Ready or Not?

Illinois Scored Five out of Ten on Key Indicators in Report on Health Emergency Preparedness

Majority of States Score 6 or Lower Out of 10 Indicators in Ready or Not?

Washington, D.C., December 19, 2012 – In the 10th annual Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism report, Illinois scored 5 out of 10 on key indicators of public health preparedness — 35 states and Washington, D.C. scored a six or lower.

The report, issued by the Trust for America’s Health (TFAH) and Robert Wood Johnson Foundation (RWJF), found that while there has been significant progress toward improving public health preparedness over the past 10 years, particularly in core capabilities, there continue to be persistent gaps in the country’s ability to respond to health emergencies, ranging from bioterrorist threats to serious disease outbreaks to extreme weather events.

In the report, Kansas and Montana scored the lowest – three out of 10 – and Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest – eight out of 10.

“In the past decade, there have been a series of significant health emergencies, including extreme weather events, a flu pandemic and foodborne outbreaks,” said Jeffrey Levi, PhD, executive director of TFAH. “But, for some reason, as a country, we haven’t learned that we need to bolster and maintain a consistent level of health emergency preparedness. Investments made after September 11th, the anthrax attacks and Hurricane Katrina led to dramatic improvements, but now budget cuts and complacency are the biggest threats we face.”

The Ready or Not? report provides a snapshot of our nation’s public health emergency preparedness. Its indicators are developed in consultation with leading public health experts based on data from publicly available sources, or information provided by public officials. Some key findings from the report include:

No. Indicator Illinois Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Funding Commitment – Did the state maintain or increase funding for public health programs from FY 2010-2011 to FY 2011-12. N 21 + D.C.
2 Response Readiness – Was the state able to notify and immediately assemble (within the goal time of 60 minutes) public health staff to ensure a quick response to an incident in 2011. Y 47 + D.C.
3 Infectious Disease Control and Vaccinations – Did the state meet the HHS goal of vaccinating 90 percent of 19- to 35-month-olds against whooping cough. N 2
4 Infectious Disease Control – Does the state require Medicaid to cover flu shots with no co-pays for beneficiaries under the age of 65. Y 38
5 Extreme Weather Event Preparedness – Does the state currently have a complete climate change adaptation plan. N 15
6 Community Resiliency – Does the state mandate all licensed child-care facilities to have a multi-hazard written evacuation and relocation plan. N 30 + D.C.
7 Emergency Management – Has the state been accredited by the Emergency Management Accreditation Program (EMAP). Y 29 + D.C.
8 Health System Preparedness – Does the state participate in a Nurse Licensure Compact. N 24
9 Public Health Laboratories Staffing and Surge Capacity – Does the state public health laboratory report having enough staffing capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as a novel influenza A H1N1, from August 10, 2011 to August 9, 2012. Y 37 + D.C.
10 Public Health Laboratories – Chemical Threat Preparedness – Did the state public health laboratory report having increased or maintained their Laboratory Response Network for Chemical Threats (LRN-C) chemical capability from August 10, 2011 to August 9, 2012. Y 49
Total 5

“Public health preparedness has improved leaps and bounds from where we were 10 years ago,” said Paul Kuehnert, MS RN Director of the Public Health Team at the Robert Wood Johnson Foundation. “But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of ‘better safe than sorry’ preparedness that should not be crossed.”

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA);
  • Assure sufficient, dedicated funds for public health preparedness to ensure basic capabilities to respond to threats public health departments face every day and also to have the trained experts and systems in place to act quickly in the face of major, unexpected emergencies;
  • Provide ongoing support to communities so they better cope and recover from emergencies;
  • Modernize biosurveillance to a real-time, interoperable system to better detect and respond to problems;
  • Seriously address antibiotic resistance;
  • Improve research, development and manufacturing of medical countermeasures;
  • Increase readiness for extreme weather events; and
  • Update the nation’s food safety system.

The report was supported by a grant from RWJF and is available on TFAH’s website at and RWJF’s website at

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website and RWJF’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials.

  • 8 out of 10: Maryland, Mississippi, North Carolina, Vermont and Wisconsin
  • 7 out of 10: Alabama, Arkansas, California, Delaware, Nebraska, New Hampshire, New Mexico, New York, North Dakota and Virginia
  • 6 out of 10: Connecticut, Idaho, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, Utah, Washington and Wyoming
  • 5 out of 10: Alaska, Arizona, Washington, D.C., Florida, Hawaii, Illinois, Indiana, Michigan, Minnesota, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas and West Virginia
  • 4 out of 10: Colorado, Georgia, Nevada and New Jersey
  • 3 out of 10: Kansas and Montana

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Follow the Foundation on Twitter or Facebook.