SOTS Financial Module

Attachment E – Core VIPP Evaluation

Form Approved
OMB No. 0920-0916
Exp. Date:
Public Reporting burden of this collection of information is estimated at 60 minutes per response, including the time for reviewing
instructions, research exiting data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays
a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information
including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NW, MS D-74, Atlanta, GA
30333; Attn: PRA (0920-0916).

Federal Fiscal Year (FFY) 2013

State of the States (SOTS) Part 1:
Finance and Personnel Survey
INTRODUCTION
Thank you for taking the time to complete the Federal Fiscal Year (FFY) 2013 State of the States (SOTS) Part 1:
Finance and Personnel Survey. This questionnaire will be administered bi-annually to help describe the
infrastructural capacity of injury and violence prevention programs nationwide.
This questionnaire will specifically ask you about your program’s financial and staffing infrastructure in FFY
2013 (October 1, 2012 – September 30, 2013).
We know your time is valuable. Therefore, this questionnaire has been pre-populated with information you
reported in previous administrations of the State of the States (SOTS) surveys. The URL provided below is unique
to your state, and depending on the size and breadth of your program, it will take approximately 1 hour to
complete this questionnaire.
PLEASE COMPLETE AND SUBMIT YOUR QUESTIONNAIRE BY FRIDAY, DECEMBER 31, 2013.
Most data collected will be presented in aggregate. If you have any questions about the questionnaire, please
email shenee.reid@safestates.org. Thank you again for your contribution to this important initiative.

INSTRUCTIONS
There are two (2) ways to complete the questionnaire:
1.
2.

Complete the entire questionnaire online through QuestionPro
Complete the questionnaire in hard copy first, and then enter all responses online through
QuestionPro.

If you cannot use one of these two methods to complete the survey, please email shenee.reid@safestates.org.
Please answer the questions based on the status of your program in Federal Fiscal Year (FFY) 2013 (October 1,
2012 – September 30, 2013).

Funding Sources
In this section you’ll be asked about the state IVP program funding sources, both current and past. Please be sure to have your
records accessible before you begin this section.

CAUTION: Once you click “Continue” to submit your answer(s) the question below, you will NOT be able to change your response.
The answer(s) you select for this question will control the response options provided in subsequent questions. Therefore, please take care
and be certain when selecting your response(s), as you will NOT be able to change your answer(s) after this point.

7A. Please select all the funding sources the state IVP program had in FFY 2013 (October 1, 2012 – September 30, 2013).







































State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1 (Please specify on next page)
Other State Funding 2 (Please specify on next page)
Other State Funding 3 (Please specify on next page)
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children (EMSC)
National Highway Traffic Safety Administration (NHTSA) CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration (SAMHSA) Campus Suicide Prevention Grants
Substance Abuse and Mental Health Services Administration (SAMHSA) State and Tribal Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state DOT or State Highway Safety Office)
Other Federal Funding 1 (Please specify on next page)
Other Federal Funding 2 (Please specify on next page)
Other Federal Funding 3 (Please specify on next page)
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
Universities
Other 1 (Please specify on next page)
Other 2 (Please specify on next page)
Other 3 (Please specify on next page)

Specify Other State Funding Sources
Other State Funding 1
Other State Funding 2
Other State Funding 3
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

