Background: CDC’s Medical Countermeasure (MCM) Operational Readiness Review (ORR) is a rigorous assessment process that evaluates a state, local, and territorial jurisdiction’s ability to execute a large response requiring medical countermeasure (MCM) distribution and dispensing.

2015-2016 Approach Refinement: CDC piloted and refined the MCM ORR process in 21 State, local, and territorial jurisdictions from 2014–2015, and fully implemented the new assessment in 487 jurisdictions from July 2015 to June 2016. The 2015-2016 MCM ORR consisted of 90 (54 planning and 36 operational) elements. Reviewers assessed each jurisdiction’s operational readiness status by evaluating each of the planning and operational elements outlined in the 2015-2016 MCM ORR using the criteria in CDC’s Public Health Preparedness Capabilities: National Standards for State and Local Planning, March 2011. MCM ORR assessments validate the work of public health departments responsible for MCM missions.

Sources: CDC collected, reviewed, and analyzed data from 487* MCM ORRs to identify key findings that offer insight into our nation’s MCM operational readiness. CDC conducted MCM ORRs in 50 states, 4 large localities, 8 territories or freely associated states*, and 70 local jurisdictions. States conducted MCM ORRs in 355 local CRI jurisdictions.

* NOTE: MCM ORR data from the eight territories and freely associated states are not included in this report

Key Findings

State and Large Locality Strengths: States (n=50) and large localities (n=4) received an “advanced” or “established” MCM ORR status for 16 of the planning elements for distributing MCMs (figure 2). These results indicate a majority of states and large localities are planning for MCM management and distribution, including cold chain storage and maintenance, transport, tracking, receiving, and distribution of MCMs.

Top “Advanced” MCM ORR Status Levels:

• 81% of states and large localities received an “advanced” MCM ORR status level for identifying and receiving distribution sites

• 74% of states and large localities received an “advanced” MCM ORR status level for having plans in place for maintaining integrity of medical materials

• 69% of states and large localities received an “advanced” MCM ORR status level for having procedures in place to identify and maintain distribution site security

• 67% of states and large localities received an “advanced” MCM ORR status level for identifying transportation assets

• 61% of states and large localities received an “advanced” MCM ORR status level for having procedures in place to request medical material from multiple partners

• 61% of states and large localities received an “advanced” MCM ORR status level for having exercised transport of material from receiving sites to dispensing sites

Top “Established” MCM ORR Status Levels:

• 37% of states and large localities received an “established” MCM ORR status level for having identified personnel to staff receiving sites

• 37% of states and large localities received an “established” MCM ORR status level for having procedures in place to operate a primary or backup inventory management system

• 37% of states and large localities received an “established” MCM ORR status level for having dispensing plans in place for open points of dispensing (PODs), closed PODs, and vulnerable populations

• 35% of states and large localities received an “established” MCM ORR status level for having processes in place to track and report inventory levels

• 31% of states and large localities received an “established” MCM ORR status level for having in place recovery and waste disposal procedures

Local Strengths: Local jurisdictions (n=425) received an “advanced” or “established” MCM ORR status for five of the planning elements for dispensing MCMs (figure 3). These results indicate more than half of local jurisdictions are planning for MCM dispensing, including having procedures to identify, acquire, and maintain security measures at MCM dispensing sites; detailed dispensing site surveys; adverse event reporting procedures; and dispensing plans for open points of dispensing (PODs), closed PODs, and vulnerable populations.

Top “Advanced” MCM ORR Status Levels:

• 67% of local jurisdictions received an “advanced” MCM ORR status level for having procedures in place to identify, acquire, and maintain security measures at dispensing sites

• 62% of local jurisdictions received an “advanced” MCM ORR status level for having dispensing plans in place for open PODs, closed PODs, and vulnerable populations

• 50% of local jurisdictions received an “advanced” MCM ORR status level for completing detailed dispensing site surveys

• 49% of local jurisdictions received an “advanced” MCM ORR status level for having adverse event reporting procedures at open PODs

• 48% of local jurisdictions received an “advanced” MCM ORR status level for having the operational planning elements necessary to provide MCMs at open PODs

Top Established MCM ORR Status Levels:

• 34% of local jurisdictions received an “established” MCM ORR status level for having the operational planning elements necessary to provide MCMs at open PODs

• 30% of local jurisdictions received an “established” MCM ORR status level for having adverse event reporting procedures at open PODs

• 28% of local jurisdictions received an “established” MCM ORR status level for completing detailed dispensing site surveys

• 27% of local jurisdictions received an “established” MCM ORR status level for having dispensing plans in place for open PODs, closed PODs, and vulnerable populations

• 8% of local jurisdictions received an “established” MCM ORR status level for having procedures to identify, acquire, and maintain security measures at dispensing sites

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