title: A state-based analysis of public health preparedness programs in the United States.
abstract: OBJECTIVE
  Given the national effort to respond to the challenge of terrorism post-9/11, this study examined the organizational structure of state public health preparedness programs across the country, their administration, and the personnel and resources supported through federal cooperative agreements and state funds.
  
  
  METHODS
  In Fall 2004, the Association of State and Territorial Health Officials surveyed state public health preparedness directors of all 50 states and territories of the United States regarding the organizational structure, administration, personnel, and resources of the state public health preparedness programs.
  
  
  RESULTS
  Individuals representing 45 states and the District of Columbia responded to the web-based questionnaire for a response rate of 88.2%, States tended to subdivide their organizations into regions for preparedness purposes. More than half the established preparedness regions (53.8%) were created post-9/11. Preparedness program directors frequently reported directly to either the state health official (40.0%) or a deputy state health official (33.3%). Responsibility for both the Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) cooperative agreements was predominantly vested in one person (73.3%). Federal resources were found to support needed preparedness workforce (CDC mean = 117.1 full-time equivalents [FTEs]; HRSA mean = 10.6 FTEs). In addition, 36.6% of the states also contributed to the public health preparedness budget.
  
  
  CONCLUSIONS
  This study of state public health agency preparedness provides new information about state-level organizational structure, administration, and support of preparedness programs. It offers the first comprehensive insights into the approaches states have adopted to build infrastructure and develop capacity through CDC and HRSA funding streams.
authors.affiliation: Center for Medicine and Public Health, Florida State University College of Medicine, 1115 W. Call St., Tallahassee, FL 32306-4300, USA. les.beitsch@med.fsu.edu
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Beitsch
authors.forename: Samata
authors.initials: S
authors.lastname: Kodolikar
authors.forename: Tim
authors.initials: T
authors.lastname: Stephens
authors.forename: Daniel
authors.initials: D
authors.lastname: Shodell
authors.forename: Art
authors.initials: A
authors.lastname: Clawson
authors.forename: Nir
authors.initials: N
authors.lastname: Menachemi
authors.forename: Robert G
authors.initials: RG
authors.lastname: Brooks
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration*; D015397:Program Evaluation; D011635:Public Health Administration; D013219:State Government; D011795:Surveys and Questionnaires; D014481:United States