Initial Evaluation of the Cities Readiness Initiative

The Cities Readiness Initiative (CRI) was created in 2004 to help the nation's largest metropolitan areas develop the ability to provide life-saving medications in the event of a large-scale biological terrorist attack or naturally occurring disease outbreak. In 2007, the Centers for Disease Control and Prevention asked RAND to provide an initial evaluation of the impact of the Cities Readiness Initiative on awardees' readiness and capability to conduct mass countermeasure dispensing above and beyond what would be the case without the program. The subsequent study drew on available empirical evidence, including data from the Technical Assistance Review, a CDC-administered assessment of jurisdictions' capabilities in 12 core functional areas associated with countermeasure distribution and dispensing, as well as qualitative data collected through discussions with personnel involved with countermeasure dispensing in nine metropolitan areas (both CRI awardees and non-CRI jurisdictions). The evaluation showed that, overall, CRI awardees had benefited from the program's preparedness guidance and scenario focus and that the program had strengthened or encouraged the development of partnerships with other stakeholders. The program also encouraged a variety of changes to awardees' training plans and had spillover effects on non-CRI sites. However, this evaluation did not address questions of how the documented benefits compare to the program costs.