In Philly region, chaos over cuts to federal health grants closes an addiction care center and threatens vaccine clinics

A Manayunk addiction recovery organization, decimated by layoffs, is turning away clients seeking help at a neighborhood drop-in center.

At a disability rights nonprofit, research on how to make medical equipment like MRIs more accessible is imperiled.

Public health departments around the region are scrambling to find new ways to pay for efforts to get vaccines to residents and to slow the spread of infectious diseases.

Philadelphia-area health organizations say they’re navigating a chaotic, uncertain environment with few answers in the wake of President Donald Trump’s attempts to cut more than $11 billion in federal public health grants — with more than half a billion dollars at stake in Pennsylvania.

The grants on the chopping block, distributed among government health agencies and hundreds of nonprofits around Pennsylvania, were appropriated by Congress during the COVID-19 pandemic. The funding supported a wide range of programs meant not only to address the pandemic, but to improve states’ public health responses for future health threats, as well as mental health and addiction treatment.

“Watching these funding cuts is like watching a slow-motion death sentence for our residents,” said Neil Makhija, the chair of the Montgomery County Board of Commissioners.

The Inquirer traced public records on the terminated state grants, for which the federal government has provided little detail, to identify hundreds of smaller projects funded, and spoke to nonprofits and local health agencies affected to better understand the impact of the potential cuts.

The U.S. Department of Health and Human Services, which distributed the grants, said in a statement when it announced the cuts last month that the government “will no longer waste billions of taxpayer dollars responding to a nonexistent pandemic that Americans moved on from years ago.”

A federal judge temporarily halted the cuts for two weeks after Gov. Josh Shapiro sued along with 22 other states and the District of Columbia, contending the surprise cuts violated federal funding laws. A hearing in the case is set for Thursday.

Data published by HHS indicated that 43 grants in Pennsylvania and New Jersey, which listed $634 million in unpaid funding, were under threat.

By Monday, a list of grants set to be terminated in Pennsylvania — seemingly those cuts paused by the court order — had been removed from HHS’s website, although they were still listed on the website for the Department of Government Efficiency. HHS did not respond to a request to clarify the funding status.

Because of the court order granted in the case, funds that were set to be terminated “continue to flow to Pennsylvania,” a spokesperson for the state health department said in an email, adding that the agency “continues to perform work under these grants.”

At the Department of Health alone, three grants slated for termination represented a loss of more than $495 million in funding not yet paid out, imperiling the work of 150 state employees and contractors.

Some Philadelphia-area organizations that received grants slated for termination had already spent the bulk of the award. Other grants were set to end soon. The court’s temporary pause on the cuts is now giving some local organizations that lost grant dollars time to seek alternative funding sources.

But others say they were forced to make difficult decisions to cut services and personnel with almost no notice.

In Manayunk, a drop-in center for people struggling with addiction has already closed. Its operator, Unity Recovery, an addiction recovery nonprofit with offices in Philadelphia, Pittsburgh, and Texas, lost $1.5 million in grant funding that helps pay for recovery specialists and street outreach.

The organization laid off 23 people among their Pittsburgh and Philadelphia offices on April 1, the day they were notified of the cuts. Robert Ashford, Unity’s executive director, said the organization relies heavily on federal funding and could not afford to keep staff on longer.

And though the temporary restraining order extended the organization’s funding for a few days, they’re unsure what more they will receive, Ashford said.

“We still exist, but we’re severely impacted, and our capacity has been ripped out overnight,” Ashford said.

Unity’s grants were slated to expire at the end of June, and Ashford expected another series of federal grants to start in July. He said he hopes to rehire staff then. But given the uncertainty in Washington, widespread funding and personnel cuts at federal health agencies, and a Republican budget proposal that’s heavy on tax cuts, he is no longer sure that future funding will arrive.

“The people we serve don’t have anywhere else to go,” Ashford said. “And we expect it to get worse again, with people sleeping on the streets. A community organization like us is often the last provider of choice. We’re the last stop on the road. Where do you send people when that gets cut?”

