There is little existing in the literature that provides a definition of readiness for a jurisdiction’s whole health care system. As defining readiness at the system level has proven to be challenging, an approach that provides a framework for planning and measuring health care readiness with broad utility is needed. The New York City Department of Health and Mental Hygiene (DOHMH) devised the Readiness Target Project. Nine areas or dimensions of readiness emerged from this work. Through focus groups and feedback from hospital stakeholders DOHMH developed a matrix of readiness areas outlining current state, target state, gaps, and recommendations to achieve readiness. The matrix is in use as a systematic approach to discover and close gaps in the readiness of the whole health care system and to provide that system a locally valid framework to drive continuous improvement. This paper describes a framework for planning and determining the status of health care readiness at the system level for the jurisdiction. (Disaster Med Public Health Preparedness. 2018;12:759-764))