention collaborative addressing HAIs (healthcare-associated infections)
Measure Name

M289

Measure Source

Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN), Prevention Status Reports

Data date(s)

2013

Limitations

The measure indicates that the state health department is a participant in the prevention collaborative, but the measure does not describe the state's rates of various types of healthcare-associated infections or if the rates are in decline as a result of the prevention collaborative. The measure does not indicate the percentage of state hospitals participating in the prevention collaborative.

Score

Foundational

m290
State has a public health veterinarian
Measure Name

M290

Measure Source

National Association of State Public Health Veterinarians (NASPHV), Designated and Acting State Public Health Veterinarians

Data date(s)

2014 & 2015, 2017

Limitations

A "yes" response indicates that this expert resource is present at the state level, but only implies that the state public health veterinarian is integrated into an animal response plan or is working in coordination with other animal-related resources such as a board of animal health or the state animal response team. The data source provides a list of contact information for each state's public health veterinarian, but no job description details or related material. Also, this source list is maintained for helping direct and develop uniform public health procedures involving zoonotic disease in the U.S. and its territories, so planning for animals in an emergency in the context of the Health Security Surveillance domain may only be a secondary consideration.

Score

1

m265
State uses an Electronic Death Registration System (EDRS)
Measure Name

M265

Measure Source

National Association for Public Health Statistics and Information Systems (NAPHSIS), Electronic Death Registration Systems by Jurisdiction (State)

Data date(s)

2014 - 2016

Limitations

The measure does not account for the quality of the death registration system, nor the timeliness with which deaths can be recorded. It also does not capture any redundant systems that might need to be used in place of the EDRS for certain scenarios such as cyber-attack and power outages.

Score

Data Missing

m801
In which of the following federal surveillance programs does your state public health laboratory participate? [Influenza Centers for Disease Control and Prevention (CDC)/World Health Organization (WHO) Surveillance Network]
Measure Name

M801

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

Participation is a "yes" or "no" determination, though from state to state the scope and quality of participation can vary significantly.

Score

Foundational

The ability of agencies to conduct rapid and accurate laboratory tests to identify biological, chemical, and radiological agents to address actual or potential exposure to all hazards, focusing on testing human and animal clinical specimens. Support functions include discovery through: active and passive surveillance (both pre- and post-event), characterization, confirmatory testing data, reporting investigative support, ongoing situational awareness. Laboratory quality systems are maintained through external quality assurance and proficiency testing.

7.4
Measure
Measure Description
Score
m1
Ability of Public Health Emergency Preparedness (PHEP) Cooperative Agreement-funded Laboratory Response Network chemical (LRN-C) laboratories to collect, package, and ship samples properly during an LRN-C exercise
Measure Name

M1

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2013

Limitations

In the exercise, all of the samples are simulated and real-life confounding issues like mislabeled specimens or specimens arriving at the laboratory at different times are not included. The current exercise is at best a demonstration of capability although it may not mimic real-life conditions.

Score

Foundational

m1314
Has your chemical terrorism/threat (CT) laboratory OR radiological terrorism/threat (RT) laboratory been certified or accredited by College of American Pathologists (CAP) or Clinical Laboratory Improvement Amendments (CLIA)? (1=Yes, 0=No)
Measure Name

M1314

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

Certification can be difficult because there are only simulated samples - at least for chemical agents.

Score

Data Missing

m208
Does your state public health laboratory have a USDA/APHIS (U.S. Department of Agriculture/Animal and Plant Health Inspection Service) permit for the importation and transportation of controlled materials, organisms, and vectors?
Measure Name

M208

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure looks at a point in time. The permit must be renewed every year. Specific language is required on the permit; laboratories may not have entered all of the right information.

Score

1

m8
Does your state public health laboratory (PHL) have enough staffing capacity to work five 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as novel influenza A (H1N1)? Or, does your PHL have a plan to handle a significant surge in testing over a six to eight week period in response to an outbreak or other public health event?
Measure Name

M8

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure specifically concerns how a laboratory must surge, or ramp up, their workforce in order to meet the testing demand of an infectious disease outbreak. Laboratories may have different ways of managing surge capacity.

Score

1

m9
Does your state public health laboratory have a documented continuity of operations plan (COOP) consistent with National Incident Management System (NIMS) guidelines?
Measure Name

M9

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure does not determine if the COOP is laboratory-specific or part of an agency plan. The measure does not evaluate the quality or comprehensiveness of the COOP.

Score

1

m11
Does your state public health laboratory have a plan in place to receive samples from a sentinel clinical laboratory during nonbusiness hours?
Measure Name

M11

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure may reflect that a laboratory has a plan in place, but does not reflect the frequency with which this plan may be used or tested. The ability to receive samples is only one step among many that result in rapid, accurate testing, which helps inform policy decisions in a response.

