Texas public health departments brace for another $119 million in federal cuts

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Texas officials have notified local public health departments to brace for another $119 million in federal cuts at the end of the month that could impact the state’s disease detection and prevention efforts, including for HIV, diabetes, vaccine outreach and emergency preparedness.

The news comes three months after the federal government notified Texas officials it was prematurely clawing back $700 million in unspent COVID pandemic funding, some of which was used to fight the spread of measles in West Texas.

With the state’s regular biennial legislative session ending less than two weeks ago, the Texas Department of State Health Services has lost its opportunity to ask the state for more money. Lawmakers left Austin increasing state funds to the agency by $86 million over the next two years, but it also expects to lose $685 million in federal funds due largely to the end of the COVID funds.

Imelda Garcia, chief deputy commissioner for the state health agency, made the disclosure on the latest potential cuts at the agency’s committee on public health funding and policy on Wednesday.

“We have staff checking the federal grant solution system every day, multiple times a day. We've made phone calls to our federal partners. However, we still don't have any additional information at this time,” Garcia said.

Expiring at the end of June, the $119 million involves Centers for Disease Control and Prevention grants that trickle down to local public health departments. Among the potentially hardest hit would be:

• $28 million to increase vaccine coverage.
• $36.4 million to prepare local communities for infectious diseases, natural disasters, man-made events and other public health threats.
• $20 million to help with hospital preparedness during emergency disasters.
• $25.5 million for HIV prevention.

Other programs facing cuts include those to address diabetes, cardiovascular disease, tuberculosis, tobacco use, wastewater testing and some public health-related school funding.

Garcia stressed that while none of the $119 million has been formally cut, Texas health officials have not yet received word that the funding would be renewed.

“I wanted to put them on your radar in case there are additional delays that we may see in the coming weeks,” she said.

On May 30, Garcia notified health departments to pause HIV prevention and testing spending because the federal government hadn’t notified the state that it will be renewing funding for those services.

Local public health departments were also told this week at the meeting that there could be more cuts by the end of the year. This comes as Texas ranks among the worst in the country for public health funding.

“In a post-covid COVID world, in a world where we've got this measles outbreak and … you're cutting immunizations, I mean, this just does not make any sense,” Dr. Philip Huang, director of the Dallas County Health and Human Services and the committee’s vice chair.

He said the cuts ran counter to the messaging from U.S. Health Secretary Robert F. Kennedy who has emphasized the federal agency should be focused on reducing the impact of chronic disease.

“You say your priorities are chronic disease, and you eliminate the whole Office on Smoking and Health and the FDA tobacco control program,” Huang said. “This doesn't make sense at all.”

When the federal government abruptly cut off $700 million that the state had up until next year to spend, both state and local public health departments laid off employees. In May, the agency offered 63 employees transfers to other divisions and 32 employees were terminated. Of those laid off, 19 were fellows whose tenure ended a week early. Huang noted that he had to lay off more than 20 employees.

Amy Yeager, director of the Bell County Public Health District, noted that the day after she had to temporarily close the district’s health clinic in Temple, the city reported its first measles case involving an unvaccinated man.

Texas has been at the center of a historic measles outbreak that has infected close to 750 people statewide and even more across state and international borders. Two children have died and although the number of new cases have decreased in recent weeks, the state can’t consider the outbreak over until there are 42 days without a new infection.

Huang asked Garcia if the CDC could provide any leeway, perhaps, in light of the fact that Texas has been spending so many resources battling the measles outbreak.

“I think they're sympathetic, but there's so much going on," Garcia said. "CDC doesn't have a full time director as yet, so they are just having difficulty getting decisions made, is what we have heard."

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