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Pharmacists' adoption of nonpharmaceutical supply roles may represent a problem of accepting a paradigm shift in nontraditional roles. Possible shortages of personnel in future disasters may change the pharmacists' approach to disaster management.

Objective. To estimate pharmaceutical emergency preparedness of US states and commonwealth territories. Methods. A quantitative content analysis was performed to evaluate board of pharmacy legal documents (ie, statutes, rules, and regulations) for the presence of the 2006 Rules for Public Health Emergencies (RPHE) from the National Association of Boards of Pharmacy's (NABP) Model Pharmacy Practice Act. Results. The median number of state-adopted RPHE was one, which was significantly less than the hypothesized value of four. Rule Two, which recommended policies and procedures for reporting disasters, was adopted significantly more than other RPHE. Ten states incorporated language specific to public health emergency refill dispensing, and among these, only six allowed 30-day refill quantities. Conclusion. Based on the 2006 NABP model rules, it does not appear that states are prepared to expedite an effective pharmaceutical response during a public health emergency. Boards of pharmacy should consider adding the eight RPHE to their state pharmacy practice acts.

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Data suggest that pharmacists may be prepared to respond to hurricanes and biological and chemical disasters in pharmaceutical supply and patient management roles. Future research should highlight efforts to prepare health systems for the effects of nuclear, radiological, and chemical disasters.