1. 1 2014: New Domains, New Measures, New Data Briefing Slides

2. 2 Contents NHSPI™ Overview and Background The 2014 NHSPI™ 2014 NHSPI™ Results Using the NHSPI™ Results Future Direction and Next Steps

3. 3 What is the National Health Security Preparedness Index™ (NHSPI™)? A first of its kind tool to annually measure and advance our preparedness Examines health security preparedness of the nation by collectively looking at states Evolving focus on public health, healthcare, and more

4. 4 Why an Index? Evaluates levels of complex things – economy (e.g., Consumer Price Index), health (e.g., Well-Being Index), etc. Provides more meaningful information groupings than sum of individual parts or measures

5. 5 Why is the Index Important? Provides the most comprehensive set of measures to date Assesses how well we are prepared for emergencies Guides improvement efforts Enhances understanding of what health security entails Before NHSPI™, many different benchmarks measured numerous aspects of preparedness No composite picture on topic existed Complexity of preparedness has made understanding and assessing it confusing to most audiences

6. 6 Why the Index is Unique Guiding Principles for Development On Health Security: 1. Includes many influencing factors of our nation’s health security 2. Emphasizes shared responsibility for our nation's health security among the whole community, including all sectors and jurisdictions 3. Uses broad PPD-8 preparedness definition 4. Incorporates fundamental disaster risk reduction and primary prevention concepts On Index Development: 5. Is practical and of greater use than what we currently have 6. Builds on public-use data; no added data collection burdens to practitioners 7. Aligns with existing national health security and preparedness capabilities / frameworks 8. Aims to reflect health security preparedness of states and the nation 9. Includes a transparent process of continuous improvement, stakeholder involvement, and real-world experience On Index Use: 10. Groups information into more meaningful picture than sum of its parts 11. Advances the science of measuring health security preparedness

7. 7 Methodology Calculate Values and Produce Annual NHSPI™ Input from Stakeholders; Refinement of Model Develop Structure, Incorporate New Areas Identify and Evaluate Measures

8. 8 Practice Experts + Academic Experts + Policy Experts Stakeholder Review and Engagement Refined and Expanded Index Structure Vetted Candidate Measures through Expert Groups Populated Index Structure with Applicable Measures State Preparedness Directors and Colleagues NHSPI TM Workgroup Members Representatives from 48 National Associations Commitment to thoroughness, transparency, and stakeholder engagement. 2014 NHSPI™ Development Process

9. 9 Contents NHSPI™ Overview and Background The 2014 NHSPI™ 2014 NHSPI™ Results Using the NHSPI™ Results Future Direction and Next Steps

10. 10 2014 NHSPI™: What’s New The NHSPI™ has expanded in both scope and depth  Updated and new data to better reflect the current cycle of protection, mitigation, preparedness, response, and recovery  2014 Index has 6 domains, 18 sub-domains, and 194 measures building upon 2013 structure  Major structural changes: New domain: Environmental & Occupational Health Overhaul: Healthcare Delivery (previously Surge Management) domain New sub-domain: Legal & Administrative

11. 11 2014 NHSPI™ Structure

12. 12 Contents NHSPI™ Overview and Background The 2014 NHSPI™ 2014 NHSPI™ Results Using the NHSPI™ Results Future Direction and Next Steps

13. 13 2014 NHSPI ™ : Results for the Nation DomainSub-domainNational ResultsState Range Health Security Surveillance7.86.0 – 9.2 Health Security Surveillance & Epi Investigation7.95.8 – 9.9 Biological Monitoring & Laboratory Testing7.65.8 – 9.3 Community Planning & Engagement6.75.3 – 8.8 Cross Sector / Community Collaboration6.42.0 – 10 Children & At-Risk Populations5.82.4 – 8.4 Management of Volunteers During Emergencies6.04.4 – 9.6 Social Capital & Cohesion8.47.1 – 9.6 Incident & Information Management8.16.6 – 9.5 Incident Management & Multi-Agency Coordination8.26.3 – 9.7 Emergency Public Information &Warning8.05.1 – 9.7 Legal & Administrative8.15.9 – 10 Healthcare Delivery6.55.5 – 7.4 Pre-hospital Care6.63.2 – 8.7 Inpatient Care5.83.5 – 7.3 Long-Term Care6.24.3 – 7.7 Mental & Behavioral Healthcare6.04.3 – 7.9 Home Care8.06.9 – 9.4 Countermeasure Management9.17.5 – 9.7 Medical Materiel Management, Distribution, & Dispensing9.47.2 – 10 Countermeasure Utilization & Effectiveness8.87.8– 9.7 Environmental & Occupational Health5.93.3 – 8.3 Food & Water Security6.74.1 – 9.7 Environmental Monitoring5.21.5 – 7.1 Overall Index Results: 7.4Overall State Range: 6.5 - 8.2