Pennsylvania and county health offices use the COVID-19 funding for a number of initiatives, from distributing air purifiers to schools and daycares to nursing home improvements that will better protect residents particularly vulnerable to infectious disease.

For the last several weeks, the federal Department of Health and Human services listed more than $41 million in terminated grants to the Philadelphia Health Department. Those grants were among those removed from HHS’ list of terminated grants on Friday.

City officials said they were monitoring potential cuts but declined further comment.

In Montgomery County, a county spokesperson said $28 million in HHS grants are “at risk,” including $1.4 million in annual funding to track infectious diseases and $1.3 million to pay for counseling and treatment for people with addiction. This funding was tied to grants initially on the HHS termination list, then removed.

Elected officials in Montgomery and Chester Counties said they were working to determine how to fund vaccine clinics and investigate disease outbreaks without federal dollars — an essential task, they said, as avian flu spreads and the U.S. sees a resurgence of measles.

“We are doing everything we can to reclassify funds to support the work, but that’s not going to last forever,” said Montgomery County’s Makhija.

Chester County, which could lose $14.5 million, is struggling with the Trump administration’s decision to end a grant funding to respond to the threat of infectious diseases 15 months earlier than anticipated and grants for vaccines three months earlier than expected, said Jeanne Franklin, the county’s public health director.

“There’s a choice: Either fund these investigations or you get a measles outbreak. Which do you want? You either fund vaccines or you get a measles outbreak. Which do you want?” she said. “We’re in several outbreaks, and our funding is being threatened.”

While the county had already begun planning to transition away from these federal funding sources, Franklin said, those plans cannot be implemented on a moment’s notice in a budget year that didn’t take sudden funding cuts into account. “It’s the abruptness with no warning,” she said.

The county is looking at ways to fund these activities without federal dollars, and may have to scale back its work if the cuts go through.

Franklin called the cuts a warning: “This is the call for health departments to step out and play out the ‘what ifs’ for any other federally funded programs, regardless of whether they’re COVID-related or not,” she said.

In Delaware County, around $1.6 million in grants supporting vaccine distribution and infectious disease mitigation was targeted for cuts. A spokesperson said the county is looking for options to reduce costs without staff cuts and exploring alternative funding.

A spokesperson for Bucks County said they did not anticipate any immediate impact on this year’s health department programming.

In South Jersey, Gloucester and Camden Counties were reeling from terminated grants affecting programs including food inspection and disease tracking efforts. Despite the court injunction, a state association representing local governments was working to close out grants, saying it had received no indication that funding would continue.

The Arc of Pennsylvania, which advocates for the rights of Pennsylvanians with disabilities, had received a grant to research access to health care for people with disabilities and to form a statewide Disabled Health Action Network to better connect community groups, advocacy organizations, and government officials.

The organization had yet to spend $360,000 through the grant, set to expire in June, said Sherri Landis, the Arc’s executive director. Losing those funds will mostly impact its research studying how to make diagnostic equipment like MRIs more accessible to people with disabilities.

The Arc is also conducting a statewide survey of emergency-management organizations to assess how prepared they are to help people with disabilities during pandemics and natural disasters.

“The work stops until we figure out other funding,” Landis said.

The Arc will likely have to tap its reserve funds to pay contractors and is considering cutting the hours of two staffers if the cuts go through, she said. “We’re a nonprofit, and we’re not swimming in millions and millions of dollars of reserves. It will have an impact.”

The Maternal Care Coalition, a Philadelphia-based nonprofit, stands to lose $40,000 to $50,000. The grant funding supported five staffers’ salaries and its program that has helped more than 100 mothers with substance-use disorders access treatment and navigate family life.

“It’s a really delicate time, and any amount of money that is no longer available does crunch things,” said Samia Bristow, the coalition’s vice president for programs. “It adds another layer of stress.”

“But we’re constantly looking at what other funding opportunities are available,” she added, ”because we have to keep things moving forward — our communities need us and families depend on us.”

Staff data reporter Lizzie Mulvey contributed reporting.