Introduction
Background
State law authorizes the California State Auditor (state auditor) to establish a state high risk audit program and to issue reports with recommendations for improving state agencies or statewide issues that it identifies as high risk. Programs and issues that are high risk include not only those particularly vulnerable to fraud, waste, abuse, and mismanagement, but also those that have major challenges associated with their economy, efficiency, or effectiveness.
The California Department of Public Health (Public Health) is responsible for preparing for public health emergencies, coordinating planning for the Strategic National Stockpile of emergency medical supplies, overseeing public health disaster planning, and distributing and overseeing funds to local health departments for disaster planning. The California Governor’s Office of Emergency Services’ (Emergency Services) mission is to protect lives and property by preparing for, protecting against, responding to, recovering from, and mitigating the impacts of all hazards and threats. We first identified the area of emergency preparedness as it related to the California Department of Health Services—the predecessor to Public Health—and Emergency Services as being a high risk to the State in our May 2007 high risk report. In that report we noted that our office issued five prior reports related to emergency preparedness, and each concluded the State is weak in one or more of four elements of emergency preparedness: planning, training, corrective action, and equipment and resources. Our subsequent high risk reports in 2009, 2011, and 2013 continued to highlight areas of both progress and concern in emergency preparedness for Public Health and Emergency Services. In our 2013 report we remained concerned about the lack, or inadequate development, of specific metrics in strategic planning for both Public Health and Emergency Services.
In order to update our analysis of the high risk status for Public Health and Emergency Services, we interviewed knowledgeable staff with significant responsibilities related to emergency preparedness at each agency. We then assessed their perspectives regarding the high‑risk issues identified in our 2013 report. We also reviewed reports and other documentation relevant to the issues.