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Reprioritizing Black Maternal Health How We Can Prioritize Black Maternal Health Lawrence Young Black women face significant rates of maternal morbidity and mortality — learn how public health can better support them in this blog post. I do not have to look far to understand the urgency of the Black maternal health crisis. I have watched friends, colleagues, and loved ones from every walk of life struggle through pregnancies that should have been safe and celebrated. Some are highly educated professionals. Others are young mothers still finding their way. Many had access to quality insurance and still faced complications, long hospital stays, and minimal follow-up care. Many have shared unfortunate experiences that run the gamut from feeling unheard or perhaps unnecessarily undergoing a procedure — the care in health care was not there for them. These are not isolated incidents. They are part of a larger, structural failure that demands our attention and our action. As public health professionals, we must ask ourselves: How can we better care for and about Black mothers? And what would it look like to center them in the systems that were created to protect women in one of the most vulnerable times of their lives? Understanding the Root of the Crisis Black women in the United States are three to four times more likely to die from pregnancy-related causes than their White counterparts. In many states, including Connecticut, this difference persists even when controlling for education and income. These outcomes are not the result of individual choices or biological differences — they are the result of systems designed with historical blind spots. Education and income, often seen as protective factors, do not shield Black women from these outcomes. Research shows that pregnancy-related mortality rates are higher among Black women with a college degree than among White women with the same level of education or with less than a high school diploma. The same is true for women with respect to the risk of dying within the first year postpartum. These disparities grow with age and extend beyond mortality to include severe maternal morbidity, such as preeclampsia — a pregnancy complication related to high blood pressure — which can have lasting health impacts if untreated including death. Additionally, American Indian, Alaska Native, Black, Native Hawaiian, Pacific Islander, Asian, and Hispanic women all experience higher rates of ICU admission during delivery compared to White women. ICU admission is considered a key marker for maternal complications and system-level failure. Public Health as Partner in Progress Public health has a responsibility to do more than document issues and concerns. We must be in the business of addressing them. In Connecticut, we are working across agencies and community organizations to move from acknowledgment to action. One of the most important leaders in this work is #Day43, an initiative launched by Waterbury Bridge to Success Community Partnership. The name refers to the period between 43 days and one year postpartum, during which approximately 20% of pregnancy-related deaths occur. #Day43 exists to raise awareness of Black maternal health and transform systems to support mothers. Their work spans research, advocacy, policy, technical assistance, and storytelling grounded in lived experience. Waterbury’s maternal health data reflects this crisis. According to the #Day43 Black Maternal Health Report, 18.6% of pregnant women in Waterbury received late or no prenatal care. Those in the city face higher rates of C-sections, limited access to postpartum care, and insufficient support for mental health and breastfeeding. The community described a significant lack of maternity care resources, particularly in the North End, where many Black and Hispanic families reside. Through initiatives like this, residents are not just seen as stakeholders. They are recognized as storytellers, system builders, and agents of change. Their leadership is shaping how we define, measure, and deliver maternal care in Connecticut. This vision aligns with broader maternal health equity efforts across the state. For example, The Connecticut Health Foundation is developing a Maternal Health Equity Blueprint in partnership with community leaders, researchers, and families. Waterbury voices are essential contributors to this process. Listening as a Path of Healing The experiences of Black mothers reflect a broader truth. Too often, our systems are not built to hear them. That lack of trust is both historical and current. It shows up in rushed appointments, dismissed symptoms, and inaccessible services. Community-based providers, such as doulas and midwives of color, are critical to bridging this gap. They do more than provide care — they restore dignity. Yet these providers are often underfunded and undervalued in mainstream health care systems. Public health must champion integrating these providers into existing systems and promoting long-term sustainability. To maximize maternal health outcomes, the next phase of this work must intentionally include structured cross-sector collaboration. It must focus on building systems that educate both providers and families on urgent maternal warning signs, provide consistent discharge education, and strengthen local surveillance and outreach infrastructure. These strategies are essential, scalable, and lifesaving. We cannot improve outcomes without acknowledging the deep cultural, emotional, and psychological work required to rebuild trust. We cannot heal what we do not hear. Re-Examining the “Public” in Public Health Re-examining the public in public health means placing the needs of our most vulnerable communities at the center. It means investing in care that is integrative and supportive with community co-designed solutions. It also means wholistically addressing other intersecting systems that influence maternal outcomes. We can start by: Expanding funding for community-based perinatal health workers, including doulas and midwives. Embedding relevant metrics into maternal health program design and evaluation. Creating statewide listening sessions and family advisory councils to ensure policies reflect lived realities. Partnering across sectors to improve access to safe housing, transportation, and mental health supports for new mothers. Supporting local initiatives like #Day43 that lead from within communities and reflect community-defined solutions. Educating families on health information and individual health rights through accessible, trusted channels. To truly care for and about Black mothers, we must act beyond awareness months and social media campaigns. We must improve current processes and design opportunities that will support them and keep them alive. Public health was created to serve the public. The most powerful way to honor that mission is to focus on the public, ensuring they are a priority and not an afterthought. article yes

