NHSPI_measure_metadata
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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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| 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. |
| 98 | 98 | 224.0 | Index | 5.2.1 | 5.0 | CM | Countermeasure Management | 16.0 | CUE | Countermeasure Utilization & Effectiveness | 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. | 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 | The measure is used by the Centers for Disease Control and Prevention (CDC) and states to monitor health status and is an important measure of achievement of immunization program objectives. The measure is a pre-event indicator of the capacity of the state's public and private immunization infrastructure needed to respond to an emerging vaccine-controllable disease. | CDC NIS | Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHC), National Immunization Survey (NIS) | 2012—2017 | 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. |
| 99 | 99 | 225.0 | Index | 5.2.2 | 5.0 | CM | Countermeasure Management | 16.0 | CUE | Countermeasure Utilization & Effectiveness | 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. | M32 | Percent of seniors age 65 and older in the state receiving a seasonal flu vaccination | The measure focuses on adults aged 65+ who have had an influenza vaccination within the past year. This measure is used by the Centers for Disease Control and Prevention (CDC) and states to monitor health status and is an important measure of achievement of immunization program objectives. The measure is a pre-event indicator of the capacity of the state's public and private immunization infrastructure needed to respond to an emerging vaccine controllable disease. | CDC FluVaxView | 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 | 2013—2018 | 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. |
| 100 | 100 | 226.0 | Index | 5.2.3 | 5.0 | CM | Countermeasure Management | 16.0 | CUE | Countermeasure Utilization & Effectiveness | 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. | M33 | Percent of seniors age 65 and older in the state receiving a pneumococcal vaccination | The measure focuses on adults aged 65+ who have ever had a pneumonia vaccination. The measure should be viewed alongside other measures in the Countermeasures Utilization Effectiveness sub-domain as an indicator of pre-event capacity of the state's immunization system. | 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 PMO personnel. | 2012—2017 | The measure evaluates the recommended vaccine for preventable disease in seniors, and may not reflect the vaccination rate for a severe emerging disease. |
| 101 | 101 | 227.0 | Index | 5.2.4 | 5.0 | CM | Countermeasure Management | 16.0 | CUE | Countermeasure Utilization & Effectiveness | 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. | M34 | Percent of children aged 6 months to 4 years old in the state receiving a seasonal flu vaccination | The measure is used by Centers for Disease Control and Prevention (CDC) and states to monitor health status and is an important measure of the achievement of the state's immunization objectives. The measure serves as a pre-event indicator of the capacity of the immunization infrastructure in the state needed to respond to an emerging vaccine-controllable disease. | CDC NIS | Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHC), National Immunization Survey (NIS) | 2012—2018 | 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. |
| 102 | 102 | 228.0 | Index | 5.2.5 | 5.0 | CM | Countermeasure Management | 16.0 | CUE | Countermeasure Utilization & Effectiveness | 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. | M35 | Percent of adults aged 18 years and older in the state receiving a seasonal flu vaccination | The measure focuses on influenza vaccination coverage for adults aged 18 to 64 years. This measure is used by the Centers for Disease Control and Prevention (CDC) and states to monitor health status and is an important measure of achievement of immunization program objectives. The measure is a pre-event indicator of the capacity of the state's public and private immunization infrastructure needed to respond to an emerging vaccine-controllable disease. | CDC FluVaxView | 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 | 2013—2018 | 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. |
| 103 | 103 | 237.0 | Index | 6.1.2 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M275_DW | State public health laboratory provides or assures testing for drinking water | Having the capability at a state public health laboratory to test different types of water samples is important to the characterization of various water-based environments that may be contaminated or otherwise affected by a health security event. Being able to rapidly characterize the level of contamination is important for preventing exposure and being able to allow re-entry/use during the recovery phase of an event. | 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. |
| 104 | 104 | 238.0 | Index | 6.1.3 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M275_PWW | State public health laboratory provides or assures testing for private well water | Having the capability at a state public health laboratory to test different types of water samples is important to the characterization of various water-based environments that may be contaminated or otherwise affected by a health security event. Being able to rapidly characterize the level of contamination is important for preventing exposure and being able to allow re-entry/use during the recovery phase of an event. | 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/). |
