The AAP is reaching out to Congress to relay concerns from its chapters that $12 billion in cuts to public health funding will harm children in their states.
“As measles spreads rapidly across more and more states, pulling back needed resources feels not only woefully short-sighted, but dangerous,” AAP President Susan J. Kressly, M.D., FAAP, said in a letter to members.
Congress appropriated the money during the COVID-19 pandemic to support efforts to combat the pandemic and meet a wide range of public health needs, including a variety of immunization initiatives. Last week, the U.S. Department of Health and Human Services (HHS) abruptly notified state and local health departments that those funds and grants for mental health and substance use initiatives had been cut, citing the end of the pandemic. Twenty-three states and Washington, D.C., filed a lawsuit Tuesday saying the move is illegal.
“The result of these massive, unexpected funding terminations is serious harm to public health, leaving Plaintiff States at greater risk for future pandemics and the spread of otherwise preventable disease and cutting off vital public health services,” the lawsuit states.
AAP chapters that received federal funds via state contracts are wondering what will happen to their funding. The AAP Pennsylvania Chapter is awaiting word on the status of a $3 million grant for work it does in partnership with the Pennsylvania Immunization Coalition. This is the fourth year it has received that amount. About $2 million goes to community-based partners providing education about vaccines in schools, churches and community centers, and the remaining $1 million supports the work of the chapter staff.
As of Wednesday morning, the chapter had not received a work stoppage order and was awaiting further information.
“As we have been building momentum over these last four years, of course hearing about these (potential) cuts is pretty devastating,” said Pennsylvania Chapter Executive Director Annette Myarick.
The commonwealth stands to lose half a billion in funding, according to the lawsuit. The cuts come as several cases of measles have been reported, and kindergarten vaccination rates have been dropping while exemptions rise.
“When we need … to be continuing these efforts to try to change that pattern, it’s a critical time to be losing this funding,” Myarick said.
While the New Mexico Pediatric Society doesn’t receive federal funding, Executive Director Carmen Meyer, R.N., B.S.N., is concerned about what the cuts to state and local health departments will mean for the children in her state. About 71% are insured through Medicaid or the Children’s Health Insurance Program, the highest rate of any state, according to an AAP analysis.
“Having been a nurse in the state of New Mexico for almost 30 years, there is no doubt it’s going to hurt New Mexico because we have a shortage of providers as it is (and) we are a state of poverty,” Meyer said. “... We have all these cuts to grants that fund a lot of health programs and social net programs for individuals. We don’t have room to spare for this.”
The state of Illinois says it lost $125 million in promised public health funding and that federal officials are blocking $324 million for future work on infectious diseases. The cuts include a $15,000 grant to the AAP Illinois Chapter for immunization outreach in Cook County.
Illinois Chapter CEO Jennie Pinkwater, M.N.M., said she is concerned about cuts to community health workers who were key in helping to increase vaccination during a measles outbreak last year.
Having community-based people on the ground who can answer questions, relieve fears and combat disinformation about vaccines is important, she said. “So … we’re just going to see more erosion around the uptake of the vaccination.”
About 85% of the chapter’s budget comes from federal grants via state contracts. Pinkwater said it is difficult to get funding from private foundations as there is a great need.
If its contracts with the state are rescinded, the chapter will continue to focus on member services but will need to stop programs like vaccine campaigns and creating educational materials. In the meantime, the chapter is fulfilling its existing contracts.
“Everyone is operating like this is what we know now,” Pinkwater said. “But we also know that the other shoe could drop at any given time.”
In addition to the funding cuts, HHS laid off thousands of employees, including pediatricians, this week.
“When coupled with executive orders and other administrative actions, these cuts hinder core aspects of our work beyond infectious diseases, including preventing injuries, taking care of children with disabilities, overcoming child health disparities and protecting the relationship between physicians and families,” Dr. Kressly said.
She is calling on pediatricians to counter misinformation on vaccines and to contact their members of Congress about the impact of funding cuts, layoffs and the potential for billions in cuts to Medicaid.
“Every day we show up as pediatricians is a better day for kids,” she said. “Even when, and especially when, it’s hard.”
