(HPP) Performance Measure Manual

APPENDIX D
Appendix D: Online Data Collection (OLDC) Template — Section 3,
Performance Measures
HHS HPP Cooperative Agreement FY12 Progress Report
Section 3: Performance Measures
Capability 1.1 (Form 3.1.1): HPP Healthcare System Preparedness
Performance Measure: Percent of healthcare coalitions (HCCs) that have established formalized agreements and
demonstrate their ability to function and execute the capabilities for healthcare preparedness, response, and
recovery as defined in Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness
Performance Target: 100% by the end of the project period (Year 1 data will be used to establish baselines)
Please enter the number of coalitions for each scoring group described below:
Scoring for each data element:
• Enter a “1” for this element has been completely implemented consistent with national expectations
• Enter a “2” for this element is partially implemented
• Enter a “3” for there IS a plan to start implementing this element within the next grant year
• Enter a “4” for there is NO plan to implement this element within the next grant year
NOTE: For 3.1.1.5–3.1.1.8, you may also use the following
• Enter a “5” for there was no opportunity to implement this element within this grant year
1 2 3 4 5
3.1.1.1 Are there formal documents such as: Memoranda of Understanding (MOUs), Mutual Aid Agreements
(MAAs), Interagency Agreement (IAAs), articles of incorporation, letters of agreement, contracts, charters,
or other supporting formal documents that define:
3.1.1.1.1 The member organizations of the HCC?
3.1.1.1.2 Formal agreement to aid coalition members and to share
resources and information
3.1.1.1.3 A process to allow representation of subject matter experts
(SMEs) to the HCC?
3.1.1.1.4 Joint or cooperative activities with non-healthcare
constituencies?
3.1.1.1.5 Formal agreements to prepare to respond as part of the HCC?
3.1.1.2 Has the HCC established a formal self-governance structure (e.g., By-laws for
the board of directors and a charter that is multidisciplinary and
representative of all members of the coalition)?
3.1.1.3 Please estimate the total percentage of the State population covered by each HCC within the State.
3.1.1.3.1 Coalition 1
3.1.1.3.2 Coalition 2
3.1.1.3.3 Coalition 3
3.1.1.3.4 Coalition 4
3.1.1.3.5 Coalition 5
3.1.1.3.6 Coalition 6
Hospital Preparedness Program (HPP) Performance Measure Manual
Guidance for Using the New HPP Performance Measures Page | 70