As of February 25, 41 states plus the District of Columbia are in regular session. These states are Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming.

Louisiana, New Mexico and North Carolina.

Arkansas, Montana, Nevada, North Dakota, Oregon and Texas.

State preparedness activities increased since receiving notification from Secretary Tommy Thompson January 31st that each state would share $1.1 billion in federal funds to prepare for public health emergencies. The funds are intended to be used to develop comprehensive bio-terrorism preparedness plans, upgrade infectious disease surveillance and investigation, enhance the readiness of hospital systems to deal with large numbers of casualties, expand public health laboratory and communications capacities, and improve connectivity between hospitals, and city, local and state health departments to enhance disease reporting. The funds come from the $2.9 billion bio-terrorism appropriations bill that President Bush signed into law Jan. 10.

The funding is divided into three parts. The first portion will be provided by the Centers for Disease Control and Prevention (CDC) and is targeted to supporting bio-terrorism infectious diseases, and public health emergency preparedness activities statewide. Each state's allocation will consist of a $5 million base award, supplemented by an additional amount based on its share of the total U.S. population.

The second portion will be provided by Health Resources and Services Administration, which will be used to create regional hospital plans to respond in the event of a bio-terrorism attack. These funds will be allocated using a formula similar to that used by the CDC.

The third portion of the funds will be provided by the Health and Human Services (HHS) Office of Emergency Preparedness and will support the Metropolitan Medical Response System (MMRS). The MMRS funding will add an additional 25 new cities to those which have already received funding in past years and will mean that 80 percent of the U.S. population will be covered by an MMRS plan. MMRS contracts are especially aimed at improving local jurisdictions' ability to respond to the possible release of a chemical or biological disease agent, but also serve to improve local response to any event involving mass casualties.

The states will be permitted to begin immediately spending up to 20 percent of their allotments to avoid delay in starting preparedness measures. The remaining 80 percent of the $1.1 billion in state funds will be released once complete plans have been received and approved.

State plans must be submitted by March 15, 2002, and no later than April 15, 2002, to HHS. HHS will complete its review of each plan within 30 days of receipt. Each statewide plan is to lay out how it will respond to a bio-terrorism event and other outbreaks of infectious disease, but also how it will strengthen core public health capacities in all relevant areas. Each statewide plan is to be reviewed and endorsed by the governor prior to submission.

A table showing state-by-state funding levels is available at www.hhs.gov/news/press/2002pres/states.html

A table showing MMRS funding levels is available at www.hhs.gov/news/press/2002pres/mmrs.html

The criteria for states to consider in developing their plans follows.

On November 7, 2001, Colorado Governor Owens, issued an Executive Order creating the Office of Preparedness and Security (OPS). The new office has two missions, first to maximize the states' preparation for terrorism events by identifying critical components within the community for business and governmental continuity and second to serve as a communications and analysis center during an emergency. OPS will be charged with creating plans for both governmental agencies and private sector that will work in concert with one another to enhance local response and recovery capacity. The plans to be devised will include those for law enforcement, first responders, public health and other relevant state and private sector organizations. The office will also be responsible for acting as a liaison with federal agencies on behalf of state and local organizations.

Florida Department of Health (DOH) Secretary John O. Agwunobi, M.D., M.B.A., announced the creation of the Office of Public Health Preparedness in the Department of Health February 20, 2002. The office will coordinate act as the coordinating entity for the Department of Health and other state agencies to ensure enhanced preparedness and response to bio-terrorism and other emergency events. John V. "Jack" Pittman has been appointed as the administrator to oversee the new office. Governor Bush has also recommended in a supplemental budget that eight million be allocated from the federal grant to prepare hospital systems for the possibility of a mass casualty disaster, that $146,064 be allocated toward additional training for Disease Investigation Specialists and $675,000 for expansion and improvement of Miami's Laboratory facilities who received an additional 5,000 plus specimens last fall due to a new focus on bio-terrorism

On February 11, 2002, the Illinois Department of Public Health (IDPH) presented a pilot of an educational session for internal staff on the basic fundamentals for conducting an epidemiological investigation. The course is part of IDPH's ongoing preparedness activities to enhance its ability to manage a major disease outbreak. When finalized, the course will be presented internally to build a pool of staff capable of assisting with a disease investigation, including bio-terrorism The three-hour program will address fundamentals for epidemiology/surveillance, terms and definitions, review of case studies and an interviewing exercise. In the future, IDPH plans to offer this course to local health departments across Illinois.

