Evaluation of State Plans and the Livestock Emergency Response Plan (LERP)

Materials and Methods

Animal disease response plans were acquired from states through open-source internet searches of their state emergency management and/or department of agriculture websites. If a plan was 2 years old or less, it was saved for analysis. If a plan was more than 2 years old, a follow-up email was sent to the appropriate agency to determine if an updated version was available; otherwise, the existing plan was included in the study. A follow-up email was also sent if the discovered plan was not an FAD/HCD plan, regardless of age.

If no relevant plans were identified through internet searches, a personalized email and/or phone call explaining the study and request for plans was initiated to each state's emergency management, department of agriculture, and/or state veterinarian's office. If necessary, up to 2 additional attempts were made to contact an appropriate person in each state, eventually using both email and phone communications. Ultimately, an email request was sent to all state animal health officials requesting that they submit plans and participate in the study. States were assured that their participation in the study was voluntary and that they would be guaranteed anonymity.

Plans were acquired from states in 9 of the 10 FEMA regions. Initially, the authors sought to randomly select 3 plans from each FEMA region in order to obtain a sampling of plans throughout the country that represented different types of animal agriculture. However, because there was no response from 1 region to the authors' request for study participation and up to only 2 plans would be excluded in other regions, it was decided to review plans from all 34 states that participated in the study.

FAD/HCD plans—whether they are a state emergency operations plan/emergency support function (ESF)-11 annex or a stand-alone FAD/HCD plan—were favored for analysis. As implied by their names, these plans prepare for a response to a disease that is either not currently found in the United States (eg, FMD) or is present at low levels but would have significant economic and health ramifications if an outbreak were to occur (eg, vesicular stomatitis). In the absence of this type of plan, other plans were considered for evaluation, including all-hazard, disaster/emergency, agent-specific (eg, avian influenza [AI] and FMD), and industry segment–specific. An all-hazard plan accounts for multiple hazards, such as disasters or disease outbreaks, whereas the other types of plans listed each target a specific situation. No standard operating procedures (SOPs) or other tiers of planning documents were included in this study.

A listing of sections for evaluation was taken from the table of contents and suggested appendices of the LERP toolkit (see Appendix 1, Supplementary Material, for a summary of these sections: http://online.liebertpub.com/doi/suppl/10.1089/hs.2017.0018/suppl_file/Supp_Data.pdf). Section names were considered to be the same if they were indeed the exact same as in the LERP, if it could be clearly understood that the name used fit the appropriate section in the LERP (eg, Roles and Responsibilities was considered the same as Organizations and Responsibilities), if the same or similar names were used but a section was divided into multiple smaller sections (eg, Direction and Control and Coordination together comprised Direction, Control, and Coordination), or if a partial section was present but referred to by the same or similar name (eg, Authorities and References was only present as Authorities). Names were considered different if the content was present but was either identified by a different name or was not clearly identified by a section name.

Results

A total of 57 plans were acquired from 34 states, representing 9 of the 10 FEMA regions. Of these, 17 were excluded from evaluation because they addressed a hazard not analyzed in this study (eg, National Veterinary Stockpile, 2 of 17), were additional types of plans other than the targeted FAD/HCD plan from each state (ie, a disease-specific plan from a state that an FAD/HCD plan has already been obtained from, 11 of 17), or were industry segment–specific plans that mirrored similar plans already analyzed from the same state (4 of 17). One state that responded to the request for plans indicated that they did not currently have any kind of agriculture emergency response plans. Multiple plans were analyzed from 5 states in order to more accurately report on the status of state planning. For instance, an avian influenza plan was analyzed in addition to a state's FAD/HCD plan if a state was far stronger in poultry production than other species of livestock and their avian influenza and FAD/HCD plans reflected this.

Accordingly, 40 plans from 34 states were included for evaluation. Of these, most were the targeted FAD/HCD (57%) plans, and nearly a quarter (23%) were for AI/HPAI or low pathogenic avian influenza (LPAI) (Table 1). Slightly more than half of the plans were stand-alone FAD/HCD plans (56%), followed largely by incident-specific annexes (38%). Six percent existed as emergency support function (ESF)-11 annexes (Figure 1).

