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pdfHSIP Report Template
May 2017
[Q1] State
[Q2] Executive Summary
Introduction
Standard text
Program Structure
Program Administration
[Q3] Describe the general structure of the HSIP in the State. [large text question]
[Q4] Where is HSIP staff located within the State DOT? [Select one]
Planning
Operations
Design
Engineering
Other
[Q5 (old Q3)] How are HSIP funds allocated in a State? [Select one]
Central Office via Statewide Competitive Application Process
SHSP Emphasis Area Data
Formula via Districts/Regions
Formula via MPOs
Other
[Q6 (old Q4)] Describe how local and tribal roads are addressed as part of HSIP. [large text question]
[Q7 (old Q5)] Identify which internal partners (e.g., State departments of transportation (DOTs)
Bureaus, Divisions) are involved with HSIP planning. [Check all that apply]
Traffic Engineering/Safety
Design
Planning
Maintenance
Operations
Districts/Regions
Local Aid Programs Office/Division
Governors Highway Safety Office
Other
[Q8 (old Q6)] Describe coordination with internal partners. [large text question]
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HSIP Report Template
May 2017
[Q9 (old Q7)] Identify which external partners are involved with HSIP planning. [Check all that apply]
Regional Planning Organizations (e.g. MPOs, RPOs, COGs)
Governors Highway Safety Office
Local Technical Assistance Program
Local Government Agency
Tribal Agency
Law Enforcement Agency
Academia/University
FHWA
Other
[Q10] Describe coordination with external partners. [large text question]
[Q11 (old Q8)] Have any program administration practices used to implement the HSIP changed since
the last reporting period? [Yes/No dropdown]
[If yes] Describe HSIP program administration practices that have changed since the last reporting
period. [large text question]
[Q12 (old Q9)] Are there any other any other aspects of HSIP Administration on which the State would
like to elaborate? [Yes/No dropdown]
[If yes] Describe other aspects of HSIP Administration on which the State would like to elaborate.
[large text question]
Program Methodology
[Q13] Does the State have an HSIP manual or similar that clearly describes HSIP planning,
implementation and evaluation processes? [Yes/no dropdown]
To upload a copy of your processes, click here [Link to file upload page for this section.]
[Q14 (old Q10)] Select the programs that are administered under the HSIP. [Check all that apply]
HSIP (no
subprograms)*
HRRR*
Wrong Way Driving*
Median Barrier
Intersection
Safe Corridor
Horizontal Curve
Bicycle Safety
Rural State Highways
Skid Hazard
Red Light Running
Prevention
Roadway Departure
Low-Cost Spot
Improvements
Sign Replacement
And Improvement
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Local Safety
Pedestrian Safety
Right Angle Crash
Left Turn Crash
Shoulder
Improvement
Segments
Crash data
HSIP Report Template
May 2017
*New response options
[Q15 (old Q11)] For each program selected above, provide additional information below.
Program: [Prepopulates based on response to Q10]
Date that program methodology was last updated: [choose from calendar]
[New] What is the justification for this program? [select one]
Addresses SHSP priority or emphasis area
FHWA focused approach to safety
Other
[New] What is the funding approach for this program? [select one]
Competes will all projects
Funding set-aside
Other
What data types were used in the program methodology? [Check all that apply]
What project identification methodology was used for this program? [Check all that apply]
Are local roads (non-state owned and operated) included or addressed in this program?
Are local road projects identified using the same methodology as state roads?
How are projects under this program advanced for implementation?
Select the processes used to prioritize projects for implementation. For the methods selected, indicate
the relative importance of each process in project prioritization. Enter either the weights or numerical
rankings. If weights are entered, the sum must equal 100. If ranks are entered, indicate ties by giving
both processes the same rank and skip the next highest rank (as an example: 1, 2, 2, 4).
[Q16 (old Q12)] What percentage of HSIP funds address systemic improvements? [Enter number]
HSIP funds are used to address which of the following systemic improvements? [Check all that apply]
Cable Median
Barriers
Rumble Strips
Traffic Control
Device Rehabilitation
Pavement/Shoulder
Widening
Install/Improve
Signing
Install/Improve
Pavement Marking
and/or Delineation
Upgrade Guard Rails
Clear Zone
Improvements
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Safety Edge
Install/Improve
Lighting
Add/Upgrade/Modif
y/Remove Traffic
Signal
Horizontal curve
signs*
HSIP Report Template
May 2017
High friction surface
treatment*
Wrong way driving
treatments*
[Q17 (old Q13)] What process is used to identify potential countermeasures? [Check all that apply]
Engineering Study
Road Safety Assessment
Crash data analysis
SHSP/Local road safety plan
Data-driven safety analysis tools (HSM, CMF Clearinghouse, SafetyAnalyst, usRAP)
Stakeholder input
[Q18] Does the State HSIP consider connected vehicles and ITS technologies? [yes/no drop-down]
[If yes] Describe how the State HSIP considers connected vehicles and ITS technologies. [large text
field]
[Q19] Does your State use the Highway Safety Manual to support HSIP efforts? [Yes/no dropdown]
[If yes] Please describe how your State uses the HSM to support HSIP efforts.