Funding Amount & Allocations
Enter the total amount awarded for each funding source to the nearest dollar. NOTE: do not enter commas (,) or decimal points
(.)
• State General Revenue __________
• Dedicated State Funding Stream (e.g., fines and fees) __________
• State Highway Safety Office (e.g., Safe Routes to School) __________
• Other State Funding 1
__________
• Other State Funding 2 __________
• Other State Funding 3 __________
• CDC/NCIPC Core VIPP Base Integration Component (BIC) __________
• CDC/NCIPC Core VIPP Regional Network Leader (RNL) __________
• CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI) __________
• CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention __________
• CDC/NCIPC Core VIPP Falls Among Older Adults __________
• CDC/NCIPC National Violent Death Reporting System (NVDRS) __________
• CDC/NCIPC – Rape Prevention and Education (RPE) __________
• CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA) __________
• CDC/NCIPC Residential Fire-related Injury Prevention Program __________
• CDC – Preventive Health and Health Services (PHHS) Block Grant __________
• CDC – Communities Putting Prevention to Work __________
• Consumer Product Safety Commission (CPSC) __________
• Federal Emergency Management Agency (FEMA) __________
• HRSA/MCHB – Title V Block Grant __________
• HRSA/MCHB – Emergency Medical Services for Children (EMSC) __________
• National Highway Traffic Safety Administration (NHTSA) CODES __________
• National Highway Traffic Safety Administration (NHTSA) Other __________
• Substance Abuse and Mental Health Services Administration (SAMHSA) Campus Suicide Prevention Grants __________
• Substance Abuse and Mental Health Services Administration (SAMHSA) State and Tribal Youth Suicide Prevention Grants __________
• U.S. Department of Justice __________
• U.S. Department of Transportation (Federal, not through the state DOT or State Highway Safety Office) __________
• Other Federal Funding 1 __________
• Other Federal Funding 2 __________
• Other Federal Funding 3 __________
• Corporate/Private __________
• Foundation __________
• Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc) __________
• Universities __________
• Other Funding Source 1 __________
• Other Funding Source 2 __________
• Other Funding Source 3 __________

Enter the allocation of the funding source to the nearest whole percent. NOTE: do not enter percent symbols (%) or decimal
points (.)
Personnel
Safety
Grants/
Overhead
Other
(Salary & Equipment Mini-Grants/
Expenses
Fringe)
Contracts (Indirect Costs)
State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and
Leadership Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block
Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children
(EMSC)
National Highway Traffic Safety Administration (NHTSA)
CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration
(SAMHSA) Campus Suicide Prevention Grants
Substance Abuse and Mental Health Services Administration
(SAMHSA) State and Tribal Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state
DOT or State Highway Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes,
etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

Funding Period Length
When did the funding period BEGIN and END? Please consider the total amount received from the funding source when answering this
question.
Month - Year
BEGIN
END
State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership
Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children (EMSC)
National Highway Traffic Safety Administration (NHTSA) CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration (SAMHSA) Campus
Suicide Prevention Grants
Substance Abuse and Mental Health Services Administration (SAMHSA) State
and Tribal Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state DOT or State
Highway Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

Other Funding Periods
The following funding source(s) have funding period(s) that started after October 1, 2012. To help us clarify how this funding
source fits within the federal fiscal year: 1) Enter the amount received from this source in your PREVIOUS funding period. 2)
Enter the number of years included in the funding period.
Proceed to the next question if there are no funding sources listed below.
(1) $ Amount From
(2) # Years Within
Previous Funding Period
Funding Period
State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership
Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children (EMSC)
National Highway Traffic Safety Administration (NHTSA) CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration (SAMHSA) Campus
Suicide Prevention Grants
Substance Abuse and Mental Health Services Administration (SAMHSA) State
and Tribal Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state DOT or State
Highway Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

The following funding source(s) have funding period(s) that ended before September 30, 2013. To help us clarify how this
funding source fits within the federal fiscal year: 1) Enter the amount received from this source in your CURRENT funding
period. 2) Enter the number of years included in the funding period
(1) $ Amount From (2) # Years Within
Current Funding Period
Funding Period
State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership
Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children (EMSC)
National Highway Traffic Safety Administration (NHTSA) CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration (SAMHSA) Campus
Suicide Prevention Grants
Substance Abuse and Mental Health Services Administration (SAMHSA) State
and Tribal Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state DOT or State
Highway Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

For each funding source, do you anticipate any budget changes in Federal Fiscal Year (FFY) 2014? Select one.
YES, it is
YES, it is confirmed
YES, it is
It is likely,
confirmed and and funding will be confirmed and
but not
funding will be at MORE than FFY
funding will be confirmed.
the same level.
2014.
LESS than FFY
2014.
State General Revenue
Dedicated State Funding Stream (e.g., fines
and fees)
State Highway Safety Office (e.g., Safe
Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration
Component (BIC)
CDC/NCIPC Core VIPP Regional Network
Leader (RNL)
CDC/NCIPC Core VIPP Surveillance
Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle
Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older
Adults
CDC/NCIPC National Violent Death
Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and
Education (RPE)
CDC/NCIPC Domestic Violence Prevention
Enhancement and Leadership Through
Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury
Prevention Program
CDC – Preventive Health and Health
Services (PHHS) Block Grant
CDC – Communities Putting Prevention to
Work
Consumer Product Safety Commission
(CPSC)
Federal Emergency Management Agency
(FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical
Services for Children (EMSC)
National Highway Traffic Safety
Administration (NHTSA) CODES
National Highway Traffic Safety
Administration (NHTSA) Other
Substance Abuse and Mental Health Services
Administration (SAMHSA) Campus Suicide
Prevention Grants
Substance Abuse and Mental Health Services
Administration (SAMHSA) State and Tribal
Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal,