San Diego Academic Health Partnership Strengthens Service During COVID-19 and Beyond San Diego Academic Health Partnership Strengthens Service Mayela Arana Learn how the Academic Health and Human Services Department in San Diego strengthens service, research, workforce development, and more in the region. In San Diego County, the connection between academia and public service continues to grow stronger, shaping the future of health and human services. With over 8,200 employees serving a diverse population of 3.3 million residents, the County of San Diego Health & Human Services Agency (HHSA) plays a crucial role in advancing health, housing, and social services across the region. Recognizing the immense value of bridging education with real-world public service, HHSA and San Diego State University (SDSU) formed an Academic Health and Human Services Department (AHHSD): the Live Well Center for Innovation & Leadership (LWCIL), a first-of-its-kind initiative in San Diego County. This partnership is more than just a collaboration; it’s a transformative effort to strengthen education, research, workforce development, and service in the region, inspired by collaborative successes during COVID-19. A Vision Years in the Making Even before the COVID-19 pandemic, leaders at HHSA, SDSU, and SDSU’s College of Health and Human Services (CHHS) recognized the opportunity to deepen their relationship through an Academic Health Department (AHD) partnership. Many of those contributing to HHSA’s success began their journey at SDSU, with over half of the agency’s leadership team and a significant portion of its workforce having graduated from SDSU, particularly from CHHS. With a long history of partnering to provide real-world experiences for students, collaborating on research, and developing practice-informed curriculum, formalizing the partnership to integrate academia and health and human services practice was a natural next step. An Academic-Public Health Partnership in Action HHSA and SDSU’s longstanding relationship initially focused on student field experiences, research collaboration, and workforce development across select schools and decentralized departments but went on to have a major impact on the ground — most notably, enhancing HHSA’s COVID-19 response. Mobilizing Promotoras for Outreach and Support SDSU and HHSA worked together on recruitment, training, and community outreach. They successfully recruited 40 community health workers for a Promotoras program, which initially helped with contact tracing within the highest-risk communities. The Promotoras also identified where people needed assistance (e.g., food, services). SDSU provided support by organizing food pantries in high-risk areas, while the Promotoras took food to those in need. As vaccines became available, HHSA trained the Promotoras on messaging and communications to dispel misinformation and to encourage vaccine uptake. The Promotoras also helped those in the highest-risk communities get appointments at the county vaccination sites. Expanding Public Health Capacity with Nursing Students In addition, SDSU and HHSA worked together to train and deploy nursing faculty, students, and recent graduates in county vaccination efforts. From January through March of 2021, the SDSU School of Nursing partnered with Champions for Health, the local nonprofit arm of the San Diego Medical Society, to train 200 vaccinators. Once trained on the proper storage and administration of the COVID-19 vaccine, faculty-led groups of undergraduate nursing students administered vaccines at community sites in primarily underserved areas of the county — many organized by the San Diego Black Nurses Association. In addition to providing surge capacity staffing to support community and public health efforts, the partnership allowed students to complete clinical hours required for graduation during the pandemic when students were restricted from other clinical sites. Many of the students and graduates who served as temporary contact tracers and case investigators transitioned into full-time positions within HHSA as the COVID-19 response scaled back. Formalizing Collaboration for Lasting Impact Given the tangible value of their collaboration demonstrated during the COVID-19 pandemic, HHSA and SDSU chose to use and adapt the national AHD model — gaining access to the growing, nationwide network of AHD partnerships that inform their goal of sustaining a high-impact academic-practice partnership. They formalized the partnership with a public signing of an overarching five-year memorandum of agreement (MOA) in October 2022 that launched the bold vision of creating San Diego County’s first and only AHHSD. They assigned an additional MOA specifically addressing joint research and data sharing in December 2024, and an addendum supporting agency-wide student field experiences is underway. With formal agreements across all key areas, the foundation will be in place for increased and accelerated collaboration by summer 2025. Building on the regional collective impact vision called Live Well San Diego, the AHD partnership adopted joint branding as LWCIL. An active Steering Committee, co-chaired by HHSA’s Deputy Chief Administrative Officer and CHHS’s Dean, meets quarterly and represents the highest-level leadership for each organization. Members include key leaders in HHSA operations, human resources, and strategy, and the directors from each of its eight service departments. On the academic side at SDSU, the Steering Committee includes representatives from the six schools and multiple institutes within CHHS. Setting Partnership Priorities LWCIL co-created and recently adopted a joint, multi-year Strategic Roadmap to guide the next three years of the partnership’s development and its contribution to a healthy, equitable, safe, and thriving San Diego region. It is organized around four high-impact priority areas: People Success: Build a diverse, competent, and engaged health and human services workforce​, including students and both partners’ workforces.​​ Research & Data Excellence: Inform and improve academia, policy, and practice with rigorous and relevant research. Service to Community: Integrate academia, practice, and community to advance equity and eliminate health disparities. Leadership & Sustainability: Create a nationally recognized academic-practice model with innovative leadership committed to improving academia, policy, and practice. Subcommittees for each priority area, co-chaired by leaders from both organizations, have launched and created action plans tied to advancing the Strategic Roadmap. In addition, emerging workgroups are aligning ​work plans​. Next steps include: Assessing what is already in place and integrating it into the partnership. Developing a standardized and streamlined process for students to complete internships at HHSA. Leveraging opportunities to bridge research and practice and, where appropriate, in collaboration with the community. Investing in capacity has been essential in moving the partnership forward and providing coordination. The director of LWCIL is a “boundary spanning” position, co-funded by SDSU and HHSA. Additional staff support has assisted the partnership, including two HHSA Management Fellows engaged in a year-long program. Advice for Others Seeking to Establish AHD Partnerships HHSA and SDSU offer the following tips to agencies looking to develop or expand AHD partnerships, based on their experiences: Secure leadership commitment: Ensure the highest-level leaders are committed to the partnership’s success and sustainability. LWCIL started with the support of the dean, deputy chief administrative officer, and directors within both organizations who continue to be actively involved as members of the Steering Committee and subcommittees. By doing so, they have helped set priorities, identified staff to participate, and continuously champion the partnership within their respective organizations. Start small: Build from what already exists between the partners, leverage willing internal resources, and celebrate early successes. LWCIL started with conversations focused on workforce development because of existing relationships and shared interests. Those conversations eventually evolved to include collaborating on rigorous equity-focused research and partnering to address needs identified by the community, such as housing stability for our older adult population and food insecurity. The subcommittee structure was created to support those shared priorities; however, it began with smaller, more narrowly focused conversations. Be strategic: Create a common agenda/plan that aligns with the goals of both organizations, making it easier for already-stretched organizations to commit to and benefit from the partnership. LWCIL's co-creation of a multi-year Strategic Roadmap allowed the partners to discuss the many opportunities for collaboration and integration, and to prioritize. It now guides where the partnership is going and helps keep everyone focused on what they collectively decided is important. Then, grow: By getting systems in place and understanding the benefits and challenges between two organizations (HHSA and SDSU), LWCIL is setting the stage for expansion to include other local universities. Take time to plan and set up structures: Creating the LWCIL ​Strategic ​Roadmap was a six-month process that engaged leadership from both organizations. This was critical for identifying priorities and direction, including what structures and systems needed to be organized so the work could move forward. Learn more about San Diego’s Live Well Center for Innovation & Leadership and AHD partnerships, or explore other workforce development resources from the Public Health Foundation. If your health agency wants more information about planning support, please submit a PHIG technical assistance request through PHIVE or contact

