NHSPI_measure_metadata
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31 rows where domain_description = "Health Security Surveillance "
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| Link | rowid ▼ | obsid | index | item_code | domain_code | domain_name | domain_description | subdomain_code | subdomain_name | subdomain_description | subdomain_long_desc | measure_name | measure_description | measure_rationale | data_source | verbose_data_source | data_dates | limitations |
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| 1 | 1 | 3.0 | Foundational | 1.1.1 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M17 | State health department participates in the Behavioral Risk Factor Surveillance System (BRFSS) | The measure indicates participation in the nation's largest surveillance system that tracks health conditions and risk behaviors. The Behavioral Risk Factor Surveillance System (BRFSS) is used to collect prevalence data from U.S. adult residents regarding risk behavior and preventive health practices that can affect health status. Participation can provide population-level data that can be useful in vulnerability assessments and developing messaging and intervention strategies. | CDC BRFSS | 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 authors. | 2012—2015 | The state's extensiveness of participation in the BRFSS based on sampling and instrumentation is not measured, and varies widely across states. |
| 2 | 2 | 4.0 | Index | 1.1.2 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M18 | Number of epidemiologists per 100,000 population in the state, by quintile (1=Lowest Quintile, 5=Highest Quintile) | The measure indicates the state-wide personnel capacity of epidemiologists. An accessible epidemiology workforce is critical to assuring an organization can maintain on-going surveillance operations to detect emerging disease and to surge, or ramp up, during and after any significant event involving exposure to a hazard. | BLS OES & ASTHO | Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES) and ASTHO Profile of State and Territorial Public Health--2012 and 2016 Epidemiologists by Jurisdiction | 2012—2017 | The measure may overestimate the number of epidemiologists who are available to prepare for and respond to emergencies, because it counts all personnel regardless of the occupational settings in which they practice and the job responsibilities they perform. 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, this is unlikely to 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. |
| 3 | 3 | 5.0 | Foundational | 1.1.3 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M19 | State health department participates in the Epidemic Information Exchange (Epi-X) System | The measure indicates participation in the Centers for Disease Control and Prevention (CDC)-sponsored national information sharing system. Participation in this system provides access to national level alerts and raises situational awareness beyond state borders. | CDC Epi-X | Centers for Disease Control and Prevention (CDC), The Epidemic Information Exchange (Epi-X) Program | 2013 | The measure does not evaluate the quality or comprehensiveness of state participation in the system. |
| 4 | 4 | 6.0 | Foundational | 1.1.4 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M20 | State health department participates in the National Electronic Disease Surveillance System (NEDSS) | The measure indicates participation in the national, electronic public health surveillance system. Participation assures that key surveillance data are comparable across states and enables national measurements of disease burden and progression. | CDC NEDSS | Centers for Disease Control and Prevention (CDC), Division of Health Informatics and Surveillance (DHIS), National Electronic Disease Surveillance System (NEDSS) | 2013—2015 | The measure does not evaluate the quality or comprehensiveness of state participation in the system. |
| 5 | 5 | 7.0 | Index | 1.1.5 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M22 | State health department has an electronic syndromic surveillance system that can report and exchange information | The measure indicates state health department-access to syndromic surveillance data. Syndromic surveillance enables continuous monitoring for indicators of population level changes in health status that can in turn provide early warning of hazardous events. | ASTHO Profile V. III | Association of State and Territorial Health Officials (ASTHO), ASTHO Profile of State Public Health: Volume Three | 2012 & 2016 | Data are self-reported by state public health agencypersonnel and may reflect differences in awareness, perspective and interpretation among respondents. Nevada did not complete the survey used as the original data source but they subsequently provided information for this measure. |
| 6 | 6 | 8.0 | Index | 1.1.6 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M217 | State public health laboratory has implemented the laboratory information management system (LIMS) to exchange laboratory information and results electronically with hospitals, clinical labs, state epidemiology units, and federal agencies | Laboratory Information Management Systems (LIMS) are important contributors to timely and accurate sending and receiving of critical laboratory testing information. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012, 2014, & 2016 | Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents. Selected responses from the all years of survey have been corrected for Wyoming and 2016 fresponse for Oklahoma has been corrected and therefore no longer correspond to the originally published survey results. |