Score

Data Missing

m12
Does your state public health laboratory currently have the capacity in place to assure the timely transportation (pick-up and delivery) of samples 24/7/365 days to the appropriate public health Laboratory Response Network (LRN) reference laboratory?
Measure Name

M12

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure does not evaluate the time between pick-up and delivery. The measure does not look at the percentage of sentinel labs (i.e., hospital-based labs that have direct contact with patients) that are covered by the transport system.

Score

1

m211
Does your state public health laboratory provide or assure the following laboratory tests? [arbovirus serology, hepatitis C serology, Legionella serology, measles serology, mumps serology, Neisseria meningitides serotyping, Plasmodium identification, Salmonella serotyping, Shigella serotyping, Varicella serology] The state's value is equal to the percentage of these tests performed.
Measure Name

M211

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

Laboratories will use a variety of methods to provide this testing, and it is not standard across all PHLs. Laboratories may have a difficult time answering the question, depending on how it is asked.

Score

0.9

m216
Does your state public health laboratory provide or assure the following laboratory tests? [antimicrobial susceptibility testing confirmation for vancomycin resistant Staphylococcus aureus, Anaplasmosis (Anaplasma phagocytophilum), Babesiosis (Babesia sp.), botulinum toxin - mouse toxicity assay, Dengue Fever, Hantavirus serology, identification of unusual bacterial isolates, identification of fungal isolates, identification of parasites, Klebsiella pneumoniae Carbapenemase (blaKPC) by PCR, Legionella by culture or PCR, malaria by PCR, norovirus by PCR, Powassan virus, rabies] The state's value is equal to the percentage of these tests performed.
Measure Name

M216

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

Laboratories will use a variety of methods to provide this testing; it is not standard across all PHLs. Laboratories may have a difficult time answering the question, depending on how it is asked.

Score

1

m2
Proportion of Laboratory Response Network biological (LRN-B) laboratory proficiency tests successfully passed by Public Health Emergency Preparedness (PHEP) Cooperative Agreement-funded laboratories
Measure Name

M2

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

Proficiency tests are at best a test of a laboratory's capability. Proficiency tests are administered only a few times annually. Laboratories will lack proficiency tests for several years for many of the assays they are capable of performing.

Score

1

m3
Percentage of pulsed field gel electrophoresis (PFGE) subtyping data results for E. coli submitted to the PulseNet (PN) national database within four working days of receiving isolate at the PFGE laboratory
Measure Name

M3

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

The measure is limited to time to perform PFGE and upload data. The measure does not look at transport time or identification time. The measure is limited to foodborne agents that have PFGE subtyping.

Score

93

m5
Proportion of agents correctly identified and quantified from unknown samples during unannounced proficiency testing during the Laboratory Response Network (LRN) Emergency Response Pop Proficiency Test (PopPT) Exercise
Measure Name

M5

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2013-2016

Limitations

A proficiency test is at best a demonstration of capability. The current proficiency testing does not measure the public health laboratory's ability to process a large number of samples.

Score

1

m7
Number of additional chemical agent detection methods demonstrated by Laboratory Response Network chemical (LRN-C) Level 1/Level 2 laboratories
Measure Name

M7

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

The measure is only looking at additional methods and not all methods the laboratory is capable of testing. Proficiency testing is the best demonstration of capability.

Score

2

m286
Total number of chemical threat and multi-hazards preparedness exercises or drills your state public health laboratory conducted or participated in annually
Measure Name

M286

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure includes all tabletop exercises, drills, functional exercises, and full-scale exercises for both chemical threats and multi-hazards (e.g., any combo of biological, chemical, and radiological threats).

Score

2

m287
Percentage of pulsed field gel electrophoresis (PFGE) sub-typing data results for Listeria monocytogenes submitted to the PulseNet (PN) national database within four working days of receiving isolate at the PFGE laboratory
Measure Name

M287

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

The measure only evaluates the timeliness of identification and reporting of Listeria moncytogenies. The measure does not indicate how many samples are being processed per year, nor does it evaluate the quality of the PFGE results being submitted.

Score

Data Missing

m288
Number of core methods (agents) demonstrated by Laboratory Response Network chemical (LRN-C) Level 1/Level 2 laboratories
Measure Name

M288

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

The measure focuses on standard laboratory procedures and fundamental tasks that are critical to the accurate identification of chemical agents. Standards set under the Clinical Laboratory Improvement Amendments (CLIA) and the College of American Pathologists (CAP) accreditation program are critical components, as is success in achieving proficiency annually in the methods necessary to meet these capabilities.

Score

9

m911
Does your state public health laboratory provide or assure testing for soil?
Measure Name

M911

Measure Source

Association of Public Health Laboratories (APHL). Comprehensive Laboratory Services Survey (CLSS). 2012 & 2014. Additional details about this measure are available from the source. Data have been compiled by APHL biennially since 2004. The CLSS covers the 50 states, the District of Columbia, and Puerto Rico. State-level data are not available to the public but can be accessed by public health laboratory directors, among others. Data were obtained directly from the source.