It is
NO, no
unknown funding from
if funding this source is
will be anticipated for
available. FFY 2014.

❏
❏

❏
❏

❏
❏

❏
❏

❏
❏

❏
❏

❏

❏

❏

❏

❏

❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏
❏

❏
❏

❏
❏

❏
❏

❏
❏

❏
❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏

❏
❏

❏
❏

❏
❏

❏
❏

❏
❏

❏
❏

YES, it is
YES, it is confirmed
YES, it is
It is likely,
confirmed and and funding will be confirmed and
but not
funding will be at MORE than FFY
funding will be confirmed.
the same level.
2014.
LESS than FFY
2014.
not through the state DOT or State Highway
Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids,
Public Health Institutes, etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

It is
NO, no
unknown funding from
if funding this source is
will be anticipated for
available. FFY 2014.

❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

❏
❏
❏
❏

History of Funding
For each funding source:
(1) Enter the first year the state IVP program ever received the funding source. Please enter the first year based on your
earliest records. Enter ‘DK’ if you don’t know.
(2) Enter the number of years (if any) that the state IVP program experienced a break in the funding source. Enter zero (0) if
there was not a break. Enter ‘DK’ if you don’t know if there was a break.
(1) 1st year the state IVP
program ever received this
funding source
yyyy
State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership
Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children (EMSC)
National Highway Traffic Safety Administration (NHTSA) CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration (SAMHSA)
Campus Suicide Prevention Grants
Substance Abuse and Mental Health Services Administration (SAMHSA) State
and Tribal Youth Suicide Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state DOT or State
Highway Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

(2) # Years was
there a break

Full Time Equivalents by Primary Role
In FFY 2013, how many individual staff members worked in the state IVP program?
Individual Staff
Paid Staff (Full-time)
Paid Staff (Part-time)
Contractor (Full-time)
Contractor (Part-time)
Intern (Paid or Unpaid)
Fellow
Other

Now thinking about paid staff, how many full time equivalents (FTEs) were staffed WITHIN the state IVP program in FFY
2013? Please enter the number of FTEs by staff roles.
IMPORTANT NOTE: For an FTE calculator that will help you determine your total number of FTEs, copy/paste the following URL into a new internet
browser, ww.safestates.org/associations/5805/files/FTE%20Calculator.xls. Calculate part-time positions (partial FTEs) using the formula found here.
For example, if you have a total of two (2) full-time staff positions at 40 hours/week (equal to 2 FTEs) and one 20 hour/week staff position (equal to one
0.5 FTE), the correct response for your total number of FTEs would be 2.5.Please enter 0.0, if the state IVP program did not have access to a primary
role. All cells must have a numerical value.

FTEs
Coalition building & coordination staff
Communications staff
Data analysis staff (e.g., epidemiologist, statistician, etc.)
Evaluation staff
Management staff
Policy staff
Program/Intervention staff
Support and administrative staff
Technical assistance & training staff
Other
Total number of FTEs within your state IVP program.

