Explore the 2018 Index Release

Drawing data from 64 sources, the 2018 Release includes five years of data from 2013 to 2017. The Index 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 Index website takes into account both preparedness and model complexities.

By Domain By State

Louisiana

The overall preparedness level in Louisiana stands at 6.7 for 2017. The national average is 7.1.

  • Louisiana’s overall health security level reached 6.7 out of 10 in 2017, a 9.8% increase from 2013.
  • The overall health security level in Louisiana was significantly below the national average health security level of 7.1 in 2017.
  • Louisiana’s largest improvement occurred in the Environmental & Occupational Health domain, which increased by 21.4% between 2013-17.
  • Health security levels in 2017 declined in one domain: a decline of -4.0% occurring in Countermeasure Management.
  • Health security levels in 2017 significantly exceeded the national average in none of the six domains.
  • Health security levels in 2017 were significantly below the national average in 4 domains: Health Security Surveillance, Incident & Information Management, Healthcare Delivery, and Countermeasure Management.
  • The state’s highest health security level in 2017 occurred in the domain of Incident & Information Management with a value of 8.4.
  • The state’s lowest health security level in 2017 occurred in Healthcare Delivery with a value of 4.3.
6.7
7.1 National average
confidence interval 6.9 - 7.2
0 10
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2013
2014
2015
2016
2017
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Select a state profile below
State Domain Scores

Health Security Surveillance

7.5
8.1 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 7.8 - 8.4

Community Planning & Engagement Coordination

6.2
6.0 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 5.7 - 6.3

Incident & Information Management

8.4
8.8 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 8.6 - 9.0

Healthcare Delivery

4.3
5.2 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 4.9 - 5.5

Countermeasure Management

7.2
7.7 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 7.4 - 7.9

Environmental & Occupational Health

6.8
6.6 National average
0 10

NATIONAL CONFIDENCE INTERVAL: 6.3 - 6.9

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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 health department 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 state's level of participation level in the BRFSS is not described, and can vary from state to state.

Score

Foundational

m18
Number of Epidemiologists per 100,000 population in the state
Measure Name

M18

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the level of training of the epidemiologists. The measure does not consider mutual aid plans that may be in place for agencies to supplement the number of available epidemiologists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of professionals, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

2.6

m19
State health department 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

The measure does not evaluate the quality or comprehensiveness of the state participation in the system.

Score

Foundational

m20
State health department participates in the 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 does not evaluate the quality or comprehensiveness of the state participation in the 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 & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m217
State public health laboratory has implemented the laboratory information management system (LIMS) to receive and report laboratory information electronically (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, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

No

m220
State has legal requirement for nongovernmental laboratories (e.g.clinical, hospital-based) in the 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, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

No

m256
State public health laboratory participates 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

The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks.

Score

Foundational

m23
Percent of foodborne illness outbreaks reported to CDC by state and local public health departments for which a causative infectious agent is confirmed
Measure Name

M23

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the state's reporting of foodborne illness outbreaks.

Score

50.0%

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 does not evaluate the quality, comprehensiveness, or effectiveness of participation in the prevention collaborative by the health department or hospitals.

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 & 2018

Limitations

The measure does not evaluate the quality or comprehensiveness of the veterinarian's integration into an animal response plan or coordination with other animal-related resources, such as a board of animal health, particularly in an health security emergency.

Score

Yes

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)

2014-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the state's death registration system, or indicate other redundant systems the might be used if the EDRS is not available such as cyber-attack and power outages.

Score

Yes

m801
State public health laboratory participates in the following federal surveillance programs: 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

The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks.

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.

6.3
Measure
Measure Description
Score
m1
Public Health Emergency Preparedness (PHEP) Cooperative Agreement-funded Laboratory Response Network chemical (LRN-C) laboratories 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

The measure is based on an exercise that includes only simulated samples, excluding real-life scenarios such as mislabeled specimens or specimens arriving at the laboratory at different times.

Score

Foundational

m1314
State public health chemical OR radiological terrorism/threat laboratory is accredited or certified by the College of American Pathologists (CAP) or Clinical Laboratory Improvement Amendments (CLIA)?
Measure Name

M1314

Measure Source

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

Data date(s)

2013-2017

Limitations

Certification may be based on simulated samples, since actual chemical samples are lacking.

Score

No

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

M208

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m8
State public health laboratory has a plan for a 6-8 week surge in testing capacity to respond to an outbreak or other public health event, with 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)
Measure Name

M8

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Data Missing

m9
State public health laboratory has a continuity of operations plan 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m11
State public health laboratory has a plan to receive specimens from sentinel clinical laboratories during nonbusiness hours
Measure Name

M11

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

No

m12
State public health laboratory has 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)

2013-2017

Limitations

The measure does not evaluate the timeliness of the sample transport, or the whether the transport available for all sentinel laboratories in the state.

Score

Yes

m211
Percent of 10 tests for infectious diseases that the state public health laboratory provides or assures, including arbovirus serology, hepatitis C serology, Legionella serology, measles serology, mumps serology, Neisseria meningitides serotyping, Plasmodium identification, Salmonella serotyping, Shigella serotyping, and Varicella serology
Measure Name

M211

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

80.0%

m216
Percent of 15 tests for infectious diseases that the state public health laboratory provides or assures including: 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
Measure Name

M216

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

13.3%

m2
Percent of Laboratory Response Network biological (LRN-B) 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)

2011-2015

Limitations

Laboratories may not undergo proficiency testing for all assay capabilities.

Score

75.0%

m3
Percent of pulsed field gel electrophoresis (PFGE) subtyping data results for e. coli submitted to the CDC PulseNet national database within four working days of receiving samples from clinical laboratories
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)

2011-2015

Limitations

The measure does not encompass time elapsed for specimen transport and identification, and is limited to foodborne agents that have PFGE subtyping.

Score

100.0%

m5
Percent of chemical agents correctly identified and quantified from unknown samples during unannounced proficiency testing during the state's 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

The measure does not consider the public health laboratory's ability to process a large number of samples.

Score

Data Missing

m7
Number of additional chemical agent detection methods-beyond the core methods-demonstrated by Laboratory Response Network chemical (LRN-C) Level 1 or 2 laboratories in the state
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)

2011-2015

Limitations

The measure does not consider all methods that the laboratory is capable of testing.

Score

0.0

m286
Number of chemical threat and multi-hazards preparedness exercises or drills the state public health laboratory conducts or participates in annually
Measure Name

M286

Measure Source

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

Data date(s)

2013-2017

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

2.0

m287
Percent of pulsed field gel electrophoresis (PFGE) sub-typing data results for Listeria monocytogenes submitted by state and local public health laboratories to the CDC PulseNet national database within four working days of receiving samples from clinical laboratories
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)

2011-2015

Limitations

The measure does not consider the volume of samples processed or quality of PFGE results, nor encompass time elapsed for specimen transport and identification.

Score

100.0

m288
Number of core chemical agent detection methods demonstrated by Level 1 or 2 LRN-C laboratories in the state
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)

2011-2015

Limitations

The measure does not consider compliance with the standards set by the Clinical Laboratory Improvement Amendments (CLIA) and the College of American Pathologists (CAP) accreditation program, and whether proficiency is achieved annually for the methods reported.

Score

7.0

m911
State public health laboratory provides or assures 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

m902
State has a high-capability laboratory to detect chemical threats (Level 1 or 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 & 2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the laboratory capabilities.

Score

Yes

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Community Planning & Engagement Coordination

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.

5.3
Measure
Measure Description
Score
m87
State health department is 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)

2014-2017

Limitations

The measure does not consider health departments that are undergoing the accreditation process.

Score

No

m501
Percent of the state's population served by a comprehensive public health system, as determined through the National Longitudinal Survey of Public Health Systems
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

Data are self-reported by local health department representatives and may reflect differences in perspective and interpretation among respondents.

Score

0.0%

m9031
Percent of hospitals in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

59.9%

m9032
Percent of emergency medical service agencies in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

59.7%

m9033
Percent of emergency management agencies in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

100.0%

m9034
Percent of local health departments in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

100.0%

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.

7.7
Measure
Measure Description
Score
m52
State requires all licensed child care providers to have a disaster 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 evaluate the quality or comprehensiveness of the disaster plan, whether the plan has been tested in the past two years, or whether there are effective partnerships supporting the plan, and does not consider nonlicensed providers.

Score

Yes

m53
State has a hazard response 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 evaluate the quality or comprehensiveness of the plan, whether the plan has been tested in the past two years, or whether there are effective partnerships supporting the plan, and does not specify the mulitple types of hazards to be considered.

Score

Yes

m163
Number of pediatricians per 100,000 population under 18 years old in the state
Measure Name

M163

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available pediatricians in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

20.6

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

M164

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available obstetricians and gynecologists in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

5.9

m170
Percent of state children (0-18 years) who reside within 50 miles of a pediatric trauma center, including out-of-state centers
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)

2012-2017

Limitations

The measure does not indicate the capacity of the trauma center, such as the number of available pediatric trauma beds or inpatient treatment beds for the care of pediatric patients.

Score

72.9%

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

M50

Measure Source

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

Data date(s)

2013-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the reunification plans, and the types of plans and target audiences are not consistently defined.

Score

Yes

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

M51

Measure Source

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

Data date(s)

2013-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the reunification plans, and the types of plans and target audiences are not consistently defined.

Score

Yes

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

3.5
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 does not evaluate the quality or comprehensiveness of the volunteer registry, indicate whether it has been used during exercises or responses,or reflect state capacity for volunteer surge during emergencies.

Score

Foundational

m266
Percent of the 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, 2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the CERT, including leadership strength, local and governmental agency suport, or participation of multiple sectors.

