Despite significant investments by public health to ensure readiness to meet Meaningful Use (MU) public health objectives, Medicaid data show a significant difference between eligible providers meeting other MU objectives versus public health objectives. This session will present alternate metrics and a more comprehensive view of state work toward MU readiness. Reports from Medicaid show a significant difference between eligible providers meeting other Meaningful Use (MU) objectives (90-98%) versus public health objectives (between 6-53%). The underlying reason between these discrepancies is the high number of providers claiming exemptions for public health objectives, as providers can claim exemptions if public health is not ready to receive information. These numbers have been presented at national conferences by CMS and are not reflective of the significant efforts undertaken by public health to ensure readiness to meet MU public health objectives. While efforts continue to gain access to stratified data sets, there are coordinated efforts to increase interoperability between public health and eligible providers and hospitals. CDC is currently heading an interoperability study with state immunization programs to identify variations and barriers. The goal of this study is to increase the number of states receiving data from eligible providers and hospitals without message content violations. While there are a number of states participating, increasing state participation is vital to increasing the number of eligible providers and hospitals successfully submitting data to public health. The next public health objective that needs to be addressed is electronic laboratory reporting. ONC will be hosting a public health and vendor call in order to assist in aligning public health needs and to assist in discussions with the vendor community. ASTHO is working with the Office of the National Coordinator of Health IT (ONC) to identify causes and potential solutions to this low level of reporting of eligible providers and hospitals on public health objectives and clearly identify reasons for why these exemptions are given. This session will be a joint presentation with states, ONC, and ASTHO to present alternate metrics and a more comprehensive view of state work toward Meaningful Use readiness.