[Q20 (oldQ14)] Have any program methodology practices used to implement the HSIP changed since
the last reporting period? [Yes/No dropdown]
[If yes] Describe program methodology practices that have changed since the last reporting period.
[large text question]
[Q21 (old Q15)] Are there any other aspects of the HSIP methodology on which the State would like to
elaborate? [Yes/No dropdown]
[If yes] Describe other aspects of the HSIP methodology on which the State would like to elaborate.
[large text question]
Progress in Implementing Highway Safety Improvement Projects
Funds Programmed
[Q22 (old Q16)] Reporting period for HSIP funding.
[Q23 (old Q17)] Enter the programmed and obligated funding for each applicable funding category.
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Funding Category
Programmed
Obligated
%
Obligated/Programmed
[calculated by ORT]
HSIP (23 U.S.C. 148)
HRRR Special Rule (23 U.S.C.
148(g)(1))
Penalty Funds (23 U.S.C. 154)
Penalty Funds (23 U.S.C. 164)
RHCP (for HSIP purposes) (23
U.S.C. 130(e)(2))
Other Federal-aid Funds (i.e.
STBG, NHPP)
State and Local Funds
Total
[Q24 (old Q18) ]How much funding is programmed to local (non-state owned and maintained) or
tribal safety projects? [Enter number]
How much funding is obligated to local or tribal safety projects? [Enter number]
[Q25 (old Q19)] How much funding is programmed to non-infrastructure safety projects? [Enter
number]
How much funding is obligated to non-infrastructure safety projects? [Enter number]
[Q26 (old Q20)] How much funding was transferred in to the HSIP from other core program areas
during the reporting period under 23 U.S.C. 126? [Enter number]
How much funding was transferred out of the HSIP to other core program areas during the reporting
period under 23 U.S.C. 126? [Enter number]
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HSIP Report Template
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[Q27 (old Q21)] Discuss impediments to obligating HSIP funds and plans to overcome this challenge in
the future. [Large text field]
[Q28 (old Q22)] Do you want to elaborate on any other aspects of the State’s progress in
implementing HSIP projects? [Yes/no dropdown]
[If yes] Describe any other aspects of the State’s progress in implementing HSIP projects on which the
State would like to elaborate. [Large text field]
[Q29 (old Q23)] General Listing of Projects [modified template]
Progress in Achieving Safety Outcomes and Performance Targets
General Highway Safety Trends
[Q30 (old Q24)] Enter annual safety performance measure data.
Performance Measure
2008 2009 2010 2011 2012^ 2013^ 2014^ 2015^ 2016^*
Fatalities
Serious Injuries#
Fatality Rate (per HMVMT)
Serious Injury Rate (per
HMVMT)
Number non-motorized
fatalities
Number of non-motorized
serious injuries#
[Note: Beginning in 2017, users can only submit annual performance measure data for general highway
safety trends. The HSIP ORT will continue to calculate the 5-yr rolling average and display both the
annual and 5-yr average in the report output. HSIP ORT will combine non-motorized fatalities and
serious injuries for report output. ]
#
Data will be used for safety performance measure assessment
^Required fields
*If reporting year - 1 is not the most recent year, the State must:
Describe efforts to obtain most current calendar year’s crash data. [large text question]
[Q31] Describe fatality data source. [Select one]
FARS
State motor vehicle crash database
Other
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HSIP Report Template
May 2017
[Q32 (old Q25)] To the maximum extent possible, present performance measure data by functional
classification and ownership.
[Q33 (old Q26)] Are there any other aspects of the general highway safety trends on which the State
would like to elaborate? [Yes/No dropdown]
[If yes] Provide additional discussion related to general highway safety trends. [large text question]
Safety Performance Targets
[Q34] Calendar Year [Insert Year = Reporting Year +1] Targets*
Number of Fatalities
Enter Numerical Value to the tenth decimal place
Describe the basis for established target, including how it supports SHSP goals.
Number of Serious Injuries
Enter Numerical Value to the tenth decimal place
Describe the basis for established target, including how it supports SHSP goals.
Fatality Rate
Enter Numerical Value to the thousandth decimal
place
Describe the basis for established target, including how it supports SHSP goals.
Serious Injury Rate
Enter Numerical Value to the thousandth decimal
place
Describe the basis for established target, including how it supports SHSP goals.
Total Number of Non-Motorized Fatalities and
Serious Injuries
Enter Numerical Value to the tenth decimal place
Describe the basis for established target, including how it supports SHSP goals.
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HSIP Report Template
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*Based on (Target Year – 4) to (Target Year) 5-year average
[For example, for the 2017 reporting period the target year is 2018 (to be displayed above table for this
question). The footnote would read “Based on 2014 – 2018 5 year average”.]