Score

51.4%

m346
Number of total Medical Reserve Corps members per 100,000 population in the state
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, 2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of licensed/credentialed/trained members, or include other formal and informal systems of registering, credentialing, and managing health and medical volunteers such as ESAR-VHP (Emergency System for the Advance Registration of Volunteer Health Professionals).

Score

30.3

m176
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of physician members who are licensed, credentialed, and received emergency response training.

Score

12.3%

m179
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of nurses or advanced practice nurses who are licensed, credentialed, and received emergency response training.

Score

27.3%

m186
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of other health professionals who are licensed, credentialed, and received emergency response training.

Score

60.3%

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.

2.3
Measure
Measure Description
Score
m175
Percent of voting-eligible population in the state participating in the highest office election
Measure Name

M175

Measure Source

United States Election Project, General Election Turnout Rates

Data date(s)

2012, 2014 & 2016

Limitations

The ideal numerator is total ballots counted (voting eligible population is the denominator), but these data are not available for all jurisdictions. Therefore, we use the next best alternative, which is the total votes for the highest office (e.g., presidential, gubernatorial, or congressional election).

Score

60.2%

m188
Percent of adults in the state who volunteer in their communities
Measure Name

M188

Measure Source

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

Data date(s)

2012-2015

Limitations

Data do not reflect the frequency, regularity or sustainability of volunteering, and respondents may be inclined to over-report their volunteerism.

Score

17.4%

m189
Number of annual volunteer hours per state resident, 15 years and older
Measure Name

M189

Measure Source

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

Data date(s)

2012-2015

Limitations

Respondents may be inclined to over-report the number of hours they volunteer. Also, certain communities that have strong social cohesion may have a low reported rate, such as settings where both parents work full-time and may not have time to volunteer.

Score

17.1

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Incident & Information Management

incm: incident management

infm: information management

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.

7.9
Measure
Measure Description
Score
m10
State public health laboratory uses a rapid method (e.g., Health Alert Network (HAN), blast e-mail or fax) to send messages to their 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 evaluate the frequency that the alert network is used or tested for routine or emergency messages, or whether it reaches all sentinel clinical laboratories and other partners in the state.

Score

Foundational

m70
CDC assessment score (0-100) of state health department dispensing plan for prophylaxis or disease fighting materiel from the CDC's Strategic National Stockpile
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 is incident-specific and focused on operational coordination issues, and does not include items such as mutual aid and resource planning.

Score

100.0

m71
CDC assessment score (0-100) of state health department coordination plan with hospitals and alternate facilities to procure medical materiel in an emergency
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 does not evaluate the quality or implementation of the plan, and does not address additional multi-agency coordination facets of procurement such as information sharing between the public health and healthcare systems.

Score

100.0

m84
State all hazards emergency management program is accredited by the Emergency Management Accreditation Program (EMAP)
Measure Name

M84

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure does not consider state emergency management programs with conditional accreditation, and some states may choose not to pursue accreditation for various state and local reasons.

Score

Yes

m333
State has a disaster preparedness plan for animals including livestock and pets
Measure Name

M333

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the animal disaster preparedness plan.

Score

Yes

m107
Percent of local health departments in the state 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 does not apply to states that do not have local health departments. The measure does not evaluate the quality or robustness of the local emergency management system.

Score

88.9%

m229
State public health laboratory has a 24/7/365 contact system in place to use in case of an emergency
Measure Name

M229

Measure Source

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

Data date(s)

2012 & 2014

Limitations

The measure does not evaluate the quality or comprehensiveness of the system, or the frequency that it is used or tested.

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 data is collected by existing state and local reporting systems using secure data entry to measure bed counts during emergencies, and does not replace states' need to evaluate state and local bed count system development and implementation.

Score

Foundational

m72
CDC assessment score (0-100) of state health department emergency response training, exercise, and evaluation plans' compliance 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 indicate whether preparedness plans are adequate, or the degree to which response plans are tested and evaluated.

Score

100.0

m335
State has statewide and/or county emergency response team(s) for animals including livestock and pets
Measure Name

M335

Measure Source

RedRover, Animal Response Teams

Data date(s)

2013-2017

Limitations

The measure does not evaluate the team's integration into the overall state plan and activities, or the resources committed to team activities. The source data includes a mix of state, county, and local teams, and a state score of "yes" indicates that the state has any combination of state, regional, or county/local teams.

Score

Yes

m701
Average number of minutes for state health department staff with incident management lead roles to report for immediate emergency response 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)

2011-2015

Limitations

Data are self-reported by health department representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

25.0

m222
State health department (or other state 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 & 2018

Limitations

The measure focuses on information sharing pertaining to water-related incidents but does not address water-intelligence information overall, and does not account for other government or public/private water systems that participate in the information sharing program.

Score

No

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)

2014-2017

Limitations

The measure does not evaluate state capacity to implement the agreement and incorporate out-of-state nurses into medical surge responses. Some states have other limited regional agreements precluding the need for participation in the national Nurse Licensure Compact.

Score

No

m338
State requires healthcare facilities to report 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 does not evaluate the healthcare facility compliance with reporting requirements.

Score

Foundational

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

CDC Public Health Law Program resources. https://www.cdc.gov/phlp/

Data date(s)

2013

Limitations

The measure does not evaluate the state's legal scope of authority, infrastructure to investigate violations, or other strategies to respond to inapproriate release of personal infomation.

Score

Foundational

m342
State law requires healthcare facilities to report communicable diseases to a health department
Measure Name

M342

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

Limitations

The measure does not evaluate the effectiveness of state monitoring and enforcement of reporting requirements, the timeliness or completeness of reporting, or the ability of the health departments to receive and use the reported information.

Score

Foundational

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

The measure does not evaluate state capacity to implement the agreement and incorporate out-of-state health care providers into medical surge responses.

Score

Foundational

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.

0.9
Measure
Measure Description
Score
m64
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 focuses on pre-event planning during a mass dispensing scenario, and does not include planning for broader emergency scenarios, for response-driven public information and risk communication strategies, or for the implementation of previously developed frameworks.

Score

Foundational

m228
Percent of households in the state 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)

2012-2016

Limitations

The measure focuses only on fixed broadband connections, and does not include an indication of the broadband system's ability to remain operational in a emergency or disaster.

Score

59.6%

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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.

3.3
Measure
Measure Description
Score
m140
Number of emergency medical technicians (EMTs) and paramedics per 100,000 population in the state
Measure Name

M140

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure may not distinguish licensed EMTs and paramedics from those that are licensed, practicing, and affiliated. BLS and other national data sources have been shown to undercount certain types of health professionals, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

80.6

m331
Percent of local emergency medical services (EMS) agencies that 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)

2015

Limitations

Quality of local level data is of concern due to limited documentation, and usefulness for full understanding of emergency health incidents may be limited since it is not benchmarked with state or national NEMSIS data measures, or linked to state or local information from emergency departments, police reports, and hospital datasets.

Score

34.4%

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.

4.9
Measure
Measure Description
Score
m147
Median time in minutes from hospital emergency department (ED) arrival to ED departure for patients admitted to hospitals in the state (identifier ED-1)
Measure Name

M147

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the severity of the patients' conditions, or the nature of their treatment between emergency department arrival and discharge.

Score

262.0

m148
Median time in minutes from hospital admission decision to emergency department (ED) departure for patients admitted to hospitals in the state (identifier ED-2)
Measure Name

M148

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the hospital's capacity to move patients from the emergency department to inpatient care during a mass casualty or other event.

Score

86.0

m149
Number of staffed hospital beds per 100,000 population in the state
Measure Name

M149

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the healthcare facilities' total capacity of licensed beds (including unstaffed beds), or plans to create additional beds through implementation of hospital surge plans.

Score

343.0

m152
Percent of the state's population who live within 50 miles of a trauma center, including out-of-state centers
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)

2012-2016

Limitations

The measure does not evaluate the quality or comprehensivenss of care provided by the trauma centers.

Score

99.1%

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

M160

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available physicians and surgeons in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

227.8

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

M167

Measure Source

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

Data date(s)

2013-2016, 2018

Limitations

The measure does not consider mutual aid plans that may be in place to supplement the number of available RNs and LPNs in the event of an emergency. The source data may undercount the RNs and LPNs available to provide care during an emergency due to limited or non-reporting by some states.

Score

1,311.5

m168
Percent of the state's population living within 100 miles of a burn center, including out-of-state centers
Measure Name

M168

Measure Source

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

Data date(s)

2014 & 2017

Limitations

The measure does not evaluate the specialized resources needed for surge capacity when an emergency results in a large number of burn patients.

Score

96.4%

m296
Percent of hospitals in the state providing a specialty geriatric services program (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)

2012-2016

Limitations

The measure does not consider hospital geriatric services provided through contractual arrangments, the program's capacity to provide services during an emergency, or whether high quality care is provided to geriatric patients without having a designated specialty program.

Score

25.5%

m297
Percent of hospitals in the state providing 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)

2012-2016

Limitations

The measure does not evaluate the quality of services provided, or the program's capacity to provide services during an emergency.

Score

11.4%

m298
Number of hospital airborne infection isolation room (AIIR) beds per 100,000 population in the state, 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)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place to supplement the number of available AIIR beds in the event of an emergency.

Score

22.3

m299
Risk-adjusted 30-day survival rate (percent) among Medicare beneficiaries hospitalized in the state 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)

2011-2013, & 2015

Limitations

Variation in state population health, such as obesity or smoking rates, may have a greater effect on the measure results than prevention and preparedness programs.

Score

87.0%

m300
Percent of hospitals in the state with a top quality ranking (Grade A) on the Hospital Safety Score
Measure Name

M300

Measure Source

The Leapfrog Group, Hospital Safety Score (HSS)

Data date(s)

2013-2017

Limitations

The measure source data does not include critical access hospitals, specialty hospitals, pediatric hospitals, hospitals in Maryland, territories exempt from public reporting to CMS, and others. 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.