Full Time Equivalents by Funding Source
In FFY 2012, how many total FTEs were supported by each funding source? IMPORTANT NOTE: Please enter 0.00, if the
state IVP program did not have access to a primary role. All cells must total to the total FTEs in the state IVP program. Total
number of FTEs across all funding sources must equal total FTEs in the questions above.
FTEs within IVP
program
State General Revenue
Dedicated State Funding Stream (e.g., fines and fees)
State Highway Safety Office (e.g., Safe Routes to School)
Other State Funding 1
Other State Funding 2
Other State Funding 3
CDC/NCIPC Core VIPP Base Integration Component (BIC)
CDC/NCIPC Core VIPP Regional Network Leader (RNL)
CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
CDC/NCIPC Core VIPP Falls Among Older Adults
CDC/NCIPC National Violent Death Reporting System (NVDRS)
CDC/NCIPC – Rape Prevention and Education (RPE)
CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA)
CDC/NCIPC Residential Fire-related Injury Prevention Program
CDC – Preventive Health and Health Services (PHHS) Block Grant
CDC – Communities Putting Prevention to Work
Consumer Product Safety Commission (CPSC)
Federal Emergency Management Agency (FEMA)
HRSA/MCHB – Title V Block Grant
HRSA/MCHB – Emergency Medical Services for Children (EMSC)
National Highway Traffic Safety Administration (NHTSA) CODES
National Highway Traffic Safety Administration (NHTSA) Other
Substance Abuse and Mental Health Services Administration (SAMHSA) Campus Suicide Prevention
Grants
Substance Abuse and Mental Health Services Administration (SAMHSA) State and Tribal Youth Suicide
Prevention Grants
U.S. Department of Justice
U.S. Department of Transportation (Federal, not through the state DOT or State Highway Safety Office)
Other Federal Funding 1
Other Federal Funding 2
Other Federal Funding 3
Corporate/Private
Foundation
Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
Universities
Other Funding Source 1
Other Funding Source 2
Other Funding Source 3

In FFY 2013, how many FTEs were directly supported by CDC/NCIPC Core VIPP Base Integration Component (BIC)? Please
enter the number of FTEs by staff roles.
IMPORTANT NOTE: For an FTE calculator that will help you determine your total number of FTEs, copy/paste the following URL into a new internet browser,
www.safestates.org/associations/5805/files/FTE%20Calculator.xls. Calculate part-time positions (partial FTEs) using the formula found here. For example, if you have a
total of two (2) full-time staff positions at 40 hours/week (equal to 2 FTEs) and one 20 hour/week staff position (equal to one 0.5 FTE), the correct response for your total
number of FTEs would be 2.5.Please enter 0.0, if the state IVP program did not have access to a primary role. All cells must have a numerical value.

FTEs Support by BIC Funding
Coalition building & coordination staff
Communications staff
Data analysis staff (e.g., epidemiologist, statistician, etc.)
Evaluation staff
Management staff
Policy staff
Program/Intervention staff
Support and administrative staff
Technical assistance & training staff
Other

Primary Roles Outside IVP Program
In FFY 2013, were individuals OUTSIDE of the state IVP program used to fill staff roles? (Check all that apply)

Coalition building & coordination staff
Communications staff
Data analysis staff (e.g., epidemiologist, statistician, etc.)
Evaluation staff
Management staff
Policy staff
Program/Intervention staff
Support and administrative staff
Technical assistance & training staff
Other

Yes, within the
state health
department

Yes, by
consultant

❏
❏
❏
❏
❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏
❏
❏
❏
❏

Yes, by Injury No, did not use
Control Research
Center (ICRC)

❏
❏
❏
❏
❏
❏
❏
❏
❏
❏

❏
❏
❏
❏
❏
❏
❏
❏
❏
❏

Primary Injury and Violence Topic Area

Primary Topics: State General Revenue
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury




















Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Dedicated State Funding Stream (e.g., fines and fees)
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: State Highway Safety Office (e.g., Safe Routes to School)
 Homicide
 NONE
 Mass trauma/disaster-related
 All Terrain Vehicle (ATV) injury
 Motor vehicle injury
 Child abuse/neglect
 Motorcycle/motorized scooter injury
 Child passenger safety
 Occupational injury
 Domestic/intimate partner violence
 Pedestrian injury
 Elder Abuse
 Poisoning
 Fall injuries
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other State Funding 1
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other State Funding 2
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury

Primary Topics: Other State Funding 3
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury




















Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC Core VIPP Base Integration Component (BIC)
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC Core VIPP Regional Network Leader (RNL)
 Homicide
 NONE
 Mass trauma/disaster-related
 All Terrain Vehicle (ATV) injury
 Motor vehicle injury
 Child abuse/neglect
 Motorcycle/motorized scooter injury
 Child passenger safety
 Occupational injury
 Domestic/intimate partner violence
 Pedestrian injury
 Elder Abuse
 Poisoning
 Fall injuries
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC Core VIPP Surveillance Quality Improvement (SQI)
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC Core VIPP Motor Vehicle Injury Prevention
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Rural/agricultural injury
 Fire and burns injury
 School-based injury
 Firearm injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury

Primary Topics: CDC/NCIPC Core VIPP Falls Among Older Adults
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC National Violent Death Reporting System (NVDRS)
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC – Rape Prevention and Education (RPE)
 Homicide
 NONE
 Mass trauma/disaster-related
 All Terrain Vehicle (ATV) injury
 Motor vehicle injury
 Child abuse/neglect
 Motorcycle/motorized scooter injury
 Child passenger safety
 Occupational injury
 Domestic/intimate partner violence
 Pedestrian injury
 Elder Abuse
 Poisoning
 Fall injuries
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC/NCIPC Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA)
 NONE
 Homicide
 Sexual assault/rape
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Spinal cord injury (SCI)
 Child abuse/neglect
 Motor vehicle injury
 Submersion injuries/drowning
 Child passenger safety
 Motorcycle/motorized scooter injury
 Suicide/self-inflicted
 Domestic/intimate partner violence
 Occupational injury
 Suicide attempts
 Elder Abuse
 Pedestrian injury
 Teen Dating Violence
 Fall injuries
 Poisoning
 Traumatic brain injury (TBI)
 Fire and burns injury
 Rural/agricultural injury
 Other
 Firearm injury
 School-based injury

Primary Topics: CDC/NCIPC Residential Fire-related Injury Prevention Program
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Poisoning
 Fall injuries
 Rural/agricultural injury
 Fire and burns injury
 School-based injury
 Firearm injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC – Preventive Health and Health Services (PHHS) Block Grant
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: CDC – Communities Putting Prevention to Work
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Consumer Product Safety Commission (CPSC)
 Homicide
 NONE
 Mass trauma/disaster-related
 All Terrain Vehicle (ATV) injury
 Motor vehicle injury
 Child abuse/neglect
 Motorcycle/motorized scooter injury
 Child passenger safety
 Occupational injury
 Domestic/intimate partner violence
 Pedestrian injury
 Elder Abuse
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Federal Emergency Management Agency (FEMA)
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: HRSA/MCHB – Title V Block Grant
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Pedestrian injury
 Elder Abuse
 Poisoning
 Fall injuries
 Rural/agricultural injury
 Fire and burns injury
 School-based injury
 Firearm injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: HRSA/MCHB – Emergency Medical Services for Children (EMSC)
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: National Highway Traffic Safety Administration (NHTSA) CODES
 NONE
 Homicide
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Child abuse/neglect
 Motor vehicle injury
 Child passenger safety
 Motorcycle/motorized scooter injury
 Domestic/intimate partner violence
 Occupational injury
 Elder Abuse
 Pedestrian injury
 Fall injuries
 Poisoning
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: National Highway Traffic Safety Administration (NHTSA) Other
 Homicide
 NONE
 Mass trauma/disaster-related
 All Terrain Vehicle (ATV) injury
 Motor vehicle injury
 Child abuse/neglect
 Motorcycle/motorized scooter injury
 Child passenger safety
 Occupational injury
 Domestic/intimate partner violence
 Pedestrian injury
 Elder Abuse
 Poisoning
 Fall injuries
 Fire and burns injury
 Rural/agricultural injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Substance Abuse and Mental Health Services Administration (SAMHSA) Campus Suicide Prevention Grants
 NONE
 Homicide
 Sexual assault/rape
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Spinal cord injury (SCI)
 Child abuse/neglect
 Motor vehicle injury
 Submersion injuries/drowning
 Child passenger safety
 Motorcycle/motorized scooter injury
 Suicide/self-inflicted
 Domestic/intimate partner violence
 Occupational injury
 Suicide attempts
 Elder Abuse
 Pedestrian injury
 Teen Dating Violence
 Fall injuries
 Poisoning
 Traumatic brain injury (TBI)
 Fire and burns injury
 Rural/agricultural injury
 Other
 Firearm injury
 School-based injury