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Figure 1.

Types of State Plans Evaluated

Plans ranged in age from 0 to 14 years, with 42% being 2 years old or less and 50% being 4 years old or less. The median age was 1.5 years; 12% of plans did not include a date on the plan. Average age was 2.5 years with a standard deviation of 2.6 years. These numbers are nearly all improved from the 2011 study (Table 2). Page length ranged from 7 to 75 pages without appendices or 9 to 578 pages with appendices (Table 3).

Most plans included Purpose, Scope, Situations, and Assumptions, and they often followed the same order as the LERP; after the Concept of Operations, section inclusion and order varied greatly among plans. Notably, 62% of plans did not include a Contact List, 70% of plans did not include Principal Parties, and 94% of plans did not include Responsibilities Matrices. Twelve of the 18 sections were absent 40% or more of the time. Direction, Control, and Coordination and Authorities and References were absent just under half of the time (47%). The LERP identifies Actions as not applicable (N/A) if a plan is a stand-alone FAD/HCD plan. Conversely, the LERP identifies Direction, Control, and Coordination, Information Collection and Dissemination, Communications, Administration, Finance and Logistics, and Plan Development and Maintenance as not applicable if a plan is an appendix or annex and not a unique stand-alone plan. Of the 16 plans that Actions pertained to, only 1 plan (6%) included that section (Table 4). Of the sections that were present and applicable in plans, 11 of 18 were referred to by the same name as the LERP more than 75% of the time. Nonetheless, 4 sections were referred to by a different name more than 80% of the time (Table 5).

All sections in the Concept of Operations were either absent or present in a different order than in the LERP a majority of the time. Recovery was present in the same order most often (40%), while Containment was never present in the same order. With the exception of Initiation, all sections were absent in 30% to 60% of plans (Table 6). Except for Communication (external, public information) and Recovery, all sections in the Concept of Operations were referred to by the same name as the LERP less than 40% of the time, with 7 of 11 sections being referred to by the same name 20% of the time or less. Initiation, Coordination, and Control did not share the same name in any instance (Table 7).

When comparing the content areas discussed in the 2011 and 2016 studies, all areas except the Introduction improved in their prevalence. Concept of Operations saw the biggest gain, increasing by 33% from 50% inclusion in 2011 to 83% in 2016. Contacts (26% increase), Authorities (23% increase), and Situation (22% increase) followed in level of improvement. In 2016, 6 of 10 sections analyzed were present at least 60% of the time, whereas only 2 of 11 sections were present at that level in 2011. Nonetheless, the Introduction section saw a 28% decline in inclusion from 2011 to 2016, and 3 sections (Introduction, Maintenance, and Contacts) were present less than 50% of the time in 2016 (Table 8).

Within the Concept of Operations, key activities were analyzed for their presence in 2011 and 2016. All activities increased in prevalence from 2011 to 2016, with Wildlife (52% increase), Movement (48% increase), and Euthanasia (36% increase) seeing the largest gains. In 2016, 10 of 11 activities were present at least 40% of the time, while in 2011 only 1 of 11 activities were present at that frequency. Even so, in 2016, 4 activities (Appraisal, Compensation/Indemnification, Biosecurity, and Epidemiology) were present less than 50% of the time (Table 9).

Discussion

There is no federal mandate requiring states to develop or maintain agriculture emergency or FAD/HCD plans. Nonetheless, all but 1 state that responded to requests for plans had at least 1 plan that addressed a hazard of this nature. It would behoove all states to plan and exercise for FAD/HCD outbreak scenarios.

Inherent variability exists between states regarding the types of agriculture present and resources available for animal disease response planning. As a result of these differences, states vary in the types of plans needed and the level of detail found in each tier of planning documents. Depending on responsible parties and state organizational structure, some plans are designed to be a stand-alone FAD/HCD plan, some are an incident-specific annex, and others exist within an emergency support function (ESF)-11 annex to a state emergency operations plan. Additional details may be found in departmental SOPs or other planning documents.