| 105 | 105 | 239.0 | Index | 6.1.4 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M275_REC | State public health laboratory provides or assures testing for recreational water | Having the capability at a state public health laboratory to test different types of water samples is important to the characterization of various water-based environments that may be contaminated or otherwise affected by a health security event. Being able to rapidly characterize the level of contamination is important for preventing exposure and being able to allow re-entry/use during the recovery phase of an event. | 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/). |
| 106 | 106 | 240.0 | Index | 6.1.5 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M275_SUR | State public health laboratory provides or assures testing for surface water | Having the capability at a state public health laboratory to test different types of water samples is important to the characterization of various water-based environments that may be contaminated or otherwise affected by a health security event. Being able to rapidly characterize the level of contamination is important for preventing exposure and being able to allow re-entry/use during the recovery phase of an event. | 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/). Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 107 | 107 | 242.0 | Index | 6.1.7 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M275_WST | State public health laboratory provides or assures testing for waste water | Having the capability at a state public health laboratory to test different types of water samples is important to the characterization of various water-based environments that may be contaminated or otherwise affected by a health security event. Being able to rapidly characterize the level of contamination is important for preventing exposure and being able to allow re-entry/use during the recovery phase of an event. | 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/). Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 108 | 108 | 243.0 | Index | 6.1.8 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | 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. | Being able to test for the most important agents that cause foodborne disease is an important capability of a state public health laboratory. Rapid identification of these agents in food and water samples can enhance the investigation of foodborne disease outbreaks and is important in identifying the source of the contamination. | 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/). |
| 109 | 109 | 244.0 | Index | 6.1.9 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M195 | Percentage of community water systems in a state that meet all applicable health-based standards | Safe and sanitary drinking water is vital to a community's health and wellbeing. Community (public) water supplies and systems that have difficulty providing water that meets the health-based standards are more likely to be systems that are not adequately maintained or operated. | EPA SDWIS | Environmental Protection Agency (EPA), Safe Drinking Water Information System Federal (SDWIS/FED) Drinking Water Data | 2012—2017 | 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. |
| 110 | 110 | 247.1 | Index | 6.1.13 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M925 | Percentage of community water systems in a state that meet all applicable non-health-based standards | Safe and sanitary drinking water is vital to a community's health and wellbeing. Community (public) water supplies and systems that have difficulty providing water that meets the non-health-based standards are more likely to be systems that are not adequately maintained or operated. | EPA SDWIS | Environmental Protection Agency (EPA), Safe Drinking Water Information System Federal (SDWIS/FED) Drinking Water Data | 2012—2017 | 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. |
| 111 | 111 | 247.2 | Index | 6.1.14 | 6.0 | EOH | Environmental & Occupational Health | 17.0 | FWS | Food & Water Security | The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. | M23PC | Number of foodborne illness outbreaks reported to CDC by state and local public health departments for which a causative infectious agent is confirmed (per 1 million population)(reverse coded) | The measure focuses on a state's ability to confirm the etiologic agent causing a foodborne disease outbreak. States actively investigating and resolving food and water outbreaks are able to identify and intervene more quickly to prevent a 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. |
| 112 | 112 | 249.0 | Index | 6.2.1 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M202 | State public health laboratory provides or assures testing for air samples | The measure focuses on the capability of a state public health laboratory to perform testing from air samples. | 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/). Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 113 | 113 | 250.0 | Index | 6.2.2 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M257_AIHA | State public health laboratory is certified or accredited by the American Industrial Hygiene Association (AIHA) | State public health laboratories that provide environmental health testing are required to meet certain industry standards to ensure safe and accurate testing of specimens and/or samples. Certification or accreditation provides assurance that a laboratory is meeting these standards to conduct laboratory tests properly. | 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. |
