Feb 28, 2013 (CIDRAP News) – Public health and food safety agencies are among the many sectors bracing for the impact of automatic budget cuts slated to kick in tomorrow, but there is much uncertainty about when and how the cuts will be felt.
A budget deal to hold off "sequestration" cuts appears next to impossible before the Mar 1 deadline, and yesterday the White House Office of Management and Budget (OMB) sent a memo to departments and agencies outlining their responsibilities in implementing the measure.
The cuts were part of a bipartisan deal passed in August 2011 to raise the national debt limit and are aimed at cutting $1.1 trillion from defense and discretionary spending over the next decade. Sequestration would amount to $85 billion in cuts over the last 7 months of the current fiscal year, which works out to about a 9% reduction for nondefense programs, according to the OMB.
Over the past weeks and months the White House, health groups, and federal agencies have outlined the possible impacts on public health and preparedness. For example, in July Sen. Tom Harkin, D-Ia., issued a report detailing the potential impact on nondefense jobs and services, which broke down the possible cuts in Public Health Emergency Preparedness (PHEP) grant funding for each state.
PHEP cooperative agreements, administered by the Centers for Disease Control and Prevention (CDC), enable states and four major metropolitan areas to improve their ability to respond to public health threats, such as pandemic flu, foodborne illness outbreaks, and bioterror events.
A report from the American Public Health Association (APHA) on possible sequestration effects on the CDC said the reductions would reduce lab and disease detection capacity. "The nation will be slower to detect and respond to new infections such as SARS and H1N1 when they emerge," the APHA said.
Sequestration would also shutter 12 of 20 domestic quarantine stations and shut down ArboNet, a key program that monitors pathogens in humans, mosquitoes, and wildlife, the APHA projected.
A recent White House memo on the possible effect of the cuts warned that Food and Drug Administration may have to reduce its food facility inspections by up to 2,100, which could pose a food safety risk and hurt food producers.
Also, Agriculture Secretary Tom Vilsack has said the cuts may force the Department of Agriculture to furlough meat and poultry inspectors for 2 weeks. Since meat and poultry plants producing for interstate commerce can't legally operate without federal inspectors present, that raises the specter of possible meat shortages.
Richard Hamburg, deputy director of the Trust for America's Health, a nonpartisan advocacy group,told CIDRAP News that though it's difficult to predict how quickly public health activities will feel the impact, in general programs and staffing within the federal government will feel the cuts more quickly. In contrast, extramural programs operate on a grant cycle that may temporarily blunt the effect of the cuts. "The money is already out there, and I don't see them (the federal government) taking it back," he said.
For some agencies, such a delay in the burden might provide time for lawmakers to negotiate a short- or long-term budget solution, he said. "It's the indecision that's the biggest negative. In the public health community, you can't hang your hat on a 'maybe'," he added.
A troubling issue for public health is that it has already been hit by significant decreases, he said, noting that recent numbers show a 38% drop in public health preparedness funding from the high-water mark in fiscal year 2005. "This is a major additional burden that's already been identified by us and others."
Federal agencies that have a role in public health will try to protect their missions, but will find it difficult to hire new personnel and will have to keep a sharp eye on new obligations, Hamburg said.
Health organizations and agencies have done a great job highlighting the possible effects of the cuts, he said, adding that sequestration cuts would move agencies back to funding levels seen in the 1990s. Public health threats are increasing at a time when funding is dropping, Hamburg said. "That's not a good mix."
Jul 27 CIDRAP News story "Senator says automatic cuts would hurt preparedness grants"
APHA report on possible sequestration impacts on CDC programs
Feb 8 White House sequestration memo
Sep 2012 ASTHO report on potential sequestration cuts
Feb 27 OMB memo to federal agencies