| 7 | 7 | 9.0 | Index | 1.1.7 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | 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 | States and the federal government have disease reporting regulations that require notification of foodborne and other infectious diseases. Reporting requirements provide population-based data on infectious diseases. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012, 2014, & 2016 | Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents. Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 8 | 8 | 10.0 | Foundational | 1.1.8 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | 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) | The measure indicates participation in national information sharing systems and electronic web-based public health surveillance systems. Participation assures that laboratory and surveillance data are comparable across states and enables national measurements of disease burden and progression. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012 & 2014 | The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks. |
| 9 | 9 | 11.0 | Index | 1.1.9 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M23 | Percent of foodborne illness outbreaks reported to CDC by state and local public health departments for which a causative infectious agent is confirmed | The measure indicates a state's ability to confirm the pathogens that cause foodborne disease outbreaks. This capability allows states to identify and intervene rapidly to prevent further spread of outbreaks in the community. | CDC NORS | Centers for Disease Control and Prevention (CDC), National Outbreak Reporting System (NORS) | 2012—2017 | The measure does not evaluate the quality or comprehensiveness of the state's reporting of foodborne illness outbreaks. |
| 10 | 10 | 12.0 | Foundational | 1.1.10 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M289 | State health department participates in a broad prevention collaborative addressing healthcare-associated infections (HAIs) | Healthcare-associated infections (HAIs) are diseases acquired by patients while receiving medical treatment in a healthcare facility. HAIs are significant sources of preventable disease burden, and place communities at elevated risk of large-scale outbreaks and epidemics. State prevention collaboratives consist of multiple hospitals within a state that support implementation of evidence-based prevention strategies through peer learning, performance measurement, and feedback reporting to clinicians and staff. State health department participation in these collaboratives is an indicator of the strength of HAI prevention strategies. | CDC PSR | Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN), Prevention Status Reports | 2013 | The measure does not evaluate the quality, comprehensiveness, or effectiveness of HAI prevention collaboratives. |
| 11 | 11 | 13.0 | Index | 1.1.11 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M290 | State has a public health veterinarian | This measure indicates a state’s ability to access veterinarian expertise in preventing, preparing for, detecting, responding to, and recovering from hazardous events that may originate in or spread through animal populations, ultimately creating health risks for humans. | NASPHV | National Association of State Public Health Veterinarians (NASPHV), Designated and Acting State Public Health Veterinarians | 2014 & 2015, 2017—2019 | 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 emergency response situation. |
| 12 | 12 | 14.0 | Index | 1.1.12 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M265 | State uses an Electronic Death Registration System (EDRS) | The measure indicates a state's adoption and use of an electronic death registration system (EDRS). This capability may reduce the time require to process and access death certificates during an emergency. | NAPHSIS | National Association for Public Health Statistics and Information Systems (NAPHSIS), Electronic Death Registration Systems by Jurisdiction (State) | 2014—2018 | The measure does not evaluate the quality or comprehensiveness of the state's death registration system, or indicate other redundant systems that might be used if the EDRS is not available such as in the event of cyber-attacks and power outages. |
| 13 | 13 | 15.0 | Foundational | 1.1.13 | 1.0 | HSS | Health Security Surveillance | 1.0 | PHSEI | Health Surveillance & Epidemiological Investigation | 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. | M801 | State public health laboratory participates in the Centers for Disease Control and Prevention (CDC) Influenza surveillance program, and/or the World Health Organization (WHO) Influenza Surveillance Network | The measure indicates state participation in national information sharing systems and electronic web-based public health surveillance systems for influenza. Participation assures that key laboratory and surveillance data will be comparable across states and enables national and global measurements of disease burden and progression.. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012 & 2014 | The measure does not evaluate the quality or comprehensiveness of participation in the surveillance networks. |
| 14 | 14 | 17.0 | Foundational | 1.2.1 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | The measure focuses on laboratory knowledge, skills, and abilities to follow federal packaging and shipping regulations and the Centers for Disease Control and Prevention's (CDC) Laboratory Response Network (LRN) protocols. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2011—2013 | 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. |
