Over the last 4 years, the Nation, as a whole has put forth a crash effort to build defenses against a possible bioterrorist attack. In addition, States have developed a wide range of emergency plans, conducted numerous exercises, and modernized their information and communication systems. However, with the building of our defenses against bioterrorism, it has been identified that there is no consistent measure of where the Nation is or where the Nation needs to be within the public health system in the fight against bioterrorism. There is concern that emphasis on preparing for mass-casualty incidents is diverting attention and funding from other mounting public health problems, such as HIV/AIDS, diabetes, and tuberculosis. Questions need to be addressed so the public knows what to expect from the public health system. This article discusses briefly what States and localities are doing to acquire new tools within the public health system in regards to biological issues and the results of their acquisitions. With the Federal Government’s assertion and influence in a field that has generally been a State and local responsibility, nudging local health departments more in the direction of emergency preparedness, it is easy to see that local health departments’ ability to deal with non-emergency health problems will become more strained.