Public Health Crisis Response Influenza A/H5N1 and Pandemic Preparedness and Response - Since 2014, the Washington State Department of Health (DOH) embraced greater responsibility for responding to public health and medical emergencies across the state. Our public health system is decentralized with significant authority for controlling communicable diseases situated at the local level. Despite this, no single local or tribal jurisdiction in our state has the resources readily available to sustain a response beyond initial operational periods. DOH, working collaboratively with local and tribal health jurisdictions, created what we termed a “quilt of capability” to effectively deploy response capabilities in Washington based on the principal of partners and DOH to: 1. Identify threats quickly. 2. Ask for assistance from neighboring jurisdictions. 3. Rapidly absorb resources into a standardized incident command system to manage the event. This framework requires DOH to maintain several key emergency response teams ready for deployment statewide. Not only are we able to provide response capability externally but are advancing internal capacity for agency staff to ensure continuation of public health services during large scale emergencies by providing services for childcare, elder care, pet care, food, sanitation, and psychosocial support. This approach requires financial resources to rapidly respond and directly speaks to Component A of the Notice of Funding Opportunity (NOFO). The application of this structure results in a robust, adaptive, and resilient public health emergency response while strengthening Biosurveillance, Information Management, Countermeasures, Mitigation, and Surge Management domains as described in Component B of the announcement. DOH demonstrated the ability to effectively apply our quilt of capability deploying response capabilities for the COVID-19 pandemic, including rapidly responding to the first confirmed COVID-19 case in the United States. DOH activated the Incident Management Team (IMT) to address initial response and subsequently all six of the NOFO domains, utilizing funding from this Crisis Response Cooperative Agreement to rapidly mobilize a response to the most unprecedented worldwide public health emergency we have experienced in our lifetimes. Over the two years of the pandemic response, DOH increased capabilities statewide across all six domains. Through the pandemic, and other smaller public health emergency activations, Washington state and the DOH consistently applied the preparedness cycle to learn from responses and incorporate lessons learned through systematic improvements to our approach. Applying this methodology, we learned the financial costs and implications of conducting emergency response efforts. In close, for this application, we are requesting $7,075,730.48 to support Component A and Component B of the NOFO to ensure rapid mobilization and public health response for Washington state.