Local public health departments have begun laying off health experts and pausing vital contract work following federal funding cuts. But the state鈥檚 top public health official said she is playing 鈥渟trategic defense鈥� to find ways to extend key programs.
Dr. Manisha Juthani, commissioner of the state Department of Public Health, said her agency is in limbo as the federal government and courts continue to go back and forth on funding cuts.
Federal officials in March terminated $150 million in COVID 19-related grants allocated to 海角换妻. But a court quickly issued a temporary restraining order on those cuts and told local health departments they would have more clarity about the fate of the funding by April 17.
鈥淎nd then last week, we got another notification that the judge was still looking into what the final outcome would be,鈥� Juthani said.
Those cuts paused two programs 鈥� immunization outreach efforts and an expansion in laboratory capacity statewide, work well beyond COVID, Juthani said.
But she said the department managed to find an opportunity in the uncertainty.
鈥淭hat is the type of strategic thinking that we鈥檝e been doing in real time with every action that we see coming from the courts,鈥� she said. 鈥淪o one of the things we were able to do was ensure that we got syndromic surveillance locked in for at least another year.鈥�
That means for the next year at least, if people show up at the emergency department with 鈥� say a fever and a rash, which are symptoms of the measles 鈥� Juthani said public health officials in 海角换妻 would not be blindsided.
Currently, there are over 800 confirmed cases of measles in the U.S., with two children in Texas dying from the infectious disease.
While measles is yet to be reported in 海角换妻, Juthani said that without surveillance measures in place, 海角换妻 and the rest of the U.S. will see a rise in morbidity and mortality from infectious diseases.
鈥淚 am concerned that this year, 25 years after we eliminated measles in the United States in the year 2000 鈥� which means that you did not have sustained transmission over 12 months 鈥� I am concerned that we are going to lose our elimination status,鈥� Juthani said. 鈥淭here's a reason we give MMR vaccines to children. It is because we're preventing something that can be deadly in children.鈥�
Local health departments already feeling impact from federal cuts
In the short term, Juthani said her department is focused on easing the way forward for local health departments.
鈥淲hen we heard of the temporary restraining order, we said you can continue to submit bills to us up to this date,鈥� she said. 鈥淏ut as a local health department, if you don't know you have confirmed funding from us that is going to be able to withstand the test of time, they may have had to make decisions, including laying people off.鈥�
Jody Bishop-Pullman, director of health for the city of Stamford, said the federal cuts have already forced her department to eliminate employees working in contact tracing and immunizations, as well as terminate vaccination outreach-related contract work.
鈥淭he school system is registering students, and those students need to be up to date with their physicals and immunizations,鈥� Bishop-Pullman said. 鈥淎nd it鈥檚 important that we need to provide access.鈥�
Nearly 98% of children entering kindergarten in 海角换妻 are vaccinated against measles, mumps and rubella. But Bishop-Pullman said Stamford, like any big city, still has undervaccinated communities that benefit from vaccine outreach and expanded hours to get shots.
Other local public health departments 鈥� like East Shore District in Branford 鈥� are bracing for additional layoffs.
鈥淲e received notice that the immunization money was coming to us and so we spent all that money, and we鈥檙e being told that the nearly $100,000, we鈥檙e not going to be receiving now,鈥� said Michael Pascucilla, the department鈥檚 director.
The district laid off its harm reduction community outreach specialist due to the federal cutbacks. But Pascucilla is also worried about state reductions to public health spending, including a 10% cut of the per capita funding to local health departments and districts that was part of Gov. Ned Lamont鈥檚 budget proposal.
鈥淭he only reduction from baseline in the Governor鈥檚 proposed budget for the Department of Public Health comes from payments to local health departments,鈥� Pascucilla said. 鈥淭he cut represents only 0.5% of the overall DPH budget but may be crippling to many local health departments.鈥�
Tools 鈥榯aken away鈥� for local health workers
Already the federal cuts are impacting work in environmental health investigations, mosquito-and-vector-borne disease prevention and foodborne illnesses, local health officials said.
The cuts have also undercut efforts to keep swimming areas safe at local lakes and beaches. And work to boost maternal child health, reduce overdose-related fatalities and bolster infectious disease monitoring was also impacted, Pascucilla said.
Juthani meanwhile continues to look for one-time investments that can be made 鈥渄uring this holding pattern [to] ensure more longitudinal safety for residents of 海角换妻,鈥� she said.
鈥淲e're doing it, and we are working hard and fast to get things done through and paid for so that we can take advantage of the fact that the courts have said that this funding is still available to us right now, as of this moment. But every day is a new day.鈥�
A daughter of Indian immigrant physicians, Juthani said her parents taught her to approach medicine as a public service, and she viewed every resident in the state as her patient, deserving of attention and respect.
Now, doctors are relying on clinical instincts given the cuts to diagnostic tools.
鈥淗undred years ago, we didn't have certain tools to detect disease, to identify, to find patterns,鈥� she said. 鈥淣ow we have them, but they're being taken away from us.鈥�
