Presents results from a follow-up survey of directors of state offices of rural health on emergency preparedness in rural communities. A telephone survey was used to identify state office involvement with emergency preparedness (EP) activities. Findings indicate that the nature of involvement varied considerably across states. Among the most pressing needs were for improvements in communication and for additional EP training, especially for EMS and hospital personnel. Most offices were involved in activities related to development of an emergency preparedness response plan encompassing the state (71 percent) or development of a plan for regions within the state (55 percent). Over half of state office directors reported involvement in assessment of training needs of emergency personnel and in assessing EP of rural hospitals. Almost half of state offices participated in assessment of rural public health system preparedness capabilities. Sixty-one percent of offices assisted in development of capabilities for the electronic exchange of information among healthcare providers and public health officials serving rural areas, and 48 percent of rural offices were engaged in activities in support of development of a system for receipt of urgent reports or information by providers on a 24-hour-7-day basis.