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HHS Budget Hearings Chart New Direction for Public Health Budget Hearings Chart New Direction for Public Health Catherine Jones Learn about the key policy/funding themes that emerged from HHS Secretary Robert F. Kennedy’s testimony during the May 2025 budget hearings. In May 2025, HHS Secretary Robert F. Kennedy Jr. appeared before the House and Senate Appropriations Committees as well as the Senate Health, Education, Labor, and Pensions (HELP) Committee to discuss the Trump Administration's proposed FY26 HHS budget. On May 2, President Trump released his “Skinny Budget,” which formed the basis of much of the questioning Sec. Kennedy received from members of both parties. These hearings illuminated a sweeping reorganization of HHS and other federal agencies, signaling a dramatic shift in public health priorities and funding. Seven key themes emerged from the testimony, highlighting how these priorities are being advanced through the Make America Healthy Again (MAHA) initiative and the newly proposed Administration for a Healthy America (AHA). The President’s Budget Appendix, released in late May, reaffirms these policy and funding proposals. Reorganizing HHS and CDC The blueprint for HHS calls for consolidating various agencies under the new AHA, including HRSA, SAMHSA, and parts of CDC. In the hearings, Republicans broadly supported MAHA and AHA initiatives, mentioning the need to disrupt bureaucratic inefficiencies, reduce regulatory hurdles, and improve health care delivery. Democrats expressed concerns about program disruptions, layoffs, and FY25 appropriated funds that remain undisbursed. A handful of Democrats pressed Sec. Kennedy on whether he would spend FY26 funds, as appropriated by Congress; he responded affirmatively. When asked who authorized the staff layoffs, Sec. Kennedy gave inconsistent responses claiming ownership in one hearing and later attributing decisions to the Department of Government Efficiency. Public Health Preparedness and Prevention Preparedness and prevention were central topics, especially in the HELP Committee hearing. The proposed elimination of the Hospital Preparedness Program and cuts to the Public Health Emergency Preparedness Program would result in a net loss of hundreds of millions of dollars in federal support. HELP Committee Chair Sen. Bill Cassidy (R-LA) voiced concerns about the implications for under-resourced and rural states. Sec. Kennedy emphasized CDC’s legal responsibility for national pandemic response and called for reauthorization of the Pandemic and All-Hazards Preparedness Act. In the House hearing, he also addressed topics such as supply chain independence from China for critical medicines, and adequate funding for the Strategic National Stockpile and Biomedical Advanced Research and Development Authority. Vaccines Sec. Kennedy's past vaccine skepticism drew bipartisan scrutiny. Lawmakers pressed him to affirm support for routine immunizations, particularly amid a measles resurgence. When asked about pediatric vaccinations in the House hearing, Sec. Kennedy demurred wanting to refrain from giving medical advice. In the HELP hearing, he confirmed that funding appropriated for vaccines would be used accordingly and stated that vaccine recommendations would continue to be made by CDC’s Advisory Committee on Immunization Practices (ACIP). However, on May 27, he contradicted that assurance by directing CDC to remove COVID-19 as a recommended vaccine for pregnant women and children — reportedly without ACIP input. It should be noted that on June 9, a directive from Sec. Kennedy offered formal notice of the immediate termination of the current 17 ACIP voting board members. Injury and Violence Prevention Substance use, suicide, and overdose prevention were major topics around injury and violence. The FY26 budget proposes transferring CDC’s National Center for Injury Prevention and Control to AHA but still eliminates a majority of its programs. These programs have driven progress on opioid surveillance and community-based interventions, and reduced rates of overdose. When asked about preserving the SAMHSA State Opioid Response Grant, Sec. Kennedy said he supported harm reduction tools such as naloxone and community care programs but needed to review the specific grant. He acknowledged overdose as a public health crisis and stated that HHS will maintain 500 addiction treatment centers nationwide. He mentioned his commitment to addiction programs and the administration’s keen attention on preventing fentanyl from entering the United States. Additional questions were raised about high alcoholism rates on reservations, general funding for Indian Health Services, and elimination of LGBTQ+ services in the suicide prevention hotline; Sec. Kennedy promised to follow up on these topics. Chronic Disease, Cancer, and Food Safety Throughout the hearings, Sec. Kennedy underscored his steadfast commitment to reducing rates of heart disease, diabetes, cancers, Alzheimer’s and dementia, and other chronic conditions. He also wants to focus on the challenges of rural health care and rural hospital closures, as well as improved access to care for vulnerable populations, such as older Americans, veterans, and people with disabilities. In his testimony, Sec. Kennedy repeated his commitment to address nutrition and physical activity and to prioritize healthy eating in the Head Start program. He is working closely with FDA to phase out harmful dyes. FDA has fast-tracked approval for vegetable substitute dyes for the food industry. Sec. Kennedy is also focused on combating ultra-processed foods stating that “nutrition reform will address the root causes of diseases,” such as cancer. CDC’s Center for Chronic Disease Prevention is proposed for elimination in the budget, and the Diabetes Prevention Program Outcome Study is paused. Children’s and Women’s Health Lawmakers from both parties voiced concern over misinformation leading to declining vaccination rates and a growing measles threat. Youth mental health and social media harms were emphasized. Senators also raised bipartisan objections to the proposed elimination of CDC’s Childhood Lead Poisoning Prevention Program, which is being revisited. He expressed interest in researching environmental causes of autism and not solely focusing on genetics. In the House hearing, he acknowledged racial disparities in maternal care. Despite proposed cuts to programs like the National Breast and Cervical Cancer Early Detection Program, Sec. Kennedy voiced support for women’s health research. He also said he supports dental care, though he offered limited assurance on fluoride access. The budget proposes to close CDC’s Division of Oral Health. Tobacco Control In the House hearing, Ranking Member DeLauro (D-CT) criticized the proposed elimination of CDC’s Office on Smoking and Health. Senators in the HELP hearing emphasized tobacco’s status as the leading preventable cause of death and warned that staffing cuts would undermine decades of progress. Sec. Kennedy acknowledged the concerns but said he needed to review the specifics. He was also asked about FDA’s inaction on regulating illicit Chinese-made vapes targeting U.S. youth. While Sec. Kennedy presented the FY26 budget as a framework for streamlining government and cutting costs, critics argued that it undermines core public health capacities. As Congress enters markup season and prepares to negotiate final programs and funding levels, the outcome of this year’s budget debate will have long-term implications for the U.S. public health system. article yes