| 15 | 15 | 18.0 | Index | 1.2.2 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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) | A laboratory must have federal certification to conduct testing for chemical agents. The measure focuses on certification or accreditation of a chemical laboratory. Also, a relevant certification framework exists for radiological terrorism laboratory certification. The measure also indicates whether a state's radiological terrorism laboratory has earned such certification. | APHL AHLPS | Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey | 2013—2018 | Certification may be based on simulated samples, since actual chemical samples are lacking. Selected responses from the 2018 survey have been corrected for Colorado and therefore no longer correspond to the originally published survey results |
| 16 | 16 | 21.0 | Index | 1.2.6 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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) | The laboratory must have a federal U.S. Department of Agriculture/Animal and Plant Inspection Service (USDA/APHIS) permit for the importation and transportation of controlled materials. The measure focuses on possession of the permit. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012, 2014, & 2016 | Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents. |
| 17 | 17 | 22.0 | Index | 1.2.7 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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) | The measure focuses on the state public health laboratory workforce readiness and surge capacity. | APHL AHLPS | Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey | 2013—2018 | The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency of the plan being used or tested. |
| 18 | 18 | 23.0 | Index | 1.2.8 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M9 | State public health laboratory has a continuity of operations plan consistent with National Incident Management System (NIMS) guidelines | The measure focuses on laboratory preparedness to sustain operations and provide alternative methods for operations during a public health emergency that directly impacts the laboratory staff or facility. | APHL AHLPS | Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey | 2013—2018 | The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency of the plan being used or tested. |
| 19 | 19 | 24.0 | Index | 1.2.9 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M11 | State public health laboratory has a plan to receive specimens from sentinel clinical laboratories during nonbusiness hours | The measure focuses on a public health laboratory's ability to receive samples at all times of the day from healthcare laboratories. It demonstrates that the public health laboratory is capable of receiving critical specimens during nonbusiness hours. | APHL AHLPS | Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey | 2013—2018 | The measure does not evaluate the quality or comprehensiveness of the plan, or the frequency of the plan being used or tested. |
| 20 | 20 | 25.0 | Index | 1.2.10 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | Rapid transport of specimens and isolates to a public health laboratory is important to decrease the time to recognize and identify a potential public health emergency. The measure focuses on a laboratory's ability to assure transport of samples at all times of the day. | APHL AHLPS | Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey | 2013—2018 | The measure does not evaluate the timeliness of the sample transport, or the whether the transport is available for all sentinel laboratories in the state. |
| 21 | 21 | 26.0 | Index | 1.2.11 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M211 | Percent of 10 tests for infectious diseases that the state public health laboratory provides or assures, including the study of the characteristics of a disease or organism in blood tests for arbovirus, hepatitis C, Legionella, measles, mumps, Neisseria meningitides serotyping, Plasmodium identification, Salmonella serotyping, Shigella serotyping, and Varicella | The measure focuses on the public health laboratory's (PHL's) ability to provide a range of diagnostic and surveillance testing. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012, 2014, & 2016 | 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. Selected responses from the 2016 survey have been corrected for Louisana and therefore no longer correspond to the originally published survey results. |
| 22 | 22 | 27.0 | Index | 1.2.12 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | The measure focuses on the public health laboratory's (PHL's) ability to provide a range of diagnostic and surveillance testing. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012, 2014, & 2016 | 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. Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 23 | 23 | 30.0 | Index | 1.2.15 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M2 | Percent of Laboratory Response Network biological (LRN-B) proficiency tests successfully passed by Public Health Emergency Preparedness (PHEP) Cooperative Agreement-funded laboratories | Recognition of a health emergency requires accurate and timely laboratory testing of a variety of samples in order to detect potential diseases or exposures. The measure focuses on the ability of lab to detect and identify biological threat agents in an exercise or test scenario. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2011—2016 | Laboratories may not undergo proficiency testing for all assay capabilities. Selected responses from the 2013, 2014, 2015, and 2016 survey have been corrected for Louisana and therefore no longer correspond to the originally published survey results. |
