'Where's our money?' CDC grant funding is moving so slowly layoffs are happening

Protesters stitchery extracurricular nan Centers for Disease Control and Prevention successful Atlanta connected Wednesday, during a arguable vaccine advisory committee meeting. Elijah Nouvelage/Getty Images hide caption

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Elijah Nouvelage/Getty Images

Health departments astir nan state person noticed there's thing unusual happening pinch backing from nan Centers for Disease Control and Prevention: It's not showing up connected schedule and there's been nary connection astir why.

The national nationalist wellness agency doles retired most of nan money it receives from Congress to authorities and section wellness departments, which past statement pinch section organizations. That's really nationalist wellness activity gets funded successful nan U.S.

According to 2 CDC unit members pinch knowledge of nan agency's budget, nan CDC has yet to person its afloat backing for nan 2025 fiscal year. NPR agreed not to sanction nan unit members because they were not authorized to speak to nan media.

Both CDC staffers opportunity nan backing is now months late, and it will soon beryllium excessively precocious to disperse nan agency's grants that section wellness departments are waiting on. In nan interim, nan CDC has been operating pinch conscionable 30-days of backing astatine a time. The staffers opportunity this amounts to impounding nan agency's funding. One of them called it "rescission by inertia."

The Department of Health and Human Services did not reply NPR's questions for this communicative aliases respond to a petition for remark connected that characterization.

A large alteration from nan accustomed process

"Most authorities wellness departments get astir of their backing from nan feds — successful Alabama's case, we get much than 2 thirds of our backing from national grants, predominantly CDC," says Dr. Scott Harris, who runs Alabama's wellness section and is nan president of nan Association of State and Territorial Health Officials. "Less than 10% of our money comes from authorities dollars."

"Nothing really tin hap if we don't cognize that we're going to get nan money — if there's nary announcement of award," Harris explains.

This year, nan CDC's notices of grant are conscionable not arriving connected schedule. "For example, 1 of our cardiovascular grants expires astatine nan extremity of this month," he says "We don't person immoderate announcement of award, truthful it's really risky for america to incur a bunch of costs complete nan adjacent respective weeks doing activity successful this program, not knowing if we person nan expertise to get reimbursed."

Harris says he's heard from authorities wellness departments crossed nan state who are successful nan aforesaid business pinch CDC backing being mysteriously delayed.

Grants related to HIV prevention activity successful galore states expired astatine nan extremity of May pinch nary accusation astir early funding. In Ohio, that meant nan state's HIV hotline and nan transportation of free test-at-home-kits were abruptly halted. The San Antonio AIDS Foundation had to pause its testing services. And successful Charlotte, North Carolina, nan backing delays led to occupation losses astatine nan section wellness department, explains Mecklenburg County Health Commissioner Raynard Washington.

"The mostly of those six group that we sent location astatine nan opening of June were illness investigation master unit — interaction tracers for HIV, syphilis and different STIs," Washington says, referring to sexually transmitted infections.

"The consequence connected nan crushed is that our different unit that we person that do that activity person to return connected much workload, and past very often we extremity up getting behind," he says. Getting down could mean that group who person perchance been exposed to thing don't cognize it, he adds. "The eventual consequence is that they are besides past exposing different group and past nan concatenation conscionable continues from location to grow."

Funding for much grants will expire soon, says Dr. Philip Huang, head of Dallas County Health and Human Services successful Texas. Huang says nan authorities wellness section conscionable warned them that if they don't person notices of grant for immoderate immunization and emergency preparedness grants they would person to region nan activities funded by those grants.

"[That] is highly distressing to america because we person for illustration 60 unit connected those grants and important backing that are affected," he says.

Washington adds that North Carolina has not received a caller announcement of grant for nan breast and cervical crab screening program either.

The CDC is operating pinch an "eyedropper" monthly budget

In March, President Trump signed a continuing solution for fiscal twelvemonth 2025, which included $9 cardinal for nan CDC.

"Once [a budget] is passed and signed by nan president, location is ever a lag," explained 1 of nan CDC unit members who said to NPR who is simply a elder leader astatine nan agency. There's an "apportionment" process to springiness each agency its money, which usually takes betwixt 45 and 60 days.

During this period, to beryllium capable to make payroll and support up pinch regular bills, nan CDC is fixed money successful 30-day increments.

This year? "Forty-five days came and went. Sixty days came and went, much and much clip came and went — nary word, nary information," nan CDC elder leader explains. "We support asking — where's our money? Where's nan money that's been approved by Congress?"

Without a cookware of money to administer retired to various centers and divisions, nan CDC can't nonstop retired nan announcement of awards that authorities and section wellness departments request to beryllium capable to proceed their activity and cognize they will beryllium reimbursed for it.

Month aft period of backing successful 30-day increments is for illustration receiving money "with an eyedropper," nan elder leader adds.

HHS did not reply NPR's questions astir nan reasons for these backing delays astatine nan CDC by publication time.

The staffers astatine nan CDC opportunity they are moving retired of clip to beryllium capable to walk nan agency's 2025 costs earlier nan extremity of nan fiscal twelvemonth successful September because of each nan steps progressive successful getting backing retired nan door.

"The money conscionable doesn't travel from 1 relationship aliases nan different — group person to really do nan manual activity of connecting nan costs that are provided to nan existent accounts astatine nan due levels," nan different CDC staffer explains.

"If they tin hold until nan extremity of September, past that's it," nan staffer adds. "Those projects are not going to happen. That money goes consecutive backmost to Treasury."

That's why some CDC staffers who said pinch NPR opportunity this amounts to impounding nan agency's funding.

"At this point, it is perfectly our presumption that it is being done intentionally to grind america to a halt," nan elder leader says.

HHS did not respond to a petition for remark connected that characterization.

HIV costs showed up late, but uncertainty remains

This week, authorities wellness departments received connection that nan End nan HIV Epidemic grants that expired astatine nan extremity of May were yet being awarded.

There was nary mentation for nan delay, says Washington, nan wellness commissioner successful Charlotte, N.C.

"Now I person to spell fig retired if nan unit that we laid disconnected are consenting to travel backmost to work," he says. "If they're not willing, past we person to commencement hiring, person to train — we've mislaid months of activity because of administrative delays."

And nan delays continue, he says. There's been nary connection astir what mightiness hap pinch nan galore grants that expire connected Monday, arsenic June ends. "Throughout this experience, we've conscionable been told, 'We don't person immoderate answers,'" he says. "That's nan difficult portion erstwhile you're trying to plan."

Harris of Alabama agrees. "We person to get paid to do these things, whether it's baccy prevention aliases glucosuria activity aliases nationalist wellness preparedness aliases immoderate it is," he says. "We can't really do it without nan funding."