States Amending Policies to Slow Congenital Syphilis Increases States Trying Policies that Increase Syphilis Testing Amelia Poulin State are exploring ways to slow the rapid increase of congenital syphilis cases by strengthening policies to require testing at key points during pregnancy. Syphilis among newborns, or congenital syphilis, is preventable. Yet the latest CDC data show that congenital syphilis cases have more than doubled (106%) from 2019-2023. In 2023 alone, there were nearly 4,000 cases of congenital syphilis resulting in 279 stillbirths and infant deaths. Timely testing and adequate treatment during pregnancy might have prevented up to 80% of these cases. Increases in congenital syphilis often mirror increases in syphilis among reproductive-aged women. From 2022 to 2023, the rate of syphilis (all stages) increased 6.8% among women aged 15–44 years; rates also increased in 39 states and Washington, D.C. CDC recommends testing pregnant women for syphilis at the first prenatal visit, as well as at 28 weeks gestation and delivery if they are at increased risk of infection. Syphilis testing recommendations extend to asymptomatic women who are at increased risk for infection as they may face additional barriers to health care. ASTHO’s policy-level interventions for states and territories suggest universal syphilis testing for pregnant women. Additionally, states have been taking action to increase access to syphilis testing for people, including those who are pregnant. The Syndemic Perspective A history of incarceration, sex work, drug use, and geography can all significantly increase risk for sexually transmitted infections (STIs), HIV, tuberculosis (TB), and more. Structural barriers, including housing instability, economic insecurity, stigma, and restricted health care access, create conditions that heighten vulnerability to multiple infections. These conditions do not occur in isolation but rather as part of a syndemic, where overlapping epidemics interact with and exacerbate one another. Health agencies may be positioned to address upstream and root cause issues recognizing and addressing the intersections of these disease areas and related structural and social issues (e.g., drug use and poverty). Health agencies carry a wealth of interdisciplinary expertise, with staff leading efforts around data collection and surveillance, policy, community mitigation, and more, all of which support capacity to identify root causes and design an evidence-based, multifaceted response. Policies that prioritize housing stability, harm reduction services, and access to comprehensive health care, including STI screening, can help mitigate these risks and improve health outcomes. Geography can also increase the chances of syphilis transmission. Some regions with limited health care infrastructure, provider shortages, and limited STI prevention program funding and capacity may have higher rates of infection. Rural areas and certain urban settings may lack accessible clinics or specialized services, creating significant barriers to timely testing and treatment. Rural areas and certain urban settings may lack accessible clinics or specialized services, creating significant barriers to timely testing and treatment. Social and economic differences across different geographic locations contribute to varying levels of disease burden. By adopting a syndemic framework, states can move beyond disease-specific interventions and implement comprehensive strategies that address upstream factors contributing to disease transmission. State Actions Several states have introduced or passed legislation to expand syphilis testing access, with a focus on increasing screening opportunities, mandating insurance coverage, and ensuring appropriate prenatal testing protocols. Syphilis Testing In 2024, Colorado enacted HB 24-1456, which gave the state’s Board of Health rulemaking authority over syphilis testing. This flexibility allows the state to adapt its public health response based on emerging epidemiological trends as new data on syphilis transmission and congenital infections become available. The 2025 legislative sessions have highlighted additional approaches to expanding access to syphilis testing. The New York legislature introduced S 2704, which would require health insurance coverage for certain approved STI home test kits. This policy would provide individuals who face barriers to in-person care a convenient and private way to get tested and stay healthy. Oregon is also addressing testing accessibility through HB 2943, which would require hospitals to test people for HIV and syphilis when they have blood tests done in the emergency department (ED). Since EDs often serve populations who do not routinely access preventive health care (e.g., people experiencing homelessness or struggling with substance use disorders), this legislation would strengthen the role of emergency settings in STI prevention and intervention. Perinatal Syphilis Testing Recognizing the importance of perinatal screening, several states have introduced legislation to add requirements for syphilis testing at key points in pregnancy. Tennessee recently enacted SB 1283, which requires that health care providers take a blood sample to screen for syphilis, hepatitis B, and hepatitis C at the first prenatal examination, ten days after the examination, and at delivery. This approach aligns with CDC recommendations and ensures infections are identified and treated in time to prevent congenital transmission. Similarly, Nebraska LB 41 would require testing for syphilis at the first examination, in the third trimester, and at birth (with the mother’s consent), reinforcing a multi-point screening strategy to detect and treat infections that may develop later in pregnancy. Missouri’s SB 178 would take a comprehensive approach to syphilis prevention during pregnancy by requiring an additional test at 28 weeks, a critical point for intervention. The legislation would also require treatment for mothers who test positive for an STI, reducing the risk of congenital infections. Additionally, it would expand Expedited Partner Therapy by allowing any health care professional authorized to prescribe medications to administer Expedited Partner Therapy as well as include other STIs in the treatment, enabling faster treatment for sexual partners who might otherwise go untreated and continue the cycle of transmission. Policy Considerations Expanding both syphilis and perinatal syphilis testing policies demonstrate a growing recognition of the need for proactive, evidence-based strategies to address the increasing rates of syphilis and congenital syphilis. However, the ability of policies to affect public health outcomes may depend on continued resource allocation, workforce training, and public awareness campaigns. State and territorial health agencies can consider additional measures, such as integrating syphilis screening into routine primary care visits and providing funding for community-based outreach. Conclusion These legislative actions represent various approaches states are taking to addressing syphilis. Implementing screening protocols aligned with current evidence may contribute to efforts to address syphilis and congenital syphilis. By leveraging legislative action and evidence-based interventions, states can improve health outcomes and reduce disparities in syphilis and other STIs. A comprehensive approach that includes additional testing, expanded health care access, and targeted interventions for populations at higher risk for infection or severe disease may ensure better health outcomes for parents and infants alike. ASTHO will continue to monitor and report on this important public health issue. article yes

Learn how peer-to-peer collaboration has helped health agencies develop their performance management and quality improvement efforts.

