School District Crisis Preparedness, Response, and Recovery Plans — United States, 2006, 2012, and 2016

Children spend the majority of their time at school and are particularly vulnerable to the negative emotional and behavioral impacts of disasters, including anxiety, depressive symptoms, impaired social relationships, and poor school performance (1). Because of concerns about inadequate school-based emergency planning to address the unique needs of children and the adults who support them, Healthy People 2020 includes objectives to improve school preparedness, response, and recovery plans (Preparedness [PREP]-5) (2). To examine improvements over time and gaps in school preparedness plans, data from the 2006, 2012, and 2016 School Health Policies and Practices Study (SHPPS) were analyzed to assess changes in the percentage of districts meeting PREP-5 objectives. Findings from these analyses indicate that districts met the PREP-5 objective for requiring schools to include post-disaster mental health services in their crisis preparedness plans for the first time in 2016. However, trend analyses did not reveal statistically significant increases from 2006 to 2016 in the percentage of districts meeting any of the PREP-5 objectives. Differences in preparedness were detected in analyses stratified by urbanicity and census region, highlighting strengths and challenges in emergency planning for schools. To promote the health and safety of faculty, staff members, children, and families, school districts are encouraged to adopt and implement policies to improve school crisis preparedness, response, and recovery plans.

SHPPS is a national survey periodically conducted by CDC to assess school health policies and practices (3). This report used district-level data from the 2006, 2012, and 2016 surveys. In each study year, a nationally representative sample of public school districts is drawn using a two-stage sample design. Five to seven questionnaires, each assessing a different component of school health, are administered in each sampled district via paper and pencil or online. This report summarizes results from the crisis preparedness module within the healthy and safe school environment questionnaire. Across the three study years, the number of sampled districts that completed this questionnaire ranged from 461 to 697, and the response rates ranged from 64.0% to 66.5%.

Each district identified the respondent who had primary responsibility for, or was most knowledgeable about, the content of each questionnaire. Respondents to the crisis preparedness module were asked whether their school district required schools to have a comprehensive plan to address crisis preparedness, response, and recovery that included four specific topics identified in PREP-5: family reunification procedures, procedures for responding to pandemic influenza or other infectious disease outbreaks (only asked in 2012 and 2016), provisions for students and staff members with special needs, and provision of mental health services for students and staff members after a crisis. Respondents also were asked whether their district provided funding for training or offered training on their crisis preparedness plans to school faculty and staff members, students, and students’ families, and whether their district offered education on crisis preparedness, response, and recovery to students’ families. To categorize SHPPS school districts accurately into U.S. Census regions, SHPPS data were linked to extant data from the Market Data Retrieval database (4), a commercial database that compiles a list of K–12 schools in the United States along with their characteristics. Analyses were stratified by census region (Midwest, Northeast, South, or West); urbanicity (city, suburb, town, or rural); and district enrollment size (small [≤4,999 students], medium [5,000–9,999], or large [≥10,000]).

Data from each study year were weighted to provide national estimates. Analyses using statistical software accounted for the complex sample design. Prevalence estimates and 95% confidence intervals were computed for all point estimates. Statistical significance (p<0.05) for linear trends was determined using logistic regression analyses with data from all 3 years. The 2016 data only were used for descriptive statistics related to training and education. T-tests were used to determine differences between subgroups, with p-values <0.05 considered statistically significant.

Overall, no significant changes over time were detected in the percentage of districts that required schools to include specific topics in their school crisis preparedness, response, and recovery plans that correspond to the Healthy People 2020 PREP-5 objectives (Table 1) (Table 2). Notably, the Healthy People 2020 district requirements for school plans to include provision of mental health services for students, faculty, and staff members after a crisis (PREP-5.4; target ≥76.2%) was met (77.6%) for the first time in 2016 (Table 2).

Assessing district requirements by subgroup identified a significant increase in the percentage of districts in suburban areas that required schools to include family reunification procedures in their plans (PREP-5.1) from 2006 to 2016 and a linear increase in this requirement among districts in the Northeast (p = 0.05) (Table 1). The percentage of school districts that required schools to include procedures for responding to pandemic influenza or other infectious disease outbreaks in their plans (PREP-5.2) decreased significantly in rural areas (p<0.05) and among districts in the South (p = 0.05) (Table 1). By 2016, all Healthy People 2020 targets assessed were met in large school districts, although trends were not statistically significant.

In 2016, large districts were significantly more likely than were small districts to provide funding for or offer training on crisis preparedness for school faculty, staff members, and students’ families (p<0.05) (Table 3). Compared with districts in the Midwest, districts in the South were less likely to provide funding for training or offer training on crisis preparedness for school faculty and staff members (p<0.05). In contrast, districts in the Midwest were less likely than were those in the Northeast, South, and West to provide funding for training or to offer training on crisis preparedness for students’ families (p<0.05). Districts in the Midwest also were less likely than were those in the West to offer education on crisis preparedness, response, and recovery to students’ families (p<0.05).

Acknowledgments

Tim McManus, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; Brenda Silverman, Division of State and Local Readiness, Office of Preparedness and Response, CDC.

Corresponding author: Judy Kruger, jkruger@cdc.gov, 404-639-2371.

¹Division of State and Local Readiness, Office of Preparedness and Response, CDC; ²Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; ³Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC; ⁴Office of Science and Public Health Practice, Office of Public Health Preparedness and Response, CDC.

References

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* Adopted a policy requiring schools’ crisis plans to include family reunification procedures.
^† Healthy People 2020 Preparedness (PREP) objective 5.
^§ Statistically significant (p<0.05).
^¶ Regions: Northeast: Connecticut, Maine, Massachusetts, New Jersey, New Hampshire, New York, Pennsylvania, Rhode Island, and Vermont; Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin; South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia; West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.
** p = 0.05.
^†† Adopted a policy requiring schools’ crisis plans to include procedures for responding to pandemic influenza or other infectious disease outbreak. Question was not asked in 2006.

* Adopted a policy requiring schools’ crisis plans to include family reunification procedures.
^† Healthy People 2020 Preparedness (PREP) objective 5.
^§ Regions: Northeast: Connecticut, Maine, Massachusetts, New Jersey, New Hampshire, New York, Pennsylvania, Rhode Island, and Vermont; Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin; South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia; West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.
^¶ Adopted a policy requiring schools’ crisis plans to include provision of mental health services for students, faculty, and staff members after a crisis occurred.
** Statistically significant (p< 0.05).

* Districts that responded “yes” to the question “During the past two years, has your district provided funding for or offered training on the crisis preparedness, response and recovery plan to…a) school faculty and staff members, b) students, c) students’ families?”
^† Districts that responded “yes” to the question “During the past two years, has your district offered education on crisis preparedness, response, and recovery to students’ families?”
^§ Significant difference (p<0.05) between districts with small and large enrollment size.
^¶ Regions: Northeast: Connecticut, Maine, Massachusetts, New Jersey, New Hampshire, New York, Pennsylvania, Rhode Island, and Vermont; Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin; South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia; West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.
** Significant difference (p<0.05) between Midwest and South districts.
^†† Significant difference (p<0.05) between Midwest and Northeast districts.
^§§ Significant difference (p<0.05) between Midwest and West districts.