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test soil in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m902
An indication of whether the state has a Level 1 or Level 2 LRN-C Laboratory
Measure Name

M902

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Environmental Health (NCEH), Division of Laboratory Sciences (DLS), Emergency Response Branch (ERB)

Data date(s)

2016

Limitations

This measure notes the presence of a particular type of lab and nothing specific about its performance.

Score

1

Close Window

Incident & Information Management

immac: incident management multi agency coordination

epiw: emergency public information warning

la: legal administrative

This is best viewed on desktop.

The ability to establish and maintain a unified and coordinated operational structure with processes that appropriately integrate all critical stakeholders and support the execution of core capabilities and incident objectives. This sub-domain includes the capability to direct and support an event or incident with public health or medical implications by establishing a standardized, scalable management system consistent with the National Incident Management System and coordinating activities above the field level by sharing information, developing strategy and tactics, and managing resources to assist with coordination of operations in the field.

9.6
Measure
Measure Description
Score
m10
Have you utilized a rapid method (e.g., Health Alert Network (HAN) blast e-mail or fax) to send messages to your sentinel clinical laboratories and other partners?
Measure Name

M10

Measure Source

Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey

Data date(s)

2013 - 2016

Limitations

The measure does not reflect the frequency with which a rapid method may be used regularly and/or in emergencies or whether this function has been tested by a jurisdiction. It mainly reflects an existing capacity to communicate via a single medium (electronic) and in one direction (outward).

Score

Foundational

m70
Degree to which state has a dispensing prophylaxis plan in place that accounts for all operational elements of a local mass prophylaxis/dispensing plan
Measure Name

M70

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure focuses narrowly on operational coordination topics and does not include other items such as mutual aid and resource planning. The measure is also incident-specific.

Score

100

m71
Degree to which a state has a hospital and alternate care facilities coordination plan in place on how to procure emergency medical material
Measure Name

M71

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure only focuses on procurement of materiel and does not address additional multi-agency coordination facets such as information sharing between the public health and healthcare systems. Additionally, this measure is only a measure of the planning component of such coordination, not the implementation or quality of such a plan.

Score

100

m84
State is Emergency Management Accreditation Program (EMAP)-accredited
Measure Name

M84

Measure Source

Emergency Management Accreditation Program (EMAP), Who Is Accredited?

Data date(s)

2014 - 2016

Limitations

Accreditation is voluntary. Some jurisdictions choose to not seek Emergency Management Accreditation Program (EMAP) accreditation for various state and local reasons. States with conditional accreditation are not considered as accredited for this measure.

Score

1

m333
State has an animal (livestock and pet) disaster preparedness plan
Measure Name

M333

Measure Source

American Veterinary Medical Association (AVMA), Animal Disaster Plans and Resources by State

Data date(s)

2014 - 2016

Limitations

While a "yes" response regarding a state animal disaster preparedness plan indicates a commitment by the state to address the needs and other important considerations for animals during and following an emergency, the source data also captures additional information related to addressing animal needs that represent a commitment beyond a plan. This additional information varies from state to state and is not captured by "yes/no" responses; the information has the potential for a more quantifiable response.

Score

1

m107
Percentage of local health departments with an emergency preparedness coordinator for states with local health departments, excludes Rhode Island and Hawaii
Measure Name

M107

Measure Source

National Association of County and City Health Officials (NACCHO), 2013 National Profile of Local Health Departments

Data date(s)

2013 & 2016

Limitations

The measure is collected less frequently than annually. Additionally, some states do not have local health departments and therefore no local health department emergency management coordinators. Lastly, leadership roles themselves do not determine the quality or robustness of an emergency management system.

Score

100

m222
State health agency participates in the Water Information Sharing and Analysis Center (WaterISAC)
Measure Name

M222

Measure Source

Water Information Sharing and Analysis Center (WaterISAC), State Agencies Participating in WaterISAC

Data date(s)

2013 & 2016

Limitations

The measure itself focuses narrowly on information sharing pertaining to water-related incidents rather than intelligence information overall. The measure has no published target that specifically identifies that a state public health agency should participate. It does not take into account the other government or public/private water systems that participate in this program.

Score

1

m229
In case of an emergency, does your state public health laboratory have a 24/7/365 contact system in place?
Measure Name

M229

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure narrowly focuses on a system only for the state public health laboratory and does not include the quality of the system in place.

Score

Foundational

m150
State participates in Hospital Available Beds for Emergencies and Disasters (HAvBED) Program
Measure Name

M150

Measure Source

Assistant Secretary for Preparedness and Response (ASPR), National Hospital Available Beds for Emergencies and Disasters (HAvBED) System

Data date(s)

2012

Limitations

The measure requires data entry into the secure platform from existing state and local reporting systems used to measure bed counts during emergencies. The measure does not replace the need to evaluate state and local bed count system development and implementation.

Score

Foundational

m334
Does state have a climate change adaptation plan?
Measure Name

M334

Measure Source

Center for Climate and Energy Solutions (C2ES), State and Local Climate Adaptation

Data date(s)

2014 - 2016

Limitations

The measure is an indicator of state planning for climate change; however, it only indicates if a state has a plan. The quality of the plan is not evaluated. The degree to which the plan is being implemented is also not evaluated.

