Rabies on the Rise in Southern AZ – Just In Time for Spring Camping Season

Arizona is in the middle of a rabies surge among wildlife, particularly in the southern regions of the state.​

There has been a significant uptick in rabies cases among wildlife, mostly among skunks, foxes, and bats (the usual cast of characters).

Pima County has reported 36 confirmed rabies wildlife cases so far this year, accounting for nearly half of Arizona’s total cases. The majority of these cases involve bats, but also a mountain lion. ​

Pinal has had multiple rabies advisories following positive tests in gray foxes, skunks, and a bobcat. Santa Cruz County has 10 confirmed cases, while Cochise County has had 8. The presence of healthy populations of common rabies carriers, such as foxes and skunks, in these areas may contribute to the higher number of cases.

Rabies cases among wildlife are usually found because someone – either a member of the general public or fish and game or state or federal parks staff meet an animal that’s acting outside the normal behavior for the species.

Bats are consistently the most common source of rabies exposure to humans in Arizona… and each year about 30 people are exposed to rabid animals (usually bats).

They euthanize the animal, and the brain is tested by staff at the ADHS state laboratory (all the lab staff that do this work are vaccinated against rabies virus).

Wildlife cases are seldom found because they bite a human – but it does happen. If wildlife does bite and behavior is weird it’s important to be able to find the animal so it can be tested. If the animal can’t be found then the general approach is to do a risk assessment to figure out whether it’s a higher risk exposure to decide whether post exposure prophylaxis is called for.

Manual for Rabies Control and Animal Bite Management

Keep in mind that rabies is 100% fatal if post exposure prophylaxis isn’t started on time. Once symptoms appear – it’s too late.

The main things to remember are not to mess with bats – dead or alive – and make sure your kids know that too. Never approach or handle wild animals, especially those with weird behavior, such as aggression or lack of fear of humans. If you meet a sick or dying wild animal, contact the Arizona Game and Fish Department at 623-236-7201.

The cost of the treatment (immunoglobulin and vaccine) is around $10K – so health insurance plans usually like to see the risk assessment before they agree to pay for the prophy.

If I could give one piece of advice it’s to make sure your kids and grandkids know not to mess with bats.

When I was a kid, I found a bat at Mt. Lemmon and brought it to school in a shoe box for show and tell. Nothing happened to me, but it could have. My parents don’t remember whether they brought the bat in for testing or not.

Title X Under Siege?

Guest Piece from AZPHA member and Affirm CEO Bre Thomas:

In light of the recently leaked Office of Management and Budget (OMB) 2026 Discretionary Budget Passback, which includes the proposed elimination of the Office of Population Affairs (OPA) and zeroing out the Title X Family Planning Program, I am writing to provide you with an update from Affirm.

We understand the document is pre-decisional and does not represent a finalized proposal. However, we want to share current Arizona’s Title X program data to support any internal discussions and monitoring. As you know, Title X is the backbone of the nation’s reproductive health safety net. It supports essential services for individuals and families who would otherwise go without care.

In Arizona, the impact of Title X is broad and deep. In 2024:

  • 35,629 clients received care through Title X-supported services.
  • These individuals accounted for 50,106 visits across dozens of clinic sites statewide.
  • Services were delivered by 505 staff members supported by Title X funding at 53 clinics statewide.
  • Most critically, 19,790 of the clients served lived at or below the federal poverty level.

Title X is the only federal program dedicated solely to providing individuals with comprehensive family planning and preventive health services. These include access to contraception, STI testing and treatment, cancer screenings, and basic preventive care for those with limited or no insurance coverage.

We are closely tracking updates and taking part in national briefings to understand the implications of the FY 2026 budget process. Please let us know if we can provide any additional information. We deeply appreciate your leadership.

Arizona’s Missing Link in Mental Health Care

Arizona is facing, and has faced for a long time, a major gap in our mental health care system: the lack of Secure Behavioral Health Residential Facilities (SBHRFs) for individuals with serious mental illness resistant to treatment.

These are often folks with conditions like schizophrenia or bipolar disorder who, due to the nature of their illness, are unwilling to engage in voluntary treatment. Their families are left watching loved one’s cycle through emergency rooms, jails, and homelessness—without access to the long-term, structured care they need.

In 2019, families and advocates achieved a significant milestone when legislation was passed to authorize SBHRFs in Arizona. These facilities would offer a secure, therapeutic environment where individuals with SMI could receive intensive treatment while also being protected—and protecting others—from the consequences of untreated illness.

But despite the legal green light, not a single SBHRF has opened.

Efforts to implement these facilities have been met with stiff resistance, especially from the ACLU of Arizona (who appears to have a hotline to the Governor’s Office) and the Arizona Center for Disability Law.