Score

14.0%

m906
Percent of hospitals in the state that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare or 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)

2013-2016

Limitations

The measure source data is estimated based on a survey of healthcare facility providers.

Score

86.0%

m907
Percent of office-based medical doctors and doctors of osteopathy in the state that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare or 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)

2013-2016

Limitations

The measure source data is estimated based on a survey of healthcare facility providers.

Score

32.0%

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 written disaster plans for long-term care and nursing home facilities
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 & 2014

Limitations

The measure does not evaluate the disaster plan quality, feasibility, or intensity of planning with other community organizations. NOTE: According to state public health personnel in Vermont, this 2013-2014 ACEP data source does not accurately reflect Vermont administrative regulations dating to 2000-2001 which require a written disaster plan for long-term care and nursing home facilities. The Vermont item measure value for M303 is changed from "0" to "1" as a result of this feedback.

Score

Yes

m308
Average number of nurse (RN) staffing hours per resident per day in nursing homes in the state
Measure Name

M308

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff recieved disaster response training.

Score

0.5

m309
Average number of nursing assistant (CNA) staffing hours per resident per day in nursing homes in the state
Measure Name

M309

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff recieved disaster response training.

Score

2.3

m307
Percent of long-stay nursing home residents in the state that are 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)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

94.0%

m310
Average number of licensed practical nurse (LPN) staffing hours per resident per day in nursing homes in the stat
Measure Name

M310

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff recieved disaster response training.

Score

1.0

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.

2.1
Measure
Measure Description
Score
m315
Percent of hospitals in the state providing chaplaincy/pastoral care services
Measure Name

M315

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2012-2016

Limitations

The measure does not evaluate whether chaplaincy/pastoral service capacity is adequate to responsd to a surge in the event of a disaster.

Score

26.4%

m316
Percent of hospitals in the state providing psychiatric emergency services
Measure Name

M316

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2012-2016

Limitations

The measure source data does not have a standard definition of emergency psychiatric services, and survey respondents may have different interpretations for positive responses. All hospital emergency medical services include emergency psychiatric services, but fewer hospitals have more complete, specialty-staffed, comprehensive psychiatric emergency services. Negative responses may indicate the absence of any emergency psychiatric services, or the absence of a separate, identifiable, comprehensive service. The measure does not evaluate the extent of service integration with other disaster preparedness and response efforts by the hospital or emergency psychiatric service, or the disaster-related services provided such as mobile crisis response capacity and telephone-based crisis services.

Score

11.8%

m317
Percent of need met for mental health care in health professional shortage areas (HPSA) 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, & 2017

Limitations

The measure data is based on the availability of psychiatrists, and does not include other behavioral health professionals (e.g., psychologists, social workers, licensed counselors, pastoral counselors, psychiatric nurses) who provide the majority of behavioral health services following disasters. The measure does not consider the ability of a state to temporarily move mental health resources within the state in response to a disaster, such as state trained and certified crisis teams that can be activated and deployed to disaster zones and rapidly supplement local resources. In addition, the measure does not evaluate lack of provider availability and readiness during disasters due to appointment waiting lists, contractual obligations to serve certain populations, or their status of skills and training necessary for optimal performance in disasters.

Score

41.6%

m800
Percent of the state's population not living in a HRSA 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, & 2017

Limitations

The measure data is estimated based on matching U. S. Census area definitions with the geographic boundaries for HRSA Mental Health Professional Shortage Areas.

Score

17.6%

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.

5.9
Measure
Measure Description
Score
m291
Percent of home health episodes of care in the state where the home health team determined whether their patient received a flu shot for the current flu season
Measure Name

M291

Measure Source

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

Data date(s)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

69.0%

m292
Percent of home health episodes of care in the state where the home health team began their patients' care in a timely manner
Measure Name

M292

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality of the services provided including length of service delays.

Score

93.0%

m293
Number of home health and personal care aides per 1,000 population in the state 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)

2012-2016

Limitations

The measure does not evaluate availability of home health aide services during a health emergency, or whether providers have emergency care plans for their clients.

Score

51.6

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Countermeasure Management

mmmdd: medical materiel management distribution dispensing

cue: countermeasure utilization effectiveness

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.

9.0
Measure
Measure Description
Score
m60
State has developed a written countermeasure managment 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 does not evaluate whether the state has the resources and ability to implement the plan in a timely and effective manner.

Score

Foundational

m61
CDC assessment score (0-100) of a state's ability to manage the CDC's Strategic National Stockpile assets, 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 does not evaluate the number of staff or volunteers that would be available during an emergency.

Score

100.0

m62
CDC assessment score (0-100) of a state's ability to request the CDC's Strategic National Stockpile (SNS) assets from local authorities, including the level of completeness and utility of state plans and procedures
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 evaluates the completeness of state plans to distribute SNS assets to local health departments, but it does not consider whether the state and local health departments have the capacity to implement the plan.

Score

100.0

m63
CDC assessment score (0-100) of a state's tactical communications plan for the CDC's Strategic National Stockpile 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

The measure does not evaluate variations in local readiness across the state, the quality of the state plan, or whether the plan has been completed, tested, or improved.

Score

100.0

m65
CDC assessment score (0-100) of a state's security planning for the CDC's Strategic National Stockpile assets, including 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 does not evaluate the quality of the state plan, or whether the plan has been completed, tested, or improved.

Score

100.0

m66
CDC assessment score (0-100) of a state's ability to receive, stage, and store (RSS) the CDC's Strategic National Stockpile materiel, including plans and procedures developed to coordinate all logistics for the SNS
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 measure does not evaluate important variations in local readiness across the state, the quality of the state plan, or whether the plan has been completed, tested, or improved.

Score

100.0

m67
CDC assessment score (0-100) of a state's controlling inventory procedure to track the CDC's Strategic National Stockpile (SNS) materiel, including an Inventory Management System (IMS)
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 measure does not evaluate important variations in local readiness across the state to receive, stage, store, move, track, and keep secure SNS supplies.

Score

100.0

m69
CDC assessment score (0-100) of a state's distribution plans and procedures for physical delivery of the CDC's Strategic National Stockpile (SNS) assets from the receipt, stage, and store (RSS) facility to dispensing 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 measure does not evaluate important variations in local readiness across the state to receive, stage, store, move, track, and keep secure SNS supplies.

Score

100.0

m161
Number of Pharmacists per 100,000 population in the state
Measure Name

M161

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available pharmacists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of providers, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

100.0

m270
Percent of hospitals in the state participating in a group purchasing arrangement
Measure Name

M270

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2012-2016

Limitations

Although group purchasing arrangements may be in place, many other economic and non-economic factors affect shortages of drugs and medical supplies and create gaps in the supply chain.

Score

32.3%

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.

4.9
Measure
Measure Description
Score
m24
Percent of children ages 19-35 months in the state receiving recommended routine childhood vaccinations, including 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)

2012-2016

Limitations

The measure evaluates routine vaccines for preventable disease in pre-school age children, and may not reflect the vaccination rate for a severe emerging disease.

Score

68.5%

m32
Percent of seniors age 65 and older in the state receiving a seasonal flu vaccination
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)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

69.0%

m33
Percent of seniors age 65 and older in the state receiving a pneumococcal vaccination
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)

2012-2016

Limitations

The measure evaluates the recommended vaccine for preventable disease in seniors, and may not reflect the vaccination rate for a severe emerging disease.

Score

67.7%

m34
Percent of children aged 6 months to 4 years old in the state receiving a seasonal flu vaccination
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)

2012-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

67.8%

m35
Percent of adults aged 18 years and older in the state receiving a seasonal flu vaccination
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)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

44.1%

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Environmental & Occupational Health

fws: food water security

em: environmental monitoring

pei: physical environment and infrastructure

wr: workforce resiliency

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.

6.7
Measure
Measure Description
Score
m275_dw
State public health laboratory provides or assures testing for drinking water
Measure Name

M275_DW

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_pww
State public health laboratory provides or assures testing for 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_rec
State public health laboratory provides or assures testing for recreational water
Measure Name

M275_REC

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_sur
State public health laboratory provides or assures testing for surface water
Measure Name

M275_SUR

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_wst
State public health laboratory provides or assures testing for waste water
Measure Name

M275_WST

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

m276
Percent of 16 tests for different organisms or toxins that the state public health laboratory provides or assures to assist with foodborne disease outbreak investigations, including 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.
Measure Name

M276

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

68.8%

m195
Percent of population in the state whose community water systems meet all applicable health-based standards
Measure Name

M195

Measure Source

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

Data date(s)

2012-2016

Limitations

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

Score

83.2%

m925
Community Water System Compliance with Non-Health Standards. Percent of the population being served by a community water system that did not experience a non-health-based violation of the federal Safe Drinking Water Act (SDWA)
Measure Name

M925

Measure Source

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

Data date(s)

2012-2016

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

73.4%

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

3.2
Measure
Measure Description
Score
m202
State public health laboratory provides or assures testing for air samples
Measure Name

M202

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

m257_aiha
State public health laboratory is certified or accredited by the American Industrial Hygiene Association (AIHA)
Measure Name

M257_AIHA

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

No

m257_epa
State public health laboratory is certified or accredited by the Environmental Protection Agency (EPA)
Measure Name

M257_EPA

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m257_nelac
State public health laboratory is certified or accredited by the National Environmental Laboratory Accreditation Conference (NELAC)
Measure Name

M257_NELAC

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m196
State public health laboratory provides or assures 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 state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Foundational

m272
Percent of 12 tests for different contaminants in environmental samples that the state public health laboratory provides or assures, including 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
Measure Name

M272

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

80.0%

m273
State public health laboratory provides or assures 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

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

The measure does not evaluate the level or effectiveness of the state participation, including the resources committed and state success in quickly detecting and identifying pathogens.

