Health departments across the United States are facing significant disruptions due to unexpected delays in funding from the Centers for Disease Control and Prevention (CDC).
These delays have raised serious concerns since many local health departments depend heavily on CDC funding to support their public health initiatives.
Traditionally, the CDC allocates most of its budget received from Congress to state and local health departments, which in turn collaborate with local organizations to manage public health programs.
However, according to two CDC staff members familiar with the agency’s budget, the complete allocation for the fiscal year 2025 has yet to be received.
As a result, the CDC has been operating on a system of distributing funds in 30-day increments, a process described by one staff member as “rescission by inertia.”
The Department of Health and Human Services (HHS) has not provided any comments regarding the funding delay or the characterization from CDC staff.
Many state health departments find themselves in a particularly precarious position, reliant on federal grants for their overall funding.
Dr. Scott Harris, who oversees Alabama’s health department and serves as president of the Association of State and Territorial Health Officials, noted that Alabama receives over two-thirds of its funding from federal sources, predominantly the CDC.
“Nothing really can happen if we don’t know that we’re going to get the money — if there’s no notice of award,” he emphasized.
This year, lack of timely notices of award has caused considerable anxiety among health departments. For instance, Dr. Harris mentioned a cardiovascular grant set to expire by the end of the month.
Without a new notice of award, Alabama’s health department faces uncertainty about undertaking any new costs related to the program.
Similar concerns echo across states with many local health departments experiencing similar funding issues.
In Ohio, the delay meant that the state had to halt its HIV hotline and suspend the distribution of free test-at-home kits due to the expiration of related grants in May.
The San Antonio AIDS Foundation also had to pause its testing services for the same reasons. In Charlotte, North Carolina, these funding delays resulted in job losses at the local health department, as noted by Mecklenburg County Health Commissioner Raynard Washington.
Washington indicated that the majority of the six staff members laid off in June were disease investigation specialists — crucial contact tracers for HIV, syphilis, and other sexually transmitted infections.
As a result, the workload on existing staff has increased significantly, leading to fears about effectively managing potential exposure cases.
Dr. Philip Huang, director of Dallas County Health and Human Services in Texas, stated his department had also been alerted by the state health department that immunization and emergency preparedness grants might be at risk.
Due to the funding uncertainty, many critical programs which rely on these grants could pause operations, affecting around 60 staff members.
Washington further pointed out that North Carolina had yet to receive its new notice of award for the breast and cervical cancer screening program, just adding to the list of uncertainties facing local health departments.
In March, President Donald Trump signed a continuing resolution for fiscal year 2025, designating $9 billion for the CDC.
After a budget is passed and signed, there is typically a 45 to 60 day lag before funds become available.
However, as one CDC senior leader clarified, this year has seen an unprecedented delay in communication regarding funding allocation.
“It’s just been month after month where we receive funding only in 30-day increments,” the staffer explained, emphasizing the frustration of not knowing when full funding would be awarded.
Without these essential funds, the CDC is unable to send notices of awards crucial for state and local departments to continue their operations.
The CDC staffers shared that the protracted process leaves little time to allocate the agency’s funds effectively before the end of the fiscal year in September.
With the money trickling in slowly, there’s a pressing concern that projects may be abandoned altogether if funding doesn’t arrive promptly.
The staff indicated that this system of distributing the budget amounts to impounding funding and has led them to suspect that it might be a strategic move to stall the agency’s efforts.
Currently, state health departments have begun receiving some of the long-awaited funds for the End the HIV Epidemic grants that lapsed in May.
Washington received news that those funds were finally awarded, but concerns linger about the timing and efficacy of bringing laid-off staff back to work.
He expressed concern about the time lost due to administrative delays, emphasizing that the lack of timely information complicates plans and operations.
Dr. Harris echoed this sentiment, stressing that without funding, initiatives for tobacco prevention, diabetes work, public health preparedness, and more cannot continue.
In summary, the cascading effects of CDC funding delays create an urgent crisis for public health departments nationwide, as they grapple with preserving essential services amidst a backdrop of uncertainty.
image source from：npr