The absence of secure residential treatment is a policy failure with real human consequences. It leaves Arizona’s most vulnerable residents (and their families) without hope for recovery and puts their families in a position of helplessness.

AzPHA will continue to push for the creation of SBHRFs, insisting that compassion and safety must guide mental health policy—not fear or ideology.

Please take a few minutes to read this article from Natalie Robbins at the Tucson Sentinel ‘Major gap in our system’: Arizona lacks secure facilities for people with serious mental illness

Whether we’re able to get these critical residential settings finally off the ground will depend on whether the upcoming state budget funds these important treatment spaces – and whether SB1604 is passed and signed.

While the ACLU does some good things and has been pushing back on some of the more harmful decisions by the Trump administration (and filing lawsuits) they’re 100% off the mark on this SBHRF issue.

We’re crossing our fingers that Governor Hobbs will listen to the Mad Moms and the Association, the Chronically Mentally Ill and AzPHA instead of just the ACLU when SB1604 hits her desk and when start-up one-time funding for SBRFs are discussed in the budget.

Helping Loved Ones Get the Care they Need – Secure Residential Treatment: A Crucial (and Scarce) Resource for Supporting Mental Health Treatment (Part III of III) – AZ Public Health Association

The Real H5N1 Threat: Kennedy’s Assault on Our Public Health System

Last week’s 60 Minutes segment on H5N1 focused on some shortcomings in the US agricultural sector as they grapple with H5N1 influenza infections among poultry, cattle, and some dairy workers.

The segment focused on legit gaps like poor USDA oversight, limited worker protection, and the spread of the virus through dairy herds. The veterinary experts featured in the piece rightly presented arguments about the need for better biosecurity and surveillance in the ag sector.

Bird flu poses growing risk to people as pathogen spreads, scientists warn | 60 Minutes – CBS News

But let’s be honest… H5N1 isn’t something we’re going to “contain.” It’s global. It’s in migratory birds, domestic poultry, and now cattle — not just in the U.S., but around the world. Mitigation is the only practical path forward at the farm and ranch level.

The real threat to humans is Kennedy’s rapid disassembly of our public health system. He’s intentionally unraveling our capacity to respond if (or when) H5N1 adapts for sustained human-to-human transmission and becomes more virulent.

Local and state health departments — the frontline of any pandemic response (think surveillance, antiviral distribution and vaccine delivery and administration) is being cut dramatically by Kennedy.

The U.S. has walked away from the WHO. Trust in public health institutions is at historic lows largely because of Kennedy and Trump’s behavior and decision-making.

Those who should be reinforcing evidence-based public health practice (Secretary Kennedy) are instead waging a war on science, vaccine development, and the very concept of public health.

NIH researchers who once focused on rapid vaccine development (and zoonotic spillover) are being defunded, fired and driven out. Entire teams are gone, and his plan is to cut even further into NIH’s mission next year.

If H5N1 reassorts and sparks a human pandemic, we’ll be ‘responding’ with an eviscerated system. And it won’t just be about late vaccine timelines or scarce antivirals (or public health’s ability to distribute and administer them) — it’ll be about the absence of the workforce and infrastructure to mount a response at all.

After just 4 months of this administration, we’re already in worse shape now than we were for H1N1 in 2009. What we’ve already lost and continue to lose isn’t just funding or programs, its institutional knowledge, technical capacity, and our public health and research workforce and institutions.

If things don’t change, three and a half years from now we’ll be responding to pandemics with stone knives & bearskins.

Vitalyst’s Suzanne Pfister to Retire this Summer

After more than 11 years leading Vitalyst Health Foundation, Suzanne Pfister, President and CEO, has announced her retirement this upcoming summer.

Suzanne has led Vitalyst through many successes, including the creation of its Systems Change Grants, the rebranding of the Foundation from St. Luke’s Health Initiatives to Vitalyst Health Foundation in 2017, and the adoption of the Elements of a Healthy Community.

The Vitalyst Board of Trustees has retained DSG | Koya to lead the search for our next Chief Executive Officer. DSG | Koya is a nationally recognized executive search firm with deep expertise in placing transformative leaders in mission-driven organizations. The search is being conducted by Managing Director Michelle Bonoan and her team. 

Candidates can inquire here  Vitalyst_CEO@koyapartners.com.

Vitalyst’s Suzanne Pfister Announces Retirement This Summer – Vitalyst Health

ASU Opening New School of Technology for Public Health

The School of Technology for Public Health, at ASU is launching this Fall with two new graduate degree programs – a two-year master of public health degree with a concentration in public health technology and a one-year master of science in public health technology (a brand-new gap year degree for the emerging field of public health technology).

These programs are the first-of-their-kind in the nation to weave together public health with elements of engineering, data science, design, and entrepreneurship. The program is hosting ongoing information sessions that we encourage you to attend in addition to reviewing the attached flier. You can also reach the department via email at [email protected] or by phone at 602-496-0100.