Public Health and Academic Leaders Unite Through Texas Consortium Mayela Arana Learn how a consortium in Texas strengthens and supports activities between public health practice and academic institutions. In a state as vast as Texas — spanning 254 counties and operating under a decentralized public health system — collaboration is key to strengthening public health efforts. With local and county health departments working independently and the state stepping in where no local health department exists, fostering partnerships across institutions is both a challenge and an opportunity. Recognizing this, the Texas Department of State Health Services (DSHS) brought multiple schools of public health together under a unified program: the Academic Health Partnership Initiative. Led by the DSHS Office of Practice and Learning within the Center for Public Health Policy and Practice, this initiative is designed to strengthen, support, and enhance activities between public health practice and academic institutions, in which the Academic Public Health Consortium plays a key strategic, collaborative role. Partnership Purpose and Benefits DSHS believes that forming Academic Health Department (AHD) partnerships creates accountability, clearer collective value, and greater access to funding opportunities. AHD partnerships, which can range from student internships to fully integrated collaborations and shared resources, provide a framework for public health departments and universities to work in lockstep. By taking a statewide approach, DSHS not only enhances public health workforce development but shapes a more resilient and connected public health infrastructure in Texas. In addition, DSHS asserts that strengthening academic public health partnerships… Improves the relevance of education to public health practice. Creates innovative public health practices and research. Strengthens connections, communication, and trust. Shares and replicates evidence-based projects, initiatives, and interventions. Maximizes resources, expertise, and funding. Provides opportunities to meet strategic goals. Helps build and train the public health workforce. Evolution of DSHS Partnerships with Academic Institutions DSHS has always valued its relationships with academia and collaborations have been a long-standing piece of their work. State legislators also acknowledge this powerful connection between public health agencies and universities. In fact, through 1999 legislation, Chapter 121, Subchapter F, Health and Safety Code directed DSHS to establish a “public health consortium” composed of academic partners to conduct activities like developing curricula and trainings, conducting research on improving health status outcomes, and developing competency certification standards for public health workers. DSHS’s partnerships with universities have since grown and evolved — while the agency has historically gravitated toward schools of public health as natural partners, DSHS recognizes that public health is a broad field and it can benefit from having expertise in other disciplines. As such, the Academic Public Health Consortium consists of schools of public health within eight Texas university systems but is open to any school or local health department to contribute and participate. Building a Shared Vision Through Statewide Collaboration The Academic Public Health Consortium held roundtable discussions across the state to collect initial input for its Statewide Strategy. Members undertook the following collaborative steps to co-create their shared strategies and goals. Set up introductory meetings with each school to introduce the concept and get buy-in. Discuss the specifics all parties would like to gain from the partnership (e.g., collaboration on research projects or grants, training for staff, internship placements, consultation on curriculum, support for accreditation, guest lectures, hosting career panels, etc.). Identify work groups or committees with each school and agree on meeting frequency. Draft a sample memorandum of understanding or agreement to answer the following: what is our purpose, what are we going to do, how are we going to do it, why is it important, and how will we both benefit. Conduct inventory of current activities. Review each organization’s strategic priorities, goals, and needs. Conduct a SWOT (strengths, weaknesses, opportunities, threats) or SOAR (strengths, opportunities, aspirations, and results) analysis. Develop goals and priorities focusing on the mutual needs of each organization and action plans to achieve them, such as: Increasing student placement in applied practice experience opportunities. Increasing the number of real-world scenarios in the classroom. Providing workforce trainings to health department staff. Increasing student exposure to public health careers through panel discussions. Conducting a rural workforce training needs assessment. The resulting roadmap helps monitor and evaluate progress on agreed-upon action areas and show the impact of the partners on achieving the organization’s mission and goals, including: Prepare, educate, and train the public health workforce. Support public health careers. Speed the translation of research to practice, share best practices, and pilot projects in communities. The Consortium plans to develop subcommittees, get more public health practitioners involved across the state, and secure funding to support the Academic Health Partnership Initiative’s activities. Advice for Others Seeking to Establish AHD Partnerships Organizations can structure AHD partnerships in a way that best suits the nature of the relationship and those involved. There is no right or wrong way to operate this type of partnership, and it may evolve over time. One of the broader and bigger goals is to lay a solid foundation of trust, communication, and structure. Create a space where you can get to know each other better; discover each other’s strengths and needs and communicate opportunities and challenges. Like any good and solid relationship, strong partnerships are not created overnight — they require consistency, intentionality, hard work, and grace. Learn more about Academic Health Department Partnerships or explore other workforce development resources from the Public Health Foundation. If your health agency wants more information about planning support, please submit a PHIG technical assistance request through PHIVE or contact performanceimprovement@astho.org. Special Thanks - Blog - PH Academic Leaders Unite Texas Consortium article yes

Learn about four Congressional hearings focused on challenges affecting older adults, including inflation and opioids.

States Reassessing Vaccine Policy and Public Health Powers Shalini Nair, Andy Baker-White Review of state policies to weaken vaccine requirements and reduce public health powers. Immunization is a key pillar of public health, crucial for protecting communities and preventing infectious diseases from spreading. State and territorial health officials and their departments play critical roles in setting and implementing immunization requirements, managing disease surveillance and outbreak response, and ensuring access to vaccines. In recent years, however, the immunization landscape has evolved as legislative changes alter public health authority and access to vaccines. As these challenges persist, public health officials must be informed and prepared to navigate the dynamic policy environment to ensure immunization programs’ continued effectiveness at protecting public health. The True Cost of Vaccine Skepticism and Misinformation In the years since the pandemic, rates of routine vaccinations among U.S. children have steadily declined; there has simultaneously been an increase in non-medical exemptions. While reasoning behind personal decisions about vaccination are not always clear, increasing prominence of vaccine-related myths is a significant contributor to this phenomenon. Perhaps the most glaring consequence of this decrease is best illustrated by the 2025 measles outbreak and the first measles-associated deaths in more than a decade. Previously considered to have been eliminated, measles is now under threat of resurgence as vaccine rates fall below the thresholds to uphold herd immunity. Health officials are also seeing declines in coverage for several other vaccine preventable diseases like pertussis, mumps, hepatitis, and even polio. Legislation Restricts Innovation and Sows Doubt About Vaccine Components The use of mRNA technology expanded in 2020 following its breakthrough success in COVID-19 vaccines. These mRNA vaccines prevented more than 120 million additional COVID-19 infections and 3.2 million additional deaths. Researchers are currently assessing mRNA technology to address pandemic influenza, HIV, Zika, and even cancer. During 2025 sessions, at least seven states introduced legislation to ban or limit using mRNA vaccines. Iowa’s SF 360 sought to prohibit any “gene-based vaccines” (i.e., those developed using mRNA or DNA technology); the bill was based on a widely debunked myth that mRNA vaccines can interact with and alter human DNA (they can’t). New York’s A 4798 would prevent administering COVID-19 mRNA vaccines until the department of health conducts a risk-benefit analysis. Several states have introduced legislation to prohibit selling — or require labeling foods that contain — vaccine or vaccine material. This bill is based on another common internet rumor that mRNA vaccines are being introduced into the food supply via livestock and produce (they aren’t). Nonetheless, Utah enacted a bill (HB 84) requiring that food intended for human consumption that contains a vaccine or vaccine material be designated as a drug. Similar bills were introduced in Florida (HB 525), Alabama (HB 316), and Tennessee (SB 616, HB 1100). Vaccine Authority’s Shifting Landscape While the federal government plays an important role in putting forth policy recommendations, the ultimate power to impose or revoke vaccine requirements and determine exemptions outside of health emergencies rests with states. In many jurisdictions, state health agency expertise determines the vaccines required for school enrollment. These decisions, while ultimately at the feet of state health officials, rely heavily on input from experienced, knowledgeable, and skilled agency staff. Recent legislative actions in several states seek to shift authority for determining school-based immunization requirements solely to the legislature. Idaho’s new law (H 290) removes the state board of health’s authority to determine which immunizations are required for daycare and school enrollment, as well as the manner and frequency of their administration. The bill also repeals a former law establishing the Idaho Childhood Immunization Policy Commission, created in 2010 to issue recommendations to the legislature and board of health. A similar effort in Maine (LD 727) would remove health department authority to determine school vaccine requirements as part of a larger repeal effort responding to the 2019 law disallowing vaccine exemptions based on religious or philosophical grounds. In New Hampshire, existing statutes define required immunizations for school attendance and allow the state health official to add to this list via the rulemaking process. Recently, lawmakers introduced a bill (HB 357) that would remove this add-on ability. If passed, existing commissioner-led requirements for vaccines such as varicella, hepatitis B, and Hib would expire in June 2026 and no future amendments could occur under this authority. Several other bills introduced in Texas (HB 468, HB 3304, SB 94, SB 117, HB 3852), West Virginia (SB 108, HB 2203), and North Carolina (HB 89) target shifting authority and/or modifying vaccine requirements for certain school types. Evidence-Based Policy as the Path Forward State and territorial health agencies are foundational to preventing the spread of infectious diseases through vaccine education and administration. ASTHO has identified public health expertise in developing vaccination policy as one of three recommended strategies that prioritize evidence-based public health authority and support agencies to protect and improve health. As this landscape further evolves, ASTHO will continue tracking legislative and executive action on this important public health issue. article yes