Score

Foundational

m904
Number of environmental scientists and specialists (including health) per 100,000 population in the state
Measure Name

M904

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the level of training of the environmental and health scientists. The measure does not consider mutual aid plans that may be in place for agencies to supplement the number of available environmental and health scientists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of health professionals, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

34.3

Actions taken to reduce health hazards in the physical environment, including elements of the natural and built environment.

6.5
Measure
Measure Description
Score
m922
Transportation Structural Integrity, percent of bridges that are in good or fair condition (not poor)
Measure Name

M922

Measure Source

U.S. Department of Transportation, Federal Highway Administration, Office of Bridges and Structures

Data date(s)

2012-2016

Limitations

The frequency of bridge inspections varies according to numerous criteria. Most bridges are on a one-, two-, or four-year inspection cycle. Consequently, the data year does not necessarily coincide with the inspection year.

Score

88.3%

m923
Surface Water Control Structural Integrity, percent of High-Hazard Potential Dams that are not in poor or unsatisfactory condition
Measure Name

M923

Measure Source

U.S. Corp of Engineers, National Inventory of Dams (NID) and the Association of State Dam Safety Officials (ASDSO)

Data date(s)

2016

Limitations

A small, but growing number of states exempt categories of dams from inspection based on the purpose of the impoundment or the owner type.  Nationally roughly a quarter (23%) of the high-hazard dams are not rated for condition, with wide differences among the states

Score

93.8%

m928
Housing Mitigation for Flood Hazards, population living in a community participating in the FEMA Community Rating System (communities with a CRS of 1 through 9) as a percent of all communities participating in the National Flood Insurance Program
Measure Name

M928

Measure Source

FEMA National Flood Insurance Program (NFIP) Community Rating System (CRS)

Data date(s)

2017

Limitations

Participation in the National Flood Insurance Program (NFIP) is voluntary.  It is possible that some communities located in flood zones are not part of the NFIP. 

Score

75.0%

m929
Flood Insurance Coverage, FEMA National Flood Insurance Policies (NFIP) in-force as a percentage of total housing units located in 100- and 500-year floodplains
Measure Name

M929

Measure Source

U.S. Department of Homeland Security, FEMA, National Flood Insurance Program, and the NYU Furman Center (FloodzoneData.us)

Data date(s)

2013-2017

Limitations

Participation in the National Flood Insurance Program (NFIP) is voluntary.  It is possible that some communities located in flood zones are not part of the NFIP.  Also, many flood zone maps are outdated.

Score

100.0%

m334
State has 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 does not evaluate the quality or comprehensiveness of the plan, or the degree to which the plan is implemented.

Score

No

Actions taken to protect workers and emergency responders from health hazards while on the job.

3.9
Measure
Measure Description
Score
m530
Percent of employed population in the state 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)

2012-2016

Limitations

The measure data is estimated based on a survey of a sample of the general population.

Score

66.3%

m531
Percent of employed population in the state 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

The measure data is estimated based on a survey of a sample of the general population.

Score

6.0%

m705
Percent of employed population in the state who work from home
Measure Name

M705

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure data does not include all individuals who can work at home on a "part-time" basis.

Score

2.4%

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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.

7.0
Measure
Measure Description
Score
m17
State health department 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 state's level of participation level in the BRFSS is not described, and can vary from state to state.

Score

Foundational

m18
Number of Epidemiologists per 100,000 population in the state
Measure Name

M18

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the level of training of the epidemiologists. The measure does not consider mutual aid plans that may be in place for agencies to supplement the number of available epidemiologists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of professionals, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

2.2

m19
State health department 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

The measure does not evaluate the quality or comprehensiveness of the state participation in the system.

Score

Foundational

m20
State health department participates in the 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 does not evaluate the quality or comprehensiveness of the state participation in the 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 & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m217
State public health laboratory has implemented the laboratory information management system (LIMS) to receive and report laboratory information electronically (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, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

No

m220
State has legal requirement for nongovernmental laboratories (e.g.clinical, hospital-based) in the 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, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m256
State public health laboratory participates 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

The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks.

Score

Foundational

m23
Percent of foodborne illness outbreaks reported to CDC by state and local public health departments for which a causative infectious agent is confirmed
Measure Name

M23

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the state's reporting of foodborne illness outbreaks.

Score

85.7%

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 does not evaluate the quality, comprehensiveness, or effectiveness of participation in the prevention collaborative by the health department or hospitals.

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 & 2018

Limitations

The measure does not evaluate the quality or comprehensiveness of the veterinarian's integration into an animal response plan or coordination with other animal-related resources, such as a board of animal health, particularly in an health security emergency.

Score

Yes

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)

2014-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the state's death registration system, or indicate other redundant systems the might be used if the EDRS is not available such as cyber-attack and power outages.

Score

Yes

m801
State public health laboratory participates in the following federal surveillance programs: 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

The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks.

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.

6.9
Measure
Measure Description
Score
m1
Public Health Emergency Preparedness (PHEP) Cooperative Agreement-funded Laboratory Response Network chemical (LRN-C) laboratories 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

The measure is based on an exercise that includes only simulated samples, excluding real-life scenarios such as mislabeled specimens or specimens arriving at the laboratory at different times.

Score

Foundational

m1314
State public health chemical OR radiological terrorism/threat laboratory is accredited or certified by the College of American Pathologists (CAP) or Clinical Laboratory Improvement Amendments (CLIA)?
Measure Name

M1314

Measure Source

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

Data date(s)

2013-2017

Limitations

Certification may be based on simulated samples, since actual chemical samples are lacking.

Score

No

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

M208

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m8
State public health laboratory has a plan for a 6-8 week surge in testing capacity to respond to an outbreak or other public health event, with 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)
Measure Name

M8

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m9
State public health laboratory has a continuity of operations plan 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m11
State public health laboratory has a plan to receive specimens from sentinel clinical laboratories during nonbusiness hours
Measure Name

M11

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m12
State public health laboratory has 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)

2013-2017

Limitations

The measure does not evaluate the timeliness of the sample transport, or the whether the transport available for all sentinel laboratories in the state.

Score

Yes

m211
Percent of 10 tests for infectious diseases that the state public health laboratory provides or assures, including arbovirus serology, hepatitis C serology, Legionella serology, measles serology, mumps serology, Neisseria meningitides serotyping, Plasmodium identification, Salmonella serotyping, Shigella serotyping, and Varicella serology
Measure Name

M211

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

80.0%

m216
Percent of 15 tests for infectious diseases that the state public health laboratory provides or assures including: 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
Measure Name

M216

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

13.3%

m2
Percent of Laboratory Response Network biological (LRN-B) 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)

2011-2015

Limitations

Laboratories may not undergo proficiency testing for all assay capabilities.

Score

66.7%

m3
Percent of pulsed field gel electrophoresis (PFGE) subtyping data results for e. coli submitted to the CDC PulseNet national database within four working days of receiving samples from clinical laboratories
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)

2011-2015

Limitations

The measure does not encompass time elapsed for specimen transport and identification, and is limited to foodborne agents that have PFGE subtyping.

Score

100.0%

m5
Percent of chemical agents correctly identified and quantified from unknown samples during unannounced proficiency testing during the state's 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

The measure does not consider the public health laboratory's ability to process a large number of samples.

Score

100.0%

m7
Number of additional chemical agent detection methods-beyond the core methods-demonstrated by Laboratory Response Network chemical (LRN-C) Level 1 or 2 laboratories in the state
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)

2011-2015

Limitations

The measure does not consider all methods that the laboratory is capable of testing.

Score

0.0

m286
Number of chemical threat and multi-hazards preparedness exercises or drills the state public health laboratory conducts or participates in annually
Measure Name

M286

Measure Source

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

Data date(s)

2013-2017

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

1.0

m287
Percent of pulsed field gel electrophoresis (PFGE) sub-typing data results for Listeria monocytogenes submitted by state and local public health laboratories to the CDC PulseNet national database within four working days of receiving samples from clinical laboratories
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)

2011-2015

Limitations

The measure does not consider the volume of samples processed or quality of PFGE results, nor encompass time elapsed for specimen transport and identification.

Score

100.0

m288
Number of core chemical agent detection methods demonstrated by Level 1 or 2 LRN-C laboratories in the state
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)

2011-2015

Limitations

The measure does not consider compliance with the standards set by the Clinical Laboratory Improvement Amendments (CLIA) and the College of American Pathologists (CAP) accreditation program, and whether proficiency is achieved annually for the methods reported.

Score

0.0

m911
State public health laboratory provides or assures 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Data Missing

m902
State has a high-capability laboratory to detect chemical threats (Level 1 or 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 & 2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the laboratory capabilities.

Score

Yes

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Community Planning & Engagement Coordination

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.

5.9
Measure
Measure Description
Score
m87
State health department is 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)

2014-2017

Limitations

The measure does not consider health departments that are undergoing the accreditation process.

Score

No

m501
Percent of the state's population served by a comprehensive public health system, as determined through the National Longitudinal Survey of Public Health Systems
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

Data are self-reported by local health department representatives and may reflect differences in perspective and interpretation among respondents.

Score

26.1%

m9031
Percent of hospitals in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

59.9%

m9032
Percent of emergency medical service agencies in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

58.2%

m9033
Percent of emergency management agencies in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

100.0%

m9034
Percent of local health departments in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

100.0%

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.

7.9
Measure
Measure Description
Score
m52
State requires all licensed child care providers to have a disaster 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 evaluate the quality or comprehensiveness of the disaster plan, whether the plan has been tested in the past two years, or whether there are effective partnerships supporting the plan, and does not consider nonlicensed providers.