Score

1

m72
Degree to which training, exercise, and evaluation plans are compliant with guidelines set forth by the Homeland Security Exercise and Evaluation Program
Measure Name

M72

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 - 2014

Limitations

The measure does not address if adequate preparedness plans are in place. It also does not determine the degree to which response plans are tested and evaluated.

Score

100

m335
State has statewide and/or county animal response team(s)
Measure Name

M335

Measure Source

RedRover, Animal Response Teams

Data date(s)

2013 - 2016

Limitations

While a "yes" response indicates a state's commitment to addressing the issues that arise regarding animals and pets during and following an emergency, the extent to which a team is integrated into the overall state plan and activities is not clearly indicated, nor is the resource commitment toward this team and this issue. There may be some ambiguity when considering this measure. The title implies a yes/no with regard to "a state team," but the source listings include a mix of state, county, and local teams. In a few cases, it appears no state level team is indicated but one or more county teams are listed. A state that has answered "yes" should be interpreted to mean a state has any combination of state, regional, or county/local teams.

Score

1

m701
Average number of minutes for state public health staff with incident management lead roles to report for immediate duty
Measure Name

M701

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness

Data date(s)

2011 - 2014

Limitations

The measure has no apparent limitations.

Score

36

The ability to develop systems and procedures that facilitate the communication of timely, accurate, and accessible information, alerts, warnings, and notifications to the public using a whole-community approach. This sub-domain includes using risk communication methods to support the use of clear, consistent, accessible, and culturally and linguistically appropriate methods to effectively relay information regarding any threat or hazard, the actions taken, and the assistance available.

5.3
Measure
Measure Description
Score
m64
Degree to which a state has a public information and communication plan developed for a mass prophylaxis campaign
Measure Name

M64

Measure Source

Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), Division of State and Local Readiness (DSLR)

Data date(s)

2012 & 2013

Limitations

The measure only accounts for pre-event planning during a mass dispensing scenario and does not account for planning towards broader emergency scenarios. In addition, the measures does not account for emergent, response-driven public information and risk communication strategies or the implementation of previously developed frameworks.

Score

Foundational

m228
Percentage of households with broadband in the home
Measure Name

M228

Measure Source

American Community Survey (ACS), 1-year estimate (GCT2801) and Current Population Survey (CPS), Computer and Internet Supplement data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The measure itself only focuses on fixed connections and in the health security context therefore relies upon the assumption that during a public health emergency broadband remain operational.

Score

73.5

The capabilities and capacities responsible for assisting in the execution of preparedness and response activities, incident management systems, and decision-making authority. This sub-domain includes: improving efficiencies in daily operations; reducing administrative barriers during response operations; ensuring efficient acquisition of resources, use of emergency funds, and implementation of legal and liability protective measures needed to take action during an incident affecting health security.

5
Measure
Measure Description
Score
m338
State requires facility reporting of healthcare-associated infections to the Centers for Disease Control and Prevention's (CDC's) National Health Safety Network (NHSN) or other systems
Measure Name

M338

Measure Source

Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN), Healthcare - Associated Infections (HAI) Progress Report

Data date(s)

2012 & 2013

Limitations

The measure evaluates whether healthcare facilities are required to report healthcare associated infections to the NHSN. The measure does not evaluate the healthcare facilities' compliance with the reporting requirements.

Score

Foundational

m340
Who must report foodborne illness within the state? Number out of the following reporting source types: clinical laboratories, physicians, hospitals, nurses, physician assistants, and/or other healthcare provides (e.g., chiropractors, veterinarians)
Measure Name

M340

Measure Source

Public Health Law Research (PHLR), Temple University. Robert Wood Johnson Foundation (RWJF), LawAtlas: State Foodborne Illness Reporting Laws Map

Data date(s)

2013

Limitations

The measure is limited to if the state has a specific law that requires foodborne illnesses or related conditions be reported by these providers. The measure does not evaluate the completeness or timeliness of the disease reporting.

Score

6

m341
State law includes a general provision regulating the release of personally identifiable information (PII) held by the health department
Measure Name

M341

Measure Source

Public Health Law Research (PHLR), Temple University. Robert Wood Johnson Foundation (RWJF), LawAtlas: State Foodborne Illness Reporting Laws Map

Data date(s)

2013

Limitations

The measure only assesses whether or not a law is in place. It does not capture the scope of the authorization. It does not measure the infrastructure in place to implement investigation, control, and other response strategies.

Score

Foundational

m342
State law requires communicable diseases to be reported to a health department
Measure Name

M342

Measure Source

Public Health Law Research (PHLR), Temple University. Robert Wood Johnson Foundation (RWJF), LawAtlas: State Foodborne Illness Reporting Laws Map

Data date(s)

2013

Limitations

The measure only evaluates whether a state requires communicable disease reporting to state or local health officials. The measure does not evaluate the timeliness or completeness of the required reporting, nor how effective the state is in monitoring and enforcing the requirements. It does not evaluate the ability of the health department to receive and use the reported information.