Academic Health Partnership Prioritizes Workforce Development in Florida Florida Academic Health Partnership Prioritizes Workforce Development Mayela Arana Learn how an Academic Health Partnership in Florida focuses on workforce development and get inspired. In Hillsborough County, the Florida Department of Health (DOH-Hillsborough) and the University of South Florida (USF) have a long history of working together. Their partnership took on a new level of structure and purpose in 2022 when they formalized an Academic Health Department (AHD) partnership agreement, focused largely on workforce development. This collaboration, supported by the Public Health Infrastructure Grant (PHIG), creates opportunities for DOH-Hillsborough staff to enhance their skills through USF’s public health programs. By providing structured training and education, the partnership is helping to build a stronger, more prepared public health workforce to serve the county’s 1.5 million residents. A Longstanding Partnership Embraces a New Opportunity When CDC released a notice of funding opportunity for PHIG in 2022, the DOH-Hillsborough health officer and the dean of USF’s College of Public Health (COPH) worked together to co-write a successful proposal. One of the resulting contracts formalized their partnership in the name of strengthening the public health workforce through recruitment, training, and retention. Like many public health agencies, many of DOH-Hillsborough’s employees do not have degrees in public health. The health department is focused on upskilling through coursework and certificate/micro-certificate programs directly related to job tasks. These opportunities are available to every staff member including those categorized as “other personnel services,” non-career services, and certain contracted employees — as DOH-Hillsborough recognizes the importance of extending these educational opportunities to all employees. Initial PHIG funding was critical in establishing the necessary dedicated staffing and infrastructure for workforce development program offerings at the health department. Current funding continues to support infrastructure, new custom program development, and the educational offerings. Infrastructure: USF works with DOH-Hillsborough to conduct staff training needs assessments and has provided training at agency-wide “all-staff” meetings. USF also developed and provides a Certified in Public Health (CPH) exam preparatory course that is open to any health department employee who is eligible to sit for the exam, at no cost to them. Custom program development: Additionally, the university, in collaboration with DOH-Hillsborough and two other local county health departments, developed a custom leadership program that groups emerging health department leaders with community partners of their choice (e.g., Healthy Start, Homegrown Hillsborough) and includes two full days of instruction over a six-month period. Educational offerings: The health department is also using PHIG funds to cover tuition for current staff to take graduate and undergraduate courses at USF’s COPH and across the university. Representatives from DOH-Hillsborough and USF hold virtual information sessions for staff about available educational offerings, the university enrollment and registration process, and completing internal agency requirements for pursuing and participating in the PHIG-funded opportunities. Measuring Impact and Continuous Improvement Given that the bulk of activities in this AHD partnership are currently PHIG-funded, PHIG performance measures provide a clear and valuable opportunity for evaluation. DOH-Hillsborough is focused on three of the PHIG measures that address hiring and retention: Number of PHIG-funded positions filled by job classification and program area. Overall agency staff retention rate. Median number of days to fill a position. Tracking performance of these measures both contributes to the agency’s overall PHIG evaluation and provides the AHD partnership with a clear process for quality improvement. Advice for Others Seeking to Establish AHD Partnerships Learning from the success of USF and DOH-Hillsborough’s partnership, considerations in developing or expanding AHD partnerships include: Appreciate the unique nature of each organization. For example, while the health department and university may have a common vision, they may also have different funding category restrictions to consider prior to solidifying the partnership. Be mindful that each organization has its own legal considerations. Allow ample time for the proper review of contracts, agreements, and external communication about the joint endeavor. Know that, at times, the collaborative process can be complex and challenging. Take a few steps back. Work together to find solutions, and don’t give up. Be flexible, humble, and willing to pivot, remaining confident that the partnership will have a bigger impact than your organization would alone. Learn more about AHD partnerships or explore other workforce development resources from the Public Health Foundation (PHF). If your health agency wants more information about planning support, please submit a PHIG technical assistance request through PHIVE or contact performanceimprovement@astho.org. Special Thanks - Blog - AHP Prioritizes Workforce Development in FL article yes

Learn how Nebraska's Division of Public Health restructured their grants monitoring process in this blog post.

Tennessee Partners with Dialysis Facilities to Strengthen Infection Prevention Tennessee and Dialysis Facilities Strengthen Infection Prevention Alex Kurutz, Joshua Key, Connie Harig Learn how Tennessee partners with dialysis facilities to address training needs and, in turn, strengthen infection prevention. More than 800,000 people in the United States are living with end-stage kidney disease, and over half receive life-sustaining treatment through dialysis. Unfortunately, healthcare-associated infections (HAIs) remain a leading cause of hospitalization and death for this population. Patients undergoing dialysis, especially hemodialysis, are at increased risk for infections due to frequent vascular access, compromised immune systems, and regular exposure to clinical settings. To support patient safety and reduce the risk of dialysis-related infections, it is critical to ensure that facility staff have access to training on evidence-based protocols such as proper hand hygiene and vascular access care. In Tennessee, the Department of Health works closely with dialysis facilities to identify and address the training needs of their staff and improve infection control practices that advance the safety of patients on dialysis. To gain further insights into this successful partnership, ASTHO spoke with two Tennessee Department of Health personnel — Dialysis Nurse Consultant Joshua Key and Epidemiologist Alex Kurutz — as well as Connie Harig, Nurse Educator from Dialysis Clinic, Inc. in Knoxville, who shared their experiences implementing and participating in this program, shedding light on the process, benefits, and lessons learned from this collaboration. Identifying Training Needs To effectively support training facility staff, the Tennessee Department of Health began by looking at what data could tell them about their state’s needs. In addition to reviewing reports from the National Healthcare Safety Network (NHSN), the Department of Health conducted a learning needs assessment in fall 2022 to identify educational and training needs expressed by dialysis providers. All dialysis facilities in Network 8, which encompasses Tennessee, Mississippi, and Alabama, received the assessment, and results revealed that dialysis technicians and nurses desired additional training related to infection prevention practices. In response, Tennessee initiated the Hemodialysis Infection Prevention Educational Program — a day-long, interactive simulation training, inspired by a similar effort in Massachusetts. Joshua Key 1 - Tennessee Partners with Dialysis Facilities to Strengthen Infection Prevention Developing and Implementing the Simulation Training The department hired four part-time educators — two dialysis nurses, one certified hemodialysis technician, and one biomedical technician — to develop the training materials based on CDC guidance. They also developed pre- and post-tests as well as a training evaluation to assess any increase in knowledge and intent to apply the content moving forward. Lastly, they worked with the Georgia Nurses Association to offer continuing education credits for participating providers. A typical simulation training has the capacity for about 40 participants and involves an eight-hour day, beginning with brief presentations on each topic and moving into applied practice in the second half of the day during which participants rotate through stations to apply the skills they learned. Participants also hear from a patient advocate to learn more about the real-life impact of dialysis-related infections, an experience many trainees have described as powerful and important. Despite facing initial challenges connecting with a patient advocate, Tennessee Department of Health emphasized its importance, ultimately leaning on partners such as the National Kidney Foundation and the National Forum of ESRD Networks to identify an available advocate. article yes