[Q35] Describe efforts to coordinate with other stakeholders (e.g. MPOs, SHSO) to establish safety
performance targets. [large text field]
[Q36] Does the State want to report additional optional targets? [Yes/no drop-down]
If yes, click here [link to page to upload attachments for this section] to include optional targets and
boundaries as a separate attachment.
Applicability of Special Rules
[Q37] Does the HRRR special rule apply to the State for this reporting period? [Yes/no dropdown]
[Q 38 (old Q27)] Provide the number of older driver and pedestrian fatalities and serious injuries for
the past seven years.
Performance Measure
Number of Older Driver and Pedestrian
Fatalities
Number of Older Driver and Pedestrian Serious
Injuries
[*Reporting year -2; all fields required]
2009
2010 2011
2012 2013
Effectiveness of Improvements
Program Effectiveness
[Q39] How does the State measure effectiveness of the HSIP? [Check all that apply]
Change in fatalities and serious injuries
Benefit/Cost Ratio
Economic Effectiveness (cost per crash reduced)
Lives saved
Other
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2014 2015*
HSIP Report Template
May 2017
[Q40] Based on the measures of effectiveness selected above, describe the results of the State’s
program level evaluations. [large text question]
[Q41 (old Q29)] What other indicators of success does the State use to demonstrate effectiveness and
success of the Highway Safety Improvement Program? [Check all that apply]
# miles improved by HSIP
More systemic programs
# RSAs completed
Policy change
Organizational change
Increased awareness of safety and data-driven process
Increased focus on local road safety
HSIP obligations
Other
[Q42 (old Q30 and Q31)]. Are there any significant programmatic changes that have occurred since the
last reporting period? [Yes/No dropdown]
[If yes]. Describe significant program changes that have occurred since the last reporting period. [large
text question]
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HSIP Report Template
May 2017
Effectiveness of Groupings or Similar Types of Improvements
SHSP Emphasis Areas
[Q43 (old Q32)] Present and describe trends in SHSP emphasis area performance measures.
Countermeasure Effectiveness
[Q44] Have you completed any countermeasure effectiveness evaluations during the reporting
period? [yes/no dropdown]
[If yes] Please provide the following summary information for each countermeasure effectiveness
evaluation.
Countermeasure name:
Description:
Target Crash Type:
# installations:
[or] Miles treated:
# years before data:
# years after data:
Methodology:
Results:
Click here [insert link to file upload for this section] to upload research report.
[+Add another countermeasure. ]
Project Effectiveness
[Q45 (old Q36)] Provide the following information for previously implemented projects that the State
evaluated this reporting period.
[Q46 (old Q35) Are there any other aspects of the overall HSIP effectiveness on which you would like
to elaborate? [Yes/No dropdown]
[If yes] Describe any other aspects of HSIP effectiveness on which you would like to elaborate. [large
text question]
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HSIP Report Template
May 2017
Compliance Assessment
[Q47] SHSP Update Cycle
What date was the State’s current SHSP approved by the Governor or designated State
representative? [Choose from calendar]
What are the years being covered by the current SHSP? [insert year (4 characters)] to [Insert year 4
characters)]
When do you anticipate completing the State’s next SHSP update? [Insert year (4 characters)]
MIRE Fundamental Data Elements
[Q48] Provide the current status (percent complete) of MIRE fundamental data elements collection
efforts using the table below. [Separate MS Excel template also available]
MIRE
FDE
Non Local Paved
Roads - Segment
State-
NonState
Non Local Paved
Roads Intersection
State-
NonState
Non Local Paved
Roads - Ramps
State-
NonState
Local Paved
Roads
State-
NonState
Unpaved Roads
State-
NonState
[Q49] Describe actions the State will take moving forward to meet the requirement to have complete
access to the MIRE fundamental data elements on all public roads by September 30, 2026. [large text
question]
[Q50] Serious Injury Definition
Provide the suspected serious injury identifier, definition and attributes used by the State for both the
crash report form and the crash database using the table below. Please also indicate whether or not
these elements are compliant with the MMUCC 4th edition criteria for data element P5. Injury Status,
suspected serious injury.
State
Crash Report
Form
Suspected
Serious Injury
Identifier
(name)
MMUCC 4th Suspected
edition
Serious Injury
Compliant* Definition
NA
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MMUCC 4th Suspected
edition
Serious Injury
Compliant* Attributes
(descriptors)
NA
MMUCC 4th
edition
Compliant*
HSIP Report Template
May 2017
Crash Report
Form
Instruction
Manual
Crash
Database
Crash
Database Data
Dictionary
[Note: *Yes/No dropdown]
NA
NA
[If no is selected for any of the elements above] Please describe the actions the State is taking to
become compliant by April 15, 2019. [large text question]
[Q51] Program Assessment
Did the State conduct an HSIP program assessment during the reporting period? [yes/no dropdown]
[If yes] Describe the purpose and outcomes of the State’s HSIP program assessment. [large text field]
[If no] When does the State plan to complete its next HSIP program assessment? [insert year]
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File Type | application/pdf |
Author | Scurry, Karen (FHWA) |
File Modified | 2017-05-16 |
File Created | 2017-05-16 |