Primary Topics: Substance Abuse and Mental Health Services Administration (SAMHSA) State and Tribal Youth Suicide
Prevention Grants
 Sexual assault/rape
 NONE
 Homicide
 Spinal cord injury (SCI)
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Submersion injuries/drowning
 Child abuse/neglect
 Motor vehicle injury
 Suicide/self-inflicted
 Child passenger safety
 Motorcycle/motorized scooter injury
 Suicide attempts
 Domestic/intimate partner violence
 Occupational injury
 Teen Dating Violence
 Elder Abuse
 Pedestrian injury
 Traumatic brain injury (TBI)
 Fall injuries
 Poisoning
 Rural/agricultural injury
 Other
 Fire and burns injury
 School-based injury
 Firearm injury

Primary Topics: U.S. Department of Justice
 NONE

 All Terrain Vehicle (ATV) injury

 Child abuse/neglect

 Child passenger safety

 Domestic/intimate partner violence

 Elder Abuse

 Fall injuries

 Fire and burns injury

 Firearm injury


Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: U.S. Department of Transportation (Federal, not through the state DOT or State Highway Safety Office)
 NONE
 Homicide
 Sexual assault/rape
 All Terrain Vehicle (ATV) injury
 Mass trauma/disaster-related
 Spinal cord injury (SCI)
 Child abuse/neglect
 Motor vehicle injury
 Submersion injuries/drowning
 Child passenger safety
 Motorcycle/motorized scooter injury
 Suicide/self-inflicted
 Domestic/intimate partner violence
 Occupational injury
 Suicide attempts
 Elder Abuse
 Pedestrian injury
 Teen Dating Violence
 Fall injuries
 Poisoning
 Traumatic brain injury (TBI)
 Fire and burns injury
 Rural/agricultural injury
 Other
 Firearm injury
 School-based injury

Primary Topics: Other Federal Funding 1
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other Federal Funding 2
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other Federal Funding 3
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Corporate/Private
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Foundation
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Nonprofit Organizations (i.e., Safe Kids, Public Health Institutes, etc)
 Homicide
 NONE
 Mass trauma/disaster-related
 All Terrain Vehicle (ATV) injury
 Motor vehicle injury
 Child abuse/neglect
 Motorcycle/motorized scooter injury
 Child passenger safety
 Occupational injury
 Domestic/intimate partner violence
 Pedestrian injury
 Elder Abuse
 Poisoning
 Fall injuries
 Rural/agricultural injury
 Fire and burns injury
 Firearm injury
 School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Universities
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other Funding Source 1
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other Funding Source 2
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Primary Topics: Other Funding Source 3
 NONE
 All Terrain Vehicle (ATV) injury
 Child abuse/neglect
 Child passenger safety
 Domestic/intimate partner violence
 Elder Abuse
 Fall injuries
 Fire and burns injury
 Firearm injury











Homicide
Mass trauma/disaster-related
Motor vehicle injury
Motorcycle/motorized scooter injury
Occupational injury
Pedestrian injury
Poisoning
Rural/agricultural injury
School-based injury










Sexual assault/rape
Spinal cord injury (SCI)
Submersion injuries/drowning
Suicide/self-inflicted
Suicide attempts
Teen Dating Violence
Traumatic brain injury (TBI)
Other

Budget/Economic Issues
Comparing the budget period for Federal Fiscal Year 2013 to Federal Fiscal Year 2012, which of the following did you
experience?
o I experienced budget cuts.
o I had level funding. (No changes in funding)
o I had budget increases.
What has been the impact of budget cuts that you experienced since October 1,2012? (Choose all the apply.)
 Staff layoffs
 Staff furloughs
 Loss of staff through attrition
 Elimination of entire program(s)
 Reduction in surveillance efforts
 Reduction in services
 Reduction in support to partners
 Reduction in support to local health departments
In Federal Fiscal Year 2014, which of the following scenarios do you expect to experience?
o I expect budget cuts.
o I expect level funding.
o I expect budget increases.
o I’m not sure what to expect with regard to funding in Federal Fiscal Year 2014.

You have completed the FFY 2013 State of the States Finance and Personnel Survey. Thank you for your time and
participation. Once you click Continue you will have an opportunity to PRINT your completed survey.
Please email shenee.reid@safestates.org if you have any questions about the survey.