Explore how states are enacting legislation to help justice-involved people avoid overdose illness and death and foster a smooth transition after release.

Exercise Excellence: Michigan Reflects on a National Level Exercise Exercise Excellence: Michigan Reflects on a National Level Exercise Adrianna Evans Learn how Michigan's health department collaborated with state and federal partners for a radiation preparedness exercise. In March 2025, the Department of Energy hosted a national level exercise designed to promote radiation readiness. This exercise, called Cobalt Magnet 25, brought together a wide variety of interdisciplinary partners from federal, state, local, and international governments, among other partners. Michigan hosted the exercise. ASTHO’s Director of Preparedness, Adrianna (Annie) Evans, sat down with representatives from the Michigan Department of Health and Human Services (MDHHS) to learn about their experiences with Cobalt Magnet 25, how they’ve applied lessons learned one year later, and how those lessons might be applied to different threats. This blog post will be the first in a series “Exercise Excellence” that shares insights and perspectives from emergency preparedness exercises. This first blog post will share insights from Michigan on Cobalt Magnet 25 overall preparation, planning, collaboration, and more. Tell us about your experience with Cobalt Magnet 25. Jason Smith, Emergency Management Coordinator: While Michigan State Police, our state’s emergency management agency, took a key role with the U.S. Department of Energy on lead exercise planning, MDHHS served as lead exercise planner, player, and co-chaired a public health and environment working group alongside partners from Ontario and the Michigan Department of Environment, Great Lakes, and Energy. MDHHS leveraged this opportunity to initiate internal play and engage local public health and health care partners across the region. This included representation from two health care coalitions, five local health departments, and four major health care systems — many of which were outside the directly affected communities for this scenario. MDHHS activated our emergency coordination center. Overall, the Cobalt Magnet 25 Full Scale Exercise featured over a thousand injects emphasizing field sampling, decontamination, and reception centers. Our participation spanned preparedness, laboratory, environmental health, behavior health, disability health, and communications, including our public information officers. This experience strengthened cross-jurisdictional coordination and enhanced MDHHS's operational readiness for radiological incidents. Terra Riddle, Director, Division of Emergency Preparedness and Response: From my perspective, Cobalt Magnet 25 was impressive. Each player jurisdiction had the opportunity to make the exercise meaningful. It was really great to see all the partners come together and how each jurisdiction worked through these scenarios. It was unique in the communications world due to the depth, richness, and realness of the exercise play. Jay Fiedler, Director, Bureau of Emergency Preparedness, EMS, and Systems of Care: I participated when the larger group convened as part of the planning process. I hadn't seen something like this before in an exercise of this caliber. One of those activities was a briefing held for departmental leadership of state and federal agencies leading into the full exercise. I also served in the response coordinator role in our Community Health Emergency Coordination Center during the exercise itself. What was the preparation and planning process like for this exercise? Fiedler: This was roughly a yearlong planning process facilitated by a federal contractor, but it required extensive engagement with our state and federal partners. Jason worked in regular planning meetings and activities throughout that year. Some ways that the players were pulled together in meetings leading up to the exercise were really valuable for creating partnerships. Our partners from Ontario joined us. We don’t always get to work with them. That helped facilitate enthusiasm for the exercise itself and enhanced coordination between all the players involved. Smith: In addition to the exercise planning itself, the beauty of Michigan hosting Cobalt Magnet 25 was the opportunity to capitalize on existing trainings, whether it be through Counter Terrorism Operations Support, general radiological emergency preparedness training, and programs through CDC — primarily their public health decision-making course for radiological emergencies. There was a lot of training going on behind the scenes to build up awareness and capacity over the year. I thought the education opportunities made the exercise itself a success. Riddle: I'm glad you mentioned that, Jason, because it brought up another thought about the in-depth training led by the federal partners in the communications world. They invited our partners at the state and local levels to participate in radiological and communications training that was pretty niche. Our partners appreciated that this training prepared them for the exercise and it has spurred lot of conversation since about where we go next. This type of scenario requires a lot of collaboration with government agencies across levels of government, different fields, and even other countries. How did you manage that collaboration and what lessons did you learn? Riddle: The big takeaway is that trust built before a crisis sustains coordination during a crisis. This exercise required management across local, state, federal, and international partners with clear roles, consistent communication channels, and shared objectives early on. Fiedler: The pre-meetings were a unique aspect of this exercise and the connections built were really valuable. I hadn't seen that until an exercise of this scope and scale, but will be helpful going forward as we think about how we work and plan exercises as a whole. Smith: One lesson learned was that there is a bigger appetite for training, both in our department and local partners. Michigan has three nuclear power plants. That prevailing threat does build some desire for general awareness throughout the state, particularly among our 45 health departments. We also realized we need to work a little bit more collaboratively with our environmental partners, our agricultural partners, and have a more unified response effort. Riddle: If I can add, there's always an appetite for training and for support for our local partners, but Cobalt Magnet 25 brought visibility into different types of training. Jason explored radiological training. We explored communications training. Now I wonder all the time if there is a partner that could offer new trainings that we haven’t done before. What’s next for MI? Does MI have any other upcoming exercises — radiological/nuclear or otherwise — that you’re looking forward to? Smith: We’re focusing on a comprehensive overhaul of our response plans — not only our radiological nuclear hazards, but also for other functional and hazard specific annexes. In February 2026, we worked with our emergency management agency, local health departments, and health care coalition partners on a severe weather functional exercise. We also have a few workshops and tabletops scheduled for spring 2026 on volunteer management and vector-borne diseases. Additionally, we're prioritizing One Health coordination and formal agreements with agriculture and environmental agencies to strengthen collaboration across the quality-of-life sector. Lastly, we have a climate change tabletop exercise planned in partnership with environmental health teams within MDHHS. These initiatives reflect our commitment to building resilience across multiple hazards while continuing to advance radiological preparedness. Riddle: The depth of relationships continue to be a leading priority. Regardless of the emergency, our teams working together will be our strength. We're all interconnected and that plays into different activities. For example, our patient movement work, which inherently has many partners and requires close coordination like we saw with Cobalt Magnet 25. Exercise Excellence - Radiation Resources article yes