Score

Yes

m53
State has a hazard response 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 evaluate the quality or comprehensiveness of the plan, whether the plan has been tested in the past two years, or whether there are effective partnerships supporting the plan, and does not specify the mulitple types of hazards to be considered.

Score

Yes

m163
Number of pediatricians per 100,000 population under 18 years old in the state
Measure Name

M163

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available pediatricians in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

20.6

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

M164

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available obstetricians and gynecologists in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

5.1

m170
Percent of state children (0-18 years) who reside within 50 miles of a pediatric trauma center, including out-of-state centers
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)

2012-2017

Limitations

The measure does not indicate the capacity of the trauma center, such as the number of available pediatric trauma beds or inpatient treatment beds for the care of pediatric patients.

Score

87.7%

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

M50

Measure Source

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

Data date(s)

2013-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the reunification plans, and the types of plans and target audiences are not consistently defined.

Score

Yes

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

M51

Measure Source

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

Data date(s)

2013-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the reunification plans, and the types of plans and target audiences are not consistently defined.

Score

Yes

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

3.5
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 does not evaluate the quality or comprehensiveness of the volunteer registry, indicate whether it has been used during exercises or responses,or reflect state capacity for volunteer surge during emergencies.

Score

Foundational

m266
Percent of the 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, 2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the CERT, including leadership strength, local and governmental agency suport, or participation of multiple sectors.

Score

51.5%

m346
Number of total Medical Reserve Corps members per 100,000 population in the state
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, 2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of licensed/credentialed/trained members, or include other formal and informal systems of registering, credentialing, and managing health and medical volunteers such as ESAR-VHP (Emergency System for the Advance Registration of Volunteer Health Professionals).

Score

30.1

m176
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of physician members who are licensed, credentialed, and received emergency response training.

Score

12.3%

m179
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of nurses or advanced practice nurses who are licensed, credentialed, and received emergency response training.

Score

27.3%

m186
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of other health professionals who are licensed, credentialed, and received emergency response training.

Score

60.3%

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.

1.3
Measure
Measure Description
Score
m175
Percent of voting-eligible population in the state participating in the highest office election
Measure Name

M175

Measure Source

United States Election Project, General Election Turnout Rates

Data date(s)

2012, 2014 & 2016

Limitations

The ideal numerator is total ballots counted (voting eligible population is the denominator), but these data are not available for all jurisdictions. Therefore, we use the next best alternative, which is the total votes for the highest office (e.g., presidential, gubernatorial, or congressional election).

Score

43.9%

m188
Percent of adults in the state who volunteer in their communities
Measure Name

M188

Measure Source

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

Data date(s)

2012-2015

Limitations

Data do not reflect the frequency, regularity or sustainability of volunteering, and respondents may be inclined to over-report their volunteerism.

Score

16.7%

m189
Number of annual volunteer hours per state resident, 15 years and older
Measure Name

M189

Measure Source

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

Data date(s)

2012-2015

Limitations

Respondents may be inclined to over-report the number of hours they volunteer. Also, certain communities that have strong social cohesion may have a low reported rate, such as settings where both parents work full-time and may not have time to volunteer.

Score

19.8

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Incident & Information Management

incm: incident management

infm: information management

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.

7.8
Measure
Measure Description
Score
m10
State public health laboratory uses a rapid method (e.g., Health Alert Network (HAN), blast e-mail or fax) to send messages to their 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 evaluate the frequency that the alert network is used or tested for routine or emergency messages, or whether it reaches all sentinel clinical laboratories and other partners in the state.

Score

Foundational

m70
CDC assessment score (0-100) of state health department dispensing plan for prophylaxis or disease fighting materiel from the CDC's Strategic National Stockpile
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 is incident-specific and focused on operational coordination issues, and does not include items such as mutual aid and resource planning.

Score

100.0

m71
CDC assessment score (0-100) of state health department coordination plan with hospitals and alternate facilities to procure medical materiel in an emergency
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 does not evaluate the quality or implementation of the plan, and does not address additional multi-agency coordination facets of procurement such as information sharing between the public health and healthcare systems.

Score

100.0

m84
State all hazards emergency management program is accredited by the Emergency Management Accreditation Program (EMAP)
Measure Name

M84

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure does not consider state emergency management programs with conditional accreditation, and some states may choose not to pursue accreditation for various state and local reasons.

Score

Yes

m333
State has a disaster preparedness plan for animals including livestock and pets
Measure Name

M333

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the animal disaster preparedness plan.

Score

Yes

m107
Percent of local health departments in the state 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 does not apply to states that do not have local health departments. The measure does not evaluate the quality or robustness of the local emergency management system.

Score

88.9%

m229
State public health laboratory has a 24/7/365 contact system in place to use in case of an emergency
Measure Name

M229

Measure Source

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

Data date(s)

2012 & 2014

Limitations

The measure does not evaluate the quality or comprehensiveness of the system, or the frequency that it is used or tested.

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 data is collected by existing state and local reporting systems using secure data entry to measure bed counts during emergencies, and does not replace states' need to evaluate state and local bed count system development and implementation.

Score

Foundational

m72
CDC assessment score (0-100) of state health department emergency response training, exercise, and evaluation plans' compliance 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 indicate whether preparedness plans are adequate, or the degree to which response plans are tested and evaluated.

Score

100.0

m335
State has statewide and/or county emergency response team(s) for animals including livestock and pets
Measure Name

M335

Measure Source

RedRover, Animal Response Teams

Data date(s)

2013-2017

Limitations

The measure does not evaluate the team's integration into the overall state plan and activities, or the resources committed to team activities. The source data includes a mix of state, county, and local teams, and a state score of "yes" indicates that the state has any combination of state, regional, or county/local teams.

Score

Yes

m701
Average number of minutes for state health department staff with incident management lead roles to report for immediate emergency response 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)

2011-2015

Limitations

Data are self-reported by health department representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

30.0

m222
State health department (or other state 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 & 2018

Limitations

The measure focuses on information sharing pertaining to water-related incidents but does not address water-intelligence information overall, and does not account for other government or public/private water systems that participate in the information sharing program.

Score

No

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)

2014-2017

Limitations

The measure does not evaluate state capacity to implement the agreement and incorporate out-of-state nurses into medical surge responses. Some states have other limited regional agreements precluding the need for participation in the national Nurse Licensure Compact.

Score

No

m338
State requires healthcare facilities to report 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 does not evaluate the healthcare facility compliance with reporting requirements.

Score

Foundational

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

CDC Public Health Law Program resources. https://www.cdc.gov/phlp/

Data date(s)

2013

Limitations

The measure does not evaluate the state's legal scope of authority, infrastructure to investigate violations, or other strategies to respond to inapproriate release of personal infomation.

Score

Foundational

m342
State law requires healthcare facilities to report communicable diseases to a health department
Measure Name

M342

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

Limitations

The measure does not evaluate the effectiveness of state monitoring and enforcement of reporting requirements, the timeliness or completeness of reporting, or the ability of the health departments to receive and use the reported information.

Score

Foundational

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

The measure does not evaluate state capacity to implement the agreement and incorporate out-of-state health care providers into medical surge responses.

Score

Foundational

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.

2.6
Measure
Measure Description
Score
m64
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 focuses on pre-event planning during a mass dispensing scenario, and does not include planning for broader emergency scenarios, for response-driven public information and risk communication strategies, or for the implementation of previously developed frameworks.

Score

Foundational

m228
Percent of households in the state 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)

2012-2016

Limitations

The measure focuses only on fixed broadband connections, and does not include an indication of the broadband system's ability to remain operational in a emergency or disaster.

Score

64.8%

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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.

3.1
Measure
Measure Description
Score
m140
Number of emergency medical technicians (EMTs) and paramedics per 100,000 population in the state
Measure Name

M140

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure may not distinguish licensed EMTs and paramedics from those that are licensed, practicing, and affiliated. BLS and other national data sources have been shown to undercount certain types of health professionals, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

71.1

m331
Percent of local emergency medical services (EMS) agencies that 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)

2015

Limitations

Quality of local level data is of concern due to limited documentation, and usefulness for full understanding of emergency health incidents may be limited since it is not benchmarked with state or national NEMSIS data measures, or linked to state or local information from emergency departments, police reports, and hospital datasets.

Score

34.4%

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.

5.1
Measure
Measure Description
Score
m147
Median time in minutes from hospital emergency department (ED) arrival to ED departure for patients admitted to hospitals in the state (identifier ED-1)
Measure Name

M147

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the severity of the patients' conditions, or the nature of their treatment between emergency department arrival and discharge.

Score

254.0

m148
Median time in minutes from hospital admission decision to emergency department (ED) departure for patients admitted to hospitals in the state (identifier ED-2)
Measure Name

M148

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the hospital's capacity to move patients from the emergency department to inpatient care during a mass casualty or other event.

Score

87.0

m149
Number of staffed hospital beds per 100,000 population in the state
Measure Name

M149

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the healthcare facilities' total capacity of licensed beds (including unstaffed beds), or plans to create additional beds through implementation of hospital surge plans.

Score

339.5

m152
Percent of the state's population who live within 50 miles of a trauma center, including out-of-state centers
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)

2012-2016

Limitations

The measure does not evaluate the quality or comprehensivenss of care provided by the trauma centers.

Score

99.2%

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

M160

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available physicians and surgeons in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

264.0

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

M167

Measure Source

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

Data date(s)

2013-2016, 2018

Limitations

The measure does not consider mutual aid plans that may be in place to supplement the number of available RNs and LPNs in the event of an emergency. The source data may undercount the RNs and LPNs available to provide care during an emergency due to limited or non-reporting by some states.

