The Nebraska Medical Center and University of Nebraska Medical Center (TNMC/UNMC) partnership has been a national leader in special pathogen care, helping to set the standard for over a decade. Our team submits this proposal to remain a Regional Emerging Special Pathogen Treatment Center (RESPTC) with the goal of supporting the National Special Pathogen System to provide high quality and equitable care to patients suffering from infection with a special pathogen while protecting healthcare workers and communities from the hazards of further spread1. This proposal draws on many opportunities learned from the COVID-19 pandemic, particularly the need to innovate our systems of clinical care, training, and performance improvement to address critical vulnerabilities in workforce, supply chain, and operational resilience. We also address the need of the relatively recent concept of special pathogens (SP) care to mature as a distinct field, creating standard overarching systems for safety and operations. Our objectives are to: 1) strengthen institutional and regional capability to deliver high-quality and safe SP care, 2) improve education and training for SP care, and 3) implement continuous performance improvement processes and expand capacity for research in SP care. Our approach will continue to leverage key partnerships with the National Emerging Special Pathogen Education Center (NETEC), fellow RESPTCs, the Regional Disaster Health Response Systems and our regional partners in public health and healthcare. Outcomes of this proposed five-year effort will include an operational template for an integrated SP safety system, improved guidance for SP care and health system operations, innovative SP training tools and resources, and enhanced access to SP care within Region VII and across NSPS.