State Policy Trends in Cybersecurity and Public Health Preparedness Maggie Nilz Learn how states are including cybersecurity in their emergency preparedness work in this Health Policy Update. Cybersecurity is an increasingly important component of public health preparedness as state cybersecurity policy intersects with public health agency responsibilities. Public health agencies rely on interconnected digital systems and critical infrastructure for disease surveillance, laboratory reporting, emergency communications, and health data management, making cybersecurity critical to maintaining these functions. Beyond compromising sensitive data and potentially harming patients, cyber incidents can disrupt essential public health services, including emergency response operations. Health care data breaches have steadily increased over the last 15 years, highlighting growing risks for government and health systems. A recent report showed that more than 7,000 health care data breaches were reported to the Department of Health and Human Services since 2009, and reported HIPAA data breaches in 2023 were nearly double the number recorded in 2018. Meanwhile, preparedness capacity has lagged: as of 2022, only 13% of local health departments reported being prepared for cyber-related disruptions, and recent scans show cybersecurity is rarely included in emergency preparedness planning. In response at the federal level, HHS recently announced it is undoing a 2024 reorganization by returning department-wide technology responsibilities to the Office of the Chief Information Officer while refocusing the Office of the National Coordinator for Health Information Technology on improving nationwide health IT interoperability and data sharing. In recent years, state and territorial legislatures have begun to address these gaps by incorporating cybersecurity into preparedness, health care oversight, and statewide governance structures. These legislative trends signal a need to integrate cybersecurity into emergency operations plans, strengthen cross-sector coordination, and safeguard the continuity of public health services. Some of the most recent policies considered and enacted by legislatures treat cyber incidents as emergencies, expand reporting requirements, and strengthen cyber governance. Cyber Incidents Are Being Built into Emergency Preparedness Frameworks In response to these growing threats, jurisdictions have begun incorporating cyber response into emergency plans and strategies, reinforcing cybersecurity as essential to preparedness. These developments highlight growing awareness that cyber incidents can disrupt critical services, much like natural disasters. In 2025, New York enacted S 7672, which requires municipal entities and public authorities report cybersecurity incidents and demands for ransom to the state Division of Homeland Security and Emergency Services. In addition, it directs the Director of the Office of Information Services to establish cybersecurity training and protection standards for state systems as well as require cybersecurity training for state and local government employees. Virginia is currently considering HB 83, which would establish a volunteer Cyber Civilian Corps within the state IT agency to provide rapid assistance during cybersecurity incidents affecting municipalities, nonprofits, education, and critical infrastructure. Preparedness efforts also extend beyond legislation to executive action. In February 2026, Minnesota Governor Tim Walz authorized $1.2 million in state disaster assistance to support response efforts and restore critical systems in response to a cyber incident that disrupted digital services in Saint Paul on July 29, 2025. Additionally, the National Governors Association has included cybersecurity as a primary consideration for planning and preparedness in their latest edition of the Public Health Emergency Playbook. Health care and Public Health Critical Sectors Are Facing New Cyber Requirements Beyond emergency response frameworks, jurisdictions are also adopting cybersecurity reporting and planning requirements for health care and public health organizations. Companion bills in Tennessee (HB 511/SB 555) would require health care providers and facilities to notify their contracted health insurers of cybersecurity incidents. In Maine, LD 2103 would require hospitals to adopt cybersecurity plans to protect patient data and maintain operations, and must include cybersecurity training for employees and board members. New Jersey is looking to adopt and implement a more comprehensive cybersecurity plan across all sectors. This session, legislators have introduced at least two cyber security bills: A 3231 would require “sensitive businesses” (defined as those engaged in financial, essential infrastructure, or health care industries) to report cybersecurity incidents to the New Jersey Cybersecurity and Communications Integration Cell (NJCCIC) when they are aware of their occurrence and would require NJCCIC to conduct a cybersecurity audit within 30 days of notification. A 3283 would require the same “sensitive businesses” to implement cybersecurity programs in accordance with standards adopted by NJCCIC and certify compliance annually. As states expand reporting and cybersecurity requirements, these obligations may intersect with public health reporting and continuity planning. States Are Strengthening Government Cyber Governance and Coordination In addition to sector-specific requirements, jurisdictions are also strengthening the governance structures responsible for coordinating cybersecurity, improving their ability to respond to large-scale incidents affecting public systems. Legislation enacted recently in Texas and California aim to improve coordination among state government by establishing a state agency centralizing cybersecurity incident prevention and response (Texas HB 150) and mandating the development of a cybersecurity playbook to strengthen information sharing (California AB 979). A 2024 bill enacted in Puerto Rico (PC 1530) requires commonwealth agencies to develop and implement a cybersecurity program, which must include a yearly risk assessment as well as vulnerability assessment. At least three jurisdictions are currently considering bills strengthening established cybersecurity programs, with two states recently passing legislation. Utah recently enacted a bill authorizing the Utah Cyber Center to conduct voluntary cybersecurity risk assessments for critical infrastructure and coordinate with government entities on infrastructure safety (HB 165). Utah also enacted legislation creating a specific funding stream for the Center to use for various activities, including implementing a statewide cybersecurity plan and conducting assessments for governmental entities (SB 123). Kansas enacted HB 2574, which would require chief information security officers for the executive, legislative, and judicial branches to adopt cybersecurity programs based on a nationally recognized standard for governmental entities. Finally, Florida recently passed SB 7024, which would expand the state’s public record exemption to include risk assessments, information related to cybersecurity breaches, and information related to data protection, ensuring the confidentiality of sensitive cybersecurity information held by state agencies; the bill is with the governor for final consideration. Key Takeaways for Preparedness Leaders Cybersecurity is critical for preparedness across multiple policy areas, and requires new planning, coordination, and oversight responsibilities. By including cyber incidents into disaster frameworks, standards for health care organizations, and governance, preparedness leaders may find themselves more directly engaged in integrating cybersecurity into emergency operations, exercises, and cross-sector partnerships. For state and territorial health agencies beginning to incorporate cybersecurity into their preparedness plans, agencies such as the Cybersecurity and Infrastructure Security Agency provide jurisdictional support and resources to guide this work. article yes

Learn about the importance of immunization information systems to public health in this Health Policy Update.

Learn about Pima County's journey to advance data modernization efforts through an elevated partnership with County IT.