Eight Plays. Two Years. One Coalition.
Eight awardees. Eight Arizona plays.
In April 2025, Pfizer announced the eight awardees of its inaugural SCALE Grants program. Every one of those initiatives is the kind of work SCFA is built to do here at home. The opening question is blunt: if Pfizer ran the cycle again next year, would SCFA make the short list? Today the answer is no. In twelve months it should be yes.
Why this matters
The 2025 SCALE cohort is a near-perfect roadmap of the eight projects every state-level sickle cell organization should be running. Pfizer told us, in dollars, what it values: state SCD registries, geospatial access mapping, community health worker integration, lived-experience data, ED treatment standards, youth policy training, and national advocacy playbooks. The grants are signals. We treat them as a procurement spec.
The whitespace
Arizona has no SCD-specific state legislation. We are not a CDC SCDC Surveillance state. We are not in the federal gene-therapy access pilot. Texas just passed HB107. New York is pushing Medicaid Health Home reform. California is applying to the federal gene therapy initiative. Arizona has done none of these things. That is the wedge.
The play
Sections 3 through 11 of this gameplan walk through each of the eight 2025 SCALE awardees and pair them with a concrete Arizona play, including funders beyond Pfizer for each. Section 12 stacks the plays into a two-year roadmap. Section 13 is a funder map. The final slide lists five things to do in the next 30 days. The goal is not to apply to SCALE 2026 cold — it is to spend the next twelve months making SCFA the obvious choice for Pfizer, while simultaneously stacking matching funding from HRSA, AzDHS, Vertex, BMS, RWJF, and Flinn.
Build the AZ SCD Registry Voice
Map the Arizona SCD Access Desert
AZ SCD CARE Connection — The Medicaid Health Home Pilot
The Arizona CARE Survey — Lived Experience Data
The One-Hour Standard — ED SCD Treatment in Arizona
The Arizona SC Crew — Youth Policy Training
The AZ L.E.A.P. Cohort — Adult Advocacy Training
Sickle Cell Care AZ — The Coalition Convening
Three bills. One coalition. One state.
Each of the eight plays can stand alone. None is fully powerful on its own. The wedge that turns SCFA from a competent state org into a national exemplar is the coalition layer on top of all eight — and the three bills that coalition will draft.
Implementation-ready when federal law passes
The federal SCD Comprehensive Care Act (S.721 / H.R.5178) was reintroduced in 2025 and remains in committee. When it passes, federal implementation funds will flow first to states that already have registries, Health Home designations, and ED standards in place. Texas, New York, Massachusetts, and California are positioning to grab the first wave. Arizona is not.
Sickle Cell Care AZ is how Arizona joins that list. Two years of coalition work positions SCFA as the natural state-level coordinating body when federal funds arrive. That is the durable strategic prize — not any single SCALE grant, but the seat at the table when federal money flows.
Why SCFA should convene rather than join
No other Arizona organization is positioned to convene this coalition. Banner is a health system with fiduciary duty. AHCCCS is a payer with procurement rules. Phoenix Children's is a hospital with pediatric scope. SCDAA is national without an AZ chapter footprint. SCFA is the only entity with statewide SCD focus, patient/family trust, technology infrastructure, and an established nonprofit operating posture.
Sequencing matters.
Each play builds funding credibility, partner relationships, or data assets needed for the next one. The dependency graph: Map → Survey → Coalition → Registry Bill → Health Home → ED Standard → Youth + Adult Training. Sequencing out of order creates funder-conversation potholes.
No single funder above 30% of SCD revenue.
Portfolio approach: this table maps each play to a primary funder, two backup funders, and an indicative cycle timing window. Funder rotation is essential — do not stack two plays on the same funder in the same year.
| Play | Tier 1 Funder | Tier 2 Funder | Tier 3 Funder | Cycle Timing |
|---|---|---|---|---|
| Play 1 — AZ SCD Registry | HRSA SCD Treatment Demo | AZ DHS | RWJF State Health & Value | HRSA: annual NOFO; AzDHS: rolling |
| Play 2 — Access Desert Map | Vertex Patient Advocacy | BMS Foundation | Flinn Foundation | Vertex: rolling; Flinn: spring |
| Play 3 — Medicaid Health Home | BMS Foundation | HRSA SCD Treatment Demo | Mercy Care community fund | HRSA: annual; Mercy: quarterly |
| Play 4 — AZ CARE Survey | RWJF | Vitalyst Health Foundation | Health Forward Foundation | RWJF: rolling LOIs; Vitalyst: fall |
| Play 5 — One-Hour Initiative | Pfizer SCALE 2026 | BMS Foundation | Emergency Medicine Foundation | Pfizer SCALE: Q1 2027 anticipated |
| Play 6 — AZ SC Crew Youth | California Endowment | Vertex Patient Advocacy | W.K. Kellogg Foundation | CA Endowment: open RFPs; Kellogg: annual |
| Play 7 — AZ L.E.A.P. Adult | Sickle Cell Consortium sub-award | Vertex | AZ Community Foundation | Consortium: Y2 TBD; AZCF: spring |
| Play 8 — Coalition Convening | RWJF State Health & Value | Helios Education Foundation | Virginia G. Piper Charitable Trust | RWJF: rolling; Piper: spring |
Pfizer remains the headline funder for SCALE 2026 — but the map assumes a portfolio approach with no single funder above 30% of SCD-restricted revenue.
HRSA SCD Treatment Demo is the largest federal funder; pursue aggressively for Plays 1 & 3. Annual NOFO typically opens late spring.
AZ-only funders (Flinn, Vitalyst, AZ Community Foundation, Helios, Piper) fund AZ-specific work national funders deprioritize. Build relationships with a program officer at each before submitting an LOI.
Industry funders (Vertex, BMS, Pfizer) move on rolling cycles and respond well to LOIs. Build the LOI bank now.
Five moves. Under four hours each.
The hardest part of this gameplan is the first 30 days. Each of these is a flag in the ground that the gameplan is in motion.
The 8 awardees weren't chosen for size. They were chosen for clarity.
The eight 2025 SCALE awardees were not chosen because they are larger than SCFA. They were chosen because they framed their work around a clear policy thesis, picked a defensible state-level audience, and showed up with named partners. SCFA can match all three.
Three things to match
1. A clear policy thesis. Ours: Arizona has no SCD-specific state legislation. We can be the first state coalition to draft model legislation that is implementation-ready for the federal SCD Comprehensive Care Act.
2. A defensible state-level audience. Ours: ~900 modeled Arizonans with SCD, concentrated in Phoenix and Tucson, served by zero NASCC Centers of Excellence, in a state that runs Medicaid (AHCCCS) at scale.
3. Named partners. Ours: Banner Health (existing nurse training contract), Phoenix Children's, U of A Center for Rural Health, AHCCCS, SCDAA, and 12 other named organizations across the eight plays.
The next twelve months
The next twelve months are about doing this visibly and consistently — through the 360° SCD Hub, through Coach Lucy's convening voice, and through Dr. Rob's clinical credibility, until Arizona is the obvious next state to win.
That is how we win. Not by applying to SCALE 2026 cold, but by spending the next twelve months making SCFA the obvious choice for Pfizer — while simultaneously stacking matching funding from HRSA, AzDHS, Vertex, BMS, RWJF, and Flinn.