Score

Foundational

m344
State has adopted the Nurse Licensure Compact (NLC)
Measure Name

M344

Measure Source

National Council of State Boards of Nursing (NCSBN), Nurse Licensure Compact (NLC) Member States

Data date(s)

2014 - 2016

Limitations

The measure covers only the reduced administrative burden states gain from membership in the Nurse Licensure Compact. It does not measure individual state capacity to incorporate out-of-state nurses into medical surge responses. Additionally, some states may have existing agreements in place, similar to but smaller in scope, than the Nurse Licensure Compact.

Score

Data Missing

m345
State has adopted Emergency Management Assistance Compact (EMAC) legislation
Measure Name

M345

Measure Source

National Emergency Management Association (NEMA), What is EMAC?

Data date(s)

2014

Limitations

All states are signatory to the EMAC; therefore, this score cannot be improved.

Score

Foundational

Close Window

Healthcare Delivery

pc: prehospital care

hps: hospital and physician services

ltc: long term care

mbh: mental behavioral healthcare

hc: home care

This is best viewed on desktop.

Prehospital care is generally provided by emergency medical services (EMS) and, includes 911 and dispatch, emergency medical response, field assessment and care, and transport (usually by ambulance or helicopter) to a hospital and between healthcare facilities.

6.7
Measure
Measure Description
Score
m140
Number of emergency medical technicians (EMTs) and paramedics per 100,000 population
Measure Name

M140

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

The measure may not distinguish licensed EMTs and paramedics from those that are licensed, practicing, and affiliated.

Score

108.4

m331
What percentage of the state's local emergency medical services (EMS) agencies submit National EMS Information System (NEMSIS) compliant data to the state?
Measure Name

M331

Measure Source

National Highway Traffic Safety Administration (NHTSA), State NEMIS Progress Reports: State & Territory Version 2 Information

Data date(s)

2014 - 2016

Limitations

Some states may collect local and regional EMS data that provide some of the data in the national data set. These states may have the capability to conduct limited quality improvement and process improvement activities, but will be unable to compare themselves to national data.

Score

90

Hospital and physician services refers to care for a patient who is formally admitted (or “hospitalized”) to an institution for treatment and/or care and stays for a minimum of one night in the hospital or other institution.

5.3
Measure
Measure Description
Score
m147
Median time in minutes from emergency department (ED) arrival to ED departure for admitted ED patients (identifier ED-1)
Measure Name

M147

Measure Source

Centers for Medicare & Medicaid Services (CMS), Timely and Effective Care - State

Data date(s)

2013 - 2016

Limitations

There is unknown information about the nature of treatment between emergency department arrival and discharge.

Score

272

m148
Median admit decision time in minutes to emergency department (ED) departure time for admitted patients (identifier ED-2)
Measure Name

M148

Measure Source

Centers for Medicare & Medicaid Services (CMS), Timely and Effective Care - State

Data date(s)

2013 - 2016

Limitations

The measure describes the pre-event capability to move patients from the emergency department to inpatient care but it does not describe the hospital's capabilities during a mass casualty or other event.

Score

97

m149
Number of staffed beds per 100,000 population
Measure Name

M149

Measure Source

American Hospital Directory (AHD), Inc. American Hospital Directory

Data date(s)

2013 - 2016

Limitations

The measure does not include the total licensed beds for which a healthcare facility maintains a license to operate. The measure also does not consider plans for creating additional beds through hospital surge plans.

Score

284.4

m152
Percentage of a state's population who live within 50 miles of a trauma center (including trauma centers from neighboring states)
Measure Name

M152

Measure Source

American Hospital Association (AHA), AHA Annual Survey of Hospitals data and U.S. Census population data analyzed by PMO personnel.

Data date(s)

2011 - 2013

Limitations

The quality of care provided by the trauma centers is not considered in this measure.

Score

1

m160
Number of physicians and surgeons per 100,000 population
Measure Name

M160

Measure Source

Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES)

Data date(s)

2012 - 2015

Limitations

This measure may not reflect that healthcare facilities and jurisdictions may have mutual aid plans in place to supplement the number of physicians and surgeons in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to under-count certain types of physicians. Specifically, BLS estimates may differ considerably from the estimates available from state medical licensing boards. These measurement errors in the national BLS data are expected to be relatively consistent across states, and therefore they should not cause significant bias in the Index state and national results.

Score

291.8

m167
Number of active registered nurse (RN) and licensed practical nurse (LPN) licenses per 100,000 population
Measure Name

M167

Measure Source

National Council of State Boards of Nursing (NCSBN), National Nursing Database

Data date(s)

2013 - 2016

Limitations

The measure may underrepresent the number of RNs or LPNs available to surge to provide care during an emergency. States that do not participate in the National Council of State Boards of Nursing include Alaska, Hawaii, and Oklahoma. Louisiana does not report data regarding PNs. Further, mutual aid protocols may exist to bring additional RNs and PNs into the jurisdiction to respond to an emergency requiring medical surge.