Score

1,303.3

m168
Percent of the state's population living within 100 miles of a burn center, including out-of-state centers
Measure Name

M168

Measure Source

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

Data date(s)

2014 & 2017

Limitations

The measure does not evaluate the specialized resources needed for surge capacity when an emergency results in a large number of burn patients.

Score

96.4%

m296
Percent of hospitals in the state providing a specialty geriatric services program (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)

2012-2016

Limitations

The measure does not consider hospital geriatric services provided through contractual arrangments, the program's capacity to provide services during an emergency, or whether high quality care is provided to geriatric patients without having a designated specialty program.

Score

22.3%

m297
Percent of hospitals in the state providing 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)

2012-2016

Limitations

The measure does not evaluate the quality of services provided, or the program's capacity to provide services during an emergency.

Score

10.7%

m298
Number of hospital airborne infection isolation room (AIIR) beds per 100,000 population in the state, 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)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place to supplement the number of available AIIR beds in the event of an emergency.

Score

20.0

m299
Risk-adjusted 30-day survival rate (percent) among Medicare beneficiaries hospitalized in the state 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)

2011-2013, & 2015

Limitations

Variation in state population health, such as obesity or smoking rates, may have a greater effect on the measure results than prevention and preparedness programs.

Score

86.7%

m300
Percent of hospitals in the state with a top quality ranking (Grade A) on the Hospital Safety Score
Measure Name

M300

Measure Source

The Leapfrog Group, Hospital Safety Score (HSS)

Data date(s)

2013-2017

Limitations

The measure source data does not include critical access hospitals, specialty hospitals, pediatric hospitals, hospitals in Maryland, territories exempt from public reporting to CMS, and others. 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.

Score

16.3%

m906
Percent of hospitals in the state that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare or 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)

2013-2016

Limitations

The measure source data is estimated based on a survey of healthcare facility providers.

Score

91.0%

m907
Percent of office-based medical doctors and doctors of osteopathy in the state that have demonstrated meaningful use of certified electronic health record technology (CEHRT). This includes the demonstration of meaningful use through either the Medicare or 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)

2013-2016

Limitations

The measure source data is estimated based on a survey of healthcare facility providers.

Score

45.0%

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 written disaster plans for long-term care and nursing home facilities
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 & 2014

Limitations

The measure does not evaluate the disaster plan quality, feasibility, or intensity of planning with other community organizations. NOTE: According to state public health personnel in Vermont, this 2013-2014 ACEP data source does not accurately reflect Vermont administrative regulations dating to 2000-2001 which require a written disaster plan for long-term care and nursing home facilities. The Vermont item measure value for M303 is changed from "0" to "1" as a result of this feedback.

Score

Yes

m308
Average number of nurse (RN) staffing hours per resident per day in nursing homes in the state
Measure Name

M308

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff recieved disaster response training.

Score

0.5

m309
Average number of nursing assistant (CNA) staffing hours per resident per day in nursing homes in the state
Measure Name

M309

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff recieved disaster response training.

Score

2.3

m307
Percent of long-stay nursing home residents in the state that are 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)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

94.4%

m310
Average number of licensed practical nurse (LPN) staffing hours per resident per day in nursing homes in the stat
Measure Name

M310

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure source data are collected during a specific two-week period and do not take into account variations related to season, region, resident acuity, skill mix of other care providers, and other factors. The measure does not evaluate staff availability for a disaster or whether staff recieved disaster response training.

Score

1.0

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.

2.0
Measure
Measure Description
Score
m315
Percent of hospitals in the state providing chaplaincy/pastoral care services
Measure Name

M315

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2012-2016

Limitations

The measure does not evaluate whether chaplaincy/pastoral service capacity is adequate to responsd to a surge in the event of a disaster.

Score

23.3%

m316
Percent of hospitals in the state providing psychiatric emergency services
Measure Name

M316

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2012-2016

Limitations

The measure source data does not have a standard definition of emergency psychiatric services, and survey respondents may have different interpretations for positive responses. All hospital emergency medical services include emergency psychiatric services, but fewer hospitals have more complete, specialty-staffed, comprehensive psychiatric emergency services. Negative responses may indicate the absence of any emergency psychiatric services, or the absence of a separate, identifiable, comprehensive service. The measure does not evaluate the extent of service integration with other disaster preparedness and response efforts by the hospital or emergency psychiatric service, or the disaster-related services provided such as mobile crisis response capacity and telephone-based crisis services.

Score

11.6%

m317
Percent of need met for mental health care in health professional shortage areas (HPSA) 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, & 2017

Limitations

The measure data is based on the availability of psychiatrists, and does not include other behavioral health professionals (e.g., psychologists, social workers, licensed counselors, pastoral counselors, psychiatric nurses) who provide the majority of behavioral health services following disasters. The measure does not consider the ability of a state to temporarily move mental health resources within the state in response to a disaster, such as state trained and certified crisis teams that can be activated and deployed to disaster zones and rapidly supplement local resources. In addition, the measure does not evaluate lack of provider availability and readiness during disasters due to appointment waiting lists, contractual obligations to serve certain populations, or their status of skills and training necessary for optimal performance in disasters.

Score

41.6%

m800
Percent of the state's population not living in a HRSA 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, & 2017

Limitations

The measure data is estimated based on matching U. S. Census area definitions with the geographic boundaries for HRSA Mental Health Professional Shortage Areas.

Score

17.6%

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.

6.2
Measure
Measure Description
Score
m291
Percent of home health episodes of care in the state where the home health team determined whether their patient received a flu shot for the current flu season
Measure Name

M291

Measure Source

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

Data date(s)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

69.0%

m292
Percent of home health episodes of care in the state where the home health team began their patients' care in a timely manner
Measure Name

M292

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality of the services provided including length of service delays.

Score

94.0%

m293
Number of home health and personal care aides per 1,000 population in the state 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)

2012-2016

Limitations

The measure does not evaluate availability of home health aide services during a health emergency, or whether providers have emergency care plans for their clients.

Score

53.4

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Countermeasure Management

mmmdd: medical materiel management distribution dispensing

cue: countermeasure utilization effectiveness

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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.

8.9
Measure
Measure Description
Score
m60
State has developed a written countermeasure managment 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 does not evaluate whether the state has the resources and ability to implement the plan in a timely and effective manner.

Score

Foundational

m61
CDC assessment score (0-100) of a state's ability to manage the CDC's Strategic National Stockpile assets, 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 does not evaluate the number of staff or volunteers that would be available during an emergency.

Score

100.0

m62
CDC assessment score (0-100) of a state's ability to request the CDC's Strategic National Stockpile (SNS) assets from local authorities, including the level of completeness and utility of state plans and procedures
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 evaluates the completeness of state plans to distribute SNS assets to local health departments, but it does not consider whether the state and local health departments have the capacity to implement the plan.

Score

100.0

m63
CDC assessment score (0-100) of a state's tactical communications plan for the CDC's Strategic National Stockpile 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

The measure does not evaluate variations in local readiness across the state, the quality of the state plan, or whether the plan has been completed, tested, or improved.

Score

100.0

m65
CDC assessment score (0-100) of a state's security planning for the CDC's Strategic National Stockpile assets, including 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 does not evaluate the quality of the state plan, or whether the plan has been completed, tested, or improved.

Score

100.0

m66
CDC assessment score (0-100) of a state's ability to receive, stage, and store (RSS) the CDC's Strategic National Stockpile materiel, including plans and procedures developed to coordinate all logistics for the SNS
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 measure does not evaluate important variations in local readiness across the state, the quality of the state plan, or whether the plan has been completed, tested, or improved.

Score

100.0

m67
CDC assessment score (0-100) of a state's controlling inventory procedure to track the CDC's Strategic National Stockpile (SNS) materiel, including an Inventory Management System (IMS)
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 measure does not evaluate important variations in local readiness across the state to receive, stage, store, move, track, and keep secure SNS supplies.

Score

100.0

m69
CDC assessment score (0-100) of a state's distribution plans and procedures for physical delivery of the CDC's Strategic National Stockpile (SNS) assets from the receipt, stage, and store (RSS) facility to dispensing 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 measure does not evaluate important variations in local readiness across the state to receive, stage, store, move, track, and keep secure SNS supplies.

Score

100.0

m161
Number of Pharmacists per 100,000 population in the state
Measure Name

M161

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available pharmacists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of providers, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

93.8

m270
Percent of hospitals in the state participating in a group purchasing arrangement
Measure Name

M270

Measure Source

American Hospital Association (AHA), Annual Survey of Hospitals

Data date(s)

2012-2016

Limitations

Although group purchasing arrangements may be in place, many other economic and non-economic factors affect shortages of drugs and medical supplies and create gaps in the supply chain.

Score

33.0%

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.

4.6
Measure
Measure Description
Score
m24
Percent of children ages 19-35 months in the state receiving recommended routine childhood vaccinations, including 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)

2012-2016

Limitations

The measure evaluates routine vaccines for preventable disease in pre-school age children, and may not reflect the vaccination rate for a severe emerging disease.

Score

69.1%

m32
Percent of seniors age 65 and older in the state receiving a seasonal flu vaccination
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)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

68.1%

m33
Percent of seniors age 65 and older in the state receiving a pneumococcal vaccination
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)

2012-2016

Limitations

The measure evaluates the recommended vaccine for preventable disease in seniors, and may not reflect the vaccination rate for a severe emerging disease.

Score

68.1%

m34
Percent of children aged 6 months to 4 years old in the state receiving a seasonal flu vaccination
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)

2012-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

67.2%

m35
Percent of adults aged 18 years and older in the state receiving a seasonal flu vaccination
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)

2013-2017

Limitations

Vaccine effectiveness varies each year as a function of the accuracy in predicting the influenza strains covered by each year's vaccine. As a result, expected influenza protection and reduced demand on healthcare facilities may be marginal in the event of a major disaster.

