A Government Accountability Office (GAO) audit of states’ influenza pandemic plans found that while they all had developed a plan in accordance with federal pandemic funding requirements, “on average the Department of Health and Human Services (HHS) found that states’ plans had ‘many major gaps’ in 16 of 22 priority areas, like policy process for school closure and communication."

In its audit of the five states and ten localities that have developed pandemic plans, GAO also found that state and local “officials … would welcome additional guidance from the federal government in a number of areas to help them to better plan and exercise for an influenza pandemic, in areas such as community containment.”

GAO stated in its report on the audit that “three of these areas were also identified as having “many major gaps” in states’ plans nationally in the HHS-led review.

“While the states and localities selected provided a broad perspective,” GAO reported, “we cannot generalize or extrapolate the information gleaned from the site visits to the nation. In addition, since the states that we selected were large, the most populous states, and likely entry points for people coming into the United States, the information we collected may not be as relevant to smaller, less populated states that are not likely entry points for people coming into the United States.”

In January 2008, HHS and the Department of Homeland Security, in coordination with other federal agencies, hosted a series of meetings of states in the five federal influenza pandemic regions to discuss the draft guidance on updating their pandemic plans.

“Although a senior DHS official reported that there are no plans to conduct further workshops, “ GAO reported, “additional regional meetings could provide a forum for state and federal officials to address gaps in states’ planning identified by the HHS-led review and to maintain the momentum of states’ pandemic preparedness through this next governmental transition.”

A matter of recurring criticism HSToday.us has heard from the many state and local pandemic preparedness authorities it has talked to is that there has not been enough guidance and interaction from the federal government.

GAO noted that “The National Pandemic Implementation Plan lays out the expectation that states and communities should have influenza pandemic preparedness plans and conduct pandemic exercises.”

“Exercises are crucial in testing and planning [and] our work has shown the importance of ensuring that lessons learned from exercises are incorporated into planning to address any gaps or challenges identified,” GAO investigators stated.

According to the Centers for Disease Control and Prevention (CDC), which administers the federal pandemic funds, all 50 states have developed an influenza pandemic plan in accordance with federal pandemic funding requirements.

At the time of GAO’s site visits, officials from the selected states and localities audited by GAO “said that they involved the federal government, other state and local agencies, tribal nations, and nonprofit and private sector organizations in their influenza pandemic planning.”

In March 2008, HHS, DHS, and other federal agencies issued guidance to states to help them update their pandemic plans, which are due this month, in preparation for another HHS-led review.

“According to CDC officials,” GAO stated, “all states and localities that received the federal pandemic funds have met the requirement to conduct an exercise to test their plans. Officials from all of the states and localities reviewed by GAO reported that they had incorporated lessons learned from influenza pandemic exercises into their influenza pandemic planning, such as buying additional medical equipment, providing training, and modifying influenza pandemic plans.”

The National Pandemic Implementation Plan states that in the event of an influenza pandemic, “the distributed nature and sheer burden of disease across the nation would mean that the federal government’s support to any particular community is likely to be limited, with the primary response to a pandemic coming from states and local communities,” GAO said. “However, given the unique nature of an influenza pandemic, all sectors of society, including the federal government, states and local communities, the private sector, nonprofit organizations, tribal nations, individual citizens, and global partners will need to be involved in preparedness for and response to a pandemic.”