Score

2151.5

m168
Percent of population who live within 100 miles of a burn center (includes burn centers in other states)
Measure Name

M168

Measure Source

American Burn Association (ABA) data on Burn Care Facilities analyzed by PMO personnel.

Data date(s)

2014

Limitations

The measure may underrepresent the specialized resources needed for an emergency that requires mass care of burn patients.

Score

1

m296
Percentage of hospital facilities in the state that provide geriatric services (includes general as well as specialized geriatic services, such as psychiatric geriatric services/Alzheimer care)
Measure Name

M296

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

The measure considers geriatric services that are owned or provided by the hospital or by the hospital's health system (i.e., doesn't require a contractual agreement). Hospitals may provide competent care to geriatric patients without having a specialty care program.

Score

0.5

m297
Percentage of hospital facilities in the state that provide palliative care programs (includes both palliative care program and/or palliative care inpatient unit, but excludes pain management program, patient-controlled analgesia, and hospice program)
Measure Name

M297

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

The measure only evaluates whether or not a hospital provides the service. The quality of care and the capacity of the program to provide services during an emergency are not considered.

Score

0.3

m298
Number of airborne infection isolation room (AIIR) beds per 100,000 population (including hospitals with AIIR rooms within 50 miles from neighboring states)
Measure Name

M298

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

There are no obvious limitations to this measure.

Score

30.2

m299
Risk-adjusted 30-day mortality among Medicare beneficiaries hospitalized for heart attack, heart failure, or pneumonia
Measure Name

M299

Measure Source

The Commonwealth Fund, Aiming Higher: Results from a Scorecard on State health System Performance

Data date(s)

2008-11, 2009-12, 2010-13

Limitations

Variations in state populations (e.g., obesity or smoking rates) may have a greater effect on this measure than public health programs, mitigating the measure's use for this purpose.

Score

12.6

m300
Percentage of grade "A" hospitals in a state for Hospital Safety Score
Measure Name

M300

Measure Source

The Leapfrog Group, Hospital Safety Score (HSS)

Data date(s)

2013 - 2016

Limitations

More than 2,600 hospitals received a score. Hospitals excluded from receiving a score include critical access hospitals, specialty hospitals, pediatric hospitals, hospitals in Maryland, territories exempt from public reporting to CMS, and others.

Score

20

m906
The percentage of short-term general and Critical Access hospitals that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare and Medicaid EHR Incentive Programs. Critical Access hospitals are facilities with no more than 25 beds and located in a rural area further than 35 miles from the nearest hospital, and/or are located in a mountainous region.
Measure Name

M906

Measure Source

The Office of the National Coordinator for Health Information Technology, a division of the U.S. Department of Health and Human Services

Data date(s)

2013 - 2015

Limitations

This is a survey estimate.

Score

0.9

m907
The percentage of all office-based medical doctors and doctors of osteopathy that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare and Medicaid EHR Incentive Programs.
Measure Name

M907

Measure Source

The Office of the National Coordinator for Health Information Technology, a division of the U.S. Department of Health and Human Services

Data date(s)

2013 - 2015

Limitations

This is a survey estimate.

Score

0.4

Long-term care refers to a continuum of medical and social services designed to support the needs of people living permanently or for an extended period in a residential setting with chronic health problems that affect their ability to perform everyday activities. This includes skilled nursing facilities, rehabilitation services, etc.

5.7
Measure
Measure Description
Score
m303
State requires that long-term care and nursing home facilities must have a written disaster plan
Measure Name

M303

Measure Source

American College of Emergency Physicians (ACEP), America's Emergency Care Environment, A State-by-State Report Card

Data date(s)

2013

Limitations

The measure does not evaluate the quality or feasibility of the emergency preparedness plan. Simply having a plan is a not enough; it is the quality and detail of the plan and actively planning with the community that provides a deeper context. Also, according to state public health personnel in Vermont, this 2013-2014 data source does not accurately reflect that state's administrative regulations dating to 2000-2001. The ACEP Report indicates that Vermont does not require a written disaster plan for long-term care and nursing home facilities, but in fact this was a requirement when the ACEP Report was published. We have changed Vermont's item measure value for M303 from "0" to "1" according to this feedback.

Score

1

m308
State average reported registered nurse (RN) staffing hours per resident per day
Measure Name

M308

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2014 - 2016

Limitations

The measure is an average that does not include more detail on the range/distribution, thus limiting its descriptive value. Data are collected during a specific two-week period; variations related to season, region, resident acuity, skill mix of other care providers, and other factors are not taken into account.

Score

0.9

m309
State average reported certified nursing assistant (CNA) staffing hours per resident per day
Measure Name

M309

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2014 - 2016

Limitations

The CNA capacity in a state does not guarantee that they are available during a disaster. Those CNAs that are available also need to have disaster-specific education.