Score

40.5%

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Environmental & Occupational Health

fws: food water security

em: environmental monitoring

pei: physical environment and infrastructure

wr: workforce resiliency

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.

6.8
Measure
Measure Description
Score
m275_dw
State public health laboratory provides or assures testing for drinking water
Measure Name

M275_DW

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_pww
State public health laboratory provides or assures testing for 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_rec
State public health laboratory provides or assures testing for recreational water
Measure Name

M275_REC

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_sur
State public health laboratory provides or assures testing for surface water
Measure Name

M275_SUR

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Yes

m275_wst
State public health laboratory provides or assures testing for waste water
Measure Name

M275_WST

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

m276
Percent of 16 tests for different organisms or toxins that the state public health laboratory provides or assures to assist with foodborne disease outbreak investigations, including 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.
Measure Name

M276

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

68.8%

m195
Percent of population in the state whose community water systems meet all applicable health-based standards
Measure Name

M195

Measure Source

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

Data date(s)

2012-2016

Limitations

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

Score

87.1%

m925
Community Water System Compliance with Non-Health Standards. Percent of the population being served by a community water system that did not experience a non-health-based violation of the federal Safe Drinking Water Act (SDWA)
Measure Name

M925

Measure Source

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

Data date(s)

2012-2016

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

71.7%

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

3.2
Measure
Measure Description
Score
m202
State public health laboratory provides or assures testing for air samples
Measure Name

M202

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

m257_aiha
State public health laboratory is certified or accredited by the American Industrial Hygiene Association (AIHA)
Measure Name

M257_AIHA

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

No

m257_epa
State public health laboratory is certified or accredited by the Environmental Protection Agency (EPA)
Measure Name

M257_EPA

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m257_nelac
State public health laboratory is certified or accredited by the National Environmental Laboratory Accreditation Conference (NELAC)
Measure Name

M257_NELAC

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m196
State public health laboratory provides or assures 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 state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Foundational

m272
Percent of 12 tests for different contaminants in environmental samples that the state public health laboratory provides or assures, including 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
Measure Name

M272

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

80.0%

m273
State public health laboratory provides or assures 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

No

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

The measure does not evaluate the level or effectiveness of the state participation, including the resources committed and state success in quickly detecting and identifying pathogens.

Score

Foundational

m904
Number of environmental scientists and specialists (including health) per 100,000 population in the state
Measure Name

M904

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the level of training of the environmental and health scientists. The measure does not consider mutual aid plans that may be in place for agencies to supplement the number of available environmental and health scientists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of health professionals, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

31.6

Actions taken to reduce health hazards in the physical environment, including elements of the natural and built environment.

6.4
Measure
Measure Description
Score
m922
Transportation Structural Integrity, percent of bridges that are in good or fair condition (not poor)
Measure Name

M922

Measure Source

U.S. Department of Transportation, Federal Highway Administration, Office of Bridges and Structures

Data date(s)

2012-2016

Limitations

The frequency of bridge inspections varies according to numerous criteria. Most bridges are on a one-, two-, or four-year inspection cycle. Consequently, the data year does not necessarily coincide with the inspection year.

Score

87.7%

m923
Surface Water Control Structural Integrity, percent of High-Hazard Potential Dams that are not in poor or unsatisfactory condition
Measure Name

M923

Measure Source

U.S. Corp of Engineers, National Inventory of Dams (NID) and the Association of State Dam Safety Officials (ASDSO)

Data date(s)

2016

Limitations

A small, but growing number of states exempt categories of dams from inspection based on the purpose of the impoundment or the owner type.  Nationally roughly a quarter (23%) of the high-hazard dams are not rated for condition, with wide differences among the states

Score

93.8%

m928
Housing Mitigation for Flood Hazards, population living in a community participating in the FEMA Community Rating System (communities with a CRS of 1 through 9) as a percent of all communities participating in the National Flood Insurance Program
Measure Name

M928

Measure Source

FEMA National Flood Insurance Program (NFIP) Community Rating System (CRS)

Data date(s)

2017

Limitations

Participation in the National Flood Insurance Program (NFIP) is voluntary.  It is possible that some communities located in flood zones are not part of the NFIP. 

Score

75.0%

m929
Flood Insurance Coverage, FEMA National Flood Insurance Policies (NFIP) in-force as a percentage of total housing units located in 100- and 500-year floodplains
Measure Name

M929

Measure Source

U.S. Department of Homeland Security, FEMA, National Flood Insurance Program, and the NYU Furman Center (FloodzoneData.us)

Data date(s)

2013-2017

Limitations

Participation in the National Flood Insurance Program (NFIP) is voluntary.  It is possible that some communities located in flood zones are not part of the NFIP.  Also, many flood zone maps are outdated.

Score

100.0%

m334
State has 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 does not evaluate the quality or comprehensiveness of the plan, or the degree to which the plan is implemented.

Score

No

Actions taken to protect workers and emergency responders from health hazards while on the job.

3.3
Measure
Measure Description
Score
m530
Percent of employed population in the state 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)

2012-2016

Limitations

The measure data is estimated based on a survey of a sample of the general population.

Score

60.7%

m531
Percent of employed population in the state 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

The measure data is estimated based on a survey of a sample of the general population.

Score

7.9%

m705
Percent of employed population in the state who work from home
Measure Name

M705

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure data does not include all individuals who can work at home on a "part-time" basis.

Score

2.4%

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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.

7.2
Measure
Measure Description
Score
m17
State health department 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 state's level of participation level in the BRFSS is not described, and can vary from state to state.

Score

Foundational

m18
Number of Epidemiologists per 100,000 population in the state
Measure Name

M18

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the level of training of the epidemiologists. The measure does not consider mutual aid plans that may be in place for agencies to supplement the number of available epidemiologists in the event of an emergency. Also, BLS and other national data sources on health provider supply have been shown to undercount certain types of professionals, and may differ considerably from the estimates available from state licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

2.4

m19
State health department 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

The measure does not evaluate the quality or comprehensiveness of the state participation in the system.

Score

Foundational

m20
State health department participates in the 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 does not evaluate the quality or comprehensiveness of the state participation in the 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 & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m217
State public health laboratory has implemented the laboratory information management system (LIMS) to receive and report laboratory information electronically (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, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

No

m220
State has legal requirement for nongovernmental laboratories (e.g.clinical, hospital-based) in the 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, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m256
State public health laboratory participates 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

The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks.

Score

Foundational

m23
Percent of foodborne illness outbreaks reported to CDC by state and local public health departments for which a causative infectious agent is confirmed
Measure Name

M23

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the state's reporting of foodborne illness outbreaks.

Score

100.0%

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 does not evaluate the quality, comprehensiveness, or effectiveness of participation in the prevention collaborative by the health department or hospitals.

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 & 2018

Limitations

The measure does not evaluate the quality or comprehensiveness of the veterinarian's integration into an animal response plan or coordination with other animal-related resources, such as a board of animal health, particularly in an health security emergency.

Score

Yes

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)

2014-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the state's death registration system, or indicate other redundant systems the might be used if the EDRS is not available such as cyber-attack and power outages.

Score

Yes

m801
State public health laboratory participates in the following federal surveillance programs: 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

The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks.

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.

4.9
Measure
Measure Description
Score
m1
Public Health Emergency Preparedness (PHEP) Cooperative Agreement-funded Laboratory Response Network chemical (LRN-C) laboratories 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

The measure is based on an exercise that includes only simulated samples, excluding real-life scenarios such as mislabeled specimens or specimens arriving at the laboratory at different times.

Score

Foundational

m1314
State public health chemical OR radiological terrorism/threat laboratory is accredited or certified by the College of American Pathologists (CAP) or Clinical Laboratory Improvement Amendments (CLIA)?
Measure Name

M1314

Measure Source

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

Data date(s)

2013-2017

Limitations

Certification may be based on simulated samples, since actual chemical samples are lacking.

Score

No

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

M208

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

Yes

m8
State public health laboratory has a plan for a 6-8 week surge in testing capacity to respond to an outbreak or other public health event, with 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)
Measure Name

M8

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m9
State public health laboratory has a continuity of operations plan 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m11
State public health laboratory has a plan to receive specimens from sentinel clinical laboratories during nonbusiness hours
Measure Name

M11

Measure Source

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

Data date(s)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency that the plan is used or tested.

Score

Yes

m12
State public health laboratory has 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)

2013-2017

Limitations

The measure does not evaluate the timeliness of the sample transport, or the whether the transport available for all sentinel laboratories in the state.

Score

Yes

m211
Percent of 10 tests for infectious diseases that the state public health laboratory provides or assures, including arbovirus serology, hepatitis C serology, Legionella serology, measles serology, mumps serology, Neisseria meningitides serotyping, Plasmodium identification, Salmonella serotyping, Shigella serotyping, and Varicella serology
Measure Name

M211

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

80.0%

m216
Percent of 15 tests for infectious diseases that the state public health laboratory provides or assures including: 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
Measure Name

M216

Measure Source

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

Data date(s)

2012, 2014, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

13.3%

m2
Percent of Laboratory Response Network biological (LRN-B) 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)

2011-2015

Limitations

Laboratories may not undergo proficiency testing for all assay capabilities.

Score

0.0%

m3
Percent of pulsed field gel electrophoresis (PFGE) subtyping data results for e. coli submitted to the CDC PulseNet national database within four working days of receiving samples from clinical laboratories
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)

2011-2015

Limitations

The measure does not encompass time elapsed for specimen transport and identification, and is limited to foodborne agents that have PFGE subtyping.

