The Trump administration thrust state and local health departments into confusion Saturday, temporarily pausing a roughly $5 billion grant that funds workers involved in community outreach, emergency preparedness, and disease outbreaks.
Notices of an immediate pause in funding were sent to health departments in every state in emails dated Friday. State and local officials didn’t start receiving them until early Saturday, they said, sparking surprise and sending them scrambling to assess the impact.
By midday Saturday, a Department of Health and Human Services official who spoke on the condition of anonymity to share ongoing discussions said the pause had been lifted.
The official did not know whether notices have been sent informing state officials that the funding pause was no longer in effect. The pause had been in effect for 12 hours, the official said. People in touch with state and local officials said Saturday afternoon they had not been notified the pause had been reversed.
The notice and rapid turnabout regarding vital public health grants is the latest confusion for public health officials over major federal dollars. Earlier this month, the Trump administration said it was slashing hundreds of millions in federal grants supporting mental health and addiction care, but backtracked a day later after intense backlash from lawmakers in both parties and public health advocates.
Around midday Saturday, Emily Hilliard, an HHS spokeswoman, said the public health infrastructure grants “were temporarily paused so HHS could implement a new review process, one that will ensure funds are used for their intended purposes. HHS will continue to protect taxpayer money and ensure they are used for legitimate purposes.”
“Activities are paused until further notice,” according to screenshots of emails that were sent to health departments, according to a state health official who spoke on the condition of anonymity for fear of retaliation.
“The reason for the pause is to review and evaluate activities funded within this PHIG [Public Health Infrastructure Grant] award program to ensure alignment with administration and agency priorities,” the notice said.
The funds are part of a broad-ranging grant administered by the Centers for Disease Control and Prevention that provide what public health officials say is the bedrock support for public health, “it’s the everyday bread and butter,” the state official said.
“There was no heads-up,” said Chrissie Juliano, the executive director of the Big Cities Health Coalition.
Health Secretary Robert F. Kennedy Jr. has been deeply critical of the nation’s public health infrastructure and has purged thousands of federal workers during his tenure.
More than 100 health departments, as well as three national public health groups, receive funding through the public health infrastructure grant period that started in late 2022. As of late December, the health departments have received roughly $4.7 billion and the public health partners have received roughly $382 million, according to the CDC’s website. The annual appropriation for the funds is about $350 million and was nudged to $360 million in the most recent bill that just passed the House.
A CDC staff member familiar with the program said they did not receive any heads-up that the funding would be paused. The staff member said notices were received by all 50 states.
Public health officials said they were taken by surprise by the announcement, which came as state and local health departments are preparing for a major snowstorm expected to hit a major swath of the United States. State and local health departments rely on the funds to hire thousands of workers, including epidemiologists, biostatisticians, and emergency response personnel.
“It’s the infrastructure for the public health system,” said Georges Benjamin, the executive director of the American Public Health Association.
Local health departments have used the funds for a wide variety of activities, said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials.
In North Carolina, local health departments have used the money to help modernize data collection efforts to better identify public health threats early, she said. In Nebraska, local officials have put the funds toward promoting safe drinking water. In Colorado, local officials have used the dollars to help hire public health nurses. And in North Dakota local officials have tried to combat health disparities in rural populations, Casalotti said.
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