Score

2.3

m307
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
Measure Name

M307

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2013 - 2016

Limitations

The additional protection gained and the reduced demand on the healthcare system is of some value but may be marginal in the context of a major disaster. Also, the effectiveness of the vaccine varies as a function of the accuracy in predicting the strains used to make each year's vaccine.

Score

0.9

m310
State average reported licensed practical nurse (LPN) staffing hours per resident per day
Measure Name

M310

Measure Source

Centers for Medicare & Medicaid Services (CMS), Nursing Home State Averages

Data date(s)

2014 - 2016

Limitations

The measure is an average that does not include more detail on the range/distribution, thus limiting its descriptive value. Data are collected during a specific two-week period; variations related to season, region, resident acuity, skill mix of other care providers, and other factors are not taken into account.

Score

0.8

Mental and behavioral healthcare is the provision and facilitation of access to medical and mental/behavioral health services including: medical treatment, substance abuse treatment, stress management, and medication with the intent to restore and improve the resilience and sustainability of health, mental and behavioral health, and social services networks. It includes access to information regarding available mass care services for at-risk individuals and the entire affected population.

6.4
Measure
Measure Description
Score
m315
Percentage of hospital facilities in the state that provide chaplaincy/pastoral care services
Measure Name

M315

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

Chaplaincy/pastoral care services may not be available in adequate numbers to respond to a surge and services are not solely focused on fatalities.

Score

0.5

m316
Percentage of hospital facilities in the state that provide psychiatric emergency services
Measure Name

M316

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2011 - 2013

Limitations

Respondents to the American Hospital Association (AHA) survey (the source for this measure) may have varying definitions of emergency psychiatric services covering a broad range. In effect, all hospitals that provide emergency medical services provide emergency psychiatric services. At the same time, fewer may have more complete, specialty-staffed, comprehensive psychiatric emergency services. Positive responses to this measure will cover a very wide range of capability. A negative may reflect the complete absence of emergency psychiatric services or the respondent's view that a positive response requires a separate, identifiable, comprehensive service when, in fact, some capacity exists. The measure does not indicate the extent of the hospital's or emergency psychiatric services integration with other disaster preparedness and response efforts (including health). It does not measure the type of services provided such as at hospital, mobile crisis response capacity, telephone-based crisis services, etc. In some cases, this measure may tend to duplicate and/or overlap with another measure that asks about licensing and certification of behavioral health and substance abuse providers.

Score

0.3

m317
Percentage of need met in mental health professional shortage areas in the state
Measure Name

M317

Measure Source

The Henry J. Kaiser Family Foundation, Mental Health Care Health Professional Shortage Areas (HPSA)

Data date(s)

2014 & 2016

Limitations

This measure is based solely on the availability of psychiatrists. While psychiatrists often play an important role in the array of services provided following disasters, the vast majority of behavioral health services following disasters are provided by behavioral health professionals other than psychiatrists (e.g., psychologists, social workers, licensed counselors, pastoral counselors, psychiatric nurses). The extent to which this measure serves as a proxy for shortages in these other professional groups will likely vary across jurisdictions. The measure does not account for the ability of a state to temporarily move mental health resources within the state in times of disasters. For example, many states have established trained and certified crisis teams that can be activated and deployed to disaster zones, thus enabling rapid supplementation of local resources. The measure does not reflect the availability of existing resources (many providers have waiting lists and/or are legally and contractually obligated to serve particular populations and may not be available for alternative service in times of disasters). The measure does not reflect the status of skills and training necessary for optimal performance in disasters.

Score

61.9

m800
Population (% of state total) living in a HRSA-designated Mental Health Professional Shortage Area
Measure Name

M800

Measure Source

U.S. Census Bureau and Health Resources & Services Administration (HRSA) data analyzed by PMO personnel.

Data date(s)

2015 & 2016

Limitations

While this measure has no apparent limitations, it can be difficult to estimate.

Score

0.1

Home care is clinical and nonclinical care that allows a person with special needs to stay in their home. It may also be assumed to include the management of patient care needs for those patients not sick enough to require hospitalization or long-term care, or for whom hospitalization is not deemed to be of benefit. Other examples of home care include, but are not limited to: skilled nursing visits, respiratory care services, provision of durable medical equipment, hospice, and pharmacist services.

6.6
Measure
Measure Description
Score
m291
How often the home health team determined whether the patient received a flu shot for the current flu season as an average percentage of home health episodes of care in the state
Measure Name

M291

Measure Source

Centers for Medicare & Medicaid Services (CMS), Home Health Care-State by State Data

Data date(s)

2013 - 2016

Limitations

How often average percentage of home health episodes of care in the state the home health team determined whether the patient received a flu shot for the current flu season as an average percentage of home health episodes of care in the state is not in itself useful to determine population-level health resiliency.