Score

0.0%

m5
Percent of chemical agents correctly identified and quantified from unknown samples during unannounced proficiency testing during the state's 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

The measure does not consider the public health laboratory's ability to process a large number of samples.

Score

100.0%

m7
Number of additional chemical agent detection methods-beyond the core methods-demonstrated by Laboratory Response Network chemical (LRN-C) Level 1 or 2 laboratories in the state
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)

2011-2015

Limitations

The measure does not consider all methods that the laboratory is capable of testing.

Score

0.0

m286
Number of chemical threat and multi-hazards preparedness exercises or drills the state public health laboratory conducts or participates in annually
Measure Name

M286

Measure Source

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

Data date(s)

2013-2017

Limitations

Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents.

Score

1.0

m287
Percent of pulsed field gel electrophoresis (PFGE) sub-typing data results for Listeria monocytogenes submitted by state and local public health laboratories to the CDC PulseNet national database within four working days of receiving samples from clinical laboratories
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)

2011-2015

Limitations

The measure does not consider the volume of samples processed or quality of PFGE results, nor encompass time elapsed for specimen transport and identification.

Score

0.0

m288
Number of core chemical agent detection methods demonstrated by Level 1 or 2 LRN-C laboratories in the state
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)

2011-2015

Limitations

The measure does not consider compliance with the standards set by the Clinical Laboratory Improvement Amendments (CLIA) and the College of American Pathologists (CAP) accreditation program, and whether proficiency is achieved annually for the methods reported.

Score

0.0

m911
State public health laboratory provides or assures 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, & 2016

Limitations

The state public health laboratory testing "provide or assure" standard is based on national consensus expert opinion and is recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services, and is reflected in the Healthy People 2020 goals concerning access to comprehensive public health and environmental health laboratory testing. This standard requires the state public health authority, through its laboratory, engage in the testing and reporting process – either by directly performing the tests or by assuring that alternative labs perform the tests adequately. This standard is designed to ensure that laboratory testing, interpretation, and reporting is guided by specialized public health knowledge and expertise found within the state public health agency, and that timely, effective public health responses and protective actions occur based on test results. States that provide testing through another type of laboratory, with no assurance role performed by the public health laboratory, do not meet this standard. (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846798/). Inclusion of this measure ensures that the Index is consistent with national expert opinion and federal recommendations concerning comprehensive public health laboratory testing capabilities. However, the measure does not assess the quality of the testing, the timeliness of results reporting to enable responses to public health threats, nor whether sufficient capacity exists to test the volume of samples required during a health security event.

Score

Data Missing

m902
State has a high-capability laboratory to detect chemical threats (Level 1 or 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 & 2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the laboratory capabilities.

Score

Yes

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Community Planning & Engagement Coordination

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.

5.9
Measure
Measure Description
Score
m87
State health department is 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)

2014-2017

Limitations

The measure does not consider health departments that are undergoing the accreditation process.

Score

No

m501
Percent of the state's population served by a comprehensive public health system, as determined through the National Longitudinal Survey of Public Health Systems
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

Data are self-reported by local health department representatives and may reflect differences in perspective and interpretation among respondents.

Score

26.1%

m9031
Percent of hospitals in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

59.9%

m9032
Percent of emergency medical service agencies in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

58.2%

m9033
Percent of emergency management agencies in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

100.0%

m9034
Percent of local health departments in the state that participate in health care preparedness 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)

2013-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of participation in the health care preparedness coalitions.

Score

100.0%

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.

7.7
Measure
Measure Description
Score
m52
State requires all licensed child care providers to have a disaster 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 evaluate the quality or comprehensiveness of the disaster plan, whether the plan has been tested in the past two years, or whether there are effective partnerships supporting the plan, and does not consider nonlicensed providers.

Score

Yes

m53
State has a hazard response 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 evaluate the quality or comprehensiveness of the plan, whether the plan has been tested in the past two years, or whether there are effective partnerships supporting the plan, and does not specify the mulitple types of hazards to be considered.

Score

Yes

m163
Number of pediatricians per 100,000 population under 18 years old in the state
Measure Name

M163

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available pediatricians in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

21.5

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

M164

Measure Source

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

Data date(s)

2012-2016

Limitations

The measure does not consider mutual aid plans that may be in place for healthcare facilities to supplement the number of available obstetricians and gynecologists in the event of an emergency. Also, BLS and other national data sources on physician supply have been shown to undercount certain types of physicians, and may differ considerably from the estimates available from state medical licensing boards. Since the measurement undercounting in the BLS data are expected to be relatively consistent across states, they should not cause significant bias in the Index state and national results. The Bureau of Labor Statistics (BLS) produces occupational estimates by surveying a sample of non-farm establishments. As such, estimates produced through the Occupational Employment Statistics (OES) program are subject to sampling error.

Score

5.5

m170
Percent of state children (0-18 years) who reside within 50 miles of a pediatric trauma center, including out-of-state centers
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)

2012-2017

Limitations

The measure does not indicate the capacity of the trauma center, such as the number of available pediatric trauma beds or inpatient treatment beds for the care of pediatric patients.

Score

74.8%

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

M50

Measure Source

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

Data date(s)

2013-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the reunification plans, and the types of plans and target audiences are not consistently defined.

Score

Yes

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

M51

Measure Source

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

Data date(s)

2013-2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the reunification plans, and the types of plans and target audiences are not consistently defined.

Score

Yes

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

3.5
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 does not evaluate the quality or comprehensiveness of the volunteer registry, indicate whether it has been used during exercises or responses,or reflect state capacity for volunteer surge during emergencies.

Score

Foundational

m266
Percent of the 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, 2016

Limitations

The measure does not evaluate the quality or comprehensiveness of the CERT, including leadership strength, local and governmental agency suport, or participation of multiple sectors.

Score

51.5%

m346
Number of total Medical Reserve Corps members per 100,000 population in the state
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, 2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of licensed/credentialed/trained members, or include other formal and informal systems of registering, credentialing, and managing health and medical volunteers such as ESAR-VHP (Emergency System for the Advance Registration of Volunteer Health Professionals).

Score

30.0

m176
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of physician members who are licensed, credentialed, and received emergency response training.

Score

12.3%

m179
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of nurses or advanced practice nurses who are licensed, credentialed, and received emergency response training.

Score

27.3%

m186
Percent of state 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)

2015-2017

Limitations

The measure does not evaluate the quality of the MRC management and current status of other health professionals who are licensed, credentialed, and received emergency response training.

Score

60.3%

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.

1.2
Measure
Measure Description
Score
m175
Percent of voting-eligible population in the state participating in the highest office election
Measure Name

M175

Measure Source

United States Election Project, General Election Turnout Rates

Data date(s)

2012, 2014 & 2016

Limitations

The ideal numerator is total ballots counted (voting eligible population is the denominator), but these data are not available for all jurisdictions. Therefore, we use the next best alternative, which is the total votes for the highest office (e.g., presidential, gubernatorial, or congressional election).

Score

43.9%

m188
Percent of adults in the state who volunteer in their communities
Measure Name

M188

Measure Source

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

Data date(s)

2012-2015

Limitations

Data do not reflect the frequency, regularity or sustainability of volunteering, and respondents may be inclined to over-report their volunteerism.

Score

18.2%

m189
Number of annual volunteer hours per state resident, 15 years and older
Measure Name

M189

Measure Source

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

Data date(s)

2012-2015

Limitations

Respondents may be inclined to over-report the number of hours they volunteer. Also, certain communities that have strong social cohesion may have a low reported rate, such as settings where both parents work full-time and may not have time to volunteer.

Score

15.9

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Incident & Information Management

incm: incident management

infm: information management

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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.

7.7
Measure
Measure Description
Score
m10
State public health laboratory uses a rapid method (e.g., Health Alert Network (HAN), blast e-mail or fax) to send messages to their 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 evaluate the frequency that the alert network is used or tested for routine or emergency messages, or whether it reaches all sentinel clinical laboratories and other partners in the state.

Score

Foundational

m70
CDC assessment score (0-100) of state health department dispensing plan for prophylaxis or disease fighting materiel from the CDC's Strategic National Stockpile
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 is incident-specific and focused on operational coordination issues, and does not include items such as mutual aid and resource planning.

Score

100.0

m71
CDC assessment score (0-100) of state health department coordination plan with hospitals and alternate facilities to procure medical materiel in an emergency
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 does not evaluate the quality or implementation of the plan, and does not address additional multi-agency coordination facets of procurement such as information sharing between the public health and healthcare systems.

Score

100.0

m84
State all hazards emergency management program is accredited by the Emergency Management Accreditation Program (EMAP)
Measure Name

M84

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure does not consider state emergency management programs with conditional accreditation, and some states may choose not to pursue accreditation for various state and local reasons.

Score

Yes

m333
State has a disaster preparedness plan for animals including livestock and pets
Measure Name

M333

Measure Source

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

Data date(s)

2014-2017

Limitations

The measure does not evaluate the quality or comprehensiveness of the animal disaster preparedness plan.

Score

Yes

m107
Percent of local health departments in the state 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 does not apply to states that do not have local health departments. The measure does not evaluate the quality or robustness of the local emergency management system.

Score

88.9%

m229
State public health laboratory has a 24/7/365 contact system in place to use in case of an emergency
Measure Name

M229

Measure Source

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

Data date(s)

2012 & 2014

Limitations

The measure does not evaluate the quality or comprehensiveness of the system, or the frequency that it is used or tested.

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 data is collected by existing state and local reporting systems using secure data entry to measure bed counts during emergencies, and does not replace states' need to evaluate state and local bed count system development and implementation.

Score

Foundational

m72
CDC assessment score (0-100) of state health department emergency response training, exercise, and evaluation plans' compliance 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)