RAND evaluated Project Public Health Ready (PPHR), a voluntary recognition program that prepares local public health agencies (LPHAs) to respond and protect the public’s health through a program of planning, needs assessment and training, and drills and exercises. Using in-person and telephone interviews, observations at meetings, conference calls, and document review, RAND staff identified project management issues that can improve the program, assessed the extent to which LPHAs used PPHR resources, whether they valued PPHR, and how their preparedness level changed after participation in the project. Findings include participants’ belief that PPHR allowed them to obtain an external assessment of their own efforts at preparedness and see what other local health agencies were doing in this area. PPHR recognition provided local agencies assurance that their work was on track, and afforded recognition of these efforts at a regional level. The largest effect of PPHR was in training and workforce competency. LPHAs gained a broader perspective on their roles in emergency response and bioterrorism incidents. PPHR seems to have had a positive effect on most local public health agencies that participated in the project. Six recommendations are made to the sponsoring agency, NACCHO, including: decide whether PPHR is more a documentation process or a preparedness effort; if the focus shifts to documenting, NACCHO should consider alternatives to assessing preparedness alternatives; and reevaluate project components to ensure they are aligned with project goals.