updated 12/18/2007 11:27:45 AM ET 2007-12-18T16:27:45

Seven states have yet to participate in a federal program to buy antivirals for a potential influenza pandemic. Thirteen states do not have adequate plans to distribute vaccines and medical supplies from the Strategic National Stockpile.

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Those findings and others are part of a new report on how well states have prepared for public health emergencies. The report concluded that states have made significant progress since the terrorist and anthrax attacks in 2001. However, critical gaps remain.

Seven states performed adequately in each of the 10 categories that were measured, which earned them a score of 10 from the Trust for America's Health, a research group. The top scores went to Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia.

The states that got the lowest score were Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming.

The federal government has had a difficult time measuring progress when it comes to the billions of dollars it has sent states over the past six years to improve preparedness. The money went to upgrade laboratories, buy medical supplies and conduct training exercises.

The Bush administration has encouraged states to stock up on antivirals in the event of an influenza pandemic. Under one program, the federal government will pay for a quarter of the cost of buying Tamiflu or Relenza, and states pay the remainder for a combined investment of about $680 million. Antivirals reduce the severity of influenza.

Seven states have so far declined to purchase any antivirals, according to the report: Colorado, Connecticut, Florida, Massachusetts, Mississippi, North Dakota and Rhode Island. Several more have bought only a fraction of what they're entitled to under the federal program.

"If a significant number of states don't pick up their share of responsibility, then the country as a whole is less protected," said Jeffrey Levi, executive director of Trust for America's Health.

A spokesman for the Department of Health and Human Services said that states have until June 2008 to get their orders in. All states, have told the federal government they plan on participating, he said. However, many have only ordered part of the medicine that's available to them.

"States that are not buying the full amount of antivirals we have allocated under this program are putting their own citizen at risk," said HHS Spokesman Bill Hall.

The report also highlighted the need for nearly half the states to update their "Good Samaritan" laws. Such laws create liability shields for those who come to the aid of another at the scene of an emergency. The trust said states need shield laws that can cover days or even weeks of voluntary work, such as a shield law tied to a declared emergency by a governor.

The report also warned that a decrease in federal funding could offset many of the improvements that states have made since 2001.

Among the other categories measured, the report said:

  • Flu vaccination rates for the elderly dropped in 11 states.
  • Six states cut their public health department budgets last year.
  • All 50 states and the District of Columbia held emergency drills with their health department and state National Guard.
  • Twenty-one states do not have key liability protections for health care volunteers who respond to emergencies.

Copyright 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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