Council gets early look at public health cuts caused by federal funding losses

Austin Public Health leaders are working to manage an ongoing budget crisis caused by federal funding cuts that have destabilized programs across the city. City Council’s Public Health Committee heard last week that APH has already lost approximately $15 million in federal grants, with further reductions anticipated in the months ahead.

APH Director Adrienne Sturrup said up to $7.8 million more in federal grants could be lost, affecting services for disease surveillance, health equity training, youth development and refugee medical services. If those reductions materialize, another 57 positions could be affected, in addition to the 50 city jobs already impacted by earlier cuts.

Austin Public Health’s total budget for Fiscal Year 2025 is just over $131 million, with roughly $39 million tied to grant funding. Grants account for more than half of APH’s workforce, covering 328.5 full-time equivalent positions, according to department figures provided to the committee​.

Sturrup said programs supporting refugee health screenings, tobacco cessation targeting LGBTQIA+ residents, plus the city’s diabetes care initiative are among those disrupted. The refugee clinic alone faces a $5 million funding gap that affected 13 full-time positions and more than 3,700 pending patient appointments for uses such as health screenings and vaccinations​.

Deputy Director Cassandra DeLeon told the committee the department is currently carrying roughly $270,000 in unreimbursed expenses for refugee services alone​.

The federal cuts follow the expiration of pandemic-era federal support, which let the city expand its Covid-19 response and temporarily fill gaps for underfunded core services. Sturrup said the pandemic grants allowed APH to scale its operations to meet longstanding community health needs, such as epidemic response and immunization outreach.

Sturrup explained that certain programs were canceled abruptly, with the city receiving notifications of contract terminations after the fact. As an example, Sturrup said the city’s tobacco prevention grant was formally extended but later canceled by the state health department without warning.

To address the budget and program cuts over the long term, staff are developing recommendations for the city manager. The recommendations will be selected after categorizing programs by statutory obligation, potential for collaboration with external partners, and discretionary services that may no longer be financially feasible.

Sturrup underscored APH’s reliance on federal support across nearly every division​. Under a worst-case scenario, she said Austin Public Health projects losing all grant funding could mean reducing its workforce to only the 314.5 positions covered by the city’s General Fund​.

In response to a question from Council Member Marc Duchen about the process and timeline for APH’s near-term plan, Sturrup said the ongoing budget decisions at the federal level have made the department “more reactive than proactive.”

“We’ve looked at all of the executive orders, we’ve matched that up with the things we know that are happening locally and we’ve identified those programs that we feel that are most at risk,” she said. “That’s gonna be the starting point for us to have the conversations with community: … If this happens, what can we do together?”

Mayor Pro Tem Vanessa Fuentes said the city’s forthcoming budget negotiations should set off talks in the public about how to address ongoing service cuts in public health.

“Knowing the loss that we already have in Austin, knowing that it could get much worse, I think it makes our upcoming budget deliberations even more challenging because we’re having to make budgetary decisions in our community amidst this chaos and confusion from the federal government on a daily, if not hourly basis,” she said. “We have very tough times ahead of us, and we’re gonna have to make some really tough decisions. These services have a direct impact on our communities.”

Photo by AgnosticPreachersKid, CC BY-SA 3.0, via Wikimedia Commons.

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