Score

0.8

m292
How often the home health team began their patients' care in a timely manner as an average percentage of home health episodes of care in the state
Measure Name

M292

Measure Source

Centers for Medicare & Medicaid Services (CMS), Home Health Care-State by State Data

Data date(s)

2014 - 2016

Limitations

The measure is a statewide average and does not indicate the lengths of delays, nor does it identify if this is a regional or statewide problem. These issues limit the usefulness of the measure.

Score

0.9

m293
Number of home health and personal care aides per 1,000 population aged 65 or older
Measure Name

M293

Measure Source

American Community Survey (ACS), 1-year Public Use Microsample (PUMS) data analyzed by PMO personnel.

Data date(s)

2012 - 2015

Limitations

The number of home health and personal care aides per 1,000 population aged 65 and older gives an indication of the total capacity of home health aides available. However, that information in itself does not describe their availability during a health emergency or the number of providers that have emergency care plans for their clients.

Score

32.4

Close Window

Environmental & Occupational Health

fws: food water security

em: environmental monitoring

This is best viewed on desktop.

The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health.

5.9
Measure
Measure Description
Score
m275_dw
Does your laboratory provide or assure testing for the following environmental matrices (Drinking water)?
Measure Name

M275_DW

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_pww
Does your laboratory provide or assure testing for the following environmental matrices (Private well water)?
Measure Name

M275_PWW

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_rec
Does your laboratory provide or assure testing for the following environmental matrices (Recreational water)?
Measure Name

M275_REC

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_sur
Does your laboratory provide or assure testing for the following environmental matrices (Surface water)?
Measure Name

M275_SUR

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_ust
Does your laboratory provide or assure testing for the following environmental matrices (Underground storage tanks)?
Measure Name

M275_UST

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m275_wst
Does your laboratory provide or assure testing for the following environmental matrices (Waste water)?
Measure Name

M275_WST

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates whether the state public health laboratory has the capability to test water in various environments. The measure does not evaluate if OTHER state laboratories have this capability. For example, Delaware and Oklahoma informed the program management office that other labs in their states do have this capability. Finally, this measure does not indicate whether the public health laboratory has the capacity to test the amount of samples necessary to respond to a health security event.

Score

Data Missing

m276
For which of the following organisms or their toxins does your state public health laboratory provide or assure testing for food and or water samples to assist with foodborne disease outbreak investigations: Bacillus cereus, Brucella sp., Campylobacter sp., Clostridium botulinum, Clostridium perfringens, Cryptosporidium sp., Cyclospora cayetanensis, Listeria monocytogenes, norovirus, Salmonella, Shigella, Staphylococcus aureus, STEC non-O157, STEC O157, Vibrio sp., Yersinia enterocolitica. The state's value is equal to the percentage of these tests performed.
Measure Name

M276

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure indicates that the state public health laboratory either has these testing capabilities or assures that the tests can be done by agreement with another laboratory. Agreement laboratories may not be located to facilitate rapid transport and timely testing.

Score

1

m195
Percent of population in the state whose community water systems meet all applicable health-based standards through approaches that include effective treatment and source water protection
Measure Name

M195

Measure Source

Environmental Protection Agency (EPA), Safe Drinking Water Information System Federal (SDWIS/FED) Drinking Water Data

Data date(s)

2013 & 2014

Limitations

The measure does not cover drinking water supplies that are non-public (private) and does not directly provide information on community water supplies that were adversely affected by emergencies or disasters.

Score

1

The systematic collection and continuous or frequent standardized measurement and observation of: environmental specimens (air, water, land/soil, and plants) analyzing the presence of an indicator, exposure, or response (warning and control), including monitoring the environment for vectors of disease to give information about the environment to assess past and current status and predict future trends

0.4
Measure
Measure Description
Score
m202
Does your state public health laboratory provide or assure testing for air?
Measure Name

M202

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure is limited to one environmental matrix and does not specify what kind of testing should be performed. The measure does not address how many of these types of samples could be tested.

Score

Data Missing

m257_aiha
Does the American Industrial Hygiene Association (AIHA) provide certification or accreditation of your state public health laboratory?
Measure Name

M257_AIHA

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure has no apparent limitations.

Score

Data Missing

m257_epa
Does the U.S. Environmental Protection Agency (EPA) provide certification or accreditation of your state public health laboratory?
Measure Name

M257_EPA

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure has no apparent limitations.

Score

Data Missing

m257_nelac
Does the National Environmental Laboratory Accreditation Conference (NELAC) provide certification or accreditation of your state public health laboratory?
Measure Name

M257_NELAC

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure has no apparent limitations.

Score

Data Missing

m197
Does your state public health laboratory provide or assure testing for radiologic agents in environmental samples?
Measure Name

M197

Measure Source

Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS)

Data date(s)

2012 & 2014

Limitations

The measure only indicates if the state public health laboratory has the capability, or assures it through agreement with another laboratory. It does not measure the capacity of the laboratory to process the number of samples that would be required for a response. The measure does not indicate if the agreement laboratory is appropriately located to minimize sample transport time.

Score

Data Missing