MWPERLC Needs Assessment Findings State and Local Respondents

Methodology This survey was designed to better understand the preparedness needs among the stakeholders operating within the Mountain West Preparedness Response and Learning Center’s (MWPERLC) service area: Arizona New Mexico Colorado Utah Nevada Tribal communities located within the borders of these states. Guidance included: Public Health Emergency Preparedness (PHEP) Capabilities List Hospital Preparedness Program (HPP) Capabilities List In order to provide a framework understood by many of the respondents, the MWPERLC team utilized the Public Health Emergency Preparedness (PHEP) Capabilities list developed by the Centers for Disease Control and Prevention (CDC), and the Hospital Preparedness Capabilities list (HPP) developed by the U.S. Department of Health and Human Service’s Office of the Assistant Secretary for Preparedness and Response (ASPR). These documents provide a common language for preparedness professionals.

Question Development Types of Questions in the Survey Multiple Choice Questions Text short-answer questions Given that the MWPERLC’s goal in this project is to develop a robust multijurisdictional network, categories for survey questions were developed to include: Emergency Preparedness Program Funding Emergency Preparedness Planning Statewide Exercise Multijurisdictional Coordination Public Health Emergency Preparedness and Hospital Preparedness Program Priorities Questions in each area were designed to evaluate the capacity, capability, and collaboration efforts undertaken by or with survey participants. To get the strongest responses possible, the survey relied on both multiple choice questions as well as short-answer text questions. Each of these types of questions provides valuable data that can be measured and analyzed for trends and patterns to give a better picture of the realities of preparedness in the respondent’s agencies.

Survey Dissemination The MWPERLC invited participants from various stakeholder agencies to participate in the Needs Assessment that best fit their profession. These participants included: Tribal public health emergency preparedness officials Tribal health departments State tribal liaisons within the MWPERLC service area State and local government partners Federal agencies which work with tribal communities (e.g., Indian Health Service, Bureau of Indian Affairs) Preparedness officials at the state and county level Regional health care coalitions Emergency management officials within the MWPERLC service area Public Health professionals who receive information from the MWPERLC listserv (Law Enforcement Personnel, Emergency Medical Technicians, Paramedics, Hospitals, Community Health Centers, Emergency Management)

Data Analysis Data was sorted through Qualtrics, which separated the responses based on the Assessment taken: State and Local Emergency Preparedness Survey Tribal Emergency Preparedness Survey University & College Partners Survey Public Health Emergency Preparedness Partners Survey

Quantitative Analysis Raw data sorted by individual assessment to find trends to determine: Highest PHEP and HPP needs for training, planning, exercise support, and technical assistance Gaps in readiness Levels of collaboration among systems partners Additionally, descriptive statistics, including sample size, mean, median, mode, averages, proportions, and total counts for each survey were used to summarize responses to the needs assessment. Data was used to develop graphs and charts allowing for a comparative analysis among Tribal and State/Local respondents.

Qualitative Analysis Each needs assessment utilized open-ended questions which were an integral part of the assessment as they allowed respondents to provide additional information, context and/or clarification in response to specific questions. These qualitative responses were separated from the multiple-choice questions for further, in-depth analysis using the following approach: Text responses were sorted into simple categories that were representative of the central theme in each response. Categories were subsequently added as needed to ensure that all central themes occurring in the responses were identified. All responses were then mapped to relevant categories and the frequency of each category was calculated. Results were aggregated and summarized into tables that identified the top 3 to 4 themes. In general, this qualitative analysis was required for questions that inquired into: Barriers to effective collaboration Identifying top PHEP/HPP capabilities Identifying needs within PHEP/HPP specific areas

The Mountain West Preparedness and Emergency Response Learning Center (MWPERLC) Service area includes the states of Nevada, Utah, Colorado, Arizona, and New Mexico. Additionally, the service area also includes the tribal communities within each state’s borders.

Expertise in Preparedness The total number of responses for the Tribal Partners Needs Assessment was 15. Since the n-value of all respondents to this survey was low, it was impossible to divide the responses by tribe or region while maintaining survey anonymity. For this reason, all data presented here is aggregate for all responses. Additionally, respondents were asked to identify their years in their respective position, agency, and field. The average of each was take to provide the following: Average Years in Position: 6.33 Average Years in Agency: 8.73 Average Years in Field: 16.40

Section I: Emergency Preparedness Program Funding

What are your sources of funding?

What happens if funding ends? Tribal Responses Reducing the program Canceling the PHEP program Seek out alternative funding sources State and Local Responses Apply for other sources of funding The program/funding responsibility would shift to different program/budget Interagency Collaboration would address gaps Preparedness Efforts would cease The respondents were asked to identify how they would continue their program should funding end. Since each jurisdiction is unique in their approach, this question was open-ended to allow for varied responses. Those responses were then reviewed for common themes and phrases. Whenever there was an answer similar to a previous one, they were both categorized in the same grouping. This analyses allowed the MWPERLC team to identify the general responses to the question listed here.

