States Are Using Policy to Strengthen Preparedness and Supply Chain Resilience

June 22, 2026 | Maggie Nilz

Effective emergency preparedness depends not only on response capacity, but also on resilient supply chain systems capable of sustaining operations during emergencies. As federal preparedness priorities shift, states are considering lessons learned from COVID-19 and recent disasters. They are also re-evaluating strategies to support preparedness and response activities, and maintain access to critical resources — including policies that strengthen fiscal flexibility, modernize procurement systems, and institutionalize stockpiling strategies to improve preparedness and supply chain resilience.

Federal Shifts Influence State Supply Chain Planning

Recent federal developments are shaping how states approach supply chain preparedness and resource management. The COVID-19 pandemic exposed challenges related to supply availability, coordination, and distribution within the Strategic National Stockpile. This prompted renewed discussion about the balance between federal and state preparedness responsibilities. In response to this — and a March 2025 Executive Order directing state and local governments to take a more active role in the management of preparedness activities — the Administration for Strategic Preparedness and Response launched the Jurisdictional Stockpile Program to support jurisdictions in developing tailored stockpiles through planning tools, technical assistance, and operational guidance. The executive order also encouraged states to evaluate and manage their own readiness capabilities, including personal protective equipment and medical countermeasures. This shift to the states will require local strategies to further support stockpiling, procurement capacity, and long-term supply chain resilience.

At the same time, the Pandemic and All-Hazards Preparedness Act is overdue for reauthorization, continuing conversations around regional coordination, stockpiling strategy, and preparedness infrastructure. Federal priorities increasingly focus on domestic manufacturing and supply chain security. The Administration for Strategic Preparedness and Response’s 2026-2029 Strategic Plan makes securing America’s medical supply chain a major objective, including efforts to strengthen domestic manufacturing capacity and reduce dependency on foreign sourcing.

Supporting Financing and Budget Flexibility

As emergencies grow more frequent and costly, jurisdictions are reassessing disaster funding and prioritizing predictable, adaptable disaster financing. Funds designed for smaller or shorter emergencies may not support prolonged operations or effectively address supply chain issues seen in recent disasters. Mississippi recently took action to increase flexibility in its disaster trust fund. Enacted in 2026, HB 1646 more than doubles the existing transfer caps into the state’s Disaster Assistance Trust Fund on both a per disaster and per fiscal year basis.

Modernizing Emergency Procurement and Contracting

Procurement systems became a major focus during recent emergencies, as states faced supply shortages, rapidly changing vendor markets, and urgent purchasing needs. In response, many jurisdictions are reevaluating procurement policies to balance speed, accountability, and flexibility during emergencies. For example:

• Hawaii recently adopted SCR 74, calling for an audit of emergency no-bid contracts issued between 2020 and 2025, focusing on contract justification, vendor selection practices, and pricing oversight.
• Maryland enacted HB 261, amending its competitive proof-of-concept procurement process to allow agencies to more efficiently contract from testing to implementation.
• Virginia considered SB635, which would have required the department of emergency management to assess the feasibility and impact of a comprehensive program to address different emergencies in the commonwealth (i.e., procurement procedures and supply chain management considerations).

Several jurisdictions also considered targeted exemptions for high-risk or time-sensitive emergency operations. Illinois considered SB 3662, which would exempt certain nuclear and radiological emergency procurements from the state procurement code. Meanwhile, Tennessee enacted SB 1778, which exempts disaster grants administered by the state’s emergency management agency from procurement requirements while maintaining audit safeguards and oversight provisions.

Expanding and Institutionalizing Strategic Stockpiles

Some jurisdictions are establishing broader statewide stockpile frameworks focused on coordination, sustainability, and operational planning. Massachusetts is considering S 537, which would establish a permanent statewide stockpile of various readiness supplies, supported by demand modeling and operational planning requirements.

Other states, like New Jersey, are considering targeted stockpiles designed to address specific vulnerabilities:

• A4324/S2812 would establish an emergency insulin stockpile and authorize pharmacies to dispense it pursuant to a standing order when a person requires it.
• A4347 would create a mask stockpile for first responders to protect against air pollutants and toxic gases, as well as a plan for maintenance of the stockpile and appropriate deployment when necessary.

These proposals reflect a growing emphasis on stockpiles as a component of preparedness infrastructure rather than a temporary measure.

Supporting Regional Supply Chain Coordination

Some jurisdictions are leveraging existing administrative policy frameworks and preparedness agreements to improve coordination and resource sharing during emergencies. For example, North Dakota is exploring ways to strengthen preparedness across neighboring states by sharing stockpile capabilities under existing authorities (e.g., the Emergency Management Assistance Compact). Utilizing established interstate agreements may allow states to share supplies and resources during emergencies using existing governance structures.

Health care coalitions are playing an increased role in supply chain preparedness. The Southwest Florida Healthcare Coalition recently conducted a supply chain risk assessment and recommended memoranda of understanding to help mitigate supply chain disruption risks across participating organizations. These efforts highlight how stakeholders increasingly use administrative policies, operational planning, and interstate coordination alongside legislation to strengthen preparedness supply chains and resource sharing during emergencies.

Conclusion

Preparedness systems continue to evolve as federal preparedness priorities change and states adapt to an increasingly complex risk environment. ASTHO will continue to monitor legislative activities and other policy actions that support innovation, flexibility, and effectiveness in emergency preparedness and response.

Reviewed by Meredith Allen, DrPH, MS, Vice President of Health Security; and Andy Baker-White, JD, MPH, Senior Director of State Health Policy.