The Master of Science in Public Health Technology weaves together introductory public health knowledge with basic elements of engineering, data science, design, and entrepreneurship, with a focus on designing and deploying accessible, ethical, and equitable digital health tools and technologies.

The Master of Public Health, Public Health Technology concentration program is for students who are seeking an education that knits together biostatistics, epidemiology, environmental health and policy with elements of engineering, data science, design and entrepreneurship.

CDC Vaccine Recommendations in Limbo Amid Leadership Uncertainty

Last week the CDC’s Advisory Committee on Immunization Practices recommended expanding RSV vaccinations to adults aged 50–59 with underlying health conditions and endorsed a new combination meningococcal vaccine for teens.

Normally, this ACIP recommendation would be translated into policy when (if) the CDC adopts the recommendation. Not this time. Acting CDC Director Susan Monarez has recused herself because of “legal limitations” pending her Senate confirmation… meaning the CDC Chief of Staff  – Matthew Buzzelli (a former federal prosecutor with zero medical or public health training) will decide whether to adopt the ACIP recommendations.

Health insurance coverage for vaccines typically follows CDC recommendations. Under the Affordable Care Act private insurance plans must cover new vaccine recommendations in the next plan year.

Until the CDC officially adopts ACIP’s recommendations, coverage for both these vaccines will remain as is. Buzzelli may very well not decide at all or veto the ACIP’s recommendation.

That’s A Wrap: AZPHA’s 2025 Conference

Thank you to all the attendees, speakers, sponsors, exhibitors, poster presenters and AZPHA board members who attended our 2025 conference on April 3! 

All in all we had about 250 attendees at the conference – and by all accounts, engagement was very good – with little attrition as the day progressed.

Here’s a link to the conference Speaker BiographiesSession Learning Objectives and our final Conference Brochure Below are links to many of the presentations that our speakers shared with you during the conference. 

Thanks again for attending and enjoy the rest of the Spring. 

U.S. Supreme Court Could Roll Back, Freeze or Eliminate Preventive Health Coverage – Oral Arguments Tomorrow (4/21/25)

On Monday the U.S. Supreme Court will hear Braidwood Management v. Becerra, which could roll back and freeze coverage for key preventive health services and screenings currently required by the Affordable Care Act. The new name for the case is Kennedy v. Braidwood Management, Inc.

At issue is whether commercial health plans have to continue to cover (w/o co pays) the Category A & B preventive services recommended by the U.S. Preventive Services Task Force (USPSTF).

USPSTF A & B Recommendations

Braidwood argues that USPSTF members have too much unreviewable authority; that they’re “principal officers” under the Constitution who should require Senate confirmation (task force members aren’t Senate confirmed). Because USPTF members aren’t Senate confirmed, the Plaintiffs argue that their decisions are void.

The Biden administration argued in the lower federal lower courts that USPSTF members are “inferior officers” – meaning that they’re adequately supervised by the HHS Secretary and that the recommendations are therefore valid.

The District Court ruled that all preventive-care coverage requirements that the task force has established since 2010 are invalid.

The U.S. Court of Appeals upheld that District Court decision but disagreed with invalidating all the post 2010 decisions, concluding that HHS should only be prohibited from enforcing the preventive-services coverage requirements against the Braidwood company itself, but not others. In other words that it doesn’t apply to the health care industry as a whole.

It’s unclear whether Kennedy’s Solicitor General will pull punches during oral arguments tomorrow in response to guidance he may get from Trump or because he doesn’t agree with the post 2010 TF decisions or preventive screenings etc. It’s a real risk, as some political appointees are more interested in keeping their jobs than doing them.

ACA’s Preventive Services Requirements are the Next Target for Opponents of the Affordable Care Act:
Braidwood Management v. Becerra

If the Supreme Court sides with the District Court, insurers could opt out of covering services recommended or updated by the USPSTF since 2010, including screenings for colorectal cancer in adults aged 45–49, depression screenings for adolescents, and HIV prevention medications like PrEP – effectively freezing preventive care standards as they existed in 2010.

If they side with the Appeals court, only Braidwood employees would be excluded from getting coverage for preventive health services.

The Supreme Court might even throw out all the currently mandatory coverage for preventive health services. 

Without mandated coverage, many insurers will reintroduce copays or exclude certain preventive services altogether, causing decreased use of preventive care resulting in delayed diagnoses, higher healthcare costs, and widened health disparities.

The ACA’s preventive service mandates will remain in effect until the Supreme Court makes their decision later this summer.

Oral arguments in the case will be held Monday, with a decision this Summer.

Court to hear challenge to ACA preventative-care coverage – SCOTUSblog