Section II: Emergency Preparedness Planning

All-Hazards Emergency Operations Plan Respondents were asked if their agency had an All-Hazards Emergency Operations Plan. 73% responded that they did, while 13% indicated that they did not, and another 13% reported that they were not sure. Those who said that their agency did have a plan were then asked to indicate how familiar they were with the plan. 91% reported being “very familiar” while 9% reported being “somewhat familiar.”

All-Hazards Emergency Operations Plan cont.

All-Hazards Emergency Operations Plan Those respondents who indicated that they were “very familiar” or “somewhat familiar” were also asked how often their agency updated the All-Hazards Emergency Operations Plan. They were given the options of “annually,” “every 2-3 years,” “greater than 3 years,” “semi-annually,” and “not sure.” Their breakdown is provided: Annually: 50% Every 2-3 years: 50%

Multi-year Training and Exercise Plan In responding to the question as to whether their agency participated in developing a Multi-year Training and Exercise Plan, 60% indicated in the affirmative, 27% in the negative, and 13% not sure.

Multi-year Training and Exercise Plan Top three priority training areas for 2016-2017 Community Recovery Community Preparedness Information and Warning Medical Countermeasure Dispensing Operations Continuity of Operations Public Health Incident Management Emergency Operations Coordination Mass Fatality Information Sharing Non-Pharmaceutical Interventions Recovery Mass Care Emergency Operation Center Survey respondents were asked to provide their top three training priorities from their MYTEP for 2016-2017. The question was open-ended, allowing respondents to reply as they saw fit. These responses were taken as a group to analyze for common phrasing and concept. The areas presented in this slide provide the most common responses for training. Whenever a training area appears larger indicates that this capability/topic was mentioned by multiple respondents.

Section III: Statewide Exercise

Are you or Your Agency Participating in a State-wide Exercise in 2017-2018? Participants were asked whether they had a role in an upcoming statewide exercise in 2016-2017. 85.37% said that they did, while 12.20% said that they did not. 2.44% reported being not sure.

What is your anticipated role? Statewide Exercise What is your anticipated role? Those who indicated that they did have a role were then asked to identify that role from a list provided: Hosting Agency: 20% Participating Agency: 74% Observing Agency: 3% Other: 3%

Capabilities Targeted by Exercise Statewide Exercise Capabilities Targeted by Exercise Respondents who were participating in a statewide exercise were asked which capabilities were targeted by the exercise. Respondents were allowed to select multiple options. Public Health Emergency Preparedness: 100% Hospital Preparedness Program: 100% Joint Commission: 29% Other: 14%

Section IV: Multijurisdictional Coordination

Multi-jurisdictional Coordination In addition to the previous question on collaboration with systems partners, the Needs Assessment asked respondents to evaluate their relationships with tribal communities specifically. 66% reported that there were sufficient opportunities for interaction. 24% reported insufficient opportunities, and 10% indicated that there were just the right amount of opportunities for collaboration.

Work to establish communication Collaboration is strong among agencies Why do you feel there are sufficient or just the right amount of opportunities? Work to establish communication Collaboration is strong among agencies Work together Partnerships developed Interaction between agencies Why do you feel there are insufficient or just the right amount of opportunities? Infrastructure could be stronger Lack of staff Location is a challenge (rural/urban) Once respondents indicated their opportunities for collaboration with tribal communities, they were then asked to specify why they felt the opportunities were as they reported. The information provided here is based off of identifying the general themes to their respective responses.

Continue to pursue relationships with tribes through What recommendations do you have to enhance collaboration with tribal partners? Continue to pursue relationships with tribes through communication and invitation Invite them more frequently to events and meetings Need a better understanding of what’s needed or expected by all partners Additionally, all respondents were asked to provide recommendations for enhancing collaboration with tribal partners. As in the qualitative data provided previously, the information provided here is based off of identifying general trends and themes in the responses to the question presented.

Section V: Public Health Emergency Preparedness and Hospital Preparedness Program Priorities

Public Health Emergency Preparedness Priorities Respondents were asked to identify their top three general PHEP priorities. Based on the results provided in the Needs Assessment, those top three were: #1: Emergency Operations Coordination #2. Community Recovery/Information Sharing (tie) #3 Medical Countermeasure Dispensing The counts are varied, since each individual respondent was asked to identify 3 distinct priorities.

Additionally, participants were asked to identify whether there was a technical assistance, planning, training, or exercise support need for each of the identified Public Health Emergency Preparedness Program priorities. Those areas are listed left-to-right within each capability.

Hospital Preparedness Program Priorities As with the PHEP priorities previously mentioned, respondents were asked to identify their top three HPP priorities. Based on the results provided in the Needs Assessment, those top three were: #1: Emergency Operations Coordination/Medical Surge (tie) #2. Information Sharing #3 Healthcare System Preparedness The counts are varied, since each individual respondent was asked to identify 3 distinct priorities.

Participants were also asked to identify whether there was a technical assistance, planning, training, or exercise support need for each of the identified Hospital Preparedness Program priorities. Those areas are listed left-to-right within each capability.

Questions can be directed to: For additional information and discussion of the findings, please refer to the Needs Assessment Report available on the MWPERLC Learning Portal Questions can be directed to: Brenda Granillo, MS, MEP Director MWPERLC bgranill@email.arizona.edu (520) 626-0617