AUSTIN - Texas’ spending on public health services has decreased over the last two years, one of two indicators that show the state is not as prepared for a public health emergency as it could be, according to a national report released Tuesday.

Texas achieved eight of 10 key indicators in a study by the Trust for America’s Health to assess how well states are prepared for health emergencies. The report concluded that states have made significant progress since the terrorist and anthrax attacks in 2001, but cautioned that much work remains.

Most state scores improved from last year to reflect an infusion of federal funding to states. Although the indicators from last year’s report are different, Texas’ score remained the same.

“Just when we are beginning to see a return on the federal investment in preparedness programs, the president and Congress have continued to cut these funds,” said Jeff Levi, executive director of the group. “These efforts may seem penny wise now, but could prove pound foolish later.”

The funding measure, which was adjusted for inflation, was used to determine states commitment to putting resources into public health programs that support the infrastructure needs that would be required in a health emergency. Texas was one of just six states that did not increase or maintain spending levels on public health.

“You’re never done getting people prepared for emergencies and disasters,” said Doug McBride, a spokesman for the Texas Department of State Health Services. “We put more emphasis on the preparations that are being made rather than on a score.”

A large part of the funding decrease was attributed to a state cut to emergency medical services and trauma care systems, said Rich Hamburg, director of government relations for the Trust for America’s Health.

“There’s no state in the nation that’s better prepared for an emergency than Texas,” said Allison Castle, a spokeswoman for Gov. Rick Perry. “The governor has made disaster preparedness a top priority and … if we’re ranking preparedness based on funding, by that measurement, FEMA would be doing a good job.”

Texas also was deducted a point for not giving adequate liability protection to health care volunteers in a public health emergency, an impediment to recruiting enough volunteers to respond to a major health emergency, researchers said. The study found 21 states have not passed laws that would give volunteers adequate legal protection in a public health emergency.

“The state does have some liability protections for health care volunteers, but our office is going to review existing protections and … to ensure that volunteers who rendered aid in a disaster are protected from liability,” Castle said.

The study found that Texas has adequate plans to distribute emergency vaccines, antidotes and medical supplies and has purchased antivirals to use during a pandemic flu.

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.

Texas had purchased 39 percent of the state’s allocation of antiviral treatment courses as of last month.

“There is little doubt that emergency health preparedness is on the national radar,” Levi said. “But until all states are equally well prepared, our country is not as safe as it can and should be.”

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.

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