Louisiana Secretary of the Department of Health and Hospitals outlined several areas on February 8th where federal funds will be used to improve state preparedness once received. Louisiana is in line to eventually receive $16.9 million of the funds allocated for state public health preparedness. The state plans to coordinate efforts for planning between the Office of Public Health (OPH), State Police and the Louisiana Office of Emergency Preparedness among others. Specific areas outlined by the secretary include;

Through the support of the Louisiana Legislature, OPH will also be enhancing its current state of readiness with the addition of $4.3 million dollars and 44 new positions targeted to the bio-terrorism preparedness efforts. These resources will be used to build capacity for disease surveillance, epidemiology, laboratories, communication systems, and preparedness planning. OPH has requested increased funding from State and Federal sources to ensure the availability of antibiotics, supplies and equipment in the event of a bio-terrorist threat.

Dr. Steven Cline, North Carolina's acting Bio-terrorism Coordinator and Epidemiology Section Chief, issued a letter January 15, 2002, notifying North Carolina organizations and individuals that possess and maintain biological agents that certain agents must be registered with the state by Feb. 25. The rapid creation of the registry fulfills one of a number of efforts undertaken by the of Public Health Division to reduce the threat of bio-terrorism

"The state called upon public health to establish a system of monitoring certain agents that, in the wrong hands, could be used against us," Dr. Cline said. "Not only are we proud of the fact that it is up and running so quickly, but also because we are the first state in the country to establish such a registry." Prompted by the anthrax attacks that occurred last fall, Attorney General Roy Cooper urged the General Assembly to pass a law requiring the registration of potentially dangerous biological agents. This legislation was passed last November and the rules adopted by the North Carolina Commission for Health Services governing reporting went into effect Jan. 10.

Under the rules, organizations or individuals that possessed and maintained any biological agents listed in Federal Register 42 CFR Part 72, Appendix A (see http://www.cdc.gov/od/ohs/lrsat/42cfr72.htm) prior to Jan. 10 are required to report them by Feb. 25. Those who receive agents after Jan. 10 are to register them within seven days of receipt of the agent. In the event of any change in the information contained in the original report, an amended report must be submitted within seven days. The suspected release, loss or theft of any listed biological agent must be reported within 24 hours.

On February 19, 2002 the Ohio Public Safety's Division of Emergency Medical Services (EMS) and the State Board of Emergency Medical Services announced they are making available $300,000 in EMS grants to local EMS providers for domestic preparedness training. The purpose of the grant is to offer EMS providers the opportunity for training needed to deal with domestic preparedness issues such as: emergency response, terrorism preparedness and bio-terrorist response.

On February 11, 2002, over 100 participants from various private, nonprofit and governmental agencies participated in a flu pandemic exercise in Racine Wisconsin. Participating in an exercise of this type will prepare organizations for any fast spreading disease or health threat. Governor Scott McCallum remarked that this type of exercise further strengthens our collective terrorism preparedness efforts as it brings response disciplines together to promote community cooperation.

Virginia Governor Mark Warner issued an Executive Order January 31, 2002 launching the Secure Virginia Initiative and establishing the Secure Virginia Panel. The panel is directed to prepare and update state agency emergency response plans and to designate a liaison within the administration to coordinate efforts with federal agencies. The panel will be chaired by John Hager, the Governor's Assistant for Commonwealth Preparedness. Panel membership will include two members from both chambers of the General Assembly; Secretaries of Public Safety, Health and Human Resources, Technology and Transportation; three local government leaders and two local first responders. The Governor also outlined some details of his budget amendments that will include the addition of 25 investigators at the Virginia Department of Health to identify and respond to biological threats and infectious disease outbreaks.