Mapping sentiment, readiness, and the need for AI governance across county and state public health agencies. Based on insights from 35 leaders spanning 22 U.S. states and territories. The results reveal a sector at a crossroads: strong interest in AI, but limited structural preparedness. Most agencies are not questioning whether to adopt AI, they are seeking the governance frameworks, workforce literacy, and data infrastructure required to do so responsibly and at scale. Report highlights: Nearly 58% of public health agencies rate their overall AI readiness as low or very low Over 70% report low workforce AI literacy, a critical capability gap 82%+ express high or very high concern about unmanaged AI use 64% have low or very low clarity on AI governance policies More than half say their data infrastructure is not yet AI-ready ~45% name AI governance a top priority for the next 12 months