Children represent 25 percent of the U.S. population and face specialized medical issues due to their unique developmental and physiologic characteristics. Pediatric care requires specialized equipment, supplies, and pharmaceuticals. While specialized pediatric hospitals provide excellent care for children on a day-to-day basis, special consideration needs to be given to providing pediatric care during public health emergencies and disasters, such as mass casualty incidents. Though much progress has been made in this area, significant gaps in pediatric disaster readiness remain. These gaps are most evident in highly specialized areas such as trauma , emerging infectious disease (EID) , exposures to chemical, biological, radiological, and nuclear (CBRN) agents, and behavioral health. ASPR envisions that this funding opportunity announcement (FOA) is part and parcel to a broader, multiyear plan to address pediatric disaster care needs as ASPR aims to address known gaps in pediatric disaster care of all pediatric patient populations by augmenting the existing clinical capabilities within states and across multi-state regions. Future elements of the vision would include additional field equipment, mobile medical facilities, telemedicine, and a network to facilitate training and education. Through this FOA, ASPR will support the creation of up to two Pediatric Disaster Care Centers of Excellence (COE) that will serve as pilot sites for the creation of a Regional Pediatric Disaster Care Network [hereinafter referred to as --The Network]. The Network is conceptualized as a tiered system for pediatric disaster care that builds upon the existing foundations for pediatric clinical care (e.g. pediatric hospitals, state Emergency Medical Services for Children (EMSC) programs, etc.) and emergency response (e.g. healthcare coalitions, etc.) by enhancing coordination mechanisms and incorporating relevant capabilities at the local, state and regional levels. The Network is intended to define the delivery of pediatric clinical care when existing referral patterns and health care delivery capacity and capabilities are compromised by catastrophic events. The Network will enable the rapid sharing of assets and expertise throughout the state and region and ensure that a well-trained cohort of highly specialized pediatric clinical care providers are available for onsite care and remote consultation. The needs of all pediatric patient populations, including children with special health care needs, and their parents and caregivers will be considered. This FOA does not aim to establish the Network in its entirety, but instead funds a limited number of demonstration projects that will help identify issues, develop best practices, and demonstrate the potential effectiveness and viability of this concept to apply nationwide. COEs will be expected to develop and/or improve their capability and capacity to provide highly specialized care to pediatric patients within and outside their own region through the pursuit of the objectives of this announcement. To be maximally successful in the project period, applicants should have existing pediatric preparedness capabilities and the capacity to manage pediatric patients within their own state and within a self-defined multi-state region during a disaster.