Montana's failing grade

Montana's Department of Public Health and Human Services (DPHHS) took a blow Dec. 14 when a report from Washington, D.C. nonprofit Trust for America's Health ranked the state lowest in the country for emergency health preparedness.

"I'm disappointed that Montana only got five out of 10 points," says Jim Murphy, chief of DPHHS' Communicable Disease Control and Prevention Bureau. "It's no fun to be the bottom of the list."

While Montana was one of only 17 states to have maintained or increased its public health budget over the past two years, the state lost points for a variety of shortcomings, including inadequate food-borne illness detection and a lack of laboratory staff to work long hours in the event of an outbreak.

Trust for America's Health began releasing its annual reports in 2002 in response to 9/11 and the rash of anthrax attacks that followed. Murphy says Montana earned a similarly low ranking last year, but received eight out of 10 points in years prior. He argues the ranking fails to accurately reflect DPHHS' current situation, offering as an example the recent hiring of two additional lab workers.

"I think it's important for people to realize that this survey is kind of a snapshot in time, and that actually if we were to answer these questions today we'd probably be scoring a seven or eight out of 10," Murphy says.

Murphy believes the state's response to the H1N1 influenza outbreak last year—when Montana vaccinated more than 200,000 people in just a few months—is a much better indicator of preparedness. Linda Noson, emergency preparedness coordinator for the Missoula City-County Health Department, agrees.

"With H1N1, we got an awful lot of positive comments from our partners in the community," Noson says. "We had weekly conference calls where we could go through the guidance that was being passed to us from a zillion sources—the [Center for Disease Control], the state, various locations."

The Trust for America's Health report has in the past offered valuable feedback for DPHHS, Murphy says. But this year, he simply doesn't buy the failing grade.

"I'd rather use our experience and our response to H1N1 as an indicator of our capabilities to respond to a public health event," Murphy says. "That's testing this stuff in the real world, rather than just some survey results."

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