14. 14 2014 NHSPI™ Results at NHSPI.org

15. 15 2014 NHSPI ™ : Results for the Nation

16. 16 2014 NHSPI ™ : Results for the States

17. 17 2014 NHSPI ™ National Results Strengths Three areas (i.e., domains) of health security preparedness strength: Incident & Information Management Result: 9.1 Countermeasure Management Result: 8.1 Result: 7.8 Health Security Surveillance

18. 18 2014 NHSPI ™ National Results Strengths Six relative areas (i.e., sub-domains) of health security preparedness strength: Countermeasure Management Medical Materiel Management, Distribution, & Dispensing Result: 9.4 Countermeasure Utilization & Effectiveness Result: 8.8 Incident & Information Management Incident Management & Multi-Agency Coordination Result: 8.2 Result: 8.1 Legal & Administrative Health Security Surveillance Health Surveillance & Epidemiological Investigation Biological Monitoring & Laboratory Testing Result: 7.9 Result: 7.6

19. 19 2014 NHSPI ™ National Results Areas in Greater Need of Development Three key areas (i.e., domains) in greater need of development: Environmental & Occupational Health Healthcare Delivery Community Planning & Engagement Result: 5.9 Result: 6.5 Result: 6.7

20. 20 2014 NHSPI ™ National Results Areas in Greater Need of Development Three relative areas (i.e., sub-domains) reflecting need for work: Environmental & Occupational Health Healthcare Delivery Community Planning & Engagement Result: 5.2 Environmental Monitoring Inpatient Care Result: 5.8 Children & Other At-Risk Populations

21. 21 2014 NHSPI™ State Results Relative to National Averages Structure View for State A

22. 22 2014 NHSPI™ State Results Relative to National Averages Structure View for State A

23. 23 2014 NHSPI™ State Results Measure Results Report View for State A

24. 24 Example Measure Detail

25. 25 Contents NHSPI™ Overview and Background The 2014 NHSPI™ 2014 NHSPI™ Results Using the NHSPI™ Results Future Direction and Next Steps

26. 26 Who is the NHSPI™ for? Emergency Management Personnel City and Regional Planners Healthcare Preparedness Staff Community Coalitions and Advocacy Groups Federal and State Legislative Staff Public Health, and more… The Index is intended to be used to: Support quality improvement, Inform resource and policy decisions, Enhance collaboration and strengthen shared responsibility, and Advance the science of measuring preparedness.

27. 27 NHSPI™: Driving Dialogue Around Results Examine results at the national or state level Examine results in relation to national averages and broad groupings of state results Areas of relative strength and areas for further development Stakeholder dialogue offers greater context and can galvanize improvement efforts

28. 28 Beyond the Numbers Usefulness also lies in NHSPI™ content and structure Understanding the types of efforts required to advance health security preparedness Emphasizing relationship between the strength of everyday systems and disaster response capability Guiding inquiry needed for informed resource and policy decisions Fostering new partnerships and collaborations Serving as a call for addressing gaps in measurement and advancing preparedness science

29. 29 Too soon for formal evaluation, though comments and early experience suggest: Sharper understanding of what is involved in health security Renewed interest in system assessment Opportunities for new collaborations around preparedness What Effect is It Having?

30. 30 Contents NHSPI™ Overview and Background The 2014 NHSPI™ 2014 NHSPI™ Results Using the NHSPI™ Results Future Direction and Next Steps

31. 31 New Leadership from RWJF  The Robert Wood Johnson Foundation (RWJF) will take over as owner and manager of the NHSPI™ in late 2014  University of Kentucky selected as the new Program Management Office  National Advisory Committee appointments in process (replaces current Steering Committee)  RWJF and UK are committed to remaining engaged with current stakeholders and expanding engagement with new sectors

32. 32 The NHSPI™ will continue to evolve with input from stakeholders, experience from use, and model refinements. Future Directions The Future of the NHSPI™ Incorporate additional sectors Model refinement and validation Expand tools to support use Build capability for trending

33. 33 Stakeholders will continue to shape the Index! Receive updates and share ideas at www.nhspi.org.www.nhspi.org Send input on the Index structure and uses Join the NHSPI™ mailing list View the NHSPI™ calendar of events Built by the Community, for the Community

34. 34 For More Information Website www.nhspi.org General Inquiries nhspi-info@astho.org Media Inquiries Scott Briscoe ASTHO Senior Director, Communications and Marketing sbriscoe@astho.org 571-527-3173 For inquiries relating to the transition in leadership: Alexis Levy Communications Officer, Robert Wood Johnson Foundation alevy@rwjf.org 609-627-5702