The purpose of the AR FY25 PHEP cooperative agreement application is to strengthen the statewide public health preparedness and response capabilities. - Arkansas is home to more than 3 million people distributed over 52,000 square miles. The state is 260 miles long (North to South) and 240 miles wide (East to West). In terms of area, Arkansas is the 29th largest of the 50 states. In terms of population, Arkansas is the 32nd most populous state. There are two significant metropolitan areas in the state, Pulaski County (Little Rock Metropolitan Statistical Area) in the center of the state and Benton/Washington County area in the Northwest corner. Another area of significant and consistent urban growth is found in Craighead County in the Northeast part of the state, in and surrounding the city of Jonesboro. Of the remaining 68 counties, 25 are sparsely populated with populations of less than 15,000. An important factor in preparedness and response activity within Arkansas is the jurisdictional and public health landscape. Arkansas is a “Home Rule State” which means that the lowest sub-jurisdiction retains significant overall authority over public programs to include emergency preparedness, response, and immediate health and medical response management. Coincidentally, Arkansas also retains a “Centralized Public Health System” meaning that all Local Health Unit (LHU) personnel and operations are directed and managed at the Regional and State Levels, although the majority of LHU facilities are owned by County Governments. Activities such as Surveillance, Communications, Epidemiological Investigation, and Public Health Laboratory Operations are all directed and managed centrally at the State level while activities such as Immunizations and Medical Countermeasures Management are conducted in close coordination between the Central Office (State), the Public Health Regions and LHU’s. This duality requires a persistent management of expectations, clear communications, strong partnerships, and a comprehensive understanding of local capacity vs State capability in consequence management. Different segments of any population can have pronounced differences in their ability to engage in preparedness and response for all-hazards threats and Arkansas has proven to be no different. Preparedness activities in BP1 will continue to focus efforts on: consequence management operations for Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE)/ terrorism events, strengthening plans and equipment needs for mass casualty / fatality events, enhancing community and regional partnerships, supporting and enhancing medical surge capabilities and decision processes, expanding volunteer and Medical Reserve Corps opportunities, enhancing partnerships with state emergency management and law enforcement entities, continuing the expansion of syndromic surveillance, continuing support for the management of disease outbreaks, providing oversight and guidance to Healthcare Preparedness Coalitions, assisting in Coalition expansions in conjunction with Centers for Medicare and Medicaid Emergency Preparedness Guidelines, strengthening and streamlining the sharing of Essential Elements of Information and developing protocols and procedures for the regular provision of preparedness posture and close top real time capability data.