This session is a Call to Action directed at leadership in fire, rescue, and emergency response which will aim to answer two questions: (1) What emerging opportunities and threats in public health and biomedicine are of the greatest importance to first-responder operations? (2) What strengths and weaknesses must be addressed by local leadership in order to prepare for the emerging public health future? The speaker will draw on his 40-year career in public health and biomedical research to report on the following: (a) emerging public health needs relevant to fire, EMS, and the first-responder community; (b) analysis of trends in biomedical R&D spending, programming, and innovation; (c) findings of a 24-month study of station-level operations in three US communities; (d) expert opinions of thought-leaders in public health preparedness, K-12 education, fire and rescue, and municipal government. Those who attend this session will receive 5-10 action items which (if acted upon) promise to enable local leadership and those in operations management at the station and community levels.