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SACRAMENTO – California must be ready to vaccinate entire regional populations in the event of a bioterrorist attack, the federal government said Thursday. 

“The risk of a bioterrorist attack is recognized now to be significant and pressing,” Jerome Hauer, director of the federal Office of Public Health Preparedness, warned in a letter approving the state’s preliminary plans. 

While the federal government is preparing to respond, “success in dealing with an epidemic depends primarily on how rapidly and effectively local and state programs can respond,” Hauer told California Health Services Director Diana Bonta. 

That includes having detailed regional plans to obtain vaccinations or antibiotics from the National Pharmaceutical Stockpile, and administer them to the entire regional population within three to five days. 

Hospitals in an area need to be ready to handle a sudden surge of 500 acutely ill patients. 

And each hospital needs to be ready to set up isolation areas in their emergency rooms for suspected smallpox cases. 

California has until Oct. 1 to detail how it will meet those requirements for handling “an acute epidemic,” Hauer wrote. 

George Vinson, a career FBI agent who now is security adviser to Gov. Gray Davis, said that with the preliminary approval, “now what we have to do is get down and drill a little deeper into the actual operational planning.” 

For instance, where will the vaccine stockpile be stored? “How are we going to secure it, and move it in a hurry if we need it?” Vinson said. Which hospitals will handle how many victims under what circumstances? 

Planning for 500 victims may unrealistic, he said: “We may have to be ready for more than 500 if you’re doing it in a populated area.” 

However, Vinson said a major goal is to quickly isolate any outbreak to keep the number of victims in check. 

Hauer’s approval of the state’s preliminary plans qualifies California for a $56.6 million federal grant to beef up its public health and emergency response systems to deal with bioterrorism threats. It follows $14 million released to the state in January after President Bush signed a $1.1 billion appropriation designed to help states improve their public health systems. 

Though Hauer approved California’s regional and statewide plans Thursday, he said the state needs to demonstrate that the various information and communication systems used in California can connect to each other and to the federal government. 

The state also needs to show that mutual aid agreements and other cooperative efforts are in place, particularly between Los Angeles and state agencies. 

Los Angeles, along with Chicago and New York City, are receiving separate grants. 

Los Angeles received $5.6 million in January and $3.6 million Thursday, but $9 million was withheld until the city provides more details on its plans to renovate space for a modern laboratory. That will likely happen quickly, said Bill Pierce, a spokesman for the U.S. Department of Health and Human Services. 

California was one of 24 states to receive full funding, as did Chicago and New York City, Pierce said. 

It’s the first time federal, state and local governments have come up with a plan to prepare for a terror attack, Health and Human Services Secretary Tommy Thompson said in announcing the funding. 

The state is required to spend 80 percent of the money for hospital improvements. But the state can use portions of the grant for more planning, to improve its infectious disease monitoring and investigation, to help hospitals prepare to deal with a large number of casualties, and to improve reporting of disease reporting between hospitals and public health departments. 

Of the total $70.8 million coming to California under the program, nearly $10 million will go to create regional hospital plans to be used in the event of a terror attack. 

However, Thompson said both the regional hospital plans and the statewide plans will help in non-terror responses, for instance to a flu epidemic.