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A new report card from the Trust for America’s Health examines emergency preparedness on a state-by-state basis. “,” scored states, as well as Washington, DC, on 10 key indicators of public health preparedness, including public health funding commitment, flu vaccination rate, reducing healthcare-associated infections and emergency health care access. Overall, the report found improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; upgrades in public health laboratories and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies. However, there remains a lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with emerging threats; gaps in the ability of the system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce, according to the report.Health emergency preparedness funding for states has been cut by $280 million since fiscal year 2002, while health system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million, the report notes.