Because of the level of detail and uniformity sought by this study, FAD/HCD plans were targeted for evaluation. If a state has a very strong poultry industry, however, its avian influenza plan may be written in greater detail than its FAD/HCD plan, so both plans were analyzed in this instance. By doing so, this study aimed to capture a comparison of all FAD/HCD plans submitted, while allowing for the strengths of individual states to also be included in the assessment.

This study did not include other tiers of planning documents a state may have, such as SOPs, which may address some sections of the LERP, particularly the Concept of Operations, in greater detail. These additional documents were omitted to conduct an even comparison of the scope of details addressed within the same tier of planning document—in this case the FAD/HCD plan. Thus, the results of the current study may not fully reflect the extent to which states have addressed all areas of the LERP.

It should also be noted that the LERP toolkit was designed to be a template to guide consistency in planning documents between states. Because it is the only document of its scope currently available and because a standard for evaluation was necessary, the LERP toolkit was selected as a model against which to compare state plans. Having been published less than 2 years from the implementation of the current study, many states may still be unfamiliar with it or have not had an opportunity to reference it in the review and update of their plans. This may account for some of the differences noted in this study.

The present study did not assess the depth to which each of the sections or activities analyzed was addressed. Rather, it looked for the presence or absence of the sections and terminology suggested by the LERP. The conclusions drawn from this study reflect this more objective assessment and do not attempt to comment on the quality of the material present in the plans collected for evaluation. The extent to which plans expound upon the content in each of the sections and activities could be the focus of a future study.

Extensive modifications in plan content occurred between the 2011 and 2016 studies. To begin with, plans in 2016 showed nearly a 20% increase in including the date of last revision or update in the document itself. An impressive 42% of plans were 2 years old or less, and 50% of the plans were 4 years old or less. Because response strategies are continually evolving based on planning exercises and actual disease outbreaks, plans should be living documents with regular updates to reflect the most current approaches toward FAD/HCD response. While it would be ideal for plans to be updated annually, it is understandable that most states will not have the resources to do so, especially considering a state is likely to have multiple plans addressing different hazards. It is thus more realistic for FAD/HCD plans to be thoroughly reviewed and updated every few years. Even so, 50% of plans in the 2016 study were 5 or more years old. Some states indicated that because of the HPAI outbreak of 2014-15, they subsequently shifted resources to reviewing their avian influenza plans. This may partially explain a shift away from updating their FAD/HCD plans and the subsequent increase in age of those plans.

From 2011 to 2016, the average number of pages in a plan was reduced from 46 to 27, with a decrease in the median from 38 to 22. The range without appendices also narrowed significantly (7 to 201 in 2011 versus 7 to 75 in 2016). This does not necessarily imply changes in the quality of content present in plans, but the tightened range could indicate an improvement in the tiered organization of plans and use of more detailed appendices or annexes for specific audiences or needs. However, the wide variability in page length also reflects inconsistencies in how much and/or what information is included in these plans. With increased implementation of the LERP toolkit and alignment of plans, this range may tighten even more.

Regarding the section order, Principal Parties and Responsibilities Matrices were absent at least 70% of the time, and Actions was absent in 94% of the plans it applied to.

While being addressed in CPG 101 v.2 and the LERP, these sections may be new concepts for states as they have not been included in previous planning guidance documents. Sixty-two percent of plans did not include a contact list. While it is understandable that a list of this nature may be kept more confidential and be more easily updated if it is not included in a statewide or publicly available plan, it should be maintained somewhere and regularly updated. A reference in an FAD/HCD plan to where it can be found may be beneficial.

