Health departments nationwide are facing a troubling issue with funding from the Centers for Disease Control and Prevention (CDC), as many have noticed that financial support is arriving later than expected, with little to no communication about the reasons behind the delays.
The CDC typically distributes most of its federal funding to state and local health departments, which then collaborate with local organizations to implement public health initiatives. However, according to two CDC insiders, the agency hasn’t yet received its complete budget for the 2025 fiscal year. These staffers, who requested anonymity, revealed that funding has become months overdue.
Without timely funding, the CDC is running on just 30-day funding increments, effectively stalling its grant distributions. One staff member termed the situation “rescission by inertia,” indicating a significant bureaucratic bottleneck.
The Department of Health and Human Services (HHS) has not responded to inquiries regarding this situation.
A shift in the funding process
Dr. Scott Harris, who oversees Alabama’s health department, pointed out that most state departments rely heavily on federal grants for their funding, sometimes accounting for over two-thirds of their budget. Harris noted that without prior notice of funding awards, it’s nearly impossible to make plans.
For instance, one of Alabama’s cardiovascular grants is set to expire shortly, yet there’s been no funding notice, making it risky to incur expenses. Harris mentioned similar concerns from other states experiencing unexpected funding delays.
In Ohio, delays in HIV funding resulted in the abrupt cessation of vital services, such as a hotline and HIV testing. North Carolina’s Mecklenburg County Health Commissioner reported job losses in the health department due to funding interruptions.
Dr. Philip Huang from Dallas County echoed the concerns, indicating that their health department has been alerted about potential halts to immunization and emergency preparedness activities pending funding resolutions.
The CDC’s constrained funding manager
This year, President Trump’s signing of the continuing resolution for fiscal year 2025 included a budget allocation of $9 billion for the CDC. However, staffers explain that delays typically follow the president’s approval due to an apportionment process, which can take 45 to 60 days. During this period, the CDC can only access funding in 30-day increments.
As time passes without any updates, staffers have grown increasingly frustrated, asking repeatedly about the whereabouts of the expected funding.
Month by month, this piecemeal funding approach feels like receiving support “with an eyedropper,” limiting the CDC’s ability to distribute funds effectively to local health departments reliant on them.
Unless the funding issues are resolved soon, there’s a real risk that unspent funds would simply revert to the Treasury.
Current uncertainty for HIV funds
This past week, state health departments finally received notification that the HIV program grants that had expired in May are now being awarded. However, there was still no clarity regarding the reasons for the initial delays. Health officials now face the challenge of reinstating laid-off staff, if possible, while grappling with ongoing uncertainties about future grant renewals.
Overall, both Harris and Washington underscore the critical need for reliable funding to maintain effective public health initiatives. Without it, the impact could be significant, putting many public health efforts at risk.
