More states are better prepared for health emergency, watchdog group says

As the Coronavirus Disease 2019 begins invading the United States, a national health care watchdog group says most states have improved their emergency preparedness plans including public health funding, participation in healthcare coalitions and compacts, hospital safety and seasonal flu vaccination.

Colorado, Utah, and Washington were among 25 states and the District of Columbia that were placed in the high preparedness performance tier, established by Trust for America’s Health, a non-profit, non-partisan organization that promotes illness prevention and injury. Last year, the group put 17 states in the high-performance tier.


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The group’s annual report measures emergency preparedness in every state, based on 10 performance indicators and by tracking public health funding. Trust for America’s Health then ranks states’ level of preparedness into three performance tiers: high, middle and low.

Twelve states – including Arizona, California, Oregon and Texas – placed in the middle performance tier this year. Last year, 20 states and the District of Columbia placed in the middle tier.

Alaska and Hawaii were among thirteen states placed in the low tier, the same number as last year.

The 10 preparedness indicators according to Trust for America’s Health are:

  • Incident Management: Adoption of the Nurse Licensure Compact
  • Cross-Sector Community Collaboration: Percentage of hospitals participating in healthcare coalitions.
  • Institutional Quality: Accreditation by the Emergency Management Accreditation Program
  • Institutional Quality: Size of the state public health budget, compared with the last year.
  • Water Security: Percentage of the population who used a community water system that failed to meet all applicable health-based standards.
  • Workforce Resiliency and Infection Control: Percentage of employed population with paid time off.
  • Countermeasure Utilization: Percentage of people ages 6 months or older who received a seasonal flu vaccination.
  • Patient Safety: Percentage of hospitals with a top-quality ranking (“A” grade) on the Leapfrog Hospital Safety Grade.
  • Health Security Surveillance: The public health laboratory has a plan for a six-to-eight-week surge in testing capacity.

“Overall the report found that states’ level of preparedness has improved in key areas, including public health funding, participation in healthcare coalitions and compacts, hospital safety, and seasonal flu vaccination.” according to Trust for America’s Health. “However, other key health security measures, including ensuring a safe water supply and access to paid time off, stalled or lost ground.”