As awareness of the LERP and time since its publication increase, perhaps these sections will be included at greater levels. A persistent absence may reflect that these are areas that do not apply to the type of planning documents many states are writing and may suggest the need for a revision to the LERP toolkit. The absence of 12 of 18 sections 40% or more of the time reflects significant room for improvement in enhancing consistency between plans and fulfilling current planning gaps. A coordinated response between states to a large-scale FAD/HCD outbreak will be even more difficult to achieve if each state has not considered the same key areas of planning.

Section names were consistent between plans and the LERP for 11 of 18 sections over 75% of the time. While this is a tremendous strength, 4 of 18 sections were referred to by a different name more than 80% of the time. These sections were all sections laid out by the LERP that may not have been present historically in many of the planning documents referenced by states. As with the section order, perhaps as awareness of the LERP toolkit and time since its publication increase, these sections will begin to be included at higher rates and referred to by the same titles.

The Concept of Operations section is at the heart of the plan contents assessed, providing the most detail regarding execution of specific tasks in the event of a large-scale FAD/HCD outbreak. Because of the limitations previously noted, it is also the section most subject to being present at different levels of detail in the full array of planning documents possessed by a state. Because SOPs and other task-specific documents were not analyzed, these results may reflect falsely low inclusion rates. Nonetheless, with the exception of Initiation, an absence of all other sections 30% to 60% of the time suggests significant planning gaps in the Concept of Operations that may need to be addressed and could be the focus of a further study.

In the Concept of Operations, 7 of 11 sections were referred to by a different name 80% or more of the time, and 9 of 11 sections were referred to by a different name more than 60% of the time. Only Recovery shared the same name a majority of the time. As with the previous name discussion, these vast differences may reflect the previous lack of uniformity provided by the various planning documents available to states. As use of the LERP toolkit may increase with time and awareness, streamlined organization of the Concept of Operations would likely improve this variability.

If a state feels the content in any of the sections of a plan does not apply to their situation, a statement should be included acknowledging the consideration of the material and decision to omit it from the document. This will help the reader know that the section was not simply overlooked.

The significant gain in similarities noted between the 2011 and 2016 studies should be encouraging to all those engaged in the agricultural emergency planning processes. The decline in the inclusion of an Introduction is partially accounted for by replacement with an Executive Summary in some plans. In some instances, it was also a heading for the Purpose and Scope sections but contained no unique content and thus was not considered for inclusion in this study.

Evolution of plans through lessons learned from actual disease outbreaks, tabletop exercises, and the like, as well as a general growth in experience and emphasis on agricultural planning, likely account for the improvements noted over the past 5 years. Increased partnerships among stakeholder groups throughout the planning process have likely led to the strong increase in the discussion and more practical understanding of Movement in plans. In recent years, the Center for Food Security and Public Health at Iowa State University, working with government, industry, and other academic partners, has led the development of secure food supply plans for eggs, poultry, milk, pork, and beef. These plans strive to maintain continuity of business for these industries in the face of an FAD/HCD outbreak ³ and are referenced or used by states in their FAD/HCD plans. Changes in mindset from the original “stamping out” policy, prolonged stop movements, and use of vaccination are all apparent by their increased presence in various sections. Wildlife saw the greatest increase in inclusion. In most plans it was not discussed in much detail but acknowledged as an expertise fulfilled by cooperation through a state department of fish and wildlife or its equivalent. This is probably sufficient detail for the plans analyzed by the current study and is another example of greater partnerships with other groups affected by an FAD/HCD.

Conclusions

Vast improvements have been made in the status of state animal disease response plans across the United States from 2011 to 2016. Nonetheless, there is significant room for continued efforts to bolster consistency and fill planning gaps between state FAD/HCD planning documents. As awareness of the LERP toolkit continues to spread, we hope its use as a template by the states will increase, thereby encouraging states to address the full spectrum of response challenges in their planning documents as guided by the LERP, ultimately enhancing consistency among plans and adequately addressing current planning gaps. The results of this study support the need for curriculum planning resources at the state level. Development of a training curriculum and planning workshops for state agriculture emergency response planners will produce a consistent planning philosophy and skill set among state planners—another means of indirectly addressing current planning gaps in agricultural emergency response.