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The National Association of County and City Health Officials (NACCHO) examined the administrative factors that impede or support the ability of health departments to report accurate data rapidly during an emergency response. This report describes factors that make emergency reporting a frequent administrative preparedness challenge. It also identifies practices that are common to streamlined and efficient health department reporting processes and procedures. Finally, the report acknowledges the importance of everyday reporting to health department accountability and emphasizes why reporting is essential during emergency response.