SACRAMENTO, California. — President Donald Trump's decision to cancel a federal disaster preparedness program has raised concerns among state health officials in both Republican-run Texas and the Democratic stronghold of California.
He Hospital training program (HPP) was created more than two decades ago in the wake of the September 11, 2001, terrorist attacks on the World Trade Center in New York and the Pentagon, and the deadly anthrax attacks days later.
Over the past 17 years, this fund has provided almost $2.2 billion states, territories, major cities and entities prepare health systems for future pandemics, cyberattacks or mass-casualty tragedies.
More recently, these resources have been used to combat avian influenza, which has affected about 70 people in the United States, caused at least one death and still poses a threat. They have also been used to respond to crises involving hurricanes, tornadoes, mass shootings, floods and heat waves.
However request sent to Congress Trump's budget director, Russell Vought, proposes eliminating the program, arguing it was “wasteful” and “lack of targeting.” Eliminating it, he added, would allow states and cities to “adequately” fund their own prevention plans.
For now, any action on the issue is paralyzed by a government shutdown caused by a partisan dispute over the expiration of health care subsidies. These subsidies help many 24 million beneficiaries who purchase health insurance through the Affordable Care Act (ACA) marketplaces.
Both Republican and Democratic states view hospital preparedness funding as essential and cannot be easily replaced by local resources.
This is an example of how the White House's attempts reduce the role of government responding to public health emergencies and natural disasters have threatened the ability of state and local governments to rely on federal funds to meet public needs.
“The program is the primary source of government funding for disaster preparedness activities in hospitals, emergency medical services and other sectors of the health care system,” explained Chris Van Deusen, a spokesman for the Texas Department of State Health Services.
Texas has received more than $20 million from hydro this year, and Van Deusen noted that it is unlikely the state will be able to close the federal funding gap anytime soon as its budget runs through August 2027.
These funds help health care providers in Texas develop contingency plans and test hospitals' ability to expand their crisis response and facilitate the distribution of medical resources and patient care without overwhelming health care facilities.
The program, along with state funds, funds the Texas Emergency Medical Services Task Force (TX EMTF)) that responded to this year's deadly flood and, in 2022, the Uvalde school shooting, as well as many other emergencies.
Georgia, which will receive $13.5 million in 2025, “continues to monitor and plan for potential changes in future federal funding while ensuring health forecasting efforts across the state remain strong and sustainable,” public health spokesman Eric Jens said.
A California health official called the funds necessary to ensure local health systems can respond to emergencies beyond their normal capabilities. The program is the only federal fund aimed at preparing the health care system for natural disasters, said Robert Barsanti, a spokesman for the California Department of Public Health.
“Without this funding, California risks losing critical emergency response infrastructure, weakening its ability to protect lives, maintain continuity of care, and meet federal preparedness standards,” Barsanti said.
As the nation's most populous state, California receives the most money, nearly $29 million this year, while facing a huge budget deficit and maintaining a back-and-forth exchange of blame with Trump administration officials.
The funds are distributed among the state Department of Public Health, the California Emergency Medical Services Authority (which coordinates the state's emergency medical services system), health care associations and about 60 local organizations.
Los Angeles County, home to more than a quarter of the state's population, received an additional $11 million, and the University of California system received $1.2 million.
Neither the White House, the Office of Strategic Preparedness and Response, which manages the program at the U.S. Department of Health and Human Services (HHS), nor the Office of the Budget responded to repeated requests for comment on the proposed hydropower cuts.
Reportedly New York TimesThe Strategic Preparedness and Response Administration saw 81% reduction in his state for the past year. It is the largest workforce reduction at HHS to date and part of a broader policy of layoffs across the federal government under Trump.
HHS has already delayed distribution of program funds for this year by nearly three months. They were supposed to be available starting in July, but most of the money was only released at the end of September. In the final days of the Biden administration, health officials wanted spread quickly these resources are part of the national response to the H5N1 avian influenza outbreak.
The months-long delay “is another example of how changes and uncertainty at the federal level are jeopardizing critical public health programs in New York State,” said Cadence Acquaviva, a spokeswoman for the Department of Health. Despite state health officials' efforts, “delays or loss of funding put New Yorkers at significant risk in the event of a disaster or emergency,” Acquaviva warned.
New York State received about $14 million, and New York City received more than $9 million.
Jim Leach, a spokesman for the Illinois Department of Public Health, noted that the medical system needs these federal funds to prepare for natural or man-made disasters “beyond the ups and downs of any particular disease.”
Illinois and the city of Chicago together received $15 million from the program.
During emergencies, the federally funded crisis response program “transforms hundreds of Illinois hospitals, ambulance services and other health care providers into one coordinated system,” Leach explained, adding that such coordination saves lives and government resources.
“If a natural disaster or infectious disease outbreak occurs, the state will not be able to respond quickly enough without hydropower,” he said.
