Public Health Emergency Preparedness (PHEP) Cooperative Agreement - Approach: Minnesota’s PHEP five-year strategy builds on BP5 work, recent incidents’ After-Action Reports, and incorporates priorities from other MDH divisions, local public health (LPH), Tribal health departments (THD), and health care coalitions (HCCs). Strengthening relationships with other state agencies, key state level partners, and LPH, THD, and HCCs is emphasized. Strategies and Activities and Workplan: MDH’s Emergency Preparedness and Response Division (EPR) will conduct a risk assessment (RA) in BP1 to inform development of the five-year work plan and MYIPP. MDH will revise their incident command structure approach. Preparedness plans revisions are ongoing. Intra-agency collaborations foster planning for data modernization, infectious disease epidemiology, and Public Health Laboratory (PHL). Gaps from recent responses will be addressed by planning with external partners, including LPH, THD, emergency management, and health care coalitions (HCCs). Strategy 1: An RA conducted in BP1 will identify and prioritize populations who may be disproportionally impacted by identified risks. The RA will inform the MYIPP. MDH’s PHL will participate in required exercises, including surge capacity, challenge panels, and proficiency testing all five years. By BP5, MDH PHL LRN-B and LRN-C electronic reporting of laboratory data will be updated. In BP1, MDH PHL will develop a five-year fiscal strategy. Data modernization activities in BP2-5 will assess and address gaps in the six data capabilities. Strategy 2: EPR will work collaboratively with partners all five years. MDH’s emergency risk communication/dissemination plan will be reviewed. Recovery operations planning will be integrated in the MYIPP. CRI, rural and frontier LPH, THD, community partners, and MDH’s Health Equity Bureau will incorporate health equity principles in plans, trainings, and exercises. Strategy 3: During BP1, MDH will revise and, in subsequent BPs, exercise its administrative and fiscal preparedness plan. MDH will strengthen workforce capacity by recruiting, hiring, and retaining diverse, qualified staff, reducing PHEP-funded positions’ vacancy times, and supporting staff wellbeing. MDH will re-establish a Senior Advisory Committee (SAC) in BP1. EPR staff will participate in communities of practice. Evaluation, performance measurement plan and Outcomes: During BP1, MDH will develop measurable outcomes concomitant with the detailed work plan creation. Quarterly reporting documents progress on MDH, LPH, and THD grant activities. The Data Management Plan follows MDH and MN data practices, records retention, and other applicable rules. Focus populations and health disparities: EPR is dedicated to addressing needs of focus populations in MN. EPR’s health equity strategist works with staff to apply a health equity lens to plans, exercise design, training, and more. MDH, LPH, THD, and HCCs collaboratively develop strategies to integrate focus populations’ needs into public health, health care, and behavioral health responses. The MYIPP will detail training and exercises addressing focus populations. Organizational capacity: MDH maintains a robust response structure. Recent organizational changes moved EPR to MDH’s Health Operations Bureau where agency-wide functions are located, e.g., Finance and HR. Collaborations: MDH continues strengthening relationships with state agencies and organizations. Coordination with Canada focuses on response coordination, communication, information sharing, data sharing, and plan improvement.