Public Health Emergency Preparedness (PHEP) Cooperative Agreement - Background: Public health threats of potentially catastrophic proportion underscore the importance of effective planning and response capabilities that can be applied to all hazards. As new threats emerge, including novel infectious diseases, the Tennessee Department of Health (TDH) must ensure that both medical and public health systems are not only integral parts of emergency response activities but also part of emergency preparedness planning with all relevant partners. Increased cooperation among responders, including state and local public health officials, emergency medical services (EMS), health care coalitions (HCCs), emergency management agencies (EMAs), and private health care organizations, ensure the nation is better prepared to respond to all hazards. Governmental public health departments and the mostly private health care delivery systems are now recognized as essential partners in emergency response, increasing their ability to identify and mitigate potential threats to the public’s health. During each previous budget year, the PHEP cooperative agreement provided technical assistance and resources to support Tennessee State and local public health departments, along with HCCs and health care organizations, to show measurable and sustainable progress toward achieving preparedness and response capabilities that promote resilient communities. Tennessee has experienced a wide range of threats and public health emergencies requiring decisive response action by our PHEP funded Emergency Preparedness program staff, health care coalitions, and partners. Methods: This 2024-2029 funding opportunity provides level funding to Tennessee to sustain public health preparedness and response capabilities across the state. A PHEP programmatic logic model provides structure to our cooperative agreement requirements and funding identity includes three overarching strategies, ten preparedness and response readiness framework (RRF) priorities, and thirty-four activities. Improved planning and response coordination across all levels will present new opportunities to leverage resources while maximizing effort, resulting in increased efficiency. Results: Short term outcomes will include timely situational awareness of statewide public health and medical resources, rapid assessment of essential elements of information, timely implementation of epidemiologic and laboratory investigation, opportune interventions to mitigate medical surge, immediate communication of information to at-risk populations, continued environment for learning to include an integrated stakeholder driven planning process, and demonstrated administrative/fiscal preparedness through streamlined allocation of funds, contracts, and procurement. Conclusion: TDH aims to demonstrate superior planning, training, operational readiness and ultimately improved outcomes and mitigated impacts on our communities.