After the devastating path COVID tore through nursing homes, many experts pushed to have long-term care facilities better integrated into local public health networks.
States had been making progress on that call, instituting new infection prevention initiatives and outbreak monitoring that often included skilled nursing facilities and sought to prepare them for future outbreaks. Many of those efforts were supported by grants awarded by the federal government — grants that were to infuse state and local health departments with $11.4 billion this fiscal year.
But the Department of Health and Human Services last week announced it was clawing them back, stripping away counted-on resources in a move some state officials and other observers called illegal.
Leaders at the Centers for Disease Prevention and Control said the funds were largely being used for COVID testing, vaccination, community health workers and initiatives to address health disparities in underserved and rural populations.
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” HHS said in a statement.
But states, hit with drastic cuts out of the blue, said Congress intended money to support local public health infrastructure and the cuts will bring to an end programs including nursing home infectious disease surveillance, tracking of healthcare staff shortages and even local responses to a historic measles outbreak.
States’ losses
Connecticut Gov. Ned Lamont (D) said his state was being stripped of more than $150 million allocated for essential public health, mental health and addiction services, such as disease outbreak surveillance, newborn screenings, immunizations, and virus and pathogen testing.
That state’s Department of Public Health had been using the funds to track staffing shortages and how they could affect response to outbreaks in nursing homes and other settings, providing data and recommendations to healthcare providers and the public on disease spread in their communities. That program will end, as well as tracking of emergency department trends that helped officials alert providers and partners to capacity or other emergencies.
Illinois officials said that $125 million was being rescinded from the state and 97 local health departments. The funding had been intended for technology to track the spread of diseases, wastewater surveillance and strengthening local health departments.
“If allowed to stand, this funding cut will set back critical upgrades to our public health labs, technology used to track infectious diseases like H5N1 avian flu and measles, vaccination efforts, and our ongoing work to better prepare for the next public health emergency,” Sameer Vohra, MD, director of the state’s health department, said in a news release.
Collateral damage
The cutbacks come as the federal government is moving forward with plans to shed its own public health apparatus, casting off 20,000 workers from HHS and killing entire agencies or divisions.
That ostensibly means state health officials may have to pick up much of the slack in providing protections and services the public has become accustomed to, and may need in the face of increasing infectious disease outbreaks.
Stripping away pre-awarded funds, much of it coming through the CARES Act, also puts health departments in a financial hole as states anticipate shrinking federal revenues more generally.
“To abruptly remove $80 million from the very [state] agency that funds Medicaid can only inflict collateral damage on long-term care, as … the loss will have to be made up for,” Brendan Williams, president and CEO of The New Hampshire Health Care Association, told McKnight’s Long-Term Care News.
“I don’t think the state can simply altogether cease performing the functions the $80 million would have helped subsidize. For that reason, I fear that scarce healthcare resources will have to be reallocated to make up some, if not all, of the difference, and that can only hurt long-term care.”