| 24 | 24 | 31.0 | Index | 1.2.16 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | Bacterial subtyping data can be important in outbreak detection. The measure focuses on the timeliness of the public health laboratory to perform subtyping tests and report results nationally. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2011—2016 | The measure does not encompass time elapsed for specimen transport and identification, and is limited to foodborne agents that have PFGE subtyping. |
| 25 | 25 | 32.0 | Index | 1.2.17 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | The measure focuses on a public health laboratory's ability to perform, without notice, tests on patient specimens for chemical agents and report the results. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2013—2016 | The measure does not consider the public health laboratory's ability to process a large number of samples. |
| 26 | 26 | 34.0 | Index | 1.2.19 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | Recognition of a health emergency requires accurate and timely laboratory testing of a variety of samples in order to detect potential diseases or exposures. The measure focuses on the ability of a laboratory to detect and identify chemical threat agents during an exercise or test. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2011—2016 | The measure does not consider all methods that the laboratory is capable of testing. |
| 27 | 27 | 36.0 | Index | 1.2.21 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M286 | Number of chemical threat and multi-hazards preparedness exercises or drills the state public health laboratory conducts or participates in annually | Drills and exercises are important to the development and improvement of emergency preparedness and response plans and procedures. Frequent testing of plans and updated plans are important to continuous quality improvement. | APHL AHLPS | Association of Public Health Laboratories (APHL), All-Hazards Laboratory Preparedness Survey | 2013—2018 | Data are self-reported by public health laboratory representatives and may reflect differences in awareness, perspective and interpretation among respondents. |
| 28 | 28 | 37.0 | Index | 1.2.22 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | 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 | Rapid identification of Listeria moncytogenes at the state's PFGE laboratory and rapid submission of the results to the Pulsenet national database is important to be able to identify multistate or national outbreaks of diseases. Once outbreaks are identified and the source is investigated, recalls and advisories can be issued to protect the public from additional exposure. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2011—2016 | The measure does not consider the volume of samples processed or quality of PFGE results, nor encompass time elapsed for specimen transport and identification. |
| 29 | 29 | 38.0 | Index | 1.2.23 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M288 | Number of core chemical agent detection methods demonstrated by Level 1 or 2 LRN-C laboratories in the state | The Centers for Disease Control and Prevention (CDC) identified nine core methods for detecting and measuring chemical agents, and conducted testing to determine LRN-C laboratories' proficiency in these methods. The core methods are significant as they use technical fundamentals that provide the foundation of chemical analysis capabilities. | CDC Snapshot | Centers for Disease Control and Prevention (CDC), Office of Public Health Preparedness and Response (OPHPR), National Snapshot of Public Health Preparedness | 2011—2016 | 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. Selected responses from the original data source have been corrected for Colorado and Louisana and therefore no longer correspond to the originally published results. |
| 30 | 30 | 38.1 | Index | 1.2.24 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M911 | State public health laboratory provides or assures testing for soil | Soil testing is an essential component of environmental monitoring. | APHL CLSS | 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. | 2012, 2014, & 2016 | 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. Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 31 | 31 | 38.2 | Index | 1.2.25 | 1.0 | HSS | Health Security Surveillance | 2.0 | BMLT | Biological Monitoring & Laboratory Testing | 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. | M902 | State has a high-capability laboratory to detect chemical threats (Level 1 or 2 LRN-C laboratory) | Level 2 laboratories are staffed with chemists who are trained to detect exposure to a broad array of chemical agents. Level 1 laboratories provide surge-capacity testing for federal CDC laboratories and are able to detect exposure to an expanded number of chemical agents beyond the Level 1 testing capabilities. State participation in LRN-C may enable faster detection of chemical exposures that are of public health concern. | CDC NCEH/DLS/ERB | Centers for Disease Control and Prevention (CDC), National Center for Environmental Health (NCEH), Division of Laboratory Sciences (DLS), Emergency Response Branch (ERB) | 2016 & 2017 | The measure does not evaluate the quality or comprehensiveness of the laboratory capabilities. |
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