| 114 | 114 | 251.0 | Index | 6.2.3 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M257_EPA | State public health laboratory is certified or accredited by the Environmental Protection Agency (EPA) | State public health laboratories that provide environmental health testing are required to meet certain industry standards to ensure safe and accurate testing of specimens and/or samples. Certification or accreditation provides assurance that a laboratory is meeting these standards to conduct laboratory tests properly. | 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. |
| 115 | 115 | 252.0 | Index | 6.2.4 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M257_NELAC | State public health laboratory is certified or accredited by the National Environmental Laboratory Accreditation Conference (NELAC) | State public health laboratories that provide environmental health testing are required to meet certain industry standards to ensure safe and accurate testing of specimens and/or samples. Certification or accreditation provides assurance that a laboratory is meeting these standards to conduct laboratory tests properly. | 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. |
| 116 | 116 | 254.0 | Foundational | 6.2.6 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M196 | State public health laboratory provides or assures testing for environmental samples in the event of suspected chemical terrorism | A state needs to be capable of determining, by appropriate scientific methods, agents involved in a suspected act of chemical terrorism. It is also necessary to be able to determine the prevalence of such agents in air, food, and water resources by testing environmental samples. This is both a measurement indicative of the incident and a measure of mitigation and recovery effectiveness. | APHL CLSS | Association of Public Health Laboratories (APHL), Comprehensive Laboratory Services Survey (CLSS) | 2012 & 2014 | 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/). |
| 117 | 117 | 255.0 | Index | 6.2.7 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | 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 | The ability of a state's public health laboratory to test for a broad spectrum of potential environmental contaminants known to cause human health effects is important. Environmental monitoring for these contaminants during a health emergency will allow responders to identify areas that should be restricted and help establish protective actions to minimize public and first responder exposure. | 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/). |
| 118 | 118 | 256.0 | Index | 6.2.8 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M273 | State public health laboratory provides or assures testing for hazardous waste | Disasters and other events can cause the release of substances that are the by-product or waste of industrial processes into the environment. These substances are often toxic and hazardous to human health. It is important that the state laboratory has the capability to test for hazardous substances (or can assure that this capability exists). This capability is significant in characterizing the area contaminated by the release and is also essential to the clean-up and site remediation/restoration. | 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/). Selected responses from the 2016 survey have been corrected for North Carolina and therefore no longer correspond to the originally published survey results. |
| 119 | 119 | 257.0 | Foundational | 6.2.9 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M274 | State participates in the National Plant Diagnostic Network (NPDN) | The National Plant Diagnostic Network (NPDN) was established in 2002 in response to the need to enhance agricultural security through protecting health and productivity of plants in agricultural and natural ecosystems in the U.S. The NPDN is a national consortium of plant diagnostic laboratories with the specific purpose of quickly detecting and identifying plant pests and pathogens of concern. | NPDN | National Plant Diagnostic Network (NPDN), National Plant Diagnostic website | 2014 | 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. |
| 120 | 120 | 257.1 | Index | 6.2.10 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M904 | Number of environmental scientists and specialists (including health) per 100,000 population in the state | States with a larger supply of environmental health specialists may have a superior ability to prevent, detect and contain health hazards related to air, water, food, housing, soil, climate, and other environmental conditions. | BLS OES | Bureau of Labor Statistics (BLS), Occupational Employment Statistics (OES), OES 19-2041 | 2012—2017 | 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. |
| 121 | 121 | 257.2 | Index | 6.2.11 | 6.0 | EOH | Environmental & Occupational Health | 18.0 | EM | Environmental Monitoring | 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 | M23A | Number of disease outbreaks in a state due to animal contact per 1 million population (reverse coded) | The measure focuses on a state's ability to confirm the etiologic agent causing a foodborne disease outbreak. States actively investigating and resolving food and water outbreaks are able to identify and intervene more quickly to prevent a 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 illness outbreaks. |
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